[Current trends and problems in disclosure to lung cancer patients]

To assess current trends in the disclosure of cancer, we studied patients with primary lung cancer. Ninety-nine of 101 surgical patients (98.0%) and 96 of 128 non-surgical patients (75.0%) had been informed of their illness. Family members of 2 surgical patients refused to allow disclosure due to concerns about mental intolerance. Reasons for non-disclosure to non-surgical patients ranged from rejection by family members (29 patients) to a lack of ability to understand (3 patients). No mental problems were observed after disclosure. All but 11 patients were informed of their cancers by their physicians. Decisions regarding disclosure were not related to the pathological type or clinical stage of the cancer. For example, small cell carcinoma did not influence methods of or decisions concerning disclosure. Among non-surgical patients, the frequency of disclosure decreased with aging. However, no clear-cut factor appeared to influence the disclosure of metastatic sites. Views about informed consent are still at a transitional stage in Japan. The doctrine that patients have the right to be informed of their cancers and to choose their treatment has not always been the best policy in practice. Nevertheless, it seems desirable that approaches to disclosure adequately reflect the special needs of each patient and provide as much information as possible to allow each patient to make an accurately informed decision about treatment options. Such approaches would foster better relationships between physicians and their patients and relieve physicians from pressure to tell a medical lie.