Should elderly patients be told they have cancer?

November 15, 2001

Should elderly patients be told they have cancer? Questionnaire survey of older people BMJ Volume 323, p 1160

Editorial: Participation of patients in decisions about treatment for cancer BMJ Volume 323, p 1144

A study in this week's BMJ finds that 88% of older people would like to be told if they developed cancer, despite evidence that doctors fail to inform patients, particularly older people, when they diagnose cancer.

A total of 270 people aged from 65 to 94 years completed a questionnaire to assess their opinions about cancer and how much they would wish to know about their diagnosis.

Altogether 238 (88%) respondents wanted to be informed of the diagnosis, whereas 11% did not and 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, whereas the remainder were more selective. Over 70% of respondents wanted their relatives to be informed when the diagnosis of cancer was made.

Disclosure of a diagnosis of cancer has on occasions caused conflict between physicians and family members, say the authors. "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," they conclude.

Many studies have shown that patients want much more information than their doctors believe they do, writes Professor Lesley Fallowfield in an accompanying editorial. True patient participation and involvement in decision making is, for most, an unachievable goal unless we see some real improvements in the current system of healthcare delivery, she concludes.


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