What do advanced cancer patients know of their disease?

Abstract

The aim of this work was to investigate the awareness of diagnosis, prognosis and meaning of palliative treatment in Italian patients with advanced, incurable cancers. A group of 100 patients, referred to a Medical Oncology facility, were interviewed. Only 38 patients were aware of the malignant neoplastic nature of their disease. The remaining patients believed they had a benign neoplasia, non-neoplastic disease, or were unable to define their illness. No patient had a correct idea of the poor prognosis of the disease. Only 11.5% of 87 patients receiving chemotherapy had a correct perception of the palliative intent of the treatment, while most believed that the chemotherapy was "preventive". Dissatisfaction with the information received was expressed by a minority of patients. The awareness of diagnosis was better among women and patients with a higher educational background. Withholding the truth from cancer patients still seems very common in Italy.

Non-disclosure of cancer diagnosis: an examination of personal, medical, and psychosocial factors

“…This parallels previous studies that found similar rates of prevalence of diagnosis non-disclosure among oncological patients [8,31,32], for example in Italy and Taiwan. These results provide continued support for the disclosure of cancer diagnosis as a standard practice, especially given that it is well-documented that withholding disclosure of cancer diagnosis generates long-term imbalance and distrust in doctor-patient relationship [33,34] and future lack of communication about cancer and disease-related issues [14,35].…”

Physicians and death: Comments and behaviour of 605 doctors in the north-east of Italy

“…It is noteworthy that, for all the topics covered in the questionnaire, a clear distinction can be made between opinion and behaviour, the only remarkable exception being the issue of whether or not to tell patients, which remains unresolved [4,13,17]. The uncertainty on this topic underlines the importance of a physician/patient relationship, which can be deep and is always unique [1, 6, 11, 121.…”

Communication with Physicians about Health Care Costs: Survey of an Insured Population

“…174 Correspondingly, patients fre quently report not knowing their prognosis 95,175 or overestimate their prognosis, even when provided accurate information. 95,105,[176][177][178][179][180][181][182] In these studies, higher educational level, lower levels of depression, and higher patient ratings of their physician were associated with better understanding, but further research is needed to examine causal relationships among these factors.…”