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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.



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



Patient Perceptions of Oncologist–Patient Communication About Prognosis: Changes From Initial Diagnosis to Cancer Recurrence  

Microsoft Academic Search

Cancer recurrence presents oncologists with many challenges, including discussing prognosis. A thematic analysis of patient interviews was conducted to learn more about how this challenge is met by doctors and patients in their communication. Female patients being treated for a cancer recurrence at a comprehensive cancer center (N = 30) were asked to recall how they discussed their prognosis with

Mary M. Step; Eileen Berlin Ray



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



Outcomes, preferences for resuscitation, and physician-patient communication among patients with metastatic colorectal cancer  

Microsoft Academic Search

Purpose: To describe characteristics, outcomes, and decision making in patients with colorectal cancer metastatic to the liver, and to examine the relationship of doctor-patient communication with patient understanding of prognosis and physician understanding of patients’ treatment preferences.Patients and Methods: The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT) was a prospective cohort study conducted at

Paul Haidet; Mary Beth Hamel; Roger B Davis; Neil Wenger; Douglas Reding; Peter S Kussin; Alfred F Connors; Joanne Lynn; Russell S Phillips



Patient–oncologist communication in advanced cancer: predictors of patient perception of prognosis  

PubMed Central

Goals of work Advanced cancer patients’ perceptions of prognosis, which are often overly optimistic compared to oncologist estimates, influence treatment preferences. The predictors of patients’ perceptions and the effect of oncologist communication on patient understanding are unclear. This study was designed to identify the communication factors that influence patient–oncologist concordance about chance of cure. Materials and methods We analyzed audiorecorded encounters between 51 oncologists and 141 advanced cancer patients with good (n=69) or poor (n=72) concordance about chance of cure. Encounters were coded for communication factors that might influence oncologist–patient concordance, including oncologist statements of optimism and pessimism. Main results Oncologists made more statements of optimism (mean=3.3 per encounter) than statements of pessimism (mean=1.2 per encounter). When oncologists made at least one statement of pessimism, patients were more likely to agree with their oncologist's estimated chance of cure (OR=2.59, 95%CI=1.31–5.12). Statements of optimism and uncertainty were not associated with an increased likelihood that patients would agree or disagree with their oncologists about chance of cure. Conclusions Communication of pessimistic information to patients with advanced cancer increases the likelihood that patients will report concordant prognostic estimates. Communication of optimistic information does not have any direct effect. The best communication strategy to maximize patient knowledge for informed decision making while remaining sensitive to patients’ emotional needs may be to emphasize optimistic aspects of prognosis while also consciously and clearly communicating pessimistic aspects of prognosis. PMID:18196288

Robinson, Tracy M.; Alexander, Stewart C.; Hays, Margie; Jeffreys, Amy S.; Olsen, Maren K.; Rodriguez, Keri L.; Pollak, Kathryn I.; Abernethy, Amy P.; Arnold, Robert; Tulsky, James A.



Patients’ and Family Members’ Views on Patient-Centered Communication During Cancer Care  

PubMed Central

Objectives To explore patients’ and family members’ views on communication during cancer care, and to identify those aspects of clinician-patient communication which were most important to patients and family members. Methods We conducted a secondary data analysis of qualitative data from 137 patients with cancer and family members of patients with cancer. We used a modified version of the constant comparative method and coding paradigm of grounded theory. Results Patients want sensitive, caring clinicians who provide information that they need, when they need it, in a way that they can understand; who listen and respond to questions and concerns, and who attempt to understand the patient’s experience. Effective information exchange and a positive interpersonal relationship with the clinician were of fundamental importance to patients and family members. These were interrelated; for instance, failure to provide information a patient needed could damage the relationship, while excellent listening could foster the relationship. Information exchange and relationship were also integral to decision making, managing uncertainty, responding to emotions, and self-management. Clinicians who were responsive to patients’ needs beyond the immediate medical encounter were valued. Conclusions The complexity of cancer care today suggest that efforts to improve communication must be multi-level, acknowledging and addressing patient, clinician, organizational and policy barriers and facilitators. Measurement tools are needed to assess cancer patients’ and family members’ experiences with communication over the course of cancer care in order to provide meaningful, actionable feedback to those seeking to optimize their effectiveness in communicating with patients with cancer. PMID:23780672

Mazor, Kathleen M.; Beard, Renee L.; Alexander, Gwen L.; Arora, Neeraj K.; Firneno, Cassandra; Gaglio, Bridget; Greene, Sarah M.; Lemay, Celeste A.; Robinson, Brandi E.; Roblin, Douglas W.; Walsh, Kathleen; Street, Richard L.; Gallagher, Thomas H.



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.



Patient-Centered Communication in Cancer Care: The Role of the NCI’s Cancer Information Service  

Microsoft Academic Search

While patient-centered care and the reduction of suffering due to cancer are primary goals of the NCI, improvement in the\\u000a delivery of patient-centered communication has been identified as a key NCI research priority. As research on patient-centered\\u000a communication evolves, the potential contributions of programs such as the National Cancer Institute’s (NCI) Cancer Information\\u000a Service (CIS) cannot be overlooked. The purpose

Rosemarie Slevin Perocchia; Julie Keany Hodorowski; Laurie A. Williams; Julie Kornfeld; Nydia Lassalle Davis; MaryAnn Monroe; Mary Anne Bright



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.


“You Are Not at All Bothersome” – Nurses’ Online Communication with Testicular Cancer Patients  

PubMed Central

To some extent, electronic communication has supplemented nurses’ face-to-face contact with patients over the last few years. In this paper, we report findings from a study in which we examined cancer nurses’ answers to messages from testicular cancer patients in a nurse-managed online patient-provider communication service. The aim of the study was to investigate how nurses manage to meet patients’ different questions and concerns, and what aspects of expert nursing care are demonstrated when they communicate with patients online. The content of the messages formed a continuum from practical to existential issues. In their answers, the nurses demonstrated an ability to make reflected choices between both support modalities and means of communication. The professional knowledge and care of expert cancer nurses were clearly exposed in the nurses’ answers, although they were good at adapting their professional language so that it would be understandable to the patients. PMID:24199140

Wibe, Torunn; Ekstedt, Mirjam; Hellesø, Ragnhild; Varsi, Cecilie; Ruland, Cornelia



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.



Evaluation of a pilot communication skills training intervention for minority cancer patients.  


The aim of this study was to pilot test in a minority cancer patient population a communication workshop to improve doctor-patient communication skills. Thirty-two patients participated. Eighteen evaluated a face-to-face workshop, while 14 completed surveys only. Participants in the workshop group completed the Patient Report of Communication Behavior (PRCB) before and after the workshop and a course evaluation. Participants did not differ on baseline PRCB scores. Posttest scores were significantly higher than pretest scores (p < 0.01). All participants agreed or strongly agreed that they would use the communication skills; 93% agreed or strongly agreed that the skills would improve their health care. PMID:21966720

Bylund, Carma L; Goytia, Elliott J; D'Agostino, Thomas A; Bulone, Linda; Horner, Jennifer; Li, Yuelin; Kemeny, Margaret; Ostroff, Jamie S



Factors Influencing Communication Between the Patients with Cancer and their Nurses in Oncology Wards  

PubMed Central

Aims: The purpose of this study was to demonstrate the factors influencing nurse-patient communication in cancer care in Iran. Materials and Methods: This study was conducted with a qualitative conventional content analysis approach in oncology wards of hospitals in Tabriz. Data was collected through purposive sampling by semi-structured deep interviews with nine patients, three family members and five nurses and analyzed simultaneously. Robustness of data analysis was evaluated by the participants and external control. Results: The main theme of the research emerged as “three-factor effects” that demonstrates all the factors related to the patient, nurse, and the organization and includes three categories of “Patient as the center of communication”, “Nurse as a human factor”, and “Organizational structures”. The first category consists of two sub-categories of “Imposed changes by the disease” and the “patient's particular characteristics”. The second category includes sub-categories of “sense of vulnerability” and “perception of professional self: Pre-requisite of patient-centered communication”. The third category consists of the sub-categories of “workload and time imbalance”, “lack of supervision”, and “impose duties in context of neglecting nurse and patient needs”. Characteristics of the patients, nurses, and care environment seemed to be the influential factors on the communication. Conclusions: In order to communicate with cancer patients effectively, changes in philosophy and culture of the care environment are essential. Nurses must receive proper trainings which meet their needs and which focus on holistic and patient-centered approach. PMID:24600177

Zamanzadeh, Vahid; Rassouli, Maryam; Abbaszadeh, Abbas; Nikanfar, Alireza; Alavi-Majd, Hamid; Ghahramanian, Akram



Patient Engagement in a Rapidly Changing Communication Environment: Reflections of a Cancer Survivor  

PubMed Central

The shared decision-making paradigm calls for patients to become as knowledgeable as they can about their illnesses and treatment options. To foster their engagement, patients today have unprecedented access to an array of health information and communication applications facilitated by the Internet revolution. In this commentary, the author, a long-term cancer survivor, reflects on his recent experiences with heart disease and discusses how he has benefited from advances in communication technologies in his quest to become an informed patient, at the same time reminding the reader about the ever-enduring salience of the patient–clinician relationship. PMID:24395997



Evaluation of a Pilot Communication Skills Training Intervention for Minority Cancer Patients  

PubMed Central

The aim of this study was to pilot test in a minority cancer patient population a communication workshop to improve doctor-patient communication skills. Thirty-two patients participated. Eighteen evaluated a face-to-face workshop, while 14 completed surveys only. Participants in the workshop group completed the Patient Report of Communication Behavior (PRCB) before and after the workshop and a course evaluation. Participants did not differ on baseline PRCB scores. Post-test scores were significantly higher than pre-test scores (p<.01). All participants agreed or strongly agreed that they would use the communication skills; 93% agreed or strongly agreed that the skills would improve their healthcare. PMID:21966720

Bylund, Carma L.; Goytia, Elliott J.; D'Agostino, Thomas A.; Bulone, Linda; Horner, Jennifer; Li, Yuelin; Kemeny, Margaret; Ostroff, Jamie S.



Hospice Nurse Communication with Patients with Cancer and their Family Caregivers  

PubMed Central

Abstract Background Effective communication by hospice nurses enhances symptom management for the patient, reduces family caregiver burden and distress, and potentially improves bereavement adjustment. However, research has not kept pace with the rising use of hospice by patients with cancer and thus we know little about how hospice nurses communicate. Methods The overriding objective of this pilot study was to provide insight into these in-home visits. Hospice nurses audiorecorded their interactions over time with family caregivers and patients with cancer. The communication within these tapes was coded using Roter Interaction Analysis System (RIAS) and analyzed. Results We found that tape recording home hospice nurse visits was feasible. RIAS was suited to capture the general content and process of the home hospice encounter and the coded interactions show the range of topics and emotions that are evident in the dialogue. Implications and future directions for research are discussed. PMID:22339285

Reblin, Maija; Clayton, Margaret F.; Berry, Patricia; Mooney, Kathleen



Communication and information-giving in high-risk breast cancer consultations: influence on patient outcomes  

Microsoft Academic Search

This longitudinal study aimed to document (i) the information-giving and patient-communication styles of clinical geneticists and genetic counsellors (consultants) in familial breast cancer clinics and (ii) assess the effect of these styles on women's knowledge, whether their expectations were met, satisfaction, risk perception and psychological status. A total of 158 women from high-risk breast cancer families completed self-report questionnaires at

E A Lobb; P N Butow; A Barratt; B Meiser; C Gaff; M A Young; E Haan; G Suthers; M Gattas; K Tucker



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


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 the disclosure of unfavourable news in an Asian population in Singapore. Two hundred cancer patients at the National Cancer Centre, Singapore, completed a Measure of Patients' Preferences (MPP) questionnaire on how they would like their physicians to tell them unfavourable news about their condition. The patients rated the content and context of the communication as well as the physicians' characteristics on a five-point Likert scale. Items that scored the highest mostly related to physicians' expertise and content of the interaction, while those relating to the supportive aspects scored the lowest. Gender was significantly associated with scores on the support subscale of the MPP such that women reported that the supportive elements were more important than the men did. No other demographic and medical characteristics were associated with patients' preferences. Exploratory factor analysis yielded two main factors, which accounted for 79.38% of the common variance. Patients' preferences in our local Asian population are fairly similar to those obtained from other studies conducted in the West, despite possible socio-cultural differences such as the use of euphemisms. PMID:16482445

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



Problematic Integration Theory: Implications of Supportive Communication for Breast Cancer Patients  

Microsoft Academic Search

In this analysis, the authors apply Problematic Integration (PI) Theory to the way breast cancer patients engage in and receive support. The theory focuses on the relationship between expectations and desires, and enlightens cognitive and communicative responses to situations that involve tensions between their perceived likelihoods of occurrence and their perceived values. The relationship between PI Theory and its significance

Michael Repass; Jonathan Matusitz



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.; Simoni?, A.; Bebb, G.; Giese–Davis, J.



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



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.


