Influence of patient's perceptions, beliefs and knowledge about cancer on treatment decision making in Pakistan

Introduction: Cancer is a cause of major disease burden across the world and Pakistani data suggest that its incidence is increasing. Pakistan's socio-cultural history, social practices, religious beliefs and family systems differ in many ways from rest of the world. These factors make the practice of oncology a challenge. Materials and Methods: A comprehensive questionnaire focusing on socio-cultural and religious aspects was administered to patients with a diagnosis of cancer and receiving chemotherapy at the Aga Khan University Hospital, Karachi, Pakistan. Results: A total of 230 patients agreed to answer the questionnaire, with a mean age of 46 years and 63% were females. Obtaining some formal education was claimed by 87%, 75.2% had received some treatment before seeing an oncologist, including homeopathic physicians and faith healers. Of all 27 % thought that cancer is contagious, a fact observed more so in those who were illiterate, 27 % believed in some myth such as past sins, evil eye or God's curse as to be cause of their cancer, while 39.6% thought that cancer can be prevented by a regular religious activity. Some 30% thought that a meaningful life after diagnosis of cancer was not possible and 28%considered that they did not have proper information about chemotherapy. About 73% wanted to have their treatment related decision made by the treating physician. Conclusions: Patient related beliefs in myths and concerns are unique in the socio-cultural set up of Pakistan. If physicians are better aware of these factors, they may be able to handle patient related issues in a more effective way.