Suffering Is Not Considered A Significant Problem For Many Cancer Patients Receiving Palliative Care
Cancer Care and Suffering
The relief of suffering is one of the central goals in all of health care, but very little research has examined how common suffering is and what it actually means to patients. Now, a new study of patients receiving palliative care for cancer has revealed that suffering may be far less common than traditionally assumed.
In detailed interviews, 381 patients across Canada were asked the basic question "In an overall, general sense, do you feel that you are suffering?" The results showed that 49 per cent reported that they were not suffering and 25 per cent reported only minimal or mild suffering. However, another 26 per cent reported that they were suffering quite significantly. The results will be published in the May 1 edition of the Journal of Clinical Oncology.
"Patients diagnosed with terminal cancer may assume they will experience profound suffering, but our results show that this is not necessarily the case, at least not when there is access to adequate palliative care," said lead author Dr. Keith Wilson, an Associate Scientist at the Ottawa Health Research Institute, Associate Professor of Medicine at the University of Ottawa, and Psychologist at The Ottawa Hospital Rehabilitation Centre. "However, the fact that more than a quarter of patients still feel that suffering is an important problem tells us that we have a long way to go."
The study also sheds new light on factors associated with suffering. "We found that suffering is related most strongly to physical symptoms, especially feeling generally sick, weak and in pain. But, there are also important contributions from psychological distress, existential concerns, and social worries," said Dr. Wilson. Younger age and greater education were also associated with suffering, but sex, religion, marital status and closeness to death were not.
The results are part of the Canadian National Palliative Care Survey, funded by the Canadian Institutes of Health Research (CIHR).
"This study shows how important access to palliative care is and the growing role of caregivers in our society," said Dr. Philip Branton, Scientific Director of the CIHR Institute of Cancer Research. "Patients with terminal cancer must be able to live with dignity and without pain."
Dr. Wilson noted that the study has several limitations. For example, some physicians chose not to approach patients about the study because they were concerned it would compromise their care, and some patients who were approached declined to participate. Despite these limitations, the study remains the most comprehensive of its kind.