 Dying Patients Who Acknowledge Terminal Prognosis Less Depressed, Groundbreaking Study Finds A groundbreaking Canadian study reveals that terminal cancer patients who are aware they are going to die are less likely to be depressed than those in denial. The study is published in the current issue (November-December, 2000) of the journal Psychosomatics. "We found that depression was about three times greater in patients who didn't acknowledge their terminal prognosis," says the study's author, Dr. Harvey Chochinov, Professor of Psychiatry and Family Medicine, Division of Palliative Care, University of Manitoba. "Denial may be a defence mechanism used by some patients to protect them from death anxiety. But our findings show that denial is often imperfect and doesn't necessarily eliminate underlying psychological distress," says Chochinov. The study found that almost 10 per cent of dying cancer patients denied their terminal prognosis - even though they were hospitalized in palliative care units. Men were more likely than women to deny that death was near, as were older patients. The study has implications for the care of dying people, says Chochinov. "When doctors see a dying patient who is in denial, they will know that the patient may in fact be distressed and quite vulnerable." Chochinov also found that dying people who were aware of their impending death didn't necessarily feel hopeless. "You would think that if people knew death was imminent, they would be more likely to feel hopeless," he says. "Although each patient's situation needs separate evaluation, the findings show that giving prognostic information to patients doesn't necessarily take away hope." The study, which is the most comprehensive of its kind, was funded by the Canadian Cancer Society and The Open Society Institute, Project Death in America. "Quality of care for cancer patients in the terminal stages of their disease is extremely important and quite often not enough attention is given to this stage of the disease," says Dr. Barb Whylie, Director, Medical Affairs/Cancer Control, Canadian Cancer Society. "These findings will help us to better understand what happens when people face a terminal prognosis, an unfortunate reality for many cancer patients." Chochinov and his team interviewed 200 patients with advanced cancer who were in their final weeks of life at two Winnipeg palliative care units. The patients, aged 31 to 94, were asked about their level of awareness of their prognosis, depressive disorders, demographic and social variables. Chochinov is also Head, Department of Psychosocial Oncology, at CancerCare Manitoba. The Canadian Cancer Society is the largest, single non-governmental funder of cancer research in Canada. The Society also informs the public about risk reduction/prevention of cancer, provides services for people living with cancer and advocates for healthy public policy. For questions about cancer, call the Canadian Cancer Society's cancer Information Specialists at 1-888-939-9333. For more information, please contact: Margaret Polanyi Senior Communications Officer (Research) Canadian Cancer Society/National Cancer Institute of Canada (416) 934-5684 |
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