Dying without suffering: new study shows that suffering is not considered a significant problem for many cancer patients receiving palliative care

May 1, 2007

The relief of suffering is one of the central goals in all of health care, but very little research has examined how common suffering is and what it actually means to patients. Now, a new study of patients receiving palliative care for cancer has revealed that suffering may be far less common than traditionally assumed.

In detailed interviews, 381 patients across Canada were asked the basic question “In an overall, general sense, do you feel that you are suffering?” The results showed that 49 per cent reported that they were not suffering and 25 per cent reported only minimal or mild suffering. However, another 26 per cent reported that they were suffering quite significantly. The results will be published in the May 1 edition of the Journal of Clinical Oncology.

“Patients diagnosed with terminal cancer may assume they will experience profound suffering, but our results show that this is not necessarily the case, at least not when there is access to adequate palliative care,” said lead author Dr. Keith Wilson, an Associate Scientist at the Ottawa Hospital Research Institute, Associate Professor of Medicine at the University of Ottawa, Psychologist at The Ottawa Hospital Rehabilitation Centre and Scientist at the Elisabeth Bruyère Research Institute. “However, the fact that more than a quarter of patients still feel that suffering is an important problem tells us that we have a long way to go.”

The study also sheds new light on factors associated with suffering. “We found that suffering is related most strongly to physical symptoms, especially feeling generally sick, weak and in pain. But, there are also important contributions from psychological distress, existential concerns, and social worries,” said Dr. Wilson. Younger age and greater education were also associated with suffering, but sex, religion, marital status and closeness to death were not.

The results are part of the Canadian National Palliative Care Survey, funded by the Canadian Institutes of Health Research (CIHR).

“This study shows how important access to palliative care is and the growing role of caregivers in our society,” said Dr. Philip Branton, Scientific Director of the CIHR Institute of Cancer Research. “Patients with terminal cancer must be able to live with dignity and without pain.”

Dr. Wilson noted that the study has several limitations. For example, some physicians chose not to approach patients about the study because they were concerned it would compromise their care, and some patients who were approached declined to participate. Despite these limitations, the study remains the most comprehensive of its kind.

About the Ottawa Hospital Research Institute
The Ottawa Hospital Research Institute (OHRI) is the research arm of The Ottawa Hospital and an affiliated institute of the University of Ottawa. The OHRI includes more than 1,200 scientists, clinicians, graduate students, postdoctoral fellows, and staff conducting research to improve the understanding, prevention, diagnosis and treatment of human disease. For more information visit

About the Canadian Institutes of Health Research
The Canadian Institutes of Health Research (CIHR) is the Government of Canada's agency for health research. CIHR's mission is to create new scientific knowledge and to catalyze its translation into improved health, more effective health services and products, and a strengthened Canadian health care system. Composed of 13 Institutes, CIHR provides leadership and support to more than 10,000 health researchers and trainees across Canada.

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