Disclosure of cancer diagnosis: the Greek experience

Purpose: To analyze the attitude of Greek health professionals towards truth disclosure and factors that may influence it. Methods: Through a self-completed questionnaire, we studied the attitudes over the initial disclosure of cancer diagnosis to cancer patients of 132 doctors and 123 nurses, partly involved in cancer patients' care, in 5 general hospitals of Crete, Greece. Results: Eighty-nine percent of the participants considered information as patient's right and 88% as professional's ethical duty, 64% believed that the whole truth should be revealed, 90% avoided the word "cancer" in the communication and 39% disclosed cancer diagnosis at patient's direct asking. Respondents informed 1/10 of their new cancer patients, mainly due to perceived limited responsibility (23%), patient's low cognitive state (22%), fear of harming the patient (17%) and relatives' objection (15%). Sixteen percent of fellows acknowledged to themselves the responsibility to inform patients. Cooperation, compliance and arrangement of patient's personal issues were considered as benefits from accurate disclosure (88%, 83% and 75%, respectively), the latter more among doctors than nurses (p = 0.01) and medical than surgical professionals (p = 0.03). Thirty-six percent of the respondents considered the presence of a psychologist necessary during disclosure, nurses more than doctors (p < 0.001). Conclusion: Despite adequate theoretical background, Greek non-cancer specialists, doctors and nurses, initially inform accurately a small part of their cancer patients. Appropriate training programs for doctors and non-medical health professionals involved in cancer patients' management are required to upgrade professional-patient communication.