LAUSR

An approximate time prognostication for a patient with incurable cancer is an important foundation for both clinical decisions and the patient’s and relatives’ opportunity to plan and prioritize [1–5]. Talking about the remaining time has been shown to help the patient reach greater insight regarding her or his illness. It also makes it easier for the patient to be open to discussions and requests concerning treatment strategies or restrictions [2,6], such as the preferred place of death or when to use antibiotics [7]. Although as many as 70%–80% [1] of patients with an incurable disease wish to receive prognostic information in some form, as few as 18% seem to actually receive it, according to one study [2]. The importance of time-prognostic and advance care planning (ACP) discussions being conducted with the patient – preferably early in the process – is emphasized in the National Guidelines of Palliative Care in Sweden. The aim is to avoid exposing the patient to unnecessary gours such as aggressive chemotherapy, excessive surgery, or futile cardiopulmonary resuscitation, and to tend to the patient’s wishes, as far as possible, regarding what their remaining life will be like [8]. A lack of time for prognostication and end-of-life (EOL) conversations with physicians can lead to a postponement of important tasks such as writing a will, looking over one’s finances, or deciding how one’s funeral will be conducted. It may also result in the patient and relatives/friends not having the time to say goodbye in an orderly manner [5]. The Swedish Patient Act states that the patient has the right to be informed of the expected course of her or his illness and treatment [9]. Patients who have received EOL conversations, time-prognostic information, and/or ACP tend to undergo less aggressive treatments, have a higher quality of life, and generate lower treatment costs during their end-oflife [10–14].