These are representative sample records from related to your search topic.
For comprehensive and current results, perform a real-time search at

Communicating with older cancer patients: impact on information recall  

Microsoft Academic Search

The central aim of this thesis was to unravel the relationship between patient characteristics, communication between patient and clinician, and subsequent patient information recall in the context of medical consultations with older cancer patients. Chapter 2 reviewed the literature to explore age differences in cancer patients’ need for information and support surrounding cancer treatment. The results indicated that older patients

J. Jansen



Communication skills of nurses during interactions with simulated cancer patients  

Microsoft Academic Search

In this paper the balance of affective and intrumental communication employed by nurses during the admission interview with recently diagnosed cancer patients was investigated. Rationale: The balance of affective and instrumental communication employed by nurses appears to be important, especially during the admission interview with cancer patients. Methods: For this purpose, admission interviews between 53 ward nurses and simulated cancer

Irma P. M. Kruijver; Ada Kerkstra; Jozien M. Bensing



Assessing Patient-Centered Communication in Cancer Care: Stakeholder Perspectives  

PubMed Central

Purpose: Patient-centered communication is critical to quality cancer care. Effective communication can help patients and family members cope with cancer, make informed decisions, and effectively manage their care; suboptimal communication can contribute to care breakdowns and undermine clinician-patient relationships. The study purpose was to explore stakeholders' views on the feasibility and acceptability of collecting self-reported patient and family perceptions of communication experiences while receiving cancer care. The results were intended to inform the design, development, and implementation of a structured and generalizable patient-level reporting system. Methods: This was a formative, qualitative study that used semistructured interviews with cancer patients, family members, clinicians, and leaders of health care organizations. The constant comparative method was used to identify major themes in the interview transcripts. Results: A total of 106 stakeholders were interviewed. Thematic saturation was achieved. All stakeholders recognized the importance of communication and endorsed efforts to improve communication during cancer care. Patients, clinicians, and leaders expressed concerns about the potential consequences of reports of suboptimal communication experiences, such as damage to the clinician-patient relationship, and the need for effective improvement strategies. Patients and family members would report good communication experiences in order to encourage such practices. Practical and logistic issues were identified. Conclusion: Patient reports of their communication experiences during cancer care could increase understanding of the communication process, stimulate improvements, inform interventions, and provide a basis for evaluating changes in communication practices. This qualitative study provides a foundation for the design and pilot testing of such a patient reporting system. PMID:23943884

Mazor, Kathleen M.; Gaglio, Bridget; Nekhlyudov, Larissa; Alexander, Gwen L.; Stark, Azadeh; Hornbrook, Mark C.; Walsh, Kathleen; Boggs, Jennifer; Lemay, Celeste A.; Firneno, Cassandra; Biggins, Colleen; Blosky, Mary Ann; Arora, Neeraj K.



Patient-centered Communication in Cancer Care Symposium

On May 15-16, 2006, the Outcomes Research Branch (ORB) and the Health Communication and Informatics Research Branch (HCIRB) organized a symposium on Patient-centered Communication (PCC) in Bethesda, MD. Participants included more than 25 researchers and practitioners from federal agencies, private sector healthcare systems, cancer centers, and other academic departments. The expert panel of researchers and practitioners represented various areas of expertise, including oncology, nursing, primary care, health services research, large delivery systems, communication and behavioral sciences, and patient advocacy.


Informational Flyer for the Patient-Centered Communication in Cancer Care monograph



Patient-Healthcare Provider Communication: Perspectives of African American Cancer Patients  

Microsoft Academic Search

Objective: African Americans are often viewed as ineffective communicators during medical encounters. However, most previous studies have been conducted among noncancer populations and based on the perceptions of health care providers (HCP) and researchers. This study aimed to explore African American cancer patients' perspectives of HCPs' communication behaviors and how these communication patterns facilitate or hinder their cancer management and

Lixin Song; Jill B. Hamilton; Angelo D. Moore



Communication: the key to improving the prostate cancer patient experience.  


In 2010, an estimated 24,600 Canadian men were diagnosed with prostate cancer (Canadian Cancer Society, 2011). Upon diagnosis, men and their family members begin an arduous journey of information gathering surrounding prostate cancer and its various forms of treatment. Men have to consider the impact a treatment may potentially have on their quality of life and, frequently, they experience decisional conflict and require support. In May 2008, the Prostate Cancer Assessment Clinic opened to receive men for an evaluation of a possible prostate cancer. Our inter-professional model of care provides support, guidance and education to our patients from assessment to diagnosis and treatment planning. A major goal of our diagnostic assessment unit has been to improve the patient experience. Communication is defined as "to make known, to exchange information or opinions" (Cayne, Lechner, et al., 1988). Nursing is the critical link for information exchange that is patient-centred and collaborative. The focus of this paper will highlight the development and implementation of nurse-led initiatives within our program to improve the prostate cancer patient experience. These initiatives include: a patient information guide, prostate biopsy care, patient resources, community links, surgery education classes and implementation of a decision aid. Communication is the key. PMID:22764588

Waldie, Marian; Smylie, Jennifer



Considering Culture in Physician- Patient Communication During Colorectal Cancer Screening  

PubMed Central

Racial and ethnic disparities exist in both incidence and stage detection of colorectal cancer (CRC). We hypothesized that cultural practices (i.e., communication norms and expectations) influence patients’ and their physicians’ understanding and talk about CRC screening. We examined 44 videotaped observations of clinic visits that included a CRC screening recommendation and transcripts from semistructured interviews that doctors and patients separately completed following the visit. We found that interpersonal relationship themes such as power distance, trust, directness/indirectness, and an ability to listen, as well as personal health beliefs, emerged as affecting patients’ definitions of provider–patient effective communication. In addition, we found that in discordant physician–patient interactions (when each is from a different ethnic group), physicians did not solicit or address cultural barriers to CRC screening and patients did not volunteer culture-related concerns regarding CRC screening. PMID:19363141

Gao, Ge; Burke, Nancy; Somkin, Carol P.; Pasick, Rena



Core communication components along the cancer care process: The perspective of breast cancer patients.  


This study sought to assess the impact of health care professional (HCP) communication on breast cancer patients across the acute care process as perceived by patients. Methodological approach was based on eight focus groups conducted with a sample of patients (n = 37) drawn from 15 Spanish Regions; thematic analysis was undertaken using the National Cancer Institute (NCI) framework of HCP communication as the theoretical basis. Relevant results of this study were the identification of four main communication components: (1) reassurance in coping with uncertainty after symptom detection and prompt access until confirmed diagnosis; (2) fostering involvement before delivering treatments, by anticipating information on practical and emotional illness-related issues; (3) guidance on the different therapeutic options, through use of clinical scenarios; and, (4) eliciting the feeling of emotional exhaustion after ending treatments and addressing the management of potential treatment-related effects. These communication-related components highlighted the need for a comprehensive approach in this area of cancer care. PMID:24980292

Prades, Joan; Ferro, Tàrsila; Gil, Francisco; Borras, Josep M



Communication in Cancer Care (PDQ®)

Expert-reviewed information summary about communicating with the cancer patient and his or her family, including unique aspects of communication with cancer patients, factors affecting communication, and training in communication skills.


The Association of Perceived Provider-Patient Communication and Relationship Quality with Colorectal Cancer Screening  

ERIC Educational Resources Information Center

Background: Two-thirds of adults aged 50 years and older are adherent to recommendations for colorectal cancer screening. Provider-patient communication and characteristics of the patient-provider relationship may relate to screening behavior. Methods: The association of provider communication quality, relationship, and colorectal cancer screening…

Underhill, Meghan L.; Kiviniemi, Marc T.



Hope and Probability: Patient Perspectives of the Meaning of Numerical Information in Cancer Communication  

Microsoft Academic Search

Although the complexities inherent in human communication make it a difficult target for empirical investigation and systematic interpretation, it is well recognized that patient- provider communication can have either a powerfully negative or positive influence on the experience of cancer. Drawing on an extensive data set derived from interviews with 200 cancer patients, the authors examine the impact of information

Sally Thorne; T. Gregory Hislop; Margot Kuo; Elizabeth-Anne Armstrong



Cancer patients’ preferences for communication of unfavourable news: an Asian perspective  

Microsoft Academic Search

It is important to understand cancer patients’ preferences for communication as it impacts on how unfavourable news should be delivered in such a way as not to demoralize the patients while at the same time maintain good doctor–patient relationships. However, few studies have been undertaken in the Asian countries. This study aims to determine the preferences of cancer patients regarding

Li-Qi Chiu; Wei-Shan Delice Lee; Fei Gao; Patricia A. Parker; Gim-Yew Ng; Chee-Keong Toh



Patient-Centered Communication in Cancer Care: Promoting Healing and Reducing Suffering

Effective patient-clinician communication is central to the delivery of high-quality care. It becomes even more crucial in the cancer setting where patients have to deal with stress, uncertainty, complex information, and life-altering medical decisions.


Communication and Cancer  

Microsoft Academic Search

Dealing with cancer involves a number of complex communication issues for patients, health professionals, and family members. This article examines over 200 clinical papers and research studies published between 1966 and 1986 that focus on communication dimensions of the cancer experience. The review analyzes communication issues from three p&spectives: the patient, the health orofessional. and the farnilv. The literature indicates

Peter G. Northouse; Laurel L. Northouse



Patient-Health Care Provider Communication among Patients with Newly Diagnosed Prostate Cancer: Findings from A Population-based Survey  

PubMed Central

Objective To examine the multidimensional concept of patient-health care provider (HCP) communication, its effects on patient satisfaction with oncology care services, and related racial differences. Methods The current analysis draws from a population-based survey sample of 1011 African American and 1034 Caucasian American men with newly diagnosed prostate cancer. The variables of satisfaction with health care services, interpersonal treatment, contextual knowledge of the patient, and prostate cancer communication were analyzed using multiple-group structural equation modeling. Results Regardless of race, patient-HCP communication was related positively to interpersonal treatment by the HCP, HCP’s contextual knowledge of the patient, and prostate cancer communication. More positive patient-HCP communication was related to more satisfaction with health care services. Racial differences were significant in the relationships between patient- HCP communication and prostate cancer communication. Conclusion Content and interpersonal relationships are important aspects of patient-HCP communication and affect patient satisfaction with oncologic care for prostate cancer. Practice Implications: HCPs need to integrate the transfer of information with emotional support and interpersonal connection when they communicate with men with newly diagnosed prostate cancer. PMID:23332967

Song, Lixin; Bensen, Jeannette T.; Zimmer, Catherine; Sleath, Betsy; Blackard, Bonny; Fontham, Elizabeth; Su, L. Joseph; Brennan, Christine S.; Mohler, James L.; Mishel, Merle



Provider Communication and Patient Accrual to Clinical Trials Lecture |

Terrance Albrecht, MD, of the Barbara Ann Karmanos Cancer Institute in Detroit, Michigan, discusses how communication occurring among physicians, patients, and family companions influences whether or not patients decide to participate in a clinical trial. Dr. Albrecht presents the results of her communications research and translates the findings into practical application in the clinic setting.


Clinician-patient communication: evidence-based recommendations to guide practice in cancer  

PubMed Central

Goals of Work To develop recommendations for effective communication between cancer health care providers and patients based on a systematic review of methods of clinician–patient communication that may affect patient outcomes associated with distress at critical points in the course of cancer care. Materials and Methods A systematic review of the literature was conducted, and evidence-based recommendations were formulated to guide clinician–patient communication in cancer care. A formal external review was conducted to validate the relevance of these recommendations. Main Results Recommendations for communication in cancer care are presented, based on guidelines from the Australian National Breast Cancer Centre and the Australian National Cancer Control Initiative,an updated systematic review of the research evidence, anda consensus by the Clinician–Patient Communications Working Panel of the Program in Evidence-Based Care of Cancer Care Ontario. The recommendations were sent to 110 Ontario practitioners for external review: 33 responded (30% response rate). Most of these respondents (87%) agreed with the draft recommendations and approved of their use as a practice guideline (90%). A condensed version of the recommendations, including 10 key points, was also created. Conclusions There is evidence to support general clinician–patient communication approaches, although the preferences of cancer patients regarding such communication exhibit individual and cultural variability. Recommendations are provided, based on evidence, the consensus of an expert panel, and feedback from a survey of external practitioners. Evidence evaluating the role of decision aids and strategies to facilitate better communication is inconsistent, although such tools may be of value for some patients. PMID:20016745

Rodin, G.; Zimmermann, C.; Mayer, C.; Howell, D.; Katz, M.; Sussman, J.; Mackay, J.A.; Brouwers, M.



December 2009 Special Issue on Patient-Centered Cancer Communication Research

A December 2009 special issue of Patient Education and Counseling highlighted empirical studies from across the world that inform researchers, clinicians, and policy makers about the salience of patient-clinician communication at different phases of the cancer control continuum, from prevention to end-of-life care. The papers highlight the multidisciplinary nature of cancer communication research. A variety of study designs and analytical strategies are employed. Neeraj K.


Breast cancer patients’ experiences of patient–doctor communication: a working relationship  

Microsoft Academic Search

The traumas of diagnosis and treatment for breast cancer are well researched and generally addressed in care. While women with breast cancer continue to identify the need for better communication with physicians, studies to date have not investigated how the process of communication between physicians and women with breast cancer actually unfolds. This phenomenological study therefore explored how women with

Carol L. McWilliam; Judith Belle Brown; Moira Stewart



Mediating processes of two communication interventions for breast cancer patients  

PubMed Central

Objective Test whether three mediating processes of Self-Determination Theory are involved in intervention effects on quality of life for breast cancer patients. Methods A randomized clinical trial recruited newly diagnosed breast cancer patients for 6 months of (1) Internet training and access, (2) access to an integrated eHealth system for breast cancer (CHESS), (3) a series of phone conversations with a Human Cancer Information Mentor, or (4) both (2) and (3). Results This paper reports results after the initial 6 weeks of intervention, at which point patients in the combined condition had higher quality of life scores than those in the other three conditions. All three Self-Determination Theory constructs (autonomy, competence, and relatedness) mediated that effect as hypothesized. In addition, the single-intervention groups were superior to the Internet-only group on relatedness, though perhaps this was too soon for that to carry through to quality of life as well. Conclusions The SDT constructs do mediate these interventions’ effects. Practice implications Intervention design can profitably focus on enhancing autonomy, competence and relatedness. PMID:21081261

Hawkins, Robert P.; Pingree, Suzanne; Shaw, Bret; Serlin, Ronald C.; Swoboda, Chris; Han, Jeong-Yeob; Carmack, Cindy L.; Salner, Andrew



Communication with terminal cancer patients in palliative care: are there differences between nurses and physicians?  

Microsoft Academic Search

The aim of this study was to find whether there were interprofessional differences in specific elements of communication with terminal cancer patients and decision-making processes that concern such patients. Given that interdisciplinary team work is one of the basic values in palliative care, if there are conflicting views between professions on such important issues it is most important to know

A. Levorato; F. Stiefel; C. Mazzocato; E. Bruera



The cultural dimensions of online communication: a study of breast cancer patients' internet spaces  

Microsoft Academic Search

Many have studied the interrelations between online spaces and offline contexts, highlighting that internet spaces are fundamentally embedded within specific social, cultural and material contexts. Drawing upon a study of breast cancer patients' computer-mediated communication (CMC), this article aims to contribute to our understanding of the role of cultural elements in shaping the participation in and design of, CMC environments.




Shame, guilt, and communication in lung cancer patients and their partners.  


Lung cancer patients report the highest distress levels of all cancer groups. In addition to poor prognosis, the self-blame and stigma associated with smoking might partially account for that distress and prevent patients from requesting help and communicating with their partners. The present study used innovative methods to investigate potential links of shame and guilt in lung cancer recovery with distress and marital adjustment. A specific emphasis was an examination of the impact of shame on partner communication. Lung cancer patients (n = 8) and their partners (n = 8) completed questionnaires and interviews that were videotaped. We report descriptive statistics and Spearman correlations between shame and guilt, relationship talk, marital satisfaction, distress, and smoking status. We coded the interviews for nonverbal expressions of shame. Greater self-reported shame was associated with decreased relationship-talk frequency and marital satisfaction, and with increased depression and smoking behaviour. Nonverbal shame behaviour also correlated with higher depression and increased smoking behaviour. Guilt results were more mixed. More recent smoking behaviour also correlated with higher depression. At a time when lung cancer patients often do not request help for distress, possibly because of shame, our preliminary study suggests that shame can also disrupt important partner relationships and might prevent patients from disclosing to physicians their need for psychosocial intervention and might increase their social isolation. Even if patients cannot verbally disclose their distress, nonverbal cues could potentially give clinicians an opportunity to intervene. PMID:25302043

Dirkse, D; Lamont, L; Li, Y; Simoni?, A; Bebb, G; Giese-Davis, J



Shame, guilt, and communication in lung cancer patients and their partners  

PubMed Central

Lung cancer patients report the highest distress levels of all cancer groups. In addition to poor prognosis, the self-blame and stigma associated with smoking might partially account for that distress and prevent patients from requesting help and communicating with their partners. The present study used innovative methods to investigate potential links of shame and guilt in lung cancer recovery with distress and marital adjustment. A specific emphasis was an examination of the impact of shame on partner communication. Lung cancer patients (n = 8) and their partners (n = 8) completed questionnaires and interviews that were videotaped. We report descriptive statistics and Spearman correlations between shame and guilt, relationship talk, marital satisfaction, distress, and smoking status. We coded the interviews for nonverbal expressions of shame. Greater self-reported shame was associated with decreased relationship-talk frequency and marital satisfaction, and with increased depression and smoking behaviour. Nonverbal shame behaviour also correlated with higher depression and increased smoking behaviour. Guilt results were more mixed. More recent smoking behaviour also correlated with higher depression. At a time when lung cancer patients often do not request help for distress, possibly because of shame, our preliminary study suggests that shame can also disrupt important partner relationships and might prevent patients from disclosing to physicians their need for psychosocial intervention and might increase their social isolation. Even if patients cannot verbally disclose their distress, nonverbal cues could potentially give clinicians an opportunity to intervene. PMID:25302043

Dirkse, D.; Lamont, L.; Li, Y.; Simonic, A.; Bebb, G.; Giese-Davis, J.



Effects of an intervention aimed at improving nurse-patient communication in an oncology outpatient clinic. |

This study evaluated a 2-day communication skills training program in nursing care through surveys with nurses and patients before and after the training. The training had no effect on patient perception of nurse empathy and attentiveness, patients’ moods, or cancer-related self-efficacy. The training also did not significantly affect nurses on measures related to communication and work-related stress.


Advancing Research Methodology for Measuring & Monitoring Patient-centered Communication in Cancer Care

A critical step in facilitating the delivery of patient-centered communication (PCC) as part of routine cancer care delivery is creating a measurement and monitoring system that will allow for the ongoing assessment, tracking, and improvement of these six functions of patient-centered communication. To build the foundation of such a system and to advance research methodology in this area, the ORB has collaborated with the Agency for Healthcare Research and Quality (AHRQ) on a research project conducted within AHRQ's DEcIDE network.


Open Communication Between Caregivers and Terminally Ill Cancer Patients: The Role of Caregivers' Characteristics and Situational Variables  

Microsoft Academic Search

This study assesses caregivers' perceived level of open communication about illness and death with their terminally ill relatives and examines the contribution of caregivers' characteristics and situational variables to the explanation of open communication. A total of 236 primary caregivers of terminal cancer patients participated in the study. Level of open communication was measured by 6 items clustered into 1

Yaacov G. Bachner; Sara Carmel



The cancer patient's use and appreciation of the internet and other modern means of communication.  


As computers and smartphones continue to transform the doctor-patient relationship, it is essential that healthcare professionals understand how their patients wish to interact with these devices. The results from a satisfaction questionnaire of 225 Oncology patients treated in 2011 in Quebec, Canada provide insight into the manner in which patients have been and wish to communicate with their healthcare teams. The survey also addressed whether or not patients searched the Internet for supplementary information regarding their condition. Generally, patients were neutral regarding adopting greater usage of modern means of communication. The majority of patients did not want to be contacted via e-mail or SMS, nor did the patients want to make appointments or fill out surveys online. Forty four percent of patients used the Internet to learn more about their condition. Concerning the patients who were not provided with links to medically relevant websites, 44% wished their doctors had supplied them with such links. Though there was much overlap between the 44% of patients who went on the Internet to learn more about their condition and the 44% of the patients who wished their physicians provided them with such links, 14% of all the patients wished their medical teams had provided them with links, but did not independently search for medically relevant information about their condition. Using chi-square testing education level was found to be the best predictor of which patients searched the web for supplementary information about their conditions (p = 0.003). Contrary to findings in other studies, a comparable proportion of patients in each age-group used the Internet to research their condition. Given the wealth of web-resources available to cancer patients, it would be beneficial for both healthcare teams and their patients if physicians consistently offered a list of trustworthy websites to their patients. PMID:24000994

Katz, J E; Roberge, D; Coulombe, G



Identifying barriers and improving communication between cancer service providers and Aboriginal patients and their families: the perspective of service providers  

PubMed Central

Background Aboriginal Australians experience poorer outcomes from cancer compared to the non-Aboriginal population. Some progress has been made in understanding Aboriginal Australians’ perspectives about cancer and their experiences with cancer services. However, little is known of cancer service providers’ (CSPs) thoughts and perceptions regarding Aboriginal patients and their experiences providing optimal cancer care to Aboriginal people. Communication between Aboriginal patients and non-Aboriginal health service providers has been identified as an impediment to good Aboriginal health outcomes. This paper reports on CSPs’ views about the factors impairing communication and offers practical strategies for promoting effective communication with Aboriginal patients in Western Australia (WA). Methods A qualitative study involving in-depth interviews with 62 Aboriginal and non-Aboriginal CSPs from across WA was conducted between March 2006 - September 2007 and April-October 2011. CSPs were asked to share their experiences with Aboriginal patients and families experiencing cancer. Thematic analysis was carried out. Our analysis was primarily underpinned by the socio-ecological model, but concepts of Whiteness and privilege, and cultural security also guided our analysis. Results CSPs’ lack of knowledge about the needs of Aboriginal people with cancer and Aboriginal patients’ limited understanding of the Western medical system were identified as the two major impediments to communication. For effective patient–provider communication, attention is needed to language, communication style, knowledge and use of medical terminology and cross-cultural differences in the concept of time. Aboriginal marginalization within mainstream society and Aboriginal people’s distrust of the health system were also key issues impacting on communication. Potential solutions to effective Aboriginal patient-provider communication included recruiting more Aboriginal staff, providing appropriate cultural training for CSPs, cancer education for Aboriginal stakeholders, continuity of care, avoiding use of medical jargon, accommodating patients’ psychosocial and logistical needs, and in-service coordination. Conclusion Individual CSPs identified challenges in cross-cultural communication and their willingness to accommodate culture-specific needs within the wider health care system including better communication with Aboriginal patients. However, participants’ comments indicated a lack of concerted effort at the system level to address Aboriginal disadvantage in cancer outcomes. PMID:24188503



Patient-centered Communication Research

Several recent reports, including NCI's Strategic Plan for Leading the Nation and the NCI-designated cancer center directors' report Accelerating Successes Against Cancer, have recognized the salience of patient-clinician communication in optimizing cancer patients' and survivors' health outcomes.


Do patients use decision and communication aids as prompted when meeting with breast cancer specialists?  


BACKGROUND: Our breast cancer clinic promotes patient use of decision and communication aids (DAs/CAs) through two mechanisms: coaching and prompting. From January through September 2010, we provided services to 462 of 1106 new visitors (42%). Of those 462 visitors, 267 (58%) received coaching. For the remainder (195 or 42%), the best we could do was prompt them to self-administer the DA and CAs. OBJECTIVE: We wanted to learn whether patients prompted to use DAs/CAs did so. METHODS: We surveyed prompted patients after their visits. We asked how much of each DA they reviewed, whether they listed questions, made notes and audio-recorded their consultations. We tallied frequencies and explored associations using logistic regression. RESULTS: Of the 195 prompted patients, 82 responded to surveys (42%). Nearly all (66/73 or 90%) reported reviewing some or all of the booklets and 52/73 (71%) reported viewing some or all of the DVDs. While 63/78 (81%) responded that they wrote a question list, only 14/61 (23%) said they showed it to their doctor. Two-thirds (51/77 or 66%) said someone took notes, but only 16/79 (20%) reported making audio recordings. DISCUSSION: More patients reported following prompts to use DAs than CAs. Few reported showing question lists to physicians or recording their visits. Our exploratory analyses surfaced associations between using CAs and race/ethnicity or education that merit further investigation. CONCLUSION: Prompting patients assures better use of decision than communication aids. Clinicians may need to take a more active role to ensure patients receive adequate notes and recordings. PMID:23294338

Volz, Shelley; Moore, Dan H; Belkora, Jeffrey K



Preferences of Cancer Patients Regarding Communication of Bad News: A Systematic Literature Review  

Microsoft Academic Search

Most physicians regard the communication of bad news to be a difficult issue in clinical oncology practice. The optimal manner of communicating bad news to patients so that physicians can create maximal understanding in patients and facilitate their psychological adjustment is unknown. A systematic review of the literature was conducted to clarify avail- able knowledge on patient preferences regarding the

Maiko Fujimori; Yosuke Uchitomi



“What am I Going to Say Here?” The Experiences of Doctors and Nurses Communicating with Patients in a Cancer Unit  

PubMed Central

This paper describes a study investigating the provider–patient communication perceptions, experiences, needs, and strategies of doctors and nurses working together in a UK cancer setting. This was a qualitative study using individual interviews and focus group discussions. Interpretative phenomenological analysis was used to underpin data collection and analysis. Twenty-six staff participated in the project (18 nurses and 8 doctors). Both professional groups identified an inherent emotional strain in their daily interactions with patients. The strategies they adopted to reduce this strain fell into two main categories: (1) Handling or managing the patient to keep negative emotion at bay; and (2) Managing self to keep negative emotion at bay. These strategies allowed staff to maintain a sense of control in an emotionally stressful environment. Most believed that their communication skills were sufficient. In conclusion, communicating with and caring for cancer patients causes considerable psychosocial burden for doctors and nurses. Managing this burden influences their communication with patients. Without recognition of the need for staff to protect their own emotional well-being, communication skills training programs, emphasized in current UK cancer care guidelines, may have little impact on practice. PMID:22144970

McLean, Margaret; Cleland, Jennifer A.; Worrell, Marcia; Vögele, Claus



Beyond Good Intentions and Patient Perceptions: Competing Definitions of Effective Communication in Head and Neck Cancer Care at the End of Life  

Microsoft Academic Search

Effective communication between dying cancer patients and their health care providers about prognosis and treatment options ensures informed decision making at the end of life. This study analyzed data from interviews with end-stage head and neck cancer patients and their health care providers about communication competence and approaches to communicating about end-of-life issues. Patients rated their oncologists as competent and

Lori A. Roscoe; Jillian A. Tullis; Richard R. Reich; Judith Czaja McCaffrey



Differences in Individual Approaches: Communication in the Familial Breast Cancer Consultation and the Effect on Patient Outcomes  

Microsoft Academic Search

This multicenter study aimed to assess (i) whether individual clinical geneticists and genetic counselors vary in their communication skills and (ii) whether this variation in communication impacts on patient outcomes, such as anxiety, depression, genetics knowledge, and satisfaction. One hundred and fifty women from high-risk breast cancer families attending their first genetic counseling consultation completed pre and post-consultation self-report questionnaires.

Elizabeth A. Lobb; Phyllis Butow; Alexandra Barratt; Bettina Meiser; Katherine Tucker



Patients' views on follow up of colorectal cancer: implications for risk communication and decision making  

PubMed Central

Background: Medical views about the clinical value and potential detrimental effect on quality of life of postoperative follow up are divided. There is no literature on the views of British patients with colorectal cancer towards the follow up process. Aim: To investigate patients' views and experiences of follow up of colorectal cancer, and to assess their attitudes towards suggested changes to follow up policy. Patients and methods: A total of 156 asymptomatic and disease-free patients with colorectal cancer were identified from the follow up clinic. Recurrence-free status was confirmed through retrieval of computerised clinic letters. A postal survey using a 39 item piloted questionnaire was undertaken. Data analysis generated descriptive statistics and logistic regression models. Results: A response rate of 61% (95) was obtained. Among these respondents, 63% (60) had undergone initial surgery within three years of the time of the survey, and 86% (82) patients expected a further follow up appointment. Majorities of the sample, ranging from 71% (67) to 96% (91), expressed satisfaction with respect to clinic delays, staff conduct and knowledge about their case, consultation time, and being able to discuss personal problems freely. However some patients reported difficulty in discussing sexual problems at the clinic. Appointment imminence caused anxiety, sleep problems, and decreased appetite in 35% (35), 27% (26), and 8 % (8) of patients respectively. However, 78% (74) patients felt reassured and optimistic for the future after receiving results. Such optimism is not necessarily justified in terms of estimated mortality risks. A majority (78%, 66) stated that they would value finding out about the presence of recurrence even if there would be no survival benefit. Nearly half of the sample (48%, 43) felt that they would disagree with the cessation of follow up in any circumstances. Only 47% (42) and 27% (24) indicated that they would accept follow up by a specialist nurse or their general practitioner, respectively. Attitude to follow up was unrelated to reported anxiety before appointments. Only 22% (19) of the sample could identify risk indicators for recurrence, but 64% (61) agreed that they would like to be told what to look for. Discussion: A sample of patients with colorectal cancer expressed a high degree of satisfaction with hospital follow up. Although a substantial minority reported suffering from pre-visit anxiety, most felt that this disadvantage was compensated for by reassuring results, and believed that investigations did not have a significant negative impact on their quality of life. Respondents valued hospital follow up, and half would reject complete discharge or alternative forms of follow up. These findings demonstrate that patients have a different perception of the risk of recurrence than clinicians who would consider the survival prospects for most patients to be more or less unaffected by follow up interventions. Attempted modifications to follow up policies should be introduced with caution, and should take account of patient understanding of medical reasoning. The findings also raise questions about risk communication with patients. PMID:12897220

Papagrigoriadis, S; Heyman, B



Communication with Breast Cancer Survivors  

Microsoft Academic Search

Breast cancer survivors must manage chronic side effects of original treatment. To manage these symptoms, communication must include both biomedical and contextual lifestyle factors. Sixty breast cancer survivors and 6 providers were recruited to test a conceptual model developed from uncertainty in illness theory and the dimensions of a patient-centered relationship. Visits were audio-taped, then coded using the Measure of

Margaret F. Clayton; William N. Dudley; Adrian Musters



A Short Communication Course for Physicians Improves the Quality of Patient Information in a Clinical Trial |

This article addresses the question of how to improve the informed consent process. The investigators tested a one-day communications course for physicians and research nurses that included lecture and role-play approaches for its ability to improve the quality of informed consent and the satisfaction of patients who enrolled in a randomized clinical trial of adjuvant treatment for breast cancer.


How Does an Online Patient-Nurse Communication Service Meet the Information Needs of Men with Recently Diagnosed Testicular Cancer?  

PubMed Central

Online communication has become a potential means of communication between patients and health care providers, but so far few studies are published about online communication as part of nursing care. The aim of this study was to explore how an online patient-nurse communication (OPNC) service meets the information needs of men with newly diagnosed testicular cancer. We applied a qualitative approach by examining the content of online messages sent by patients to nurses in a specialist cancer unit. In addition, individual interviews were conducted with patients who had used the OPNC service. Four themes became distinct through a synthesis of the material from the interviews and the messages: “a means for managing illness-related concerns at home,” “a means for ensuring information flow,” “a means for strategic information seeking,” and “not yet available when needed most.” Individualized information provided by nurses with access to their medical record was shown to be important to these patients. The findings of this study indicate that not only may access to an OPNC service help patients fulfill their otherwise unmet information needs, but also it may prevent delays and discontinuity in care due to informational gaps and lead to improved patient safety. PMID:23251816

Wibe, Torunn; Helles?, Ragnhild; Varsi, Cecilie; Ruland, Cornelia; Ekstedt, Mirjam



Cancer Centers Program - Recent Communications

 Cancer Centers Program - Recent Communications Home > News & Events > Recent Communications Recent Communications Participation in Trials of Rare Cancers NCI-designated Cancer Centers play a key national role in developing new therapies


Web-based cancer communication and decision making systems: connecting patients, caregivers, and clinicians for improved health outcomes.  


Over the cancer disease trajectory, from diagnosis and treatment to remission or end of life, patients and their families face difficult decisions. The provision of information and support when most relevant can optimize cancer decision making and coping. An interactive health communication system (IHCS) offers the potential to bridge the communication gaps that occur among patients, family, and clinicians and to empower each to actively engage in cancer care and shared decision making. This is a report of the authors' experience (with a discussion of relevant literature) in developing and testing a Web-based IHCS-the Comprehensive Health Enhancement Support System (CHESS)-for patients with advanced lung cancer and their family caregivers. CHESS provides information, communication, and coaching resources as well as a symptom tracking system that reports health status to the clinical team. Development of an IHCS includes a needs assessment of the target audience and applied theory informed by continued stakeholder involvement in early testing. Critical issues of IHCS implementation include 1) need for interventions that accommodate a variety of format preferences and technology comfort ranges; 2) IHCS user training, 3) clinician investment in IHCS promotion, and 4) IHCS integration with existing medical systems. In creating such comprehensive systems, development strategies need to be grounded in population needs with appropriate use of technology that serves the target users, including the patient/family, clinical team, and health care organization. Implementation strategies should address timing, personnel, and environmental factors to facilitate continued use and benefit from IHCS. PMID:21041539

DuBenske, Lori L; Gustafson, David H; Shaw, Bret R; Cleary, James F



Patient-physician communication concerning participation in cancer chemotherapy trials. |

Physicians seem to underestimate patients’ desire for information and their ability to understand it. Patients perceived obtaining as much information as possible about the trial as an asset rather than a burden. Providing detailed and comprehensive treatment information helps patients make decisions about participating in clinical trials.


Breast cancer: communication with a breast cancer patient and a relative  

Microsoft Academic Search

relatives are predominantly spouses, followed indeterminately by children, parents or siblings (12, 15, 16). Results of previous studies indicate that relatives are often present in 'difficult' situations or when patients are 'vulnerable' (12, 15, 16). Relatives are more likely to be present when the patient is older and has a poorer performance status. Relatives are also more likely to be

I. Merckaert; Y. Libert; N. Delvaux; D. Razavi



Can the caregiver replace his\\/her elderly cancer patient in the physician–patient line of communication?  

Microsoft Academic Search

Goals of works  Only few studies have focussed on the information needs of senior cancer patients. The aim of this study was to evaluate to\\u000a what extent caregivers perceive their elderly cancer patients’ informational needs.\\u000a \\u000a \\u000a \\u000a Materials and methods  Between June 2004 and February 2005, at the National Cancer Institute of Aviano (northern Italy), we asked 112 elderly cancer\\u000a patients naïve for treatments

Annalisa Giacalone; Renato Talamini; Michele Spina; Lucia Fratino; Simon Spazzapan; Umberto Tirelli



Adherence to adjuvant hormone therapy in low-income women with breast cancer: the role of provider-patient communication.  


To assess the impact of patient-provider communication on adherence to tamoxifen (TAM) and aromatase inhibitors (AIs) 36 months after breast cancer (BC) diagnosis in a low-income population of women. California statewide surveys were conducted among 921 low-income women with BC at 6, 18, and 36 months after BC diagnosis. A subset of 303 women with stage I-III BC who initiated hormone treatment after diagnosis was identified. Bivariate and multivariate logistic regression analyses were performed, and adjusted adherence rates were calculated. The main outcome measure was self-reported hormone use at 36 months after BC diagnosis and the chief independent variables were patient-centered communication after diagnosis by patient report as measured by the Consumer Assessment of Healthcare Providers and Systems (CAHPS) and patients' self-efficacy in patient-physician interactions (PEPPI). Overall adherence to TAM/AI was relatively high (88 %). Adjusted rates of adherence were 59 and 94 % for patients with the lowest versus highest scores on the CAHPS communication scale (AOR = 1.22, P = 0.006) and 72 versus 91 % for patients with the lowest and highest rating of PEPPI (AOR = 1.04, P = 0.04). Having at least one comorbid condition also increased the odds of adherence to hormonal therapy (AOR = 3.14, P = 0.03). Having no health insurance and experiencing side-effects from hormone treatment were barriers for adherence (AOR = 0.12, P = 0.001; AOR = 0.26, P = 0.003, respectively). Patient-centered communication and perceived self-efficacy in patient-physician interaction were significantly associated with patient adherence to ongoing TAM/AI therapy among low-income women with BC. Interventions on patient-provider communication may provide opportunities to improve patient outcomes in this vulnerable population. PMID:23263740

Liu, Yihang; Malin, Jennifer L; Diamant, Allison L; Thind, Amardeep; Maly, Rose C



Physician Communication Regarding Prostate Cancer Screening: Analysis of Unannounced Standardized Patient Visits  

PubMed Central

PURPOSE Prostate cancer screening with prostate-specific antigen (PSA) is a controversial issue. The present study aimed to explore physician behaviors during an unannounced standardized patient encounter that was part of a randomized controlled trial to educate physicians using a prostate cancer screening, interactive, Web-based module. METHODS Participants included 118 internal medicine and family medicine physicians from 5 health systems in California, in 2007–2008. Control physicians received usual education about prostate cancer screening (brochures from the Center for Disease Control and Prevention). Intervention physicians participated in the prostate cancer screening module. Within 3 months, all physicians saw unannounced standardized patients who prompted prostate cancer screening discussions in clinic. The encounter was audio-recorded, and the recordings were transcribed. Authors analyzed physician behaviors around screening: (1) engagement after prompting, (2) degree of shared decision making, and (3) final recommendations for prostate cancer screening. RESULTS After prompting, 90% of physicians discussed prostate cancer screening. In comparison with control physicians, intervention physicians showed somewhat more shared decision making behaviors (intervention 14 items vs control 11 items, P <.05), were more likely to mention no screening as an option (intervention 63% vs control 26%, P <.05), to encourage patients to consider different screening options (intervention 62% vs control 39%, P <.05) and seeking input from others (intervention 25% vs control 7%, P<.05). CONCLUSIONS A brief Web-based interactive educational intervention can improve shared decision making, neutrality in recommendation, and reduce PSA test ordering. Engaging patients in discussion of the uses and limitations of tests with uncertain value can decrease utilization of the tests. PMID:23835817

Feng, Bo; Srinivasan, Malathi; Hoffman, Jerome R.; Rainwater, Julie A.; Griffin, Erin; Dragojevic, Marko; Day, Frank C.; Wilkes, Michael S.



Communicating about Cancer Pain

Patients with cancer may be reluctant to discuss their pain with their doctors for a variety of reasons. NCI sponsors research that examines the barriers that prevent patients from talking about pain.


Family caregiver engagement in a coping and communication support intervention tailored to advanced cancer patients and families.  


We describe family caregiver (FCG) participation in a tailored coping and communication support intervention for advanced cancer patients and families. Preliminary descriptive data on characteristics and patterns of early engagement in the intervention for 132 FCGs are presented. Engagement assessed at an initial in-person meeting and the following 6 weeks includes problems raised, strategies used, and initiation, frequency, and mode of contact. A sizable proportion of FCGs were male, African American, and nonspouse. The FCGs had modest scores on a standard survey measure of burden yet volunteered caregiving demands as their primary problem. Other problems raised initially by more than 40% of the sample included psychological, practical, and communication with healthcare providers. Few reported physical and psychosocial difficulties. Engagement preferences expressed at the initial meeting largely mapped with actual engagement during the 6 weeks of intervention. Most FCGs were actively engaged during follow-up. Some (14%) did not opt for coping and communication support during this early treatment phase. This intervention is expected to affect quality of care and quality-of-life outcomes for FCGs over time from patient diagnosis to end of life. Findings will guide modification and dissemination of this intervention primarily in cancer clinics for the underserved. PMID:19104204

Bowman, Karen F; Rose, Julia H; Radziewicz, Rosanne M; O'Toole, Elizabeth E; Berila, Rose A



Educational Counseling in Improving Communication and Quality of Life in Spouses and Breast Cancer Patients

Anxiety Disorder; Depression; Ductal Breast Carcinoma in Situ; Lobular Breast Carcinoma in Situ; Psychosocial Effects of Cancer and Its Treatment; Stage IA Breast Cancer; Stage IB Breast Cancer; Stage II Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer



Perceptions of Patient-Provider Communication in Breast and Cervical Cancer-Related Care: A Qualitative Study of Low-Income English- and Spanish-Speaking Women  

PubMed Central

To explore patient perceptions of patient-provider communication in breast and cervical cancer-related care among low-income English- and Spanish- speaking women, we examined communication barriers and facilitators reported by patients receiving care at safety net clinics. Participants were interviewed in English or Spanish after receiving an abnormal breast or cervical cancer screening test or cancer diagnosis. Following an inductive approach, interviews were coded and analyzed by the language spoken with providers and patient-provider language concordance status. Of 78 participants, 53% (n = 41) were English-speakers and 47% (n = 37) were Spanish-speakers. All English-speakers were language-concordant with providers. Of Spanish-speakers, 27% (n = 10) were Spanish-concordant; 38% (n = 14) were Spanish-discordant, requiring an interpreter; and 35% (n = 13) were Spanish mixed-concordant, experiencing both types of communication throughout the care continuum. English-speakers focused on communication barriers, and difficulty understanding jargon arose as a theme. Spanish-speakers emphasized communication facilitators related to Spanish language use. Themes among all Spanish-speaking sub-groups included appreciation for language support resources and preference for Spanish-speaking providers. Mixed-concordant participants accounted for the majority of Spanish-speakers who reported communication barriers. Our data suggest that, although perception of patient-provider communication may depend on the language spoken throughout the care continuum, jargon is lost when health information is communicated in Spanish. Further, the respective consistency of language concordance or interpretation may play a role in patient perception of patient-provider communication. PMID:23553683

Simon, Melissa A.; Ragas, Daiva M.; Nonzee, Narissa J.; Phisuthikul, Ava M.; Luu, Thanh Ha; Dong, XinQi



Promoting Chinese-speaking primary care physicians' communication with immigrant patients about colorectal cancer screening: a cluster randomized trial design.  


Chinese Americans underutilize colorectal cancer screening. This study evaluated a physician-based intervention guided by social cognitive theory (SCT) to inform future research involving minority physicians and patients. Twenty-five Chinese-speaking primary care physicians were randomized into intervention or usual care arms. The intervention included two 45-minute in-office training sessions paired with a dual-language communication guide detailing strategies in addressing Chinese patients' screening barriers. Physicians' feedback on the intervention, their performance data during training, and pre-post intervention survey data were collected and analyzed. Most physicians (~85%) liked the intervention materials but ~84% spent less than 20 minutes reading the guide and only 46% found the length of time for in-office training acceptable. Despite this, the intervention increased physicians' perceived communication self-efficacy with patients (p<.01). This study demonstrated the feasibility of enrolling and intervening with minority physicians. Time constraints in primary care practice should be considered in the design and implementation of interventions. PMID:25130226

Wang, Judy Huei-yu; Liang, Wenchi; Ma, Grace X; Gehan, Edmund; Wang, Haoying Echo; Ji, Cheng-Shuang; Tu, Shin-Ping; Vernon, Sally W; Mandelblatt, Jeanne S



Interviewing patients using interpreters in an oncology setting: initial evaluation of a communication skills module |

The authors developed a communication skills training module for health professionals who work with professional translators in interviewing patients. The module combines didactic presentation of information and group role-play exercises in which trained medical interpreters help trainees communicate with bilingual patients. The module stresses communication strategies, including optimal seating arrangements that strengthen the clinician-patient relationship and de-emphasize interpreter-patient and interpreter-clinician interactions.


Communication and Patient Safety  

Microsoft Academic Search

Faulty communication is among the most common underlying causes of medical error and frequently erodes the doctor-patient\\u000a relationship. Communication should be understood in the broadest sense, including nonverbal, oral, and written. This chapter\\u000a reviews the most common mechanisms responsible for communication failures and recommends specific routines to minimize or\\u000a avoid them altogether.

Mark Gorney


Testing a Mediational Model of Communication Among Medical Staff and Families of Cancer Patients  

ERIC Educational Resources Information Center

Three structural equation models of communication between family members and medical staff were examined to understand relations among staff accessibility, inhibitory family attitudes, getting communication needs met, perceived stress, and satisfaction with communication. Compared to full and direct models, a mediational model fit best in which…

Gionta, Dana A.; Harlow, Lisa L.; Loitman, Jane E.; Leeman, Joanne M.



Teaching communication and stress management skills to junior physicians dealing with cancer patients: a Belgian Interuniversity Curriculum  

Microsoft Academic Search

Background  Ineffective physicians’ communication skills have detrimental consequences for patients and their relatives, such as insufficient detection of psychological disturbances, dissatisfaction with care, poor compliance, and increased risks of litigation for malpractice. These ineffective communication skills also contribute to everyday stress, lack of job satisfaction, and burnout among physicians. Literature shows that communication skills training programs may significantly improve physicians’ key

Isabelle Bragard; Darius Razavi; Serge Marchal; Isabelle Merckaert; Nicole Delvaux; Yves Libert; Christine Reynaert; Jacques Boniver; Jean Klastersky; Pierre Scalliet; Anne-Marie Etienne



Communicating with Cancer Patients: What Areas do Physician Assistants Find Most Challenging?  

