Many of the families undergoing cancer treatment turn to our team with a specific request. That is, to hide the facts about the condition from the patient. Their treatment typically lasts for months or years. During this time we are asked to maintain a certain illusion, although everyone is equally aware of the truth.
This style of coping with stress is known as “avoidance”. In such cases, doctors try to help patients by keeping them away from excessive stress. Emotionally charged words like “cancer,” “tumor,” or “chemotherapy” are believed to cause such. In the long run, however, this strategy does more damage than good.
Word choice when talking about cancer
Requests that we often receive from families of cancer patients include, among others:
- “Can you avoid mentioning the diagnosis?”
- “Do not tell him that he has cancer.”
- “She should not hear this word [tumor].”
- “Please, warn the doctor not to mention that he has cancer.”
Of course, we respect such requests. Ultimately, everything is a matter of personal choice. That is why doctors have no ethical obligation to violate such a request. When I try to suggest the risks of this approach, I tend to receive a defensive response. Most often it goes in lines of “He [the patient] is different.”, “He will not bear it,” “It will get worse.”
While avoidance has some short-term benefits, studies show that continued denial is associated with worse survival data, indicating that it is ineffective in the long run. So if you are wondering how to talk to the patient and what words to choose, the answer is one – be direct!
The damage of denial
Avoidance is used as a strategy to tackle the disease mostly because people think it reduces the stress from the diagnosis and treatment. In this way, families create an additional source of stress – the constant focus on the words they use, the artificially positive atmosphere they tend to maintain or simply said – they get tired of living the lie.
As one of the doctors in our team commented: “The patient knows the truth, the family knows the truth, but we all just avoid using these words to create a more acceptable environment.” The efforts though drain the families’ coping resources. If all these resources are directed towards the use of adaptive coping strategies, there is far greater likelihood to experience an improvement in survival rates and quality of life.
Through the use of denial, not only the patient and the caregiver, but other family members suffer as well. Many times this suffering leads to the development of anxious and depressive symptoms.
Ways to cope
If you are looking for the right approach, and you want to do the best for your loved one, you are certainly not alone. The cancer diagnosis is one of the most stressful events in our lives. Coping with it requires plenty of resources. Unfortunately, the disease is becoming more and more common.
Communication within the patient’s social environment is one of the factors that influence the outcome of the disease. A supportive environment in which emotions are expressed, experienced and worked through collectively has an extremely beneficial effect on the healing process. If you are not sure whether you are providing such an environment, there is nothing wrong with seeking help.
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