Prognosis Disclosure in Oncological Medicine

Abstract

“Faced with mortality, scientific knowledge can provide only an ounce of certainty: Yes, you will die. But one wants a full pound of certainty, and that is not on offer.” -Paul Kalanithi.

Cancer, to patients is more than just a diagnosis, and their lived experiences in the journey go far beyond the cleverly invented interventions, medications, and investigations. One would think that clinical outcome predictions, like weather forecast, should become more and more accurate as the event being predicted draws closer, but this is often not the case. A full pound of certainty, in Paul Kalanithi’s words, could guide patients in prioritising treatment options, putting affairs in order, going on a cruise this summer, or delaying it till next year. It could guide patient relatives in deciding whether to go home tonight or remain by the bedside to see mum take her last breath. In this article, we discuss prognosis disclosure in general terms, its ethical aspects, challenges, and possible solutions.