Challenges of mediated communication, disclosure and patient autonomy in cross-cultural cancer care  

PubMed Central

Background: Evidence concerning the influence of ethnic diversity on clinical encounters in cancer care is sparse. We explored health providers' experiences in this context. Methods: Focus groups were conducted with a purposeful sample of 106 health professionals of differing disciplines, in 18 UK primary and secondary care settings. Qualitative data were analysed using constant comparison and processes for validation. Results: Communication and the quality of information exchanged with patients about cancer and their treatment was commonly frustrated within interpreter-mediated consultations, particularly those involving a family member. Relatives' approach to ownership of information and decision making could hinder assessment, informed consent and discussion of care with patients. This magnified the complexity of disclosing information sensitively and appropriately at the end of life. Professionals' concern to be patient-centred, and regard for patient choice and autonomy, were tested in these circumstances. Conclusion: Health professionals require better preparation to work effectively not only with trained interpreters, but also with the common reality of patients' families interpreting for patients, to improve quality of cancer care. Greater understanding of cultural and individual variations in concepts of disclosure, patient autonomy and patient-centredness is needed. The extent to which these concepts may be ethnocentric and lack universality deserves wider consideration. PMID:21863029

Kai, J; Beavan, J; Faull, C



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



Risk communication with Arab patients with cancer: a qualitative study of nurses and pharmacists  

PubMed Central

Objectives To explore pharmacist and nurse views and experiences in educating patients regarding their treatment safety and tolerability as well as the roles of other professions in this regard. Design In this qualitative study, six focus group discussions were conducted. Setting The National Center for Cancer Care and Research in Qatar. Participants Eleven pharmacists and 22 nurses providing direct patient care. Results Concepts related to three key themes were drawn from the seeding questions and included factors for determining the level of risk they communicated: the specific treatment regimen in question; the patient; and their assessment of the patient. Patient-related considerations arose from additional subthemes; both nurses and pharmacists described aspects related to the perceived psychological health status of the patient, as well as anticipated comprehension, as ascertained by demonstrated education and language abilities. In all discussions, it was noted that physician and family non-disclosure of cancer diagnosis to the patient profoundly influenced the nature of information they provided. While a high level of cohesion in safety communication prioritisation among these two health disciplines was found, a number of pharmacists asserted a more formal role compared to informal and repeated teaching by nurses. Conclusions Nurses and pharmacists in this Middle East healthcare environment were not reluctant to discuss treatment side effects with patients and draw on similar professional judgements in prioritising treatment risk information. We found that they did not always recognise each other's informal educational encounters and that there are opportunities to explore increased collaboration in this regard to enhance the patient care experience. PMID:25833667

Wilbur, Kerry; Babiker, Alya; Al-Okka, Maha; Jumaat, Ebaa; Al-Yafei, Sumaya M Al Saadi; Nashwan, Abdulqadir J



Does the number of cancer patients' close social ties affect cancer-related information seeking through communication efficacy? Testing a mediation model.  


This study addresses whether having a broad social network of close friends equips cancer patients with increased efficacy to engage in communication about their cancer, which then leads to an increased likelihood of patients actively seeking cancer-related information. Guided by the theory of motivated information management, the study also tests whether the effect of the number of close social ties on information seeking is mediated, in part, by communication efficacy. Results are based on data collected from a randomly drawn sample from the Pennsylvania Cancer Registry of 2,013 cancer patients who completed mail surveys in the Fall of 2006. Results are consistent with a cross-sectional mediation effect in which the number of close social ties in one's social network is positively associated with communication efficacy (b = .17, p = .001), which, in turn, is positively associated with cancer-related information seeking (b = .13, p < .001). PMID:24673194

Lewis, Nehama; Martinez, Lourdes S



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



[New European Information and Communication Platform Striving for Improved Care for Colorectal Cancer Patients -].  


The article introduces a new information and communication platform that focuses on the promotion of colorectal cancer prevention and on the improvement of care for colorectal cancer patients. In addition to the platforms objectives, the article also presents the conclusions of the first year of the "European Colorectal Cancer Days" international conference held annually in Brno since 2012. Further information and news are available at PMID:25494899

Dušek, L; Poc, P; Májek, O; Suchánek, S; Seifert, B; Gregor, J; Zavoral, M



Cancer patients’ experiences of using an Interactive Health Communication Application (IHCA)  

PubMed Central

Interactive Health Communication Applications (IHCAs) are increasingly used in health care. Studies document that IHCAs provide patients with knowledge and social support, enhance self- efficacy and can improve behavioural and clinical outcomes. However, research exploring patients’ experiences of using IHCAs has been scarce. The aim of this study was to explore cancer patients’ perspectives and experiences related to the use of an IHCA called WebChoice in their homes. Qualitative interviews were conducted with infrequent, medium and frequent IHCA users—six women and four men with breast and prostate cancer. The interviews were transcribed and analyzed inspired by interactionistic perspectives. We found that some patients’ perceived WebChoice as a “friend,” others as a “stranger.” Access to WebChoice stimulated particularly high frequency users to position themselves as “information seeking agents,” assuming an active patient role. However, to position oneself as an “active patient” was ambiguous and emotional. Feelings of “calmness”, “normalization of symptoms”, feelings of “being part of a community”, feeling “upset” and “vulnerable”, as well as “feeling supported” were identified. Interaction with WebChoice implied for some users an increased focus on illness. Our findings indicate that the interaction between patients and an IHCA such as WebChoice occurs in a variety of ways, some of which are ambivalent or conflicting. Particularly for frequent and medium frequency users, it offers support, but may at the same time reinforce an element of uncertainty in their life. Such insights should be taken into consideration in the future development of IHCAs in healthcare in general and in particular for implementation into patients’ private sphere. PMID:22582085

Grimsbø, Gro H.; Engelsrud, Gunn H.; Ruland, Cornelia M.



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



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.


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.


Communication Practices in Physician Decision-Making for an Unstable Critically Ill Patient with End-Stage Cancer  

PubMed Central

Abstract Background Shared decision-making has become the standard of care for most medical treatments. However, little is known about physician communication practices in the decision making for unstable critically ill patients with known end-stage disease. Objective To describe communication practices of physicians making treatment decisions for unstable critically ill patients with end-stage cancer, using the framework of shared decision-making. Design Analysis of audiotaped encounters between physicians and a standardized patient, in a high-fidelity simulation scenario, to identify best practice communication behaviors. The simulation depicted a 78-year-old man with metastatic gastric cancer, life-threatening hypoxia, and stable preferences to avoid intensive care unit (ICU) admission and intubation. Blinded coders assessed the encounters for verbal communication behaviors associated with handling emotions and discussion of end-of-life goals. We calculated a score for skill at handling emotions (0–6) and at discussing end of life goals (0–16). Subjects Twenty-seven hospital-based physicians. Results Independent variables included physician demographics and communication behaviors. We used treatment decisions (ICU admission and initiation of palliation) as a proxy for accurate identification of patient preferences. Eight physicians admitted the patient to the ICU, and 16 initiated palliation. Physicians varied, but on average demonstrated low skill at handling emotions (mean, 0.7) and moderate skill at discussing end-of-life goals (mean, 7.4). We found that skill at discussing end-of-life goals was associated with initiation of palliation (p?=?0.04). Conclusions It is possible to analyze the decision making of physicians managing unstable critically ill patients with end-stage cancer using the framework of shared decision-making. PMID:20642362

Mohan, Deepika; Alexander, Stewart C.; Garrigues, Sarah K.; Arnold, Robert M.



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



Values and options in cancer care (VOICE): study design and rationale for a patient-centered communication and decision-making intervention for physicians, patients with advanced cancer, and their caregivers  

PubMed Central

Background Communication about prognosis and treatment choices is essential for informed decision making in advanced cancer. This article describes an investigation designed to facilitate communication and decision making among oncologists, patients with advanced cancer, and their caregivers. Methods/design The Values and Options in Cancer Care (VOICE) Study is a National Cancer Institute sponsored randomized controlled trial conducted in the Rochester/Buffalo, NY and Sacramento, CA regions. A total of 40 oncologists, approximately 400 patients with advanced cancer, and their family/friend caregivers (one per patient, when available) are expected to enroll in the study. Drawing upon ecological theory, the intervention uses a two-pronged approach: oncologists complete a multifaceted tailored educational intervention involving standardized patient instructors (SPIs), and patients and caregivers complete a coaching intervention to facilitate prioritizing and discussing questions and concerns. Follow-up data will be collected approximately quarterly for up to three years. Discussion The intervention is hypothesized to enhance patient-centered communication, quality of care, and patient outcomes. Analyses will examine the effects of the intervention on key elements of physician-patient-caregiver communication (primary outcomes), the physician-patient relationship, shared understanding of prognosis, patient well-being, and health service utilization (secondary outcomes). Trial registration Clinical Trials Identifier: NCT01485627 PMID:23570278



Communication to Pediatric Cancer Patients and their Families: A Cultural Perspective  

PubMed Central

Background: Communication is a key component of palliative care. The area of pediatric palliative care is emotionally distressing for families and healthcare providers. Inadequate communication can increase the stress and lead to mistrust or miscommunication. Materials and Methods: Reviewing the literature on communication between physicians and patients, we identified several barriers to communication such as paternalism in medicine, inadequate training in communication skills, knowledge of the grieving process, special issues related to care of children and cultural barriers. In order to fill the void in area of cultural communication, a study questionnaire was administered to consecutive families of children receiving chemotherapy at a large, north Indian referral hospital to elicit parental views on communication. Results: Most parents had a protective attitude and favored collusion, however, appreciated truthfulness in prognostication and counseling by physicians; though parents expressed dissatisfaction on timing and lack of prior information by counseling team. Conclusion: Training programs in communication skills should teach doctors how to elicit patients’ preferences for information. Systematic training programs with feedback can decrease physicians stress and burnout. More research for understanding a culturally appropriate communication framework is needed. PMID:20859468

Seth, Tulika



Cancer patient expectations of and communication with oncologists and oncology nurses: the experience of an integrated oncology and palliative care service  

Microsoft Academic Search

The purpose of this study was to evaluate ambulatory cancer patients' knowledge of their diagnosis and stage, their expectations of medical and nursing staff, and issues related to communication with the professional staff. A structured interview was conducted with each of 103 consecutive cancer patients attending the Oncology Day Hospital of the Shaare Zedek Medical Center. There were 77 women

Rama Sapir; Raphael Catane; Bella Kaufman; Ruti Isacson; Amiel Segal; Simon Wein; Nathan I. Cherny



Information and communication needs of Chinese American breast cancer patients: perspectives on survivorship care planning  

PubMed Central

Background The existing knowledge on the survivorship experiences of Chinese American breast cancer survivors (CABCS) has arisen largely from aggregated data across multiethnic or multicancer studies that have focused on quality of life. Little is known about Chinese American perspectives and preferences for survivorship care. Objective To examine the experiences of CABCS to better understand their information and communication needs and their preferences for survivorship care plans (SCPs). Methods 16 CABCS, aged 37-72 years, were recruited through community-based organizations in the Northeast United States to participate in one-on-one telephone interviews about their breast cancer survivorship experience. The semistructured interviews were conducted in Mandarin, Cantonese, or English. Two investigators transcribed and translated the audio recordings into English and analyzed the interview transcripts using established methods of qualitative content analysis. Results Three main themes were identified through analysis of interview transcripts: the need for evidence-based and culturally and linguistically appropriate health information; the role of language or communication barriers and culture in accessing care and communicating with providers; and preferences for SCP elements and format. Limitations The sample may not be representative of the entire population of CABCS. Conclusions The findings provide insight into the information and communication needs and SCP preferences of CABCS. Understanding the cultural nuances that underlie these needs and preferences is critical for improving CABCS's quality of life after treatment for cancer. SCPs that incorporate Chinese-language resources and address the unique cultural needs of this population should be developed and they should include information about diet and nutrition as well as traditional Chinese medicine.

Wen, Kuang-Yi; Hu, Angela; Ma, Grace X; Fang, Carolyn Y; Daly, Mary B



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.


Treatment-related symptoms among underserved women with breast cancer: the impact of physician–patient communication  

Microsoft Academic Search

Low-income, minority women are more likely to be undertreated for breast cancer (BC) treatment-related symptoms than whites.\\u000a This study assessed the impact of patient–physician communication on symptom resolution. A cross-sectional, California statewide\\u000a survey was conducted among 921 low-income women with BC. Ethnic\\/racial differences in BC treatment-related symptoms (pain,\\u000a nausea\\/vomiting, depression) reporting and physician’ awareness of these symptoms were assessed by

Rose C. Maly; Yihang Liu; Barbara Leake; Amardeep Thind; Allison L. Diamant



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



Communicating with patients.  