Microsoft Academic Search

Physician assistants (PAs) and other midlevel practitioners have been taking on increasing clinical roles in oncology settings.\\u000a Little is known about the communication needs and skills of oncology PAs. PAs working in oncology (n?=?301) completed an online survey that included questions about their perceived skill and difficulty on several key communication\\u000a tasks. Overall, PAs rated these communication tasks as “somewhat”

Patricia A. Parker; Alicia C. Ross; Maura N. Polansky; J. Lynn Palmer; M. Alma Rodriguez; Walter F. Baile



List of Participants in the Patient-centered Communication in Cancer Care Symposium

Skip to Main Content at the National Institutes of Health | Print Page E-mail Page Search: Please wait while this form is being loaded.... Home Browse by Resource Type Browse by Area of Research Research Networks Funding Information About


Increasing Pain Related Communication Skills to Improve Pain Management in Metastatic Breast Cancer Patients.  

National Technical Information Service (NTIS)

The goal of this study is to improve the management of pain related to metastatic breast cancer (MBC) through psycho-social intervention. Although clinical guidelines for the treatment of MBC pain have been issued, under- treatment of pain remains a probl...

K. DuHamel



Fear of Death, Mortality Communication, and Psychological Distress Among Secular and Religiously Observant Family Caregivers of Terminal Cancer Patients  

Microsoft Academic Search

Previous research suggests that caregivers and terminally ill patients face substantial difficulties discussing illness and death. Existing research, however, has focused primarily on the experience of patients. The current study compared responses as well as the relative strength of association between mortality communication, fear of death, and psychological distress (i.e., depressive symptomatology, emotional exhaustion) among secular and religiously observant family

Yaacov G. Bachner; Norm ORourke; Sara Carmel



Fear of Death, Mortality Communication, and Psychological Distress among Secular and Religiously Observant Family Caregivers of Terminal Cancer Patients  

ERIC Educational Resources Information Center

Previous research suggests that caregivers and terminally ill patients face substantial difficulties discussing illness and death. Existing research, however, has focused primarily on the experience of patients. The current study compared responses as well as the relative strength of association between mortality communication, fear of death, and…

Bachner, Yaacov G.; O'Rourke, Norm; Carmel, Sara



NCI Community Cancer Centers Program - Pilot Subcommittees - Communications

Community awareness of the goals and benefits of the NCCCP pilot is critical to its success. The Communications Subcommittee works with public affairs and communications representatives from the 16 participating hospitals to educate pilot communities about the local availability of the latest evidence-based cancer care and the importance of patient participation in cancer research.


Cancer Communication: Status and Future Directions  

Microsoft Academic Search

On November 7, 2005, the directors of the National Cancer Institute's (NCI's) Comprehensive Cancer Centers met to identify ways of accelerating success against cancer using current knowledge. Not surprisingly, cancer communication was identified as a focal point of research that needed to be conducted to extend the benefits of cancer knowledge throughout the population. There were three foci of communication

Bradford W. Hesse



Development of an Educational Video to Improve Patient Knowledge and Communication with Their Healthcare Providers about Colorectal Cancer Screening  

ERIC Educational Resources Information Center

Background: Low rates of colorectal cancer (CRC) screening persist due to individual, provider, and system level barriers. Purpose: To develop and obtain initial feedback about a CRC screening educational video from community members and medical professionals. Methods: Focus groups of patients were conducted prior to the development of the CRC…

Katz, Mira L.; Heaner, Sarah; Reiter, Paul; van Putten, Julie; Murray, Lee; McDougle, Leon; Cegala, Donald J.; Post, Douglas; David, Prabu; Slater, Michael; Paskett, Electra D.



Enhancing Patient-Provider Communication With the Electronic Self-Report Assessment for Cancer: A Randomized Trial  

PubMed Central

Purpose Although patient-reported cancer symptoms and quality-of-life issues (SQLIs) have been promoted as essential to a comprehensive assessment, efficient and efficacious methods have not been widely tested in clinical settings. The purpose of this trial was to determine the effect of the Electronic Self-Report Assessment–Cancer (ESRA-C) on the likelihood of SQLIs discussed between clinicians and patients with cancer in ambulatory clinic visits. Secondary objectives included comparison of visit duration between groups and usefulness of the ESRA-C as reported by clinicians. Patients and Methods This randomized controlled trial was conducted in 660 patients with various cancer diagnoses and stages at two institutions of a comprehensive cancer center. Patient-reported SQLIs were automatically displayed on a graphical summary and provided to the clinical team before an on-treatment visit (n = 327); in the control group, no summary was provided (n = 333). SQLIs were scored for level of severity or distress. One on-treatment clinic visit was audio recorded for each participant and then scored for discussion of each SQLI. We hypothesized that problematic SQLIs would be discussed more often when the intervention was delivered to the clinicians. Results The likelihood of SQLIs being discussed differed by randomized group and depended on whether an SQLI was first reported as problematic (P = .032). Clinic visits were similar with regard to duration between groups, and clinicians reported the summary as useful. Conclusion The ESRA-C is the first electronic self-report application to increase discussion of SQLIs in a US randomized clinical trial. PMID:21282548

Berry, Donna L.; Blumenstein, Brent A.; Halpenny, Barbara; Wolpin, Seth; Fann, Jesse R.; Austin-Seymour, Mary; Bush, Nigel; Karras, Bryant T.; Lober, William B.; McCorkle, Ruth



The Role of the Clinician in Cancer Clinical Communication  

Microsoft Academic Search

Clinician communication is critical to positive outcomes for patients and families in most health contexts. Researchers have investigated areas such as defining and teaching effective communication and identifying specific outcomes that can be improved through more effective communication. In the area of cancer care, advances in detection and treatment require that clinicians develop new skills to adapt to the evolving

Susan S. Eggly; Terrance L. Albrecht; Kimberly Kelly; Holly G. Prigerson; Lisa Kennedy y Sheldon; Jamie Studts



Clinician-patient communication: a systematic review  

Microsoft Academic Search

Goal of Work  The goal of this work was to identify methods of clinician–patient cancer-related communication that may impact patient outcomes\\u000a associated with distress at critical points in the course of cancer care.\\u000a \\u000a \\u000a \\u000a Materials and methods  A systematic review of practice guidelines, systematic reviews, or randomized trials on this topic was conducted. Guidelines\\u000a for quality was evaluated using the Appraisal of Guidelines

Gary Rodin; Jean A. Mackay; Camilla Zimmermann; Carole Mayer; Doris Howell; Mark Katz; Jonathan Sussman; Melissa Brouwers



Communication and Decision Making in Cancer Care: Setting Research Priorities for Decision Support/Patients' Decision Aids  

PubMed Central

The following is a summary report from a special symposium, entitled “Translating Research into Practice: Setting a Research Agenda for Clinical Decision Tools in Cancer Prevention, Early Detection, and Treatment”, that was held on October 23, 2005 in San Francisco at the Annual Meeting of the Society for Medical Decision Making (SMDM). The symposium was designed to answer the question: “What are the top two research priorities in the field of patientscancer-related decision aids?” After introductory remarks by Dr. Barry, each of four panelists–Drs. Hilary Llewellyn-Thomas, Ellen Peters, Laura Siminoff, and Dale Collins–addressed the question and provided their rationale during prepared remarks. The moderator, Dr. Michael Barry, then facilitated a discussion between the panelists, with input from the audience, to further explore and add to the various proposed research questions. Finally, Dr. Amber Barnato conducted a simple vote count (see Table 1) to prioritize the panelists’ and the audience’s recommendations. PMID:17873249

Barnato, Amber E.; Llewellyn-Thomas, Hilary A.; Peters, Ellen M.; Siminoff, Laura; Collins, E. Dale; Barry, Michael J.



Communicating with patients  


... Ask your patients about their outlooks, attitudes, and motivations. Learn the patient's perspective. Talk to the patient ... beliefs. This will help you understand the patient's motivation and let you plan the best ways to ...


Communication about cancer near the end of life  

PubMed Central

Cancer communication near the end of life has a growing evidence base, and requires clinicians to draw on a distinct set of communication skills. Patients with advanced and incurable cancers are dealing with the emotional impact of a life-limiting illness, treatment decisions that are complex and frequently involve consideration of clinical trials, and the challenges of sustaining hope while also having realistic goals. In this review, we sought to provide a guide to important evidence about communication for patients with advanced cancer regarding: Communication at diagnosis; Discussing prognosis; Decision-making about palliative anticancer therapy and Phase 1 trials; Advance care planning, Transitions in focus from anticancer to palliative care; and Preparing patients and families for dying and death. PMID:18798531

Back, Anthony L; Anderson, Wendy G; Bunch, Lynn; Marr, Lisa A; Wallace, James A; Yang, Holly B; Arnold, Robert M



Fatigue in cancer patients.  

PubMed Central

In this paper an overview is presented on what is currently known of fatigue in cancer. Fatigue is considered to be a multi-dimensional concept, that should be measured as such. However, fatigue has been assessed mostly by single items in general symptom checklists. The few specific instruments that have been used in cancer patient populations are discussed. The majority of cancer patients, about 70%, report feelings of fatigue during radio- or chemotherapy. Follow-up results show that, at least for some diagnoses, patients remain fatigued long after treatment has ended. Somatic and psychological mechanisms that have been proposed to explain fatigue are discussed. It is argued that the significance of the results obtained on fatigue as a symptom in cancer depends on comparison with other patient and non-patient populations. Also the occurrence of a response-shift has to be considered, leading to under reporting of fatigue. Finally, possible interventions to decrease feelings of fatigue are presented. PMID:8347475

Smets, E. M.; Garssen, B.; Schuster-Uitterhoeve, A. L.; de Haes, J. C.



Discussing cancer: communication with African Americans.  


Regular screening for colorectal cancer (CRC) facilitates earlier detection, lowers mortality, and may reduce incidence through detection and removal of pre-cancerous polyps. Optimizing health professional delivery of CRC screening information and recommendations can assist in reducing CRC disparity in the African-American community. This article presents qualitative data on African Americans' attitudes about health professional CRC communications based on the analysis of focus groups (N = 79). Using a social-ecological framework, colorectal cancer and professional communication themes are examined to offer four general and nine cancer-specific theoretically based and culturally appropriate strategies for improving health professional cancer communication with African Americans. PMID:25050658

Caito, Nikki; Hood, Sula; Thompson, Vetta L Sanders



Development of Dual Language Information Cards as a Tool for Communication Between Radiation Therapists and Cantonese-Speaking Patients Undergoing Radiation Treatments for Head-and-Neck Cancer  

Microsoft Academic Search

The establishment of an effective relationship between patient and provider is dependent upon effective communication. However, this can be difficult to achieve with patients who do not speak English as their first language. Language barriers are associated with adverse effects on quality of care, treatment outcomes, and patient and provider satisfaction. These patients are more likely to experience acute side

Jenny Soo; Stephanie Aldridge; John French; Alison Mitchell



Evaluation of an educational program to improve communication with patients about early-phase trial participation. |

Skip to content The National Cancer Institute The National Institutes of Health AccrualNetTM STRATEGIES, TOOLS AND RESOURCES TO SUPPORT ACCRUAL TO CLINICAL TRIALS User menu Register Sign In Search form Search Main menu Protocol Accrual


A disparity of words: racial differences in oncologist-patient communication about clinical trials. |

Skip to content The National Cancer Institute The National Institutes of Health AccrualNetTM STRATEGIES, TOOLS AND RESOURCES TO SUPPORT ACCRUAL TO CLINICAL TRIALS User menu Register Sign In Search form Search Main menu Protocol Accrual


Malnutrition among gynaecological cancer patients  

Microsoft Academic Search

Objective:To assess the nutritional status of patients with gynaecological cancer.Design:A prospective study assessing the nutritional status of gynaecological patients with suspected or proven gynaecological cancer.Setting:Queensland Centre for Gynaecological Cancer, Brisbane, Australia; a tertiary referral centre for gynaecological cancer.Subjects:One hundred forty-five patients with suspected or proven gynaecological cancer aged 20–91 years.Intervention:Scored patient-generated subjective global assessment (PG-SGA) and serum albumin before treatment.Results:One

B Laky; M Janda; J Bauer; C Vavra; G Cleghorn; A Obermair



Cancer-Related Communication, Relationship Intimacy, and Psychological Distress Among Couples Coping with Localized Prostate Cancer  

PubMed Central

Introduction The present study evaluated intimacy as a mechanism for the effects of relationship-enhancing (self-disclosure, mutual constructive communication) and relationship-compromising communication (holding back, mutual avoidance, and demand-withdraw communication) on couples' psychological distress. Methods Seventy-five men diagnosed with localized prostate cancer in the past year and their partners completed surveys about communication, intimacy, and distress. Results Multi-level models with the couple as unit of analyses indicated that the association between mutual constructive communication, mutual avoidance, and patient demand-partner withdraw and distress could be accounted for by their influence on relationship intimacy. Self-disclosure, holding back, and partner demand-patient withdraw did not mediate the associations between communication and distress. Discussion/Conclusions These findings indicate that the way in which couples talk about as well as the degree to which one or both partners avoid talking about cancer-related concerns can either facilitate or reduce relationship closeness, and that it is largely by this mechanism that these three communication strategies impact psychological distress. Implications for Cancer Survivors Relationship intimacy and how patients and partners communicate to achieve this intimacy is important for the psychological adjustment of early stage prostate cancer survivors and their partners. PMID:19967408

Manne, Sharon; Badr, Hoda; Zaider, Talia; Nelson, Christian; Kissane, David



JAMA Patient Page: Testicular Cancer  


... of the American Medical Association JAMA PATIENT PAGE Testicular Cancer C ancer of the testicle, the male reproductive ... developed nations, the chance of a man developing testicular cancer during his life is 1 in 300. The ...


[Patient-physician electronic communication].  


There is a patient demand for online services provided by their doctor, but at the present, in Belgium, there are very few physicians offering such services. This article examines the different types of services and the practical, technical, legal and economic aspects of an interface for electronic doctor-patient communication in the ambulatory sector in the Belgian context. The inventory of pilot projects carried out in other countries shows high patient satisfaction rates and a low impact on doctors' workload. However, the lack of funding hinders the implementation. Given the confidential nature of data exchanged, both high level of security and development of guidelines adapted to the local Belgian context are required. Electronic communication should remain one of the modalities in a therapeutic relationship. At a technical level, using the Belgian electronic identity card and the opportunity to create a digital signature with legal value would provide a solution to most of the security requirements. PMID:21942075

Davidsen, C; André, J-F; Giet, D; Vanmeerbeek, M



NCI: SBIR & STTR - Find Funding - Contracts - 262 Health Information Technology to Facilitate Patient-centered Communication in Cancer-related Care

The 2001 Institute of Medicine (IOM) report titled “Crossing the Quality Chasm” cited a need to make care “patient-centered”. To achieve that end physicians and organizations who are delivering care must begin to see medical care from the patient perspective. As outlined in a recent NCI report on Patient-Centered Communication (2007), “patient-centeredness” is a multi-dimensional concept that goes beyond the notion of satisfaction.


Understanding patient decisions about clinical trials and the associated communication process: a preliminary report. |

This article presents a conceptual model of factors affecting patient decisions about participating in clinical trials and describes videotaping methods for observing interactions between patients, physicians, and family members. Preliminary findings suggest that awareness of the camera during videotaped conversations does not significantly alter the behavior of participants. Further study of this model and methodology may produce results that can be incorporated into provider training.


Patients' beliefs about cancer management  

Microsoft Academic Search

The results of a questionnaire answered by 205 medical patients are reported (100 patients with cancer and 105 with other medical conditions). The questionnaire examined beliefs and preferences regarding various aspects of cancer, including expectations of medical management and treatment. The issues examined relate to beliefs and preferences about information giving, trust of doctors' control of decision making, expectations of

John Buchanan; Walter Cosolo; Robyn Millership; Allan Zimet; John Zalcberg; Ron Borland; Ian Haines



Nutritional Considerations for Cancer Patients  

PubMed Central

Although weight loss is a frequent, though not invariable, component of the cancer syndrome, the associated malnutrition is a poor prognostic sign among both children and adults. This article describes the possible mechanisms of cancer cachexia; reviews the present state of nutritional support in cancer patients; identifies nutritional problems and workable approaches during the pre- and post-treatment periods; discusses the unconventional nutritional practices commonly encountered and lists resource materials for patients and families. PMID:21274086

Chen, Angela



Elderly patients with pancreatic cancer.  


Pancreatic cancer marked significant increase of incidence during the last decades in the elderly population. Despite the certain increase of incidence there are no international guidelines for elderly patients who are suffering from pancreatic cancer. During the ASCO Annual Meeting 2014, two abstracts focusing on elderly patients suffering from different histological types of pancreatic cancer were presented. The first retrospective study (Abstract #4119) showed the benefit of the systemic treatment on overall survival for elderly patients with stage IV pancreatic adenocarcinoma. The second retrospective study (Abstract #4112) demonstrates the positive effect of somatostatin analogue (octreotide-LAR) treatment on overall survival for elderly patients with neuroendocrine pancreatic carcinoma. PMID:25076333

Kougioumtzopoulou, Andromachi S; Syrigos, Kostas N; Saif, Muhammad Wasif



Verbal analysis of doctor-patient communication  

Microsoft Academic Search

A microscopic analysis of doctor-patient communication in the general practitioner's surgery is presented. Verbatim transcripts of 85 medical interviews, audiotaped in a natural situation were analysed. The effects of type of complaint, patient gender and physician gender on the process of verbal communication were assessed. This study focused upon the relational aspects of communication, using Stiles' Verbal Response Mode coding

Ludwien Meeuwesen; Cas Schaap; Cees van der Staak



[Helping a terminal cancer patient establish hope].  


Cancer patients who feel a sense of hopelessness concerning the prospects of long-term treatment success may defeat all efforts to stop their diseases. The authors present a case study of a breast cancer patient, a former nursing instructor, who suffered from passiveness, depression, resistance to communication, blunted affect, lack of participation in self-care, and refusal to eat--all resulting from a lack of treatment-related progress. One of the authors established a continuing and active care relationship with the patient. As part of her nursing care plan, she enacted encouraging social interactions, provided medical treatment information, assisted with self-care procedures, and attempted to maintain a constant level of psychological calm. Outcomes included an improved positive attitude toward treatment, enhanced self-control, active participation in self-care, and improved social interaction. The patient was also better able to adapt to her illness and to face an uncertain future. PMID:15045901

Juang, Chuen-Mih; Chang, Yu-Ping



Doctors' decision-making on giving information to cancer patients  

Microsoft Academic Search

A major focus in the literature about doctor-patient communication is information-giving. In the case of cancer patients, one significant issue is which factors determine whether and how, general practitioners and oncologists give information to their patients. Whatever may be the content of information, the most important choice for the doctor is to give information or not. Our research group at

Jesús Rodríguez-Marín; Sofía López-Roig; María A. Pastor



Financial Distress in Cancer Patients  

PubMed Central

Novel diagnostic and therapeutic options offer hope to cancer patients with both localized and advanced disease. However, many of these treatments are often costly and even well-insured patients can face high out-of-pocket costs. Families may also be at risk of financial distress due to lost wages and other treatment-related expenses. Research is needed to measure and characterize financial distress in cancer patients and understand how it affects their quality of life. In addition, health care providers need to be trained to counsel patients and their families so they can make patient-centered treatment decisions that reflect their preferences and values. PMID:24349677

de Souza, Jonas A.; Wong, Yu-Ning



[Neurological complications in cancer patients].  


Neurological symptoms in cancer patients have a great impact on quality of life and need an interdisciplinary approach. They lead to significant impairment in activities of daily living (gait disorders, dizziness), a loss of patients independency (vegetative disturbances, wheel-chair dependency) and interfere with social activities (ban of driving in case of epilepsy). In this article we describe three main and serious neurological problems in the context of oncological patients. These are chemotherapy-induced polyneuropathy, malignant spinal cord compression and epileptic seizures. Our aim is to increase the awareness of neurological complications in cancer patients to improve patients care. PMID:25146945

Hundsberger, Thomas; Roth, Patrick; Roelcke, Ulrich



[Sexy cancer--sexuality for cancer patients].  


Sexuality is a basic need for every human being as long as he or she is alive, irrespective of age or health status. Approximately 23,500 individuals are diagnosed with cancer each year in Israel and join the 120,000 cancer patients currently living in Israel. The results of cancer treatments are traditionally assessed and based on the outcome regarding mortality versus survival. An equally important aspect to be addressed in this assessment must relate to quality of life. One of the more painful insults to the quality of life of cancer patients relates to the deleterious effects on sexuality. This article aims to present physicians with the spectrum of sexuality-related issues which are encountered by cancer patients and their partners, starting from the moment of diagnosis, throughout the various stages of treatment and to provide basic knowledge. Many individuals contracting cancer have difficulty dealing with the issue of sexuality. They are typically embarrassed and feel uneasy when asking health care providers about such a non-life threatening issue. Partners similarly feel both shame and guilt. In many cases sexuality, intimacy and emotional attachment are important aspects and may be essential for survival. Addressing these issues during treatment can provide patients with a sense of security, avoiding embarrassment and further exacerbation of such problems. Unfortunately, little has been done to develop an optimal interventional program, although standard sexual treatments have often been applied. Prospective clinical research and outcomes are missing. The physician can use the well-known PLISSIT model (1978): to provide sexuality involvement on different levels. The very new BETTER model (2004) can help emphasize that cancer treatment and the disease have an influence on intimacy and sexuality. PMID:20070056

Peleg-Nesher, Sharon; Yachini, Brurya; Inbar, Moshe



Study of dyadic communication in couples managing prostate cancer: a longitudinal perspective  

PubMed Central

OBJECTIVE Cancer patients and partners often report inadequate communication about illness-related issues, although it is essential for mutual support and informal caregiving. This study examined the patterns of change in dyadic communication between patients with prostate cancer and their partners, and also determined if certain factors affected their communication over time. METHOD Using multilevel modeling, this study analyzed longitudinal data obtained from a randomized clinical trial with prostate cancer patients and their partners, to examine their communication over time. Patients and partners (N=134 pairs) from the usual-care control group independently completed baseline demographic assessment and measures of social support, uncertainty, symptom distress, and dyadic communication at baseline, and 4-, 8-, and 12-month follow-ups. RESULTS The results indicated that (1) patients and partners reported similar levels of open communication at the time of diagnosis. Communication reported by patients and partners decreased over time in a similar trend, regardless of phase of illness; (2) phase of illness affected couples’ open communication at diagnosis but not patterns of change over time; and (3) couples’ perceived communication increased as they reported more social support, less uncertainty, and fewer hormonal symptoms in patients. Couples’ demographic factors and general symptoms, and patients’ prostate cancer-specific symptoms did not affect their levels of open communication. CONCLUSIONS Perceived open communication between prostate cancer patients and partners over time is affected by certain baseline and time-varying psychosocial and cancer-related factors. The results provide empirical evidence that may guide the development of strategies to facilitate couples’ interaction and mutual support during survivorship. PMID:20967920

Song, L; Northouse, LL; Zhang, L; Braun, TM; Cimprich, B; Ronis, DL; Mood, DW



Support groups for cancer patients  

Microsoft Academic Search

Within the last two decades psychosocial group interventions have been developed to help cancer patients cope better with the psychosocial sequelae of cancer diagnosis and treatment. Support groups include a variety of different approaches some of which focus on behavioral aspects and symptoms (e.g. pain, fatigue) and some on the expression of emotions. Most of these support programs are structured

Joachim Weis



Cultural Aspects of Communication in Cancer Care  

Microsoft Academic Search

Cancer is increasing in incidence and prevalence worldwide, and the WHO has recently included cancer and its treatments as\\u000a a health priority in developed and developing countries. The cultural diversity of oncology patients is bound to increase,\\u000a and cultural sensitivity and competence are now required of all oncology professionals. A culturally competent cancer care\\u000a leads to improved therapeutic outcome and

A. Surbone


Communication between cancer specialists and family doctors.  

PubMed Central

In a qualitative study using focus group interviews, family physicians in London, Ont, were asked to describe how they perceived their role in follow-up cancer patient care. Barriers to fulfilling this role existed both in the tertiary cancer care setting and among the family physicians themselves. Suggestions for overcoming these barriers were generated. PMID:8382093

Wood, M. L.



Cancer and Communication in the Health Care Setting: Experiences of Older Vietnamese Immigrants, A Qualitative Study  

PubMed Central

Background As patients grow older, accurate communication with health care providers about cancer becomes increasingly important. However, little is known about the cancer communication experiences of older Asian immigrants. Objective To learn about the cancer-related communication experiences of older Vietnamese immigrants from the insider perspective. Design Qualitative study (grounded theory, constant comparative method) using individual interviews with older Vietnamese immigrants with the purpose of discussing how they learn about cancer. Interviews were conducted in Vietnamese. Participants Vietnamese immigrants aged 50–70 years, recruited through community-based organizations. Most had low education and limited English proficiency. The sample size of 20 was sufficient to achieve theoretical saturation. Results We identified 3 categories of themes concerning informants’ experiences with cancer communication in the health care setting: (1) attitudes about addressing screening with providers, (2) issues/problems communicating with physicians about cancer, and (3) language/translation difficulties. There was substantial overlap between informants who mentioned each theme category, and 40% of the participants mentioned all 3 categories. Conclusion Clinicians should be aware of and act upon specific cancer communication needs/challenges of their older immigrant patients. Moreover, health care systems need to be prepared to address the needs of an increasingly multiethnic and linguistically diverse patient population. Finally, community-level interventions should address baseline knowledge deficits while encouraging immigrant patients to engage their doctors in discussions about cancer screening. PMID:18030538

Barg, Frances K.; Armstrong, Katrina; Holmes, John H.; Hornik, Robert C.



Informal Caregiving for Cancer Patients  

PubMed Central

According to the recent worldwide estimation by the GLOBOCAN project, in total, 12.7 million new cancer cases and 7.6 million cancer deaths occurred in 2008. The worldwide number of cancer survivors within 5 years of diagnosis has been estimated at be almost 28.8 million. Informal caregivers, such as family members and close friends, provide essential support to cancer patients. The authors of this report provide an overview of issues in the study of informal caregivers for cancer patients and long-term survivors in the United States and Europe, characterizing the caregivers commonly studied; the resources currently available to them; and their unmet needs, their psychosocial outcomes, and the psychosocial interventions tailored to their special circumstances. A broad overview of the state of research and knowledge, both in Europe and the United States, and observations on the directions for future research are provided. PMID:23695928

Romito, Francesca; Goldzweig, Gil; Cormio, Claudia; Hagedoorn, Mariet; Andersen, Barbara L.



Patients' communication with doctors: a randomized control study of a brief patient communication intervention.  


In research on doctor-patient communication, the patient role in the communication process has received little attention. The dynamic interactions of shared decision making and partnership styles which involve active patient communication are becoming a growing area of focus in doctor-patient communication. However, patients rarely know what makes "good communication" with medical providers and even fewer have received coaching in this type of communication. In this study, 180 patients were randomly assigned to either an intervention group using a written communication tool to facilitate doctor-patient communication or to standard care. The goal of this intervention was to assist patients in becoming more effective communicators with their physicians. The physicians and patients both rated the quality of the communication after the office visit based on the patients' knowledge of their health concerns, organizational skills and questions, and attitudes of ownership and partnership. The results supported that patients in the intervention group had significantly better communication with their doctors than patients in the standard care condition. Physicians also rated patients who were in the intervention group as having better overall communication and organizational skills, and a more positive attitude during the office visit. This study supports that helping patients structure their communication using a written format can facilitate doctor-patient communication. Patients can become more adept at describing their health concerns, organizing their needs and questions, and being proactive, which can have a positive effect on the quality of the doctor-patient communication during outpatient office visits. (PsycINFO Database Record (c) 2011 APA, all rights reserved). PMID:21787080

Talen, Mary R; Muller-Held, Christine F; Eshleman, Kate Grampp; Stephens, Lorraine



Understanding frailty in cancer patients.  


As population ages, the number of older adults with cancer is increasing rapidly. Chronological age per se is a poor guide for an oncologist to determine tolerance to cancer treatment. Older adults have been underrepresented in cancer clinical trials, leading to paucity of guidelines to meet the treatment challenges in this population. To evaluate an older adult with cancer, oncologists must understand age-related changes and identify the subset of population who is vulnerable and at risk of cancer treatment toxicity. Comprehensive geriatric assessments focusing on functional status, multimorbidity, nutritional status, cognitive impairment, and psychosocial support help recognize heterogeneity among older adults, leading to individualized approaches toward cancer treatment. The treatment decisions need to be made in collaboration with the patient's values and preferences. PMID:25299146

Baijal, Pooja; Periyakoil, Vyjeyanthi



Critically Ill Cancer Patients: Indications  

E-print Network

Critically Ill Cancer Patients: Indications for Concurrent Palliative Care Although significant in the need for supportive services such as palliative care concomitantly with life-prolonging treatments), the approach of palliative care is to promote quality of life for patients and their families during life

von der Heydt, Rüdiger


Can Metaphors and Analogies Improve Communication with Seriously Ill Patients?  

PubMed Central

Abstract Objective It is not known how often physicians use metaphors and analogies, or whether they improve patients' perceptions of their physicians' ability to communicate effectively. Therefore, the objective of this study was to determine whether the use of metaphors and analogies in difficult conversations is associated with better patient ratings of their physicians' communication skills. Design Cross-sectional observational study of audio-recorded conversations between patients and physicians. Setting Three outpatient oncology practices. Patients Ninety-four patients with advanced cancer and 52 physicians. Intervention None. Main outcome measures Conversations were reviewed and coded for the presence of metaphors and analogies. Patients also completed a 6-item rating of their physician's ability to communicate. Results In a sample of 101 conversations, coders identified 193 metaphors and 75 analogies. Metaphors appeared in approximately twice as many conversations as analogies did (65/101, 64% versus 31/101, 31%; sign test p?patient ratings of communication (??=?0.27; p?=?0.006), as did physicians who used more analogies (Spearman ??=?0.34; p?communicate. PMID:19922170

Pickard, Amy; Fishman, Jessica M.; Alexander, Stewart C.; Arnold, Robert M.; Pollak, Kathryn I.; Tulsky, James A.



Communication in conversation in stroke patients.  


In stroke patients, it has been suggested that communication disorders could result from lexical and syntactic disorders in left hemisphere lesions and from pragmatics problems in right lesions. However, we have little information on patient behaviour in dyadic communication, especially in conversation. Here, we analyzed the various processes participating in communication difficulties at the rehabilitation phase (1-6 months) post-stroke, in order to define the main mechanisms of verbal and non-verbal communication (VC, NVC) disorders and their relationship with aphasic disorders. Sixty-three patients were recruited, who belonged to six groups, with left or right cortico-sub-cortical (L-CSC, R-CSC) or sub-cortical (L-SC, R-SC), frontal (Fro) or posterior fossa (PF) lesions. They were compared with an equivalent control group (gender, age, education level). We used the Lille Communication Test, which comprises three parts: participation to communication (greeting, attention, engagement), verbal communication (verbal comprehension, speech outflow, intelligibility, word production, syntax, verbal pragmatics and verbal feedback) and non-verbal communication (understanding gestures, affective expressivity, producing gestures, pragmatics and feedback). We also used the Functional Communication Profile and the Boston Diagnostic Aphasia Examination (BDAE). Decrease in participation was found in L-CSC, R-CSC and Fro patients. Verbal communication was essentially disrupted in L-SCS and L-SC groups, including by verbal pragmatic disorders, and to a lesser degree in frontal patients. Nonverbal communication was mainly affected in R-CSC patients, especially by pragmatic difficulties. L-CSC patients showed an increase in gesture production, compensating for aphasia. In conclusion, communication disorders were relatively complex and could not be summarised by syntactical and lexical difficulties in left stroke and pragmatic problems in right stroke. The former also showed severe verbal pragmatic difficulties. Frontal stroke also resulted in evident verbal and non-verbal disorders. PMID:20143108

Rousseaux, Marc; Daveluy, Walter; Kozlowski, Odile



Clinical trial awareness, attitudes, and participation among patients with cancer and oncologists. |

This study reinforces the need for better communication between oncologists and cancer patients regarding clinical trials. In general, oncologists believe that patients are more fearful of trial participation than patients really are. In addition, although 84 percent of oncologists believe they discuss clinical trials with eligible patients, 81 percent of patients indicated that they were unaware of available and appropriate trials when they were exploring treatment options.


Discordance between Perceived and Actual Cancer Stage among Cancer Patients in Korea: A Nationwide Survey  

PubMed Central

Purpose We assessed the accuracy of communication between doctors and patients by evaluating the consistency between patient perception of cancer stage and the medical records, and analyzed the most influential factors of incongruence among cancer patients at 10 cancer centers across Korea. Methods Information was gathered from cancer patients at the National Cancer Center and nine regional cancer centers located in every province of Korea between 1 July 2008 and 31 August 2008. Data were analyzed using Pearson's ?2 test and multivariate logistic regression analysis. Results The stages of cancer reported by the 1,854 patients showed a low degree of congruence with the stages given in medical records (k?=?0.35, P<0.001). Only 57.1% of the patients had accurate knowledge of their cancer stage. In total, 18.5% underestimated their stage of disease, and the more advanced the cancer stage, the more likely they were to underestimate it, in order of local (14.2%), regional (23.7%), and distant (51.6%). Logistic regression analysis showed that congruence was lower in patients with cervical cancer (odds ratio [OR]?=?0.51, 95% confidence interval [CI]?=?0.30–0.87), recurrence (OR?=?0.64, 95% CI?=?0.50–0.83), and treatment at the National Cancer Center (OR?=?0.53, 95% CI?=?0.39–0.72). Conclusion There are knowledge gaps between patients' perceived and actual stage of cancer. Patients with cervical cancer, recurrence, and who received treatment at a regional cancer center showed less understanding of their cancer stage. PMID:24817193

Shim, Hye-Young; Park, Jong-Hyock; Kim, So-Young; Shin, Dong Wook; Shin, Ji-Yeon; Park, Bo Young; Huh, Jung-Sik; Shin, Hee-Young; Won, Young Joo; Seo, Hong Gwan



Communication in end-stage cancer: review of the literature and future research.  


Concerns have been raised about the quality of life and health care received by cancer patients at the end of life (EOL). Many patients die with pain and other distressing symptoms inadequately controlled, receiving burdensome, aggressive care that worsens quality of life and limits patient exposure to palliative care, such as hospice. Patient-physician communication is likely a very important determinate of EOL care. Discussions of EOL with physicians are associated with an increased likelihood of the following (1) acknowledgment of terminal illness, (2) preferences for comfort care over life extension, and (3) receipt of less intensive, life-prolonging and more palliative EOL care; while this appears to hold for White patients, it is less clear for Black, advanced cancer patients. These results highlight the importance of communication in determining EOL cancer care and suggest that communication disparities may contribute to Black-White differences in EOL care. We review the pertinent literature and discuss areas for future research. PMID:19449273

Trice, Elizabeth D; Prigerson, Holly G



Emotional support for cancer patients: what do patients really want?  

Microsoft Academic Search

For many cancer patients and their families the experience of cancer is an intensely stressful one. Emotional support is important for most cancer patients during their illness and can be gained from different people and services. This study evaluates patients' attitudes to different sources of support and rates their satisfaction with sources already used. A total of 431 patients completed

ML Slevin; SE Nichols; SM Downer; P Wilson; TA Lister; S Arnott; J Maher; RL Souhami; JS Tobias; AH Goldstone; M Cody



Cultural aspects of communication in cancer care  

Microsoft Academic Search

Cultural competence in oncology requires the acquisition of specific knowledge, clinical skills, and attitudes that facilitate\\u000a effective cross-cultural negotiation in the clinical setting, thus, leading to improved therapeutic outcomes and decreased\\u000a disparities in cancer care. Cultural competence in oncology entails a basic knowledge of different cultural attitudes and\\u000a practices of communication of the truth and of decision-making styles throughout the

Antonella Surbone



CCC meets ICU: Redefining the role of critical care of cancer patients  

Microsoft Academic Search

BACKGROUND: Currently the majority of cancer patients are considered ineligible for intensive care treatment and oncologists are struggling to get their patients admitted to intensive care units. Critical care and oncology are frequently two separate worlds that communicate rarely and thus do not share novel developments in their fields. However, cancer medicine is rapidly improving and cancer is eventually becoming

Michael von Bergwelt-Baildon; Michael J Hallek; Alexander A Shimabukuro-Vornhagen; Matthias Kochanek



Gastric Cancer in Young Patients  

PubMed Central

Aim. The aim of this study was to see the clinical, pathological, and demographic profile of young patients with stomach carcinoma besides association with p53. Patients and Methods. Prospective study of young patients with stomach carcinoma from January 2005 to December 2009. A total of 50 patients with age less than 40 years were studied. Results. Male female ratio was 1?:?1.08 in young patients and 2.5?:?1 in older patients. A positive family history of stomach cancer in the first degree relatives was present in 10% of young patients. Resection was possible only in 50% young patients. 26% young patients underwent only palliative gastrojejunostomy. The most common operation was lower partial gastrectomy in 68%. Amongst the intraoperative findings peritoneal metastasis was seen in 17.4% in young patients. 50% young patients presented in stage IV as per AJCC classification (P value .004; sig.). None of the patients presented as stage 1 disease in young group. Conclusion. Early detection of stomach carcinoma is very important in all patients but in young patients it is of paramount importance. PMID:24381753

Dhobi, Manzoor A.; Wani, Khursheed Alam; Parray, Fazl Qadir; Wani, Rouf A.; Peer, G. Q.; Abdullah, Safiya; Wani, Imtiyaz A.; Wani, Muneer A.; Shah, Mubashir A.; Thakur, Natasha



Rebuilding immunity in cancer patients  

PubMed Central

Rebuilding and maintaining immunity is paramount to the success of cancer immunotherapy and hematopoietic stem cell transplantation. If immune surveillance indeed can protect from cancer, the very manifestation of malignancy means that the disease has prevailed over immunity. Yet, often, tumor–specific T cells can be found in cancer patients irrespective of vaccination. Interestingly, patients suffering from malignancy often harbor unexpectedly high levels of immature CD14+HLA-DR? monocytes, although the abundance of CD4+ cells, CD8+ cells and CD4+CD25high cells may be normal. It is plausible that in cancer such cells suppress T cell function, analogous to CD14+HLA-DR? cells in sepsis and major trauma, in addition to their likely failure to re–present tumor-associated antigens once dendritic cells have initiated the T cell response. Recent evidence indicates that tumor–borne adenosine, lactate and hypoxia in the tumor environment may modulate tumor–specific immunity to a significant extent, but their effects on myeloid cell function is unclear. Thus, understanding and controlling these factors may appreciably impact the success of rebuilding and maintaining immunity in cancer patients. PMID:17827037

Vuk-Pavlovic, Stanimir



Patient-centered Care & Communication

Patient-centeredness is increasingly being recognized as a critical indicator of high-quality health care delivery. Although several definitions of patient-centeredness have been proposed in the literature, two attributes are considered central to the delivery of patient-centered care. These attributes are being responsive to patient needs and incorporating the patient's perspective and experiences in care planning and decision-making.


Traditional Chinese medicine use among Chinese immigrant cancer patients.  


Traditional Chinese Medicine (TCM) includes both herbal remedies and non-herbal practices. Chinese cancer patients are particularly at high risk for herb-drug interactions. Providers, both primary care physicians and oncologists, frequently do not ask patients about TCM use, which has potentially dangerous consequences. This study describes an assessment of TCM use while undergoing conventional cancer treatment, among a cohort of Chinese immigrant cancer patients in New York City. The Immigrant Health and Cancer Disparities Service at Memorial Sloan-Kettering Cancer Center assists underserved cancer patients through a patient navigation program, the Cancer Portal Project. Six questions related to TCM are included in the existing Portal Needs Assessment Intake. Mandarin- or Cantonese-speaking Portal patients enrolled between January 2010 and May 2012 were surveyed. One hundred nine Chinese-speaking patients were enrolled in the Portal Project during the study period. Forty-six completed the TCM questions. Ninety-six percent preferred to speak Mandarin, Cantonese, or Fujianese in the healthcare setting. Thirty-nine percent (n?=?18) of the 46 participants reported using TCM since being diagnosed with cancer. Nearly all (n?=?16) who used TCM reported using herbal medicines. Ten TCM users did not describe sharing their use with Western doctors. Eight (44%) of TCM users reported concurrently using TCM and conventional cancer treatment. Larger scale studies should further explore the concurrent use of TCM and conventional cancer treatment in this unique population. Future research should also address patient-provider communication related to the concurrent use of TCM and cancer treatment. This is also an important area of education for both patients and providers. PMID:24072455

Leng, Jennifer C F; Gany, Francesca



Does breast cancer change patients’ dietary habits?  

Microsoft Academic Search

Purpose: The results of epidemiological studies on diet and cancer are often difficult to interpret on an individual level and may influence patients’ beliefs, attitudes and behaviour. This study investigated the behaviour of breast cancer patients and their attitudes to dietary changes and the need of dietary advice during their disease.Patients and methods: The study population consisted of breast cancer

EK Salminen; HK Lagström; SP Heikkilä; SJ Salminen



Do Cancer Patients Tweet? Examining the Twitter Use of Cancer Patients in Japan  

PubMed Central

Background Twitter is an interactive, real-time media that could prove useful in health care. Tweets from cancer patients could offer insight into the needs of cancer patients. Objective The objective of this study was to understand cancer patients’ social media usage and gain insight into patient needs. Methods A search was conducted of every publicly available user profile on Twitter in Japan for references to the following: breast cancer, leukemia, colon cancer, rectal cancer, colorectal cancer, uterine cancer, cervical cancer, stomach cancer, lung cancer, and ovarian cancer. We then used an application programming interface and a data mining method to conduct a detailed analysis of the tweets from cancer patients. Results Twitter user profiles included references to breast cancer (n=313), leukemia (n=158), uterine or cervical cancer (n=134), lung cancer (n=87), colon cancer (n=64), and stomach cancer (n=44). A co-occurrence network is seen for all of these cancers, and each cancer has a unique network conformation. Keywords included words about diagnosis, symptoms, and treatments for almost all cancers. Words related to social activities were extracted for breast cancer. Words related to vaccination and support from public insurance were extracted for uterine or cervical cancer. Conclusions This study demonstrates that cancer patients share information about their underlying disease, including diagnosis, symptoms, and treatments, via Twitter. This information could prove useful to health care providers. PMID:24867458

Tsuya, Atsushi; Sugawara, Yuya; Tanaka, Atsushi



Doctor-patient communication: A review of the literature  

Microsoft Academic Search

Communication can be seen as the main ingredient in medical care. In reviewing doctor-patient communication, the following topics are addressed: (1) different purposes of medical communication; (2) analysis of doctor-patient communication; (3) specific communicative behaviors; (4) the influence of communicative behaviors on patient outcomes; and (5) concluding remarks.Three different purposes of communication are identified, namely: (a) creating a good inter-personal

L. M. L. Ong; A. M. Hoos; F. B. Lammes



Platelet indices in patients with colorectal cancer  

Microsoft Academic Search

The interaction between cancer cells and platelets has been known for a long time. Although platelet indices have been also\\u000a investigated in several clinical settings, it has not been exactly demonstrated in cancer patients. We investigated platelet\\u000a indices in colorectal cancer patients and compared with healthy subjects. Two hundred and twenty-one colorectal cancer patients\\u000a and 110 healthy subjects were enrolled

Bülent Karagöz; ?lker Sücüllü; Özkan Sayan; O?uz Bilgi; Tolga Tuncel; Ali ?lker Filiz; Ergün Yücel; Alpaslan Ozgun; Alev Akyol Erikçi; Ahmet Alacacio?lu; Emin Gokhan Kandemir



Maintaining the reproductive potential of cancer patients during cancer treatment.  


Cancer therapies are known to alter the reproductive potential in cancer patients. Due to improved survival rates in cancer patients of reproductive age, considerations of the long-term effects of cancer therapy have become more significant. Oncofertility is a new discipline in medicine that deals with maintaining the reproductive potential of cancer patients while they are receiving gonadotoxic cancer treatment. The purpose of this review is to explore how cancer treatment impairs reproductive functioning and present the current options for preservation of fertility in women. All patients with reproductive potential should be made aware of the possible treatment-related infertility and be offered appropriate fertility preservation options before cancer treatment is instituted. The hope is that, in the future, mechanism(s) can be developed to preserve immature germ cells in the ovary, so that they can be used for fertilization in vivo or in vitro. PMID:24389259

Harp, Djana; Chowdhury, Indrajit; Garcia-Barrio, Minerva; Welch, Crystal; Matthews, Roland; Thompson, Winston



Patient perspectives of patient-provider communication after adverse events  

Microsoft Academic Search

Objective. To explore patient perceptions of patient-provider communication after an actual adverse medical event because prior patient error studies are rarely based on real situations. Design. We conducted four patient focus groups using a semi-structured guide. We analyzed transcripts using an editing approach to identify themes. Setting. Three sites in Colorado. Study participants. Participants were recruited from statewide post-injury program.




Communication by mothers with breast cancer or melanoma with their children.  


