There is no easy way to tell someone that they have cancer. However, many people describe their cancer experience as life-changing and the way in which they are told about the diagnosis can have a powerful impact on their state of mind, coping ability and future relationship with their medical team.
A few people felt that their doctor had broken the news in a compassionate manner. Stephen thought the surgeon gave the diagnosis sensitively and spent time answering all their questions. One woman describes such an encounter and explains how it helped her not to feel isolated by the diagnosis:
The diagnosis was a shock to Stephen but he thought the surgeon broke the news sensitively.
Her consultant’s way of breaking the news helped her feel confident about treatment.
Other people said that the manner in which they were told was blunt but not unsympathetic, which they felt was probably for the best.
Unfortunately many of the people we talked to felt they were told they had cancer in an insensitive or inappropriate manner. Nowadays doctors receive more training and guidance on how to break bad news to people and this has helped to reduce the number of people who are unhappy with the way they were told their diagnosis.
The shock of having cancer was compounded for those who had received repeated assurances from their GP or consultant that what they had was certainly not serious and, in some cases, a product of their imagination. Many had gone to the appointment alone. One woman, whose GP and consultant had both been slow to act and unhelpful in their communication with her, explains how she never understood that a polyp could be cancerous:
She did not understand that a polyp could be cancerous and was shocked by her diagnosis.
Having some idea that cancer is a possibility before diagnosis can help to reduce fear and uncertainty about what happens if cancer is diagnosed. One woman described being shocked when she found out but at least knew what would follow.
In some cases people felt that their personal dignity had not been appropriately considered. Several people described being slapped on the bottom by their consultant after examination of their back passage, or being told they had cancer while they were still undressed and on the table. One man describes such an experience and how it made him feel. A woman recalls being told she had cancer only after a group of medical students were given the opportunity to look at her tumour.
He felt his dignity was not considered when he was given his diagnosis.
Medical students were allowed to look at her tumour before she was told she had cancer.
A few people felt that the way they were told they had cancer was completely unacceptable. One woman received her initial diagnosis in a public ward and was then bluntly told she had multiple secondary tumours of the liver by the radiologist doing her scan. She describes the discussion with her consultant that followed. A man described being (wrongly) told he had only months to live by a surgeon – who then immediately left the room.
Her diagnosis of inoperable cancer was insensitively conveyed.
Describes being wrongly told he had only a short time to live.
Several people also recalled being left entirely alone after receiving their diagnosis. The woman who only found out she had cancer after a group of medical students were given the opportunity to look at her tumour explains how she felt when this happened to her:
She was left completely alone after her diagnosis.
A number of people said that their cancer was deliberately concealed from them or that throughout diagnosis and treatment the word ‘cancer’ was never mentioned. A woman who had bowel surgery but was never told she had cancer explains how she found out by accident and how this discovery might have saved her life.
A man who had an ileostomy as treatment for ulcerative colitis only found out years later that, in fact, he’d had cancer.
She was never told shed had cancer and only found out accidentally.
The reason given for concealing the diagnosis was always “not wanting to worry” the patient even though the information was sometimes relevant to a family history of the disease. Other patients found it strange and unhelpful that words like ‘blockage’, ‘polyp’, or ‘problem’ were always used instead of the word ‘cancer’.
A woman who did not hear cancer mentioned throughout her treatment explains how she never fully understood she had the disease until a letter arrived about a chemotherapy appointment.
A man who also was treated without the word ‘cancer’ being mentioned pointed out that people with a life-threatening illness might well want to put their affairs and personal relationships in order.
She went through diagnosis and surgery without hearing the word cancer mentioned.
Several people felt strongly that health professionals needed training in appropriate forms of communication.
Since these interviews everyone diagnosed with colorectal cancer (also known as bowel cancer) in the NHS is treated by a team of experts in the diagnosis, treatment and management of people with bowel cancer. This team is known as the multi-disciplinary team (MDT). The MDT works together, sharing expertise, to plan and agree a treatment plan specific to individual needs.