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

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 how the physician should perform the difficult task of conveying bad news, but only a small number of articles specifically assess the patients' perceptions when being told of a serious diagnosis. The purpose of this survey was to evaluate the thoughts and concerns of patients receiving diagnoses of head and neck cancer.

Questionnaire survey.

A 41-item questionnaire was sent to head and neck cancer patients who have been treated for and remain free of disease for at least 2 years.

All of the respondents felt that their diagnosis was adequately explained to them and that no further explanations were necessary. Eighty-one percent of the respondents did not wish to have anyone else present at the time of diagnosis. 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 respondents had further discussions with family, friends, or other physicians after being told of their diagnosis.

When patients are told of the diagnosis of head and neck cancer, they want their physician to be truthful, caring, 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 when they are undertaking the difficult task of conveying bad news to their patients.