Cancer Patients Benefit From Terminal-Diagnosis Disclosure

In other study, cancer patients may have distress over health care that questionnaires don't assess
By Eric Metcalf
HealthDay Reporter

THURSDAY, March 18 (HealthDay News) -- Patients with terminal cancer may have less emotional distress and a better quality of life if they are aware of their diagnosis, and standardized questionnaires may not capture common concerns in patients with inoperable lung cancer, according to two studies published online March 8 in the Journal of Clinical Oncology.

Young Ho Yun, M.D., of the National Cancer Center in Goyang, Korea, and colleagues analyzed data from 481 patients and 381 family caregivers interviewed shortly after a physician diagnosed the patients as terminal. Caregivers were more likely to know of the patient's terminal status than the patient (83.4 versus 58 percent). Patients who learned of their terminal status directly from a physician or family member had better quality of life, less emotional distress and fewer symptoms than those who learned it by chance or guessed it from their worsening condition. Patients were more likely than caregivers to want to know when their illness was terminal.

In the other study, Carol Tishelman, R.N., of the Karolinska Institutet in Stockholm, Sweden, and colleagues analyzed data from interviews with 343 patients with inoperable lung cancer conducted at six points during their first year after diagnosis. Researchers asked patients about what they found most distressing at each point. Most responses were related to somatic and psychosocial problems, but 27 percent reported a concern related to "iatrogenic distress" as most distressing. The researchers found that many concerns (55 percent to 59 percent) were clearly assessed by three questionnaires widely used with cancer patients, but none of these specifically targets iatrogenic distress.

"Using this approach, several distressing issues were found to be commonly reported by this patient group but were not assessed by standardized questionnaires. This highlights the need to carefully consider choice of instrument in relation to study objectives and characteristics of the sample investigated and to consider complementary means of assessment in clinical practice," Tishelman and colleagues conclude.

Abstract - Yun
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Abstract - Tishelman
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