Skip to main content
Log in

Perceptions of Cancer Status Disclosure in Lebanon

  • Published:
Journal of Cancer Education Aims and scope Submit manuscript

Abstract

In Lebanon, cancer used to be regarded as a taboo and referred to as “the disease” and was rarely disclosed to patients. However, patients are now increasingly interested in knowing their cancer status but with varying degrees of information requested. The aim of this qualitative descriptive study was to explore the perceptions of cancer patients, their families, oncologists, and healthy individuals concerning the disclosure of cancer prognosis. In-depth interviews were conducted with 21 family members, 20 middle-aged cancer patients, 11 elderly cancer patients, 22 healthy individuals, and 6 oncologists at the American University of Beirut Medical Center. The interviews focused on the following: general perception of cancer in Lebanese society, type, and extent of information that should be disclosed, factors affecting patient autonomy, and elements contributing to the decisions taken by oncologists and patients. The oncologist’s compassion and communication with patients affected their emotional status greatly, and some gaps in communication skills of oncologists were in need of standardized training courses to improve the process of cancer status disclosure. Also, patients had an increased preference towards the disclosure of cancer prognosis, and a desire to know the truth and this need increased as the patient progressed to a terminal state. Future work should be directed at addressing the needs of cancer patients through every disease stage. More research and further deliberation are needed to confirm the findings of this study since the Lebanese Code of Medical Practice does not protect the right of full disclosure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Alrukban M, Albadr B, Almansour M, Sami W, Alshuil M, Aldebaib A, Algannam T et al (2014) Preferences and attitudes of the Saudi population toward receiving medical bad news: a primary study from Riyadh City. J Fam Community Med 21(2):85–92. https://doi.org/10.4103/2230-8229.134763.

    Article  Google Scholar 

  2. Baile WF, Lenzi R, Parker PA, Buckman R, Cohen L (2002) Oncologists’ attitudes toward and practices in giving bad news: an exploratory study. J Clin Oncol 20(8):2189–2196. https://doi.org/10.1200/jco.2002.08.004

    Article  PubMed  Google Scholar 

  3. Bou Khalil R (2013) Attitudes, beliefs and perceptions regarding truth disclosure of cancer-related information in the Middle East: a review. Palliat Support Care 11(1):69–78. https://doi.org/10.1017/S1478951512000107

    Article  PubMed  Google Scholar 

  4. Tieying Z, Haishan H, Meizhen Z, Yan L, Pengqian F (2011) Health professionals’ attitude towards information disclosure to cancer patients in China. Nurs Ethics 18(3):356–363. https://doi.org/10.1177/0969733011398096

    Article  PubMed  Google Scholar 

  5. Elwyn TS, Fetters MD, Sasaki H, Tsuda T (2002) Responsibility and cancer disclosure in Japan. Soc Sci Med 54(2):281–293

    Article  Google Scholar 

  6. Pang A, Ho S, Lee S-C (2013) Cancer physicians’ attitude towards treatment of the elderly cancer patient in a developed Asian country. BMC Geriatr 13(1):35. https://doi.org/10.1186/1471-2318-13-35

    Article  PubMed  PubMed Central  Google Scholar 

  7. Marc Ho ZJ, Krishna LK, Goh C, Alethea Yee CP (2013) The physician-patient relationship in treatment decision making at the end of life: a pilot study of cancer patients in a Southeast Asian society. Palliat Support Care 11(1):13–19. https://doi.org/10.1017/S1478951512000429

    Article  PubMed  Google Scholar 

  8. Farhat F, Othman A, El Baba G, Kattan J (2015) Revealing a cancer diagnosis to patients: attitudes of patients, families, friends, nurses, and physicians in Lebanon—results of a cross-sectional study. Curr Oncol 22(4):e264–e272. https://doi.org/10.3747/co.22.2351.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Friedrichsen M, Lindholm A, Milberg A (2011) Experiences of truth disclosure in terminally ill cancer patients in palliative home care. Palliat Support Care 9(2):173–180. https://doi.org/10.1017/S1478951511000046

    Article  PubMed  Google Scholar 

  10. Ni YH, Alræk T (2017) What circumstances lead to non-disclosure of cancer-related information in China? A qualitative study. Support Care Cancer 25(3):811–816. https://doi.org/10.1007/s00520-016-3464-z

