To The Editor, Jefford et al discuss the results of a study designed to assess patients’ knowledge and satisfaction regarding the informed consent process in cancer clinical trials (CCT) [1]. This study, carried out across four Australian hospitals, enrolled 102 patients registered in 27 therapeutic CCT. The quality of informed consent and understanding of CCT were assessed using a patient-completed questionnaire developed by Joffe and colleagues [2]. In this population, the overall knowledge of CCT was found to be similar to previous published data [3]. While aspects of trial participation were poorly understood by objective assessment, satisfaction with the decision to participate (SWD) was very high. Objective knowledge was inversely correlated with the length of the patient information and consent form (PICF) [4]. Satisfaction was associated with greater subjective understanding of the trial and an improved quality of life. In the study, patients were also surveyed about their understanding of their specific clinical situation, and we present these results here. Questions assessed (1) knowledge of diagnosis, site and extent of disease, the aim of treatment, and potential for complete response, (2) general understanding of what their treatment entailed, (3) general comprehension of the purpose of their treatment, and (4) knowledge of at least two therapy related side-effects detailed in the PICF. Associations were sought between responses and the phase of CCT, and with aspects of the PICF including the Flesch–Kincaid readability score (FKR), reading grade level, number of pages, and compliance with the National Cancer Institute (NCI) template, for which a compliance index was constructed. A PICF with a higher FKR score and lower grade level is easier to read [5]. Data were available for all 102 patients. All were aware that they had cancer: 95.1% knew what type of cancer they had and 88.2% knew the sites (primary and/or metastatic) of their disease. Some 81.4% of patients correctly understood the main aim of their treatment, i.e., whether to cure, control, or prevent recurrence of their cancer. Eleven people (10.8%) incorrectly thought cure was the aim; eight patients in this group had metastatic disease. Correct understanding of the chance of cure was not related to any features of the PICF. A number of patients (70.6%) could describe what their trial treatment involved; 24.5% could not (4.9% did not answer this question). Better responses were seen with phase I trials, higher FKR scores and lower grade level (i.e., easier to read), and a shorter PICF. Some 66.7% of patients could name at least one of the drugs that they were being treated with. Almost a third (30.4%) were unable to name any of the drugs (2.9% did not answer this question). Better responses were seen in phase I and II trials and with shorter PICFs. Some patients (80.4%) accurately described at least two side effects of their treatment; however, 12.7% were not able to identify any side effects (6.9% did not answer this J. Yoong :M. Jefford : L. Mileshkin Peter MacCallum Cancer Centre, Locked Bag 1, A’Beckett St, Melbourne, VIC 8006, Australia