Diagnosis uncertainty a source of patient stress

Chicago: Uncertainty about a possible diagnosis causes more anxiety and can be more stressful than knowing you actually have a serious illness, a study said.

In fact, patients can sometimes be so anxious they won't complete testing procedures such as MRIs, said study leader Elvira Lang, at Harvard Medical School in Boston.

"Once people have the diagnosis, they gain some understanding and control. But without it, all they have is anxiety, and they do not know how to handle it," Lang told Reuters Health about the study, reported at the annual meeting of the Radiological Society of North America.

Lang and a colleague studied 214 women waiting to undergo either a breast biopsy, hepatic chemoembolization -- a treatment for cancer such as liver cancer -- or treatment for uterine fibroid tumors.

Immediately prior to the procedures the women completed tests to measure their stress and anxiety levels. The breast biopsy patients scored significantly higher on tests for anxiety and slightly higher on all other tests.

"We were very surprised to see that the women having breast biopsy were significantly more anxious than the women who came for treatment for malignant cancer and those who came for fibroids," Lang said in an interview. "People in health care and also family members may judge what is minor or major by how much risk is involved. But that is not what the patient is experiencing."

Lang noted that with lost revenue from tests that patients are too anxious to complete having an impact on insurance premiums, dealing with patient anxiety is a plus for health care institutions as well.

"People want to make patients feel better but they use language that is not helpful," Lang said.

"For instance, they will say 'oh, it's not going to be that bad' or 'it's just going to be a little sting,' but using such vocabulary only increases anxiety and pain."

Lang recommended that medical personnel involved with diagnostic tests avoid negative suggestions and words such as 'hurt' in explanations, and that they use comforting language that at the same time helped patients recognize their own strength.