It is better for patients with advanced cancer to be informed as early as possible

  In recent years, we have come into contact with more and more cancer patients in the clinic, and we have slowly gained a certain understanding of their psychology and that of their families. One very profound experience is that most of the patients are deliberately concealed by their family members even though they have been seen in oncology department for many times, so that they do not know they have cancer at the end of their lives; as for patients who are not seen in oncology department, they are more likely to be blocked by their family members.  When asked why, the answer from family members is basically “they are worried that the patient’s mental breakdown will aggravate the disease due to knowledge”. Perhaps, this is a desperate attempt by the family to shelter the patient, so that the patient can spend the rest of his life with as little mental stress as possible; or perhaps, this is a mistake by the family to implement the strategy of “boiling a frog in warm water”, so that the patient misses the time to escape.  Should patients with advanced cancer be informed of their cancer or not? According to my own clinical practice, I think patients should be informed as early as possible for the following reasons.  Firstly, if cancer is a terminal disease, patients will eventually die whether they are informed or not, so the difference between late and early is not significant.  Secondly, the psychological tolerance of patients is very malleable, and they are not as fragile as people think, and usually face the disaster openly after a round of shock and pain. The so-called fear, in fact, is more of the patient’s relatives own heart disease. Conceal the peace of the crisis is more likely to be a major disaster and secondary disaster, what is the use of fear.  Third, the patient is informed, easy to buy time to self-arrange the aftermath and account for the hidden, regret will be reduced since. So although the death and a great sense of light and openness as much as possible to feel at ease, and no sense of being cheated. Afterwards, if there is no spirit in heaven, it is not good; if there is a spirit in heaven, it is difficult to blame the living person’s inability to return to heaven. In addition, cover up the condition and treatment, patients will produce a variety of psychological pressure, that is, blind toss; cover up the condition and do not treat, patients will also produce a variety of abandoned suspicion, and will not understand why give up treatment.  Fourth, the sense of crisis and hope coexist. In times of crisis, especially when life is under great threat, people often have a strong psychological motivation to fight and get rid of it, and will take the initiative to save themselves or accept to be saved, and will be willing to bear the greater pain in the rescue process. After advanced cancer patients are informed, the original psychology of resistance or negligence to rescue will often change into the psychology of accepting or even taking the initiative to rescue, which greatly facilitates the implementation of effective therapies (of course, ineffective therapies will eventually be rejected). Therefore, the sense of crisis will become the beginning of hope.  Fifthly, if cancer is not a terminal disease and there is a way to escape, patients who are informed will try their best to cooperate and seize the opportunity to take the path of hope, and their chances of success will be greatly increased; while patients who are not informed will not cooperate and seize the opportunity to succeed, and will eventually wait for extinction in vain. This is called born in worry, why fear its worry; die in comfort, why try to false peace.  Based on the above experience, when I use TCM to treat advanced cancer (usually patients who are already considered by oncology specialists to have very little hope of treatment), I usually let patients know about the cancer as early as possible so that they can cooperate seriously. As a result, the life expectancy of those who are informed is significantly longer than those who are concealed. For patients with early to mid-stage cancer, it is difficult to answer at this time because I have not yet had the opportunity to contribute to their care.