THE "NEW" PROSTATE CANCER INFOLINK

According to a study published on Monday in the Journal of Clinical Oncology, cancer patients “do not hear much of what is said after bad news is delivered.” In this study, according to the authors, “more than half of the provided information was forgotten.”

The study, carried out in the Netherlands and Australia, enrolled 260 cancer patients who were newly diagnosed and were seeing their oncologist or radiation oncologist for the first time. On average, each appointment lasted for about 30 minutes. Every appointment was tape-recorded so that it could be carefully reviewed.

Each study participant was subsequently contacted by telephone and asked how much they could remember from their appointments. The researchers compared the patients’ answers to the statements on the tape recordings to assess how much information had been retained.

The study hypothesis actually being tested was that older patients would remember less than younger patients. However, the data showed a quite different set of results, as follows:

• People under 65 recalled about 49.5 percent of what they’d been told; those over 65 recalled about 48.4 percent of what the doctor had told them.
• Recall decreased significantly with age, but only when the total amount of information presented was taken into account.
• Recall was selectively influenced by prognosis. The patients with poorer prognoses recalled less and, in addition, the more information that was provided about the prognosis, the less information patients recalled, regardless of their actual prognosis.

The authors concluded that, “Recall is not simply a function of patient age. Age only predicts recall when controlling for amount of information presented. Both prognosis and information about prognosis are better predictors of recall than age.” They add that their results “provide important insights into intervention strategies to improve information recall in patients with cancer.”

A report on this paper was also published by HealthDay and appears in today’s Washington Post. However, this report neglects to note that the original study was based on the idea that a patient’s age might be relevant to how much he or she remembered.

We don’t know how many of the patients in this study were being given a prostate cancer diagnosis, but it would be surprising to find that the specific form of cancer under discussion had a profound impact on the results of this study.

The implications of this study are relatively clear. Physicians who give someone a cancer diagnosis and then try to discuss the details with them at the same meeting are wasting their breathe. Better to give the patient the diagnosis at one meeting (or even over the phone) and get him (or her) to come back to the office, preferably with a spouse or other “listener,” to hear the details later.

Filed under: Diagnosis, Management