Positive pressure can have negative impact for cancer patients

Macmillan Cancer Support has revealed that the need to ‘fight’ and remain positive could be having a negative effect on people living with cancer.

The charity has found that 76 per cent of people with cancer have thought about the fact that they may die from their disease, but report that the pressure to stay positive and support people to ‘fight’ cancer remains one of the biggest barriers to introducing honest conversations about dying.

Missed Opportunities, a research undertaking by YouGov, actually discovered that of those people surveyed who had spoken to their healthcare team about dying, only 19 per cent of conversations were initiated by a health or social care professional. Furthermore, 25 per cent also admitted to not sharing their own thoughts about dying with anyone due to seeing themselves as a ‘fighter’, while 28 per cent feel guilty if they cannot stay positive about their disease.

Although many patients benefit from the positive attitude taken in ‘fighting talk’, Macmillan wants to encourage and support health and social care professionals to facilitate more open and honest conversations about end of life using a process known as ‘Advance Care Planning’, which allows people to discuss their individual worries, values and preferences for their care. This has been found to significantly improve people’s experiences of care at end of life.

Adrienne Betteley, specialist advisor for End of Life Care at Macmillan Cancer Support, said: “We know that ‘battling’ against cancer can help some people remain upbeat about their disease, but for others the effort of keeping up a brave face is exhausting and unhelpful in the long-term. We need to let people define their own experiences without using language that might create a barrier to vital conversations about dying.

“For health and social care professionals, there is often a fear that the person is not ready to talk about dying. We know, however, that making plans while receiving treatment allows people with cancer to retain a sense of control during an emotionally turbulent time. Future planning before a person’s health deteriorates is also strongly associated with lower hospital death rates. When staff have a record of where someone would like to die, that person is almost twice as likely to die in the place of their choosing [xii] as well as have other care preferences met and fewer emergency admissions at the end of their life.”

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