Cancer patient needs realistic information as well as hope

Explicit information about life expectancy and reassuring words about continuing support can help to soften the blow of a poor cancer diagnosis. This has been shown by a NIVEL study into communication during consultations to break bad news to patients with breast cancer. On April 26, 2013 Liesbeth van Vliet received her doctorate on this subject from the University of Utrecht.

When communicating with women who have been given the diagnosis of incurable breast cancer, physicians should balance between some apparently conflicting needs of their patients. On the one hand patients expect both explicit and general information – including about their life expectancy – and on the other hand realism and hope. The study shows that the majority of breast cancer patients/survivors and healthy women participating in the study value explicit information about their life expectancy. In addition physicians can offer realistic hope, for example, by reassuring patients that they will not be abandoned by the oncologist and hospital throughout their disease. Women with a high need for information appear to benefit less from predominantly explicit information than women who do not require as much information.
 
Video study
Dr. van Vliet based her conclusions on a qualitative study with group discussions and on an experimental study using videos. Four versions of a bad news consultation were developed on video specifically for this experimental study. Although largely similar, the videos varied in the degree to which the physician explicitly discussed the patient’s life expectancy and in the degree to which the physician offered emotional support. These videos were evaluated by breast cancer patients/survivors and healthy women who were asked to put themselves in the shoes of the video-patient. As the videos were otherwise identical, it was possible to determine the influence of the differing forms of communication. Support for the validity of this method was found in a systematic literature study.
 
Funding
This project was funded by the Spinoza Prize awarded to Professor Jozien Bensing, PhD in 2006 by the Dutch Research Council (NWO).
 
Expert/Contact person
Liesbeth van Vliet, phone NIVEL 0031 (0)30 272 9700 or e-mail.