Dental care providers need to be able to communicate effectively with their patients in order to build rapport and trust. Highly developed communication skills also enable the dental care provider to extract more accurate diagnostic information and to more effectively present treatment options to the patient. Neurolinguistic programming techniques can be employed to accomplish these as well as other objectives. PMID:10687469

Kaplowitz, G J



The Process of Deciding About Prophylactic Surgery for Breast and Ovarian Cancer: Patient Questions, Uncertainties, and Communication  

PubMed Central

Many women who have, or are at risk for, BRCA 1/2 mutations or breast cancer decline prophylactic surgery, but questions remain as to how they make and experience these decisions. Our methods consisted of interviewing 32 women for 2 hr each; 19 were tested, 20 were symptomatic. Our results showed that these surgical options forced women to confront questions, involving stresses and uncertainties, regarding: implications of test results, prognoses with and without surgery, and effects of surgery (e.g., on self-image). Given these dilemmas, many women turned to doctors who then ranged in what and how they communicated about these issues, and how strongly they offered input. Some patients felt disappointed at provider non-directiveness, while others found providers too directive. Patients turned to family members and friends, who also ranged in how and what they communicated, and whether they agreed with the patient and/or each other. Many women turned to patient communities, but then had to decide how involved to be, and what information to provide or accept. These data suggest that providers and others may need to be more aware of the series of questions, involving stresses and uncertainties, that these women face, and the complex roles providers themselves may play. These data highlight needs for physicians to be able to address these issues flexibly, gauging patient preferences for information and paternalism (vs. autonomy). These data suggest areas for future research: for example, on how providers decide whether, what and how to communicate about these issues, and how these choices shape treatment decisions. PMID:20014126

Klitzman, Robert; Chung, Wendy



Development Of An Educational Video To Improve Patient Knowledge And Communication With Their Healthcare Providers About Colorectal Cancer Screening.  


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 an educational video and focus groups of patients provided initial feedback about the developed CRC screening educational video. Medical personnel reviewed the video and made recommendations prior to final editing of the video. RESULTS: Patients identified CRC screening barriers and made suggestions about the information to include in the educational video. Their suggestions included using a healthcare provider to state the importance of completing CRC screening, demonstrate how to complete the fecal occult blood test, and that men and women from diverse ethnic groups and races could be included in the same video. Participants reviewed the developed video and mentioned that their suggestions were portrayed correctly, the video was culturally appropriate, and the information presented in the video was easy to understand. Medical personnel made suggestions on ways to improve the content and the delivery of the medical information prior to final editing of the video. DISCUSSION: Participants provided valuable information in the development of an educational video to improve patient knowledge and patient-provider communication about CRC screening. The educational video developed was based on the Protection Motivation Theory and addressed the colon cancer screening barriers identified in this mostly minority and low-income patient population. Future research will determine if CRC screening increases among patients who watch the educational video. TRANSLATION TO HEALTH EDUCATION PRACTICE: Educational videos can provide important information about CRC and CRC screening to average-risk adults. PMID:20209024

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



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.



Telehealth Personalized Cancer Risk Communication to Motivate Colonoscopy in Relatives of Patients With Colorectal Cancer: The Family CARE Randomized Controlled Trial  

PubMed Central

Purpose The rate of adherence to regular colonoscopy screening in individuals at increased familial risk of colorectal cancer (CRC) is suboptimal, especially among rural and other geographically underserved populations. Remote interventions may overcome geographic and system-level barriers. We compared the efficacy of a telehealth-based personalized risk assessment and communication intervention with a mailed educational brochure for improving colonoscopy screening among at-risk relatives of patients with CRC. Methods Eligible individuals age 30 to 74 years who were not up-to-date with risk-appropriate screening and were not candidates for genetic testing were recruited after contacting patients with CRC or their next of kin in five states. Enrollees were randomly assigned as family units to either an active, personalized intervention that incorporated evidence-based risk communication and behavior change techniques, or a mailed educational brochure. The primary outcome was medically verified colonoscopy within 9 months of the intervention. Results Of the 481 eligible and randomly assigned at-risk relatives, 79.8% completed the outcome assessments within 9 months; 35.4% of those in the personalized intervention group and 15.7% of those in the comparison group obtained a colonoscopy. In an intent-to-treat analysis, the telehealth group was almost three times as likely to get screened as the low-intensity comparison group (odds ratio, 2.83; 95% CI, 1.87 to 4.28; P < .001). Persons residing in rural areas and those with lower incomes benefitted at the same level as did urban residents. Conclusion Remote personalized interventions that consider family history and incorporate evidence-based risk communication and behavior change strategies may promote risk-appropriate screening in close relatives of patients with CRC. PMID:24449229

Kinney, Anita Y.; Boonyasiriwat, Watcharaporn; Walters, Scott T.; Pappas, Lisa M.; Stroup, Antoinette M.; Schwartz, Marc D.; Edwards, Sandra L.; Rogers, Amy; Kohlmann, Wendy K.; Boucher, Kenneth M.; Vernon, Sally W.; Simmons, Rebecca G.; Lowery, Jan T.; Flores, Kristina; Wiggins, Charles L.; Hill, Deirdre A.; Burt, Randall W.; Williams, Marc S.; Higginbotham, John C.



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


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



Racial\\/Ethnic Differences in Breast Cancer Outcomes Among Older Patients: Effects of Physician Communication and Patient Empowerment  

Microsoft Academic Search

Objectives: To examine racial\\/ethnic disparities in older women's health-related quality of life (QoL) and type of breast cancer treatment as mediated by physician-level and individual-level variables. Methods: A cross-sectional survey of a population-based, consecutive sample identified through the Los Angeles Cancer Surveillance Program of Latina (n = 99), African American (n = 66), and White (n = 92) women aged

Rose C. Maly; Judith A. Stein; Yoshiko Umezawa; Barbara Leake; M. Douglas Anglin



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.


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.



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



The development and preliminary testing of a multimedia patient–provider survivorship communication module for breast cancer survivors  

PubMed Central

Objective This paper describes the development of a theory-guided and evidence-based multimedia training module to facilitate breast cancer survivors’ preparedness for effective communication with their health care providers after active treatment. Methods The iterative developmental process used included: (1) theory and evidence-based content development and vetting; (2) user testing; (3) usability testing; and (4) participant module utilization. Results Formative evaluation of the training module prototype occurred through user testing (n = 12), resulting in modification of the content and layout. Usability testing (n = 10) was employed to improve module functionality. Preliminary web usage data (n = 256, mean age = 53, 94.5% White, 75% college graduate and above) showed that 59% of the participants accessed the communication module, for an average of 7 min per login. Conclusion The iterative developmental process was informative in enhancing the relevance of the communication module. Preliminary web usage results demonstrate the potential feasibility of such a program. Practice implications Our study demonstrates survivors’ openness to the use of a web-based communication skills training module and outlines a systematic iterative user and interface program development and testing process, which can serve as a prototype for others considering such an approach. PMID:22770812

Wen, Kuang-Yi; Miller, Suzanne M.; Stanton, Annette L.; Fleisher, Linda; Morra, Marion E.; Jorge, Alexandra; Diefenbach, Michael A.; Ropka, Mary E.; Marcus, Alfred C.



Cancer Patients and Fungal Infections  


... About . Fungal Diseases Share Compartir Cancer Patients and Fungal Infections As a cancer patient, you ... Top of Page Preventing fungal infections in cancer patients Fungi are difficult to avoid because they are ...


Effective communication skills are the key to good cancer care  

Microsoft Academic Search

Communication within oncology is a core clinical skill but one in which few oncologists or specialist cancer nurses have received much formal training. Inadequate communication may cause much distress for patients and their families, who often want considerably more information than is usually provided. Many patients leave consultations unsure about the diagnosis and prognosis, confused about the meaning of—and need

L Fallowfield; V Jenkins



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 ...


Preventing Infections in Cancer Patients  


... Publications Mold Stay Informed Cancer Home Information for Patients and Caregivers Language: English Español (Spanish) Recommend on Facebook Tweet Share Compartir Cancer patients who are treated with chemotherapy are more likely ...


Comparing Effects in Regular Practice of E-Communication and Web-Based Self-Management Support Among Breast Cancer Patients: Preliminary Results From a Randomized Controlled Trial  

PubMed Central

Background While Web-based interventions have been shown to assist a wide range of patients successfully in managing their illness, few studies have examined the relative contribution of different Web-based components to improve outcomes. Further efficacy trials are needed to test the effects of Web support when offered as a part of routine care. Objective Our aim was to compare in regular care the effects of (1) an Internet-based patient provider communication service (IPPC), (2) WebChoice, a Web-based illness management system for breast cancer patients (IPPC included), and (3) usual care on symptom distress, anxiety, depression, (primary outcomes), and self-efficacy (secondary outcome). This study reports preliminary findings from 6 months’ follow-up data in a 12-month trial. Methods We recruited 167 patients recently diagnosed with breast cancer and undergoing treatment from three Norwegian hospitals. The nurse-administered IPPC allowed patients to send secure e-messages to and receive e-messages from health care personnel at the hospital where they were treated. In addition to the IPPC, WebChoice contains components for symptom monitoring, tailored information and self-management support, a diary, and communication with other patients. A total of 20 care providers (11 nurses, 6 physicians, and 3 social workers) were trained to answer questions from patients. Outcomes were measured with questionnaires at study entry and at study months 2, 4, and 6. Linear mixed models for repeated measures were fitted to compare effects on outcomes over time. Results Patients were randomly assigned to the WebChoice group (n=64), the IPPC group (n=45), or the usual care group (n=58). Response rates to questionnaires were 73.7% (123/167) at 2 months, 65.9 (110/167) at 4 months, and 62.3% (104/167) at 6 months. Attrition was similar in all study groups. Among those with access to WebChoice, 64% (41/64) logged on more than once and 39% (25/64) sent e-messages to care providers. In the IPPC group, 40% (18/45) sent e-messages. Linear mixed models analyses revealed that the WebChoice group reported significantly lower symptom distress (mean difference 0.16, 95% CI 0.06-0.25, P=.001), anxiety (mean difference 0.79, 95% CI 0.09-1.49, P=.03), and depression (mean difference 0.79, 95% CI 0.09-1.49, P=.03) compared with the usual care group. The IPPC group reported significant lower depression scores compared with the usual care group (mean difference 0.69, 95% CI 0.05-1.32, P=.03), but no differences were observed for symptom distress or anxiety. No significant differences in self-efficacy were found among the study groups. Conclusions In spite of practice variations and moderate use of the interventions, our results suggest that offering Web support as part of regular care can be a powerful tool to help patients manage their illness. Our finding that a nurse-administered IPPC alone can significantly reduce depression is particularly promising. However, the multicomponent intervention WebChoice had additional positive effects. Trial Registration; (Archived by WebCite at PMID:25525672

Børøsund, Elin; Cvancarova, Milada; Moore, Shirley M; Ekstedt, Mirjam



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


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


Controversies in communication of genetic risk for hereditary breast cancer.  


Increased availability and heightened consumer awareness of "cancer genes" has increased consumer interest in, and demand for breast cancer risk assessment, and thus a pressing need for providers to identify effective, efficient methods of communicating complicated genetic information to consumers and their potentially at-risk relatives. With increasing direct-to-consumer and -physician marketing of predictive genetic tests, there has been considerable growth in web- and telephone-based genetic services. There is urgent need to further evaluate the psychosocial and behavioral outcomes (i.e., risks and benefits) of telephone and web-based methods of delivery before they become fully incorporated into clinical care models. Given the implications of genetic test results for family members, and the inherent conflicts in health care providers' dual responsibilities to protect patient privacy and to "warn" those at-risk, new models for communicating risk to at-risk relatives are emerging. Additional controversies arise when the at-risk relative is a minor. Research evaluating the impact of communicating genetic risk to offspring is necessary to inform optimal communication of genetic risk for breast cancer across the lifespan. Better understanding the risks and benefits associated with each of these controversial areas in cancer risk communication are crucial to optimizing adherence to recommended breast cancer risk management strategies and ensuring psycho-social well-being in the clinical delivery of genetic services for breast cancer susceptibility. PMID:19775327

Mackenzie, Amy; Patrick-Miller, Linda; Bradbury, Angela R



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.


Alzheimer's disease. Physician-patient communication.  

PubMed Central

The number of cognitively impaired elderly in Canada has increased greatly during the past two decades; nearly all have Alzheimer's disease (AD). The memory problems and changes in language and communication of these patients place tremendous strain on physicians who are searching for a differential diagnosis and are trying to communicate with them. Reviewing the salient language and communication features of AD patients leads to strategies for improving effective physician-patient communication. PMID:8019193

Orange, J. B.; Molloy, D. W.; Lever, J. A.; Darzins, P.; Ganesan, C. R.



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.


Public Communication Programs for Cancer Control.  

ERIC Educational Resources Information Center

For many years several organizations and agencies at the national, regional, and local level have sought to reduce the incidence of cancer by publicizing facts on prevention, screening/detection, and treatment. This report reviews 41 public communication programs on cancer. Fifteen of these are presented as detailed case studies, each having…

Butler-Paisley, Matilda; And Others


Two augmentative communication systems for speechless disabled patients.  


Patients may be rendered speechless because of many conditions, including cancer surgery, stroke, cerebral palsy, cervical cord and head trauma, neuromuscular paralysis, and intubation for respiratory failure. These same conditions may also be associated with decreased use of the hands, so that writing and other nonverbal forms of communication are also impaired. Lack of communication can frustrate the patient, the family, and health care personnel; increase the patient's isolation; and lead to poor patient cooperation, thus impeding progress in therapy and producing secondary psychiatric disturbances. Two communication programs that use a Commodore 64 computer are described in this paper. One communication program uses the alphabet and the other is based on the international Morse code. These programs are easy to use and inexpensive to establish, and they accommodate any switching device. PMID:2528298

Newman, G C; Sparrow, A R; Hospod, F E



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



Communication with patients suffering from serious physical illness.  