Communication of familial risk of breast cancer and melanoma has the potential to educate relatives about their risk, and may also motivate them to engage in prevention and early detection practices. With the Health Insurance Portability and Accountability Act (HIPAA) privacy laws, the patient often becomes the sole communicator of such risks to family members. This study surveys mothers diagnosed with either breast cancer or melanoma and their adult children about their family communication style, knowledge of increased risk, and early detection practices. In both cancer groups, most mothers alerted their children of the risk and need for early detection practices. Breast cancer mothers communicated risk and secondary prevention with early detection by breast self-examination and mammograms whereas the melanoma mothers communicated risk and primary prevention strategies like applying sunscreen and avoiding deliberate tanning. Open communication about health matters significantly increased the likelihood that children engaged in early detection and/or primary prevention behaviors. Examining the information conveyed to at-risk family members, and whether such information motivated them to engage in early detection/prevention behaviors, is key to guiding better cancer prevention communication between doctors and patients. PMID:23965923

Gaber, Rikki; Desai, Sapna; Smith, Maureen; Eilers, Steve; Blatt, Hanz; Guevara, Yanina; Robinson, June K



Communication by Mothers with Breast Cancer or Melanoma with Their Children  

PubMed Central

Communication of familial risk of breast cancer and melanoma has the potential to educate relatives about their risk, and may also motivate them to engage in prevention and early detection practices. With the Health Insurance Portability and Accountability Act (HIPAA) privacy laws, the patient often becomes the sole communicator of such risks to family members. This study surveys mothers diagnosed with either breast cancer or melanoma and their adult children about their family communication style, knowledge of increased risk, and early detection practices. In both cancer groups, most mothers alerted their children of the risk and need for early detection practices. Breast cancer mothers communicated risk and secondary prevention with early detection by breast self-examination and mammograms whereas the melanoma mothers communicated risk and primary prevention strategies like applying sunscreen and avoiding deliberate tanning. Open communication about health matters significantly increased the likelihood that children engaged in early detection and/or primary prevention behaviors. Examining the information conveyed to at-risk family members, and whether such information motivated them to engage in early detection/prevention behaviors, is key to guiding better cancer prevention communication between doctors and patients. PMID:23965923

Gaber, Rikki; Desai, Sapna; Smith, Maureen; Eilers, Steve; Blatt, Hanz; Guevara, Yanina; Robinson, June K.



Communicating Cancer Risk Information: The Challenges of Uncertainty.  

ERIC Educational Resources Information Center

Accurate and sensitive communication of cancer-risk information is important. Based on a literature review of 75 research reports, expert opinion papers, and clinical protocols, a synthesis of what is known about the communication of cancer-risk information is presented. Relevance of information to those not tested is discussed. (Author/EMK)

Bottorff, Joan L.; Ratner, Pamela A.; Johnson, Joy L.; Lovato, Chris Y.; Joab, S. Amanda



[Enteral nutrition in cancer patients].  


The significance of nutritional management in patients with malignant tumors is under-recognized due to the lack of clear evidence of a direct link with survival rate. However, for cancer patients, with markedly reduced food intake continuing for?7 days or intake of under 60% of estimated energy expenditure for?10 days, as referred to in the European Society for Clinical Nutrition and Metabolism, rapid implementation of nutritional support constitutes a clinically appropriate intervention. With regard to route of administration, as with other conditions, enteral nutritional management is recommended if the gastrointestinal tract is available. The utility of enteral immunonutrition formulae containing eicosapentaenoic acid and other forms of nutritional management has also recently been reported and further studies are anticipated. However, the principles of nutritional management for cancer patients comprise not simply weight increase or improvement in nutritional markers but the maintenance of patient QOL in ways that include alleviation of symptoms and antitumor therapy side-effects, and decreased risk of infection. Administration routes such as percutaneous endoscopic gastrostomy should therefore also be discussed from this perspective. PMID:25335700

Suzuki, Yutaka



Nursing CommunicationAdvocacy for the Patient or Physician?  

Microsoft Academic Search

Communication among nurses, patients, and physicians is a key component of effective health care. In addition to communication with patients, nurses directly or indirectly influence physician-patient communications. This secondary analysis examined registered nurses’ interactions with a simulated patient regarding what the physician had told the patient about the reason for hospitalization. Taped interviews (N = 86) were transcribed and content

Carol A. Williams; Monette T. Gossett



Improving cancer patient care: development of a generic cancer consumer quality index questionnaire for cancer patients  

PubMed Central

Background To develop a Consumer Quality Index (CQI) Cancer Care questionnaire for measuring experiences with hospital care of patients with different types of cancer. Methods We derived quality aspects from focus group discussions, existing questionnaires and literature. We developed an experience questionnaire and sent it to 1,498 Dutch cancer patients. Another questionnaire measuring the importance of the quality aspects was sent to 600 cancer patients. Data were psychometrically analysed. Results The response to the experience questionnaire was 50 percent. Psychometric analysis revealed 12 reliable scales. Patients rated rapid and adequate referral, rapid start of the treatment after diagnosis, enough information and confidence in the healthcare professionals as most important themes. Hospitals received high scores for skills and cooperation of healthcare professionals and a patient-centered approach by doctors; and low scores for psychosocial guidance and information at completion of the treatment. Conclusions The CQI Cancer Care questionnaire is a valuable tool for the evaluation of the quality of cancer care from the patient’s perspective. Large scale implementation is necessary to determine the discriminatory powers of the questionnaire and may enable healthcare providers to improve the quality of cancer care. Preliminary results indicate that hospitals could improve their psychosocial guidance and information provision. PMID:23617741



NCI Cancer Patient Educators Listserv Unsubscribe Form

NCI Cancer Patient Educators Listserv Unsubscribe Form Name: * Email: Reason for leaving listserv: (please select one option below or describe your reason in the comments field if none of the options are appropriate) No longer involved in cancer


Breast cancer patients’ topic avoidance and psychological distress: The mediating role of coping  

Microsoft Academic Search

Avoiding communication about cancer is common and is likely to have negative psychological health consequences for patients, yet the connection between topic avoidance and psychological well-being is not well understood. This study of women with breast cancer examined coping behaviors as mediating mechanisms through which their cancer-related topic avoidance might affect their psychological distress. Consistent with predictions, greater levels of

Erin Donovan-Kicken; John P. Caughlin



Patients' Experiences with Navigation for Cancer Care  

PubMed Central

Objective We examined how navigation, defined as the assessment and alleviation of barriers to adequate health care, influences patients' perspectives on the quality of their cancer care. Methods We conducted post-study patient interviews from a randomized controlled trial (usual care vs. patient navigation services) from cancer diagnosis through treatment completion. Patients were recruited from 11 primary care, hospital and community oncology practices in New York. We interviewed patients about their expectations and experience of patient navigation or, for non-navigated patients, other sources of assistance. Results Thirty-five patients newly diagnosed with breast or colorectal cancer. Valued aspects of navigation included emotional support, assistance with information needs and problem-solving, and logistical coordination of cancer care. Unmet cancer care needs expressed by patients randomized to usual care consisted of lack of assistance or support with childcare, household responsibilities, coordination of care, and emotional support. Conclusion Cancer patients value navigation. Instrumental benefits were the most important expectations for navigation from navigated and non-navigated patients. Navigated patients received emotional support and assistance with information needs, problem-solving, and logistical aspects of cancer care coordination. Practice Implications Navigation services may help improve cancer care outcomes important to patients by addressing fragmented, confusing, uncoordinated, or inefficient care. PMID:20006459

Carroll, Jennifer K.; Humiston, Sharon G.; Meldrum, Sean C.; Salamone, Charcy M.; Jean-Pierre, Pascal; Epstein, Ronald M.; Fiscella, Kevin



Communicating Effectively PDF

Effective communication is essential for the delivery of quality cancer palliative care. And yet, healthcare providers often lack the skills to communicate effectively with their patients and families.


Cancer Screening in Patients Infected with HIV  

Microsoft Academic Search

Non–AIDS-defining cancers are a rising health concern among HIV-infected patients. Cancer screening is now an important component\\u000a of health maintenance in HIV clinical practice. The decision to screen an HIV-infected patient for cancer should include an\\u000a assessment of individualized risk for the particular cancer, life expectancy, and the harms and benefits associated with the\\u000a screening test and its potential outcome.

Keith Sigel; Robert Dubrow; Michael Silverberg; Kristina Crothers; Scott Braithwaite; Amy Justice



Communication skills to ensure patient satisfaction.  


Every pediatrician would want to satisfy their patients and their parents to sustain good practice, earn name and fame and simultaneously to avoid litigation in this era of consumer protection act. This can be achieved only by use of good communication skills. Today the patients demand time, information and want their questions to be answered. They expect politeness, empathy and human touch from doctors. Time constraints, arrogance, telephone calls, language barriers and cultural insensitivity are the important barriers to good communication. Research has shown that doctor, who undergoes training to acquire good communication skills, can better satisfy his patients. Good communication skill is an art which can be acquired or improved by putting conscious efforts in day to day practice. Such skills should also be incorporated as part of medical teaching curriculum. Asking open ended questions, effective listening, appropriate praise, providing enough information as part of advice and finally checking their understanding, are the key areas of communication during medical interview. During this process pediatrician should ensure to address the parental concerns, should empathize with parents and involve parents in decision making. This will not only ensure satisfaction of parents but also their adherence to the therapy and to the pediatrician. PMID:23378053

Shendurnikar, Niranjan; Thakkar, Pareshkumar A



Challenges in DCIS Risk Communication and Decision-Making: Report from an American Cancer Society and National Cancer Institute Workshop  

PubMed Central

In September 2010, the American Cancer Society and National Cancer Institute convened a conference to review current issues in DCIS risk communication and decision-making and to identify directions for future research. Specific topics included patient and healthcare provider knowledge and attitudes about DCIS and its treatment, how to explain DCIS to patients given the heterogeneity of the disease, consideration of nomenclature changes, and the utility of decision tools/aids. This report describes the proceedings of the workshop in the context of the current literature and discusses future directions. Evidence suggests that there is lack of clarity about the implications and risks of a diagnosis of DCIS, among patients, providers and researchers. Research is needed to understand better the biology and mechanisms of the progression of DCIS to invasive breast cancer and the factors which predict those subtypes of DCIS which do not progress, as well as efforts to improve communication and informed decision-making surrounding DCIS. PMID:22488610

Partridge, Ann H.; Elmore, Joann G.; Saslow, Debbie; McCaskill-Stevens, Worta; Schnitt, Stuart J.



Understanding Cancer Series: Patient's Genetic Background

While attention must be paid to the changes discovered within the genomic profile of a cancerous growth, equal attention must be paid to the intrinsic genetic background of each patient. Cancer does not develop in a vacuum, but within a patient, and each patient's distinctive genetic background results from both intrinsic and extrinsic factors.


Chemotherapy-Induced Peripheral Neuropathy in Pediatric Cancer Patients  

PubMed Central

Chemotherapy-induced peripheral neuropathies (CIPNs) are an increasingly common neuropathic and pain syndrome in adult and pediatric cancer patients and survivors [1–69]. However, symptoms associated with CIPNs are often undiagnosed, under-assessed, and communications problems between clinicians, family members, and patients have been observed [70–73]. Less is known about the prevalence and impact of CIPNs on pediatric cancer populations [70–71]. This article aims to provide a brief understanding of CIPNs in pediatric populations, and to review the evidence for both its prevention and treatment. PMID:25144779

Groninger, Hunter



Patient-centred care: making cancer treatment centres accountable.  


Patient-centred care is argued to be an essential component in the delivery of quality health and cancer care. This manuscript discusses the need to generate credible data which indicates the quality of patient-centred care provided by cancer treatment centres. Patient-centred care covers six domains including physical comfort; emotional support; respect for patients' preferences and values; integration and coordination; involvement of family and friends; and the provision of information, communication and education to enable patients to understand and make informed decisions about their care. First, we identify priority areas within each domain. Next, we propose three questions that should be asked of every patient across the six domains of patient-centred care. The first question explores whether patients were specifically asked by a healthcare provider at the cancer treatment centre about their concerns, values and preferences. Research indicates that it cannot be assumed that clinicians are aware of patient's needs or preferences in these six areas. Second, if the answer from the patient suggests that they would like assistance, then it would be expected that this would be offered. Thirdly, if the patient indicates that they would like such assistance and it is provided, then it might be expected that the patient would report that the provided assistance did relieve their suffering, or the assistance provided was consistent with their preferences, needs and values. Regular measurement and reporting of these aspects of patient-centred cancer care has the potential to identify deficits and inequities in care delivery, allow for comparisons across treatment centres and stimulate an improvement in the patient-centred care provided to cancer patients. PMID:24696084

Zucca, Alison; Sanson-Fisher, Rob; Waller, Amy; Carey, Mariko



Familial cancer among consecutive uterine cancer patients in Sweden  

PubMed Central

Background Uterine cancer (UC) represents 5.1% of all female malignancies in Sweden. Accumulation of UC in families occurs in around 5% of cases. We wanted to identify any familial association between UC and other selected cancers and to study the frequency of Lynch,Cowden and cancer syndromes among consecutive UC patients in Sweden. Methods 481 UC patients were included. Information on the cancer diagnoses of their relatives (first- (FDRs) and second-degree (SDRs) relatives and first cousins) was obtained. The relative frequencies of different cancers among relatives were compared to those in the Swedish general cancer population in 1970 and 2010. Families that fulfilled the criteria for hereditary cancer syndromes were tested for mutations in the causative genes. Families with at least one case of UC in addition to the index patient were compared to families with no additional cases to investigate possible characteristics of putative hereditary cancer syndromes. Results There was an increased prevalence of UC in our study population compared to the Swedish general cancer population in 1970 and 2010 (6% vs. 4% and 3%, respectively). Seven families had Lynch Syndrome according to the Amsterdam II criteria. No families fulfilled the criteria for Cowden syndrome. In total 13% of index patients had at least one relative with UC and these families tended to have more cases of early onset cancer among family members. In addition, 16% of index patients were diagnosed with at least one other cancer. No families fulfilled the criteria for Cowden syndrome. Conclusion We showed a familial clustering of UC among relatives of our index patients. Of the seven families with mutation-verified Lynch Syndrome, only one had been previously diagnosed, highlighting the need to increase gynecologists’ awareness of the importance of taking family history. Our data on multiple cancers and young age of onset in families with uterine cancer is compatible with the existence of additional hereditary uterine cancer syndromes. PMID:24851142



Nutritional concerns in cancer patients.  


One of the prime nutritional concerns in cancer patients is cachexia and deteriorating nutritional status. Cachexia can occur as a result of either treatment or the tumor itself. The progressive malnutrition ultimately affects performance status and organ function. Tolerance to treatment may thus be decreased, which, in turn, may adversely affect toxicity and response. In addition, the deleterious effects of malnutrition on the immune system can increase susceptibility to infection. The weakness and fatigue related to muscle wasting and changes in metabolism affect physical appearance, leading to a loss of self-esteem. Thus, the vicious cycle of cachexia severely impacts on every aspect of daily life. Providing nutritional support and effective treatment may reverse the cachexia. Studies involving caloric supplements alone have not been encouraging. Conversely, studies using megestrol acetate have shown that cancer patients gain weight and that their sense of well-being improves. However, the mechanisms of weight gain remain unknown, and further studies are needed to determine the mechanisms by which appetite is stimulated or catabolism is inhibited or both. Nursing interventions to stimulate appetite and promote greater food intake, coupled with the use of agents that alter metabolism, such as megestrol acetate, may reverse the trend of cachexia and thus provide an increased sense of well-being and improved quality of life. PMID:2727453

Tait, N; Aisner, J



Mechanical ventilation in cancer patients.  


Acute respiratory failure (ARF) in cancer patients remains a frequent and severe complication, despite the general improved outcome over the last decade. The survival of cancer patients requiring ventilatory support in Intensive Care Unit (ICU) has dramatically improved over the last years. The diagnostic approach, including an invasive strategy using fiber optic bronchoscopy or a non-invasive strategy, must be effective to identify a diagnostic, as it is a crucial prognostic factor. The use of non-invasive ventilation (NIV) instead of invasive mechanical ventilation (IMV), has contributed to decrease mortality, but NIV has to be used in appropriate situations. Indeed, NIV failure (i.e., need for IMV) is deleterious. Classical prognostic factors are not relevant anymore. The number of organ failure at admission and over the first 7 ICU days governs outcomes. Ventilatory support can thus be included in different management contexts: full code management with unlimited use of life sustaining therapies, full code management for a limited period, no-intubation decision, or the use of palliative NIV. The objectives of this review article are to summarize the modified ARF diagnostic and therapeutic management, induced by improvements in both intensive care and onco-hematologic management and recent literature data. PMID:24280820

Saillard, C; Mokart, D; Lemiale, V; Azoulay, E



Breast-cancer patients' participation behavior and coping during presurgical consultations: a pilot study.  


In the context of breast-cancer care, there is extremely little research on the association between observed (i.e., taped and coded) communication behaviors and patients' health outcomes, especially those other than satisfaction. In the context of presurgical consultations between female breast cancer patients and a surgeon, the aim of this exploratory study was to test the association between communication-based participation behaviors and pre-post consultation changes in aspects of patients' mental adjustment to cancer (i.e., coping). Participants included 51 women newly diagnosed with breast cancer and a surgical oncologist from a National Cancer Institute (NCI)-designated cancer center in the northeastern United States. Outcomes were changes in patients' fighting spirit, helplessness/hopelessness, anxious preoccupation, cognitive avoidance, and fatalism (measured immediately before and after consultations via survey), and the main predictors were three communication-based participation behaviors coded from videotapes of consultations: patient question asking, patient assertion of treatment preferences, and surgeon solicitation of patient question/concern/opinion. Patients who more frequently asserted their treatment preferences experienced increases in their fighting spirit (p = .01) and decreases in their anxious preoccupation (p = .02). When companions (e.g., sister, spouse) asked more questions, patients experienced decreases in their anxious preoccupation (p = .05). These findings suggest that, in the present context, there may be specific, trainable communication behaviors, such as patients asserting their treatment preferences and companions asking questions, that may improve patients' psychosocial health outcomes. PMID:25122519

Venetis, Maria K; Robinson, Jeffrey D; Kearney, Thomas



Communication in the physician-patient relationship.  

PubMed Central

Political, legal, ethical, social, economic, and technological changes in the twentieth century have produced a profound effect on the health care and health status of Americans and the way in which physicians and patients communicate. In the latter half of this century, the responsibility for individual health care has shifted from a physician-oriented, paternalistic approach to a patient-centered one. Patients now assume two identities: health consumers and active participants in the medical decision-making process. This phenomenon has created an environment where consumer demand for information has shifted from a single focus on symptoms, diagnosis, and treatment of diseases to an increasing preoccupation with cost, quality, and access to health care. This shift emphasizes the critical role played by medical librarians in the dissemination of needed information, and it challenges librarians to take a leadership role in opening newer channels of communication between physicians and patients. The 1992 Janet Doe Lecture analyzes the evolutionary change in the physician-patient relationship and its modes of communication, projects future roles for medical librarians, and provides an extensive list of references for further reading. PMID:8428183

Rees, A M



Communicating with older ethnic minority patients.  


In a time of increasing cultural diversity, it is essential that healthcare professionals respond by providing culturally competent care. Healthcare professionals must recognise the diverse needs of people from ethnic minority communities to ensure that they receive equal standards of care. This is particularly pertinent when providing care for older ethnic minority patients who may not be fluent in English. This article focuses on the need to communicate effectively with this group of patients to meet their health and social care needs, with the ultimate aim of improving patient outcomes. PMID:24894254

Likupe, Gloria



Significance of prostate specific antigen in prostate cancer patients and in non cancerous prostatic disease patients  

Microsoft Academic Search

Objective: To evaluate the significance of prostate specific antigent (PSA) and scan in prostate cancer patients and in non cancerous prostatic disease patients. Methods: The study was carried out in Radioimmunoassay (RIA) lab, KIRAN Hospital, Karachi during 2002 to 2006. A total of 149 serum samples were collected in which 93 samples were biopsy positive prostate cancer patients referred to

Muhammad Hanif; Parveen Zaidi; Shahid Kamal; Samreen Idrees; Sheikh Ajaz Rasool


Towards patient-based cancer therapeutics  

PubMed Central

A new approach to the discovery of cancer therapeutics is emerging that begins with the cancer patient. Genomic analysis of primary tumors is providing an unprecedented molecular characterization of the disease. The next step requires relating the genetic features of cancers to acquired gene and pathway dependencies and identifying small-molecule therapeutics that target them. PMID:20829823



Guidelines Urge Exercise for Cancer Patients, Survivors

The benefits of exercise are well documented in a number of cancers. A panel of experts in cancer, fitness, obesity, and exercise training convened by the American College of Sports Medicine is spreading what they believe to be one of the most important messages for cancer patients and survivors: Avoid inactivity.


Is exercise ignored in palliative cancer patients?  

PubMed Central

Exercise and rehabilitation approaches in palliative care programs for cancer patients affect patients’ symptoms, physical functioning, muscle strength, emotional wellbeing, psychological symptoms, functional capacities, quality of life, mortality and morbidity positively. Based on scientific data, palliative cancer patients should be recommended to participate in exercise programs. There is no standard approach to recipe an exercise regimen for a palliative cancer survivor. Studies for demonstrating the positive effects of exercising in palliative care patients are increasing in number day by day. At this point, increasing awareness about exercising in the entire team monitoring the patient and our efforts in this matter seems to be very important. PMID:25114869

Eyigor, Sibel; Akdeniz, Sedef



Is exercise ignored in palliative cancer patients?  


Exercise and rehabilitation approaches in palliative care programs for cancer patients affect patients' symptoms, physical functioning, muscle strength, emotional wellbeing, psychological symptoms, functional capacities, quality of life, mortality and morbidity positively. Based on scientific data, palliative cancer patients should be recommended to participate in exercise programs. There is no standard approach to recipe an exercise regimen for a palliative cancer survivor. Studies for demonstrating the positive effects of exercising in palliative care patients are increasing in number day by day. At this point, increasing awareness about exercising in the entire team monitoring the patient and our efforts in this matter seems to be very important. PMID:25114869

Eyigor, Sibel; Akdeniz, Sedef



Grantee Research Highlight: Taking Account of the Patient's Perspective when Examining the Quality of Cancer Care

Optimizing patient experiences with care is especially important in cancer because cancer care is often complex and involves communication with and coordination across providers of multiple specialties and across multiple institutional settings. Unsatisfactory interactions with the health care system pose an additional burden on patients when they are already ill and vulnerable. More importantly, less-than-optimal patient experiences can have a significant negative impact on patients’ health-related quality of life.


Cancer patient supportive care and pain management. Special listing  

SciTech Connect

This Special Listing of Current Cancer Research Projects is a publication of the International Cancer Research Data Bank (ICRDB) Program of the National Cancer Institute. Each Listing contains descriptions of ongoing projects in one selected cancer research area. The research areas include: Infectious disease in cancer patients; Immunological aspects of supportive care of cancer patients; Nutritional evaluation and support of cancer patients; Pain management of cancer patients.

Not Available



Incidence of prostate cancer in male breast cancer patients: a risk factor for prostate cancer screening  

Microsoft Academic Search

Synchronous or metachronous occurrences of both prostate cancer and male breast cancer are rarely reported, but provide insight into their hormonal and genetic biology. We sought to determine the incidence of prostate cancer in male breast cancer patients at our institution, and to examine estrogen receptor (ER), progesterone receptor (PR) and HER-2\\/neu receptor (HR) status in these patients. A retrospective

U J Lee; J S Jones



Risk of cancer in relatives of testicular cancer patients  

E-print Network

Summary The incidence of cancer at sites other than the testis has been investigated in the families of 797 Norwegian and 178 Swedish patients diagnosed with testicular cancer during 1981-91. In the families of the Norwegian patients, the total number of cancers in the relatives was significantly lower than the expected number derived from national incidence rates [observed number of cancers 250, expected number of cancers 281.92, standardised incidence ratio (SIR) 0.89, 95 % confidence interval (CI) 0.78-1.00]. This finding can be accounted for almost entirely by the finding of fewer than expected prostate and gastrointestinal cancers in the parents of cases. The other common cancers were found at slightly lower than or near the expected levels in the relatives. In the Swedish cohort, which accounts for less than 20 % of cases, the observed number of cancers was very close to the expected number. Fourteen fathers of cases had prostate cancer compared with 27.57 prostate cancers expected, giving a SIR of 0.51 (P = 0.006). Mothers had more lung cancers (ten cases observed, SIR = 2.11, P = 0.04) and cancers of the endometrium than expected (13 cases observed, SIR = 1.73, P = 0.09). These findings may be interpreted as support for theories proposing hormonal dysfunction as causing testicular cancer. Fifty-four gastrointestinal cancers were observed in the parents compared with 68.48 expected (SIR = 0.78, P = 0.082). Furthermore, testicular cancer was not found to be associated with the known dominantly inherited cancer syndromes [Familial breast (-ovarian) cancer, hereditary non-polyposis colon

K Heimdal; H Olsson; S Tretli; P Flodgren A-l Brresen


Malnutrition and Metabolic Abnormalities in Cancer Patients  

Microsoft Academic Search

Summary Malnutrition is a common problem in cancer patients. The most clear-cut cause is anorexia and a decrease in food intake. Other causes include alterations in carbohydrate, fat and protein metabolism which result in losses of energy and amino acids from the host. Understanding the pathophysiology of these changes will provide avenues to better nourish cancer patients and improve their

J. M. Daly



Rehabilitation of head and neck cancer patients  

Microsoft Academic Search

\\u000a Patients who are treated for head and neck cancer can present with some of the most significant posttreatment morbidity of\\u000a any cancer group [1–29]. Their eating, talking, respiration, and cosmesis can all be significantly altered by their treatment.\\u000a All these effects may be quite visible and may interfere with socialization and employment. Therefore, rehabilitation for\\u000a head and neck cancer patients

Jeri A. Logemann


A quality of life subscale for terminally ill cancer patients  

Microsoft Academic Search

A subscale was developed to assess the quality of life of cancer patients with a life expectancy of six months or less. Phase I of this study identified the major concerns of 74 terminally ill cancer patients (19 with breast cancer, 19 with lung cancer, 18 with colorectal cancer, 9 with renal cell cancer, 9 with prostate cancer), 39 family

Anthony James Greisinger



Original Article Communication boards in critical care: patients' views B  

Microsoft Academic Search

Background: Some patients receiving mechanical ventilation experience an intensified need to communicate while their ability to do so is compromised as the endotracheal tube prevents speech. Although the use of a communication board to enhance communication with such patients has been suggested, few descriptive or empirical studies have addressed the content and format of these devices or of patients' perspectives

Lance Patak; Anna Gawlinski; Ng Irene Fung; Lynn Doering; Jill Berg; Elizabeth A. Henneman


Quality of life in head and neck cancers patients: predictive factors, functional and psychosocial outcome  

Microsoft Academic Search

The principal endpoints in head and neck cancer are survival with improvement of quality of life (QoL) in cancer patients.\\u000a Patients treated for head and neck cancer suffer from a number of symptom domains: physical symptoms linked to diet and feeding,\\u000a communication disorders, pain and their general state of health; psychological symptoms including depression, irritability,\\u000a loss of self-esteem (occasionally feelings

E. Babin; E. Sigston; M. Hitier; D. Dehesdin; J. P. Marie; O. Choussy



Do not attempt resuscitation decisions in a cancer centre: addressing difficult ethical and communication issues  

PubMed Central

Talking to patients about ‘Do Not Attempt Resuscitation’ decisions is difficult for many doctors. Communication about ‘Do Not Attempt Resuscitation’ decisions should occur as part of a wider discussion of treatment goals at an earlier stage in the patient's illness. A doctor should not initiate any treatment, including cardio-pulmonary resuscitation if he/she does not believe it will benefit the patient. An ethical framework is offered which may be of practical help in clarifying decision-making. British Journal of Cancer (2002) 86, 1057–1060. DOI: 10.1038/sj/bjc/6600205 © 2002 Cancer Research UK PMID:11953848

Reid, C; Jeffrey, D



Communication about Cancer Clinical Trials in Internet Cancer-Related Forums |

A qualitative analysis revealed that Internet-based cancer groups engage in discussion regarding clinical trials. The communication related to diverse aspects of participation and reflected the complex nature of decision making about trial participation. This abstract may be of interest for those designing interventions and recruitment procedures to promote trial participation.


Sperm banking and the cancer patient  

PubMed Central

The current concepts, recommendations, and principles of sperm banking as it pertains to the comprehensive care of young men of reproductive age with cancer are reviewed. Obstacles to sperm banking are addressed as well as future directions for fertility-preserving technologies. All cancer therapies—chemotherapy, radiation, and surgery—are potential threats to a man’s reproductive potential. In addition, cancer itself can impair spermatogenesis. Thus, sperm cryopreservation prior to initiating life-saving cancer treatment offers men and their families the best chance to father biologically related children and should be offered to all men with cancer before treatment. Better patient and provider education, as well as deliberate, coordinated strategies at comprehensive cancer care centers are necessary to make fertility preservation for male cancer patients a priority during pretreatment planning. PMID:21789080

Williams, Daniel H.



A survey of breast cancer physicians regarding patient involvement in breast cancer treatment decisions  

PubMed Central

Purpose Shared breast cancer treatment decision-making between patients and physicians increases patient treatment satisfaction and compliance and is influenced by physician-related factors. Attitudes and behaviors about patient involvement in breast cancer treatment decisions and treatment-related communication were assessed by specialty among breast cancer physicians of women enrolled in the Breast Cancer Quality of Care Study (BQUAL). Results Of 275 BQUAL physicians identified, 50.0% responded to the survey. Most physicians spend 46–60 min with the patient during the initial consult visit and 51.5% report that the treatment decision is made in one visit. Oncologists spend more time with new breast cancer patients during the initial consult (p = 0.021), and find it more difficult to handle their own feelings than breast surgeons (p = <0.001). Conclusion Breast surgeons and oncologists share similar attitudes and behaviors related to patient involvement in treatment decision-making, yet oncologists report more difficulty managing their own feelings during the decision-making process. PMID:23107518

Hillyer, Grace Clarke; Hershman, Dawn L.; Kushi, Lawrence H.; Lamerato, Lois; Ambrosone, Christine B.; Bovbjerg, Dana H.; Mandelblatt, Jeanne S.; Rana, Sargam; Neugut, Alfred I.



“What concerns me is…” Expression of emotion by advanced cancer patients during outpatient visits  

Microsoft Academic Search

Objective  Cancer patients have high levels of distress, yet oncologists often do not recognize patients’ concerns. We sought to describe\\u000a how patients with advanced cancer verbally express negative emotion to their oncologists.\\u000a \\u000a \\u000a \\u000a Materials and methods  As part of the Studying Communication in Oncologist–Patient Encounters Trial, we audio-recorded 415 visits that 281 patients\\u000a with advanced cancer made to their oncologists at three US

Wendy G. Anderson; Stewart C. Alexander; Keri L. Rodriguez; Amy S. Jeffreys; Maren K. Olsen; Kathryn I. Pollak; James A. Tulsky; Robert M. Arnold



Mortality communication as a predictor of psychological distress among family caregivers of home hospice and hospital inpatients with terminal cancer  

Microsoft Academic Search

Terminally ill cancer patients and their caregivers experience significant difficulties discussing illness and impending death (herein defined as mortality communication). The current study compares response levels as well as patterns of association between mortality communication and psychological distress among caregivers of home hospice and hospital inpatients. For this study, 231 family caregivers were recruited within a year of bereavement from

Yaacov G. Bachner; Norm ORourke; Eldad Davidov; Sara Carmel



An Ecological Framework for Cancer Communication: Implications for Research  

PubMed Central

The field of cancer communication has undergone a major revolution as a result of the Internet. As recently as the early 1990s, face-to-face, print, and the telephone were the dominant methods of communication between health professionals and individuals in support of the prevention and treatment of cancer. Computer-supported interactive media existed, but this usually required sophisticated computer and video platforms that limited availability. The introduction of point-and-click interfaces for the Internet dramatically improved the ability of non-expert computer users to obtain and publish information electronically on the Web. Demand for Web access has driven computer sales for the home setting and improved the availability, capability, and affordability of desktop computers. New advances in information and computing technologies will lead to similarly dramatic changes in the affordability and accessibility of computers. Computers will move from the desktop into the environment and onto the body. Computers are becoming smaller, faster, more sophisticated, more responsive, less expensive, and—essentially—ubiquitous. Computers are evolving into much more than desktop communication devices. New computers include sensing, monitoring, geospatial tracking, just-in-time knowledge presentation, and a host of other information processes. The challenge for cancer communication researchers is to acknowledge the expanded capability of the Web and to move beyond the approaches to health promotion, behavior change, and communication that emerged during an era when language- and image-based interpersonal and mass communication strategies predominated. Ecological theory has been advanced since the early 1900s to explain the highly complex relationships among individuals, society, organizations, the built and natural environments, and personal and population health and well-being. This paper provides background on ecological theory, advances an Ecological Model of Internet-Based Cancer Communication intended to broaden the vision of potential uses of the Internet for cancer communication, and provides some examples of how such a model might inform future research and development in cancer communication. PMID:15998614

Intille, Stephen S; Zabinski, Marion F



The creation of hope in patients with lung cancer.  


Abstract Background. Lung cancer is associated with biomedical and psychological symptoms as well as a generally poor prognosis. When healthcare staff communicate with lung cancer patients it is essential that they consider the patients' own views of the situation to avoid putting unnecessary strain upon the patients' shoulders. The purpose of the present study is to better understand how a group of patients with lung cancer reflects upon their new life situation after diagnosis and primary treatment. Method. Fifteen patients with non-small cell lung cancer were consecutively included and, where possible, repeatedly interviewed during the course of the disease process. The 29 interviews were conducted in a thematically structured narrative form that facilitated a dialog between the interviewer and the patient. The interviews covered experiences with health care, living an everyday life, and thoughts about the future. Findings and reflections. By focusing on how the patients more or less preconsciously elaborated mentally with their vulnerable situation, it was possible to detect different mental manoeuvres that they used as a way of creating hope. The patients distanced themselves from their disease, relied on a feeling of a sound body, idealised treatment possibilities, relied on healthy behaviour, focused on a concrete project, found that they were better off than others, and took solace in the fact that there were patients who had successfully managed the disease. Discussion. The patients were not passive victims in the face of their diagnosis, but were actively trying to find ways of looking at their despairing situation in a positive light. A creative process for psychological survival had thus been initiated by the patients. We suggest that acknowledging this process should be the starting point from which physicians can engage in hope work with their patients. PMID:24909242

Salander, Pär; Bergknut, Mirjam; Henriksson, Roger



Breast Cancer Drug Helps Patients with Gastric Cancer

Patients with advanced gastric cancer who received standard chemotherapy plus trastuzumab (Herceptin®) survived several months longer than those who received chemotherapy alone, according to findings presented at the 2009 ASCO meeting in Orlando.


Cultural beliefs and values in cancer patients.  


In 2008, the International Agency for Research on Cancer (IARC) released its World Cancer Report, which indicated that cancer accounts for approximately 12% of all-cause mortality worldwide. IARC estimated that globally 7.6 million people died from cancer and that 12.4 million new cases were diagnosed in 2008. The report went on to project that, due to increases in life expectancy, improvements in clinical diagnostics, and shifting trends in health behaviors (e.g. increases in smoking and sedentary lifestyles), in the absence of significant efforts to improve global cancer control, cancer mortality could increase to 12.9 million and cancer incidence to 20 million by the year 2030. Looking deeper into the data, it becomes clear that cancer-related stigma and myths about cancer are important problems that must be addressed, although different from a country to another. Stigmas about cancer present significant challenges to cancer control: stigma can have a silencing effect, whereby efforts to increase cancer awareness are negatively affected. The social, emotional, and financial devastation that all too often accompanies a diagnosis of cancer is, in large part, due to the cultural myths and taboos surrounding the disease. Combating stigma, myths, taboos, and overcoming silence will play important roles in changing this provisional trajectory. There are several reasons that cancer is stigmatized. Many people in our area perceived cancer to be a fatal disease. Cancer symptoms or body parts affected by the disease can cultivate stigma. Fears about treatment can also fuel stigma. There was evidence of myths associated with cancer, such as the belief that cancer is contagious, or cancer may be seen as a punishment. After reviewing these different examples of cultural myths and taboos met in cancer care, we can report these lessons learned: 1. Around the world, cancer continues to carry a significant amount of stigma, myths, and taboos; however, there are opportunities to capitalize upon shifting perceptions and positive change. 2. Awareness of cancer prevention, early detection, treatment, and survival are on the rise; however, too many people still report that they feel uninformed when it comes to cancer. 3. Communication is critical to decreasing cancer-related stigma, raising cancer awareness, and disseminating cancer education. People with a personal history of cancer-especially well-known or celebrity survivors-and multiple mass media channels are key resources for dissemination. 4. The school system represents a potential venue for cancer education, and increasing cancer awareness among children may be an investment with high returns. 5. When facing cancer, people around the world want information and emotional support for themselves and their families. 6. Tobacco use and poor nutrition are widely acknowledged as cancer risks. Programs and policies that help people translate this awareness into action are needed. The global cancer community should capitalize upon positive shifts in attitudes about awareness of cancer and leverage these shifts to develop, and disseminate effective media campaigns and behavioral interventions to decrease the incidence of and morbidity and mortality associated with cancer. PMID:22628419

Daher, M



Improving Physician-Patient Communication through Coaching of Simulated Encounters  

ERIC Educational Resources Information Center

Objective: Effective communication between physicians and their patients is important in optimizing patient care. This project tested a brief, intensive, interactive medical education intervention using coaching and standardized psychiatric patients to teach physician-patient communication to family medicine trainees. Methods: Twenty-six family…

Ravitz, Paula; Lancee, William J.; Lawson, Andrea; Maunder, Robert; Hunter, Jonathan J.; Leszcz, Molyn; McNaughton, Nancy; Pain, Clare



Treatment decision-making in breast cancer: the patient–doctor relationship  

Microsoft Academic Search

A diagnosis of breast cancer, whether the disease is early or advanced, can be devastating. With this in mind, constructive\\u000a patient–physician relationships are essential to minimizing disease-related stress and anxiety, as patients undergo treatment\\u000a and learn to cope with their diagnosis. Good communication skills are vital, and achieve measurable benefits, yet doctors\\u000a receive very little training in communication. Patients may

L. J. Fallowfield



Physician-patient communication: breaking bad news.  


Physicians often struggle with how to manage the task of breaking bad news with patients. Moreover, the arduous nature of the task can contribute to physician detachment from the patient or an avoidance of breaking the news in a timely manner. A plan of action can only improve physician confidence in breaking bad news, and also make the task more manageable. Over a decade ago, Rabow and McPhee offered a strategy; the ABCDE plan, which provided a patient centered framework from which to deliver troubling news to patients and families. At the heart of this plan was the creation of a safe environment, the demonstration of timely communication skills, and the display of empathy on the physician's part. Careful consideration of the doctor's own reactions to death and dying also played an important role. A close review of the five tenets of this plan indicates the relevance of Rabow and McPhee's strategy today. The patient base in our nation and state continues to be older, on average, and physicians are faced with numerous patients who have terminal illness. A constructive plan with specific ideas for breaking bad news can help physicians effectively navigate this difficult task. PMID:22655433

Fields, Scott A; Johnson, W Michael



Helping cancer patients disclose their concerns  

Microsoft Academic Search

Health professionals are reluctant to enquire actively about cancer patients' concerns and feelings. They fear that probing will damage patients psychologically and believe they have had insufficient training in the relevant interviewing skills. In considering how their interviewing skills might be improved, the key question is which interviewing behaviours promote patient disclosure and which inhibit it. To test our predictions

P. Maguire; A. Faulkner; K. Booth; C. Elliott; V. Hillier



Patient Delay in Colorectal Cancer Patients: Associations with Rectal Bleeding and Thoughts about Cancer  

PubMed Central

Rectal bleeding is considered to be an alarm symptom of colorectal cancer. However, the symptom is seldom reported to the general practitioner and it is often assumed that patients assign the rectal bleeding to benign conditions. The aims of this questionnaire study were to examine whether rectal bleeding was associated with longer patient delays in colorectal cancer patients and whether rectal bleeding was associated with cancer worries. All incident colorectal cancer patients during a 1-year period in the County of Aarhus, Denmark, received a questionnaire. 136 colorectal cancer patients returned the questionnaire (response rate: 42%). Patient delay was assessed as the interval from first symptom to help-seeking and was reported by the patient. Patients with rectal bleeding (N?=?81) reported longer patient intervals than patients without rectal bleeding when adjusting for confounders including other symptoms such as pain and changes in bowel habits (HR?=?0.43; p?=?0.004). Thoughts about cancer were not associated with the patient interval (HR?=?1.05; p?=?0.887), but more patients with rectal bleeding reported to have been wondering if their symptom(s) could be due to cancer than patients without rectal bleeding (chi2?=?15.29; p<0.001). Conclusively, rectal bleeding was associated with long patient delays in colorectal cancer patients although more patients with rectal bleeding reported to have been wondering if their symptom(s) could be due to cancer than patients without rectal bleeding. This suggests that assignment of symptoms to benign conditions is not the only explanation of long patient delays in this patient group and that barriers for timely help-seeking should be examined. PMID:23894527

Pedersen, Anette F.; Hansen, Rikke P.; Vedsted, Peter



"Best Practice" for Patient-Centered Communication: A Narrative Review  

PubMed Central

Background Communicating with patients has long been identified as an important physician competency. More recently, there is a growing consensus regarding the components that define physician-patient communication. There continues to be emphasis on both the need to teach and to assess the communication skills of physicians. Objective This narrative review aims to summarize the work that has been conducted in physician-patient communication that supports the efficacy of good communications skills. This work may also help to define the physician-patient communication skills that need to be taught and assessed. Results A review of the literature shows it contains impressive evidence supporting positive associations between physician communication behaviors and positive patient outcomes, such as patient recall, patient understanding, and patient adherence to therapy. There is a consensus about what constitutes “best practice” for physician communication in medical encounters: (1) fostering the relationship, (2) gathering information, (3) providing information, (4) making decisions, (5) responding to emotions, and (6) enabling disease- and treatment-related behavior. Conclusions Evidence supports the importance of communication skills as a dimension of physician competence. Effort to enhance teaching of communication skills to medical trainees likely will require significant changes in instruction at undergraduate and graduate levels, as well as changes in assessing the developing communication skills of physicians. An added critical dimension is faculty understanding of the importance of communication skills, and their commitment to helping trainees develop those skills. PMID:24404300

King, Ann; Hoppe, Ruth B.



Prognostic significance of intraperitoneal free cancer cells in gastric cancer patients  

Microsoft Academic Search

We performed intraoperative peritoneal cytology in 171 gastric cancer patients undergoing curative surgery. Intraperitoneal free cancer cells were demonstrated in almost all patients in whom the area of serosal cancer invasion exceeded 15–20 cm2. In patients with both serosal cancer invasion and free cancer cells the 5-year survival rat was 13% as compared with 85% for patients who had neither,

S. Koga; N. Kaibara; Y. Iitsuka; H. Kudo; A. Kimura; H. Hiraoka



Nutritional Support for the Cancer Patient  

Microsoft Academic Search

Cancer cachexia is a complex syndrome clinically manifest by progressive involuntary weight loss and diminished food intake\\u000a and characterized by a variety of biochemical alterations. Importantly, cancer cachexia has been associated with increased\\u000a morbidity and mortality and decreased response to therapy. The impact of cancer cachexia on patient outcome and healthcare\\u000a resources continues to be significant. It is therefore important

Lawrence E. Harrison


Discharge advice in cancer patients: posttreatment patients' report  

Microsoft Academic Search

BACKGROUND: Cancer patients are presented with advice and instructions during treatment and at discharge. Most recommendations aim at relief of physical problems, psychosocial well-being, and patients' health care behaviors. Patients often struggle to incorporate advice into daily life, and this influences symptom relief, quality of life, and even longevity. OBJECTIVE: The aim of this study was to gain insight into

J. De Leeuw; J. B. Prins; M. A. W. Merkx; H. A. M. Marres; T. van Achterberg



Life-Threatening Disparities: The Treatment of Black and White Cancer Patients  

PubMed Central

Cancer mortality and survival rates are much poorer for Black patients than for White patients. We argue that Black–White treatment disparities are a major reason for these disparities. We examine three specific kinds of Black–White treatment disparities: disparities in information exchange in oncology interactions, disparities in the treatment of breast cancer, and disparities in the treatment of clinically localized prostate cancer. In the final section, we discuss possible causes of these disparities, with a primary focus on communication within medical interactions and the role that race-related attitudes and beliefs may play in the quality of communication in these interactions. PMID:24319297

Penner, Louis A.; Eggly, Susan; Griggs, Jennifer J.; Underwood, Willie; Orom, Heather; Albrecht, Terrance L.



Wounds and survival in cancer patients  

Microsoft Academic Search

A number of validated and objectively based prognostic models are available for use in cancer care. The quest for additional prognostic factors continues in order to increase their accuracy. To date, none has considered the effect that wounds may contribute to assessing survival. This study serves to demonstrate that certain wound classes affecting cancer patients carry associations with survival. As

Vincent Maida; Marguerite Ennis; Craig Kuziemsky; Jason Corban



Breast Cancer Patients Might Prefer 'Invisible Tattoo'  


... enable JavaScript. Breast Cancer Patients Might Prefer 'Invisible Tattoo' Dark ink used to mark treatment area is ... TUESDAY, Nov. 4, 2014 (HealthDay News) -- Using "invisible" tattoos instead of permanent dark ink ones when breast ...


