Cancer -what patients actually believe

One of the major difficulties in treating cancer patients is dealing with the preconceived notions and beliefs that patients have about the disease. These beliefs are often wrong and need to be looked for and carefully corrected before a patient can be successfully cared for. No study has previously attempted to assess the extent of these misconceptions amongst cancer patients or the public. Consequently, we designed a questionnaire (0) that used bold statements about some aspects of cancer and asked patients for either a true(T)/false(F)/unsure(E) or a always (A)/usually(U)/sometimes(S)/rarely(R) or never(N) response. The 0 was given to 2 sets of patients (total 152) who attend the hospital as inpatients or outpatients, 55 who have cancer (c) 97 who do not (NCP). The answers are grouped under various subject categories.

1. PAIN. 50% of respondents (R) think cancer produces great pain (especially believed by NCP) 41 % of R said T or E to "Cancer pain cannot really be treated".

2. ANALGESICS. 200/0 R think analgesics by mouth as effective as parenteral and 20% Ragain believed morphine and other pain killers become ineffective if used too early in the illness. 55% R said T or E to "being on morphine for cancer pain invariably means the end of life has come". 65% R believed patients using morphine for cancer pain S, U or A became addicted to it.

3. DEATH AND CANCER. To "if dying of cancer my choice would be to die at ". R were evenly divided between home, hospital and hospice, Only 52% believed that there are resources in the community which make it possible for patients with cancer to die comfortably at home. 53% replied T or E to "cancer patients die in terrible pain and agony".

4. TREATMENT OF CANCER. Only 26% disagreed with "the treatment for cancer is often worse than the disease". 61 % said F and 14% E to "there are no cures for cancer", 53% think chemotherapy U & A makes the patient very sick. 33% said T and 29% E to "radiotherapy treatment is only used if it is thought the cancer can be cured", 53% said T & 23% E to "people with a serious illness such as cancer who believe emotionally upset should be referred to a counsellor, psychiatrist or psychologist", 45% said T & 32% E to "' would want assisted euthanasia if I had incurable cancer",

5. DOCTOR/PATIENT INTERACTION. 27% T & 23% E to "when you have cancer, most doctors and nurses will leave you on your own to cope emotionally", 38% T & 30% E to "most doctors are more concerned with prolonging life at all costs rather than the quality of life of the patient", while 72% said "decisions about cancer treatment should be made by the patient after discussion with the doctor", 50% later replied that doctors should have the final say re treatment",

6. CAUSES OF CANCER. 33% of CP and 11% NCP thought stress caused cancer, otherwise 79% thought cigarettes, 27% certain foods, 27% alcohol, 42% insecticides and 5% negative thoughts could cause cancer.

7. LIFE SPAN PREDICTION. 77% would want to be told how long they had to live if they had cancer, but only 12% thought doctors could accurately predict prognosis of cancer, 31% (22% CP, 35% NCP) would try and avoid discussions about death if a relative or friend had cancer.

SUMMARY

This study reveals important issues regarding community perceptions and understanding about cancer in areas of pain relief, treatment options, quality of life issues and community supports available that need to be considered when counselling patients with cancer and their families, and particularly in community education programs.

Associated Publication(s):
Buchanan J, Borland R, Cosolo W, Millership R. Haines I. Zimet A. Zalcberg J. Patients' beliefs about cancer management. Supportive Care in Cancer 1996 Mar; 4(2):110-7