A comment made by a journalist on breakfast news struck me this morning. Historically, they were banned from mentioning the word ‘cancer,’ on TV. Instead, journalists and presenters could only say ‘the big C’ or less.
It reminded me of what it was like in the NHS 25-30 years ago, working on an acute surgical ward as a young nurse. I recall feeling horrified to see some people undergoing surgery without being informed about their cancer diagnosis. It felt dishonest. The frequent use of words like ‘tumour,’ ‘lump’, or ‘cyst’ contributed to this unsettling reality. There were many reasons for this. In some instances doctors used euphemistic language to avoid discussing uncomfortable information, or to spare patients from facing a difficult diagnosis.
These conversations though, influenced my decision to [a] work in oncology and [b] do all that I could to improve how we communicate with patients and their families.
Fast forward to when I did my PhD, 6 out of 16 patients, learned that they had cancer, when they received a letter to attend the oncology (cancer) department for an appointment. This was staggering. Some patients were rightly angry that they had never been told and some were relieved to know what was finally wrong with them. Imagine that – being relieved to know you have cancer? One distinguished and highly intelligent man provided me with this quote. He described the uncertainty of knowing as extremely tough. One of my recommendations was to avoid euphemistic language where possible, and use a person-centred approach to communication.
Nobody said to us..we heard the word tumour but tumour is a growth that shouldn’t be where it is, like a weed. So a tumour doesn’t have to be malignant, it can be benign. So we both assumed it had been a cancer but nobody was telling us. So we floated about for a fortnight. That was tough. We did get to a stage when we wanted somebody to say this is what it is.’
It is particularly important to be honest and transparent when people are first diagnosed with cancer. Your honesty sets the foundation for a therapeutic relationship (between patient and clinical team) built on trust and rapport. It also empowers people to navigate the challenges of a cancer diagnosis early on.
Why am I saying all this now? Well, it seemed like an opportune moment, in light of King Charles diagnosis of cancer. I have immense respect for his honesty and transparency. I sincerely hope that something good can come out of this. That people become more aware of the importance of effective communication, openness and transparency, and do so in a kind and compassionate manner. Take a moment to step on to their planet and see what this is like for them. How would you want to be told?
We all have our own experiences and tales to tell about an experience where we received information or a situation where we gave information and it has stuck in our mind. I would love to hear of your experiences, in the hope that we can all learn from each other and achieve something positive together.
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