What do cancer patients want from their doctors? A study presented at the American Society for Radiation Oncology’s annual meeting stated among other things patients want honesty about their chance for cure.
I wonder how the question was posed to the 500 patients in their interview. Was it, ‘True or False, Do you want your radiation oncologist to lie to you about the chance that your cancer is cured?’ Yikes! Maybe I am wrong, but do some people want the lie?
In a recent entry in the Journal of the American Medical Association, Danish scientists surveyed 3,000 women who had breast cancer surgery. About half of the women said they had pain for up to 2 years after surgery, but only 1 in 5 told their doctors about their pain. I wonder how the question was posed to the patients. Was it ‘True or False, No pain, Right?’ Yikes again!
Doctors know patients lie, and patients know when they are lying to their doctors. The question is; Does everyone know they are lying to each other when it comes to pain and cancer prognosis? What would be the goal to lie?
Cancer is such a complex disease, that honesty is truly the best policy, but then again lying can be easier than the truth. It wasn’t that long ago that doctors held a bad or terminal diagnosis from a woman patient and told her husband or some other male at first. Not that long ago women kept their diagnosis to themselves so not to upset the family. How interesting that deceit has a long and growing history when it comes to the patient-doctor relationship.
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I think that this is a more complicated question than it appears to be.
Speaking from the experience of having a mother diagnosed with breast cancer (for the first time) in the 1960′s (!), there wasn’t nearly as much information, drugs or procedures as there are now. There also was zero to no empathy or compassion (again speaking from my experience) for my mother because doctors she saw were not concerned with curing the WHOLE person as opposed to treating the cancer.
Doctors routinely avoided any discussion regarding the chances for a patients survival because discussion about death was very very limited and very clinical in nature if it ever came up in conversation at all. From the time that I was 8 until her passing when I was age 40, I lost track of how many times she/we/I/our family was told that she did not have long to live. How exactly was that helpful? How exactly did that give me back a childhood more memorable for hospital rooms than childhood games or passages? How different would her life have been if any one of the dozens of physicians/specialiasts mom would see in her lifetime would have said, “We really don’t know but we are doing all that we can to help bring you relief and hopefully will return you to good health? It was an easier choice for doctors to be “doctors” rather than “healers” in most instances.
You ask, “What would be the goal to lie?” and the best answer I can give you is that it makes the doctor in question “look like a better physician” if he can give an answer with conviction. At least that is what I began to feel after years of this stuff.
I read Elisabeth Kubler Ross’ seminal book “On Death and Dying” as an 11 yr old child, soaking up like a sponge what I felt was the reality of mom’s life and death situation. Aside from the fact that there was dysfunction rampant in our household, it did not help to have that pesky little “terminal illness” element on top of most conversations.
Did mom want the truth when speaking about her latest cancer issue? Absolutely. Was she told the truth? If she was, she must not have been very lucid because she was certainly confused by the numerous treatments and cocktails created for her benefit, many without any more explanation than “drink this, it will help.”
Mom never really could answer directly that she knew what was going on with her. At least not until the end of her life when she finally said, ENOUGH. I only wish to leave this pain and entered hospice.
Until there is a consensus among physicians that honesty should be the only way patients should be treated, if for no other reason, then out of respect and dignity for that person, we remain at square one.
Some patients may not want the reality of their infirmity discussed with them, I’ll give you that. Maybe reality is too harsh for them and a fantasy of sorts makes it easier to sleep? Having been the daughter of someone who did want honesty, and also having been a long time volunteer with cancer patients, I can tell you that in my experience honesty has always been the best policy. That is exactly why so many programs putting survivors with those currently ill are hugely successful.
I am sorry about your experience with your Mother back in the 60′s. Cancer treatment then was truly barbaric and the norm was the doctor knows best and do not question. THere were no such things as support groups for patients or family or social wokers devoted to breast cancer patients.
We have come a long way now and I know from my own cancer treatments that I still had to be my own advocate. Having a medical background that I made clear to my doctors also helped. I have a good friend diagnosed a year after me who took the advise unquestioned from her doctors. For her it was a coping mechanism. What ever works is really best for all cancer patients and family.
Thank you for your kind response. Barbaric is a good word, it gave me pause actually. I also agree with your statement that how we respond to illness is going to be filtered through our own coping mechanism – it is what it is and if we feel some relief then yes. I guess I have learned to be in the “too much information” is better than little to none category. Good for you being pro-active with your own health too. I will hope for you that it will continue to be positive.
Funny how the events of our lives color our choices down the road. Not only do I absolutely agree with you in that we all must be advocates for our own health, I believe it is essential to participate in our own well-being. It is one of the reasons I became a social worker myself.