Qingqing Huang Dennis Mazur Thanks for your reply. I think the decision may be related to their emotional responds and beliefs.
Segun Michael Abegunde From my experience, it is possible even the patient is unaware of the cancer. A patient is diagnosed with gastric cancer, but the family told she was having a "severe" gastric ulcer. She has undergone a partial gastrectomy. On the following treatment, the family tells lies. The family never tells the truth to the patient, even at the moment of death.
If directly told to patient regarding diagnosis of Cancer then patient will undergo suddenly shock/fear. Therefore, the best way to avoid this uncomfortable situation is to avoid the tendency to automatically communicate with the family instead of the patient.