Communication is the corner stone of the relationship with the patient in all medical settings with the main aims of creating a good inter-personal relationship, exchanging information, and making treatment-related decisions. In a rapidly changing cultural and social context, the paternalistic approach of doctors knowing the best and deciding what should be done for a patient has been replaced by a shared decision-making approach, with patients being advised to educate themselves, ask questions and influence the course of the discussion with their doctors. Thus, a need for an improvement in the communication skills of physicians is extremely important for patients affected by serious physical illness (e.g. cancer, HIV infection, multiple sclerosis, amyotrophic lateral sclerosis). Certain attitudes, behaviour and skills (e.g. capacity to impart confidence, being empathetic, providing a 'human touch', relating on a personal level, being forthright, being respectful, and being thorough) are part of effective communication. However, some specific aspects influencing doctor-patient communication and relationships, such as personality variables, coping and attachment styles, as well as cultural factors, should also be taken in to account. The development of training curricula to help doctors acquire proper skills in communication is mandatory, since research has shown that training in communication may facilitate the effectiveness of a doctor-patient relationship and the patient's satisfaction with care and give a general sense of humanity, which is easily lost in a biotechnologically oriented medicine. © 2015 S. Karger AG, Basel. PMID:25832510

Grassi, Luigi; Caruso, Rosangela; Costantini, Anna



[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



Group Interventions with Cancer Patients  

Microsoft Academic Search

Cancer support groups have become increasingly available to patients over the last two decades. Although the various patient groups differ in their philosophy, membership, and aims, the majority can be categorized as predominantly “supportive” or “psychoeduca-tional” in their approach. To date, there is little evidence regarding the relative benefits of the two types of group in improving patients' psychological outcomes.

Sarah Edelman; Ashley Craig; Antony D. Kidman



Barriers to participation of Aboriginal people in cancer care: communication in the hospital setting  

Microsoft Academic Search

Objective: To report Aboriginal patients' views about effective communication between Aboriginal people and health service providers in Western Australian hospital settings. Design, setting and participants: Qualitative study involving indepth interviews between 1 March 2006 and 30 September 2007 with 30 Aboriginal people affected by cancer from across WA. Main outcome measures: Aboriginal patients' views about the quality of communication within

Shaouli Shahid; Lizzie D Finn; Sandra C Thompson



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.



Pneumococcal bacteremia in cancer patients  

Microsoft Academic Search

Twenty-eight episodes of Streptococcus pneumoniae bacteremia occurring in 27 cancer patients hospitalized in the Institut Jules Bordet between July 1979 and April 1985 were reviewed. Ten patients had hematological malignancies and 17 had solid tumors (in 7 cases, of the lung). Forty-four per cent of the patients were neutropenic (<1000\\/µl) and 36% of the patients were in septic shock. In

V. Richard; F. Meunier; P. Auwera; P. Dejace; D. Daneau; J. Klastersky



Communication in End-Stage Cancer: Review of the Literature and Future Research  

Microsoft Academic Search

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

Elizabeth D. Trice; Holly G. Prigerson



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


Cancer communication and informatics research across the cancer continuum.  


Over the past decade, dramatic changes brought about by a rapid diffusion of Internet technologies, cellular telephones, mobile devices, personal digital assistants, electronic health records, and data visualization have helped to create a revolution in health communication. To understand the implications of this communication revolution for cancer care, the National Cancer Institute launched an ambitious set of research priorities under its "extraordinary opportunities" program. We present an overview of some of the relevant behavioral research being conducted within the perspective of this extraordinary opportunity in cancer communication research. We begin by tracing the implications of this research for behavioral scientists across the continuum of cancer care from primary prevention (e.g., tobacco control, diet, exercise, sun protection, and immunization against human papilloma virus), to secondary prevention (e.g., screening for polyps, lesions, and early stage neoplasms), to diagnosis and treatment, posttreatment survivorship, and end of life. Along each point of the continuum, we describe a natural evolution of knowledge from studies on the traditional role of media to research on the changing role of new media and informatics, and we carefully highlight the role that psychological research has played in improving communication- and health-related outcomes along the way. We conclude with an appeal to psychologists of many different backgrounds to join with biomedical researchers, engineers, clinical practitioners, and others to accelerate progress against cancer. (PsycINFO Database Record (c) 2015 APA, all rights reserved). PMID:25730725

Hesse, Bradford W; Beckjord, Ellen; Rutten, Lila J Finney; Fagerlin, Angela; Cameron, Linda D



Communication and Technology in Genetic Counseling for Familial Cancer  

PubMed Central

When a cancer predisposing germline mutation is detected in an index case, the presence of the underlying syndrome is confirmed and the potential for predictive testing of at-risk relatives is established. However, the reporting of a positive family history does not routinely lead to communication of information about risk to close, much less distant relatives. This review summarizes information technology utilized to address penetration or “reach” of knowledge of risk within extended families, including the use of telephone and video counseling to reach distant patients, and anticipate novel internet-based processes for communication between investigators and relatives. PMID:24355094

Lynch, Henry T.; Snyder, Carrie; Stacey, Mark; Olson, Brooke; Peterson, Susan; Buxbaum, Sarah; Shaw, Trudy; Lynch, Patrick



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, Mariët; Andersen, Barbara L.



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.


A Better Patient Experience Through Better Communication  

PubMed Central

The transformation of healthcare from a seller’s market to a consumer’s market has pushed the element of patient satisfaction into the forefront of various medical facility evaluation tools, including those used by Medicare when weighing reimbursement to hospitals for patient care. Research has identified good communication skills to be a key factor in ensuring better patient outcomes, and nurturing patient satisfaction. Because of the growing amount of money at stake for patients’ satisfaction with a facility, the communication skills of individual healthcare providers are bound to impact their employees' reimbursement, bonuses, and promotion options. Although the dangers of “poor communication,” are evident: “poor communication” is a primary reason for filing a law suit in >80% of cases (Avery, 1985). Identifying the characteristics of “good communication” has been difficult. One factor that adds to the confusion is that research has found some long accepted codes of professional communication protocol to actually be counterproductive. Another factor that adds to the uncertainty is that accurate interpretations of some communication events are counterintuitive. Fortunately it has been possible to extract observable, proven, and teachable “good communication” behaviors from large-scale trials in the radiology department. The resultant Comfort Talk™ approach to communication includes rapid rapport techniques, patient-centered talking styles, and use of hypnotic language. This article overviews some of the Comfort Talk™ approaches to patients interaction and provides operational summaries of a sampling of specific Comfort Talk™ communication techniques, which nurses, technologists, and other healthcare workers can implement in their own practices. PMID:23471099

Lang, Elvira V.



Headache in Patients with Cancer  

Microsoft Academic Search

Contemporary cancer research has led to unparalleled advances in therapeutics and improved survival. Even as treatment options\\u000a continue to improve, quality of life should remain a priority. Headache drastically impacts the quality of life of patients\\u000a with cancer and has a wide etiological scope, making diagnosis a challenge. Intracranial mass lesions are only one cause;\\u000a others include extracranial tumors, paraneoplastic

Samuel A. Goldlust; Jerome J. Graber; Dana F. Bossert; Edward K. Avila



Many Breast Cancer Patients Lack Info on Their Cancer  


... features on this page, please enable JavaScript. Many Breast Cancer Patients Lack Info on Their Cancer Problem more ... 2015) Monday, January 26, 2015 Related MedlinePlus Pages Breast Cancer Health Disparities Talking With Your Doctor MONDAY, Jan. ...


Hypertension in Patients with Cancer  

PubMed Central

There is a known association between chemotherapy and radiotherapy for treatment of cancer patients and development or worsening of hypertension. The aim of this article is to review this association. A literature search was conducted for articles reporting this association on the databases PubMed, SciELO and LILACS between 1993 and 2013. There was a high coprevalence of hypertension and cancer, since both diseases share the same risk factors, such as sedentary lifestyle, obesity, smoking, unhealthy diet and alcohol abuse. The use of chemotherapy and adjuvant drugs effective in the treatment of cancer increased the survival rate of these patients and, consequently, increased the incidence of hypertension. We described the association between the use of angiogenesis inhibitors (bevacizumab, sorafenib and sunitinib), corticosteroids, erythropoietin and non-steroidal anti-inflammatory drugs with the development of hypertension. We also described the relationship between hypertension and carotid baroreceptor injury secondary to cervical radiotherapy. Morbidity and mortality increased in patients with cancer and hypertension without proper antihypertensive treatment. We concluded that there is need for early diagnosis, effective monitoring and treatment strategies for hypertension in cancer patients in order to reduce cardiovascular morbidity and mortality. PMID:25742420

de Souza, Vinicius Barbosa; Silva, Eduardo Nani; Ribeiro, Mario Luiz; Martins, Wolney de Andrade



Outcomes Research Branch | Stimulating Research on the Patient-Centeredness of Cancer Care

Effective patient-clinician communication is central to the delivery of high-quality care and is crucial in the cancer setting where patients face stress, uncertainty, complex information, and life-altering medical decisions.


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



A qualitative analysis of communication between members of a hospital-based multidisciplinary lung cancer team.  


The aim of the study was to explore how patient information is communicated between health professionals within a multidisciplinary hospital-based lung cancer team and to identify mechanisms to improve these communications. A qualitative method was employed using semi-structured in-depth interviews with a representative sample (n = 22) of members of a multidisciplinary hospital-based lung cancer team including medical, nursing and allied health professionals. Analysis was undertaken using a thematic grounded theory approach to derive key themes to describe communication patterns within the team and how communication could be improved. Two themes with sub-themes were identified: (1) characteristics of communication between team members including the impact of role on direction of communications, and doctors' dominance in communications; and (2) channels of communication including, preference for face-to-face and the suboptimal roles of the Multidisciplinary Team Meeting and the hospital medical record as mediums for communication. Traditional influences of role delineation and the dominance of doctors were found to impact on communication within the multidisciplinary hospital-based lung cancer team. Existing guidelines on implementation of multidisciplinary cancer care fail to address barriers to effective team communication. The paper-based medical record does not support team communications and alternative electronic solutions need to be used. PMID:22966875

Rowlands, S; Callen, J



Ethics of ongoing cancer care for patients making risky decisions.  


Patients who decline conventional cancer therapy yet seek to continue follow-up while pursuing alternative therapy can pose an ethical challenge. The potential benefits and harms of an ongoing clinical relationship need be assessed on a case-by-case basis. Ongoing efforts at communicating, understanding the patient’s basis for decision making, and seeking to negotiate evidence-based care that is respectful of the patient’s preferences may improve outcomes.13 However, respect for the patient’s autonomy does not require support for inappropriate care and should not require that the oncologist check his or her professional judgment at the door. PMID:23277773

Peppercorn, Jeffrey



The Child with Cancer: Patterns of Communication and Denial.  

ERIC Educational Resources Information Center

Examines the role of communication and denial in coping efforts of children with cancer. Results indicate level of family communication about cancer expressed by mother's communication is correlated with hypothesized responses in child. Usefulness of three instruments as effective tools in measuring child's reactions is demonstrated. (Author/BEF)

Spinetta, John J.; Maloney, Lorrie J.



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.


Dissociative symptomatology in cancer patients  

PubMed Central

Introduction: The utilization of the post-traumatic stress disorder (PTSD) diagnostic spectrum is currently being debated to categorize psychological adjustment in cancer patients. The aims of this study were to: (1) evaluate the presence of cancer-related traumatic dissociative symptomatology in a sample of cancer patients; (2) examine the correlation of cancer-related dissociation and sociodemographic and medical variables, anxiety, depression, and post-traumatic stress symptomatology; (3) investigate the predictors of cancer-related dissociation. Methods: Ninety-two mixed cancer patients (mean age: 58.94, ds = 10.13) recruited from two hospitals in northern Italy were administered a questionnaire on sociodemographic and medical characteristics, the Karnofsky Scale to measure the level of patient activity and medical care requirements, the Hospital Anxiety and Depression Scale (HADS) to evaluate the presence of anxiety and depression, the Impact of Event Scale Revised (IES-R) to assess the severity of intrusion, avoidance, and hypervigilance, and the Peritraumatic Dissociative Experiences Questionnaire (PDEQ) to quantify the traumatic dissociative symptomatology. Results: 31.5% of participants report a PDEQ score above the cutoff. The results indicated that dissociative symptomatology was positively correlated with HADS scores (HADS-Anxiety: r = 0.476, p < 0.001; HADS-Depression: r = 0.364, p < 0.001) and with IES-R scores (IES-R-Intrusion: r = 0.698, p < 0.001; IES-R-Avoidance: r = 0.619, p < 0.001; IES-R- Hypervigilance: r = 0.681, p < 0.001). A stepwise regression analysis was performed in order to find the predictors of cancer-related traumatic dissociative symptomatology. The results converged on a three predictor model revealing that IES-R-Intrusion, IES-R-Avoidance, and IES-R-Hyperarousal accounted for 53.9% of the explained variance. Conclusion: These findings allow us to hypothesize a specific psychological reaction which may be ascribed to the traumatic spectrum within the context of cancer, emphasizing the close relationship between the origin of dissociative constituents which, according to the scientific literature, compose the traumatic experience. Our results have implications for understanding dissociative symptomatology in a cancer population and can help develop clinical programs of prevention and support for patients.

