Cancer: the announcement of the disease considered too brutal for patients

For a quarter of patients with cancer, the announcement of their disease was too brutal , according to a survey by the Directorate of Research, Studies , Evaluation and Statistics ( Drees ) .
It is not so easy!
This survey of the conditions of life of cancer patients was conducted in late 2004, before the implementation of effective measures of the Cancer Plan , with patients surveyed two years after diagnosis.

Since the Cancer Plan has promoted the implementation of a consultation announcement at first in sixty institutions for experimentation , a measure that has become widespread in 2006 and 2007 in all facilities health that supports cancer patients .

To help institutions implement this measure 40 Cancer Plan , the National Cancer Institute ( Inca ) sent their national recommendations that are downloadable on its website ( www.e- cancer.fr ) with tools developed by teams that have experienced this device . A budget of € 15 million was allocated to the deployment of the device.

According to the survey of Drees , which covered 4,270 people , the most common cancers were breast cancer (30 %) and prostate ( 21%). Other urogenital tumors ( uterus , ovary , bladder, kidney ) were 12% of surveyed patients and 11 % had cancer of the colon or rectum. Cancers of the lung and upper aerodigestive tract ( UAT ) accounted for 7 % of the sample , as well as hematologic malignancies .

Most patients were treated with surgery ( 81%), almost half (48%) with radiotherapy and 37 % had received chemotherapy .

At two years of diagnosis, interviewed on two patient (49 %) were in remission from cancer .

Patients reminisce about the announcement of their diagnosis was conducted face to face with a doctor in about 80 % of cases. For nearly one in five in 2002 , " the conditions of surrender diagnosis could ask questions ," note the authors of the survey , revealing that in 6% of cases , the announcement took place during a telephone interview and 3% by mail. In 11 %, it came from a paramedical professional.

More importantly, one in four patients (25%) said they felt this ad as " too brutal " , including those who had not received an announcement face to face .

However, nearly nine out of 10 patients (86%) felt they received during these two years , sufficient medical information, although almost one in two considers that it has not been associated with the choice of treatment.

In the vast majority of cases ( 87%), the main source of information comes from the physician or health care team who monitored . But 6 % believe they inform primarily through the media . They are only 3% turn to patient associations for further information. "This gives a measure of what remains to be done to better recognize and organize the presence of the associations of patients in health care facilities (measure 60 of the Plan) ," the authors write .

If medical information appeared sufficient , 38% of surveyed patients say however that doctors do not take enough time to answer their questions , half the information was "too complicated " and a third that it was " too important. " Nearly one in four ( 39%) said that he had found " often " or " occasionally " unable to ask all the questions that concern .

Satisfied patients medical monitoring
Seven out of 10 say they are " very " satisfied with their medical care. Almost all patients (97%) reported receiving at least one annual follow-up visit and , overall , they are monitored twice a year ( 40%) or every three months ( 32%).

However, patients with breast cancer remain less satisfied with their follow-up ( 64%) than others ( 73%). Similarly, patients who continue to exercise a professional activity are less likely to be satisfied (66 % versus 73% in inactive ) , which could point to a " lack of flexibility in terms of time or consultation" suggest authors .

Few patients received psychological support at the beginning of their illness (4 % of their own initiative and 7% as part of a follow-up organized by the institution) , while 20 % who did not receive would have liked.

At the time of the survey, the proportion of patients who consult for psychological counseling on their own initiative is still 4 % but the one proposed by the property falls to 2 %.