When cancer becomes terminal, someone has to tell the patient and family—but some people might not want to know the truth. To find out what patients and their families want to know, researchers in Australia and Canada interviewed patients about their experiences.

What the researchers wanted to know: What do terminally ill cancer patients and their families want to know?

What they did: The researchers talked to 21 cancer patients and their families in Perth, Western Australia, and 23 cancer patients (21 with families) in Winnipeg, Manitoba. All patients were receiving palliative care, which gives relief but no cure. Hospice volunteer Ingrid Kirk, one of the authors of the study, started each interview with "Could you tell me something about what you know about your [your relative's] illness?" and went from there. Among other questions, she asked how the doctor prepared the patient or relative for bad news, and whether they would prefer not knowing. Patients and family members all gave a lot of detail.

What they found: The need for sensitivity and respecting individual wishes was important, the researchers write. Almost everyone said they wanted open communication about the illness and its progress, and all patients said they wanted to know their own diagnosis. The most important kinds of information were prognosis and hope, even when patients and family accepted that the disease was terminal. Patients and families generally found evasiveness unhelpful. And even if they wanted to know the prognosis, they were often upset about how or when they were told. "I asked how much time," said one Winnipeg patient, "and he said he couldn't tell me because he wasn't God. . . . I didn't care for that answer very much. I thought maybe he could be a little more specific. Sometimes it seems that the information is strictly for the medical staff and not for the people."

What it means to you: Doctors should pay attention to the sort of information their patients want, the researchers write, and should be taught better communication skills.

Caveats: The researchers weren't able to target different ethnic groups as they'd hoped. Also, families that were in conflict over how much information to share probably wouldn't have agreed to join the study.

Find out more: The National Hospice and Palliative Care Organization: http://www.nhpco.org/

The Agency for Healthcare Research and Quality offers some tips for patients when talking to a doctor: http://www.ahrq.gov/

Read the article: Kirk, P., Kirk, I., and L.J. Kristjanson. "What Do Patients Receiving Palliative Care for Cancer and Their Families Want to Be Told? A Canadian and Australian Qualitative Study." British Medical Journal. June 5 2004, Vol. 328, p. 1343.

Abstract free online http://bmj.bmjjournals.com