Many people wonder how they'd feel if they were told life changing news such as they have cancer.
They run the scenario over in their minds. How would they react and who would they tell?
For many that moment of thinking is sadly a reality. They have been told they have cancer and they're facing the reality of how to handle that information. They now have to make a decision that will impact upon them and their loved ones for the rest of their lives.
A study released by Bupa found that a considerable number of cancer patients are choosing to go it alone and keep friends and family in the dark about their diagnosis and treatment, in order to protect them.
A quarter of women (25%) and nearly a fifth of men (19%) who've been diagnosed said they considered not telling family. There was also a notable difference between telling a spouse or partner about diagnosis - one in 25 (4%) women admitted that they considered not telling their spouse or partner about their cancer, compared to 1 in 100 (1%) men.
One of the biggest reasons for women keeping their diagnosis a secret from friends, was because they wanted as much of their life as possible to carry on as normal (59%).
I wasn't surprised by the findings, as part of Bupa's Oncology Support Team I speak to patients every day and they all react to their diagnosis and approach how they'll tell people very differently - that's simply human nature. What we do find is that some people want to keep the diagnosis to themselves for a short time and then tell family and children weeks afterwards once they've come to terms with it - others keep it a secret for months.
I do think that the research will be a surprise for many though. As I mentioned earlier, many of us have considered what we'd do if we were told. Most people assume that patients will tell their family and close friends, but this isn't always the case.
For me as a Care Manager, I often think the choice to keep cancer diagnosis secret is the patient's need to understand their own situation first. Many want to be fully clear of all of the facts before they face others' questions - those facts aren't always immediately available. However, there are multiple reasons for not sharing a diagnosis. A fifth of women (21%) said they considered not telling friends because they simply couldn't face the conversation, whilst a similar amount wanted to protect them. Equally there is the desire to carry on as normal, and not wanting sympathy or special treatment.
Whichever option patients choose, we remind them that it's their choice and only they know what is best for them and those around them. Cancer can have physical and emotional effects on the body, which can be difficult to hide and can be very difficult for even the most resilient and independent patient. Therefore, when choosing to go it alone, patients need to consider a number of factors.
If a patient chooses not to tell their family and friends, then they need to know where they can get support. It is there in a variety of forms, whether it be their doctor, nurse or a local support group. There can also be physical side-effects to their treatment, which can be difficult to hide from those closest to them, although this is not say it hasn't been done. The strain of 'hiding' the illness can, at times, compound the stress the patient is feeling; pretending everything is normal can, in itself, be a huge burden that someone going through treatment can do without.
It is always possible that someone could find out by chance what a patient has been going through - loved ones who realise they haven't been told can get very upset and feel disappointed, while others will respect the decision. At Bupa we often see and speak to family members of patients who need support themselves or advice on how they can best help their loved one.
One of the most important things for me is that it really doesn't matter why people choose to keep their diagnosis a secret - many just do - for as long as they wish. What this research should do is give reassurance to anyone who's in this position themselves and is unsure of what the 'right' decision is. There are others out there experiencing the same - sometimes confusing - decision and it is an individual choice and one only that person can make. But, whatever decision is made, it's important to remember that there are others out there who can provide help and support.