A study published in the American Journal of Oncology (May 23, 2016) and highlighted by Bioedge reports the hardly surprising news that patients come to a clearer understanding about the prognosis of a fatal cancer after honest and effective communication with their doctors.
Such communication may not be frequent or effective enough, however. In this study only 5% of the terminally ill patients at the beginning of the study understood the gravity of their diagnosis. This improved over the six week period in which they were given more informed details about their disease and the likely outcome of chemo or other therapies. The authors of the study rightly worry that without such information, a person may not be able to make timely and appropriate plans for medical care especially hospice.
Patients may not have the information they need for many reasons: they do not ask; family or physicians are reluctant to tell them; many of the clinicians, caregivers, family or patient may harbor unrealistic expectations of the outcome; fractured lines of communication between specialists and primary care physicians; fear of removing all hope from the suffering.
The authors of the study report conflicting evidence in the literature about the effects of accurate prognostic information on patients' peace of mind and equanimity. Some studies have reported the troublesome reactions we fear when we conspire not to tell someone about the dire nature of their diagnosis, while others report no harm to the psychological or spiritual well being of either the patient or those involved in such direct communication.
The study concludes that accurate, ongoing and recent communication with oncologists and physicians can inform realistic decisions about end of life care in terminal cancer patients.
How does one balance hope and realistic acceptance? It is surely a spiritual discipline we can practice every day of the Christian journey, especially during times like Lent and around the time of mourning the death of a loved one or friend.
How and when to have these discussions needs prayer above all. The Sacrament of the Sick can be an important help to the dying and their loved ones in not only drawing strength from the presence of Christ and the Holy Spirit, but with wisdom, prudence and courage.