GUEST had the answer way back there. My wife works with terminally ill persons, and has for 30+ years. Her take: The patient is the first to know. Then they react to how those closest to them are acting. If friends/family/relatives all pretend the news is better than it is, they'll go along with it trying to please those friends/family/relatives.

And the most devistating part of all this? Watching the absolute hurt, agony, regret of those "loved ones" when, in the last breath the person says, "You can quit pretending now; I knew all along."