    Article  PubMed  Google Scholar 

  11. Lebanese code of medical ethics. October 22, 2012 in law no.240

  12. Sacristan JA, Aguaron A, Avendano-Sola C, Garrido P, Carrion J, Gutierrez A, Kroes R, Flores A (2016) Patient involvement in clinical research: why, when, and how. Patient Prefer Adherence 10:631–640. https://doi.org/10.2147/ppa.s104259.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Narayanan V, Bista B, Koshy C (2010) ‘BREAKS’ protocol for breaking bad news. Indian J Palliat Care 16(2):61–65. https://doi.org/10.4103/0973-1075.68401

    Article  PubMed  PubMed Central  Google Scholar 

  14. Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP (2000) SPIKES—a six-step protocol for delivering bad news: application to the patient with cancer. Oncologist 5(4):302–311

    Article  CAS  Google Scholar 

  15. Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3(2):77–101. https://doi.org/10.1191/1478088706qp063oa

    Article  Google Scholar 

  16. Adib SM, Hamadeh GN (1999) Attitudes of the Lebanese public regarding disclosure of serious illness. J Med Ethics 25(5):399–403

    Article  CAS  Google Scholar 

  17. Hamadeh GN, Adib SM (1998) Cancer truth disclosure by Lebanese doctors. Soc Sci Med 47(9):1289–1294

    Article  CAS  Google Scholar 

  18. Konstantis A, Exiara T (2015) Breaking bad news in cancer patients. Indian J Palliat Care 21(1):35–38. https://doi.org/10.4103/0973-1075.150172

    Article  PubMed  PubMed Central  Google Scholar 

  19. Ehsani M, Taleghani F, Hematti S, Abazari P (2016) Perceptions of patients, families, physicians and nurses regarding challenges in cancer disclosure: a descriptive qualitative study. Eur J Oncol Nurs 25:55–61. https://doi.org/10.1016/j.ejon.2016.09.003

    Article  PubMed  Google Scholar 

  20. Stiefel F, Barth J, Bensing J, Fallowfield L, Jost L, Razavi D, Kiss A (2010) Communication skills training in oncology: a position paper based on a consensus meeting among European experts in 2009. Ann Oncol 21(2):204–207

    Article  CAS  Google Scholar 

  21. Korsvold L, Lie HC, Mellblom AV, Ruud E, Loge JH, Finset A (2016) Tailoring the delivery of cancer diagnosis to adolescent and young adult patients displaying strong emotions: an observational study of two cases. Int J Qual Stud Health Well-being 11:30763. https://doi.org/10.3402/qhw.v11.30763

    Article  PubMed  Google Scholar 

  22. Yun YH, Lee CG, Kim SY, Lee SW, Heo DS, Kim JS, Lee KS, Hong YS, Lee JS, You CH (2004) The attitudes of cancer patients and their families toward the disclosure of terminal illness. J Clin Oncol 22(2):307–314

    Article  Google Scholar 

  23. Matsuyama RK, Kuhn LA, Molisani A, Wilson-Genderson MC (2013) Cancer patients’ information needs the first nine months after diagnosis. Patient Educ Couns 90(1):96–102. https://doi.org/10.1016/j.pec.2012.09.009

    Article  PubMed  Google Scholar 

  24. Pang A, Ho S, Lee SC (2013) Cancer physicians’ attitude towards treatment of the elderly cancer patient in a developed Asian country. BMC Geriatr 13:35. https://doi.org/10.1186/1471-2318-13-35

    Article  PubMed  PubMed Central  Google Scholar 

  25. Belachew SA, Mekuria AB, Erku DA (2017) Preferred information sources and needs of patients with cancer on disease symptoms and management: a cross-sectional study. J Glob Oncol 3(2_suppl):2s. https://doi.org/10.1200/jgo.2017.009399

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ali Shamseddine.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Temraz, S., Salim Hammoud, M., Saleh, A. et al. Perceptions of Cancer Status Disclosure in Lebanon. J Canc Educ 34, 874–881 (2019). https://doi.org/10.1007/s13187-018-1389-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13187-018-1389-6

Keywords

Navigation