Truth telling to cancer patients: Views of Myanmar primary care physicians

Abstract

17030 Background: Due to cultural and social concern, non oncology physicians are still practicing nondisclosure in Myanmar. The views of Myanmar primary care physicians about truth telling to cancer patients were studied. Methods: A Questionnaire about revealing diagnosis and prognosis to cancer patients was prepared and given to 150 qualified Primary care physicians attending the oncology related lecture in CME course for General Practitioners in 2006, Yangon, Myanmar. Results: A total of 145 completed forms (96.66%) were returned. Age of primary care physicians range from 23 yrs to 52 yrs. 90 doctors (62.06%) were under age of 35 yrs (mean 29.94 yrs) and practicing experience ranged from 1 to 10 yrs. The remaining 55 (37.93%) were over 35 yrs of age (mean 44.52 yrs) with practicing duration of 10 to 28 yrs. The common cancer patients they have seen in daily practice were breast cancer (40%), lung cancer (28.96%), GI cancer (15.17%), cervical cancer (8.96%), ovarian cancer (3.4%), head and neck cancer ( 2.06%) and hematological malignancies (1.37%).A total of 73 doctors (50.34%) answered that they let the patient know they were suffering from a serious disease (not mentioning the word cancer) that needs further specialized treatment. Interestingly, 69.09% of physicians over 35 yrs of age agree with this approach, whereas only 38.88% of young physicians prefer it. Besides, 56.6% of senior primary care physicians prefer to reveal the diagnosis and prognosis to one or more family members first. Although all doctors are aware of the psychological distress on patients by painful truth telling, 58.8% of younger generation prefer to practice full disclosure to patients. Altogether, 105 physicians (72.41%) agree that disclosure of diagnosis and prognosis depends on education status of the individual patient. Conclusions: In this study, there were variations in physicians’ attitude and practice of truth telling. Full disclosure was preferred more by young physicians in Myanmar. Further studies on patients’ preference of telling the truth will help to better understand doctor-patient communication in Myanmar. No significant financial relationships to disclose.