Relevance to non-symptomatic diagnoses Kenneth Campbell, Leukaemia Research Fund - posted in a private capacity 18 June 2004 The data presented by Montazeri et al are very valuable in indicating the impact of knowledge or ignorance of a cancer diagnosis. A caveat on their generalisability is that the study was carried out in a largely symptomatic population - 75-80% of patients in the study were symptomatic. Lung cancer, even treated in centres of excellence, continues to have low five-year survival - it is unclear from the paper whether patients who knew their diagnosis also knew their prognosis.It would be of great interest, and possibly more important in at least some respects, to establish the impact of a cancer diagnosis in the increasingly common context of patients with indolent haematological neoplasms, asymptomatic or minimally symptomatic at time of diagnosis and who have a long life-expectancy. In this group it is conceivable that attachment of the label cancer to their illness may have a significantly greater impact on their quality of life and perceived well-being. Additionally, they face the problem in many cases of living with a diagnosis of cancer but a management plan of "watch and wait". Their prolonged survival means that they must live with the knowledge of their diagnosis for many years, even for decades. Competing interests No conflicting interests exist.