What to Tell Cancer Patients

TLDR

Cancer is often viewed with pessimism and futility. The study surveyed 219 physicians via questionnaire and interviews to examine their policies on telling cancer patients, revealing that strong concerns and difficulties trigger denial mechanisms. Ninety percent of physicians prefer not to tell patients, driven by emotion‑laden judgments and resistance to change rather than clinical experience, and these attitudes hinder progress in cancer therapy.

Abstract

A questionnaire and interviews were used to study the policies of 219 physicians about "telling" cancer patients. Ninety per cent indicated a preference for not telling. Although clinical experience was cited by three-quarters as the major policy determinant, the data bear no relation to experience or age. Instead, inconsistencies, opinionatedness, and resistance to change and to research were found which indicated emotion-laden a priori personal judgments as the real determinants. Feared reactions to telling (e.g., suicide) could rarely be substantiated. Equally undocumented assumptions were given as justifications for telling. Underlying were feelings of pessimism and futility about cancer. The strong feelings mobilized by our deep and serious concerns for cancer patients, and our difficulties in helping them, stimulate denial mechanisms. These responses, unfortunately, operate as interferences to progress in cancer therapy.