Resilience Among Patients Across the Cancer Continuum: Diverse Perspectives  

PubMed Central

Each phase of the cancer experience profoundly affects patients’ lives. Much of the literature has focused on negative consequences of cancer; however, the study of resilience may enable providers to promote more positive psychosocial outcomes before, during, and after the cancer experience. The current review describes the ways in which elements of resilience have been defined and studied at each phase of the cancer continuum. Extensive literature searches were conducted to find studies assessing resilience during one or more stages of the adult cancer continuum. For all phases of the cancer continuum, resilience descriptions included preexisting or baseline characteristics, such as demographics and personal attributes (e.g., optimism, social support), mechanisms of adaptation, such as coping and medical experiences (e.g., positive provider communication), as well as psychosocial outcomes, such as growth and quality of life. Promoting resilience is a critical element of patient psychosocial care. Nurses may enable resilience by recognizing and promoting certain baseline characteristics and optimizing mechanisms of adaptation. PMID:24476731

Molina, Yamile; Yi, Jean C.; Martinez-Gutierrez, Javiera; Reding, Kerryn W.; Yi-Frazier, Joyce P.; Rosenberg, Abby R.



Fatigue in patients with cancer  

Microsoft Academic Search

This paper reviews current knowledge regarding cancer-related fatigue assessment, prevalence, mechanisms and management. Most quality of life questionnaires contain at least some items pertaining to fatigue and a number of more specific self-assessment tools have now also been developed. As a result, there is a growing body of literature which documents the extent and severity of fatigue in cancer populations.

P. Stone; M. Richards; J. Hardy




PubMed Central

The increasing life expectancy in Saudi Arabia will be accompanied by an alteration of the patterns of disease similar to that in Western countries. One of these will be cancer, the second leading cause of death in the west at present, where 1:3 people develop cancer during their lifetime and 1:4 die of it. Cancer deaths are rarely easy. The distress particularly the pain it can cause is legendary. Palliative care is the care and study of patients with active progressive far advanced disease, where cure is impossible, the prognosis predictably short, and the focus of care is the patient's quality of life. A Palliative Care Program has been developed at KFSH&RC, since 1991. This has broadened the spectrum of health services available to cancer patients. Palliative care needs to be more widely available in the kingdom to relieve an important cause of human suffering. PMID:23008572

Gray, Alan; Ezzat, Adnan



Therapy Insight: management of cardiovascular disease in patients with cancer and cardiac complications of cancer therapy  

Microsoft Academic Search

Cardiac disease in patients with cancer or caused by cancer therapy is a clinical problem of emerging importance. Optimum management of cardiovascular disease can mean that patients with cancer can successfully receive therapies to treat their malignancy and can reduce morbidity and mortality due to cardiovascular disease in cancer survivors. The presence of cancer and cancer-related morbidities substantially complicates the

Aarif Y Khakoo; Edward TH Yeh



Communication preferences in patients with fibromyalgia syndrome: descriptive results and patient characteristics as predictors  

PubMed Central

Background Communication with patients with fibromyalgia syndrome (FMS) is often considered difficult. The primary objective of this explorative study was to describe the communication preferences of FMS patients in comparison with other chronic diseases, and the secondary objective was to identify patient-related predictors of those communication preferences. Methods A total of 256 FMS patients were asked to fill out the KOPRA [(Kommunikationspraeferenzen), communication preferences of patients with chronic illness] questionnaire at the beginning of their rehabilitation, answering questions about their communication preferences. The KOPRA’s descriptive parameters were calculated and compared with other diagnosis groups. In order to include as many influencing factors as possible, data on patient-related sociodemographic, medical, pain impact and psychologic variables were gathered. A hierarchical regression analysis with four steps was performed to identify patient-related predictors of patientscommunication preferences. Results FMS patients consider an open and patient-centered communication style to be especially important. Emotionally supportive communication and communication about personal circumstances are important for FMS patients, but the preferences of individual patients vary widely. FMS patients reveal higher values in all the subdimensions of communication preferences compared with patients with low back pain or chronic ischemic heart disease. Only a few variables appear to predict patient communication preferences. The explained variance ranged from 3.1% to 9.7%. Psychologic variables have been identified as predictors in conjunction with all communication preferences. Conclusion Health care providers who communicate with FMS patients should employ an open and patient-centered communication style, and affective communication components should be adapted to accommodate each patient. PMID:24520192

Ullrich, Antje; Hauer, Johannes; Farin, Erik



Is communication guidance mistaken? Qualitative study of parent-oncologist communication in childhood cancer  

PubMed Central

Background: Guidance encourages oncologists to engage patients and relatives in discussing the emotions that accompany cancer diagnosis and treatment. We investigated the perspectives of parents of children with leukaemia on the role of paediatric oncologists in such discussion. Methods: Qualitative study comprising 33 audio-recorded parent–oncologist consultations and semi-structured interviews with 67 parents during the year following diagnosis. Results: Consultations soon after the diagnosis were largely devoid of overt discussion of parental emotion. Interviewed parents did not describe a need for such discussion. They spoke of being comforted by oncologists' clinical focus, by the biomedical information they provided and by their calmness and constancy. When we explicitly asked parents 1 year later about the oncologists' role in emotional support, they overwhelmingly told us that they did not want to discuss their feelings with oncologists. They wanted to preserve the oncologists' focus on their child's clinical care, deprecated anything that diverted from this and spoke of the value of boundaries in the parent–oncologist relationship. Conclusion: Parents were usually comforted by oncologists, but this was not achieved in the way suggested by communication guidance. Communication guidance would benefit from an enhanced understanding of how emotional support is experienced by those who rely on it. PMID:23900218

Young, B; Hill, J; Gravenhorst, K; Ward, J; Eden, T; Salmon, P



Patient advocacy in the USA: key communication role functions.  


Researchers have long documented the importance of patient advocacy programs as a means of providing customer service in health-care organizations. Yet, while effective communication is often acknowledged as key to effective patient advocacy, knowledge of the specific communication role functions enacted by patient advocates remains limited, as does our understanding of the function of patient advocacy at the organizational level. This qualitative investigation not only provides a typology of communication roles enacted by patient advocates while solving problems on behalf of patients and their family members, but also integrates scholarly research on "boundary-spanning" as a means of theoretically contextualizing the advocacy role at the organizational level. PMID:17688476

Martin, Donald R; Tipton, Bryan K



Cancer and fertility preservation: fertility preservation in breast cancer patients  

Microsoft Academic Search

Aggressive chemotherapy has improved the life expectancy for reproductive-age women with breast cancer, but it often causes\\u000a infertility or premature ovarian failure due to destruction of the ovarian reserve. Many questions concerning fertility preservation\\u000a in breast cancer patients remain unanswered – for example, whether fertility preservation methods interfere with chemotherapy,\\u000a and whether subsequent pregnancy has negative effects on the prognosis.

Theodoros Maltaris; Michael Weigel; Andreas Mueller; Marcus Schmidt; Rudolf Seufert; Franz Fischl; Heinz Koelbl; Ralf Dittrich



Attitudes of patients to randomised clinical trials of cancer therapy.  


The aim of this study was to test an instrument which might be useful for doctors in explaining the randomisation procedure to an individual patient. The sample comprised 323 patients with cancer attending for out-patient appointments and/or chemotherapy treatment in two major cancer centres in the U.K. 315 patients completed a self-report questionnaire--The Attitudes to Randomised Trials Questionnaire (ARTQ). The results show that the majority of subjects 287 (91.1%) believe that patients should be asked to take part in medical research, but only 242 (76.8%) would be prepared to take part in a study comparing two treatments. If treatment was randomised, only 141 (44.8%) would agree to participate. When given further information about the randomisation procedure, 119 (68.4%) of the 174 (55.2%) who initially said 'no' to randomisation or who were unsure, would change their minds and take part in a trial. The ARTQ discriminated between three categories of patient with the following prevailing attitudes: (a) those who seem comfortable with the concept of randomisation; (b) those with some concerns, who with fuller explanation are prepared to consider randomisation; and (c) those firmly against randomisation and participation in trials whatever information is provided. Prior knowledge of patients' attitudes might assist communication about trials and encourage more doctors to approach eligible patients. PMID:9893627

Fallowfield, L J; Jenkins, V; Brennan, C; Sawtell, M; Moynihan, C; Souhami, R L



Catalyzing social support for breast cancer patients  

Microsoft Academic Search

Social support is a critical, yet underutilized resource when undergoing cancer care. Underutilization occurs in two conditions: (a) when patients fail to seek out information, material assistance, and emotional support from family and friends or (b) when family and friends fail to meet the individualized needs and preferences of patients. Social networks are most effective when kept up to date

Meredith M. Skeels; Kenton T. Unruh; Christopher Powell; Wanda Pratt



Food avoidance in patients undergoing cancer chemotherapy  

Microsoft Academic Search

Cancer and its treatment are known to cause malnutrition in significant numbers of patients. Although a variety of contributory factors have been identified it is clear that the aetiology of malnutrition is complex and multifactorial. Taste aberrations are believed to be amongst the causative factors and to contribute to the development of food avoidance\\/aversion in affected patients. The study described

Susan Holmes; Surrey GU



Multidisciplinary approach for patients with esophageal cancer  

PubMed Central

Patients with esophageal cancer have a poor prognosis because they often have no symptoms until their disease is advanced. There are no screening recommendations for patients unless they have Barrett’s esophagitis or a significant family history of this disease. Often, esophageal cancer is not diagnosed until patients present with dysphagia, odynophagia, anemia or weight loss. When symptoms occur, the stage is often stage III or greater. Treatment of patients with very early stage disease is fairly straight forward using only local treatment with surgical resection or endoscopic mucosal resection. The treatment of patients who have locally advanced esophageal cancer is more complex and controversial. Despite multiple trials, treatment recommendations are still unclear due to conflicting data. Sadly, much of our data is difficult to interpret due to many of the trials done have included very heterogeneous groups of patients both histologically as well as anatomically. Additionally, studies have been underpowered or stopped early due to poor accrual. In the United States, concurrent chemoradiotherapy prior to surgical resection has been accepted by many as standard of care in the locally advanced patient. Patients who have metastatic disease are treated palliatively. The aim of this article is to describe the multidisciplinary approach used by an established team at a single high volume center for esophageal cancer, and to review the literature which guides our treatment recommendations. PMID:23239911

Villaflor, Victoria M; Allaix, Marco E; Minsky, Bruce; Herbella, Fernando A; Patti, Marco G



Oncologists' attitudes to treatment of cancer patients  

Microsoft Academic Search

This study, based on questionnaire responses of 46 Israeli oncologists, explores the factors influencing these physicians' beliefs and decisions regarding chemo and radiation therapy. A simple discriminant analysis identified five physician-related variables with a significant impact on the subjects' attitudes to treatment: age, sex, years of oncology experience, pity for the patient, and whether they believed all cancer patients suffer

Ora Gilbar; Ben-Zion Cohen



Prolactin Concentrations in Patients with Breast Cancer  

PubMed Central

Basal prolactin levels were measured before operation in 113 patients undergoing surgery for a lump in the breast. Prolactin concentrations were not significantly higher in those patients with breast cancer than in those with benign lumps. Prolactin concentrations were, however, found to be higher in premenopausal women than in postmenopausal ones, regardless of tumour histology. PMID:4434088

Franks, S.; Ralphs, D. N. L.; Seagroatt, Valerie; Jacobs, H. S.



Helping Patients Decide: Ten Steps to Better Risk Communication  

PubMed Central

With increasing frequency, patients are being asked to make complex decisions about cancer screening, prevention, and treatment. These decisions are fraught with emotion and cognitive difficulty simultaneously. Many Americans have low numeracy skills making the cognitive demands even greater whenever, as is often the case, patients are presented with risk statistics and asked to make comparisons between the risks and benefits of multiple options and to make informed medical decisions. In this commentary, we highlight 10 methods that have been empirically shown to improve patients’ understanding of risk and benefit information and/or their decision making. The methods range from presenting absolute risks using frequencies (rather than presenting relative risks) to using a risk format that clarifies how treatment changes risks from preexisting baseline levels to using plain language. We then provide recommendations for how health-care providers and health educators can best to communicate this complex medical information to patients, including using plain language, pictographs, and absolute risks instead of relative risks. PMID:21931068

Zikmund-Fisher, Brian J.; Ubel, Peter A.



Protein energy malnutrition (PEM) in cancer patients  

Microsoft Academic Search

Introduction  Cancer patients show protein energy malnutrition (PEM) throughout the evolution of the disease. The main objective of this\\u000a work is to find out the prevalence of PEM in the studied sample, as well as how to assess the nutritional state of patients.\\u000a \\u000a \\u000a \\u000a Material and methods  Non-interventionist, longitudinal and prospective study. Cancer patients from 103 researchers (6 specialties) from 65 hospitals\\u000a of

Jaime Sanz Ortiz; José Andrés Moreno Nogueira; Abelardo García de Lorenzo y Mateos



Lactic acidosis in patients with cancer.  


Lactic acidosis is the most common metabolic acidosis in hospitalized patients-the result from an underlying pathogenic process. To successfully manage lactic acid production, its cause needs to be eliminated. Patients with cancer have many risk factors for developing lactic acidosis, including the cancer diagnosis itself. Patients with lactic acidosis are critically ill, requiring an intense level of nursing care with accompanying frequent cardiopulmonary and renal assessments. The mortality rate from lactic acidosis is high. Therefore, appropriate nursing interventions may include end-of-life and palliative care. PMID:25253114

Held-Warmkessel, Jeanne; Dell, Deena Damsky



Fertility preservation in breast cancer patients.  


Systemic therapies have been shown to effectively improve prognosis in patients with breast cancer. However, such therapies also become increasingly harmful as their duration increases, and they have adverse effects on fertility and ovarian function. Fertility preservation (FP) is important in young adult cancer survivors who may wish to have children. In Japan, some cancer societies recommend that the potentially serious effects of systemic therapy on ovarian function should be explained to women with cancer, and they should be encouraged to undergo FP prior to commencing treatment. Still, as there are no official guidelines, many oncologists lack the required knowledge and mind-set to advise young breast cancer patients on fertility issues. Counseling of patients and their families might improve their understanding about the influence of such treatment on fertility and ensure effective FP. There are several FP methods that can be selected before beginning treatment, and these methods have both advantages and disadvantages. Young adults with breast cancer who want to bear children in the future must be provided with FP counseling, in addition to advice about breast cancer treatment and prognosis. PMID:23526260

Shien, Tadahiko; Nakatsuka, Mikiya; Doihara, Hiroyoshi



CRCHD PNP Project: Moffitt Cancer Center Patient Navigator Program

CRCHD PNP Project: Moffitt Cancer Center Patient Navigator Program  Back to CRCHD Ongoing Research PNP Project Listing Patient Navigation Research Program (PNRP) Participating Research Sites Moffitt Cancer Center Patient Navigator Program


Fertility preservation for breast cancer patients.  


Breast cancer is the most common neoplasm in women and accounts for 26% (182,460) of all new cancer cases among women. With the use of screening mammography and advancement in other diagnostic modalities, many cases of breast cancer now can be diagnosed and treated at early stages of the disease. Unfortunately, adjuvant chemotherapy regimens commonly used in the treatment of breast cancer may cause premature ovarian failure due to their cytotoxic effects on the germ cells in the ovary. Therefore preservation of fertility in breast cancer survivors at reproductive age has become an important quality of life issue. Fertility preservation is a recently emerged field of reproductive medicine that may help protect the reproductive capability of the cancer survivors and allow them to have children in the future. Embryo freezing is the most established fertility preservation strategy. But conventional ovarian stimulation protocols are contraindicated in breast cancer patients because of the rise of estrogen and its metabolites to supraphysiological levels. Recently developed ovarian stimulation protocols with aromatase inhibitor letrozole and tamoxifen appear to provide a safe stimulation with endogenous estrogen levels comparable with those achieved in the natural cycle. Oocyte freezing can be considered in single women and in those who do not wish donor sperm. Ovarian tissue freezing could also be an option in breast cancer patients who do not wish or have a time for an in vitro fertilization cycle, which requires 10 to 14 days of ovarian stimulation. PMID:19806518

Oktem, Ozgur; Oktay, Kutluk



Kelp use in patients with thyroid cancer.  


To report on the incidence and use of kelp among patients with thyroid cancer. Data were collected using a web-based online anonymous survey under Institutional Review Board approval from Boston University. This report is based on 27 responses from subjects with thyroid cancer who use kelp. Demographic factors and complementary and alternative use were included. Respondents were primarily over age 40, white, female and have at least a high school education. The top five modalities were multivitamins, special diets, herbal supplements, prayer for health reasons and herbal tea. Only one patient reported perceiving a particular modality had a negative effect on treatment. Complementary and alternative medicine (CAM) was more often perceived as being used to aid their thyroid cancer treatment than to help with symptoms. On average, respondents who use kelp also use at least 11 additional CAM modalities. Only 1/2 of respondents who use kelp reported telling their physicians about their CAM use, and nearly 1/3 of respondents reported their CAM use was neither known, prescribed nor asked about by their physicians. In comparison to both national surveys of the general US population and patients with thyroid cancer, kelp users with thyroid cancer use at least twice the number of additional CAM therapies and report their use far less often. Physicians who treat patients with thyroid cancer should be aware of these data to further assist in their assessment and care. PMID:24573490

Rosen, Jennifer E; Gardiner, Paula; Saper, Robert B; Pearce, Elizabeth N; Hammer, Kallista; Gupta-Lawrence, Rebecca L; Lee, Stephanie L



Place of death: preferences among cancer patients and their carers  

Microsoft Academic Search

The place of death of cancer patients has become an important theme in UK cancer and palliative care policy. This paper examines the place of death preferences of 41 terminally ill cancer patients and 18 of their informal carers, living in the Morecambe Bay area of north-west England. We interviewed cancer patients referred to the research team by 13 specialist

C Thomas; S. M Morris; D Clark



Use of TPN in terminally ill cancer patients  

Microsoft Academic Search

Total parenteral nutrition (TPN) is often used as an adjunct to cancer therapy. However, it is increasingly being used in terminally ill cancer patients without clearly defined reasons. To determine the validity of the use of TPN in terminally ill cancer patients, 26 patients with limited life expectancy due to end-stage cancer were given TPN by their physicians, and the

Giovanni F Torelli; Antonio C Campos; Michael M Meguid



Clinical Course of Pulmonary Embolism in Lung Cancer Patients  

Microsoft Academic Search

Background: Although lung cancer is the most common malignancy diagnosed in patients with venous thromboembolism (VTE), data regarding pulmonary embolism (PE) in lung cancer patients are limited. Objectives: To investigate the clinicoradiological features, clinical course and survival of lung cancer patients with PE. Methods: We performed a retrospective case-control study investigating the clinical course and survival of 40 lung cancer

Jung-Woo Lee; Seung-Ick Cha; Chi-Young Jung; Won-Il Choi; Kyung-Nyeo Jeon; Seung-Soo Yoo; Chang-Ho Kim; Jae-Yong Park; Tae-Hoon Jung



Embracing technology: patients', family members' and nurse specialists' experience of communicating using e-mail.  


This paper reports on a study exploring the usefulness of e-mail as a means of communication between nurse specialists and patients with lung cancer and their families. The study involved two lung cancer nurse specialists and 16 patients and family members who used e-mail with them during the 6-month study period. Data were collected from three sources: (1) e-mail contact between the nurse specialists and patients/family members, (2) patient/family member questionnaire and (3) a focus group/reflective session with the nurse specialists. Quantitative data collected from the e-mails and the questionnaires were analysed descriptively and are presented as summary statistics. Text data from the questionnaires and e-mails were analysed using content analysis. Findings suggest that e-mail can be an effective and convenient means of communication between nurse specialists, and patients and family members. Patients and family members reported high levels of satisfaction with this method of communication. It was found to be quick and easy, and patients and family members were satisfied with both the response and the speed of response from the nurse specialists. Nurse specialists were also positive about e-mail use and found that the benefits of using e-mail with patients/family members outweighed any disadvantages. Further investigation is recommended involving other health care professionals and different patient groups to ensure the safe and appropriate use of e-mail within health care. PMID:18406667

Cornwall, Amanda; Moore, Sally; Plant, Hilary



Patient Communication: A Multidisciplinary Approach Using Animated Cartoons  

ERIC Educational Resources Information Center

Communication is a major problem in the management of patients. Miscommunication occurs frequently in populations with low reading skills, illiteracy does not completely account for the observed low rates of recall of communicated information. Transmission of the message also plays an important role. Successful strategies to improve communication

Leiner, Marie; Handal, Gilbert; Williams, Darryl



Cancer risk in patients with diabetes mellitus  

Microsoft Academic Search

Cancer incidence was ascertained in a population-based cohort of 51,008 patients in Uppsala, Sweden, who were given a discharge diagnosis of diabetes mellitus during 1965–83. Complete follow-up through 1984 with exclusion of the first year of observation showed that the observed number of cancers in females (1,294) was eight percent higher than expected (relative risk [RR]=1.1, 95 percent confidence interval

Hans-Olov Adami; Joseph McLaughlin; Anders Ekbom; Christian Berne; Debra Silverman; David Hacker; Ingemar Persson



Supportive Care of the Older Cancer Patient  

Microsoft Academic Search

Cancer mainly affects individuals aged 65 and over, so that supportive care for cancer treatment concerns mostly elderly patients.\\u000a Age is a risk factor for increased incidence and severity of chemotherapy-related toxicity and also for the emergence of different\\u000a forms of toxicity including delirium and malnutrition; in addition age may modulate the perception of pain and the response\\u000a to analgesics,

Lodovico Balducci


Ischemic Stroke and Cancer: Stroke Severely Impacts Cancer Patients, While Cancer Increases the Number of Strokes  

PubMed Central

Background Cancer and ischemic stroke are two of the most common causes of death among the elderly, and associations between them have been reported. However, the main pathomechanisms of stroke in cancer patients are not well known, and can only be established based on accurate knowledge of the characteristics of cancer-related strokes. We review herein recent studies concerning the clinical, laboratory, and radiological features of patients with cancer-related stroke. Main Contents This review covers the epidemiology, underlying mechanisms, and acute and preventive treatments for cancer-related stroke. First, the characteristics of stroke (clinical and radiological features) and systemic cancer (type and extent) in patients with cancer-specific stroke are discussed. Second, the role of laboratory tests in the early identification of patients with cancer-specific stroke is discussed. Specifically, serum D-dimer levels (as a marker of a hypercoagulable state) and embolic signals on transcranial Doppler (suggestive of embolic origin) may provide clues regarding changes in the levels of coagulopathy related to cancer and anticoagulation. Finally, strategies for stroke treatment in cancer patients are discussed, emphasizing the importance of preventive strategies (i.e., the use of anticoagulants) over acute revascularization therapy in cancer-related stroke. Conclusion Recent studies have revealed that the characteristics of cancer-related stroke are distinct from those of conventional stroke. Our understanding of the characteristics of cancer-related stroke is essential to the correct management of these patients. The studies presented in this review highlight the importance of a personalized approach in treating stroke patients with cancer. PMID:21779292

Seok, Jin Myoung; Kim, Seon Gyeong; Hong, Ji Man; Kim, Hahn Young; Lee, Jun; Chung, Pil-Wook; Park, Kwang-Yeol; Kim, Gyeong-Moon; Chung, Chin-Sang; Lee, Kwang Ho



Health literacy, health communication challenges, and cancer screening among rural Native Hawaiian and Filipino Women  

PubMed Central

Native Hawaiians and Filipinos are disproportionately impacted by cancer, and are less likely to participate in cancer screening than whites. Limited information exists about health information pathways and health communication challenges as they relate to cancer screening in these groups. Six focus groups (n=77) of Native Hawaiian and Filipino women age 40+ years were conducted to investigate these research gaps. Participants noted many health information challenges. Challenges were both practical and interpersonal and included both written and oral health communication. Practical challenges included “big” words, complexity of terms, and lack of plain English. Interpersonal issues included doctors rushing, doctors not assessing comprehension, and doctors treating respondents as patients not people. Women noted that they would often not ask questions even when they knew they did not understand because they did not want the provider to think negatively of them. Overarching themes to improve cancer communication gaps included: (1) the importance of family and community in health information dissemination; (2) the key role women play in interpreting health information for others; (3) the importance of personal experience and relationships to the salience of health information; and (4) the desire for local cultural relevance in health communication. Findings are discussed in light of the 2010 National Action Plan for Health Literacy. PMID:23536194

Sentell, Tetine; Cruz, May Rose Dela; Heo, Hyun Hee; Braun, Kathryn



Patient educational needs of patients undergoing surgery for lung cancer.  


There often exists a discrepancy between the information health care professionals (HCPs) provide to patients in preoperative teaching sessions and the information patients perceive as important. This study's purpose was to determine what information patients undergoing a lung cancer surgical resection wanted to learn before and after their surgery and also to uncover the information HCPs currently provide to these patients. Ten patients were interviewed preoperatively and postoperatively, and eleven HCPs involved in both their preoperative and postoperative care were interviewed. Emerging themes were noted. Patients reported that the most helpful aspects of the preoperative education included surgical details and the importance of physiotherapy, including exercises. Postoperatively, patients wished they had known more about postoperative pain. HCPs provided information that they felt prepared, informed and empowered their patients. Overall, patients expressed satisfaction with the information they received; they felt prepared for their surgery but not for postoperative pain control. PMID:24756546

King, Judy; Chamberland, Paul; Rawji, Anissa; Ager, Amanda; Léger, Renée; Michaels, Robin; Poitras, Renée; Skelton, Deborah; Warren, Michelle



Complementary therapy use by cancer patients. Physicians' perceptions, attitudes, and ideas.  

PubMed Central

OBJECTIVE: To explore family physicians' perceptions of their cancer patients' use of complementary therapy. DESIGN: Qualitative pilot study. SETTING: British Columbia and Alberta. PARTICIPANTS: Rural and urban family physicians. METHOD: Five focus groups were conducted with a total of 28 participants. Content analysis of focus group transcripts. MAIN FINDINGS: Eight themes were identified: definition of complementary therapies, importance of holistic health, role of evidence, attitudes toward complementary therapies, perceptions of cancer patients' use of complementary therapies, patient-physician communication, perceptions of family physicians' role with respect to complementary therapies, and concerns about complementary therapies. Family physicians believed that many of their patients were using complementary therapies and that patients and physicians needed to communicate about this practice. CONCLUSION: The study increased understanding of physicians'perspectives on communication about complementary therapies and exposed issues that need to be addressed through education and research. PMID:15233371

O'Beirne, Maeve; Verhoef, Marja; Paluck, Elan; Herbert, Carol



Partnering against cancer today: a blueprint for coordinating efforts through communication science.  


One of the hallmarks of the communication revolution over the past decade has been its support for participation, whether that be in the active engagement of patients searching the Web for answers to vital health questions, or in the collective energies of self-organizing communities through social media. At the same time, some of the major obstacles to achieving a full and equitable reach of evidence-based cancer control knowledge have been traced back to discontinuities in communication either within clinical care or the broader public awareness system. Communication scientists from the National Cancer Institute, the Centers for Disease Control and Prevention, and the American Cancer Society joined forces in 2010 to investigate ways in which communication science can be used to improve coordination and enhance participation in cancer control for the nation. From 2010 to 2013, the three organizations worked together in 1) convening two meetings designed to assess the status of funded research in communication science, 2) completing a systematic review of literature published over the previous 10 years, and 3) authoring a blueprint for coordinated efforts using the implications of communication science. The blueprint consists of three major goals: first, to identify high-yield targets of opportunity using the health impact pyramid articulated by Centers for Disease Control and Prevention Director, Thomas Frieden; second, to leverage opportunities within the new communication environment, including the opportunities catalyzed by national efforts to create an infrastructure for evidence implementation through health information technology; and third, to assist in coordinating efforts across collaborative entities through participative media. PMID:24395998

Hesse, Bradford W; Cole, Galen E; Powe, Barbara D



Nutrition in Head and Neck Cancer Patients  

PubMed Central

Anorexia and cachexia frequently complicate the late stages of malignancy and can be a prominent feature of early disease. The resulting weight loss significantly affects the morbidity and mortality of the cancer patient. A fundamental understanding of nutrition and the pathophysiology of cancer cachexia will aid in diligent treatment decisions to achieve optimal results. The pathophysiology of cancer cachexia is discussed, together with methods of nutritional assessment, nutritional requirements, and postoperative nutritional support. The advantages and disadvantages of the various modes of parenteral and enteral feeding are presented, together with information about enteral feeding in the home. PMID:22550454

Varkey, Prashanth; Tang, Wen-Ruay; Tan, Ngian Chye



Coordinating care and treatment for cancer patients.  


Survival following a diagnosis of cancer is contingent upon an interplay of factors, some non-modifiable (e.g., age, sex, genetics) and some modifiable (e.g., volitional choices) but the majority determined by circumstance (personal, social, health system context and capacity, and health policy). Accordingly, mortality and survival rates vary considerably as a function of geography, opportunity, wealth and development. Quality of life is impacted similarly, such that aspects of care related to coordination and integration of care across primary, community and specialist environments; symptom control, palliative and end-of-life care for those who will die of cancer; and survivorship challenges for those who will survive cancer, differs greatly across low, middle and high-income resource settings. Session 3 of the 4th International Cancer Control Congress (ICCC-4) focused on cancer care and treatment through three plenary presentations and five interactive workshop discussions: 1) establishing, implementing, operating and sustaining the capacity for quality cancer care; 2) the role of primary, community, and specialist care in cancer care and treatment; 3) the economics of affordable and sustainable cancer care; 4) issues around symptom control, support, and palliative/end-of-life care; and 5) issues around survivorship. A number of recommendations were proposed relating to capacity-building (standards and guidelines, protocols, new technologies and training and deployment) for safe, appropriate evidence-informed care; mapping and analysis of variations in primary, community and specialist care across countries with identification of models for effective, integrated clinical practice; the importance of considering the introduction, or expansion, of evidence-supported clinical practices from the perspectives of health economic impact, the value for health resources expended, and sustainability; capacity-building for palliative, end-of-life care and symptom control and integration of these services into national cancer control plans; the need for public education to reduce the fear and stigma associated with cancer so that patients are better able to make informed decisions regarding follow-up care and treatment; and the need to recognize the challenges and needs of survivors, their increasing number, the necessity to integrate survivorship into cancer control plans and the economic and societal value of functional survival after cancer. Discussions highlighted that coordinated care and treatment for cancer patients is both a ' systems'challenge and solution, requiring the consideration of patient and family circumstances, societal values and priorities, the functioning of the health system (access, capacity, resources, etc.) and the importance assigned to health and illness management within public policy. PMID:22631594

Yip, Cheng Har; Samiei, Massoud; Cazap, Eduardo; Rosenblatt, Eduardo; Datta, Niloy Ranjan; Camacho, Rolando; Weller, David; Pannarunothai, Supasit; Goh, Cynthia; Black, Fraser; Kaur, Ranjit; Fitch, Margaret; Sutcliffe, Catherine; Sutcliffe, Simon



Communicating to Farmers about Skin Cancer: The Behavior Adaptation Model.  

ERIC Educational Resources Information Center

States health campaign messages designed to encourage behavior adaptation have greater likelihood of success than campaigns promoting avoidance of at-risk behaviors that cannot be avoided. Tests a model of health risk behavior using four different behaviors in a communication campaign aimed at reducing farmers' risk for skin cancer--questions…

Parrott, Roxanne; Monahan, Jennifer; Ainsworth, Stuart; Steiner, Carol



Pharmacist-Patient Communication: A Structure of Intrapersonal Processes.  

ERIC Educational Resources Information Center

A study examined the perceptions of pharmacy students regarding pharmacist-patient communication to determine whether the increased emphasis on the patient counseling role of pharmacists resulted in perceptual differences between students, pharmacists, and faculty. Data were gathered from 25 students, 2 pharmacy faculty, 8 communication studies…

Aitken, Joan E.


Doctor-Patient Communication in Southeast Asia: A Different Culture?  

ERIC Educational Resources Information Center

Studies of doctor-patient communication generally advocate a partnership communication style. However, in Southeast Asian settings, we often see a more one-way style with little input from the patient. We investigated factors underlying the use of a one-way consultation style by doctors in a Southeast Asian setting. We conducted a qualitative…

Claramita, Mora; Nugraheni, Mubarika D. F.; van Dalen, Jan; van der Vleuten, Cees



Patient-Physician Communication About Complementary and Alternative Medicine in a Radiation Oncology Setting  

PubMed Central

Purpose Despite the extensive use of complementary and alternative medicine (CAM) among cancer patients, patient-physician communication regarding CAM therapies remains limited. This study quantified the extent of patient-physician communication about CAM and identified factors associated with its discussion in radiation therapy (RT) settings. Methods and Materials We conducted a cross-sectional survey of 305 RT patients at an urban academic cancer center. Patients with different cancer types were recruited in their last week of RT. Participants self-reported their demographic characteristics, health status, CAM use, patient-physician communication regarding CAM, and rationale for/against discussing CAM therapies with physicians. Multivariate logistic regression was used to identify relationships between demographic/clinical variables and patients’ discussion of CAM with radiation oncologists. Results Among the 305 participants, 133 (43.6%) reported using CAM, and only 37 (12.1%) reported discussing CAM therapies with their radiation oncologists. In multivariate analyses, female patients (adjusted odds ratio [AOR] 0.45, 95% confidence interval [CI] 0.21-0.98) and patients with full-time employment (AOR 0.32, 95% CI 0.12-0.81) were less likely to discuss CAM with their radiation oncologists. CAM users (AOR 4.28, 95% CI 1.93-9.53) were more likely to discuss CAM with their radiation oncologists than were non-CAM users. Conclusions Despite the common use of CAM among oncology patients, discussions regarding these treatments occur rarely in the RT setting, particularly among female and full-time employed patients. Clinicians and patients should incorporate discussions of CAM to guide its appropriate use and to maximize possible benefit while minimizing potential harm. PMID:23040545

Ge, Jin; Fishman, Jessica; Vapiwala, Neha; Li, Susan Q.; Desai, Krupali; Xie, Sharon X.; Mao, Jun J.



Content and style of radiation risk communication for pediatric patients.  


The diagnostic benefits of medical imaging, including CT, must be weighed against the risks of ionizing radiation and communicated effectively to patients. Health care providers requesting and performing these examinations have a shared responsibility for this risk-benefit discussion. Effective and balanced communication of these risks requires style as well as content mastery. Fundamentals of communication are similar for all patients, but special attention is needed in the pediatric setting. PMID:24589396

Broder, Joshua S; Frush, Donald P



Patients' Reflections on Communication in the Second-Opinion Hematology-Oncology Consultation  

PubMed Central

OBJECTIVE The nature of communication between patients and their second-opinion hematology consultants may be very different in these one-time consultations than for those that are within long-term relationships. This study explored patients’ perceptions of their second-opinion hematology oncology consultation to investigate physician-patient communication in malignant disease at a critical juncture in cancer patients’ care and decision-making. METHODS In-depth telephone interviews with a subset of 20 patients from a larger study, following their subspecialty hematology consultations. RESULTS Most patients wanted to contribute to the consultation agenda, but were unable to do so. Patients sought expert and honest advice delivered with empathy, though most did not expect the consultant to directly address their emotions. They wanted the physician to apply his/her knowledge to the specifics of their individual cases, and were disappointed and distrustful when physicians cited only general prognostic statistics. In contrast, physicians’ consideration of the unique elements of patients’ cases, and demonstrations of empathy and respect made patients’ feel positively about the encounter, regardless of the prognosis. CONCLUSIONS Patients provided concrete recommendations for physician and patient behaviors to enhance the consultation. PRACTICE IMPLICATIONS Consideration of these recommendations may result in more effective communication and increased patient satisfaction with medical visits. PMID:19135824

Goldman, Roberta E.; Sullivan, Amy; Back, Anthony L.; Alexander, Stewart C.; Matsuyama, Robin K.; Lee, Stephanie J.



Access Family Functioning and Related Factors from the Viewpoints of Male Cancer Patients  

PubMed Central

Introduction: Assessment of family functioning is essential prior to planning any family-based intervention for cancer patients. In an extensive literature review, any relevant studies related to the functions of Iranian families with cancer patient was not found. Therefore, the aims of present study were to investigate the function of Iranian families with a male cancer patient and its related factors from patients' perspectives. Methods: This was a descriptive- corelational study in which 101 men with cancer admitted to Tabriz Shahid Ghazi hospital were participated by convenience sampling method. Family assessment device was used for data collection that investigates family functioning in problem solving, communication, roles, affective involvement, affective responsiveness, behavior control, and general functioning domains. Also, demographic characteristics were collected. The higher score indicates better family functioning. Data analyzed by SPSS software version13 using descriptive and inferential statistics is including independent samples t-test, one-way ANOVA and Pearson correlation tests. Results: Male participants in this study reported inappropriate family functioning in all domains. The lower score was on communication and the higher score was on behavior control domain. There was significant statistical correlation between patients' perception of family functioning with the participants' education level and job, while, there was no significant correlation between patients' score of family functioning with age, life situation, number of children, age of senior child, marriage duration and time passed since diagnosis. Conclusion: Inappropriate family functioning reported by the male cancer patients indicates importance of providing consultation services for cancer patients and their family.

Barzanjeh Atri, Shirin; Rahmani, Azad; Sheikhnejhad, Leila



ICSN - Designing Print Materials: A Communications Guide for Breast Cancer Screening

Skip to Main Content Search International Cancer Screening Network Sponsored by the National Cancer Institute Home | About ICSN | Collaborative Projects | Meetings | Cancer Sites | Publications | Contact Us Publications: Search the Database | Communications


Medical Specialists??? Patient-Centered Communication and Patient-Reported Outcomes  

Microsoft Academic Search

Background: Physicians' patient-centered communication in the medical consultation is generally expected to improve patient out- comes. However, empirical evidence is contradictory so far, and most studies were done in primary care. Objective: We sought to determine the association of specialists' patient-centered communication with patient satisfaction, adher- ence, and health status. Methods: Residents and specialists in internal medicine (n 30) and

Linda C. Zandbelt; Ellen M. A. Smets; Frans J. Oort; Mieke H. Godfried



The social gradient in doctor-patient communication  

PubMed Central

Objective In recent years, the importance of social differences in the physician-patient relationship has frequently been the subject of research. A 2002 review synthesised the evidence on this topic. Considering the increasing importance of social inequalities in health care, an actualization of this review seemed appropriate. Methods A systematic search of literature published between 1965 and 2011 on the social gradient in doctor-patient communication. In this review social class was determined by patient's income, education or occupation. Results Twenty original research papers and meta-analyses were included. Social differences in doctor-patient communication were described according to the following classification: verbal behaviour including instrumental and affective behaviour, non-verbal behaviour and patient-centred behaviour. Conclusion This review indicates that the literature on the social gradient in doctor-patient communication that was published in the last decade, addresses new issues and themes. Firstly, most of the found studies emphasize the importance of the reciprocity of communication. Secondly, there seems to be a growing interest in patient's perception of doctor-patient communication. Practice implications By increasing the doctors' awareness of the communicative differences and by empowering patients to express concerns and preferences, a more effective communication could be established. PMID:22409902



Cancer Patients Versus Cancer SurvivorsSocial and Emotional Consequences of Word Choice  

Microsoft Academic Search

Two studies examined the social and emotional implications of different linguistic classifications of individuals with cancer. Undergraduates were randomly assigned to rate their reactions to either cancer patients or cancer survivors. Across studies, participants held more favorable perceptions of the character of cancer survivors relative to cancer patients and displayed more positive attitudes toward the former group. In addition, participants

Catherine E. Mosher; Sharon Danoff-Burg



The Communications Revolution and Health Inequalities in the 21st Century: Implications for Cancer Control  

PubMed Central

The radical and transformative developments in information and communication technologies (ICTs) offer unprecedented opportunities to promote cancer control and enhance population and individual health. However, the current context in which these technologies are being deployed—where cancer incidence and mortality and communication are characterized by inequalities among different racial/ethnic and socioeconomic status groups—raises important questions for cancer communication research, policy, and practice. Drawing on illustrative data, this essay characterizes the communications revolution and elucidates on its implications for cancer control, with a particular focus on communication inequalities and cancer disparities. PMID:23045545

Viswanath, K.; Nagler, Rebekah; Bigman-Galimore, Cabral; McCauley, Michael; Jung, Minsoo; Ramanadhan, Shoba



Empathic communication and gender in the physician-patient encounter.  


Although empathy in the physician-patient relationship is often advocated, a theoretically based and empirically derived measure of a physician's empathic communication to a patient has been missing. This paper describes the development and initial validation of such a measure, the Empathic Communication Coding System (ECCS), which includes a method for identifying patient-created empathic opportunities. To determine the extent to which empathic communication varies with physician and patient gender, we used the ECCS to code 100 videotaped office visits between patients and general internists. While male and female patients created a comparable number of empathic opportunities, those created by females tended to exhibit more emotional intensity than those created by males. However, female patients were no more likely than male patients to name an emotion in their empathic opportunities. Physician communication behavior was consistent with the literature on gender differences: female physicians tended to communicate higher degrees of empathy in response to the empathic opportunities created by patients. The ECCS appears to be a viable and sensitive tool for better understanding empathy in medical encounters, and for detecting modest gender differences in patients' creation of empathic opportunities and in physicians' empathic communication. PMID:12477605

Bylund, Carma L; Makoul, Gregory



Anxiety in Terminally Ill Cancer Patients  

PubMed Central

Context Anxiety in terminal cancer is linked to diminished quality of life, yet overall it is poorly understood with regard to prevalence and relationship to other aspects of psychological distress. Objectives This study examines anxiety in terminally ill cancer patients, including the prevalence of anxiety symptoms, the relationship between anxiety and depression, differences in anxiety between participants receiving inpatient palliative care and those receiving outpatient care, and characteristics that distinguish highly anxious from less anxious patients. Methods Participants were 194 patients with terminal cancer. Approximately half (n = 103) were receiving inpatient care in a palliative care facility and half (n = 91) were receiving outpatient care in a tertiary care cancer center. The Hospital Anxiety and Depression Scale was used to assess anxiety and depression, and was administered along with measures of hopelessness, desire for hastened death, and social support. Results Moderately elevated anxiety symptoms were found in 18.6% of participants (n = 36) and 12.4% (n = 24) had clinically significant anxiety symptoms. Level of anxiety did not differ between the two treatment settings. However, participants receiving palliative care reported significantly higher levels of depression and desire for hastened death. A multivariate prediction model indicated that belief in an afterlife, social support, and anxiolytic and antidepressant use were unique, significant predictors of anxiety. Conclusion Severity of anxiety symptoms did not differ between the study sites, suggesting that anxiety may differ from depression and desire for hastened death in the course that it takes over the duration of terminal cancer. PMID:21565460

Kolva, Elissa; Rosenfeld, Barry; Pessin, Hayley; Breitbart, William; Brescia, Robert



A metasynthesis of patient-provider communication in hospital for patients with severe communication disabilities: informing new translational research.  


Abstract Poor patient-provider communication in hospital continues to be cited as a possible causal factor in preventable adverse events for patients with severe communication disabilities. Yet to date there are no reports of empirical interventions that investigate or demonstrate an improvement in communication in hospital for these patients. The aim of this review was to synthesize the findings of research into communication in hospital for people with severe communication disabilities arising from lifelong and acquired stable conditions including cerebral palsy, autism, intellectual disability, aphasia following stroke, but excluding progressive conditions and those solely related to sensory impairments of hearing or vision. Results revealed six core strategies suggested to improve communication in hospital: (a) develop services, systems, and policies that support improved communication, (b) devote enough time to communication, (c) ensure adequate access to communication tools (nurse call systems and communication aids), (d) access personally held written health information, (e) collaborate effectively with carers, spouses, and parents, and (f) increase the communicative competence of hospital staff. Currently there are no reports that trial or validate any of these strategies specifically in hospital settings. Observational and evaluative research is needed to investigate the ecological validity of strategies proposed to improve communication. PMID:25229213

Hemsley, Bronwyn; Balandin, Susan



Central Nervous System Infections in Cancer Patients  

Microsoft Academic Search

Despite the development of effective prophylactic regimens and better antimicrobials for active infection, central nervous\\u000a system infections in cancer patients continue to be a source of significant morbidity and mortality. The combination of more\\u000a intense immunosuppression and longer survival has changed the spectrum of infections in several vulnerable populations. Patients\\u000a at highest risk for CNS infection include hematopoietic cell transplant

Amy A. Pruitt


Drug management of pain in cancer patients.  

