CA: A Cancer Journal for Clinicians, Vol 12, 82-86, Copyright
© 1962 by American Cancer Society
Should the Doctor Tell the Patient that the Disease is Cancer?
Victor A. Gilbertsen M.D.1 and
Owen H. Wangensteen M.D.1
1 The Department of Surgery, University of Minnesota, Minneapolis, Minnesota.
In conclusion, nearly all of our cancer patients are told their diagnosis, honestly, sincerely, and sympathetically, without requiring that they ask specifically about cancer before being told. Patients, in general, are also informed about prognosis and other pertinent information. We have found that patients aware of the nature of their illness usually are able to offer several distinct benefits to the physician in his provision of care: associated inconveniences are more easily accepted; most patients cooperate in furtherance of their care and willingly accept the necessity of recommended therapy; follow-up appointments are routinely kept, and follow-up studies of survival have been accorded wholehearted cooperation.
It appears that at the present time we are passing through an era in which discussions concerning whether the cancer patient should be told his diagnosis are receiving remarkable attention. The attention presently being accorded, in fact, is somewhat surprising, as we have no question that the physician should be honest with the patient. In addition, because so many misunderstanings occur regarding the disease itself, as well as the use of the words tumor and cancer, we believe that patients require more than merely being told the truth, but should be informed about their illness in a way that is understood.
Patients with cancer also need help with their feelings about the illness and with problems which arise. Patients with recurrent cancer, for example, should be clearly aware that while it may not be within our power to restore them to normal, or even to reverse the course of the disease, all efforts will be made for effective treatment and that they will not be abandoned as hopeless cases.
This concept, of course, involves significantly more than merely informing the cancer patient of his microscopic diagnosis; in fact, the utilization of telling the diagnosis as a means of relieving the doctor of further responsibility for the patient's care, cannot be condoned. The plight of the victim of malignant disease who has merely been told his diagnosis without the provision of further help, has been compared to that of the patient, who, while undergoing a bowel resection, is faced with having the surgeon walk out of the operating room before completion of the anastomosis. We believe that a necessary and important part of informing the cancer patient of his diagnosis includes providing assurance of sympathetic, understanding efforts for his welfare, as well as fostering his continued faith in the sincerity of his physician.
