Honesty the best policy with cancer, doctors say
Full medical disclosure is the best way to help patients deal with a cancer diagnosis, doctors said.
Reacting to a recent study that claimed patients often panicked when told they had cancer, UAE doctors said wording could drastically change a patient’s perception of their condition.
Researchers at the University of Sydney and the Mayo Clinic in the US said the term “cancer” should not be used for some low-grade lesions and malignant growths less than a centimetre in size.
Doctors in the UAE said they rarely use the word when describing such conditions but still offer a full diagnosis.
“I’m very careful using the word ‘cancer’, especially during the patient’s first visit,” said Dr Ramzi Alshaiba, a specialist in general surgery at Bareen International Hospital in Mohammed bin Zayed City, Abu Dhabi.
“I discuss the case with the patient by explaining how the condition, such as a lesion, should be investigated fully to prove whether or not it is a malignant cancer.
“To encourage the patient to move further with the medical investigation, I remind them an excellent cure rate is linked with early detection and treatment.”
Although a pre-cancerous condition is a warning sign and may or may not progress, UAE doctors said patients should be informed about the medical situation early and in the clearest way possible.
Because of low awareness of survival rates, many patients immediately start crying, assuming they are terminally ill, doctors said.
“In every step of the journey, full medical disclosure with the patient is very important,” Dr Alshaiba said.
“We have seen many patients change their mindset, behaviour and lifestyle towards the less positive approach – and this affects not only the individual but the family and people around them.
“The doctor-patient relationship plays a significant role in managing this scenario. Factors such as trust, experience and communication from the doctor really matter.”
The research, published in the British Medical Journal, gave supporting evidence that disease labels can affect a patient’s psychological response and their decisions about treatment options.
The study found patients often had a strong perception that aggressive treatments were needed to beat cancer, when sometimes less-invasive approaches were more suitable.
Patients suffering from low-risk forms of the disease would benefit from having the cancer label removed, researchers said.
Dr Basim Alkhafaji, a consultant laparoscopic surgeon at Canadian Specialist Hospital, Dubai, said Middle East patients were more likely to associate cancer with a possible premature death.
“Depending on the psychological background of the patient, sometimes for a small cancer we don’t exactly use the word ‘cancer’,” Dr Alkhafaji said.
“The patient might understand they have cancer but there is no need to tell them directly.
“They are often so scared of the word. We inform them they are suffering from a treatable disease, especially if it’s a papillary cancer or small breast lesion.”
The Department of Health said about 4,500 new cancer cases were reported every year in the UAE.
As part of the UAE National Agenda, the department aims to reduce related deaths by 18 per cent by 2021.
Leukaemia is the most common cancer in men in the UAE, followed by colorectal and prostate cancers. In women, breast cancer is the most common, followed by leukaemia and colorectal cancer.
“I inform the patient that cells in their body have changed, which can be attributed to a bad disease, rather than say they have cancer,” Dr Alkhafaji said.
“Cancer is a disease that’s associated with mortality. We have to be careful in dealing with a patient’s expectations. Regardless of the size of the cancer, we always discuss the risks and possibilities.”
Unaware of survival rates, many patients immediately fear the worst after diagnosis