Civilotti, Cristina; Castelli, Lorys; Binaschi, Luca; Cussino, Martina; Tesio, Valentina; Di Fini, Giulia; Veglia, Fabio; Torta, Riccardo



Cancer-specific Relationship Awareness, Relationship Communication, and Intimacy Among Couples Coping with Early Stage Breast Cancer.  


If couples can maintain normalcy and quality in their relationship during the cancer experience, they may experience greater relational intimacy. Cancer-specific relationship awareness, which is an attitude defined as partners focusing on the relationship and thinking about how they might maintain normalcy and cope with cancer as a couple or "team", is one factor that may help couples achieve this goal. The main aim of this study was to evaluate the associations between cancer-specific relationship awareness, cancer-specific communication (i.e., talking about cancer's impact on the relationship, disclosure, and responsiveness to partner disclosure), and relationship intimacy and evaluate whether relationship communication mediated the association between relationship awareness and intimacy. Two hundred fifty four women diagnosed with early stage breast cancer and their partners completed measures of cancer-specific relationship awareness, relationship talk, self-and perceived partner disclosure, perceived partner responsiveness, and relationship intimacy. Results indicated that patients and spouses who were higher in cancer-specific relationship awareness engaged in more relationship talk, reported higher levels of self-disclosure, and perceived that their partner disclosed more. Their partners reported that they were more responsive to disclosures. Relationship talk and perceived partner responsiveness mediated the association between cancer-specific relationship awareness and intimacy. Helping couples consider ways they can maintain normalcy and quality during the cancer experience and framing coping with cancer as a "team" effort may facilitate better communication and ultimately enhance relationship intimacy. PMID:25242854

Manne, Sharon L; Siegel, Scott; Kashy, Deborah; Heckman, Carolyn J



Cancer Patients Rarely Request Unneeded Tests, Treatments  


... features on this page, please enable JavaScript. Cancer Patients Rarely Request Unneeded Tests, Treatments: Study Doctors' claims ... Despite some doctors' claims to the contrary, cancer patients rarely request unnecessary tests or treatments, a new ...


Motivational Deficit in Depressed Cancer Patients.  

ERIC Educational Resources Information Center

Tested accuracy of motivational theory of depression for adjustment disorder with depressed mood in 48 patients with terminal and nonterminal cancer. Results supported motivational theory: cancer patients exhibited low expectations and low values; hence, they were unmotivated and depressed. (NRB)

Layne, Christopher; And Others



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



What Lung Cancer Patients Need to Know  

E-print Network

What Lung Cancer Patients Need to Know About Bone Health A Publication of The Bone and Cancer CANCER AND BONE HEALTH. HOW BONE WORKS (PAGE 2). WHAT LUNG CANCER CAN DO TO BONE (PAGE 2). TREATING BONE AFFECTED BY LUNG CANCER (PAGE 3). HYPERCALCEMIA (PAGE 5). GLOSSARY (PAGE 6). 1 #12;How Bone Works

Kaski, Samuel


Health Insurance And Spending Among Cancer Patients  

Microsoft Academic Search

ABSTRACT: Over 1.3 million new cancer cases are diagnosed,each year. While most can- cer patients are older and covered by Medicare, our analysis indicates that 10 percent of cancer patients under age sixty-five are uninsured,and that 20 percent of Hispanic cancer patients under,age sixty-five are uninsured. We find substantial differences in cancer spending,by insurance status; uninsured,patients under age sixty-five spent

Kenneth E. Thorpe; David Howard



The Effectiveness of a Patient Communication Course.  

ERIC Educational Resources Information Center

Reports data from three consecutive classes of first- year optometry students at the Southern California College of Optometry, who were tested preceding and following completion of a patient communication course. Findings indicated that students improved their ability to respond to patients and were better able to discriminate among various levels…

Marsden, Harue J.



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



Effective communication about the use of complementary and integrative medicine in cancer care.  


Complementary and integrative medicine (CIM) is becoming an increasingly popular and visible component of oncology care. Many patients affected by cancer and their family members are looking for informed advice and desire communication with their physicians about CIM use. Patients affected by cancer come to discuss CIM use with intense emotions and are experiencing an existential crisis that cannot be ignored. Effective communication is crucial in establishing trust with these patients and their families. Communication is now recognized as a core clinical skill in medicine, including cancer care, and is important to the delivery of high-quality care. The quality of communication affects patient satisfaction, decision-making, patient distress and well-being, compliance, and even malpractice litigation. The communication process about CIM use requires a very sensitive approach that depends on effective communication skills, such as experience in listening, encouraging hope, and ability to convey empathy and compassion. This process can be divided into two parts: the "how" and the "what". The "how" relates to the change in clinician attitude, the process of gathering information, addressing patients' unmet needs and emotions, and dealing with uncertainty. The "what" relates to the process of information exchange while assisting patients in decisions about CIM use by using reliable information sources, leading to informed decision-making. PMID:23863085

Frenkel, Moshe; Cohen, Lorenzo



Effective Communication About the Use of Complementary and Integrative Medicine in Cancer Care  

PubMed Central

Abstract Complementary and integrative medicine (CIM) is becoming an increasingly popular and visible component of oncology care. Many patients affected by cancer and their family members are looking for informed advice and desire communication with their physicians about CIM use. Patients affected by cancer come to discuss CIM use with intense emotions and are experiencing an existential crisis that cannot be ignored. Effective communication is crucial in establishing trust with these patients and their families. Communication is now recognized as a core clinical skill in medicine, including cancer care, and is important to the delivery of high-quality care. The quality of communication affects patient satisfaction, decision-making, patient distress and well-being, compliance, and even malpractice litigation. The communication process about CIM use requires a very sensitive approach that depends on effective communication skills, such as experience in listening, encouraging hope, and ability to convey empathy and compassion. This process can be divided into two parts: the “how” and the “what”. The “how” relates to the change in clinician attitude, the process of gathering information, addressing patients' unmet needs and emotions, and dealing with uncertainty. The “what” relates to the process of information exchange while assisting patients in decisions about CIM use by using reliable information sources, leading to informed decision-making. PMID:23863085

Cohen, Lorenzo



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



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 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.


Couples' Support-Related Communication, Psychological Distress, and Relationship Satisfaction among Women with Early Stage Breast Cancer  

ERIC Educational Resources Information Center

This study examined associations between couple communication about cancer and psychological distress and relationship satisfaction of women diagnosed with early stage breast cancer. One hundred forty-eight couples completed a videotaped discussion of a cancer-related issue and a general issue. Patients completed measures of psychological distress…

Manne, Sharon; Sherman, Marne; Ross, Stephanie; Ostroff, Jamie; Heyman, Richard E.; Fox, Kevin



Quality of life in lung cancer patients  

Microsoft Academic Search

Given that lung cancer is one of the common cancers world-wide, the implications of focusing on quality of life as well as survival require to be understood. We have carried out a study of the relationship between survival and quality of life in patients with lung cancer comparing patients those who lived with those who died within 3 months. The

Ali Montazeri; Robert Milroy; David Hole; James McEwen; Charles R. Gillis



Monitoring care of colorectal cancer patients in  

E-print Network

Monitoring care of colorectal cancer patients in Northern Ireland diagnosed 2006 (with comparisons 1996 & 2001) Colorectal1996-2006 #12;Monitoring care of colorectal cancer patients in Northern Ireland in Northern Ireland diagnosed 2006 (with comparisons 1996 & 2001). N. Ireland Cancer Registry. Available

Müller, Jens-Dominik


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



[Quick guide to communicate important news to terminally ill patients].  


The aim of this work is to be able to publish the information concerning communication with cancer patients as recommended in England. The observation and the study protocol during the stay abroad have been given the opportunity to stylize specific information on the methodology of communication of important information to terminally ill patients. It seems readily apparent as they characterized by both technical precision and sensivity to emotions and descriptions for the individual patient. How is shared by all chronic pain is predominantly complex emotion, a mix of additions and perceived physical and emotional pain - emotional. Because accurate information is beneficial to the patient and that really is not turned, so to speak, a "bullet" it is necessary that you have created, over time, a concrete "therapeutic alliance" between body physician, patient and possibly family. This arises, for sure, even at first accepted the patient during the clinical visit attentive to detail, is renewed in the definition of the common objective to be achieved, so analgesia and it is expressed in the certainty that the physician provides all the resources realistically available. It is then up to the sensitivity of the operator, doctor and/or nurse, described in the "take charge" find, from time to time, the words and manners, verbal and nonverbal, to respond fully to questions of the patient same. PMID:21533322

Ghio, P; Dell'Orco, L



Medical Interpreting: Improving Communication with Your Patients.  

ERIC Educational Resources Information Center

The guide is designed for physicians and other medical practitioners who need to work with medical interpreters to improve communication with patients. Special attention is given to the Australian context. An introductory section discusses the need for medical interpreters and explains the guide's organization. Subsequent sections address these…

Tebble, Helen


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



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



Values and options in cancer care (VOICE): study design and rationale for a patient-centered communication and decision-making intervention for physicians, patients with advanced cancer, and their caregivers  

E-print Network

Reyna VF: A theory of medical decision making and health:theory has been informed by experimental research on how Framing affects patient understanding and decision-making [decision making to a greater degree [32,33]. Ecological theory



Illustrations enhance older colorectal cancer patients' website satisfaction and recall of online cancer information.  


This study aims to investigate the effects of illustrations in online cancer information on older cancer patients' website satisfaction (i.e. satisfaction with the attractiveness, comprehensibility and emotional support from the website) and recall of information. In an online experiment, 174 younger (<65 years) and older (?65 years) colorectal cancer patients were randomly exposed to a webpage about transanal endoscopic microsurgery consisting of either text-only information, text with two cognitive illustrations or text with two affective illustrations. In general, adding cognitive illustrations compared with text-only information improved the satisfaction with the attractiveness of the website in both younger and older patients. For older patients in particular, cognitive illustrations facilitated recall of cancer information: whereas older patients recalled less information overall compared with younger patients (39% vs. 50%), no statistically significant differences in age on recall were observed when cognitive illustrations were added to text. Furthermore, older patients were more satisfied with the emotional support from the website than younger patients, especially when affective illustrations were present. Our results suggest that effective online cancer communication for ageing populations involves considering both cognitive and affective illustrations to enhance website satisfaction and recall of cancer information. PMID:25615269

Bol, N; Smets, E M A; Eddes, E H; de Haes, J C J M; Loos, E F; van Weert, J C M



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



Group psychological therapy for cancer patients  

Microsoft Academic Search

The growing evidence for the efficacy of psychological therapy in improving quality of life in cancer patients suggests that we should now consider it an adjuvant treatment in cancer management, analogous to adjuvant chemotherapy. If this is accepted, it follows that the main indication for advocating such adjuvant psychological therapy to patients should be an expert assessment that the patient

Alastair J. Cunningham



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



Epilepsy in the cancer patient  

Microsoft Academic Search

Purpose  Epileptic seizures in patients with malignancies usually occur as a consequence of brain metastases from systemic cancer or\\u000a the presence of a primary brain tumor. Other less-frequent causes include metabolic disorders such as electrolyte abnormalities,\\u000a hypoglycemia, hypoxia and liver failure, paraneoplastic encephalitis, leptomeningeal carcinomatosis, side effects of certain\\u000a chemotherapeutic agents, central nervous system infections, and pre-existing epilepsy.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We reviewed all

Odysseas Kargiotis; Sofia Markoula; Athanasios P. Kyritsis



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



Access to Cancer Services for Rural Colorectal Cancer Patients  

ERIC Educational Resources Information Center

Context: Cancer care requires specialty surgical and medical resources that are less likely to be found in rural areas. Purpose: To examine the travel patterns and distances of rural and urban colorectal cancer (CRC) patients to 3 types of specialty cancer care services--surgery, medical oncology consultation, and radiation oncology consultation.…

Baldwin, Laura-Mae; Cai, Yong; Larson, Eric H.; Dobie, Sharon A.; Wright, George E.; Goodman, David C.; Matthews, Barbara; Hart, L. Gary



DCCPS: HCIRB: CECCR: Centers of Excellence in Cancer Communication Research at The Cancer Research Network Cancer Communication Research Center

Along with administrative core funding, four research projects were awarded as part of the center’s establishment. In addition, a Discovery Core was funded with the goal of identifying, documenting, and assessing clinical innovations in cancer communication. This Discovery Core was then paired with a Dissemination Core to accelerate the spread of effective practices, programs, and organizational policies into health care systems.


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



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


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.


Spiritual Needs of Cancer Patients: A Qualitative Study  

PubMed Central

Introduction: Diagnosis of cancer can cause huge spiritual crisis in a person and affect different aspects of life. At this stage, patients have certain spiritual needs. Aim: This study was conducted to explain spiritual needs of cancer patients in Iran. Materials and Methods: In this qualitative study, 18 cancer patients, referred to the Cancer Institute of Imam Khomeini Hospital in Tehran were selected using purposive sampling method, and their spiritual needs emerged out of conventional content analysis of interviews conducted with them. Results: From 1850 initial codes, 4 themes (connection, peace, meaning and purpose, and transcendence) were identified that contained categories of social support, normal behavior, inner peace, seeking forgiveness, hope, acceptance of reality, seeking meaning, ending well, change of life meaning, strengthening spiritual belief, communication with God, and prayer. Conclusions: Spiritual needs of cancer patients should be recognized, realized, and considered in care of patients by the medical team. An all-out support of health system policy makers to meet patients’ spiritual needs is particularly important. PMID:25709188

Hatamipour, Khadijeh; Rassouli, Maryam; Yaghmaie, Farideh; Zendedel, Kazem; Majd, Hamid Alavi



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



Cancer patient survival and erythropoietin.  