PubMed Central

Chronic severe cancer pain is often not well controlled because both patient and physician have a poor understanding of the nature of the pain and of the actions of various potent analgesics. Physicians often fail to tailor analgesic dosages to the needs of the individual and unnecessarily limit the dosage because they have an ill founded fear that the patient will become addicted. The basis of rational management of cancer pain with drugs is an appropriate analgesic given regularly in doses adequate to suppress pain continuously. This review compares the potent analgesics and identifies and discusses those that have a role in treating chronic cancer pain. It emphasizes the value of morphine sulfate and gives information on starting and individualizing dosages and managing side effects. PMID:2856896

Tuttle, C B



Risk of gastric cancer among Korean familial adenomatous polyposis patients  

Microsoft Academic Search

Gastric cancer has been recognized as an extracolonic manifestation in patients with familial adenomatous polyposis (FAP). In Korea, gastric cancer is the most common malignant neoplasm. In a recent survey, we collected data from 72 Korean patients with FAP. Among them, three (4.2 percent) were found to have associated gastric cancer. This incidence of gastric cancer in our series is

Jae-Gahb Park; Kyu Joo Park; Yoon-Ok Ahn; In Sung Song; Kyoo Wan Choi; Hong Young Moon; Sang-Yong Choo; Jin-Pok Kim



Palliative care in patients with lung cancer  

PubMed Central

Lung cancer accounts for 12% of all cancers and has the highest annual rate of mortality in men and women. The overall aim is cure or prolongation of life without evidence of disease. Almost 60% of patients at the moment of diagnosis are not eligible for radical treatment. Therefore soothing and supportive treatment is the only treatment of choice. Patients with lung cancer who have symptoms of dyspnea, chronic cough, severe pain, exhaustion and cachexia syndrome, fear and depression and significantly reduced physical and intellectual activities are qualified for inpatient or home palliative care. Knowledge about various methods used in palliative treatment allows one to alleviate symptoms that occur in an advanced stage of disease with an expected short survival period. Methods of oncological treatment that are often used in patients with advanced lung cancer include radiotherapy and chemotherapy. Drawing attention to the earlier implementation of palliative care is an objective of research carried out during recent years. Advances in surgical and conservative treatment of these patients have contributed to better outcomes and longer survival time. PMID:24596508

Farbicka, Paulina



Depression in cancer patients: a critical review  

Microsoft Academic Search

Cancer patients experience several stressors and emotional upheavals. Fear of death, interruption of life plans, changes in body image and self-esteem, changes in social role and lifestyle are all important issues to be faced. Moreover, Depressive Disorders may impact the course of the disease and compliance. The cost and prevalence, the impairment caused, and the diagnostic and therapeutic uncertainty surrounding

Massimo Pasquini; Massimo Biondi



Denial in cancer patients, an explorative review  

Microsoft Academic Search

Denial is a clinically relevant concept in cancer patients. It has been investigated and discussed extensively. Its definition, however, has been subject to different theoretical trends over time. From a psychoanalytical viewpoint, denial is a pathological, ineffective defence mechanism. On the other hand, according to the stress and coping model denial can be seen as an adaptive strategy to protect

M. S. Vos



Palliative care in patients with lung cancer.  


Lung cancer accounts for 12% of all cancers and has the highest annual rate of mortality in men and women. The overall aim is cure or prolongation of life without evidence of disease. Almost 60% of patients at the moment of diagnosis are not eligible for radical treatment. Therefore soothing and supportive treatment is the only treatment of choice. Patients with lung cancer who have symptoms of dyspnea, chronic cough, severe pain, exhaustion and cachexia syndrome, fear and depression and significantly reduced physical and intellectual activities are qualified for inpatient or home palliative care. Knowledge about various methods used in palliative treatment allows one to alleviate symptoms that occur in an advanced stage of disease with an expected short survival period. Methods of oncological treatment that are often used in patients with advanced lung cancer include radiotherapy and chemotherapy. Drawing attention to the earlier implementation of palliative care is an objective of research carried out during recent years. Advances in surgical and conservative treatment of these patients have contributed to better outcomes and longer survival time. PMID:24596508

Farbicka, Paulina; Nowicki, Andrzej



Patient-Centered Communication and Health Assessment with Youth  

PubMed Central

Background Patient-centered communication is the hallmark of care that incorporates the perspective of patients to provide tailored care that meets their needs and desires. However, at this time there has been limited evaluation of patient-provider communication involving youth. Objectives This manuscript will report on results from secondary analysis of data obtained during a participatory research-based randomized control trial designed to test a sexual risk event history calendar intervention with youth to address the following research questions: (a) Based on the event history calendar’s (EHC) inclusion of contextual factors, does the EHC demonstrate improved communication outcomes (i.e., amount, satisfaction, mutuality, client involvement, client satisfaction, patient-provider interaction, and patient-centeredness) when compared to the Guidelines for Adolescent Preventive Services (GAPS) tool? and (b) How do patients and providers describe the characteristics of each tool in regards to patient-centered communication? Method This report will utilize a sequential explanatory mixed methods approach to evaluate communication. A split plot design with one between factor (i.e., communication structure between EHC and GAPS) and one within factor (i.e., time between pretest and posttest) was used for analyses of data collection from male and female youth (n=186) and providers (n=9). Quantitative analysis of survey data evaluated changes in communication from pre-test to post-test. Qualitative data collected from open-ended questions, audio-taped visits, and exit interviews was employed to enhance interpretation of quantitative findings. Results Patient-centered communication using assessment tools (EHC and GAPS) with youth demonstrated improved communication outcomes both quantitatively and qualitatively. Additional analyses with subgroups of males and Arab-Americans demonstrated better post-intervention scores among the EHC group in certain aspects of communication. Qualitative results revealed that the EHC demonstrated improved outcomes in the four components of patient-centered communication including: validation of the patient’s perspective; viewing the patient within context; reaching a shared understanding on needs and preferences; and helping the patient share power in the healthcare interaction. Discussion Though both tools provided a framework from which to conduct a clinical visit, the integrated time-linked assessment captured by the EHC enhanced the patient-centered communication in select groups compared to GAPS. PMID:24165214

Munro, Michelle L.; Darling-Fisher, Cynthia S.; Ronis, David L.; Villarruel, Antonia M.; Pardee, Michelle; Faleer, Hannah; Fava, Nicole M.



Surgical errors and risks - the head and neck cancer patient  

PubMed Central

Head and neck surgery is one of the basic principles of head and neck cancer therapy. Surgical errors and malpractice can have fatal consequences for the treated patients. It can lead to functional impairment and has impact in future chances for disease related survival. There are many risks for head and neck surgeons that can cause errors and malpractice. To avoid surgical mistakes, thorough preoperative management of patients is mandatory. As there are ensuring operability, cautious evaluation of preoperative diagnostics and operative planning. Moreover knowledge of anatomical structures of the head and neck, of the medical studies and data as well as qualification in modern surgical techniques and the surgeons ability for critical self assessment are basic and important prerequisites for head and neck surgeons in order to make out risks and to prevent from mistakes. Additionally it is important to have profound knowledge in nutrition management of cancer patients, wound healing and to realize and to be able to deal with complications, when they occur. Despite all precaution and surgical care, errors and mistakes cannot always be avoided. For that it is important to be able to deal with mistakes and to establish an appropriate and clear communication and management for such events. The manuscript comments on recognition and prevention of risks and mistakes in the preoperative, operative and postoperative phase of head and neck cancer surgery. PMID:24403972

Harreus, Ulrich



Rehabilitation of the head and neck cancer patient: Psychosocial aspects  

SciTech Connect

This book contains 42 chapters divided among six sections. Some of the chapter titles are: The Challenge of Cancer; Communicaton Needs of Head and Neck Cancer Patients; Normal Tissue Effects of the Radiotherapy of Head and Neck Cancer; Chemotherapy in the Treatment of Head and Neck Cancer; and Thyroid Cancer.

Blitzer, A.; Baredes, S.; Kutscher, A.; Seeland, I.B.; Barrett, V.W.; Mossman, K.L.



Assessing the Nursing and Midwifery Students Competencies in Communication With Patients With Severe Communication Problems  

PubMed Central

Background: Clients with communication impairment are at risk for health disparity. Hence, health care workers should be knowledgeable and skillful in communication. However, no studies are available on Iranian nursing and midwifery students’ communication skills with patients with severe communication problems. Objectives: The present study was conducted to investigate Iranian nursing and midwifery students' competencies in communication with patients with severe communication problems. Materials and Methods: This study was performed on all senior nursing and midwifery students of Kashan University of Medical Sciences in spring 2013. Data were collected through a knowledge questionnaire and two checklists for evaluation of skills needed for communication with patients with severe communication problems. Data analysis was performed through independent samples t test, and Fisher’s exact test. Results: In total, 68.8% of the participants were female, 37.6% had a history of part-time job as a nurse or midwife. The mean score of knowledge were 4.41 ± 1.42 and 4.77 ± 1.77 for nursing and midwifery students, respectively and the difference was not significant (P = 0.312). In addition, the mean score of communication skills with deaf patients was 13.23 ± 4.68 and 11.86 ± 5.55 for nursing and midwifery students, respectively and the difference was not significant (P = 0.258). Also, the mean score of communication skills with stutter patients was 23.91 ± 4.17 and 21.25 ± 3.91 for nursing and midwifery students, respectively but the difference was not significant (P = 0.269). Conclusions: Nursing and midwifery students did not significantly differ in terms of communication with patients with severe communication problems. Most of the students had low or very low knowledge and skills in communication with patients with hearing impairment. However, they had better skills in communication with patient with speech problem. Special workshops or training programs are recommended to empower nursing and midwifery students in communication with patients with communication problems.

Adib Hajbaghery, Mohsen; Rezaei Shahsavarloo, Zahra



Gendered communicative construction of patients in consultation settings.  


This study aimed to explore the communication in consultations between patients and health care staff from a gender perspective. We used 23 tape-recorded consultations between patients with Atrial Fibrillation and 5 nurses and 5 physicians at cardiac outpatient clinics at 6 different hospitals in southern Sweden during autumn 2009 to explore the verbal gendered constructions of patients. Through critical discourse analysis, we revealed that the male patients tended to describe their ailments with performance-oriented statements, whereas the female patients usually used emotional-oriented statements. The staff downplayed the male patients' questions and statements, while they acknowledged concern toward the female patients. Both the patients and the staff made conclusions according to a mutual construction. Male patients were constructed as competent, and female patients as fragile through gender-stereotypical communication. Open-ended statements and questions enabled consultations to be less limited by gender stereotypes. PMID:24964371

Hedegaard, Joel; Ahl, Helene; Rovio-Johansson, Airi; Siouta, Eleni



Empowering Chinese Cancer Patients: Taking Culture into Account  

Microsoft Academic Search

Many Chinese cancer patients encounter a high degree of anxiety, but lack the vocabulary to express themselves emotionally. This is an attempt to develop a culturally sensitive psycho-social intervention for Chinese cancer patients in Hong Kong. A seven-phase model of emotional responses to cancer was developed from interviews with patients and focus group discussions with professionals. Based on an understanding

Cecilia Chan; Pamela Leung; K. M. Ho



Surgical Management of Infiltrating Bladder Cancer in Elderly Patients  

Microsoft Academic Search

Objectives: To review the surgical therapeutic options in elderly patients with infiltrating bladder cancer.Methods: A review of the literature relevant to cystectomy and transurethral resection for infiltrating bladder cancer in elderly patients was conducted using Medline Services.Results: Thanks to progress in anaesthesia, intensive care and surgery, cystectomy now forms part of the classical treatments for bladder cancer in elderly patients,

Michaël Peyromaure; Florent Guerin; Bernard Debre; Marc Zerbib



Cancer patient education in Iran: a descriptive study  

Microsoft Academic Search

This study was carried out to examine the status of cancer patient education in Iran. Using the Multinational Association of Supportive Care in Cancer's (MASCC) patient education questionnaire, 310 individuals - a sample of heterogeneous cancer patients (n=167) and their relatives (n=143) - were enrolled in the study. The pooled results indicated that only 15% of respondents believed more than

Ali Montazeri; Mariam Vahdani; Mehregan Haji-Mahmoodi; Soghra Jarvandi; Mandana Ebrahimi



Nononcologic Disease in Patients with Cancer  

PubMed Central

Nononcologic medical problems are common in patients with cancer. Failure to evaluate and treat these problems leads to considerable morbidity and mortality in people who often have potential for both comfortable and productive lives. While a physician is sometimes powerless to prevent the progression of underlying cancer, he must not allow a diagnostic category to color his approach. By seeing only an end point which is inevitable for all people, one could be inclined not to treat what is treatable. With clinical judgment, information and the eternal question of diagnosticians, “What else could this be?”, a physician can focus not on the inevitability of death but on the quality of life. PMID:878475

Lowitz, Barry B.; Benjamin, Robert S.



Communication and Information Barriers to Health Assistance for Deaf Patients  

ERIC Educational Resources Information Center

In Brazil, recent regulations require changes in private and public health systems to make special services available to deaf patients. In the present article, the researchers analyze the perceptions of 25 sign language-using patients regarding this assistance. The researchers found communication difficulties between these patients and health…

Pereira, Patricia Cristina Andrade; Fortes, Paulo Antonio de Carvalho



NCI Community Cancer Centers Program - Related Programs - Centers of Excellence in Cancer Communications Research

The novelty and scope of this initiative reflects the enormous potential of cancer communication to improve health, and NCI's recognition that effective communications can and should be used to narrow the gap between discovery and application and to reduce health disparities among our citizens. It is expected that the Centers' interdisciplinary efforts will result in new theories, methods, and interventions, including those for diverse populations.


[Wasting and postoperative infection in cancer patients].  


Denutrition decreases immunological responses of non-cancer patients, the healing is altered whereas infectious complications increase. Now during hospitalization, malnutrition prevails in cancer patients. The suppression of the adaptability to fasting which reduces the expenditure of energy at rest, an a normal metabolic response to nutrients' supply with the impossibility to compensate totally the metabolic deficits with the artificial nutrition alone, raise the fear of postoperative disorders, particularly an increase of the infectious risk. The key point is therefore to identify the cachexia's degree owing to a simple, predictive and consensual index. This check-up allows a postoperative complications' prevention by starting up a perioperative refeeding in high-risk subjects: that is to say all severe wasting patients, the people booked for a severe surgical procedure, especially for oesophageal and gastric neoplasms. Actually, we consider that the quality of the results depend more on the making up of the different nutritional solutions dispensed than to strictly providing for cancer patients' wants, which could be harmful in the postoperative period. Supplementation with antioxidant micronutrients or arginine, glutamine, ribonucleic acids and omega-3 fatty acids would allow an immuno- modulation of the renutrition. But complications strictly due to preoperative denutrition are still to be established. PMID:11244601

Tessier, C; Corda, B; Marty, J



Fertility Preservation for Cancer Patients: A Review  

PubMed Central

Infertility can arise as a consequence of treatment of oncological conditions. The parallel and continued improvement in both the management of oncology and fertility cases in recent times has brought to the fore-front the potential for fertility preservation in patients being treated for cancer. Oncologists must be aware of situations where their treatment will affect fertility in patients who are being treated for cancer and they must also be aware of the pathways available for procedures such as cryopreservation of gametes and/or embryos. Improved cancer care associated with increased cure rates and long term survival, coupled with advances in fertility treatment means that it is now imperative that fertility preservation is considered as part of the care offered to these patients. This can only be approached within a multidisciplinary setting. There are obvious challenges that still remain to be resolved, especially in the area of fertility preservation in prepubertal patients. These include ethical issues, such as valid consent and research in the area of tissue retrieval, cryopreservation, and transplantation. PMID:20379357

Ajala, Tosin; Rafi, Junaid; Larsen-Disney, Peter; Howell, Richard



Communication in Emergency Medicine: Implications for Patient Safety  

Microsoft Academic Search

Emergency medicine is largely a communicative activity, and medical mishaps that occur in this context are too often the result of vulnerable communication processes. In this year-long qualitative study of two academic emergency departments, an interdisciplinary research team identified four such processes: triage, testing and evaluation, handoffs, and admitting. In each case, we found that narrative rationality (the patient's story)

Eric M. Eisenberg; Alexandra G. Murphy; Kathleen Sutcliffe; Robert Wears; Stephen Schenkel; Shawna Perry; Mary Vanderhoef



Practical aspects of telehealth: doctor-patient relationship and communication.  


The fourth in a series of articles about the practical aspects of telehealth, this paper provides advice and information for specialists to communicate effectively with patients during a telehealth video consultation. PMID:24450527

Sabesan, S; Allen, D; Caldwell, P; Loh, P K; Mozer, R; Komesaroff, P A; Talman, P; Williams, M; Shaheen, N; Grabinski, O



Complementary and alternative medicine use in lung cancer patients in eight European countries.  


This paper presents findings from a cross-sectional survey about the use of complementary and alternative medicine (CAM) in patients with lung cancer, forming part of a larger study. Data from 111 lung cancer patients in 8 countries in Europe were collected through a descriptive 27-item questionnaire. The data suggest that 23.6% of the lung cancer patients used CAM after the diagnosis with cancer. The most popular CAM modalities were herbal medicine (48.1%), medicinal teas (11.5%), homeopathy (11.5%), use of animal extracts (11.5%) and spiritual therapies (11.5%). Herbal use increased by three times after the diagnosis of cancer. Patients seemed quite satisfied with the CAM used. They were also spending on average about 142 Euros monthly on CAM therapies or remedies. The most common motivation to use CAM was to increase the body's ability to fight the cancer. Main sources of information about CAM were friends and family. As CAM is increasingly used by patients with lung cancer, it is important to be able to assist patients make an appropriate decision by discussing the issue of CAM openly, providing reassurance and communicating safe and appropriate information to patients. PMID:16401528

Molassiotis, Alexander; Panteli, Vassiliki; Patiraki, Elisabeth; Ozden, Gulten; Platin, Nurgun; Madsen, Elin; Browall, Maria; Fernandez-Ortega, Paz; Pud, Dorit; Margulies, Anita



Mapping Cancer Patients' Symptoms to UMLS Concepts  

PubMed Central

A prerequisite for patient-friendly personal health records (PHR) is their ability to allow seamless integration of patient terminology with professional terminologies. In this work, we mapped a set of symptoms/problems from the self-assessment component of a cancer patient support system to concepts in the Unified Medical Language System (UMLS) Metathesaurus. Our objective was to learn how the UMLS can be used as a tool to connect patient terminology with professional vocabularies. The mapping to UMLS was done with the help of ten expert cancer nurses who evaluated concepts, their synonyms and placement in the source vocabulary hierarchical structure. The UMLS concepts were also compared with terms and phrases found in patient medical records that addressed the same set of symptoms. In this study we observed several problems related to the use of the UMLS Metathesaurus as a tool to connect from patient-level expressions to professional-level classification systems. More work is needed to increase interoperability between layperson health applications and clinical systems. PMID:16779130

Slaughter, Laura; Ruland, Cornelia; Rotegard, Ann Kristin



Does training increase the use of more emotionally laden words by nurses when talking with cancer patients? A randomised study  

Microsoft Academic Search

The emotional content of health care professionals–cancer patient communication is often considered as poor and has to be improved by an enhancement of health care professionals empathy. One hundred and fifteen oncology nurses participating in a communication skills training workshop were assessed at three different periods. Nurses randomly allocated to a control group arm (waiting list) were assessed a first

D Razavi; N Delvaux; S Marchal; J-F Durieux; C Farvacques; L Dubus; R Hogenraad



Psychosocial, educational and communicative interventions for patients with cachexia and their family carers  

PubMed Central

Purpose of review Cancer cachexia has a substantial impact on both patients and their family carers. It has been acknowledged as one of the two most frequent and devastating problems of advanced cancer. The impact of cachexia spans biopsychosocial realms. Symptom management in cachexia is fraught with difficulties and globally, there remains no agreed standard care or treatment for this client group. There is a need to address the psychosocial impact of cachexia for both patients and their family carers. Recent findings Patients living at home and their family carers are often left to manage the distressing psychosocial impacts of cancer cachexia themselves. Successful symptom management requires healthcare professionals to address the holistic impact of cancer cachexia. High quality and rigorous research details the existential impact of cachexia on patients and their family carers. This information needs to inform psychosocial, educational and communicative supportive healthcare interventions to help both patients and their family carers better cope with the effects of cachexia. Summary Supportive interventions need to inform both patients and their family carers of the expected impacts of cachexia, and address how to cope with them to retain a functional, supported family unit who are informed about and equipped to care for a loved one with cachexia. PMID:25144837

Reid, Joanne



Clinicopathologic Characteristics of Colorectal Cancer Patients with Synchronous and Metachronous Gastric Cancer  

Microsoft Academic Search

SocieteInternationale de Chirurgie 2010 Colorectal cancer is the third most common cancer worldwide, with approximately 1 million new diagnoses each year. This high incidence is a major health problem in the USA and Europe. Synchronous and metachronous diagnosis of gastric cancer among patients with colorectal cancer is rare in the Western world, and at present no gastric cancer surveillance is

Ernst Hanisch; Charalambos Batsis



Pancreatic Cancer Center: Providing the Research Tools Necessary to Advance Pancreatic Cancer Patient Care  

E-print Network

Pancreatic Cancer Center: Providing the Research Tools Necessary to Advance Pancreatic Cancer the fourth leading cause of cancer deaths, and PDAC patients have a dismal 5-year survival rate of 6 number of NCI-designated cancer centers have a specialized pancreatic cancer program. The creation

Zhou, Yaoqi


E-cigarettes and cancer patients.  


The increasing popularity and availability of electronic cigarettes (i.e., e-cigarettes) in many countries have promoted debate among health professionals as to what to recommend to their patients who might be struggling to stop smoking or asking about e-cigarettes. In the absence of evidence-based guidelines for using e-cigarettes for smoking cessation, some health professionals have urged caution about recommending them due to the limited evidence of their safety and efficacy, while others have argued that e-cigarettes are obviously a better alternative to continued cigarette smoking and should be encouraged. The leadership of the International Association for the Study of Lung Cancer asked the Tobacco Control and Smoking Cessation Committee to formulate a statement on the use of e-cigarettes by cancer patients to help guide clinical practice. Below is this statement, which we will update periodically as new evidence becomes available. PMID:24736063

Cummings, K Michael; Dresler, Carolyn M; Field, John K; Fox, Jesme; Gritz, Ellen R; Hanna, Nasser H; Ikeda, Norihiko; Jassem, Jacek; Mulshine, James L; Peters, Matthew J; Yamaguchi, Nise H; Warren, Graham; Zhou, Caicun



Measuring fatigue in patients with cancer  

Microsoft Academic Search

Our current state of knowledge of the fatigue experiencd by patients with cancer is limited, and further development is hampered\\u000a by the definitions of fatigue, which remain numerous, inconsistent, and varied according to the discipline of the author and\\u000a the nature of the research. It is fairly well established within the healthcare literature that it is multidimensional in\\u000a nature. This

Alison Richardson



Nutritional support in patients with oesophageal cancer  

Microsoft Academic Search

Background  Obesity and overweight are risk factors for developing an oesophageal cancer, especially the adenocarcinoma in the distal\\u000a oesophagus or at the gastroesophageal junction, and many patients still are overweight at the clinical presentation even if\\u000a they are losing weight. Main mechanisms involved in weight loss are a decreased nutrients’ intake and an alteration in metabolism\\u000a due to a cytokine-driven inflammatory

Federico Bozzetti



Pharmacokinetics of intravenous ATP in cancer patients  

Microsoft Academic Search

Objective: To characterise the pharmacokinetics of adenosine 5?-triphosphate (ATP) in patients with lung cancer after i.v. administration\\u000a of different ATP dosages.\\u000a \\u000a \\u000a \\u000a Methods: Twenty-eight patients received a total of 176 i.v. ATP courses of 30?h. Fifty-two infusions were given as low-dose infusions\\u000a of 25–40??g kg?1 min?1, 47 as middle-dose infusions of 45–60??g kg?1 min?1 and 77 as high-dose infusions of 65–75??g

H. J. Agteresch; P. C. Dagnelie; T. Rietveld; J. W. O. van den Berg; A. H. J. Danser; J. H. P. Wilson



Healthcare needs of noninstitutionalized Jordanian cancer patients: an exploratory descriptive study.  


Despite all advances in healthcare, provision of healthcare for cancer patients remains one of major continuing challenges for healthcare professionals. One of these challenges is shorter hospital stay. In this fast-paced environment, identification of cancer patients' needs is limited yet necessary to initiate an appropriate treatment plan for this group of patients. The major purpose of this study was to identify healthcare needs of noninstitutionalized patients with cancer from Arab Jordanians' perspective. The study was conducted at a chemotherapy clinic of a major university hospital in Jordan. An exploratory descriptive design using a structured interview was used to collect the data. The questions of the interview composed of items of several scales including the Patient Need Scale. Sixty-two participants met the inclusion criteria and agreed to participate. The participants were patients with cancer, were receiving chemotherapy, and were (a) Jordanian male or female patients, (b) able to communicate in Arabic, (c) 19 years of age or older, and (d) free from psychiatric or mental illnesses. Participants reported 70 existing needs (68.6%). However, 50% of these identified needs were perceived as being not met. Jordanian patients with cancer reported more healthcare needs than patients in Western cultures. Individualized comprehensive assessment of patients' needs from their perspective is essential to initiate an effective treatment plan. PMID:19444081

Al-Jauissy, Mohammed Said; Al-Hassan, Muosa; Akhu-Zaheya, Laila



Psychiatric morbidity among cancer patients and awareness of illness  

Microsoft Academic Search

A significant proportion of cancer patients experience psychiatric morbidity. Potential predictors of psychiatric morbidity include patient disease-related factors and factors relating to the patient’s environment. The aim of this study was to investigate the prevalence of psychiatric morbidity and the relationship between the clinical or personal factors, especially psychiatric morbidity, and awareness of cancer diagnosis among a group of Turkish

FigenCulha Atesci; Bahar Baltalarli; NalanKalkan Oguzhanoglu; Filiz Karadag; Osman Ozdel; Nursel Karagoz



Neuroticism and Reactions to Social Comparison Information Among Cancer Patients  

Microsoft Academic Search

In an experimental study neuroticism was examined as a moderator of breast cancer patients' affective reactions to social comparison information about a fellow patient. Fifty-seven women with breast cancer completed Eysenck's Personality Questionnaire and received social comparison information about a fellow patient who was either doing better (upward condi- tion) or worse (downward condition) than themselves. As expected, patients showed

Karen Van der Zee; Bram Buunk; Robbert Sanderman


Factors Associated with Use of Interactive Cancer Communication System: An Application of the Comprehensive Model of Information Seeking  

PubMed Central

In order to provide insights about cancer patients’ online information seeking behaviors, the present study analyzes individuals’ transaction log data and reports on how demographics, disease-related factors, and psychosocial needs predict patterns of service use within a particular Interactive Cancer Communication System (ICCS). Study sample included 294 recently diagnosed breast cancer patients. Data included pretest survey scores of demographic, disease-related, and psychosocial factors and automatically collected ICCS use data over the 4-month intervention. Statistical analyses correlated pre-test survey scores with subsequent, specific types of ICCS service usage. Patterns of online cancer information seeking differed according to the patients’ characteristics, suggesting that lower income, less educated women and those lacking in information-seeking competence use the computer and online services to the same or a greater degree if those services are made available to them. Results of this study can inform more effective resource development for future eHealth applications. PMID:21760702

Han, Jeong Yeob; Wise, Meg; Kim, Eunkyung; Pingree, Ray; Hawkins, Robert P.; Pingree, Suzanne; McTavish, Fiona; Gustafson, David H.



Management of Pain in the Cancer Patient.  

National Technical Information Service (NTIS)

Contents: Cancer pain management--diagnosis and evaluation; Cancer pain management--multidisciplinary pain clinics; Cancer pain management--psychologic technics; Cancer pain management--pharmacologic technics; Cancer pain management--neurosurgical technic...



Project Connect Online: Randomized Trial of an Internet-Based Program to Chronicle the Cancer Experience and Facilitate Communication  

PubMed Central

Purpose Evidence suggests that expressing emotions related to cancer and receiving interpersonal support can promote psychological and physical health in women diagnosed with breast cancer. However, adaptive expression of feelings and communication with one's social network can pose challenges for patients with cancer. We report on a randomized controlled trial of an intervention, Project Connect Online, for patients with breast cancer to create personal Web sites to chronicle their experience and communicate with their social network. Patients and Methods Women (N = 88) diagnosed with breast cancer (any stage, any interval since diagnosis) were randomly assigned to participate in a 3-hour workshop for hands-on creation of personal Web sites with a follow-up call to facilitate Web site use, or to a waiting-list control. Assessed before randomization and 6 months after the intervention, dependent variables included depressive symptoms, positive and negative mood, cancer-related intrusive thoughts, and perceived cancer-related benefits in life appreciation and strengthened relationships. Results Relative to control participants, women randomly assigned to Project Connect Online evidenced significant benefit 6 months later on depressive symptoms, positive mood, and life appreciation, but not negative mood, perceived strengthened relationships, or intrusive thoughts. Treatment status moderated the intervention effects, such that women currently undergoing medical treatment for cancer benefitted significantly more from the intervention on depressive symptoms and positive mood than did women not receiving treatment. Conclusion Findings suggest the promise of an intervention to facilitate the ability of women diagnosed with breast cancer to chronicle their experience and communicate with their social network via the Internet. PMID:23940228

Stanton, Annette L.; Thompson, Elizabeth H.; Crespi, Catherine M.; Link, John S.; Waisman, James R.



[Teaching doctor-patient communication - a proposal in practice].  


Traditionally, doctor-patient communication was considered a matter of and , and a topic for informal learning. Recently, studies have shown the importance of communication skills in medical practice. Doctor-patient communication skills, such as knowing how to listen, how to observe, and how to inform are today considered important components of Medical Education, although they are often difficult to integrate in Medical Curricula. In the current work, the authors describe the program of Communication in the Doctor-Patient Relationship, initiated in 2001 in the Medical School of the University of Porto, part of its undergraduate program. Future studies will allow us to assess the effectiveness of the learning and application of these skills in clinical practice. PMID:20654275

Carvalho, Irene P; Ribeiro-Silva, Raquel; Pais, Vanessa G; Figueiredo-Braga, Margarida; Castro-Vale, Ivone; Teles, Ana; Almeida, Susana S; Mota-Cardoso, Rui



Empowering communication: a community-based intervention for patients.  


The "How to Talk to Your Doctor" community education forums operate under the assumption that information exchange and consumer involvement in healthcare can empower communities in need. We report on the development and preliminary evaluation of this community-based intervention designed to activate and enhance patients' communicative abilities in the medical encounter. We review evidence supporting the feasibility of and benefits that can be expected from improving patients' communication competency. Our intervention is simple and flexible so, therefore, can be portable to a large number of communities. Our preliminary evaluation suggests that the intervention is well-received and produces improved self-perceptions of communication competence across diverse settings and participants. We describe our intervention and its development and dissemination as a model for improving patients' communicative abilities through a community-based, active learner approach. By sharing our experiences, the barriers we encountered, and our ongoing efforts to improve patient communication in the medical encounter, we hope to empower patients to communicate better with their physicians. PMID:14729298

Tran, Anh N; Haidet, Paul; Street, Richard L; O'Malley, Kimberly J; Martin, Frank; Ashton, Carol M



Cancer Carepartners: Improving patients' symptom management by engaging informal caregivers  

PubMed Central

Background Previous studies have found that cancer patients undergoing chemotherapy can effectively manage their own symptoms when given tailored advice. This approach, however, may challenge patients with poor performance status and/or emotional distress. Our goal is to test an automated intervention that engages a friend or family member to support a patient through chemotherapy. Methods/Design We describe the design and rationale of a randomized, controlled trial to assess the efficacy of 10 weeks of web-based caregiver alerts and tailored advice for helping a patient manage symptoms related to chemotherapy. The study aims to test the primary hypothesis that patients whose caregivers receive alerts and tailored advice will report less frequent and less severe symptoms at 10 and 14 weeks when compared to patients in the control arm; similarly, they will report better physical function, fewer outpatient visits and hospitalizations related to symptoms, and greater adherence to chemotherapy. 300 patients with solid tumors undergoing chemotherapy at two Veteran Administration oncology clinics reporting any symptom at a severity of ?4 and a willing informal caregiver will be assigned to either 10 weeks of automated telephonic symptom assessment (ATSA) alone, or 10 weeks of ATSA plus web-based notification of symptom severity and problem solving advice to their chosen caregiver. Patients and caregivers will be surveyed at intake, 10 weeks and 14 weeks. Both groups will receive standard oncology, hospice, and palliative care. Discussion Patients undergoing chemotherapy experience many symptoms that they may be able to manage with the support of an activated caregiver. This intervention uses readily available technology to improve patient caregiver communication about symptoms and caregiver knowledge of symptom management. If successful, it could substantially improve the quality of life of veterans and their families during the stresses of chemotherapy without substantially increasing the cost of care. Trial Registration NCT00983892 PMID:22117890



Elderly Breast and Colorectal Cancer Patients' Clinical Course: Patient and Contextual Influences  

PubMed Central

Background The social and medical environments which surround people are each independently associated with their cancer course. The extent to which these characteristics may together mediate patientscancer care and outcomes is not known. Methods Using multilevel methods and data, we studied elderly breast and colorectal cancer patients (level I) within urban social (level II- ZIP code tabulation area) and health care (level III – hospital service area) contexts. We sought to determine (1) which, if any, observable social and medical contextual attributes were associated with patient cancer outcomes after controlling for observable patient attributes, and (2) the magnitude of residual variation in patient cancer outcomes at each level. Results Numerous patient attributes and social area attributes including poverty were associated with unfavorable patient cancer outcomes across the full clinical cancer continuum for both cancers. Health care area attributes were not associated with patient cancer outcomes. After controlling for observable covariates at all three levels, there was substantial residual variation in patient cancer outcomes at all levels. Conclusions After controlling for patient attributes known to confer risk of poor cancer outcomes, we find that neighborhood socioeconomic disadvantage exerts an independent and deleterious effect on residents' cancer outcomes but the area supply of the specific types of health care studied do not. Multilevel interventions targeted at cancer patients and their social areas may be useful. We also show substantial residual variation in patient outcomes across social and health care areas, a finding potentially relevant to traditional small area variation research methods. PMID:25119954

Lamont, Elizabeth B.; Zaslavsky, Alan M.; Subramanian, SV; Meilleur, Ashley E.; He, Yulei; Landrum, Mary Beth



Nutrition Intervention Study for Patients Undergoing Treatment for Gastrointestinal Cancer  

Microsoft Academic Search

LEARNING OUTCOME: To determine the potential for improving quality of life and nutritional status for patients undergoing treatment for gastrointestinal (GI) cancer through the provision of a formalized nutrition intervention program.Many cancer patients have detectable malnutrition during the course of their disease due to the cancer or any of the commonly used treatment modalities. The adverse impact of malnutrition on

M. Marian; D. Brooks; C. Thomson



Prospective study of cancer in patients with hypogammaglobulinaemia.  


Among 377 patients with primary hypogammaglobulinaemia, mainly common variable immunodeficiency (CVID), 316 patients survived the first 2 years after diagnosis and were the subject of a study of cancer incidence. Among the 220 patients with CVID, there was a 5-fold increase of cancer due mainly to large excesses of stomach cancer (47-fold) and lymphomas (30-fold). The excess of stomach cancer is probably related to the high frequency of achlorhydria in CVID. 3 of the 7 patients with stomach cancer and CVID survived for 5 years or longer. PMID:2857327

Kinlen, L J; Webster, A D; Bird, A G; Haile, R; Peto, J; Soothill, J F; Thompson, R A



Patient Education Video Series |

The free patient education website ( offers information about cancer and clinical trials in patient-friendly videos. The videos are produced by ASCO and posted regularly on their YouTube channel. The series includes a variety of cancer topics that patients will find helpful, including clinical trials. Information is presented by physicians and advocates and helps patients accumulate accurate information and formulate questions for their physician as they consider a clinical trial.


Determining the effectiveness of illustrated communication material for communication with intubated patients at an intensive care unit.  


Communication with non-speaking patients in intensive care unit is stress for both nurse and patients. Semi-experimental study that took place at a University Hospital was to develop illustrated material for patient communication and determine its effectiveness. The study sample consisted of 90 intubated patients at the Adult Cardiovascular Intensive Care Unit who had undergone open heart surgery. The patients were divided into the intervention and control groups. Data analysis was with descriptive statistics and the ?(2) test. The illustrated communication material was stated to be helpful by 77.8% and partially helpful by 22.2% of the intervention group patients regarding the communication between the health-care staff and the patients. Control group patients had more difficulties communicating with the health-care staff. Illustrated communication material was an effective method in communicating with intubated patients. PMID:24118470

Otuzo?lu, Münevver; Karahan, Azize



Patients' assessment of professionalism and communication skills of medical graduates  

PubMed Central

Background Professionalism and communication skills constitute important components of the integral formation of physicians which has repercussion on the quality of health care and medical education. The objective of this study was to assess medical graduates’ professionalism and communication skills from the patients’ perspective and to examine its association with patients’ socio-demographic variables. Methods This is a hospital based cross-sectional study. It involved 315 patients and 105 medical graduates selected by convenient sampling method. A modified and validated version of the American Board of Internal Medicine’s (ABIM) Patient Assessment survey questionnaire was used for data collection through a face to face interview. Data processing and analysis were performed using the Statistical Package for Social Science (SPSS) 16.0. Mean, frequency distribution, and percentage of the variables were calculated. A non-parametric Kruskal Wallis test was applied to verify whether the patients’ assessment was influenced by variables such as age, gender, education, at a level of significance, p ? 0.05. Results Female patients constituted 46% of the sample, whereas males constituted 54%. The mean age was 36?±?16. Patients’ scoring of the graduate’s skills ranged from 3.29 to 3.83 with a mean of 3.64 on a five-point Likert scale. Items assessing the “patient involvement in decision-making” were assigned the minimum mean values, while items dealing with “establishing adequate communication with patient” assigned the maximum mean values. Patients, who were older than 45 years, gave higher scores than younger ones (p?Patients with higher education reported much lower scores than those with lower education (p?=?0.003). Patients’ gender did not show any statistically significant influence on the rating level. Conclusion Generally patients rated the medical graduates’ professionalism and communication skills at a good level. Patients’ age and educational level were significantly associated with the rating level. PMID:24517316



Talking with text: communication in therapist-led, live chat cancer support groups.  


CancerChatCanada is a pan-Canadian initiative with a mandate to make professionally led cancer support groups available to more people in Canada. Although online support groups are becoming increasingly popular, little is known about therapist-led, synchronous groups using live chat. The purpose of this study was to generate a rich descriptive account of communication experiences in CancerChatCanada groups and to gain an understanding of processes associated with previously-reported benefits. We used interpretive description to analyze interview segments from 102 patients, survivors and family caregivers who participated in CancerChatCanada groups between 2007 and 2011. The analysis yielded four inter-related process themes (Reaching Out From Home, Feeling Safe, Emotional Release, and Talking With Text) and one outcome theme (Resonance and Kinship). The findings extend previous research about text-only online support groups and provide novel insights into features of facilitated, live chat communication that are valued by group members. PMID:24581076

Stephen, Joanne; Collie, Kate; McLeod, Deborah; Rojubally, Adina; Fergus, Karen; Speca, Michael; Turner, Jill; Taylor-Brown, Jill; Sellick, Scott; Burrus, Kimberly; Elramly, Mai



Perianesthesia communications with hearing-impaired patients  

Microsoft Academic Search

The prospect of having surgery can be a frightening experience for anyone, especially someone who suffers a sensory deficit such as hearing impairment. For the millions of people who are hearing impaired, there are some simple steps that perianesthesia nurses can take to identify hearing problems and to facilitate accurate communications. Such steps on the part of the staff often

Mary C. Redmond



Non-verbal behaviour in nurse-elderly patient communication.  


This study explores the occurrence of non-verbal communication in nurse-elderly patient interaction in two different care settings: home nursing and a home for the elderly. In a sample of 181 nursing encounters involving 47 nurses a study was made of videotaped nurse-patient communication. Six non-verbal behaviours were observed: patient-directed eye gaze, affirmative head nodding, smiling, forward leaning, affective touch and instrumental touch. With the exception of instrumental touch these non-verbal behaviours are important in establishing a good relationship with the patient. To study the relationship between non-verbal and verbal communication, verbal communication was observed using an adapted version of Roter's Interaction Analysis System, which distinguishes socio-emotional and task-related communication. Data were analysed in hierarchical linear models. The results demonstrated that nurses use mainly eye gaze, head nodding and smiling to establish a good relation with their patients. The use of affective touch is mainly attributable to nurses' personal style. Compared to nurses in the community, nurses in the home for the elderly more often display non-verbal behaviours such as patient-directed gaze and affective touch. PMID:10215971

Caris-Verhallen, W M; Kerkstra, A; Bensing, J M



Control and Communication in Provider-Patient Relationships.  

ERIC Educational Resources Information Center

Noting that loss of control is a major concern confronting patients experiencing an illness, this paper critically analyzes the research literature on control and clarifies the implications of this research for provider-patient communication. The paper first defines control, noting that the most frequently cited definition is the "locus of…

Northouse, Peter G.


Nurse-patient interaction and communication: A systematic literature review  

Microsoft Academic Search

Aim  The purpose of this review is to describe the use and definitions of the concepts of nurse-patient interaction and nurse-patient\\u000a communication in nursing literature. Furthermore, empirical findings of nurse-patient communication research will be presented,\\u000a and applied theories will be shown.\\u000a \\u000a \\u000a \\u000a Method  An integrative literature search was executed. The total number of relevant citations found was 97. The search results were\\u000a reviewed,

Steffen Fleischer; Almuth Berg; Markus Zimmermann; Kathleen Wüste; Johann Behrens



Qualitative inquiry: a method for validating patient perceptions of palliative care while enrolled on a cancer clinical trial  

PubMed Central

Background Palliative care is a vital component of patient-centered care. It has increasingly become central to the management and care of seriously ill patients by integrating physical, psychosocial, and spiritual supportive services. Through qualitative inquiry, this paper examines cancer patients’ perceptions of the process and outcomes of the pain and palliative care consultative services they received while enrolled in a clinical trial. Methods A qualitative analysis of open-ended questions was conducted from a sub-sample of patients (n?=?34) with advanced cancers enrolled in a randomized controlled trial exploring the efficacy of a palliative care consult service. Two open-ended questions focused on patient perceptions of continued participation on their primary cancer clinical trials and their perceptions of interdisciplinary communication. Results Three overarching themes emerged when asked whether receiving pain and palliative care services made them more likely to remain enrolled in their primary cancer clinical trial: patients’ past experiences with care, self-identified personal characteristics and reasons for participation, and the quality of the partnership. Four themes emerged related to interdisciplinary communication including: the importance of developing relationships, facilitating open communication, having quality communication, and uncertainty about communication between the cancer clinical trial and palliative care teams. Conclusions Our findings suggest the importance of qualitative inquiry methods to explore patient perceptions regarding the efficacy of palliative care services for cancer patients enrolled in a cancer clinical trial. Validation of patient perceptions through qualitative inquiry regarding their pain and palliative care needs can provide insight into areas for future implementation research. Trial registration NIH Office of Human Subjects Research Protection OHSRP5443 and University of Pennsylvania 813365



[Sentinel nodes in patients with breast cancer].  


The aim of this paper is to debate, on the basis of medical literature review, the importance of detection the sentinel nodes in surgery of breast cancer. The beginning of the paper emphasized the problems of the sentinel nodes definition, and then we discuss the dates related to the history and the importance of the sentinel nodes knowledge that consist in the avoidance of axillary lymph nodes dissection in patients with breast cancer N-. Afterwards, we present the indications for detecting the sentinel nodes and the criterion to exclude from the detection of the sentinel nodes. As a part of the results of surgery sentinel nodes, we present dates about the techniques of detection the sentinel nodes, the place of injection of the radiopharmaceuticals, the size of the radiocolloid. Finally, we come up in the conclusion that the identification of the sentinel nodes is useful and possible for majority of the patients with breast cancer T1 or T2N0M0. PMID:17059146

Me?in?, C; Pa?alega, M; Calot?, F; Me?in?, Mihaela Iustina; Vîlcea, D; Persu, B; Vasile, I



Motives of cancer patients for using the Internet to seek social support.  


The purpose of the study was to describe why Finnish cancer patients choose the internet as a source of social support. The data were collected in May 2010, using an online questionnaire with open-ended questions, through four discussion forums on the websites of the non-profit Cancer Society of Finland. Seventy-four adult patients with cancer participated. The data were analysed using inductive content analysis. The mean age of the participants was 53 years and they were predominantly women. The most common cancer was breast cancer and more than three quarters of the participants had suffered from cancer for less than 5 years. The initial stimuli to use the internet as a source of social support were the ease of communication and access to information as well as the need for emotional and informational support. The actual motives that drove the use of the internet as a source of social support were the requirements for information and peer support, internet technology, a lack of support outside the internet and the negative experiences caused by the illness. The fact that there is an enormous need for information as well as for emotional support and that cancer treatment in Finland is concentrated in major hospitals, to which cancer patients may travel a considerable distance, suggests that nurses should learn to make more frequent virtual contact with their patients. PMID:23320398

Yli-Uotila, T; Rantanen, A; Suominen, T



Skin Cancer: A Young Person's Disease By Lauren Duffy (B.S. Communication, Journalism '14)  

E-print Network

Skin Cancer: A Young Person's Disease By Lauren Duffy (B.S. Communication, Journalism '14 is that this behavior is extremely unhealthy and risky for their bodies, specifically their skin. Skin cancer is the most common form of cancer found in young adults and second most common cancer found in adolescents

Massachusetts at Amherst, University of


Radium-223 Improves Survival in Patients with Advanced Prostate Cancer  


Radium-223 Improves Survival in Patients with Advanced Prostate Cancer Summary Results from a phase III trial called ... Xofigo®) improves overall survival in men with advanced prostate cancer that has spread to their bones compared with ...


