Cancer Patients want Honesty from Doctors

If you had cancer, would you want to be told your odds of dying? Absolutely, suggests a survey of more than 500 people with breast, lung, or prostate cancer.
Ninety-five percent said they wanted their doctor to be honest about their chances of a cure and how long they can expect to live, says Ajay Bhatnagar, MD, a radiation oncologist at the University of Pittsburgh Cancer Institute in Pittsburgh.

Men with prostate cancer were more likely to want their doctors to be honest about their odds of survival than people with lung cancer: 97% vs. 91%, he says.

While respondents were not asked why, “we think that has to do with the fact that is pretty well known that the prognosis for lung cancer is quite dismal,” Bhatnagar tells WebMD.

Men with prostate cancer, on the other hand, “have an excellent prognosis and we think they like to hear that reaffirmed by their physician,” he says.

The findings were presented at the annual meeting of the American Society for Radiation Oncology (ASTRO).

Patients Want Informal Doctors
The survey findings also suggest that many patients want their doctors to shed the formality, Bhatnagar says. Nearly three-fourths of those surveyed said they prefer to be called by their first name. And 79% said they didn’t care if their doctor dons a white coat; 70% don’t care if their doctor dresses professionally, in suit and tie or a dress.

Only 17% said they would be put off by a hug after a two-month course of radiation treatment. And one-third of women with cancer said they’d like to have their hands held by their oncologists during important office visits, as would 12% of men.

“The findings are reminiscent of the trusting relationship between patients and doctors of 50 years ago. Doctors have changed, but patients haven’t,” says Harvard Medical School’s Anthony Zietman, MD, incoming president of ASTRO. “Patients want doctors to stop hiding behind the technology.”

Explaining Treatment in Everyday Language
Bhatnagar says 84% of respondents said they want their doctor to explain their treatment plan in detail; 95% said they want their doctor to use everyday terms when they do so.

“Physicians need to be more aware of this preference and take the time and effort to explain details in everyday language,” he says.

And if they don’t? Then patients should take matters into their own hands, Zietman says. “Tell your doctor to slow down, talk things through. If you don’t understand something, stop them.”

When it comes to religion, 40% of respondents said they’d be comfortable talking about their own beliefs. But 30% said they would be uncomfortable if their doctors talked about their beliefs.

“Patients don’t want doctors imposing their own view of religion, but might like doctors to foster [the patient’s] own beliefs,” Bhatnagar says.

The study involved 508 patients undergoing radiation for breast, prostate, or lung cancer between June 2006 and March 2008. They filled out a written survey asking whether they agreed or disagreed with, or felt neutral toward, 10 statements focusing on the patient-doctor relationship.