“What Is My Prognosis?” Why Cancer Patients Are Not Receiving Honest Answers


Today, expensive, modern cancer treatments are mushrooming quickly, providing patients with more therapy options than ever before. However, cancer patients are for the most part kept in the dark about their illness, because their physicians won’t or can’t communicate clearly. You also have patients that refuse to listen to anything that has to do with their condition, in an attempt to avoid bad news.

Shockingly, large numbers of patients with cancer are lacking the basic information about their life expectancy, why a specific treatment is being prescribed and whether their condition is curable, said Dr. Rab Razzak, director of outpatient palliative medicine at John Hopkins Medicine.


Hospice Patient
Image Source: Telegraph.co.uk

The result is individuals with advanced cancer are are lacking enough information about their condition and disease to make informed decisions about how they spend the rest of their life or choose the right treatment.

Even oncologists are clueless on how many of their patients do not know what is going on. “I don’t think they recognize the enormity of it,” Razzak said.

Some cancer patients are still in denial when they are nearing the end of life, supposing they will live longer that what is realistic. Nevertheless, physicians are more realistic when it comes to their patient’s life expectancy.

A 2016 study revealed only 5 percent of cancer patients that have been given less than six months to live truly understood the severity of their disease. It was also revealed that 38 percent of cancer patients could not even remember communicating with their physician about their life expectancy.

In a study published in 2012, 81 percent of patients with advanced colorectal cancer and 69 percent of patients with metastatic lung cancer were under the assumption that their disease could be cured, even though both of those conditions are typically considered fatal, according to co-author and professor at Harvard Medical School, Dr. Nancy Keating.

Patients and caregivers are the ones that are harmed by such misunderstandings. Patients who misunderstand their disease and do not know their life expectancy will oftentimes choose the most aggressive therapy available, which only leads to more pain and suffering.

According to the Dartmouth Atlas of Health Care, about one-third of patients with cancer end up being admitted to the intensive care unit (ICU) during the last month of life. While intensive care can successfully save the lives of healthier, younger individuals, it is unsuccessful in improving or lengthening the lives of terminally ill cancer patients.

“It’s surprising how many people end up in an ICU, critically ill and dying, without realizing they’re dying,” said Dr. Mark Siegal, professor at the Yale School of Medicine.

These final measures to expand life only leaves the families with extended trauma and grief, Siegel said. Previous studies suggest that while nearly half of Americans utilize hospice care, they enter it late in their illness and many times only a week before death.

“The real question is, “How do these patients become overly optimistic about their prognosis and what part do physicians play in this?” Siegel said. “What do physicians tell the patients? What are patients hearing?”

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