Optimizing Communication in Mechanically Ventilated Patients  

PubMed Central

Purpose To describe the types of talking tracheostomy tubes available, present four case studies of critically ill patients who used a specialized tracheostomy tube to improve speech, discuss their advantages and disadvantages, propose patient selection criteria, and provide practical recommendations for medical care providers. Methods Retrospective chart review of patients who underwent tracheostomy in 2010. Results Of the 220 patients who received a tracheostomy in 2010, 164 (74.55%) received a percutaneous tracheostomy and 56 (25.45%) received an open tracheostomy. Among the percutaneous tracheostomy patients, speech-language pathologists were consulted on 113 patients, 74 of whom were on a ventilator. Four of these 74 patients received a talking tracheostomy tube, and all four were able to speak successfully while on the mechanical ventilator even though they were unable to tolerate cuff deflation. Conclusions Talking tracheostomy tubes allow patients who are unable to tolerate-cuff deflation to achieve phonation. Our experience with talking tracheostomy tubes suggests that clinicians should consider their use for patients who cannot tolerate cuff deflation.

Pandian, Vinciya; Smith, Christine P.; Cole, Therese Kling; Bhatti, Nasir I.; Mirski, Marek A.; Yarmus, Lonny B.; Feller-Kopman, David J.



Breaking bad news of cancer diagnosis - Perception of the cancer patients in a rural community in Malaysia  

PubMed Central

Context: Breaking of bad news is an important component in the management of cancer patients. Aims: This study aimed to assess the perceptions of breaking bad news of cancer diagnosis. Settings and Design: It was a cross-sectional study using Breaking Bad News Assessment Schedule (BAS) questionnaire on cancer patients in Serian district. Materials and Methods: Using snowballing sampling method, a total of 134 patients were interviewed face-to-face after the consent was obtained from each of the respondents. Statistical Analysis Used: Data was entered and analyzed using SPSS version 19.0. Results: Majority were comfortable with the current method of breaking bad news. The main aspects found to be the areas of concern were the importance of the usage of body language, management of time and identifying patients’ key area of concerns. There were significant difference between sex and “information giving” (P = 0.028) and “general consideration” (P = 0.016) and also between “the age and setting the scene” (P = 0.042). Significant difference was also found between the types of cancer and “the setting of scene” (P = 0.018), “breaking bad news technique” (P = 0.010), “eliciting concerns” (P = 0.003) and “information giving” (P = 0.004). Conclusion: Good and effective communication skill of breaking bad news is vital in the management of cancer patients. As the incidence of new cases of cancer increase every year, breaking of bad news has become a pertinent to the medical professionals’ role. Specific aspects of communication skills based on local characteristics should be more emphasized in the formulation of training for doctors. PMID:24818107

Bain, Mathew Gabriel; Lian, Cheah Whye; Thon, Chang Ching



Skin Cancer Risk and Sun Protection Learning by Helpers of Patients with Nonmelanoma Skin Cancer  

Microsoft Academic Search

Background. Knowledge-based skin cancer risk and prevention educational interventions by physicians and nurses were directed to subjects who had a nonmelanoma skin cancer. These high-risk patients asked relatives or friends to assist with postoperative care rendered after surgical removal of the skin cancer. The patient?s experience with the nonmelanoma skin cancer was expected to raise the awareness of the helper.

J. K. Robinson; A. W. Rademaker



[Communication between health care professionals and patients].  


In recent years, a wide variety of health-related issues make the headlines almost everyday: the shortage of physicians, an increase in elderly patients, a difficulty in maintaining emergency pediatric care services (due to the declining birthrate), the capacity of the existing emergency medical services, medical malpractice, and the H1N1 influenza vaccine. In Japan, there has been an increasing demand for health care with an emphasis on quality over quantity based the viewpoint of health care recipients, instead of providers. Since 1995, when the obligation of informed consent was adopted, there has been an improvement, although still insufficient, in patient-oriented medical services, including attitudes towards patients. A clinical laboratory technician is required to conduct a clinical examination in a prompt and accurate manner, based on a physician's instructions written on the examination slip. Based on the results of the examination, the physician determines the diagnosis and informs the patient of it, which means that clinical laboratory technicians support the QOL of patients indirectly. Patients sometimes ask about the purpose, methods, and results of a clinical examination, prior to, following, or during its implementation. In hospitals with recently developed complex, advanced equipment for clinical examination, physicians and laboratory technicians place orders for examinations without providing any detailed explanation to patients. Patients feel very anxious and nervous wondering what clinical examination they are going to undergo, and demand an adequate explanation of the test from laboratory technicians. However, patients are often dissatisfied with their manner and remarks, such as "The attending physician will give you the results in detail", and make complaints in some cases. As a provider of health care services, clinical laboratory technicians have a responsibility to meet their patients' demands. It is very important for clinical laboratory technicians to provide patients with an explanation in a caring and considerate manner, making it simple and easy-to-understand as long as it does not contradict the laws and results of an examination. PMID:20662272

Ohara, Yoshiko



Evaluation of FDG PET in Patients with Cervical Cancer  

Microsoft Academic Search

Although many human cancers can be imaged by 2-(18F)-fluoro- 2-deoxy-D-glucose (FDG) and PET,there is little clinical experi ence with FDG PET in cervical cancer. The purpose of this study was to evaluate the feasibility of FDG PET scans on patients with cervical cancer. Methods: FDG PET scans were performed on 21 patients with histologically proven uterine cervical cancer (17 newly

Yoshifumi Sugawara; Avraham Eisbruch; Shigeru Kosuda; Betty E. Recker; Paul V. Kison; Richard L. Wahl


Cancer as a problem to be solved: internet use and provider communication by men with cancer.  


Increasingly, cancer-related Web sites have been developed to provide information for patients. More needs to be done to understand the experience of men with cancer using the Internet. Heideggerian hermeneutics is the interpretive approach used to guide this study. Fifteen men with cancer who used the Internet were recruited through a prostate cancer support group and snowball sampling. Participants were individually interviewed and asked to tell stories of Internet use and practices. Transcribed interviews provided data for interpretive analysis. The overall constitutive pattern describing the men's experience is "cancer diagnosis as a problem to be solved." Five related themes included (1) seeking disease and treatments information from the Internet for decision making, to become comfortable with treatment plan; (2) organizing information to facilitate provider encounters and to monitor for reoccurrence; (3) evaluating Web information by credibility and usability with trust in the physician influencing the end decision point; (4) symptom management by knowing possibilities by hearing patient stories; and (5) navigating through the healthcare system politics and power. Men with cancer are incorporating Internet use into their cancer journey. They perceive changing provider-patient relationships when they participate in treatment decisions and monitor for reoccurrence. PMID:20975535

Dickerson, Suzanne S; Reinhart, Amber; Boemhke, Marcia; Akhu-Zaheya, Laila



Recall in older cancer patients: measuring memory for medical information  

Microsoft Academic Search

PURPOSE: Remembering medical treatment information may be particularly taxing for older cancer patients, but to our knowledge this ability has never been assessed in this specific age group only. Our purpose in this study was to investigate older cancer patients' recall of information after patient education preceding chemotherapy. DESIGN AND METHODS: We constructed a recall questionnaire consisting of multiple-choice questions,




Denial in lung cancer patients: a longitudinal study  

Microsoft Academic Search

Background: Although denial in cancer patients is well known clinically, few studies investigating the prevalence of denial over time have been conducted. The objectives of this study are to investigate the level of denial in lung cancer patients over time and the impact of socio-demographic and illness-related variables on denial in these patients. Methods: The level of denial was measured

Martina S. Vos; Hein Putter; Hans C. van Houwelingen



Potential health risks of complementary alternative medicines in cancer patients  

Microsoft Academic Search

Many cancer patients use complementary alternative medicines (CAMs) but may not be aware of the potential risks. There are no studies quantifying such risks, but there is some evidence of patient risk from case reports in the literature. A cross-sectional survey of patients attending the outpatient department at a specialist cancer centre was carried out to establish a pattern of

U Werneke; J Earl; C Seydel; O Horn; P Crichton; D Fannon



Sentinel Lymph Node Detection in Patients with Cervical Cancer  

Microsoft Academic Search

Purpose. We investigated the validity of sentinel lymph node (SLN) detection after radioactive isotope and\\/or blue dye injection in patients with cervical cancer.Patients and methods. Between December 1998 and May 2000, 50 patients (mean age 44 years) with cervical cancer FIGO stage I (n = 32), stage II (n = 16), or stage IV (n = 2) underwent SLN detection

Sabine Malur; Norman Krause; Christhardt Köhler; Achim Schneider



Decreased taste sensitivity in cancer patients under chemotherapy  

Microsoft Academic Search

Goals of work The aim of the study was to measure taste thresholds among cancer patients under chemotherapy compared to controls. Patients and methods The study was performed with 110 cancer patients and 170 healthy subjects of similar age distribution were included in the study. The electrogustometric detection threshold was evaluated as the lowest current intensity perceived by the subject

M. V. Berteretche; A. M. Dalix; A. M. Cesar d’Ornano; F. Bellisle; D. Khayat; A. Faurion



The need for reproductive and sexual health discussions with adolescent and young adult cancer patients.  


Reproductive health consistently ranks as one of the most important issues cited by adolescent and young adult (AYA) cancer survivors. Most literature on AYA cancer populations neglects broader reproductive health issues such as unintended pregnancies, contraception use and sexually transmitted infections, which, for cancer patients and survivors with compromised immune systems, can facilitate a multitude of future health problems. Lack of attention coupled with traditional risk-taking behaviors of AYAs poses a significant health risk to patients and survivors, particularly if fertility status is unknown or inaccurately assessed. AYA oncology patients and survivors are vulnerable to reproductive health complications that should be addressed prior to, during and after treatment; however, there are currently no tracking systems or evidence-based guidelines to discuss this subject with patients and survivors. Further research is needed to identify physician practices, AYA preferences and strategies for communication that can pave the way to establishing guidelines to discuss in oncology settings. PMID:23040131

Murphy, Devin; Klosky, James L; Termuhlen, Amanda; Sawczyn, Kelly K; Quinn, Gwendolyn P



Targeting cancer stem cells: a new therapy to cure cancer patients  

PubMed Central

Cancer stem cells (CSCs) have been defined as cells within tumor that possess the capacity to self-renew and to cause the heterogeneous lineages of cancer cells that comprise the tumor. They have been identified in blood, breast, brain, colon, melanoma, pancreatic, prostate, ovarian, lung cancers and so on. It is often considered to be associated with chemo-resistance and radio-resistance that lead to the failure of traditional therapies. Most therapies are directed at the fast growing tumor mass but not the slow dividing cancer stem cells. Eradicating cancer stem cells, the root of cancer origin and recurrence, has been thought as a promising approach to improve cancer survival or even to cure cancer patients. Understanding the characteristics of cancer stem cells will help to develop novel therapies to eliminate the initiating cancer stem cell, and the relevant patents on the cancer stem cell and cancer therapy by cancer stem cells will be discussed. PMID:22679565

Hu, Yapeng; Fu, Liwu



Hematological Support of a Cancer Patient  

PubMed Central

Transfusion medicine has come to function as a pivotal support in the treatment of cancer patients in the late 1980s. The authors of this article discuss the indications for, and uses of, various blood components, including packed red blood cells, leukocyte-poor and/or washed blood cells, random donor and single donor platelets, granulocyte concentrates, fresh frozen plasma, and cryoprecipitate. They also discuss common and not-so-common risks, reactions, and diseases associated with the transfusion of the aforementioned blood components. PMID:21253128

Shear, J.M.; Rock, G.



Breaking bad news in the transition from curative to palliative cancer care – patient's view of the doctor giving the information  

Microsoft Academic Search

In the transition from curative to palliative cancer care, communication is of special importance. The aim of this study\\u000a was to explore how patients with a disseminated cancer disease experienced the information about their incurable state, focusing\\u000a on the physician. The persons taking part were 30 patients admitted to a hospital-based home care unit in Sweden. Semi-structured\\u000a interviews were conducted

Maria J. Friedrichsen; Peter M. Strang; Maria E. Carlsson



Competent gastrostomy for patients with head and neck cancer  

Microsoft Academic Search

This study was performed to evaluate the efficiency and patient satisfaction with a modified Janeway gastrostomy for patients\\u000a with head and neck cancer and cancer of the upper GI tract and involved 24 consecutive patients with serious malnutrition\\u000a caused by advanced cancer of these sites. All underwent surgery during which a tube was constructed from the anterior gastric\\u000a wall with

P. P. Vassilopoulos; E. Filopoulos; N. Kelessis; M. Gontikakis; G. Plataniotis



[Aromatase activity in lymphocytes of cancer patients and healthy subjects].  


Conversion of androgens (aromatization) to estrogens in lymphocytes of cancer patients and healthy subjects in vitro was discovered. Aromatase activity in lymphocytes was comparable to that of fat and breast tumor tissues. It was completely suppressed in one out of two breast cancer patients receiving orimeten (aminoglutethimide). The activity in large bowel cancer was lower than in adenoma patients; however, the two groups were not balanced for age. PMID:2345991

Bershte?n, L M; Kondrat'ev, V B; Dil'man, V M



Efficacy of Intense Screening and Treatment for Synchronous Second Primary Cancers in Patients with Esophageal Cancer  

Microsoft Academic Search

Background: The optimum management of esophageal cancers with synchronous second pri- mary cancer (SPC) has not been determined. The aim of this study was to evaluate the efficacy of intense screening and treatment for esophageal cancers with synchronous SPC. Methods: Between 1981 and 1997, 1479 patients with esophageal cancers were screened for synchronous SPC during the process of initial staging.

Kenji Kagei; Masao Hosokawa; Hiroki Shirato; Takaya Kusumi; Yuichi Shimizu; Akihito Watanabe; Michihiro Ueda


Dancing around death: hospitalist-patient communication about serious illness.  


Hospital physicians care for most seriously ill patients in the United States. We employed dimensional analysis to describe communication about death and dying in audio-recorded admission encounters between seriously ill patients and hospitalists. Acknowledging or not acknowledging the possibility of dying emerged as a key process. Acknowledgment was rare, and depended on synergistic communication behaviors between patient and physician. Facilitators included patients cuing for information and disclosing emotional distress, and physicians exploring the patient's understanding of his or her illness and emotional distress. When hospitalists focused on acute issues, stated that they were awaiting test results, and deferred to other physicians, discussion moved away from acknowledgment. Meaningful discussion of end-of-life issues, including goals and values, fears about death and dying, prognosis, and options for palliative care followed open acknowledgment. This acknowledgment process can serve as a guide for providers to sensitively and honestly discuss essential end-of-life issues. PMID:23034778

Anderson, Wendy G; Kools, Susan; Lyndon, Audrey



Surgical Outcome of Synchronous Second Primary Cancer in Patients with Gastric Cancer  

E-print Network

Purpose: In order to improve the likelihood of curative and safe gastric surgery, this study investigated the clinical features and surgical outcomes of gastric cancer with a synchronous cancer. Patients and Methods: The clinicopathological data of 10,090 gastric cancer patients at Samsung

Tae Kyung Ha; Ji Yeong An; Ho Geun Youn; Jae Hyung Noh; Tae Sung Sohn; Sung Kim



Increasing participation of cancer patients in randomised controlled trials: a systematic review. |

Researchers conducted a systematic review of studies of interventions to improve cancer patient participation in randomized controlled trials. Across all studies included in this review, there was no evidence that any of the experimental interventions evaluated led to an increase in cancer patient participation. Further research is required to evaluate the effectiveness of strategies to increase participation in cancer treatment trials.


Patient Centered Communication During Primary Care Visits for Depressive Symptoms  

PubMed Central

Background Patient Centered Communication (PCC) is associated with more appropriate treatment of depression in primary care. In part a function of patient presentation, little is known about other influences on PCC. We investigated whether PCC was also influenced by personality dispositions of primary care providers (PCPs), independent of patient presentation. Methods 46 PCPs completed personality scales from the NEO-Personality Inventory, Revised and provided care to 88 Standardized Patients (SPs) presenting with either major depression or adjustment disorder with comorbid musculoskeletal symptoms, either making or not making a medication request. Coders scored each visit using the Measure of Patient Centered Communication, assessing physicians’ ability to explore the patient’s illness experience (component 1), understand the patient’s psychosocial context (component 2), and involve the patient in collaborative discussions of treatment (component 3). Results Adjusting for physician demographics, training, and patient presentation, physicians who were more open to feelings explored the patient’s experience of illness more (p = .05). More dutiful, or rule-bound physicians engaged in greater exploration of the patient’s psychosocial and life circumstances (p = .04), but involved the patient less in treatment discussions (p = .03), as did physicians reporting more anxious vulnerability (p = .03). Physician demographics, training, and patient presentation explained 4-7% of variance in MPCC components, with personality explaining an additional 4-7% of the variance. Conclusion Understanding of personality dispositions which promote or detract from PCC may help medical educators better identify trainees of varying aptitude, addressing individual training needs in a tailored fashion. PMID:18665060

Chapman, Benjamin P.; Duberstein, Paul R.; Epstein, Ron; Fiscella, Kevin; Kravitz, Richard L.



GUCY2C molecular staging personalizes colorectal cancer patient management.  


While the most significant prognostic and predictive marker in the management of colorectal cancer patients is cancer cells in regional lymph nodes, approximately 30% of patients whose lymph nodes are ostensibly free of tumor cells by histopathology ultimately develop recurrent disease reflecting occult metastases. Molecular techniques utilizing highly specific markers and ultra-sensitive detection technologies have emerged as powerful staging platforms to establish prognosis and predict responsiveness to chemotherapy in colorectal cancer patients. This review describes the evolution of the tumor suppressor GUCY2C as a prognostic and predictive molecular biomarker that quantifies occult tumor burden in regional lymph nodes for staging patients with colorectal cancer. PMID:22731908

Gong, Jian P; Schulz, Stephanie; Hyslop, Terry; Waldman, Scott A



Using a population-based cancer registry for recruitment of newly diagnosed patients with ovarian cancer. |

A population-based cancer registry was successfully used to identify and enroll 60 late-stage ovarian cancer patients to a psychosocial intervention designed to improve quality of life. Cancer registries can be used to screen for some medical eligibility requirements and may be a valuable resource for clinical trials examining interventions to promote quality of life or prevent cancer recurrence.


Physician-Patient Communication about Dietary Supplements  

PubMed Central

Objective Describe the content and frequency of provider-patient dietary supplement discussions during primary care office visits. Methods Inductive content analysis of 1477 transcribed audio-recorded office visits to 102 primary care providers was combined with patient and provider surveys. Encounters were collected in Los Angeles, California (2009–2010), geographically-diverse practice settings across the United States (2004–2005), and Sacramento, CA (1998–1999). Results Providers discussed 738 dietary supplements during encounters with 357 patients (24.2% of all encounters in the data). They mentioned: 1) reason for taking the supplement for 46.5% of dietary supplements; 2) how to take the supplement for 28.2%; 3) potential risks for 17.3%; 4) supplement effectiveness for 16.7%; and 5) supplement cost or affordability for 4.2%. Of these five topics, a mean of 1.13 (SD=1.2) topics were discussed for each supplement. More topics were reviewed for non-vitamin non-mineral supplements (mean 1.47 (SD=1.2)) than for vitamin/mineral supplements (mean 0.99 (SD=1.1); p<0.001). Conclusion While discussions about supplements are occurring, it is clear that more discussion might be needed to inform patient decisions about supplement use. Practice Implication Physicians could more frequently address topics that may influence patient dietary supplement use, such as the risks, effectiveness, and costs of supplements. PMID:23466249

Tarn, Derjung M.; Paterniti, Debora A.; Good, Jeffrey S.; Coulter, Ian D.; Galliher, James M.; Kravitz, Richard L.; Karlamangla, Arun; Wenger, Neil S.



Prevention of Venous Thromboembolism in Hospitalized Patients With Cancer  

PubMed Central

This is a literature review of the frequency of venous thromboembolism in hospitalized patients with cancer and of the available evidence supporting the use of thromboprophylaxis. Patients with cancer are at particularly high risk of venous thromboembolism and account for almost 20% of patients in the population. Hospitalization is an important risk factor in patients with cancer, with rates reported between 0.6% and 7.8%. The incidence has been increasing over the past decade. Three randomized controlled trials and meta-analyses indicate that prophylaxis with low molecular weight heparin, heparin, or fondaparinux significantly reduces the rate of venous thromboembolism in hospitalized medical patients who are at high risk. Patients with cancer were included in these studies, but prospective trials specifically focused on patients with cancer are not available. Evidence indicates that appropriate thromboprophylaxis is provided to a minority of hospitalized patients with cancer and that targeted educational efforts and computerized prompt systems can increase appropriate use. Guidelines developed by both oncology and thrombosis organizations support the use of thromboprophylaxis in hospitalized patients with cancer. In conclusion, most patients hospitalized with cancer are at high risk of venous thromboembolism, and thromboprophylaxis should be provided in the absence of active bleeding or a high bleeding risk. PMID:19704060

Francis, Charles W.



Management of patients with metastatic breast cancer.  


Hormone treatment is one of the key strategies in the management of metastatic breast cancer. Hormone treatment is one of the key strategies in the management of metastatic breast cancer. Aromatase inhibitors (AI) have been extensively studied in this setting. This section summarizes the key data regarding the use of AI in advanced breast cancer. In postmenopausal women, AI are the first line of treatment for untreated patients, or those who had prior AI treatment and progress after 12 months of adjuvant therapy. A longer disease-free interval and absence of visceral disease is associated with a better response. If tumors recur in less than 12 months, it is recommended that tamoxifen (TAM) or the estrogen-receptor antagonist fulvestrant (FUL) treatment be initiated. In the second-line setting, the best option after progression is the administration of either FUL or TAM. In the third-line setting, reintroduction of AI is considered an acceptable option. In premenopausal women who have not received prior treatment or who have progressed after 12 months following adjuvant treatment, it is recommended to initiate therapy with a combination of TAM and a luteinizing hormone-releasing hormone (LHRH) analog. If there is treatment failure with the use of this combination, megestrol acetate or an LHRH agonist plus an AI may be reasonable alternatives. Intensive research is ongoing to understand the mechanisms of resistance to hormone therapy. In human epidermal growth factor receptor 2 positive-patients, combinations with HER2 antagonists are associated with significant clinical activity. PMID:21922395

Cruz Jurado, J; Richart Aznar, P; García Mata, J; Fernández Martínez, R; Peláez Fernández, I; Sampedro Gimeno, T; Galve Calvo, E; Murillo Jaso, L; Polo Marqués, E; García Palomo, A



“Breaking Bad News”: Standardized Patient Intervention improves communication skills for hematology-oncology fellows and advanced practice nurses  

Microsoft Academic Search

Background. Breaking bad news is 1 of cancer specialists’ most common and difficult duties, yet hematology-oncology fellowship programs\\u000a typically offer little formal preparation for this daunting task. We designed the Breaking Bad News Standardized Patient Intervention\\u000a (BBNSPI) as a standardized patient educational intervention to improve the communication skills of hematology-oncology fellows\\u000a (HOFs) and advanced practice nurses (APNs) in breaking bad

Ahmed Eid; Michael Petty; Laura Hutchins; Reed Thompson



A Conceptual Model for Evaluation of Patient Education for Cancer.  

ERIC Educational Resources Information Center

Procedures for the evaluation of patient education programs have been slow to evolve; the majority of programs, in fact, remain unevaluated. Patient education efforts, particularly with cancer patients, are effective in enhancing recovery, alleviating anxiety, and facilitating compliance. Patient education should minimize patient dependence on…

Newby, Larry G.; And Others


Assessing longitudinal quality of life in prostate cancer patients and their spouses: a multilevel modeling approach  

PubMed Central

Purpose This study aimed at examining the relationship between quality of life (QOL) in prostate cancer (PCa) patients and partners and how baseline demographics, cancer-related factors, and time-varying psychosocial and symptom covariates affect their QOL over time. Methods Guided by a modified Stress-Coping Model, this study used multilevel modeling to analyze longitudinal data from a randomized clinical trial that tested a family-based intervention to improve QOL in couples managing PCa. Patients and partners from the usual-care control group (N = 134 dyads) independently completed the measurements at baseline, and at 4-, 8-, and 12-month follow-ups. Results Correlations of QOL between patients and partners over time were small to moderate. Patients’ lower education level, partners’ older age, higher family income, and localized cancer at baseline were associated with better QOL in couples. Over time, couples’ QOL improved as their social support and cancer-related dyadic communication increased and as couples’ uncertainty, general symptoms, and patients’ prostate cancer-related sexual and hormonal symptoms decreased. Conclusions Evidence indicates that couples’ QOL during cancer survivorship is affected by multiple contextual factors (e.g., baseline demographics and time-varying psychosocial factors and symptoms). Intervention research is needed to explore comprehensive strategies to improve couples’ QOL during the continuum of PCa survivorship. PMID:20927648

Northouse, Laurel L.; Braun, Thomas M.; Zhang, Lingling; Cimprich, Bernadine; Ronis, David L.; Mood, Darlene W.



Infrared-Guided Patient Setup for Lung Cancer Patients  

SciTech Connect

Purpose: To evaluate the utility of an infrared-guided patient setup (iGPS) system to reduce the uncertainties in the setup of lung cancer patients. Methods and Materials: A total of 15 patients were setup for lung irradiation using skin tattoos and lateral leveling marks. Daily electronic portal device images and iGPS marker locations were acquired and retrospectively reviewed. The iGPS-based shifts were compared with the daily electronic portal device image shifts using both the central axis iGPS marker and all five iGPS markers. For shift calculation using the five markers, rotational misalignment was included. The level of agreement between the iGPS and portal imaging to evaluate the setup was evaluated as the frequency of the shift difference in the range of 0-5 mm, 5-10 mm, and >10 mm. Results: Data were obtained for 450 treatment sessions for 15 patients. The difference in the isocenter shifts between the weekly vs. daily images was 0-5 mm in 42%, 5-10 mm in 30%, and >10 mm in 10% of the images. The shifts seen using the iGPS data were 0-5 mm in 81%, 5-10 mm in 14%, and >10 mm in 5%. Using only the central axis iGPS marker, the difference between the iGPS and portal images was <5 mm in 77%, 5-10 mm in 16%, and >10 mm in 7% in the left-right direction and 73%, 18%, and 9% in the superoinferior direction, respectively. When all five iGPS markers were used, the disagreements between the iGPS and portal image shifts >10 mm were reduced from 7% to 2% in the left-right direction and 9% to 3% in the superoinferior direction. Larger reductions were also seen (e.g., a reduction from 50% to 0% in 1 patient). Conclusion: The daily iGPS-based shifts correlated well with the daily electronic portal device-based shifts. When patient movement has nonlinear rotational components, a combination of surface markers and portal images might be particularly beneficial to improve the setup for lung cancer patients.

Lyatskaya, Yulia; James, Steven; Killoran, Joseph H.; Soto, Ricardo; Mamon, Harvey J.; Chin, Lee [Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA (United States); Allen, Aaron M. [Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA (United States)], E-mail:



'It stays with me': the experiences of second- and third-year student nurses when caring for patients with cancer.  


Little is known about student nurses experiences of nursing patients with cancer in the UK. With the increasing survival of people with cancer and with cancer no longer seen as a terminal illness it is useful to understand student nurses clinical experience when nursing those with cancer. This study takes a phenomenological approach involving three focus group interviews with 20 student nurses from the second and third year of their course in one centre in the UK. All the students had experience of caring for patients with cancer. The key themes emerging from the study were: Communication, Impact on Self, Lack of Support and End-of-Life-Care. Students emphasised the need to have more knowledge and support in relation to cancer care. They describe how they lack communication skills and found it difficult to handle their emotions. A number of students found the whole experience of caring for patients with cancer emotionally distressing and draining and they describe avoiding contact with these patients by using distancing and avoidance strategies. Student nurses need additional support through demystifying cancer, using reflective practice and good mentoring in the clinical area to enable students to feel supported, and develop confidence in their capacity for care for people with cancer. PMID:24134475

King-Okoye, M; Arber, A



Clinical Oncology Society of Australia position statement on the use of complementary and alternative medicine by cancer patients.  


Health professionals involved in the clinical management of cancer are becoming increasingly aware that their patients use complementary and alternative medicine (CAM). As cancer incidence and survival rates increase, use of CAM is also likely to increase. This paper outlines the position of the Clinical Oncology Society of Australia (COSA) on the use of CAM by cancer patients and provides guidance for health professionals involved with the treatment of cancer patients who are using or wish to use CAM. Key definitions and common communication scenarios are presented along with evidence-based recommended steps for health professionals when discussing CAM use. COSA encourages health professionals to focus on open discussion with their patients regarding CAM, to become familiar with reputable resources for CAM information, to discuss with patients the concept of evidence-based medicine, to recognize limitations to their knowledge of CAM and seek further advice when necessary, and to be respectful of the patients' right to autonomy. PMID:25244342

Braun, Lesley; Harris, Jessica; Katris, Paul; Cain, Michael; Dhillon, Haryana; Koczwara, Bogda; Olver, Ian; Robotin, Monica



Partner-Assisted Emotional Disclosure for Patients with GI Cancer: Results from a Randomized Controlled Trial  

PubMed Central

Background For patients with cancer who are married or in an intimate relationship, their relationships with their partners play a critical role in their adaptation to their illness. However, cancer patients and their partners often have difficulty in talking with each other about their cancer-related concerns. Difficulties in communication may ultimately compromise both the patient-partner relationship and the patient's psychological adjustment. The present study tested the efficacy of a novel partner-assisted emotional disclosure intervention in a sample of patients with gastrointestinal (GI) cancer. Methods 130 patients with GI cancer and their partners were randomly assigned to receive four sessions of either partner-assisted emotional disclosure or a couples cancer education/support intervention. Patients and partners completed measures of relationship quality, intimacy with their partner, and psychological distress before randomization and at the end of the intervention sessions. Data were analyzed using multilevel modeling. Results Compared to an education/support condition, the partner-assisted emotional disclosure condition led to improvements in relationship quality and intimacy for couples in which the patient initially reported higher levels of holding back from discussing cancer-related concerns. Conclusions Partner-assisted emotional disclosure is a novel intervention that builds on both the private emotional disclosure and the cognitive-behavioral marital literature. The results of this study suggest that this intervention may be beneficial for couples in which the patient tends to hold back from discussing concerns. Future research on methods of enhancing the effects of partner-assisted emotional disclosure is warranted. PMID:19731357

Porter, Laura S.; Keefe, Francis J.; Baucom, Donald H.; Hurwitz, Herbert; Moser, Barry; Patterson, Emily; Kim, Hong Jin



Perceptions, Expectations, and Attitudes about Communication with Physicians among Chinese American and non-Hispanic White Women with Early-Stage Breast Cancer  

PubMed Central

Purpose Asian Americans have consistently reported poorer communication with physicians compared with non-Hispanic Whites (NHW). This qualitative study sought to elucidate the similarities and differences in communication with physicians between Chinese and NHW breast cancer survivors. Methods Forty-four Chinese and 28 NHW women with early-stage breast cancer (stage 0-IIa) from the Greater Bay Area Cancer Registry participated in focus group discussions or individual interviews. We oversampled Chinese women because little is known about their cancer care experiences. In both interview formats, questions explored patients’ experiences and feelings when communicating with physicians about their diagnosis, treatment, and follow-up care. Results Physician empathy at the time of diagnosis was important to both ethnic groups; however, during treatment and follow-up care, physicians’ ability to treat cancer and alleviate physical symptoms was a higher priority. NHW and US-born Chinese survivors were more likely to assert their needs, whereas Chinese immigrants accepted physician advice even when it did not alleviate physical problems (e.g., pain). Patients viewed all physicians as the primary source for information about cancer care. Many Chinese immigrants sought additional information from primary care physicians and stressed optimal communication over language concordance. Conclusions Physician empathy and precise information were important for cancer patients. Cultural differences such as the Western emphasis on individual autonomy vs. Chinese emphasis on respect and hierarchy can be the basis for the varied approaches to physician communication we observed. Interventions based on cultural understanding can foster more effective communication between immigrant patients and physicians ultimately improving patient outcomes. PMID:23903797

Wang, Judy Huei-yu; Adams, Inez F.; Pasick, Rena J.; Gomez, Scarlett L.; Allen, Laura; Ma, Grace X.; Lee, Michael X.; Huang, Ellen



Clues to Occult Cancer in Patients with Ischemic Stroke  

PubMed Central

Background We hypothesized that hidden malignancy could be detected in patients with cryptogenic stroke without active cancer when they showed the distinctive characteristics of cancer-related stroke. Methods and Findings Among 2,562 consecutive patients with acute ischemic stroke, patients with cryptogenic stroke were analyzed and categorized into two groups according to the presence of active cancer: cryptogenic stroke with active cancer (cancer-related stroke, CA-stroke) group and without active cancer (CR-stroke) group. Patients with active lung cancer without stroke were also recruited for comparison purposes (CA-control). Clinical factors, lesion patterns on diffusion-weighted MRI (DWI), and laboratory findings were analyzed among groups. A total of 348 patients with cryptogenic stroke were enrolled in this study. Among them, 71 (20.4%) patients had active cancer at the time of stroke. The D-dimer levels were significantly higher in patients with CA-stroke than those with CR-stroke or CA-control (both p<0.001). Regarding lesion patterns, patients with CA-stroke mostly had multiple lesions in multiple vascular territories, while more than 80% of patients with CR-stroke had single/multiple lesions in a single vascular territory (P<0.001). D-dimer levels (OR 1.11 per 1 µg/mL increase; 95% CI 1.06–1.15; P<0.001) and DWI lesion patterns (OR 7.13; 95% CI 3.42–14.87; P<0.001) were independently associated with CA-stroke. Workup for hidden malignancy was performed during hospitalization in 10 patients who showed elevated D-dimer levels and multiple infarcts involving multiple vascular territories but had no known cancer, and it revealed hidden malignancies in all the patients. Conclusion Patients with CA-stroke have distinctive D-dimer levels and lesion patterns. These characteristics can serve as clues to occult cancer in patients with cryptogenic stroke. PMID:22984594

Kim, Suk Jae; Park, Jae Hyun; Lee, Mi-Ji; Park, Yun Gyoung; Ahn, Myung-Ju; Bang, Oh Young



The Signatures of Autozygosity among Patients with Colorectal Cancer  

E-print Network

, and 5 Medicine, Memorial Sloan-Kettering Cancer Center; 6 Laboratory of Statistical Genetics Cancer Institute at Frederick, Frederick, Maryland; 10 Department of Genetics and Genomics, BostonThe Signatures of Autozygosity among Patients with Colorectal Cancer Manny D. Bacolod, 1 Gunter S

Stengel, Robert F.


Preventing Mucositis in Head and Neck Cancer Patients

In this trial, patients undergoing combination chemotherapy and radiation therapy (chemoradiotherapy) for advanced head and neck cancer will receive intravenous palifermin or placebo before and during cancer treatment to prevent mucositis, a common but serious side effect of chemoradiotherapy for this type of cancer.


Choice of cancer therapy varies with age of patient  

Microsoft Academic Search

The authors used data on 22,899 cancer cases collected by the New Mexico Tumor Registry to examine the relationship between patient age and the use of potentially curative therapy for cancers of selected sites and acute leukemias. For cancers of most sites, either local or regional stage, the proportion of cases receiving potentially curative therapy declined with age. For local-stage

J. Samet; W. C. Hunt; C. G. Humble; J. S. Goodwin



Improving Rural Cancer Patients' Outcomes: A Group-Randomized Trial  

ERIC Educational Resources Information Center

Significant barriers exist in the delivery of state-of-the-art cancer care to rural populations. Rural providers' knowledge and practices, their rural health care delivery systems, and linkages to cancer specialists are not optimal; therefore, rural cancer patient outcomes are less than achievable. Purpose: To test the effects of a strategy…

Elliott, Thomas E.; Elliott, Barbara A.; Regal, Ronald R.; Renier, Colleen M.; Haller, Irina V.; Crouse, Byron J.; Witrak, Martha T.; Jensen, Patricia B.



Quality of Life in Cancer Patients and its Related Factors  

PubMed Central

Introduction: Despite the importance of quality of life (QOL) in outcomes of cancer pa-tients, there have been a few Iranian studies investigating the Iranian patients’ quality of life. The present study aimed to assess the cancer patients’ QOL and its related factors. Methods: This cross-sectional study conducted in Shahid Ghazi Tabatabaei Hospital affiliated to Tabriz University of Medical Sciences in 2009. The samples included 150 cancer patients aged more than 18 years who were aware of their own diagnosis. They were selected through convenient sampling method and European Organization for Research and Treatment of Cancer–Quality of life questionnaire (EORTC–QOL 30) were completed. Results: Our findings showed that 44.1% of the patients had moderate QOL. QOL had a significant correlation with the level of family support (p = 0.002). Conclusion: Many of cancer patients have a moderate QOL. However, confirmation of such finding requires further investigations.

Abdollahzadeh, Farahnaz; Sadat Aghahossini, Shima; Rahmani, Azad; Asvadi Kermani, Iraj



An analysis of communication in conversation in patients with dementia.  


Patients with degenerative dementia often show language disorders, but little is known about their verbal (VC) and non-verbal communication (NVC). Our aim was to analyse VC and NVC in patients with standard criteria of mild-moderately severe dementia (MMSE ?14/30) resulting from Alzheimer's disease (AD; 29 cases), behavioural variant of frontotemporal dementia (FTD; 16), or dementia with Lewy bodies (DLB; 13). We used the Lille Communication Test, which addresses three domains: participation in communication (PC: greeting, attention, participation), VC (verbal comprehension, speech outflow, intelligibility, word production, syntax, verbal pragmatics and verbal feedback), and NVC (understanding gestures, affective expressivity, producing gestures, pragmatics and feedback). Patients were compared with 47 matching control subjects. AD patients were partially impaired (p?0.01) in PC (greeting), and more definitely in VC, especially by verbal comprehension and word finding difficulties and to a much lesser degree in verbal pragmatics (responding to open questions, presenting new information), while NVC was mostly preserved. FTD patients were severely impaired in PC. VC difficulties were related to lexical-semantic, syntactic and more specifically pragmatic problems. NVC was impaired by difficulties in affective expressivity, pragmatics and feedback management. DLB patients showed modest difficulties with VC. PC, VC and NVC strongly correlated with performance in the dementia rating scale. In conclusion, the profile of communication difficulties was quite different between groups. FTD patients showed most severe difficulties in PC and verbal and non-verbal pragmatics, in relation to their frontal lesions. AD patients had prominent impairment of lexical-semantic operations. PMID:20888846

Rousseaux, Marc; Sève, Amandine; Vallet, Marion; Pasquier, Florence; Mackowiak-Cordoliani, Marie Anne



[Psychological and psychiatric problems in cancer patients: relationship to the localization of the disease].  


Cancer may be localized in a variety of areas in the human body. This localization is associated with significant issues concerning not only therapy and prognosis but also psychological and psychiatric problems that the patient may be confronted with. The psychic impact on the patient is determined to a significant degree by the symbolism the affected organ carries. The symbolic significance of a sick body area triggers emotions and sets in motion self-defence mechanisms. In this way, patients deal with the new psychic reality that cancer creates. Therapeutic choices may include interventions, involving mutilation, which cause disfigurement and major consequences in the body image which result in narcissistic injuries. The phenomenology of anxiety and depressive disorders is connected to the affected body area. The appearance of cancer not only in sexual organs but also in other body areas, may disturb sexual function and therefore lead to sexual disorders. Especially, head and neck are connected with vital functions. This area of the body has had a major impact on psychic reality since early life. Complicated psychic functions have developed in relation to organs of the head and neck. Therefore, localization of cancer in this area leads to individual psychological and psychiatric problems, since eating and breathing are harmed, verbal communication becomes difficult and body image alters. Also, increased incidence of alcohol and nicotine abuse in these patients reflects special aspects of psychic structure and personality. Because of severe somatic symptoms and poor prognosis, lung cancer patients feel hopelessness and helplessness. Patients with gynaecological cancer are confronted with a disease that affects organs like breast and internal female sexual organs associated with femininity, attractiveness and fertility. Dietary habits are often a source of guilt for patients who suffer from cancer of the gastrointestinal tract. Additionally, stomas, as colostomy, affect body image and cause feelings of embarrassment with severe consequences on the patient's sense of wellbeing, his or her daily activities, interpersonal relationships or sexuality. Depressive symptoms often occur in prodromal stages of pancreatic cancer. Depression is a common diagnosis in patients with prostate cancer. Prostatectomy negatively affects patient's self-esteem, because it might be experienced as a threat to his sexual life. Disfigurement is related to skin cancer because of both cancer and surgical procedures. Therefore, it is a challenge for modern psycho-oncology to identify those patients who are vulnerable in developing psychiatric symptoms, to early diagnose anxiety and depression and to use psychotherapeutic interventions targeting individual psychological and psychiatric problems in relation to the localization of disease in the human body. PMID:22549040

Moussas, G I; Papadopoulou, A G; Christodoulaki, A G; Karkanias, A P



The quality of life of patients following treatment for laryngeal cancer  

SciTech Connect

One hundred and twenty-nine patients have been interviewed 9 to 15 months following treatment for laryngeal cancer to determine the post treatment quality of voice and life. The patients were subdivided into 3 groups, successfully irradiated T1 and T2 patients, (89 patients), successfully irradiated T3 and T4 patients (24 patients) and those treated by surgery (16 patients). Ninety-three percent of T1 and T2 patients and 79% of T3 and T4 patients were working following treatment as compared to 44% of the surgery patients. Ninety-eight percent of the T1 and T2 and 87.5% of the T3 and T4 patients were able to use the telephone normally as compared to 12% of the surgery patients. Similarly major differences between the successfully irradiated patients and the surgically treated patients in terms of ability to live a normal social life have been noted. The patients also rated their voice in terms of volume, pitch, ability to communicate, quality, rate of speech, flow of speech and dry throat. In every parameter of rating of the voice, with the exception of dryness of the throat, the successfully irradiated patients in all stage groupings had better ratings than the surgery group. Since, in Toronto, survival in advanced glottic and supraglottic cancer is the same using radical radiation with surgery in reserve as survival with primary surgery, it is concluded in view of the superior quality of voice and life in the successfully irradiated patients that irradiation with surgery in reserve is the optimal treatment for these patients. We also concluded that the measurement of quality of life in patients with cancer of the larynx is of vital importance in determining optimal treatment and that further studies in this area are indicated.

Harwood, A.R.; Rawlinson, E.



Chronic Kidney Disease in Cancer Patients: An Independent Predictor of Cancer-Specific Mortality  

Microsoft Academic Search

Background\\/Aims: The effects of chronic kidney disease (CKD) on the risk of death for patients with malignant disease are uncertain. The aim of this study was to determine the association between the presence of CKD and mortality in cancer patients. Method: We retrospectively reviewed the cases of 8,223 cancer patients with one or more serum creatinine measurements from January 1,

Sun Young Na; Ji Yoon Sung; Jae Hyun Chang; Sejoong Kim; Hyun Hee Lee; Yeon Ho Park; Wookyung Chung; Kook-Hwan Oh; Ji Yong Jung



Determinants and implications of cancer patients’ psychosocial needs  

Microsoft Academic Search

Goals of work  Cancer patients often experience distress. However, the majority of newly diagnosed patients gradually adapt to the crisis.\\u000a When symptoms of distress and anxiety persist over months, patients require psychosocial support. The aim of the present study\\u000a was to determine the proportion of cancer patients who indicate the need for psychosocial support and to identify sociodemographic,\\u000a psychological and illness-related

N. Ernstmann; M. Neumann; O. Ommen; M. Galushko; M. Wirtz; R. Voltz; M. Hallek; H. Pfaff



Ocular and Orbital Infections in the Immunocompromised Cancer Patient  

Microsoft Academic Search

\\u000a Significant progress has been made in the treatment of cancer patients, and the proportion of cancer patients achieving complete\\u000a remission and longer survival has increased in recent years. However, a significant proportion of patients still do not achieve\\u000a complete remission, and infection remains a frequent cause of treatment failure, particularly in patients with hematologic\\u000a malignancies. Ocular and orbital infections are

Viet H. Ho; Hao H. Ho


Node-Negative Breast Cancer: Which Patients Should Be Treated?  

Microsoft Academic Search

SummaryAdjuvant systemic therapy has led to markedly improved outcome in early-stage breast cancer. However, the absolute gains from chemotherapy might be modest in node-negative patients. Adjuvant chemotherapy is the only option for triple-negative breast cancer patients and should be used with trastuzumab in HER2-positive patients. Considering the large group of patients with some degree of endocrine responsiveness, adding chemotherapy according

Marcus Schmidt



Developing a referral system for fertility preservation among patients with newly diagnosed cancer.  


The goal of this project was to develop a referral system to increase the likelihood that patients of childbearing age with newly diagnosed cancer receive timely information about fertility, and reduce the burden oncologists may feel when discussing and exploring fertility preservation options with their patients. The group developed and examined the effectiveness of a fertility preservation referral system through pilot-testing a developed patient education brochure. During the 12-month pilot-testing period, 776 patients of childbearing age (< 40 years) were seen at H. Lee Moffitt Cancer Center and 349 brochures were taken. The reproductive endocrinologist/infertility clinic experienced a 9-fold increase in the number of calls received during the 12-month study period, with 122 calls received compared with 13 the prior year. The large increase in calls illuminates the gap in patient interest and referral, and shows an effective method to transmit this information. Improving the communication of time-sensitive information about fertility and preservation options to patients with cancer is associated with an increased likelihood of improving quality of life, reducing patient distress, and increasing use of ancillary fertility-related health services. Through referring and providing patient information, this referral system allows oncologists to fulfill their obligation and make informed decisions about fertility preservation, thereby improving the full cancer care continuum. PMID:22056654

Quinn, Gwendolyn P; Vadaparampil, Susan T; Gwede, Clement K; Reinecke, Joyce D; Mason, Tina M; Silva, Celso



Older female cancer patients: importance, causes, and consequences of undertreatment.  