Cancer patients are frequently anemic. Treatment of anemic patients with erythropoiesis-stimulating proteins (ESPs) such as epoetin and darbepoetin is associated with benefits that include a reduced transfusion risk and improved quality of life. The recent reports of two randomized trials in which ESP treatment was associated with a decreased survival raised valid concerns regarding the safety of these agents in oncology practice. Reports of erythropoietin receptors on non-hematologic human tumor cells have increased the level of concern and provided a relatively simple model for the effects of ESPs on tumor progression and resistance to treatment. This article reviews available data, which lead to a number of conclusions: 1) the two trials suggesting a negative impact on survival have serious methodologic issues that may compromise interpretation; 2) when used to treat rather than prevent anemia in cancer patients, ESPs show no significant negative impact on survival outcomes; 3) with the exception of erythroleukemia cell lines, the presence of functional erythropoietin receptors on human tumor cells has not been conclusively shown; and 4) a sound theoretical basis exists, supported by preclinical evidence, that any effect of ESP therapy on tumor outcomes may depend on baseline hemoglobin levels, with different effects when anemic and non-anemic individuals are treated. For the present, it is prudent to withhold ESP therapy unless hemoglobin concentrations fall below 12 g/dL and to titrate treatment to maintain a target of 12 g/dL, with adjustments in therapy to insure that levels do not exceed 13 g/dL. PMID:16316615

Glaspy, John A



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.



PubMed Central

Despite evidence that nurses may play a crucial part in the wellbeing and recovery of cancer patients by facilitating their expression of feelings, research is lacking into the emotional content of nurse–patient talk and patients' use of language in emotion disclosure. In this study, 23 participating nurses in a variety of cancer care settings were asked to tape-record their conversations with patients during daily care. A data set of 60 nurse–patient conversations was collected. Individual expression of emotion by patients was identified through interpretive literary analysis within a framework of psychodynamic theory. Overall the picture of emotion disclosure was intense. In particular, patients' use of metaphor and figurative language to express their distress was powerful and pervasive. Participating nurses demonstrated responsive skills but their responses to figurative expression were often problematic. The study provides evidence of unconscious processes in nurses' work and advocates career-long psychoanalytically informed supervision for nurses to better support them in challenging dialogue with cancer patients. Research is needed to evaluate the impact of supervision on communications with cancer patients to ensure patients have access to appropriate emotional supportive and care. PMID:24748706

Lanceley, Anne; Clark, Jill Macleod



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

The purpose of this initiative is to provide support for the development of high throughput antibody arrays for quantitative analysis of multiple biomarkers for cancer detection, diagnosis and prognosis.


An information system to support the care for head and neck cancer patients.  


The potential of Information and communication technology (ICT) as a method to improve care is widely acknowledged. However, before ICT can be used in a specific patient population, the needs of that population must first be made explicit. In this paper we aim to explore the feasibility and functionality of an electronic information system to support head and neck (H&N) cancer care. We describe communication and information bottlenecks in supportive care for H&N cancer patients. These bottlenecks were used to determine the functionality of an electronic health information support system. We discern three perspectives of problems in H&N cancer care: lacking communication among professionals, lacking information about the disease and its treatment, and lacking supportive measures to reduce uncertainty and fear in patients. To support care, an information support system can facilitate (1). communication among all professionals involved and between professionals and patients, (2). professionals' and patients' access to information, (3). contact with fellow sufferers, and (4). early detection of patient problems by means of monitoring. Based on these analyses we subsequently built such a system and established a setting for evaluation. Information and communication technology can be tailored to address the communication and information bottlenecks in supportive H&N cancer care. As we aim to investigate whether care for H&N cancer patients may benefit from ICT, we are currently performing a clinical evaluation study. PMID:12707835

van den Brink, Jaap L; Moorman, Peter W; de Boer, Maarten F; van Bemmel, Jan H; Pruyn, Jean F A; Verwoerd, Carel D A



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



Factors predicting fatigue in breast cancer patients  

Microsoft Academic Search

A prospective study was designed to investigate the factors predicting fatigue in breast cancer patients using the Cancer Fatigue Scale (CFS) in addition to the Hospital Anxiety and Depression Scale (HADS) and a questionnaire containing items on demographic and clinical data, and measures of patients' physical symptoms. The CFS measures total fatigue score ranging from 0 (lowest level) to 60

Shahpar Haghighat; Mohammad Esmail Akbari; Kourosh Holakouei; Abbas Rahimi; Ali Montazeri



Early psychological adjustment in breast cancer patients  

Microsoft Academic Search

Objective: A significant proportion of breast cancer patients experiences psychiatric morbidity in the first year after a breast cancer diagnosis and\\/or beginning of treatment. This study attempted to identify and understand the risk factors for developing such problems. Methods: A consecutive series of 87 patients, aged 40–75 years, was assessed prior to diagnosis of breast cancer and followed-up approximately 8

Chiara Nosarti; Jonathan V Roberts; Timothy Crayford; Kwame McKenzie; Anthony S David



Other Optic Nerve Maladies in Cancer Patients  

Microsoft Academic Search

\\u000a Many optic neuropathies in cancer patients are related to the direct effect of cancer on the optic nerve (e.g., orbital and\\u000a parasellar skull base compressive lesions or infiltration of the optic nerve with leptomeningeal disease). However, a number\\u000a of optic neuropathies occur unrelated to those mechanisms. Other mechanisms of optic neuropathy in cancer patients include\\u000a those caused by raised intracranial

Jade S. Schiffman; Anitha Raghunath; Rosa Ana Tang


Percutaneous endoscopic gastrostomy (PEG) in cancer patients  

Microsoft Academic Search

Ninety-nine cancer patients underwent PEG placement attempt at Rosewell Park Cancer Institute between January 1, 1985, and December 1, 1987. Ninety-eight of these were successful and were retrospectively reviewed to determine if cancer patients constitute a high-risk group for PEG placement. Procedure-related mortality was 2% and morbidity was 19%. Morbidity of 17% was noted at less than 30 days and

Richard T. Zera; Hector R. Nava; Joan I. Fischer



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



Rehabilitation of cancer patients - research perspectives.  


Rehabilitation of cancer patients include a broad range of activities aimed at information, counselling, advices on possible change of lifestyle and behaviour, psychological support, social welfare questions, ways of coping with side-effects of the anti-carcinogenic treatment given and additional treatment of numerous clinical problems. The change in the age distribution combined with the growing number of cancer survivors and the scarce economic resources allocated to 'after-treatment' clinical follow-up of cancer patients, even in the Scandinavian countries characterised by their public tax financed health system, emphasize the need for screening of rehabilitation needs among cancer patients. There is a need to identify patients in need for psychological and social intervention. However, this intervention among cancer patients in need has to be based on results achieved in clinical studies. This paper gives a brief introduction to the field of rehabilitation research and indicates a number of areas in which research would be of benefit for the clinical organisation of rehabilitation activities. These areas include the implication of social inequality, a characterisation of cancer patients who rehabilitate successfully, the gender perspective in rehabilitation, the age perspective, how to establish cancer disease specific rehabilitation modules, family and community aspects of rehabilitation, the dilemma between individual responsibility for lifestyle changes and feelings of guilt and the need for models which can determine the best timing of the intervention among cancer patients. PMID:17497310

Johansen, Christoffer



Preferences of elderly cancer patients in their advance directives.  


Efforts to improve the quality of end-of-life decision-making have emphasized the principle of individual autonomy to better ensure that patients receive care consistent with their preferences. Advance directives (ADs) can be vehicles for in-depth and ongoing discussions among health care professionals, patients, and families. The aim of our study was to identify preferences and values expressed in ADs of 50 elderly patients with cancer. Main concerns of the patients were resuscitation and introduction of artificial nutrition. Very few patients had unrealistic expectation. Preferences about patient's symptom management were quite different from one to another. Content of ADs not only involved life-sustaining technology, but also psychosocial items and religious beliefs and values. All patients designated at least one surrogate. In conclusion, ADs should not be considered simply as another questionnaire, but more as a process to improve communication. PMID:19446467

Pautex, Sophie; Notaridis, Grigorios; Déramé, Laurence; Zulian, Gilbert B



Older patient satisfaction with communication during an initial medical encounter  

Microsoft Academic Search

There has been extensive research on the factors associated with patient satisfaction with communication during medical encounters, however, little attention has been paid to satisfaction among subgroups of patients, including the elderly. It is inappropriate to assume that all patients have the same physician-patient relationship needs, and thus, they will all be satisfied with the same communication approaches during medical

Michele G. Greene; Ronald D. Adelman; Erika Friedmann; Rita Charon



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



[Pulmonary rehabilitation in patients with lung cancer].  


The paper presents current news on the possibilities of conducting rehabilitation of patients suffering from lung cancer. It presents the principles of conducting and contraindications for pulmonary rehabilitation for these patients according to current guidelines of American College of Sport Medicine. The methods of measuring exercise capacity for patients with lung cancer have been discussed. The value of ergospirometrial test with maximum oxygen consumption (VO(2peak)) in predicting not only the survival of patients with lung cancer, but also assessing the possibility of pulmonary rehabilitation programs has been highlighted. In the part devoted to physical training for patients before a surgery for lung cancer, current research results have been presented- these show that even a short, high intensity program of pulmonary rehabilitation for patients with lung cancer before surgery is effective and increases the safety of both- the safety of the surgery and extends survival time after operation for lung cancer. The paper describes difficulties in the implementation of rehabilitation programs after surgery conducted on patients with lung cancer resulting from dysfunction of cardiovascular and muscle atrophy - both skeletal and respiratory. The issue of patients with inoperable lung cancer treated with chemotherapy has been discussed so far in only one paper published in 2007. The results shown in it have been discussed as well. The authors demonstrated a significant improvement in the efficiency of respiratory-circulatory system assessed by six-minute walk test, although the rehabilitation program was graduated by small number of patients (44%). It was noted that patients with inoperable lung cancer now account for a large group of patients who use this type of medical intervention and can significantly improve the quality of life and the method shows positive impact on the survival rate. PMID:23109207

Jastrz?bski, Dariusz; Ziora, Dariusz; Hydzik, Grzegorz; Pasko, Ewa; Bartoszewicz, Agnieszka; Kozielski, Jerzy; Nowicka, Jolanta



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.


To worry or not to worry: breast cancer genetic counseling communication with low-income Latina immigrants.  


The purpose of this pilot study was to describe communication practices during hereditary breast cancer genetic counseling (GC) with low-income immigrant Latina patients in a public hospital setting. We utilized qualitative ethnographic methods, including direct observation of GC appointments with Latina patients at a public hospital offering free GC and BRCA testing and in-depth qualitative interviews with patients after they had received their BRCA genetic test results. Twenty-five patients participated; 20 were observed during genetic counseling appointments, and ten participated in interviews after BRCA testing with six participating in both observations and an interview. Analyses of qualitative data from observation field notes and interviews identified both strengths and limitations of current communication practices within the following themes: (1) family health history communication, (2) education regarding genes and genetics and patient information needs, (3) the purpose of the genetic test, (4) genetic test results and cancer risk, (5) building rapport and providing support, and (6) medical interpretation for monolingual Spanish speakers. As access to cancer GC expands in the public safety net settings and for the diverse populations they serve, it is critical to ensure effective communication in order for patients, whether or not they have a BRCA mutation, to understand the nature of their cancer risk and recommended methods of screening and prevention. Intervention strategies that address both structural constraints and patient-provider communication are needed to improve GC communication with immigrant Latinas, especially monolingual Spanish speakers. PMID:25148879

Joseph, Galen; Guerra, Claudia



“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.



Patient communication: a multidisciplinary approach using animated cartoons  

Microsoft Academic Search

Communication is a major problem in the man- agement of patients. Miscommunication occurs frequentlyinpopulationswithlowreadingskills, 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 with patients include the use of videotapes, videotape modeling or cartoon illustrations. Do these products commu- nicate

Marie Leiner; Gilbert Handal; Darryl Williams



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



Individual Patient Cancer Profiles in The Cancer Genome Atlas - Jianjiong Gao, TCGA Scientific Symposium 2012

Home News and Events Multimedia Library Videos Individual Patient Cancer Profiles in The Cancer Genome Atlas - Jianjiong Gao Individual Patient Cancer Profiles in The Cancer Genome Atlas - Jianjiong Gao, TCGA Scientific Symposium 2012 You will need


Anesthesic Considerations in Genitourinary Cancer Patients  

Microsoft Academic Search

A successful outcome following major surgery in patients with malignant urological disease necessitates a multidisciplinary\\u000a approach and close communication among the different disciplines involved in the patient’s care. Surgical intervention in\\u000a patients with urological malignancy must balance the benefits of early surgery, and the risks to patients, many of whom have\\u000a preexisting conditions requiring investigation, treatment, and optimization.

