Medical care is increasingly implementing shared decision making that requires participation of informed patients in an effort to maximize treatment-related decision satisfaction (DS). Patient comprehension of relevant information is important in decisions involving high risk and uncertainty, like surgery for lung cancer. Lung cancer patients (N=43) completed pre- and post-consult questionnaires, and their consults with the surgeon were audio recorded. Post consult knowledge was low (53%) while DS was moderately low (M=44.56, SD=13.71). Higher complication risk (rs = .34, P<.05), external locus of control (r = .31, P < .05), belief in a controlling deity (r = .37, P< .05), and desire for control (r = -.38, P < .016) predicted lower DS. Consult recordings showed that patients possess counterfactual beliefs, such as airborne spread of cancer in surgery, and benefit from removing most of the tumor. Experiments are needed to understand how patient comprehension can be improved.