Cancer patients want to know

A majority of patients want to know as much as possible, the study suggests

An overwhelming majority of older patients want to be told if they are suffering from cancer, research suggests.

There is evidence that doctors fail to inform some patients - particularly elderly people - when they diagnose cancer.

Some older people often don't ask direct questions

Gwen Kaplin,
Information nurse

But a survey indicated that 88% of older people would like to be told if they developed the disease.

The researchers, from Mid-Staffordshire General Hospitals, quizzed 270 people aged between 65 and 94.

A total of 238 respondents wanted to be informed of the diagnosis. Just 11% said they did not, while 1% were indifferent.

Only 6.4% of those aged under 75 did not want to be informed, compared with 13.7% of those aged 75 or over.

Of those who expressed a desire to be informed, 62% wanted to know as much as possible about their cancer. The remainder were more selective.

More than 70% of respondents wanted their relatives to be informed when the diagnosis of cancer was made.

More information

The researchers, writing in the British Medical Journal, say that disclosure of a diagnosis of cancer has on occasions caused conflict between physicians and family members.

"Our study clarifies this issue and should help decision making in the difficult situation where family members ask that their elderly relatives should not be informed."

Patients preferences about choice of treatment are poorly understood and are usually based on intuitive assumptions about their perceived intelligence, age, or quality of life

Professor Lesley Fallowfield

Professor Lesley Fallowfield, of the Cancer Research Campaign Psychosocial Oncology Group at Sussex University, said many studies had shown that patients want much more information than their doctors believe they do.

"We also know that the ability of doctors to predict which patients want an active, shared, or passive role in decision making is very poor in palliative care and when active, potentially curative treatment is discussed.

"Patients' preferences about choice of treatment are poorly understood and are usually based on intuitive assumptions about their perceived intelligence, age, or quality of life."

She said there was a "compelling" need for training to help improve communication between doctors and patients.

However, she also warned that it would be difficult for doctors to adequately meet the information needs of individual patients while they continued to work in an over-stretched and under-resourced health service.

Clues

Gwen Kaplin, a Cancer Research Campaign information nurse, told BBC News Online that doctors sometimes told older people they were ill without actually mentioning the word cancer.

She said: "In the current climate where information is readily available we much more likely to ask about disease than in the past, but some older people often don't ask direct questions.

"Many give clues to doctors about what they want to know, but doctors historically do not tend to pick up on them.

"Doctors were never taught to communicate effectively with patients in the past, but things are now getting better."