Many widowers not told wife's illness is terminal

NEW YORK (Reuters Health) - Men whose wives have terminal cancer are often not informed that their spouse’s illness is incurable, or are only told within a week of her death, according to the largest study to date to investigate this issue.

“Communication of incurable illness is difficult for everybody,” Dr. Hanna Dahlstrand of Karolinska University Hospital in Stockholm noted in an interview with Reuters Health. Nevertheless, she added, research has shown that spouses who are aware that their wife’s illness is terminal well in advance of her death are less likely to suffer from depression and anxiety long-term.

Dahlstrand and her colleagues sent questionnaires to 691 widowers whose wives had died of cancer 4 to 5 years previously. Twenty percent said they were never told that their wife’s illness was incurable, while 21 percent got this information only within a week before her death.

But 86 percent of the men in the study said they felt that next of kin should be told immediately when their loved one’s illness is terminal, including 71 percent of those who didn’t get this information at all.

“The finding indicates that the caregivers’ wish for information on the chance of cure is greater than acknowledged by the professionals in the field,” Dahlstrand and her team note in the Journal of Clinical Oncology. However, they also point out that there are a substantial subgroup of family members and patients who don’t want this information.

“It is a great challenge for physicians and other professionals to perceive which patients and family members do not desire and will not benefit from open communication,” the researchers write.

A first step, Dahlstrand said, would simply be for physicians to ask patients and their families about their preferences. “We should raise the question: Do you want to know?”

SOURCE: Journal of Clinical Oncology, online July 10, 2008.