Hope and misunderstanding in cancer treatment

So interesting – a study in this week’s New England Journal of Medicine finds that the majority of patients with advanced cancers (lung and colorectal) are fundamentally not understanding what it is that chemotherapy and other treatments do.  Something is not getting communicated effectively between doctors and patients, because most have some belief that chemotherapy, beyond extending their lives, might actually cure them.

Is this another manifestation of the ideology of hope?

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As discussed in the Boston Globe, it’s unclear “whether patients receive unclear information from a physician or fail to fully comprehend what they are told, or whether there is a kind of clinical “collusion” in which the discussion moves rapidly from a dire prognosis to a focus on what can be tried, leaving patients with an inflated sense of hope.”

Here’s the kicker: the patients who rated their doctors as worse communicators were more likely to have a realistic view of the potential benefits and limitations of chemotherapy.  Are some doctors being seen as better communicators just because they’re giving good (false) news? What are the forces that pressure them to sugar-coat?

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