Despite increased interest in treatment of senior cancer patients, older patients are much too often undertreated. This review aims to present data on treatment practices of older women with breast and gynecologic cancers and on the consequences of undertreatment on patient outcome. We also discuss the reasons and validity of suboptimal care in older patients. Numerous studies have reported suboptimal treatment in older breast and gynecologic cancer patients. Undertreatment displays multiple aspects: from lowered doses of adjuvant chemotherapy to total therapeutic abstention. Undertreatment also concerns palliative care, treatment of pain, and reconstruction. Only few studies have evaluated the consequences of nonstandard approaches on cancer-specific mortality, taking into account other prognostic factors and comorbidities. These studies clearly showed that undertreatment increased disease-specific mortality for breast and ovarian cancers. For other gynecological cancers, data were insufficient to draw conclusions. Objective reasons at the origin of undertreatment were, notably, higher prevalence of comorbidity, lowered life expectancy, absence of data on treatment efficacy in clinical trials, and increased adverse effects of treatment. More subjective reasons were putative lowered benefits of treatment, less aggressive cancers, social marginalization, and physician's beliefs. Undertreatment in older cancer patients is a well-documented phenomenon responsible for preventable cancer deaths. Treatments are still influenced by unclear standards and have to be adapted to the older patient's general health status, but should also offer the best chance of cure. PMID:17488984

Bouchardy, Christine; Rapiti, Elisabetta; Blagojevic, Stina; Vlastos, Anne-Thérèse; Vlastos, Georges



Influence of type of cancer and hematopoietic stem cell transplantation on clinical presentation of Pneumocystis jiroveci pneumonia in cancer patients  

Microsoft Academic Search

Pneumocystis jiroveci pneumonia is a common infection in patients with AIDS but an infrequent cause of pneumonia in cancer patients. Little is known about the impact of cancer type and hematopoietic stem cell transplantation on the presentation and outcome of P. jiroveci pneumonia in cancer patients. A retrospective cohort study of all patients with cancer and P. jiroveci pneumonia cared

H. A. Torres; R. F. Chemaly; R. Storey; E. A. Aguilera; G. M. Nogueras; A. Safdar; K. V. I. Rolston; I. I. Raad; D. P. Kontoyiannis



Narrative communication in cancer prevention and control: A framework to guide research and application  

Microsoft Academic Search

Narrative forms of communication—including entertainment education, journalism, literature, testimonials, and storytelling—are\\u000a emerging as important tools for cancer prevention and control. To stimulate critical thinking about the role of narrative\\u000a in cancer communication and promote a more focused and systematic program of research to understand its effects, we propose\\u000a a typology of narrative application in cancer control. We assert that narrative

Matthew W. Kreuter; Melanie C. Green; Joseph N. Cappella; Michael D. Slater; Meg E. Wise; Doug Storey; Eddie M. Clark; Daniel J. O’Keefe; Deborah O. Erwin; Kathleen Holmes; Leslie J. Hinyard; Thomas Houston; Sabra Woolley



The Effect of Anxiety on Breast Cancer Patients  

PubMed Central

Cancer is a disease wherein abnormal cells divide without control and are able to attack other tissues. Most of the patients and their families face some degree of depression, anxiety, and fear when cancer becomes a part of their lives. They feel helpless and eager to find ways on how to get rid of it. The study focuses on anxiety among breast cancer patients. It aims at investigating cancer, its symptoms, and effects the disease has on the anxiety level of patients. PMID:23162185

Baqutayan, Shadiya Mohamed Saleh



Quality Assurance for Patients with Breast Cancer - the Impact of Clinical Cancer Registries  

PubMed Central

Introduction: Since 2000 all service providers in the German healthcare system are legally obliged to take part in quality assurance (QA) procedures as stipulated in Book Five of the German Social Code. Clinical cancer registries provide methodological tools to assess the quality of structures, processes and outcomes. The aim of this study was to analyze the consequences of guideline-concordant treatment using two examples of quality indicators: endocrine therapy (adjuvant hormonal therapy, AHT) to treat patients with steroid hormone receptor (SHR)-positive breast cancer and trastuzumab therapy to treat patients with HER2-positive breast cancer. Material and Methods: Data from the Tumor Center Regensburg (Bavaria, Germany) included all female patients listed in the registry with primary, non-metastatic invasive breast cancer diagnosed between 2000 and 2012. Results: A total of 6164 patients with invasive breast cancer and known HER2 status were analyzed. 1134 patients (18.4?%) had HER2-positive and 5346 patients (86.7?%) had SHR-positive breast cancer. Premenopausal patients with HER2-positive breast cancer receiving trastuzumab had a 7-year OS rate of 93.8?% compared to 86.8?% of patients who did not receive trastuzumab (p?=?0.079). Similarly, postmenopausal patients with HER2-positive breast cancer treated with trastuzumab had better 7-year OS rates (87.3?%) than patients who did not receive the antibody (76.7?%) (p?patients with SHR-positive breast cancer receiving AHT had a 7-year OS rate of 95.2?% compared to 75.9?% of patients who did not receive AHT (p?patients treated with AHT had a 7-year OS rate of 83.8?% compared to 64.1?% without AHT (p?cancer registries depend on the cooperation of the various health service providers to generate data that are essential for QA for breast cancer patients.

Inwald, E. C.; Klinkhammer-Schalke, M.; Koller, M.; Ortmann, O.



Using Community-Based Research Methods to Design Cancer Patient Navigation Training  

PubMed Central

Background Cancer mortality continues to be higher in Native Hawaiians than Whites, and research has identified numerous barriers to good cancer care. Cancer navigator programs provide individualized assistance to patients and family members to overcome barriers, promoting early diagnosis and timely and complete treatment. Objectives Our purpose was to design a training curriculum to provide community-based outreach workers serving Native Hawaiians with cancer patient navigator skills. Methods The Ho`okele i ke Ola (Navigating to Health) curriculum was informed by data gathered from Native Hawaiian cancer patients and their family members, outreach workers in Native Hawaiian communities, and cancer care providers. Based on findings, the 48-hour curriculum focused on cancer knowledge, cancer resources, and cancer communications. Three versions were developed: 1) 6 days of training and on-site tours in urban Honolulu; 2) 4 days of training on a neighbor island, with 2 days of on-site tours in Honolulu; and 3) a 3-credit community college independent study course. Graduates were interviewed after each session and 3 months after graduation about application of navigation skills. Results In 18 months, 62 health workers from community-based, clinical and community college settings were trained—31 in Honolulu-based trainings, 29 in neighbor island trainings where earlier graduates served as co-faculty, and 2 through Maui Community College. Follow-up data suggest increased knowledge, skills, capacity, and feelings of competence among trainees. Conclusions All three versions of the Ho`okele i ke Ola curriculum, developed with community input, have proven successful in increasing cancer patient navigation skills of trainees. PMID:20208313

Braun, Kathryn L.; Allison, Amanda; Tsark, JoAnn U.



A survey of pain in patients with advanced cancer  

Microsoft Academic Search

One hundred eleven patients with advanced cancer and pain newly referred to a palliative care center completed the Brief Pain Inventory (BPI) weekly for up to 4 weeks. The aims were (a) to review the numbers and causes of pain, (b) to consider the usefulness of the BPI in the evaluation of pain in cancer patients, and (c) to determine

Robert Twycross; Jean Harcourt; Stephen Bergl



Prospective Assessment of Quality of Life of Female Cancer Patients  

Microsoft Academic Search

Objective. The aims of this study were to compare the quality of life (QOL) of women with different cancer sites; to identify predictors of QOL; and to examine the agreement between patient self-reported QOL and QOL ratings provided by clinicians and significant others.Methods. A prospective study was conducted including 248 patients with gynecologic and breast cancer. QOL data were collected

E. Greimel; I. Thiel; F. Peintinger; I. Cegnar; E. Pongratz



Psychological States in Terminal Cancer Patients as Measured Over Time.  

ERIC Educational Resources Information Center

Determined the level and change in denial, death anxiety, anxiety, depression, hostility, love, being, and self-esteem over time in terminal cancer patients. Cancer patients had significantly lower death anxiety than the control subjects and a relative increase in the being variable over time. The clinical opinion that denial protects against…

Dougherty, Kimberly; And Others



Treatment outcome following radiotherapy in elderly patients with bladder cancer  

Microsoft Academic Search

Background and purpose: The optimal treatment of elderly patients with bladder cancer is not established. This study aimed to evaluate prognostic variables for survival and morbidity, which may be important for treatment strategy.Material and methods: The medical records of 94 patients aged ? 75 years receiving curatively intended radiotherapy for bladder cancer were reviewed retrospectively.Results: Median age was 78 years

Lisa Sengeløv; Søren Klintorp; Hanne Havsteen; Claus Kamby; Susanne L. Hansen; Hans von der Maase



Social Support of Cancer Patients in Hong Kong  

Microsoft Academic Search

This article reports the significant findings of an empirical investigation of 60 Chinese cancer patients receiving chemotherapy in Hong Kong. Taking into consideration its multi-faceted characteristics, social support was operationalized in social network analysis, subjective perception of social support and the natural helping behaviour.It was found that cancer patients trusted their spouse and their parents most: Emotional support and socially

Joyce L. C. Ma; Cecilia L. W. Chan; Iris Chi; Jonathan S. T. Sham



Adjuvant radiotherapy on older and oldest elderly rectal cancer patients  

Microsoft Academic Search

The purpose of this study was to evaluate the impact of radiotherapy in terms of feasibility and activity in the patients aged ?75 with advanced rectal cancer. From January 2002 to December 2006, 41 consecutive patients (27 men and 14 women) aged ?75 received radiotherapy for local advanced rectal cancer, 9 in a pre-operative and 22 in a post-operative setting.

F. Fiorica; F. Cartei; B. Carau; S. Berretta; D. Spartà; U. Tirelli; A. Santangelo; D. Maugeri; S. Luca; C. Leotta; R. Sorace; M. Berretta




E-print Network

AMERICAN THORACIC SOCIETY PATIENT HEALTH SERIES Lung Cancer Prevention What are the chances that I. 182, Number 10, P3. ATS Patient Health Series ©2011 American Thoracic Society What can I do to decrease my risk of developing lung cancer? The best way to lower your risk is to avoid

Kaski, Samuel


Quality of Life in Patients Undergoing Radiation Therapy for Primary Lung Cancer, Head and Neck Cancer, or Gastrointestinal Cancer

Anal Cancer; Colorectal Cancer; Esophageal Cancer; Extrahepatic Bile Duct Cancer; Gallbladder Cancer; Gastric Cancer; Head and Neck Cancer; Liver Cancer; Lung Cancer; Pancreatic Cancer; Small Intestine Cancer



An Intervention to Improve Communication Between Breast Cancer Survivors and Their Physicians  

Microsoft Academic Search

Breast cancer survivors often use clues to convey their concerns to their oncologists. The authors conducted a randomized trial of a communication coaching intervention in which 22 female breast cancer survivors were randomized to the coaching and 22 to treatment as usual. They hypothesized that the intervention would increase breast cancer self-efficacy, improve mood, and reduce fears of recurrence. Through

Cleveland G. Shields; Kim Wagler Ziner; Sara A. Bourff; Katherine Schilling; Qianqian Zhao; Patrick Monahan; George Sledge; Victoria Champion



Mass Media and Marketing Communication Promoting Primary and Secondary Cancer Prevention  

Microsoft Academic Search

People often seek and receive cancer information from mass media (including television, radio, print media, and the Internet), and marketing strategies often inform cancer information needs assessment, message development, and channel selection. In this article, we present the discussion of a 2-hour working group convened for a cancer communications workshop held at the 2008 Society of Behavioral Medicine meeting in

Peggy Hannon; Gareth P. Lloyd; K. Viswanath; Tenbroeck Smith; Karen Basen-Engquist; Sally W. Vernon; Gina Turner; Bradford W. Hesse; Corinne Crammer; Christian von Wagner; Cathy L. Backinger



Use of and Communication about Dietary Supplements Among Hospitalized Patients  

PubMed Central

BACKGROUND Use of dietary supplements (DS) is common in the United States; however little is known about the use of DS specifically in hospitalized patients. OBJECTIVE The goal of this study is to begin to characterize trends in DS use by hospitalized patients and to assess the degree of patient–physician communication about use of DS that occurs during hospitalization. DESIGN This is a cross-sectional, observational pilot study. PARTICIPANTS Participants were admitted to the general internal medicine or geriatrics service by house staff residents; those ? 18 years of age who were medically stable, cognitively intact and fluent in English and/or Spanish were invited to participate in the study. RESULTS Nearly 80% of hospitalized patients reported use of DS, with 52% reporting use of non-vitamin/non-mineral DS. During the admission process, physicians documented inquiring about DS use only 20% of the time. While the majority of patients had no concern about temporarily discontinuing their DS during hospitalization, 13% of patients reported that they believed there was nothing wrong with continued use of DS while hospitalized regardless of the recommendations provided by their inpatient physicians. CONCLUSIONS Use of DS in hospitalized patients is common, and communication between patients and physicians regarding their use is limited. PMID:19096896

Faurot, Keturah R.; Gaylord, Susan A.



African American Women's Perspectives on Breast Cancer: Implications for Communicating Risk of Basal-like Breast Cancer  

PubMed Central

African American women suffer a higher burden of basal-like breast cancer, an aggressive subtype that has no targeted therapy. While epidemiologic research has identified key prevention strategies, little is known about how best to communicate risk to this population. This study explored women’s knowledge, beliefs, and attitudes about breast cancer to learn about risk perceptions. Six focus groups with 57 women (ages 18–49) women were conducted in North Carolina. Findings revealed that age, race (especially perceptions of cancer as a “White disease”), and lack of family history of breast cancer contributed to women’s perceptions of low breastcancer susceptibility. Perceptions of low risk were also attributed to conflicting risk information from family, media, and health providers. Women had little knowledge about breast cancer subtypes, but emphasized that health communications should be personally relevant, culturally appropriate, and convenient. These study findings will assist in developing health communication tools that encourage prevention. PMID:23728042

Allicock, Marlyn; Graves, Neasha; Gray, Kathleen; Troester, Melissa A.



The Relationship Between Multimorbidity and Patients’ Ratings of Communication  

Microsoft Academic Search

BACKGROUND  The growing interest in pay-for-performance and other quality improvement programs has generated concerns about potential\\u000a performance measurement penalties for providers who care for more complex patients, such as patients with more chronic conditions.\\u000a Few data are available on how multimorbidity affects common performance metrics.\\u000a \\u000a \\u000a \\u000a OBJECTIVE  To examine the relationship between multimorbidity and patients’ ratings of communication, a common performance metric.\\u000a \\u000a \\u000a \\u000a DESIGN  Cross-sectional

Constance H. Fung; Claude M. Setodji; Fuan-Yue Kung; Joan Keesey; Steven M. Asch; John Adams; Elizabeth A. McGlynn



Lymphedema After Surgery in Patients With Endometrial Cancer, Cervical Cancer, or Vulvar Cancer

Lymphedema; Stage IA Cervical Cancer; Stage IA Endometrial Carcinoma; Stage IA Vulvar Cancer; Stage IB Cervical Cancer; Stage IB Endometrial Carcinoma; Stage IB Vulvar Cancer; Stage II Endometrial Carcinoma; Stage II Vulvar Cancer; Stage IIA Cervical Cancer; Stage IIIA Vulvar Cancer; Stage IIIB Vulvar Cancer; Stage IIIC Vulvar Cancer; Stage IVB Vulvar Cancer



Predictors of communication preferences in patients with chronic low back pain  

PubMed Central

Background The objective of this exploratory study was to identify patient-related predictors of communication preferences in patients with chronic low back pain for various dimensions of patient-physician communication (patient participation and orientation, effective and open communication, emotionally supportive communication, communication about personal circumstances). Methods Eleven rehabilitation centers from various parts of Germany participated in collection of data between 2009 and 2011. A total of 701 patients with chronic low back pain were surveyed at the start of rehabilitation. The patient questionnaire captured communication preferences, pain impact, pain intensity, and psychologic variables (fear avoidance beliefs, illness coherence, control beliefs, communication self-efficacy, and personality characteristics). The rehabilitation physicians filled out a documentation sheet containing information on diagnosis, inability to work, duration of the illness, and comorbidity at the beginning and end of rehabilitation. Hierarchical regression analyses were performed. Results On average, effective, open, and patient-centered communication was very important for patients with back pain, emotionally supportive communication was important, and communication about personal circumstances was somewhat important. The variance in communication preferences explained by the predictors studied here was 8%–19%. Older patients showed a lower preference for patient-centered and open communication, but a higher preference for communication about personal circumstances. Patients with psychologic risk factors (eg, fear avoidance beliefs), extroverted patients, and patients with high self-efficacy in patient-physician interaction generally had higher expectations of the physician’s communicative behavior. Conclusion Providers should take into consideration the fact that patients with back pain have a strong need for effective, open, and patient-centered communication. A flexible approach to communication needs appears to be especially important for communication about emotional and personal circumstances, because the patients differ most clearly in this respect. Personal characteristics provided only initial clues to possible preferences; for more precision, an individual assessment (by means of questionnaires or discussion) is needed. PMID:24187489

Farin, Erik; Gramm, Lukas; Schmidt, Erika



Assessing the risk for suicide in patients with cancer.  


The Joint Commission publishes its annual National Patient Safety Goals to guide accredited organizations in addressing high-risk, low-volume concerns related to patient safety. The 2010 list includes a goal to identify patients at risk for suicide, but do oncology nurses need to be concerned about the risk of suicide in patients with cancer? PMID:21112846

Aiello-Laws, Lisa B



Chronicling cancer experience online can reduce depressive symptoms in breast cancer patients

Adults increasingly are conveying their personal experiences with serious disease online, but do such chronicles help the authors or their audience? In the first known study of its kind, UCLA Jonsson Comprehensive Cancer Center researchers discovered that creating a personal website to chronicle the cancer experience and communicate with one's social network can reduce depressive symptoms, increase positive mood and enhance appreciation for life among women diagnosed with breast cancer.


The Relation between Awareness of Cancer Diagnosis and Spiritual Health among Cancer Patients  

PubMed Central

Introduction: Disclosure of cancer diagnosis is one the main challenges in caring of patients with cancer since it may have negative effects on the spiritual health of patients. No study has ever been performed in Iran to investigate the relationship between awareness of cancer diagnosis and spiritual health in cancer patients. Therefore, the present study aimed to review the effects of awareness of cancer on spiritual health in patients with cancer. Methods: This was a descriptive-comparative study conducted in Shahid Ghazi Tabatabaei University Hospital in 2009. The subjects included 150 patients aware of their cancer diagnosis and 150 unaware patients. The patients were selected through convenient sampling method. Using a questionnaire, the patient's spiritual health was assessed. Data analysis was conducted in SPSS17 using descriptive and inferential statistics. Results: Results showed the mean (SD) of spiritual health among aware and unaware patients to be 75.1 (3.8) and 75.4 (3.9), respectively. Statistically, there was no significant difference between the spiritual health of the two groups (p = 0.96). Conclusion: These findings showed that awareness of cancer diagnosis had no effects on spiritual health of patients. It is not surprising considering Iranian culture. However, confirmation of this finding requires further studies.

Sadat Aghahosseini, Shima; Rahmani, Azad; Abdollahzadeh, Farahnaz; Asvadi Kermani, Iraj



Integrating cancer survivors' experiences into UK cancer registries: design and development of the ePOCS system (electronic Patient-reported Outcomes from Cancer Survivors)  

PubMed Central

Background: Understanding the psychosocial challenges of cancer survivorship, and identifying which patients experience ongoing difficulties, is a key priority. The ePOCS (electronic patient-reported outcomes from cancer survivors) project aims to develop and evaluate a cost-efficient, UK-scalable electronic system for collecting patient-reported outcome measures (PROMs), at regular post-diagnostic timepoints, and linking these with clinical data in cancer registries. Methods: A multidisciplinary team developed the system using agile methods. Design entailed process mapping the system's constituent parts, data flows and involved human activities, and undertaking usability testing. Informatics specialists built new technical components, including a web-based questionnaire tool and tracking database, and established component-connecting data flows. Development challenges were overcome, including patient usability and data linkage and security. Results: We have developed a system in which PROMs are completed online, using a secure questionnaire administration tool, accessed via a public-facing website, and the responses are linked and stored with clinical registry data. Patient monitoring and communications are semiautomated via a tracker database, and patient correspondence is primarily Email-based. The system is currently honed for clinician-led hospital-based patient recruitment. Conclusions: A feasibility test study is underway. Although there are possible challenges to sustaining and scaling up ePOCS, the system has potential to support UK epidemiological PROMs collection and clinical data linkage. PMID:22048035

Ashley, L; Jones, H; Thomas, J; Forman, D; Newsham, A; Morris, E; Johnson, O; Velikova, G; Wright, P



Cultural perceptions in cancer care among African-American and Caucasian patients.  

PubMed Central

PURPOSE: This exploratory study examined perceptions and beliefs of African Americans and Caucasians related to cancer care. Understanding belief systems and cultures optimizes cancer treatment and care delivery to ethnic minority individuals. PATIENTS AND METHODS: Focus groups were conducted with 39 African-American and Caucasian cancer patients. Data analysis included whole group analysis with a team of five researchers. RESULTS: Regardless of ethnicity, cancer patients share many of the same emotions and experiences, and want complete information and quality care. Differences were also apparent. African-American participants were more likely to report increased religious behaviors, believe that healthcare providers demonstrate care with simple actions and provision of practical assistance, and use church and community information sources. Caucasian participants were more likely to report spiritual but not overtly religious changes, and depend on healthcare providers for information. CONCLUSION: Understanding how culture colors perceptions, communication and information requirements is critical to providing effective care to ethnically diverse cancer patients. Findings have implications for professionals understanding ways patients seek information, the role of spirituality and religion in care, and ways healthcare providers demonstrate care. PMID:17987914

Matsuyama, Robin K.; Grange, Christina; Lyckholm, Laurie J.; Utsey, Shawn O.; Smith, Thomas J.



Complementary and alternative medicine use in patients with head and neck cancers in Europe.  


The aim of the present study was to examine the patterns of complementary and alternative medicine (CAM) use in a sample of head and neck cancer patients, forming part of a larger study. A cross-sectional survey design was used collecting data through a descriptive 27-item questionnaire in nine countries in Europe. The participants were 75 patients with head and neck cancers. The prevalence rate of CAM use was 22.7%. The most common therapies used were herbal medicine (47%), medicinal teas (23.5%), use of vitamins/minerals (11.8%) and visualization (11.8%). Use of CAM dramatically increased after the diagnosis with cancer (i.e. eightfold increase in the use of herbs). A profile of CAM users was not evident in this sample. Patients used CAM for a variety of reasons together, with counteracting the ill effects from cancer and its treatment being the most common one. Information about CAM was obtained mostly from friends and family. As one in five head and neck cancer patients use CAM it is important that clinicians explore practices with their patients, improve communication about CAM with them and assist those who want to use CAM in using appropriate and safe therapies. PMID:16441673

Molassiotis, A; Ozden, G; Platin, N; Scott, J A; Pud, D; Fernandez-Ortega, P; Milovics, L; Panteli, V; Gudmundsdottir, G; Browall, M; Madsen, E; Patiraki, E; Kearney, N



The Relationship between Communication and Health-related Quality of Life in Survivorship Care for Chinese- and Korean-American Breast Cancer Survivors  

PubMed Central

Objective The purpose of this study was (1) to compare family communication, decision support (i.e., supporting the patient in making decisions), self-efficacy in patient-physician communication (i.e., patients’ confidence level in communicating with physicians), and health-related quality of life (HRQOL) between Chinese- and Korean-American breast cancer survivors (BCS), and (2) to investigate how family communication, decision support, and self-efficacy in patient-physician communication influences HRQOL for Chinese- and Korean-American BCS. Methods A cross-sectional design was used. A total of 157 Chinese- (n=86) and Korean-American (n=71) BCS were recruited from the California Cancer Surveillance Program and area hospitals in Los Angeles County. The Chronic Care Model was utilized. Results Chinese- and Korean-Americans showed a significant difference in the decision support only. Self-efficacy in patient-physician communication was directly associated with HRQOL for Chinese-Americans, whereas for Korean-Americans, family communication was related to HRQOL. The mediating effects of decision support and self-efficacy in physician-patient communication in the relationship between family communication and HRQOL were observed for Chinese-Americans only. Multiple group analysis demonstrated that the structural paths varied between Chinese- and Korean-American BCS. Conclusions Our results provide insight into the survivorship care of Chinese- and Korean-American BCS, allowing a better understanding of communication among survivors, family, and healthcare providers. Communication skills to manage conflict and attain consensus among them under the cultural contexts are essential to improve HRQOL for BCS. PMID:23111944

Lim, Jung-won; Paek, Min-so



Oncology clinicians' defenses and adherence to communication skills training with simulated patients: an exploratory study.  


The aim of this exploratory study was to assess the impact of clinicians' defense mechanisms-defined as self-protective psychological mechanisms triggered by the affective load of the encounter with the patient-on adherence to a communication skills training (CST). The population consisted of oncology clinicians (N=31) who participated in a CST. An interview with simulated cancer patients was recorded prior and 6 months after CST. Defenses were measured before and after CST and correlated with a prototype of an ideally conducted interview based on the criteria of CST-teachers. Clinicians who used more adaptive defense mechanisms showed better adherence to communication skills after CST than clinicians with less adaptive defenses (F(1, 29)?=5.26, p=0.03, d=0.42). Improvement in communication skills after CST seems to depend on the initial levels of defenses of the clinician prior to CST. Implications for practice and training are discussed. Communication has been recognized as a central element of cancer care [1]. Ineffective communication may contribute to patients' confusion, uncertainty, and increased difficulty in asking questions, expressing feelings, and understanding information [2, 3], and may also contribute to clinicians' lack of job satisfaction and emotional burnout [4]. Therefore, communication skills trainings (CST) for oncology clinicians have been widely developed over the last decade. These trainings should increase the skills of clinicians to respond to the patient's needs, and enhance an adequate encounter with the patient with efficient exchange of information [5]. While CSTs show a great diversity with regard to their pedagogic approaches [6, 7], the main elements of CST consist of (1) role play between participants, (2) analysis of videotaped interviews with simulated patients, and (3) interactive case discussion provided by participants. As recently stated in a consensus paper [8], CSTs need to be taught in small groups (up to 10-12 participants) and have a minimal duration of at least 3 days in order to be effective. Several systematic reviews evaluated the impact of CST on clinicians' communication skills [9-11]. Effectiveness of CST can be assessed by two main approaches: participant-based and patient-based outcomes. Measures can be self-reported, but, according to Gysels et al. [10], behavioral assessment of patient-physician interviews [12] is the most objective and reliable method for measuring change after training. Based on 22 studies on participants' outcomes, Merckaert et al. [9] reported an increase of communication skills and participants' satisfaction with training and changes in attitudes and beliefs. The evaluation of CST remains a challenging task and variables mediating skills improvement remain unidentified. We recently thus conducted a study evaluating the impact of CST on clinicians' defenses by comparing the evolution of defenses of clinicians participating in CST with defenses of a control group without training [13]. Defenses are unconscious psychological processes which protect from anxiety or distress. Therefore, they contribute to the individual's adaptation to stress [14]. Perry refers to the term "defensive functioning" to indicate the degree of adaptation linked to the use of a range of specific defenses by an individual, ranging from low defensive functioning when he or she tends to use generally less adaptive defenses (such as projection, denial, or acting out) to high defensive functioning when he or she tends to use generally more adaptive defenses (such as altruism, intellectualization, or introspection) [15, 16]. Although several authors have addressed the emotional difficulties of oncology clinicians when facing patients and their need to preserve themselves [7, 17, 18], no research has yet been conducted on the defenses of clinicians. For example, repeated use of less adaptive defenses, such as denial, may allow the clinician to avoid or reduce distress, but it also diminishes his ability to respond to the patient's emotions, to identify and to respon

Bernard, Mathieu; de Roten, Yves; Despland, Jean-Nicolas; Stiefel, Friedrich



Epidemiology and Prognostic Factors of Candidemia in Cancer Patients  

PubMed Central

Aim The study of candidemia in cancer patients has been limited. This retrospective study aims to investigate the epidemiologic characteristics and prognostic factors of candidemia among cancer patients. Materials and Methods From 2009 to 2012, cancer patients with candidemia were identified at a hospital in Taiwan. The medical records of all patients with bloodstream infections due to Candida species were retrospectively reviewed. Results During the four-year period, a total of 242 episodes of candidemia were identified among cancer patients. Half of these patients were classified as elderly (?65 years old), and more than 95% of the candidemia episodes were classified as healthcare-associated infections. Among the 242 cancer patients with candidemia, head and neck cancer was the most common, followed by gastrointestinal tract and lung cancer. Additionally, most of the patients had variable underlying conditions, such as the presence of CVC (99%) or prior exposure to broad-spectrum antibiotics (93%) and were receiving an immunosuppressant (86%). Overall, C. albicans (n?=?132, 54.5%) was the most common pathogen, followed by C. tropicalis (n?=?52, 21.5%), C. parapsilosis (n?=?38, 15.7%), and C. glabrata (n?=?29, 12.0%). Seventeen patients had polycandidal candidemia, and 77 patients had concomitant bacteremia. Approximately one-third of the patients required admission to the intensive care unit (ICU) or mechanical ventilation, and the overall in-hospital mortality was 50.8%. Multivariable analysis showed that the in-hospital mortality was significantly associated with only the non-use of antifungal agents and acute respiratory failure (P<.001). Conclusions Candidemia can develop in patients with both solid cancer and hematological malignancy, especially for patients with underlying conditions. Overall, the associated morbidity and mortality due to Candidemia remain high. It was also determined that the non-use of antifungal agents and acute respiratory failure conditions were associated with in-hospital mortality. PMID:24901336

Tang, Hung-Jen; Liu, Wei-Lun; Lin, Hsin-Lan; Lai, Chih-Cheng



Perioperative Nutritional Status Changes in Gastrointestinal Cancer Patients  

PubMed Central

Purpose The presence of gastrointestinal (GI) cancer and its treatment might aggravate patient nutritional status. Malnutrition is one of the major factors affecting the postoperative course. We evaluated changes in perioperative nutritional status and risk factors of postoperative severe malnutrition in the GI cancer patients. Materials and Methods Nutritional status was prospectively evaluated using patient-generated subjective global assessment (PG-SGA) perioperatively between May and September 2011. Results A total of 435 patients were enrolled. Among them, 279 patients had been diagnosed with gastric cancer and 156 with colorectal cancer. Minimal invasive surgery was performed in 225 patients. PG-SGA score increased from 4.5 preoperatively to 10.6 postoperatively (p<0.001). Ten patients (2.3%) were severely malnourished preoperatively, increasing to 115 patients (26.3%) postoperatively. In gastric cancer patients, postoperative severe malnourishment increased significantly (p<0.006). In univariate analysis, old age (>60, p<0.001), male sex (p=0.020), preoperative weight loss (p=0.008), gastric cancer (p<0.001), and open surgery (p<0.001) were indicated as risk factors of postoperative severe malnutrition. In multivariate analysis, old age, preoperative weight loss, gastric cancer, and open surgery remained significant as risk factors of severe malnutrition. Conclusion The prevalence of severe malnutrition among GI cancer patients in this study increased from 2.3% preoperatively to 26.3% after an operation. Old age, preoperative weight loss, gastric cancer, and open surgery were shown to be risk factors of postoperative severe malnutrition. In patients at high risk of postoperative severe malnutrition, adequate nutritional support should be considered. PMID:24142640

Shim, Hongjin; Cheong, Jae Ho; Lee, Kang Young; Lee, Hosun; Noh, Sung Hoon



Barbershop Communications on Prostate Cancer Screening Using Barber Health Advisers  

PubMed Central

Objective The authors report the outcomes of a community-based, barber health adviser pilot intervention that aims to develop customized educational materials to promote knowledge and awareness of prostate cancer (CaP) and informed decision making about prostate cancer screening (PCS) among a predominantly African American clientele. Method First, the authors implemented a series of learner verification processes with barbershop clients (n = 15) to adapt existing CaP health promotion materials. Following intervention implementation in the barbershop, they conducted structured surveys with barbershop clients (n = 40) to evaluate the intervention. Results Findings from the posttest showed both a significant increase in barbershop clients' self-reported knowledge of CaP and in the likelihood of discussing PCS with a health care provider (p < .001). The client's cultural model of CaP risk factors revealed cultural consensus (eigenratio = 3.3) and mirrored the biomedical model. All clients surveyed reported positively on the contents of the educational materials, and more than half (53%) had discussed CaP at least twice with their barber in the last month. Conclusion Based on the pilot results, the barber-administered intervention was an appropriate and viable communication channel for promoting CaP knowledge and awareness in a priority population, African American men. PMID:20413392

Luque, John S.; Rivers, Brian M.; Gwede, Clement K.; Kambon, Maisha; Green, B. Lee; Meade, Cathy D.



Factors Associated With Decisions to Undergo Surgery Among Patients With Newly Diagnosed Early-Stage Lung Cancer  

PubMed Central

Context Lung cancer is the leading cause of cancer death in the United States. Surgical resection for stage I or II non–small cell cancer remains the only reliable treatment for cure. Patients who do not undergo surgery have a median survival of less than 1 year. Despite the survival disadvantage, many patients with early-stage disease do not receive surgical care and rates are even lower for black patients. Objectives To identify potentially modifiable factors regarding surgery in patients newly diagnosed with early-stage lung cancer and to explore why blacks undergo surgery less often than whites. Design, Setting, and Patients Prospective cohort study with patients identified by pulmonary, oncology, thoracic surgery, and generalist practices in 5 communities through study referral or computerized tomography review protocol. A total of 437 patients with biopsy-proven or probable early-stage lung cancer were enrolled between December 2005 and December 2008. Before establishment of treatment plans, patients were administered a survey including questions about trust, patient-physician communication, attitudes toward cancer, and functional status. Information about comorbid illnesses was obtained through chart audits. Main Outcome Measure Lung cancer surgery within 4 months of diagnosis. Results A total of 386 patients met full eligibility criteria for lung resection surgery. The median age was 66 years (range, 26–90 years) and 29% of patients were black. The surgical rate was 66% for white patients (n=179/273) compared with 55% for black patients (n=62/113; P=.05). Negative perceptions of patient-physician communication manifested by a 5-point decrement on a 25-point communication scale (odds ratio [OR], 0.42; 95% confidence interval [CI], 0.32–0.74) and negative perception of 1-year prognosis postsurgery (OR, 0.27; 95% CI, 0.14–0.50; absolute risk, 34%) were associated with decisions against surgery. Surgical rates for blacks were particularly low when they had 2 or more comorbid illnesses (13% vs 62% for <2 comorbidities; OR, 0.04 [95% CI, 0.01–0.25]; absolute risk, 49%) and when blacks lacked a regular source of care (42% with no regular care vs 57% with regular care; OR, 0.20 [95% CI, 0.10–0.43]; absolute risk, 15%). Conclusions A decision not to undergo surgery by patients with newly diagnosed lung cancer was independently associated with perceptions of communication and prognosis, older age, multiple comorbidities, and black race. Interventions to optimize surgery should consider these factors. PMID:20551407

Cykert, Samuel; Dilworth-Anderson, Peggye; Monroe, Michael H.; Walker, Paul; McGuire, Franklin R.; Corbie-Smith, Giselle; Edwards, Lloyd J.; Bunton, Audrina Jones



Prescribing for older patients with cancer.  


Pharmacotherapy in the elderly is very complex owing to age-related physiologic changes, the presence of multiple comorbidities, the use of multiple medications, the involvement of multiple prescribers and pharmacies, and an increased prevalence of cognitive deficits. The treatment of cancer and the management of symptoms related to therapy-induced toxicity significantly add to this complexity, with an increased risk of drug interactions, using potentially inappropriate medications (PIMs), and adverse drug reactions. There are several ways to evaluate inappropriate prescribing, with various levels of support for their use. We review the most widely used. Older adults are more susceptible than younger ones to chemotherapy toxicity, and may require dose modifications. Before starting therapy, the goals of care should be clearly defined and the general state of the patient should be assessed using some form of geriatric evaluation. Changes in the pharmacokinetics of the drugs related to aging and the possibility of end-organ dysfunction must be taken into consideration, particularly the age-related decline of glomerular filtration rate that is not always reflected by an increase in serum creatinine. The treatment plan for the older adult needs to be carefully defined in order to prevent adverse events, and allow the patient to benefit from treatment without a major impact on quality of life. PMID:25003487

Korc-Grodzicki, Beatriz; Boparai, Manpreet K; Lichtman, Stuart M



Prevention and treatment of venous thromboembolism in patients with cancer  

PubMed Central

Background: Many patients who experience a venous thromboembolic event have cancer, and thrombosis is much more prevalent in patients with cancer than in those without it. Thrombosis is the second most common cause of death in cancer patients and cancer is associated with a high rate of recurrence of venous thromboembolism (VTE), bleeding, requirement for long-term anticoagulation and poorer quality of life. Methods: A literature review was conducted to identify guidelines and evidence pertaining to anticoagulation prophylaxis and treatment for patients with cancer, with the goal of identifying opportunities for pharmacists to advocate for and become more involved in the care of this population. Results: Many clinical trials and several guidelines providing guidance to clinicians in the treatment and prevention of VTE in patients with cancer were identified. Current clinical evidence and guidelines suggest that cancer patients receiving care in hospital with no contraindications should receive VTE prophylaxis with unfractionated heparin (UFH), a low-molecular-weight heparin (LMWH) or fondaparinux. Patients who require surgery for their cancer should receive prophylaxis with UFH, LMWH or fondaparinux. Cancer patients who have experienced a VTE event should receive prolonged anticoagulant therapy with LMWH (at least 3 months to 6 months). No routine prophylaxis is required for the majority of ambulatory patients with cancer who have not experienced a VTE event. Most publicly funded drug plans in Canada have developed criteria for funding of LMWH therapy for patients with cancer. Conclusions: Evidence suggests that LMWH for 3 to 6 months is the preferred strategy for most cancer patients who have experienced a thromboembolic event and for hospital inpatients, but this is often not implemented in practice. Concerns about adherence with injectable therapy should not prevent use of these agents. Pharmacists should assess cancer patients for their risk of VTE and should advocate for optimal VTE pharmacotherapy as appropriate. If LMWH is the preferred agent, on the basis of the evidence, the pharmacist should educate the patients appropriately and work with the prescriber to ensure best care. PMID:23509484

Semchuk, William M.; Sperlich, Catherine



Systemic Therapy for Elderly Patients with Gastrointestinal Cancer  

PubMed Central

The majority of patients with gastrointestinal cancers are over the age of 65. This age group comprises the minority of the patients enrolled in clinical trials, and it is unknown whether older patients achieve similar results as younger patients in terms of survival benefit and tolerability. In addition, there are few studies specifically designed for patients over 65 years. Subset analyses of individual trials and studies using pooled patient data from multiple trials provide some understanding on outcomes in older patients with gastrointestinal cancers. This article reviews the evidence on chemotherapeutic regimens in the elderly with colorectal, pancreatic, and gastroesophageal cancers, and discusses a practical approach to provide the best outcomes for older patients. PMID:21603244

Hubbard, Joleen M.; Grothey, Axel; Sargent, Daniel J.



Surgical Treatment for Lung Cancer Patients with Poor Pulmonary Function  

Microsoft Academic Search

This retrospective study was aimed to review the risk factors of postoperative hospital death in lung cancer patients with poor pulmonary reserves. We performed surgery on 30 lung cancer patients (average age: 71 years) with less than 1.0L of preoperative forced expiratory volume in one second (FEV1.0<1.0L) between 1982 and 2003. The preoperative FEV1.0 of these 30 patients was 0.81±0.1L

Kiyoshi Koizumi; Shuji Haraguchi; Tomomi Hirata; Kyoji Hirai; Iwao Mikami; Daisuke Okada; Shigeki Yamagishi; Tetsuo Kawashima; Hiroyasu Kinoshita; Yutaka Enomoto; Yuki Nakajima; Kazuo Shimizu



Management of Nausea and Vomiting in Cancer Patients  

Microsoft Academic Search

\\u000a Nausea and vomiting in patients with cancer may be due to the patient’s specific disease state or may be due to cancer treatment\\u000a interventions such as chemotherapy, radiation therapy, opioids, or other medications. The main approach to the treatment of\\u000a nausea and vomiting has been the use of antiemetic agents developed primarily for the prevention of chemotherapy-induced nausea\\u000a and vomiting

Rudolph M. Navari; Paula P. Province; Steven D. Passik


Protein-calorie malnutrition in patients with colorectal cancer  

Microsoft Academic Search

Summary  Protein-calorie malnutrition, as determined by anthropometric measures and laboratory tests, was assssed in 17 preoperative\\u000a patients with colorectal cancer and 47 control patients. The cancer patients had significant deficits in visceral protein\\u000a and skeletal muscle and no deficit in fat stores. Greater attention should be given to preoperative nutritional assessment\\u000a and to the correction of protein deficits.

John L. Rombeau; Stephen L. Goldman; Keith N. Apelgren; Ildiko Sanford; Charles F. Frey



Pain and its treatment in hospitalized patients with metastatic cancer  

Microsoft Academic Search

GoalsThe aim of this prospective study was to assess the quality of pain management hospitalized cancer patients.Patients and methodsIn a quantitative and qualitative evaluation from six oncology centers in Italy, all consecutive cancer patients complaining of pain and hospitalized during the same 2 weeks were requested to fill in a McGill pain questionnaire (MPQ), a present pain intensity scale (PPI),

Stefano Cascinu; Paolo Giordani; Romina Agostinelli; Giampietro Gasparini; Sandro Barni; Giordano D. Beretta; Franca Pulita; Laura Iacorossi; Domenico Gattuso; Marzia Mare; Stefania Munaò; Roberto Labianca; Renata Todeschini; Roberta Camisa; Riccardo Cellerino; Giuseppina Catalano



Herpes Infections in Breast Cancer Patients Treated with Adjuvant Chemotherapy  

Microsoft Academic Search

Objective: There is little information on Herpes zoster infection in breast cancer patients as a complication during adjuvant chemotherapy. The aim of this study is to evaluate the incidence of Herpes zoster and simplex infections in this patients setting. Methods: We analyzed 623 early-stage breast cancer patients in our Institute over a period of 7 years (1998–2005). Four-hundred and sixty-onepatients

Giovanna Masci; Massimo Magagnoli; Giuseppe Gullo; Emanuela Morenghi; Isabella Garassino; Matteo Simonelli; Armando Santoro



Patient comprehension of doctor-patient communication on discharge from the emergency department  

Microsoft Academic Search

An exit interview was conducted during March, 1994 on 314 patients treated and released from the Emergency Department at Kern Medical Center in Bakersfield, California. The questionnaire was designed to assess understanding of diagnosis, prescribed medications, additional instructions, and plans for follow-up care. The patients' own perceptions of the adequacy of communication and whom they considered the most important source

John A. Crane



Do Dutch doctors communicate differently with immigrant patients than with Dutch patients?  

Microsoft Academic Search

The aim of this study was to gain deeper insight into relational aspects of the medical communication pattern in intercultural consultations at GP practices in the Netherlands. We ask whether there are differences in the verbal interaction of Dutch GPs with immigrant and Dutch patients. Data were drawn from 144 adult patient interviews and video observations of consultations between the

Ludwien Meeuwesen; Johannes A. M. Harmsen; Roos M. D. Bernsen; Marc A. Bruijnzeels



A qualitative exploration of Malaysian cancer patients' perspectives on cancer and its treatment  

PubMed Central

Background Cancer patients' knowledge about cancer and experiences with its treatment play an important role in long-term adherence in their disease management. This study aimed to explore cancer patients' knowledge about cancer, their perceptions of conventional therapies and the factors that contribute to medication adherence in the Malaysian population. Methods A qualitative research approach was adopted to gain a better understanding of the current perceptions and knowledge held by cancer patients. Twenty patients were interviewed using a semi-structured interview guide. A saturation point was reached after the 18th interview, and no new information emerged with the subsequent 2 interviews. All interviews were transcribed verbatim and analysed by means of a standard content analysis framework. Results The majority of patients related the cause of their cancer to be God's will. Participants perceived conventional therapies as effective due to their scientific methods of preparations. A fear of side effects was main reasons given for delay in seeking treatment; however, perceptions were reported to change after receiving treatment when effective management to reduce the risk of side effects had been experienced. Conclusions This study provides basic information about cancer patients' perceptions towards cancer and its treatment. These findings can help in the design of educational programs to enhance awareness and acceptances of cancer screening. Priorities for future research should focus on patients who refused the conventional therapies at any stage. PMID:21718547



Validation and reliability of distress thermometer in Chinese cancer patients  

Microsoft Academic Search

Objective  To examine the validation and reliability of the distress thermometer (DT) recommended by National Comprehensive Cancer Network\\u000a (NCCN) in Chinese cancer patients.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A total of 574 Chinese cancer patients from Beijing Cancer Hospital completed the detection of DT, the Hospital Anxiety and\\u000a Depression Scale (HADS) and Symptom Checklist 90 (SCL-90), Receiver Operating Characteristic (ROC) curve and Area Under the\\u000a Curve

Li-li Tang; Ye-ning Zhang; Ying Pang; Hai-wei Zhang; Li-li Song



Issues of hope and faith in the cancer patient.  


