[A Meaning for incurable patients to know the truth of their disease]

Actually most of unresectable solid cancers are incurable, except some pediatric cancers and germ cell tumors etc. For these patients, what doctors can provide is basically prolongation of life with acceptable quality. Without knowing the fact and possible advantage and disadvantage or side effect of any treatment, these patients cannot choose the treatment, either anti-cancer therapy or best supportive therapy. In such situation, prognosis is almost mandatory information. No body feels comfortable to hear severe facts of their diseases especially when they are hopeless. However, this information is essential to choose the treatment which has strong influence on their lives themselves. The 38 incurable patients and 33 with poor prognosis (cure rate will be less than 10%) treated by the author between 1993 and 1995 were analyzed to see the attitude of patients in such situation. After getting all information including effect and side effect of possible treatment, mean survival, and natural course of their disease, 24 out of 70 selected supportive care. 11 of 70 requested consultation of a psychiatrist but all recovered soon with minimum treatment. In such critical or life threatening situation, decision is completely personal and cannot be done by their family. When doctors and patients can make a good relationship with confidence, patients can create their own style of remaining life and even death.