The Art of Prognostication in Advanced Cancer: Missing the Big Picture

Prognostication is defined as “a statement about what is going to happen in the future.” In the medical arena it pertains to predicting the course and survival of a patient with certain disease processes. It is both a science and an art. Although it is recognized that no physician can ever certainly predict what the future holds, a reasonable estimation of the course ahead can certainly be ascertained and communicated to their patients. Unfortunately, prognostication, especially in advanced cancer, is fraught with many difficulties including not only omission of such discussions, but also inaccurate estimations. Using a case of a patient with metastatic lung cancer whose likelihood of survival was grossly misjudged, we outline how to approach prognostication in advanced cancer.