Bad news can make cancer symptoms WORSE

GPs should avoid giving cancer patients too much bad news as it can worsen their pain and side effects, according to a leading doctor.

Professor Frede Olesen, said telling sufferers about the progression of the illness or the side effects of chemotherapy may make them feel more ill.

Instead, the Danish public health expert urged doctors to sit patients down and reassure them ‘not to worry’ as it may significantly improve their health.

Addressing the Royal College of GP’s annual conference in Glasgow, Professor Olesen said the phenomenon was known as the ‘nocebo effect’, when doctors provide too much bad news.

This is the opposite of the placebo effect, when patients taking dummy pills feel better because they convince themselves the drugs have improved their health.

When it comes to their prognosis, we cannot provide false hope. But it is correct that if you focus on bad news, people are more likely to feel pain.

Professor Olesen said: ‘Telling a patient that drugs or chemotherapy can give them a lot of side effects can lead to them experiencing these effects.

‘They are actually more likely to experience nausea, fatigue, pain and depression, studies show.

‘This raises the question of informed consent and whether a patient should be asked if they would like all the information or more of an overview.

‘When it comes to their prognosis, we cannot provide false hope. But it is correct that if you focus on bad news, people are more likely to feel pain. Sometimes a doctor can improve a patient’s state just by telling them not to worry.’

A study published in the Lancet medical journal in 2011 found that patient expectations play a major part in the side effects, such as pain, dizziness and memory loss, caused by radiotherapy and chemotherapy.

It involved research from the last decade showing that neurological pathways in the brain are triggered by concerns and negative expectations.

This has been proven to happen when doctors tell cancer patients about the ‘potential adverse events’ which may occur during their illness.

The research was presented by Professor Olesen along with a study published seven years ago in the British Medical Journal found patients with irritable bowel syndrome were significantly more likely to feel better if seen by a warm, attentive and ‘confident’ doctor.

Almost two-thirds of those told by a doctor ‘I have had much positive experience treating IBS and look forward to demonstrating that acupuncture is a valuable treatment’ reported an improvement after three weeks, although the acupuncture was useless in treating the condition.

Professor Olesen described this as the ‘doctor drug’. He said: ‘It is not enough that patients see a good GP, they must see a GP they have a relationship with. Doctors are a cheap, strong drug who can help patients cope with many of their symptoms.’

The former GP, from Aarus University, in Denmark, warned that doctors who do not have a good relationship with patients, or make them too fearful for the future, can affect their condition.

Speaking after the conference, he said encouraging words from a doctor could ‘switch on’ the parts of a patient’s brain which help them to manage pain.

Written by Victoria Allen and Sophie Borland for The Daily Mail ~ October 1, 2015

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