Alistair F. McNarry; Heather Hackett


Nurse-Patient Communication Interactions in the Intensive Care Unit  

PubMed Central

Background The inability to speak during critical illness is a source of distress for patients, yet nurse-patient communication in the intensive care unit has not been systematically studied or measured. Objectives To describe communication interactions, methods, and assistive techniques between nurses and nonspeaking critically ill patients in the intensive care unit. Methods Descriptive observational study of the nonintervention/usual care cohort from a larger clinical trial of nurse-patient communication in a medical and a cardiothoracic surgical intensive care unit. Videorecorded interactions between 10 randomly selected nurses (5 per unit) and a convenience sample of 30 critically ill adults (15 per unit) who were awake, responsive, and unable to speak because of respiratory tract intubation were rated for frequency, success, quality, communication methods, and assistive communication techniques. Patients self-rated ease of communication. Results Nurses initiated most (86.2%) of the communication exchanges. Mean rate of completed communication exchange was 2.62 exchanges per minute. The most common positive nurse act was making eye contact with the patient. Although communication exchanges were generally (>70%) successful, more than one-third (37.7%) of communications about pain were unsuccessful. Patients rated 40% of the communication sessions with nurses as somewhat difficult to extremely difficult. Assistive communication strategies were uncommon, with little to no use of assistive communication materials (eg, writing supplies, alphabet or word boards). Conclusions Study results highlight specific areas for improvement in communication between nurses and nonspeaking patients in the intensive care unit, particularly in communication about pain and in the use of assistive communication strategies and communication materials. PMID:21362711

Happ, Mary Beth; Garrett, Kathryn; Thomas, Dana DiVirgilio; Tate, Judith; George, Elisabeth; Houze, Martin; Radtke, Jill; Sereika, Susan



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



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.


Supportive Care Needs of Iranian Cancer Patients  

PubMed Central

Background: A supportive needs assessment is an essential component of any care program. There is no research evidence regarding the supportive care needs of cancer patients in Iran or other Middle Eastern countries. Aims: The aim of this study was to determine the supportive care needs of Iranian cancer patients. Materials and Methods: This descriptive study was conducted in a referral medical center in the northwest of Iran. A total of 274 cancer patients completed the Supportive Care Needs Survey (SCNS-59). Descriptive statistics were used for data analysis. Results: In 18 items of the SCNS, more than 50% of the participants reported that their needs were unmet. Most frequently, unmet needs were related to the health system, information, physical, and daily living domains, and most met needs were related to sexuality, patient care, and support domains. Conclusions: Iranian cancer patients experience many unmet needs and there is an urgent need for establishing additional supportive care services in Iran. PMID:25191012

Rahmani, Azad; Ferguson, Caleb; Jabarzadeh, Faranak; Mohammadpoorasl, Asghar; Moradi, Narges; Pakpour, Vahid



[Spiritual care model for terminal cancer patients].  


Providing spiritual care to patients with advanced cancer may improve the quality of life of these patients and help them experience a good death. Cancer patients are eager for additional spiritual care and for a sense of peace at the end of their life. However, spirituality is an abstract concept. The literature on spiritual care focuses primarily on elaborations of spirituality theory. Thus, first-line medical care professionals lack clear guidelines for managing the spiritual needs of terminal cancer patients. The purposes of this article were to: 1) introduce a spiritual care model based on the concept of repair and recovery of relationships that addresses the relationship between the self and God, others, id, and objects and 2) set out a four-step strategy for this model that consists of understanding, empathizing, guiding, and growing. This article provides operational guidelines for the spiritual care of terminal cancer patients. PMID:25464961

Cheng, Ju-Fen; Lin, Ya-Ching; Huang, Pai-Ho; Wei, Chih-Hsin; Sun, Jia-Ling



Researching the experience of kidney cancer patients.  


The author's personal experience as a kidney cancer patient, researcher and founder of a kidney cancer support group forms the basis for consideration of the challenges involved in researching patients' experiences. The researcher needs to understand the variability of those experiences in both clinical and psychological-emotional terms, and in relation to the personal, familial and social contexts of the patient. It is also essential to define the purpose of the research and to show how an understanding of personal experiences of cancer can be used to enhance the quality of care for cancer patients. The research encounter with a patient is also in some respects a therapeutic encounter requiring a considerable degree of sensitivity on the part of the researcher. The person-centred approach of Carl Rogers is of value in supporting such an encounter. PMID:12296838

Taylor, K



Sleep Dysfunction in Patients with Cancer  

PubMed Central

Opinion statement Sleep complaints are common in cancer patients. Insomnia is particularly a concern in this population. Although pharmacotherapy is the most prescribed treatment for sleep disturbances, there is evidence that cognitive-behavioral therapy (CBT) is an effective treatment for insomnia in all patients, including those with cancer. CBT for insomnia is a flexible treatment, tailored to the needs of a specific patient, and focusing on behavioral and psychologic skills that foster better sleep and lower anxiety. Many cancer patients with insomnia may be hesitant to use drugs for their sleep treatment because they are already overwhelmed by the chemical and pharmacologic treatments they are prescribed for the cancer; thus, CBT may become the treatment of choice for insomnia in these patients. PMID:17716597

Fiorentino, Lavinia; Ancoli-Israel, Sonia



The Relationship of Perceived Physician Communicator Style to Patient Satisfaction.  

ERIC Educational Resources Information Center

Examines how patients' perceptions of their physicians' communicator styles were related to patient satisfaction. Identifies eight communicator styles and six dimensions of patient satisfaction. Concludes that most significant relationships were nonlinear and that different styles were related to different types of satisfaction. Discusses…

Cardello, Laura L.; And Others



Cancer in Patients With Gabapentin (GPRD)

Pain, Neuropathic; Epilepsy; Renal Pelvis Cancer; Pancreatic Cancer; Breast Cancer; Nervous System Cancer; Chronic Pancreatitis; Stomach Cancer; Renal Cell Carcinoma; Diabetes; Bladder Cancer; Bone and Joint Cancer; Penis Cancer; Anal Cancer; Cancer; Renal Cancer



Breast cancer, prostaglandins and patient survival  

Microsoft Academic Search

Prostaglandins may have both undesirable and desirable effects in malignant disease. Their possible roles in breast cancer were studied by examining the relationships between different variables and the amounts of prostaglandin-like material (PG-LM) extracted from 141 breast carcinomas. Univariate analysis indicates a direct correlation with patient age and menopausal status, with a greater yield from cancers of post- compared with

A Bennett; DA Berstock; F Dische; L Singh; RP A'Hern



Survival Curve for Cancer Patients Following Treatment  

Microsoft Academic Search

On the basis of experience with calculated survivorships of patients following treatment for cancer, a simple function, in terms of two physically meaningful parameters, has been evolved, which fits such survivorship data very well. These two parameters can be used to compare succinctly the mortality of two groups, different in respect of treatment, type of cancer, or other characteristics.The parameters

Joseph Berkson; Robert P. Gage



Approach to the older patient with cancer  

PubMed Central

The incidence of cancer increases with advanced age. And as the world population ages, clinicians will be faced with a growing number of older patients with cancer. The challenge that clinicians face involves carefully choosing the type of therapeutic care plan that is most appropriate given a person’s level of physical reserve, medical comorbidities, and psychosocial resources. Inclusion of assessment tools in clinical practice such as a comprehensive geriatric assessment can assist clinicians in identifying patients who will benefit from aggressive cancer care or palliative measures. The role of palliative care, especially in the frail older patient, is critical in improving quality of life. Improvement in best care practices in older patients with cancer requires their inclusion in clinical trials. PMID:24172314



Support for cancer patients: the Bahrain experience.  


Cancer, a disease people avoid talking about, is the second leading cause of death in Bahrain. The Bahrain Cancer Society established a support group in 1993 with the goals of helping patients and their families cope with this disease and increasing public awareness concerning early detection. Services provided by the group include a weekly 2-hour session to encourage patients to express their feelings and concerns, distribution of informational booklets and visits to people at home and in hospital. Furthermore, the group organizes recreational activities for children with cancer. Patients or their families can also page the group to discuss their problems. The main goal of this paper is to share the Bahrain experience of supporting cancer patients, their families and friends. PMID:17333812

Awadallah, M S



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.



Second Cancers in Patients with Neuroendocrine Tumors  

PubMed Central

Background Second cancers have been reported to occur in 10-20% of patients with neuroendocrine tumors (NETs). However, most published studies used data from a single institution or focused only on specific sites of NETs. In addition, most of these studies included second cancers diagnosed concurrently with NETs, making it difficult to assess the temporality and determine the exact incidence of second cancers. In this nationwide population-based study, we used data recorded by the Taiwan Cancer Registry (TCR) to analyze the incidence and distribution of second cancers after the diagnosis of NETs. Methods NET cases diagnosed from January 1, 1996 to December 31, 2006 were identified from the TCR. The data on the occurrence of second cancers were ascertained up to December 31, 2008. Standardized incidence ratios (SIRs) of second cancers were calculated based on the cancer incidence rates of the general population. Cox-proportional hazards regression analysis was performed to estimate the hazard ratio (HR) and 95% confidence interval (CI) for the risk of second cancers associated with sex, age, and primary NET sites. Results A total of 1,350 newly diagnosed NET cases were identified according to the selection criteria. Among the 1,350 NET patients, 49 (3.63%) developed a second cancer >3 months after the diagnosis of NET. The risk of second cancer following NETs was increased compared to the general population (SIR = 1.48, 95% CI: 1.09-1.96), especially among those diagnosed at age 70 or older (HR = 5.08, 95% CI = 1.69-15.22). There appeared to be no preference of second cancer type according to the primary sites of NETs. Conclusions Our study showed that the risk of second cancer following NETs is increased, especially among those diagnosed at age 70 or older. Close monitoring for the occurrence of second cancers after the diagnosis of NETs is warranted. PMID:24392036

Tsai, Hui-Jen; Wu, Chun-Chieh; Tsai, Chia-Rung; Lin, Sheng-Fung; Chen, Li-Tzong; Chang, Jeffrey. S.



Posttraumatic growth among cancer patients in India  

Microsoft Academic Search

Cancer patients sometimes report positive life changes in addition to more harrowing ones. Theoretically, several cognitive\\u000a processes are thought to contribute to posttraumatic growth, but few studies have examined these relationships empirically\\u000a among cancer patients. Moreover, most research has been conducted in western developed countries. This preliminary study offered\\u000a a novel examination of posttraumatic growth and its cognitive correlates among

Avinash Thombre; Allen C. Sherman; Stephanie Simonton



Patient Satisfaction after Treatment of Nonmelanoma Skin Cancer  

PubMed Central

Background Patient satisfaction is an important aspect of patient-centered care, but has not been systematically studied after treatment of nonmelanoma skin cancer (NMSC), the most prevalent cancer. Objective To compare patient satisfaction after treatment for NMSC and to determine factors associated with better satisfaction. Methods We prospectively measured patient, tumor and care characteristics in 834 consecutive patients at two centers before and after destruction, excision and Mohs surgery. We evaluated factors associated with short-term and long-term satisfaction. Results In all treatment groups, patients were more satisfied with the interpersonal manners of the staff, communication, and financial aspects of their care, than with the technical quality, time with the clinician, and accessibility of their care (p<0.05). Short-term satisfaction did not differ across treatment groups. In multivariable regression models adjusting for patient, tumor, and care characteristics, higher long-term satisfaction was independently associated with younger age, better pre-treatment mental health and skin-related quality of life, and treatment with Mohs surgery (p<0.05). Conclusions Long-term patient satisfaction after treatment of NMSC is related to pre-treatment patient characteristics (mental health, skin-related quality of life) as well as treatment type (Mohs) but not related to tumor characteristics. These results can guide informed decision-making for treatment of NMSC. PMID:19438672

Asgari, Maryam M.; Bertenthal, Daniel; Sen, Saunak; Sahay, Anju; Chren, Mary-Margaret



Ovarian stimulation in patients with breast cancer.  


