Breaking the bad news of cancer: The patient's perspective

Objective: Head and neck cancers present a special challenge to the patient and the physician because they affect the quintessential aspects of living such as breathing, eating, and speaking Numerous articles have described h ow the physician should perform the difficult task of conveying bad news, b ut only a small number of articles specifically assess the patients' percep tions when being told of a serious diagnosis. The purpose of this survey wa s to evaluate the thoughts and concerns of patients receiving diagnoses of head and neck cancer. Study Design: Questionnaire survey. Methods: A 41-ite m questionnaire was sent to head and neck cancer patients who have been tre ated for and remain free of disease for at least 2 years. Results: All of t he respondents felt that their diagnosis was adequately explained tb them a nd that no further explanations were necessary, Eighty-one percent of the r espondents did not wish to have anyone else present at the time of diagnosi s. Additionally, 75% of the respondents did not want the physician to touch their hands or hug them when given the bad news. Only 63% of the responden ts had further discussions with family, friends, or other physicians after being told of their diagnosis. Conclusion: When patients are told of the di agnosis of head and neck cancer, they want their physician to be truthful, earing, and compassionate, The patients want their diagnosis in simple and direct terms without the incorporation of complex medical terminology. The results of this survey can provide insightful information to physicians whe n they are undertaking the difficult task of conveying bad news to their pa tients.