Breaking News of Cancer Diagnosis: A Qualitative Study on the Experiences and Emotional Needs of Patients With Cancer in a Multiethnic Asian Setting

Abstract

PURPOSE: The breaking of news of a cancer diagnosis is an important milestone in a patient’s cancer journey. We explored the emotional experiences of patients with cancer during the breaking of news of a cancer diagnosis and the arising needs in a multiethnic Asian setting with limited supportive cancer care services. METHODS: Twenty focus group discussions were conducted with 102 Asian patients with cancer from diverse sociodemographic backgrounds. Thematic analysis was performed. RESULTS: While most participants, especially younger patients with young children, experienced intense emotional distress upon receiving a cancer diagnosis, those with a family history of cancer were relatively calm and resigned. Nonetheless, the prior negative experience with cancer in the family made affected participants with a family history less eager to seek cancer treatment and less hopeful for a cure. Although a majority viewed the presence of family members during the breaking of bad news as important, a minority opted to face it alone to lessen the emotional impact on their family members. Difficulties disclosing the news of a cancer diagnosis to loved ones also emerged as an important need. Sensitive and empathetic patient-physician communication during the breaking of news of a cancer diagnosis was stressed as paramount. CONCLUSION: A patient-centered communication approach needs to be developed to reduce the emotional distress to patients and their families after the breaking of bad news of a cancer diagnosis. This is expected to positively affect the patients’ subsequent coping skills and attitudes toward cancer, which may improve adherence to cancer therapy.

Psychosocial factors influencing distress among cancer patients in South India

“…The findings on the relationship between awareness of diagnosis and prognosis and distress have implications for provider-patient communication. Communication about the diagnosis between practitioners and patients and their families has been explored in another Asian setting [20] . Wong et al found that sensitive and empathetic patient–physician communication during the “breaking news” of a cancer diagnosis may mitigate a patient's emotional distress.…”

“…Communication about the diagnosis between practitioners and patients and their families has been explored in another Asian setting. [20] Wong et al found that sensitive and empathetic patient-physician communication during the "breaking news" of a cancer diagnosis may mitigate a patient's emotional distress. Future research could focus on how communication about the diagnosis between practitioners and patients and their families in India may affect a patient's distress with the ultimate aim to develop communication approaches to reduce the emotional distress.…”

Perceived health-related quality of life among patients living with cancer at Kamuzu Central Hospital in Malawi

“…Communicating about concerns and decision making is important during all phases of treatment and supportive care for cancer 22,23 . A patient-centered communication approach needs to be developed to reduce the emotional distress to patients and their families following a cancer diagnosis 24 .The results were also supported by the ndings in Belgium and Italy where patients also provided good understanding of the disease condition they were going through 10 .…”

“…Denial, anger, sadness and depression are common reactions to cancer diagnosis 6, 25 . Receipt of a cancer diagnosis is often deemed as bad news because it is widely regarded as synonymous to a death sentence 24 . This is particularly so because cancer is a life threating illness often associated with a lot of physical disability such as loss of body functions, change in physical appearance, disruption of family and personal life plans, recurrence or progression of the disease and high symptom burden 6,10,11,26 .…”

Surviving Colorectal Cancer: More Than Treatment

“…Evidence revealed that persons with a family history of cancer were also relatively less shocked by the news of a cancer diagnosis. 2,3 Psychosocial Support from Healthcare Workers Patients and caregivers could benefit from support from having a good working relationship with the healthcare workers. In particular, it seems that the presence of this therapeutic relationship made the staff more approachable to patients and carers, promoting interaction and information-seeking.…”