How Long Do I Have?

Few questions evoke physicians' discomfort like “Doctor, how much time do I have?”

In oncology it's a common question that comes with the territory, forcing clinicians and patients to grapple with issues of trust, hope, uncertainty, disappointment, and grief....

Unless patients are literally on their deathbed, one answer is “Nobody knows. Nobody can predict your future.” It's tempting to embrace this uncertainty as the fulcrum on which patients can then seesaw between hope and acceptance until they find a balance that works well for them.

But withholding a prognosis breaks the essential bond of trust and can leave patients feeling confused, angry, or abandoned....

Clinicians may worry that articulating a prognosis will extinguish a patient's hope. The literature suggests otherwise. If anything, open communication about a poor prognosis may increase patients' sense of hope that motivates them toward achievable goals....

To experience the healing potential of a prognosis, patients first have to get
through the initial shock, fear, and grief—a painful process that begins the moment after they ask, “How long?”

[Excerpted from "How Long Do I Have?" in current online issue of Oncology Times. To read entire essay, click here.]

 

Comments

[Angeline Chen]

Thank you for this well written article on a difficult and sensitive topic. Besides being a useful reminder to physicians, it is also very applicable to caregivers who might be the main go between person or communicator between patient and physician.

I have friends who were primary caregivers and withheld information about "how long" to patients as they were afraid perhaps of "extinguishing hope".

As a cancer survivor, if or when it comes a point that I have limited time left, I would appreciate knowing.

I also have had friends and family with cancer who passed on, but i only found out after the fact because my family kept the information away for fear of upsetting me (especially during the time i was undergoing treatment) but on the contrary, I would have liked to have a chance to say goodbye.