In most people's minds there is no scarier diagnosis than that of cancer. Cancer is often thought of as an untreatable, unbearably painful disease with no cure. However popular this view of cancer may be, it is exaggerated and over-generalized. Cancer is undoubtedly a serious and potentially life-threatening illness. For example, it is the leading cause of death in Americans under the age of 85, and the second leading cause of death in older Americans. There will be 1.5 million new cases of cancer occurring in the United States coming year, and over 570,000 deaths because of it not including basal and squamous skin cancers which are not reported but could add another two million cases per year (ACS, 2010). However, it is a misconception to think that all forms of cancer are untreatable and deadly. The truth of the matter is that there are multiple types of cancer, many of which can today be effectively treated so as to eliminate, reduce or slow the impact of the disease on patients' lives. While a diagnosis of cancer may still leave patients feeling helpless and out of control, in many cases today there is cause for hope rather than hopelessness.
Cassileth and colleagues found that most cancer patients in the USA wanted detailed information about their cancer, whether the news was good or bad. This finding has been confirmed in surveys of patients with cancer in the UK, North America, and Australia. A large study in the UK, involving 2231 patients, found that 87% of participants preferred to have as much information as possible, good or bad. Only 1,9% did not want to know whether they had cancer and 95% wished to know their chance of cure. Interestingly, there were no differences in specific information needs between patients receiving curative treatment or palliative care and those in remission. Over 90% of patients who took part in the study stated that they absolutely needed or would like to have information about all possible treatments, all possible side-effects, and how the treatments work.
There are many reasons for the increased emphasis on involvement of patients. As communities have become better educated and information about healthcare has become more accessible, a fundamental shift in society's expectations of clinicians has occurred. Calls for increased accountability have also come from within government and professional ranks, in efforts to standardise clinical practice according to best medical evidence, and to improve healthcare outcomes. A growing awareness of the importance of involving patients in making decisions about their care, because this can contribute to better-quality decisions, and perhaps improve health outcomes.
“It is now by no means uncommon to find amongst lay people a general appreciation of health-care issues, which was certainly absent in earlier generations. To treat such patients with condescension and paternalism not only creates a feeling of resentment, it also minimises the opportunities for insightful discussion.”
- Justice Kirby of the High Court of Australia
Several studies have found that patients with cancer who achieve their desired degree of participation during decision-making are in the minority. Irrespective of preference, patients who had a shared role in decision-making were most satisfied with the consultation with their doctor. They were also more satisfied with information about treatments and emotional support.
"Patients who are more involved in treatment decisions, or simply offered choices, can have better physical and psychological outcomes than those with less involvement. Studies have suggested a link between involvement in decision-making and better psychological adjustment and satisfaction. Greater participation by patients may also be associated with better health outcomes measured physiologically (blood pressure or blood sugar control), behaviourally (functional status), or subjectively (overall health status)."
(source: The Lancet Oncology)
OUR TEAM BY NUMBERS SINCE 2016
TOTAL IMPACT POINTS
MANUSCRIPTS UNDER REVIEW