Akira Kurosawa's 1952 film about a man with a terminal gastric cancer introduces a discussion of hope and faith in the oncology patient. A psychodynamic relationship between hope and faith is explored, using Lawrence LeShan's research in cancer psychotherapy and Erik Erikson's lifespan developmental theory. LeShan describes a cancer personality characterized by hopeless despair, while Erikson formulates a psychogenetic framework for the development of hope and despair. Hope and faith are linked through the individual's earliest strivings toward basic trust in the world and his or her own self-efficacy. Accordingly, cancer psychotherapy may aim at restoring adult patients' faith in life and inner creative resources. PMID:24302437

Carni, E



Prevalence of depression and anxiety among cancer patients  

PubMed Central

Background: Depression and anxiety had negative effects on the quality of life of cancer patients, thus hospital anxiety and depression scale (HADS) is a useful instrument for screening these problems. This research was performed to assess the prevalence of their anxiety and depression. Methods: From 2012-2013, one hundred fifty patients with recent diagnosis of different cancers in Babol, Iran were assessed. A presumptive diagnosis of anxiety and depression was based on a four point 14-item HADS. The score of 0-7 means without clinical symptoms of anxiety or depression, 8-10 mild and 11-21 symptomatic anxiety or depression. The data were collected and analyzed. Results: Forty-four (29.3%) patients had mild anxiety, 25 (16.7%) symptomatic anxiety but mild and symptomatic depression were seen in 40 (26.7%) and 32 (21.3%) patients, respectively. There were significant relationships between anxiety, depression and the age group of the patients with higher frequency in older ages. There were significant relationships between anxiety and depression with the type of cancer and type of treatment. Breast and stomach cancer patients had the highest prevalence of anxiety and depression and the higher prevalence was observed in the patients who received chemotherapy as the single treatment. Conclusion: The results show that patients with breast and stomach cancer had the highest prevalence of anxiety and depression among all others cancer patients. PMID:25202445

Nikbakhsh, Novin; Moudi, Sussan; Abbasian, Setareh; Khafri, Soraya



Functional disability high among newly diagnosed older breast cancer patients

Many older women with newly diagnosed breast cancer have difficulty accomplishing daily tasks, and African-Americans seem to be disproportionately affected. Those are the findings of a new study published early online in CANCER by researchers from the Case Western Reserve University School of Medicine and University Hospitals Case Medical Center in Cleveland (home of the Case Comprehensive Cancer Center), a peer-reviewed journal of the American Cancer Society. The study's results suggest that many breast cancer patients could benefit from receiving therapy to improve their physical function.


Attitudes of Patients With Cancer About Personalized Medicine and Somatic Genetic Testing  

PubMed Central

Purpose: Dramatic advances in genomic technology stand to revolutionize cancer care; however, little is known about patients' understanding and acceptance of personalized medicine and widespread genetic testing (GT). Patients and Methods: We conducted a formative, semi-structured interview study with a random sample of patients with lung, colorectal, and breast cancers to assess awareness of personalized medicine and GT and attitudes about somatic GT. Willingness to undergo GT was elicited through hypothetic scenarios. Results: Sixty-nine patients participated; 71% were women; 42% were black; median age was 59 years; and 42% had an education level ? college. We found that a majority of patients either were not aware of the term “personalized medicine” or defined it in unexpected ways. Although many patients identified relevant benefits of somatic testing (eg, informs treatment), many patients also expressed significant concerns (ie, psychological harm and discrimination). A majority of patients expressed a willingness to undergo somatic (predictive, 96%, prognostic, 93%) and germline (cancer risk without incidental information, 87%; cancer risk with incidental information, 81%; pharmacogenetic, 91%) testing; however, far fewer patients expressed a willingness to undergo full genome sequencing (62%). Reluctance was attributed to concerns over incidental findings, information overload, and the lack of a clear benefit. Conclusion: Many patients relayed misunderstandings about somatic testing and a reluctance to undergo full sequencing; oncologists must carefully consider how they present testing to patients so that concerns over discrimination and psychological harm do not hinder test uptake. More work is needed to identify effective ways to communicate complex genomic concepts to patients and research participants. PMID:23598841

Gray, Stacy W.; Hicks-Courant, Katherine; Lathan, Christopher S.; Garraway, Levi; Park, Elyse R.; Weeks, Jane C.



Public reaction to the death of steve jobs: implications for cancer communication.  


The present study aimed to examine the public reaction to the death of Steve Jobs, focusing on general and cancer-specific information seeking and interpersonal communication. Shortly after Jobs's death, employees from a large university in the Southeastern United States (N = 1,398) completed a web-based survey. Every employee had heard about Steve Jobs's death, and 97% correctly identified pancreatic cancer as the cause of his death. General (50%) and pancreatic cancer-specific (7%) information seeking, as well as general (74%) and pancreatic cancer-specific (17%) interpersonal communication, took place in response to Steve Jobs's death. In multivariate logistic regression analyses controlling for demographics and several cancer-oriented variables, both identification with Steve Jobs and cancer worry in response to Steve Jobs's death significantly (p < .05) predicted pancreatic cancer information seeking as well as interpersonal communication about pancreatic cancer. Additional analyses revealed that cancer worry partially mediated the effects of identification on these outcome variables. Implications of these results for future research as well as cancer prevention and communication efforts are discussed. PMID:24716627

Myrick, Jessica Gall; Noar, Seth M; Willoughby, Jessica Fitts; Brown, Jennifer



How does patient-clinician information engagement influence self-reported cancer-related problems? Findings from a longitudinal analysis  

PubMed Central

Background Past research has linked patient-physician communication with improved emotional, physical, and social health. One component of communication, patient-clinician information engagement (PCIE) predicts improved short-term patient-reported outcomes such as treatment satisfaction through perceptions of feeling informed. However, the relationship between PCIE and longer term cancer-related problems has not previously been examined. Objective This study examines the influence of PCIE on self-reported problems associated with cancer diagnosis and treatment based on a longitudinal survey among a randomly selected sample from the 2005 Pennsylvania Cancer Registry. Methods We surveyed 1,293 respondents diagnosed with colorectal, breast, or prostate cancers in 2006 and 2007 (baseline response rate was 64%, retention rate was 65%). We predicted an index of cancer-related problems at one-year follow-up with the baseline cancer-related problem index and PCIE, controlling for demographic and clinical factors using regression analyses. The mean age of participants was 65 years, about half were female, and 86% were White. Results Having more cancer-related problems and PCIE at baseline significantly predicted more cancer-related problems at follow-up. Additionally, baseline cancer-related problems and PCIE interacted significantly (p=0.01) – PCIE was associated with more cancer-related problems at follow-up among participants who reported more rather than fewer symptoms at baseline. Conclusion If respondents reported engaging more with their physicians at baseline, they reported experiencing more cancer-related issues at follow-up; this pattern was stronger among those reporting more baseline problems. Increased discussion of cancer information with physicians may maintain the salience of these problems in cancer survivors’ minds over time. PMID:24048804

Tan, Andy SL; Bourgoin, Angel; Gray, Stacy W; Armstrong, Katrina; Hornik, Robert C



Use of dietary supplements by breast cancer patients undergoing conventional cancer treatment  

PubMed Central

Background: Many breast cancer patients use some form of dietary supplement (DS) to complement their conventional cancer treatment, in the hope that they might lessen the side effects of treatment, improve quality of life, give a greater sense of control, and reduce stress. This pilot study assessed the level of DS usage by breast cancer patients undergoing conventional cancer treatment, and their concerns about the use of DS. Method: A cross-sectional descriptive survey in three breast cancer centers in Hong Kong using face-to-face interviewing was performed. Results: Of 82 female Chinese breast cancer patients who completed the survey, 99% reported that they had been using DS since their cancer was diagnosed. The most frequently used DS were Chinese herbal medicines, and patients spent about US$258 on DS every month. The reason given for using DS was to enhance their recovery from cancer, but at the same time the patients had safety concerns. However, most patients did not feel able to discuss these concerns with health professionals. Conclusion: The majority of the patients had some safety concerns, and said that they would welcome detailed and reliable information on DS. The lack of reliable information on the potential risks and benefits of using such supplements as an adjuvant to conventional treatment and the reluctance of patients to discuss their use of DS with health professionals is a major area of concern that warrants further attention. PMID:21206516

Wong, Lai Yi Eliza; Leung, Ping Chung; Tang, Jin-Ling; Mercer, Stewart W



Emotional distress in cancer patients: the Edinburgh Cancer Centre symptom study  

Microsoft Academic Search

To: (1) estimate the prevalence of clinically significant emotional distress in patients attending a cancer outpatient department and (2) determine the associations between distress and demographic and clinical variables, we conducted a survey of outpatients attending selected clinics of a regional cancer centre in Edinburgh, UK. Patients completed the Hospital Anxiety and Depression Scale (HADS) on touch-screen computers and the

V Strong; R Waters; C Hibberd; R Rush; A Cargill; D Storey; J Walker; L Wall; M Fallon; M Sharpe



Does Increased Patient Awareness Improve Accrual Into Cancer-Related Clinical Trials? |

A set of educational interventions designed for cancer patients significantly improved their satisfaction with information on clinical research, but did not improve clinical trial enrollment of these participants. The authors concluded that information relating to research may be most effectively delivered by the patients' primary cancer care providers rather than through educational materials.


Gender differences in physicians' communicative skills and their influence on patient satisfaction in gynaecological outpatient consultations  

Microsoft Academic Search

As previous research has displayed, a physician's communication style is an essential factor predicting patient satisfaction and compliance. Furthermore, a good physician–patient relationship and high communication quality seem to be crucial elements fostering the activation of patients' self-healing powers. Due to their intimate nature, gynaecological health issues require specific adapted communicative skills. Several studies in primary care reveal gender differences

Regula Nelly Christen; Judith Alder; Johannes Bitzer



The newer anticoagulants in thrombosis control in cancer patients.  


Cancer and hemostasis are strongly correlated and the development of venous thromboembolism (VTE) has a major adverse impact on the outcome of cancer patients. Treatment of cancer-associated VTE is far more challenging than treating VTE in the non-cancer population, as the clinical course of cancer patients is characterized by increased rates of both recurrent thromboembolic episodes and bleeding complications. This has led to the development of a distinct management approach towards VTE in patients with active cancer. Low-molecular-weight heparins (LMWHs) currently represent the therapeutic agent of choice, as a result of a proven higher efficacy compared to vitamin K antagonists (VKAs). However, as LMWHs require daily subcutaneous injections, weight-adjusted doses, and still confers high risks of recurrent VTE and bleeding complications, management of cancer-associated VTE warrants further optimization. In recent years several novel, target-specific oral anticoagulants have been introduced and evaluated in clinical trials. These new anticoagulants display several advantages compared to conventional anticoagulants. This review will evaluate their trial results up-to-date with a particular focus on the cancer patients included in these trials. The potential of these agents in the setting of cancer-associated VTE will be discussed and directions for future research will be provided. PMID:25023349

den Exter, Paul L; van der Hulle, Tom; Klok, Frederikus A; Huisman, Menno V



New treatment options for patients with metastatic prostate cancer.  


Prostate cancer is one of the most common cancers in men. When metastasised (40% of patients), classic anti-androgen therapy is the first-line treatment. Usually, this treatment becomes ineffective when castration-resistant prostate cancer (CRPC) develops. Thus far, docetaxel was the only chemotherapeutic option that has shown to be able to extend overall survival and improve quality of life in these patients. Recently, cabazitaxel and abiraterone have shown significant survival benefits for patients progressive on or after docetaxel treatment, as did enzalutamide and radium-223. In North America, immune therapy (sipuleucel-T) became available for a subgroup of CRPC patients. These new treatment options will change the treatment paradigm of patients with metastatic castration resistant prostate cancer. A multidisciplinary approach by both medical oncologists and urologists seems mandatory. PMID:23956309

Snoeks, L L; Ogilvie, A C; van Haarst, E P; Siegert, C E H




Microsoft Academic Search

The Australian population is ageing. It is estimated that between the years 2002-2011, the population aged 65 and over is projected to increase by 30%. Cancer is predominantly a disease of elderly, with more than 60% of new cancer diagnosis and 70% of cancer deaths occurring in the elderly, ie. ? 65 years. The largest increase is seen in the

Nimit Singhal; Arati V Rao


HLA and tumor necrosis factor ? gene polymorphisms in Okinawa lung cancer patients: Comparative study with mainland Japan lung cancer patients  

Microsoft Academic Search

The frequencies of HLA class I and II antigens and TNF-? polymorphism in lung cancer patients were investigated in two areas with different immunogenetic backgrounds, in Okinawa and in mainland Japan (Honshu). In Okinawa frequencies of HLA-Cw3 in squamous cell lung carcinoma patients were higher and those of HLA-DR, both in all lung cancer and in adeno lung carcinoma patients,

Masao Hagihara; Tatsuo Shimura; Kaoru Sato; Keiichiro Genga; Makoto Suzuki; Kimiyoshi Tsuji



Physician–patient communication about over-the-counter medications  

Microsoft Academic Search

The purpose of this study was to describe physician–patient communication about over-the-counter medications using a data set comprised of audio-tapes and transcripts of 414 primary care medical visits. The data set was collected during 1995 at the family practice and general medicine clinics at the University of New Mexico Health Sciences Center. Twenty-seven resident physicians and 414 of their adult

Betsy Sleath; Richard H. Rubin; William Campbell; Lisa Gwyther; Trina Clark



Clinical significance of plasma metastin level in pancreatic cancer patients.  


Metastin, which is a 54-residue peptide coded by KiSS-1 gene, is an endogenous ligand to a G-protein-coupled receptor GPR54. Metastin suppresses a malignant tumor to metastasize and regulates secretion of gonadotropine releasing hormone. Physiological action of metastin has been focused on in oncology. It is reported that less KiSS-1 gene and more hOT7T175 gene which codes GPR54 are expressed in pancreatic cancers than in normal pancreatic tissues; however, there is no study that investigates the relationship between clinicopathological characteristics and plasma metastin concentration in pancreatic cancer patients. The purpose of this study was to investigate the relationship between plasma metastin-like immunoreactive substance (LI) levels and clinical characteristics in pancreatic cancer patients. Thirty-three patients with pathologically confirmed pancreatic cancer before or just after treatments and 24 healthy volunteers were included in the study. Patients were grouped according to the International Union Against Cancer TNM classification. Plasma metastin-LI was measured by enzyme immunoassay. The plasma metastin-LI levels of cancer patients were significantly higher when compared with healthy volunteers. Significant relationship was not found between the plasma metastin-LI levels and the clinicopathological factors such as tumor size, invasion, lymph node metastasis and distant metastasis. The plasma metastin levels may be a significant biomarker to predict the presence of pancreatic cancer and could be used in pancreatic cancer screening. PMID:19212644

Katagiri, Fumihiko; Nagai, Kazuyuki; Kida, Atsushi; Tomita, Kenji; Oishi, Shinya; Takeyama, Masaharu; Doi, Ryuichiro; Fujii, Nobutaka



Comprehensive geriatric assessment in Korean elderly cancer patients receiving chemotherapy  

Microsoft Academic Search

Background  Growing evidence suggests that a comprehensive geriatric assessment (CGA) in older patients with cancer can detect unsuspected\\u000a health problems, predict survival, and predict tolerance to chemotherapy. However, studies regarding CGA in cancer patients\\u000a are scarce in Asia.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We prospectively enrolled 65 elderly cancer patients who were candidates of systemic chemotherapy between July 2006 and March\\u000a 2008. Baseline CGA data including

Yu Jung Kim; Jee Hyun Kim; Myung-Sook Park; Keun-Wook Lee; Kwang-Il Kim; Soo-Mee Bang; Jong Seok Lee; Cheol-Ho Kim



Interleukin-6, Cortisol, and Depressive Symptoms in Ovarian Cancer Patients  

PubMed Central

Purpose Inflammatory processes have been implicated in the pathogenesis of both depression and cancer. Links between depressive symptoms, interleukin-6 (IL-6), and cortisol dysregulation have been demonstrated in cancer patients, but vegetative versus affective components of depression have been minimally examined. The objective of the current study was to examine associations between IL-6, diurnal cortisol rhythms, and facets of depression in epithelial ovarian cancer patients. Patients and Methods Patients awaiting surgery for a pelvic mass suspected for ovarian cancer completed questionnaires, collected salivary samples for 3 days presurgery, and gave a presurgical blood sample. Ascites was obtained during surgery. IL-6 was measured by enzyme-linked immunosorbent assay and cortisol by a chemiluminescence immunoassay. The final sample included 112 invasive ovarian cancer patients (86 advanced stage, 26 early stage) and 25 patients with tumors of low malignant potential (LMP). Results Advanced-stage ovarian cancer patients demonstrated elevations in vegetative and affective depressive symptoms, plasma IL-6, and the cortisol area under the curve (AUC) compared with patients with LMP tumors (all P < .05). Among invasive ovarian cancer patients, greater vegetative depression was related to elevated IL-6 in plasma (P = .008) and ascites (P = .024), but affective depression was unrelated to IL-6. Elevations in total depression (P = .026) and vegetative depression (P = .005) were also related to higher evening cortisol levels. Plasma IL-6 was related to greater afternoon and evening cortisol and cortisol AUC (all P values < .005). Conclusion These results demonstrate significant relationships between IL-6, cortisol, and vegetative depression, and may have implications for treatment of depression in ovarian cancer patients. PMID:18779606

Lutgendorf, Susan K.; Weinrib, Aliza Z.; Penedo, Frank; Russell, Daniel; DeGeest, Koen; Costanzo, Erin S.; Henderson, Patrick J.; Sephton, Sandra E.; Rohleder, Nicolas; Lucci, Joseph A.; Cole, Steven; Sood, Anil K.; Lubaroff, David M.



Colorectal cancer in geriatric patients: Endoscopic diagnosis and surgical treatment  

PubMed Central

AIM: To investigate the prevalence of colorectal cancer in geriatric patients undergoing endoscopy and to analyze their outcome. METHODS: All consecutive patients older than 80 years who underwent lower gastrointestinal endoscopy between January 1995 and December 2002 at our institution were included. Patients with endoscopic diagnosis of colorectal cancer were evaluated with respect to indication, localization and stage of cancer, therapeutic consequences, and survival. RESULTS: Colorectal cancer was diagnosed in 88 patients (6% of all endoscopies, 55 women and 33 men, mean age 85.2 years). Frequent indications were lower gastrointestinal bleeding (25%), anemia (24%) or sonographic suspicion of tumor (10%). Localization of cancer was predominantly the sigmoid colon (27%), the rectum (26%), and the ascending colon (20%). Stage Dukes A was rare (1%), but Dukes D was diagnosed in 22% of cases. Curative surgery was performed in 54 patients (61.4%), in the remaining 34 patients (38.6%) surgical treatment was not feasible due to malnutrition and asthenia or cardiopulmonary comorbidity (15 patients), distant metastases (11 patients) or refusal of operation (8 patients). Patients undergoing surgery had a very low in-hospital mortality rate (2%). Operated patients had a one-year and three-year survival rate of 88% and 49%, and the survival rates for non-operated patients amounted to 46% and 13% respectively. CONCLUSION: Nearly two-thirds of 88 geriatric patients with endoscopic diagnosis of colorectal cancer underwent successful surgery at a very low perioperative mortality rate, resulting in significantly higher survival rates. Hence, the clinical relevance of lower gastrointestinal endoscopy and oncologic surgery in geriatric patients is demonstrated. PMID:15637734

Kirchgatterer, Andreas; Steiner, Pius; Hubner, Dietmar; Fritz, Eva; Aschl, Gerhard; Preisinger, Josef; Hinterreiter, Maximilian; Stadler, Bernhard; Knoflach, Peter



Radiotherapy of Choroidal Metastases in Patients with Disseminated Cancer  

Microsoft Academic Search

Summary Background: >Choroidal metastasis is the most common ocular tumor, in most cases related to breast and lung cancer. Radiotherapy (RT) mostly is the therapy of choice. However, there is a lack of data about the results of uniformly, prospective treated patients. Patients and Methods: Between November 1994 and September 1997, 37 patients with 49 metastatic eyes were enrolled into

D. Bottke; T. Wiegel; K.-M. Kreusel; N. Bornfeld; G. Schaller; W. Hinkelbein



Patients? experiences of intracavity brachytherapy treatment for gynaecological cancer  

Microsoft Academic Search

Summary Intracavity brachytherapy for gynaecological cancer presents patients with a wide range of physical and psychological challenges. Previous research into women's experiences of this treatment has been limited. This study explores the experiences of patients before, during and after treatment. 32 patients completed questionnaires or interviews before and after treatment and symptom checklists at two hourly intervals during treatment. Nurses

Clare Warnock



Confidant and breast cancer patient reports of quality of life  

Microsoft Academic Search

It is well known that breast cancer patients report a temporary decline in their quality of life following diagnosis. Caregivers observe these changes, but only a few studies have examined the shared perceptions of patients and others concerning the patient's QOL. In this study, 112 women (96% white, 4% Native American), ages 34–84, rated their QOL 1–3 months after diagnosis

Ann K. Sandgren; Amy B. Mullens; Shannon C. Erickson; Kathleen M. Romanek; Kevin D. McCaul



Supporting cancer patients' unanchored health information management with mobile technology  

E-print Network

, Seattle, WA Abstract Cancer patients often need to manage care-related information when they are away from that HealthWeaver Mobile can help patients to access care-related information from anywhere, to capture. The enhanced ability to manage information, in turn, helps patients to manage their care and to feel more

Anderson, Richard


Clinical guide SEOM on venous thromboembolism in cancer patients.  


Venous thromboembolism (VTE) is a common event in cancer patients and one of the major causes of cancer-associated mortality and a leading cause of morbidity. In recent years, the incidence rates of VTE have notably increased; however, VTE is still commonly underestimated by oncologists. VTE is considered an adverse prognostic factor in cancer patients in all settings. In 2011 the Spanish Society of Medical Oncology (SEOM) first published a clinical guideline of prophylaxis and treatment of VTE in cancer patients. In an effort to incorporate evidence obtained since the original publication, SEOM presents an update of the guideline for thrombosis and cancer in order to improve the prevention and management of VTE. PMID:25366189

Muñoz Martín, A J; Font Puig, C; Navarro Martín, L M; Borrega García, P; Martín Jiménez, M



Biological Therapy in Treating Patients With Metastatic Cancer

Breast Cancer; Colorectal Cancer; Extrahepatic Bile Duct Cancer; Gallbladder Cancer; Gastric Cancer; Head and Neck Cancer; Liver Cancer; Lung Cancer; Metastatic Cancer; Ovarian Cancer; Pancreatic Cancer; Testicular Germ Cell Tumor



Patients with cancer and family caregivers: management of symptoms caused by cancer or cancer therapy at home  

PubMed Central

Summary People are diagnosed with cancer sooner nowadays thanks to increased awareness and improvements in cancer screenings. Patients are able to live longer due to cancer treatment regimens; however, they suffer the consequences of living with cancer and therapy-related symptoms. Symptom management is challenging for both patients and family caregivers. Therefore, family members must be integrated in the patient’s care plan. For this review, a literature search was conducted to determine what types of interventions were available that involved family members of cancer patients with the management of cancer and therapy-related symptoms. The following interventions were found that were designed for the family caregivers or both the patient and caregiver to aide with symptom management: pain intervention program, massage therapy, telephone intervention, self-efficacy improvement, coping enhancement and a multidimensional intervention. A positive effect was noted in all the studies, but several had no significance in the patient intervention group but did in the caregiver intervention group. However, studies indicated decreased symptom intensity for various symptoms, decreased symptom distress for both the patient and caregiver, increased self-efficacy of the family member, and increased satisfaction with certain interventions. Further research should be conducted on both existing interventions to better determine their effect and on family symptom management of cancer patients as they need support from healthcare professionals as well. PMID:24027658

Hazelwood, Daniela Maria; Wallner, Martin; Anderson, Kathryn Hoehn; Mayer, Hanna



CYP19 gene polymorphism in endometrial cancer patients  

Microsoft Academic Search

Purpose: Initiation\\/promotion of endometrial cancer is known to be associated with estrogenic influence. Therefore, it is possible\\u000a that some allelic polymorphisms of the genes involved in steroidogenesis or steroid metabolism contribute to endometrial cancer\\u000a susceptibility. Methods: Here, we compared CYP19 (aromatase) gene polymorphism in 85 endometrial cancer patients and in 110 non-affected women. Results: The genotypes containing the longest alleles

Lev M. Berstein; Evgeny N. Imyanitov; Evgeny N. Suspitsin; Maxim Y. Grigoriev; Evgeny P. Sokolov; Alexandr Togo; Kaido P. Hanson; Tatjana E. Poroshina; Dmitry A. Vasiljev; Anatolij Y. Kovalevskij; Vera B. Gamajunova



Readability of Educational Materials for Patients with Cancer  

NSDL National Science Digital Library

This article, jointly created by authors Mary E. Cooley, Helene Moriarty and Thomas H. Short, describes a dataset on the readability of American Cancer Society and National Cancer Institute pamphlets about cancer. This tests are designed to test whether the reading levels of these patients are high enough to comprehend this literature. Students should be familiar with scales of measurement, data reduction, measuring center, constructing and interpreting displays, and reaching conclusions in real problems.

Cooley, Mary E.; Moriarty, Helene; Short, Thomas H.



Glucose metabolism disorders in cancer patients in a Chinese population  

Microsoft Academic Search

Background Characteristics of glucose metabolism disorders (GMDs) in different cancers and the contributory role of GMDs in developing\\u000a cancers are still not so clear. Methods Two thousand four hundred and five patients with malignancy who had been hospitalized in the First Affiliated Hospital of\\u000a Jinan University were pooled as case group. Two thousand and sixteen non-cancer people who finished health

Ya-Shi Zhan; Lie Feng; Shao-Hui Tang; Wan-Geng Li; Meng Xu; Tian-Fu Liu; You-Fen Zhou; Yu-Lin Ma; Yun Zhang; Xian-Ming Pu



Microvesicles as mediators of intercellular communication in cancer.  


The discovery that cancer cells generate large membrane-enclosed packets of epigenetic information, known as microvesicles (MVs), that can be transferred to other cells and influence their behavior (Antonyak et al., Small GTPases 3:219-224, 2012; Cocucci et al., Trends Cell Biol 19:43-51, 2009; Rak, Semin Thromb Hemost 36:888-906, 2010; Skog et al., Nat Cell Biol 10:1470-1476, 2008) has added a unique perspective to the classical paracrine signaling paradigm. This is largely because, in addition to growth factors and cytokines, MVs contain a variety of components that are not usually thought to be released into the extracellular environment by viable cells including plasma membrane-associated proteins, cytosolic- and nuclear-localized proteins, as well as nucleic acids, particularly RNA transcripts and micro-RNAs (Skog et al., Nat Cell Biol 10:1470-1476, 2008; Al-Nedawi et al., Nat Cell Biol 10:619-624, 2008; Antonyak et al., Proc Natl Acad Sci U S A 108:4852-4857, 2011; Balaj et al., Nat Commun 2:180, 2011; Choi et al., J Proteome Res 6:4646-4655, 2007; Del Conde et al., Blood 106:1604-1611, 2005; Gallo et al., PLoS One 7:e30679, 2012; Graner et al., FASEB J 23:1541-1557, 2009; Grange et al., Cancer Res 71:5346-5356, 2011; Hosseini-Beheshti et al., Mol Cell Proteomics 11:863-885, 2012; Martins et al., Curr Opin Oncol 25:66-75, 2013; Noerholm et al., BMC Cancer 12:22, 2012; Zhuang et al., EMBO J 31:3513-3523, 2012). When transferred between cancer cells, MVs have been shown to stimulate signaling events that promote cell growth and survival (Al-Nedawi et al., Nat Cell Biol 10:619-624, 2008). Cancer cell-derived MVs can also be taken up by normal cell types that surround the tumor, an outcome that helps shape the tumor microenvironment, trigger tumor vascularization, and even confer upon normal recipient cells the transformed characteristics of a cancer cell (Antonyak et al., Proc Natl Acad Sci U S A 108:4852-4857, 2011; Martins et al., Curr Opin Oncol 25:66-75, 2013; Al-Nedawi et al., Proc Natl Acad Sci U S A 106:3794-3799, 2009; Ge et al., Cancer Microenviron 5:323-332, 2012). Thus, the production of MVs by cancer cells plays crucial roles in driving the expansion of the primary tumor. However, it is now becoming increasingly clear that MVs are also stable in the circulation of cancer patients, where they can mediate long-range effects and contribute to the formation of the pre-metastatic niche, an essential step in metastasis (Skog et al., Nat Cell Biol 10:1470-1476, 2008; Noerholm et al., BMC Cancer 12:22, 2012; Peinado et al., Nat Med 18:883-891, 2012; Piccin et al., Blood Rev 21:157-171, 2007; van der Vos et al., Cell Mol Neurobiol 31:949-959, 2011). These findings, when taken together with the fact that MVs are being aggressively pursued as diagnostic markers, as well as being considered as potential targets for intervention against cancer (Antonyak et al., Small GTPases 3:219-224, 2012; Hosseini-Beheshti et al., Mol Cell Proteomics 11:863-885, 2012; Martins et al., Curr Opin Oncol 25:66-75, 2013; Ge et al., Cancer Microenviron 5:323-332, 2012; Peinado et al., Nat Med 18:883-891, 2012; Piccin et al., Blood Rev 21:157-171, 2007; Al-Nedawi et al., Cell Cycle 8:2014-2018, 2009; Cocucci and Meldolesi, Curr Biol 21:R940-R941, 2011; D'Souza-Schorey and Clancy, Genes Dev 26:1287-1299, 2012; Shao et al., Nat Med 18:1835-1840, 2012), point to critically important roles for MVs in human cancer progression that can potentially be exploited to develop new targeted approaches for treating this disease. PMID:24839024

Antonyak, Marc A; Cerione, Richard A



[Involving family members of chronically ill patients in physician-patient communication].  


Involving family members in the patient's treatment is central for coping with chronic diseases. The family's functioning and their involvement in the treatment process have a significant influence on compliance as well as on the patient's coping and quality of life. This article illustrates this broad topic through selected aspects. First, the importance of the family for the patient's coping and quality of life is highlighted in certain examples. Criteria for the family's involvement and important topics for the doctor's encounter with family members are introduced. Second, the necessities, problems, and consequences of doctor-family communication are illustrated for the examples of stroke and dementia. Overall, there is only limited time to include the family in in-patient as well as out-patient care. As a result, physician-family communication is not integrated sufficiently in general care, even for chronic diseases. PMID:22936480

Wilz, G; Meichsner, F



Cancer patients' preferences for written prognostic information provided outside the clinical context.  


Cancer patients' preferences for written prognostic information independent of the clinical context have not previously been investigated. This study aimed to assist a state cancer organisation to provide information to patients by assessing patients' understanding of statistical information; eliciting their preferences for framing, content and presentation; and assessing the acceptability of a card sort for obtaining preferences. With the exception of conditional and relative survival, initial difficulties in understanding statistical concepts were improved with a plain language explanation. Analysis of the interview transcripts revealed that participants generally supported the provision of written information about survival in booklets and on the Internet. They wanted positive, relevant and clear information. Participants said that the use of, and preferences for, this information would be affected by a patient's age, time since diagnosis, ability to cope with having cancer and the perceived credibility of the information source. They found the card sort acceptable, saying it made the assessment of understanding and selection of preferences easy. This study has identified two fundamental, and sometimes conflicting, factors underlying patients' preferences: the communication of hope and the need to understand information it has also identified patient characteristics thought to influence preferences. These factors and characteristics need to be taken into account when developing written prognostic information for patients. PMID:14562016

Davey, H M; Butow, P N; Armstrong, B K



Comparison of three severity scores for critically ill cancer patients  

Microsoft Academic Search

Objective To compare three scoring systems, the Acute Physiology and Chronic Health Evaluation (APACHE) II, the Simplified Acute Physiology Score (SAPS) II and a modified Mortality Probability Model II (ICU cancer mortality model, ICMM) for their prognostic value for mortality during hospital stay in a group of cancer patients admitted to a medical ICU. Design Prospective cohort study. Setting Medical

Peter Schellongowski; Michael Benesch; Thomas Lang; Friederike Traunmüller; Christian Zauner; Klaus Laczika; Gottfried J. Locker; Michael Frass; Thomas Staudinger



The Psychosocial Problems of Cancer Patients: A Prospective Study.  

ERIC Educational Resources Information Center

The course of psychosocial adjustment to cancer was examined in 105 adults with cancer of the lung, breast and skin. Half of the patients received a program of systematic psychosocial rehabilitation plus evaluation, and the other half received only an evaluation, consisting of a series of psychometric instruments and a problem-oriented structured…

Gordon, Wayne; And Others


Breakthrough pain: characteristics and impact in patients with cancer pain  

Microsoft Academic Search

Few surveys have been performed to define the characteristics and impact of breakthrough pain in the cancer population. In this cross-sectional survey of inpatients with cancer, patients responded to a structured interview (the Breakthrough Pain Questionnaire) designed to characterize breakthrough pain, and also completed measures of pain and mood (Memorial Pain Assessment Card (MPAC)), pain-related interference in function (Brief Pain

Russell K Portenoy; David Payne; Paul Jacobsen



Flattened cortisol rhythms in metastatic breast cancer patients  

Microsoft Academic Search

Allostatic load, the physiological accumulation of the effects of chronic stressors, has been associated with multiple adverse health outcomes. Flattened diurnal cortisol rhythmicity is one of the prototypes of allostatic load, and has been shown to predict shorter survival among women with metastatic breast cancer. The current study compared diurnal cortisol slope in 17 breast cancer patients and 31 controls,

Heather C. Abercrombie; Janine Giese-Davis; Sandra Sephton; Elissa S. Epel; Julie M. Turner-Cobb; David Spiegel



Generic Drugs May Help Breast Cancer Patients Stick to Therapy  


... page, please enable JavaScript. Generic Drugs May Help Breast Cancer Patients Stick to Therapy Cost a key factor ... Preidt Friday, October 31, 2014 Related MedlinePlus Pages Breast Cancer Medicines FRIDAY, Oct. 31, 2014 (HealthDay News) -- Access ...


Acupuncture, Exercise May Ease Pain for Breast Cancer Patients  


... enable JavaScript. Acupuncture, Exercise May Ease Pain for Breast Cancer Patients Treatment-related discomfort, swelling helped by the ... Thursday, November 13, 2014 Related MedlinePlus Pages Acupuncture Breast Cancer Exercise and Physical Fitness THURSDAY, Nov. 13, 2014 ( ...


Gastric emptying in patients with fundal gastritis and gastric cancer.  

PubMed Central

Gastric emptying was compared in patients with gastric cancers and fundal gastritis to determine its value in identifying patients at high risk of gastric cancer. Gastric emptying was measured by the acetaminophen absorption method, and the extent of fundal gastritis was determined by the endoscopic Congo red test. The results showed that gastric emptying was significantly slower in patients with severe fundal gastritis than in those without. Gastric emptying in patients with differentiated adenocarcinomas was significantly slower than in those with undifferentiated adenocarcinoma, its value being similar to that in patients with severe fundal gastritis. The Congo red test showed that the incidence of severe fundal gastritis was significantly greater in patients with differentiated adenocarcinomas than in those with undifferentiated cancers. These findings suggest that delayed gastric emptying may allow prolonged contact between dietary carcinogens and the stomach. PMID:2370013

Tatsuta, M; Iishi, H; Okuda, S



Acute bacterial infection negatively impacts cancer specific survival of colorectal cancer patients  

PubMed Central

AIM: To assess the impact of bacterial infections on cancer-specific survival in patients with colorectal cancer. METHODS: This was a retrospective cohort study of colorectal cancer patients treated at the A.C. Camargo Cancer Center between January 2006 and April 2010. The presence of bacterial infection during cancer treatment, or up to one year after, was confirmed by laboratory tests or by the physician. Infections of the urinary, respiratory or digestive tracts, bloodstream, skin or surgical site were defined by testing within a single laboratory. Criteria for exclusion from the study were: chronically immunosuppressed patients; transplant patients (due to chronic immunosuppression); human immunodeficiency virus carriers; chronic use of corticosteroids or other immunosuppressive drugs; patients with autoimmune disease or primary immunodeficiency; known viral or parasitic infections. Patients with infections that did not require hospitalization were not included in the study because of the difficulty of collecting and tracking data related to infectious processes. In addition, patients hospitalized for pulmonary thromboembolism, stroke, acute myocardial infarction, uncontrolled diabetes, malignant hypercalcemia or other serious non-infectious complications not directly related to infection were also excluded. Survival curves were plotted using the Kaplan-Meier method, and log-rank tests (univariate analysis) and a Cox test assuming a proportional hazards model (multivariate analysis) were performed to examine associations between clinical history and characteristics of infection with cancer-specific survival. RESULTS: One-hundred and six patients with colorectal cancer were divided into two groups based on the presence or absence of bacterial infection. Patient ages ranged from 23 to 91 years, with a median of 55 years. The majority of patients were male (57/106, 53.77%) with stage III colorectal cancer (45/106, 44.11%). A total of 86 bacteriologic events were recorded. Results indicate that the presence and number of infections during or after the end of treatment were associated with poorer-cancer specific survivals (P = 0.02). Elevated neutrophil counts were also associated with poorer cancer-specific survival (P = 0.02). Analysis of patient age revealed that patients > 65 years of age had a poorer cancer-specific survival (P = 0.04). A multivariate analysis demonstrated that infection was an independent predictor of poor survival (HR = 2.62, 95%CI: 1.26-5.45; P = 0.01) along with advanced clinical staging (HR = 2.63, 95%CI: 1.08-6.39; P = 0.03). CONCLUSION: Infection and high neutrophil counts are associated with a poorer cancer-specific survival in colorectal cancer patients. PMID:25320529

Attie, Regina; Chinen, Ludmilla Thome Domingos; Yoshioka, Eliane Muta; Silva, Michele Cristina F; de Lima, Vladmir Claudio Cordeiro



Dietary Intervention for Patients Receiving Chemoradiotherapy for Lung Cancer

In this phase I clinical trial, patients with advanced non-small cell lung cancer who are about to undergo chemoradiation therapy will consume a very low-carbohydrate ketogenic diet for the duration of their treatment.


Combining Chemotherapy with Bevacizumab Improves Outcomes for Ovarian Cancer Patients

Results from two phase III randomized clinical trials suggest that, at least for some patients with ovarian cancer, adding the antiangiogenesis agent bevacizumab to chemotherapy increases the time to disease progression and may improve survival.


Implementing Thrombosis Guidelines in Cancer Patients: A Review  

PubMed Central

Venous thromboembolism is a frequent and serious complication in patients with cancer. It is an independent prognostic factor of death in cancer patients and the second leading cause of death, but physicians often underestimate its importance, as well as the need for adequate prevention and treatment. Management of venous thromboembolism in patients with cancer requires the coordinated efforts of a wide range of clinicians, highlighting the importance of a multidisciplinary approach. However, a lack of consensus among various national and international clinical practice guidelines has contributed to knowledge and practice gaps among practitioners, and inconsistent approaches to venous thromboembolism. The 2013 international guidelines for thrombosis in cancer have sought to address these gaps by critically re-evaluating the evidence coming from clinical trials and synthesizing a number of guidelines documents. An individualized approach to prophylaxis is recommended for all patients. PMID:25386357

Farge-Bancel, Dominique; Bounameaux, Henri; Brenner, Benjamin; Buller, Harry R.; Kakkar, Ajay; Pabinger, Ingrid; Streiff, Michael; Debourdeau, Philippe



Predictors of final histology in patients with endometrial cancer  

Microsoft Academic Search

ObjectiveTo assess the usefulness of preoperative tumor grade and intraoperative assessment of gross depth of myometrial invasion as “predictors” of final grade, final depth of myometrial invasion and surgical stage in patients with “low-risk” endometrial cancer.

Michael Frumovitz; Diljeet K. Singh; Larissa Meyer; Daniel H. Smith; Iris Wertheim; Ephraim Resnik; Diane C. Bodurka



New Drug for Patients with Advanced Thyroid Cancer

In this phase II trial, researchers are studying the effects of treatment with 17-AAG, an antitumor antibiotic drug that targets a protein called HSP90, in patients with advanced medullary or differentiated thyroid cancer.


Cancer Patients in Hospice Face Less Aggressive Treatment  


... enable JavaScript. Cancer Patients in Hospice Face Less Aggressive Treatment: Study More health care strategies and costs ... choose hospice care are less likely to receive aggressive end-of-life treatment or to die in ...


Many Patients with Cancer Need Better Treatments for Pain

Inadequate pain treatment in patients with cancer remains a significant problem and appears to be more frequent among minorities, according to a new study published online April 16, 2012, in the Journal of Clinical Oncology.


NCI Awards $25 Million for Patient Navigator Research Program for Minority and Underserved Cancer Patients

The NCI today announced a total of $25 million in grants to eight research institutions to develop an innovative Patient Navigator Research Program. Navigators help patients and their families manage cancer diagnoses and overcome common barriers to obtaining timely and appropriate cancer care and treatment. Questions and Answers


Communication of ALS Patients by Detecting Event-Related Potential  

NASA Astrophysics Data System (ADS)

Amyotrophic Lateral Sclerosis(ALS) patients are unable to successfully communicate their desires, although their mental capacity is the same as non-affected persons. Therefore, the authors put emphasis on Event-Related Potential(ERP) which elicits the highest outcome for the target visual and hearing stimuli. P300 is one component of ERP. It is positive potential that is elicited when the subject focuses attention on stimuli that appears infrequently. In this paper, the authors focused on P200 and N200 components, in addition to P300, for their great improvement in the rate of correct judgment in the target word-specific experiment. Hence the authors propose the algorithm that specifies target words by detecting these three components. Ten healthy subjects and ALS patient underwent the experiment in which a target word out of five words, was specified by this algorithm. The rates of correct judgment in nine of ten healthy subjects were more than 90.0%. The highest rate was 99.7%. The highest rate of ALS patient was 100.0%. Through these results, the authors found the possibility that ALS patients could communicate with surrounding persons by detecting ERP(P200, N200 and P300) as their desire.

Kanou, Naoyuki; Sakuma, Kenji; Nakashima, Kenji


Lung cancer in HIV infected patients: facts, questions and challenges  

PubMed Central

AIDS related mortality has fallen sharply in industrialised countries since 1996 following the introduction of highly active antiretroviral therapy. This has been accompanied by an increase in the proportion of deaths attributable to non?AIDS defining solid tumours, especially lung cancer. The risk of developing lung cancer seems to be higher in HIV infected subjects than in the general population of the same age, partly because the former tend more frequently to be smokers and, especially, intravenous drug users. The carcinogenic role of the antiretroviral nucleoside drugs and their interaction with smoking needs to be examined. Interestingly, there is no clear relationship between the degree of immunosuppression and the risk of lung cancer, so the reason for the increased risk is unknown. The mean age of HIV infected patients at the time of lung cancer diagnosis is 45?years and most are symptomatic. Lung cancer is diagnosed when locally advanced or metastatic (stage III–IV) in 75–90% of cases, similar to patients with unknown HIV status. Adenocarcinoma is the most frequent histological type. The prognosis is worse in HIV infected patients than in the general lung cancer population. Efficacy and toxicity data for chemotherapy and radiation therapy are few and imprecise. Surgery remains the treatment of choice for localised disease in patients with adequate pulmonary function and general good health, regardless of immune status. Prospective clinical trials are needed to define the optimal detection and treatment strategies for lung cancer in HIV infected patients. PMID:17071836

Cadranel, J; Garfield, D; Lavole, A; Wislez, M; Milleron, B; Mayaud, C



Stanford study finds Hispanic lung cancer patients have higher survival than non-Hispanic white patients

Analysis of non-small cell lung cancer (NSCLC) patient records in the California Cancer Registry database during the 20-year period of 1988-2008 indicates that Hispanics/Latinos with NSCLC have a higher overall survival compared to non-Hispanic white patients, according to Stanford University research presented at the 2012 Chicago Multidisciplinary Symposium in Thoracic Oncology. Stanford University is home to the Stanford Cancer Institute.


Nurse-patient communication: language mastery and concept possession.  


Influential holistic analyses of patient perspectives assume that the concepts that patients associate with medical terms are formed by their total social and cultural contexts. Holistic analyses presuppose conceptual role semantics in the sense that they imply that a medical term must have the same role for a nurse and a patient in order for them to associate the same concept with the term. In recent philosophy of mind, social externalism has emerged as a non-holistic alternative to conceptual role theories. According to social externalism, a nurse and a patient express the same concept by a term if they both have a minimal or better understanding of the term. Three arguments in favour of social externalism are presented in connection with nurse-patient interaction. The first concerns successful communication, the second focuses on belief reports made by patients and the third centres on the need for including medical terms in medical discourse. Finally, the practical implications of the arguments are clarified. The most important of these is that, in cases of misunderstanding, a nurse should not conform to a patient's idiosyncratic understanding, but instead correct the mistaken applications of the term in question. PMID:16494668

Nordby, Halvor