The physical, mental and social impacts of telling prostate cancer patients the true diagnosis

Abstract

(Background) Telling cancer patients the true diagnosis is inevitable to acquire informed consent especially in the Western world. In Japan, however, no such consensus has been established yet. We investigated the influence of telling the true diagnosis on QOL of prostate cancer patients. (Methods) We measured physical, mental and social aspect of prostate cancer outpatients by the General Health Questionnaire (GHQ) and the international Prostate Symptom Score (I-PSS). Using the general linear models we tried to explore which variables would attribute to 'severe depression', 'anxiety and insomnia' and 'social dysfunction'. (Results) No significant differences were found in any of the eight variables (age, performance status, clinical stage, I-PSS and Goldberg's four factors of GHQ) among the two groups that were informed the true diagnosis or not. The correlation structures of 'severe depression', 'somatic symptoms' and I-PSS are significantly different in the two groups. As a result of the analysis by the GLM, 'somatic symptoms', I-PSS and clinical stages had main effect on 'severe depression'. Also, there was an interaction between the effect of telling the true diagnosis and 'somatic symptoms'. (Conclusion) These results suggest that the mental condition of prostate cancer patients remain stable when they are in good physical condition regardless of being informed the true diagnosis or not. However, the patients who weren't told the true diagnosis have a tendency to get depression accompanying deterioration of physical condition. It is therefore considered that telling the true diagnosis makes the patients understand the changes of their physical conditions and help their mind to be stable.