Swedish study finds many men not told wife's cancer incurable or told too late

Jul 9 2008

A study conducted in Sweden found that more than 40 percent of widowers in that country whose wives died from cancer four or five years earlier reported they were either never told that their spouse's cancer was incurable, or they heard this information during the last week of her life.

Eighty-six percent of widowers believed next-of-kin should be told immediately when a wife's cancer is incurable, including 71 percent of the men who did not recall being told this information. The study, which is the largest to explore this topic, is being published online July 10 in the Journal of Clinical Oncology (JCO).

"Our findings suggest that there is room for improvement in the level of communication between healthcare providers and the husbands of women with advanced cancer," said Hanna Dahlstrand, MD, PhD, an oncology resident and researcher at the Karolinska Institute in Stockholm and the study's lead author.

Using the Swedish Cancer Registry, the researchers identified and surveyed 691 men whose wives had died of breast, ovarian, or colon cancer in 2000 or 2001. The widowers were asked whether they were told about the extent of their wives' disease, and if so, when and by whom. They were also asked about their desire to learn such information. The study is part of a larger data collection by Arna Hauksdottir and colleagues, who are investigating men's preparedness for the death of a spouse.

Twenty percent of the men reported they were never told that the wife's cancer was incurable; 21 percent said they learned the same day or within the week before her death. Twenty four percent of men learned the information two weeks to two months before her death; 14 percent learned three to five months before; and 21 percent learned more than six months prior. Most (79 percent) of the men who were informed that their wife's cancer was incurable were told by the physician.

The study also found that 24 percent of men whose wives died of breast cancer reported they were not told their wives' illness was incurable, compared with 11 percent of widowers of women who died of ovarian cancer. The researchers speculated that because ovarian cancer is often diagnosed at an advanced stage, husbands may have known about the severity of their wives' illness.

Dr. Dahlstrand noted that attitudes toward the communication of health information are similar in other western countries, including the United States. She advises cancer patients and their family members who desire clear information about the extent of a patient's disease and chance of a cure to inform their physicians of their wishes in a direct manner. She also suggests that physicians ask patients and family members how much information they want to receive.