|LETTER TO EDITOR
|Year : 2020 | Volume
| Issue : 2 | Page : 363
Author reply to Thomas et al., Konstantis and Chittem et al.
Department of Medical Oncology, Aster Malabar Institute of Medical Sciences, Kozhikode, Kerala, India
|Date of Submission||31-Mar-2020|
|Date of Decision||01-Apr-2020|
|Date of Acceptance||02-Apr-2020|
|Date of Web Publication||19-Jun-2020|
Department of Medical Oncology, Aster Malabar Institute of Medical Sciences, Mini Bypass Road, Govindapuram, Kozhikode - 673 016, Kerala
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Chandrasekharan A. Author reply to Thomas et al., Konstantis and Chittem et al. Cancer Res Stat Treat 2020;3:363
Chittem et al. expertly break down the Indian psyche regarding cancer communication and lay out a map to help navigate the stormy seas of “patient disclosure.” Studies have shown that hiding prognosis may definitely worsen the course of treatment. Thomas and Konstantis also recommend questioning the patients about their preferred extent of disclosure of prognosis.
One aspect that could be considered a barrier to informed choice is the low health literacy that prevails in our country. Health literacy is defined as the extent to which individuals have the capacity to obtain, process, and understand basic health information and services required to make appropriate health decisions. We have had several instances where the patients did not want to know about their prognosis, as it was difficult for them to comprehend despite simplifying things as much as possible. In such cases, a responsible family member was chosen by the patients for further decision-making and discussions.
In certain other circumstances, the relative/decision maker informs us that the patient is of a weak constitution and would not be able to handle a diagnosis of cancer. In such cases, we recommend psychiatric counseling prior to breaking the news to the patient. However, even that carries a stigma, and I have had patients vehemently refuse an appointment with the psychiatrist, thinking that others would label him “mad.”
In a country like ours, where rampant misinformation and bizarre stigma permeate deep and where people even commit suicide based on the suspicion of having the Coronavirus disease, or on being diagnosed with cancer,, much more headway needs to be made before achieving complete “patient disclosure” among all our patients. The suggestions of Thomas, Chittem and Konstantis go a long way in accomplishing this, but to quote Frost, there are “miles to go before I sleep.”
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Conflicts of interest
There are no conflicts of interest.
| References|| |
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