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The Attitudes of Cancer Patients and Their Families Toward the Disclosure of Terminal Illness

From the Research Institute and Hospital, National Cancer Center, Goyang; Yonsei University College of Medicine, Kyunghee University Hospital; Asan Medical Center, Seoul National University Hospital; Korea University Medical Center; Kangdong Sacred Heart Hospital, St Mary's Hospital, Seoul, Korea

Address reprint requests to Young Ho Yun, MD, PhD, Quality of Cancer Care Branch, Research Institute and Hospital, National Cancer Center 809, Madu-dong, Ilsan-gu, Goyang-si, Gyeonggi-do 411-769, Korea; e-mail: lawyun{at}ncc.re.kr.

PURPOSE: To ascertain the attitude of cancer patients and their families toward disclosure of terminal illness to the patient.

PATIENTS AND METHODS: We constructed a questionnaire that included demographic and clinical information and delivered it to 758 consecutive individuals (433 cancer patients and 325 families that have a relative with cancer) at seven university hospitals and one national cancer center in Korea.

RESULTS: 380 cancer patients and one member from each of 281 families that have a relative with cancer completed the questionnaire. Cancer patients were more likely than family members to believe that patients should be informed of the terminal illness (96.1% v 76.9%; P < .001). Fifty percent of the family members and 78.3% of the patients thought that the doctor in charge should be the one who informs the patient. Additionally, 71.7% of the patients and 43.6% of the family members thought that patients should be informed immediately after the diagnosis. Stepwise multiple logistic regression indicated that the patient group was more likely than the family group to want the patient to be informed of the terminal illness (odds ratio [OR], 9.76; 95% CI, 4.31 to 22.14), by the doctor (OR, 4.00; 95% CI, 2.61 to 6.11), and immediately after the diagnosis (OR, 3.64; 95% CI, 2.45 to 5.41).

CONCLUSION: Our findings indicated that most cancer patients want to be informed if their illness is terminal, and physicians should realize that the patient and the family unit may differ in their attitude toward such a disclosure. Our results also reflect the importance of how information is given to the patient.

Presented at the 39th Annual Meeting of the American Society of Clinical Oncology, Chicago, IL, May 31-June 3, 2003.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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