Breast cancer is the most prevalent malignancy among women under 50. Improvements in diagnosis and treatment have yielded an important decrease in mortality in the last 20 years. In many cases, chemotherapy and radiotherapy develop side effects on the reproductive function. Therefore, before the anti-cancer treatment impairs fertility, clinicians should offer some techniques for fertility preservation for women planning motherhood in the future. In order to obtain more available oocytes for IVF, the ovary must be stimulated. New protocols which prevent exposure to increased estrogen during gonadotropin stimulation, measurements to avoid the delay in starting anti-cancer treatment or the outcome of ovarian stimulation have been addressed in this review. There is no evidence of association between ovarian stimulation and breast cancer. It seems that there are more relevant other confluent factors than ovarian stimulation. Factors that can modify the risk of breast cancer include: parity, age at full-term birth, age of menarche, and family history. There is an association between breast cancer and exogenous estrogen. Therefore, specific protocols to stimulate patients with breast cancer include anti-estrogen agents such as letrozole. By using letrozole plus recombinant follicular stimulating hormone, patients develop a multifollicular growth with only a mild increase in estradiol serum levels. Controlled ovarian stimulation (COS) takes around 10 days, and we discuss new strategies to start COS as soon as possible. Protocols starting during the luteal phase or after inducing the menses currently prevent a delay in starting ovarian stimulation. Patients with breast cancer have a poorer response to COS compared with patients without cancer who are stimulated with conventional protocols of gonadotropins. Although many centres offer fertility preservation and many patients undergo ovarian stimulation, there are not enough studies to evaluate the recurrence, breast cancer-free interval or mortality rates in these women. PMID:25729417

Muñoz, Elkin; González, Naira; Muñoz, Luis; Aguilar, Jesús; Velasco, Juan A García



Ovarian stimulation in patients with breast cancer  

PubMed Central

Breast cancer is the most prevalent malignancy among women under 50. Improvements in diagnosis and treatment have yielded an important decrease in mortality in the last 20 years. In many cases, chemotherapy and radiotherapy develop side effects on the reproductive function. Therefore, before the anti-cancer treatment impairs fertility, clinicians should offer some techniques for fertility preservation for women planning motherhood in the future. In order to obtain more available oocytes for IVF, the ovary must be stimulated. New protocols which prevent exposure to increased estrogen during gonadotropin stimulation, measurements to avoid the delay in starting anti-cancer treatment or the outcome of ovarian stimulation have been addressed in this review. There is no evidence of association between ovarian stimulation and breast cancer. It seems that there are more relevant other confluent factors than ovarian stimulation. Factors that can modify the risk of breast cancer include: parity, age at full-term birth, age of menarche, and family history. There is an association between breast cancer and exogenous estrogen. Therefore, specific protocols to stimulate patients with breast cancer include anti-estrogen agents such as letrozole. By using letrozole plus recombinant follicular stimulating hormone, patients develop a multifollicular growth with only a mild increase in estradiol serum levels. Controlled ovarian stimulation (COS) takes around 10 days, and we discuss new strategies to start COS as soon as possible. Protocols starting during the luteal phase or after inducing the menses currently prevent a delay in starting ovarian stimulation. Patients with breast cancer have a poorer response to COS compared with patients without cancer who are stimulated with conventional protocols of gonadotropins. Although many centres offer fertility preservation and many patients undergo ovarian stimulation, there are not enough studies to evaluate the recurrence, breast cancer-free interval or mortality rates in these women. PMID:25729417

Muñoz, Elkin; González, Naira; Muñoz, Luis; Aguilar, Jesús; Velasco, Juan A García



Evaluation of New Multimedia Formats for Cancer Communications  

PubMed Central

Background Providing quality, current cancer information to cancer patients and their families is a key function of the National Cancer Institute (NCI) Web site. This information is now provided in predominantly-text format, but could be provided in formats using multimedia, including animation and sound. Since users have many choices about where to get their information, it is important to provide the information in a format that is helpful and that they prefer. Objective To pilot and evaluate multimedia strategies for future cancer-information program formats for lay users, the National Cancer Institute created new multimedia versions of existing text programs. We sought to evaluate user performance and preference on these 3 new formats and on the 2 existing text formats. Methods The National Cancer Institute's "What You Need to Know About Lung Cancer" program was the test vehicle. There were 5 testing sessions, 1 dedicated to each format. Each session lasted about 1 hour, with 9 participants per session and 45 users overall. Users were exposed to the assigned cancer program from beginning to end in 1 of 5 formats: text paperback booklet, paperback booklet formatted in HTML on the Web, spoken audio alone, spoken audio synchronized with a text Web page, and Flash multimedia (animation, spoken audio, and text). Immediately thereafter, the features and design of the 4 alternative formats were demonstrated in detail. A multiple-choice pre-test and post-test quiz on the cancer content was used to assess user learning (performance) before and after experiencing the assigned program. The quiz was administered using an Authorware software interface writing to an Access database. Users were asked to rank from 1 to 5 their preference for the 5 program formats, and provide structured and open-ended comments about usability of the 5 formats. Results Significant improvement in scores from pre-test to post-test was seen for the total study population. Average scores for users in each of the 5 format groups improved significantly. Increments in improvement, however, were not statistically different between any of the format groups. Significant improvements in quiz scores were seen irrespective of age group or education level. Of the users, 71.1% ranked the Flash program first among the 5 formats, and 84.4% rated Flash as their first or second choice. Audio was the least-preferred format, ranking fifth among 46.7% of users and first among none. Flash was ranked first among users regardless of education level, age group, or format group to which the user was assigned. Conclusions Under the pilot study conditions, users overwhelmingly preferred the Flash format to the other 4 formats. Learning occurred equally in all formats. Use of multimedia should be considered as communication strategies are developed for updating cancer content and attracting new users. PMID:14517107

Strickman-Stein, Nancy



Effective physician-patient communication and health outcomes: a review.  

PubMed Central

OBJECTIVE: To ascertain whether the quality of physician-patient communication makes a significant difference to patient health outcomes. DATA SOURCES: The MEDLINE database was searched for articles published from 1983 to 1993 using "physician-patient relations" as the primary medical subject heading. Several bibliographies and conference proceedings were also reviewed. STUDY SELECTION: Randomized controlled trials (RCTs) and analytic studies of physician-patient communication in which patient health was an outcome variable. DATA EXTRACTION: The following information was recorded about each study: sample size, patient characteristics, clinical setting, elements of communication assessed, patient outcomes measured, and direction and significance of any association found between aspects of communication and patient outcomes. DATA SYNTHESIS: Of the 21 studies that met the final criteria for review, 16 reported positive results, 4 reported negative (i.e., nonsignificant) results, and 1 was inconclusive. The quality of communication both in the history-taking segment of the visit and during discussion of the management plan was found to influence patient health outcomes. The outcomes affected were, in descending order of frequency, emotional health, symptom resolution, function, physiologic measures (i.e., blood pressure and blood sugar level) and pain control. CONCLUSIONS: Most of the studies reviewed demonstrated a correlation between effective physician-patient communication and improved patient health outcomes. The components of effective communication identified by these studies can be used as the basis both for curriculum development in medical education and for patient education programs. Future research should focus on evaluating such educational programs. PMID:7728691

Stewart, M A



Mucopolysaccharides in Peripheral Leucocytes of Cancer Patients  

PubMed Central

The presence of mucopolysaccharides (MPS) in leucocytes of peripheral blood of 19 cancer patients, 13 patients with pulmonary tuberculosis and 14 normal controls, was studied histochemically. MPS was revealed in different proportions in polynuclears and mononuclears. According to the staining technics, the MPS appear to be mainly carboxylated and contain hyaluronic acid and chondroitinsulphate groups. The quantitative analysis revealed that MPS appeared only in around 3% of leucocytes of normal controls, while in the cancer patients 56% of polynuclear and 90% of mononuclears contained it. In the tuberculous patients, 90% of polynuclears and 86% of the mononuclears revealed MPS. The differences between the prevalence of leucocytes containing MPS in controls and in cancer or tuberculous patients are highly significant. The possibility that the difference in MPS content of leucocytes is related with low inmunological activity is postulated. PMID:4256006

Riesco, Andres; Leyton, Cecilia



Managing Body Image Difficulties of Adult Cancer Patients: Lessons from Available Research  

PubMed Central

Background Body image is a critical psychosocial issue for cancer patients as they often undergo significant changes to appearance and functioning. In this review article, our primary purpose was to identify empirically-supported approaches to treat body image difficulties of adult cancer patients that can be incorporated into high-quality comprehensive cancer care. Methods We provided an overview of theoretical models of body image relevant to cancer patients, and presented findings from published literature on body image and cancer from 2003–2013. We integrated these data with information from the patient-doctor communication literature to delineate a practical approach for assessing and treating body image concerns of adult cancer patients. Results Body image difficulties were found across patients with diverse cancer sites, and were most prevalent in the immediate postoperative and treatment period. Age, body mass index, and specific cancer treatments have been identified as potential risk factors for body image disturbance in cancer patients. Current evidence supports the use of time-limited cognitive-behavioral therapy interventions for addressing these difficulties. Other intervention strategies also show promise but require further study. We identified potential indicators of body image difficulties to alert healthcare professionals when to refer patients for psychosocial care, and proposed a framework for approaching conversations about body image that can be used by the oncologic treatment team. Conclusions Body image issues affect a wide array of cancer patients. Providers can use available evidence combined with information from the healthcare communication literature to develop practical strategies for treating body image concerns of cancer patients. PMID:24895287

Fingeret, Michelle Cororve; Teo, Irene; Epner, Daniel E.



Delirium in patients with cancer: assessment, impact, mechanisms and management.  


Delirium is a frequent neurocognitive complication in patients with cancer, particularly in patients with advanced-stage disease (in whom a combination of factors might trigger an episode) and in patients with a high degree of predisposing vulnerability, such as the elderly or patients with dementia. The communicative impediments associated with delirium generate distress for the patient and their family, and substantive challenges for health-care practitioners, who might have to contend with agitation, and difficulty in assessing pain and other symptoms. Validated assessment tools exist for screening, diagnosing and monitoring the severity of delirium in cancer care. The level of investigative and therapeutic intervention in a delirium episode is determined by the patient's estimated prognosis and the agreed goals of care. Although delirium is ominously associated with the terminal phase of life, part or complete reversal can be possible depending on the nature of the precipitating factors, and on whether investigation and treatment of these factors is consistent with the established goals of care. Pharmacological treatment for symptom control is indicated for most patients with delirium, and antipsychotics are the drugs of choice, but some patients with refractory and nonreversible delirium can require continuous deep sedation with agents such as midazolam. PMID:25178632

Lawlor, Peter G; Bush, Shirley H



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



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



Effective Nurse Communication With Type 2 Diabetes Patients: A Review.  


Many type 2 diabetes mellitus patients have difficulties reaching optimal blood glucose control. With patients treated in primary care by nurses, nurse communication plays a pivotal role in supporting patient health. The twofold aim of the present review is to categorize common barriers to nurse-patient communication and to review potentially effective communication methods. Important communication barriers are lack of skills and self-efficacy, possibly because nurses work in a context where they have to perform biomedical examinations and then perform patient-centered counseling from a biopsychosocial approach. Training in patient-centered counseling does not seem helpful in overcoming this paradox. Rather, patient-centeredness should be regarded as a basic condition for counseling, whereby nurses and patients seek to cooperate and share responsibility based on trust. Nurses may be more successful when incorporating behavior change counseling based on psychological principles of self-regulation, for example, goal setting, incremental performance accomplishments, and action planning. PMID:24757047

Mulder, Bob C; Lokhorst, Anne Marike; Rutten, Guy E H M; van Woerkum, Cees M J



Nurses' experiences of communicating with hospitalized, suddenly speechless patients.  


We used a qualitative focus group design to explore the experiences and challenges of nurses who work with hospitalized patients experiencing the sudden inability to verbalize their needs, also known as sudden speechlessness. In response to open-ended questions in facilitated focus groups, 18 nurses discussed issues around the care and communication needs of suddenly speechless (SS) patients. Nurses identified multiple, commonly occurring communication challenges when caring for SS patients. They believed these challenges led to poorer recognition of patient needs, with the potential for compromised patient care. Nurses described how the lack of reliable strategies to facilitate communication sometimes resulted in negative patient outcomes, including unmet psychosocial needs and the potential that informed consent and educational issues were being inadequately addressed for the SS patients. Even experienced nurses indicated ongoing problems in communicating with SS patients, despite using a multitude of strategies, leaving many to deal with issues of frustration and role conflict. PMID:25225048

Rodriguez, Carmen S; Spring, Heather J; Rowe, Meredeth



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



Monitoring of opioid therapy in advanced cancer pain patients  

Microsoft Academic Search

Until now, there have not been any parameters to monitor opioid therapy in cancer patients with pain. In this study, 325 consecutive advanced cancer patients were scheduled for a prospective longitudinal survey. After exclusions, 67 patients were surveyed. All included patients were advanced cancer patients with pain that required opioid therapy for more than 6 weeks before death. Opioid escalation,

Sebastiano Mercadante; Gabriella Dardanoni; Leonardo Salvaggio; Maria Gabriella Armata; Antonio Agnello



Pain Management in Cancer Patients  

Microsoft Academic Search

\\u000a Cancer is one of the most debilitating and deadly diseases that, broadly speaking, shows no preference for demographic, sex,\\u000a age, or culture. It is the second leading cause of mortality of all Americans as a single disease [1], and the sheer potential\\u000a for mortality from cancer can be a horrifying experience for anyone bearing this diagnosis. Pain is probably one

Hrachya Nersesyan; Jeffrey J. Mucksavage; Eljim Tesoro; Konstantin V. Slavin


DCCPS: HCIRB: CECCR: Penn’s Center of Excellence in Cancer Communication Research, University of Pennsylvania

Skip Navigation Twitter Multimedia Home About Key Initiatives Funding Resources Tools Cancer Control & Population Sciences Home Behavioral Research Program Home Health Communication and Informatics Research Home Center of Excellence in Cancer Communication


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



Catalyzing Social Support for Breast Cancer Patients  

PubMed Central

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 on the patient’s status, yet updating everyone takes effort that patients cannot always put in. To improve this situation, we describe the results of our participatory design activities with breast cancer patients. During this process, we uncovered the information a social network needs to stay informed as well as a host of barriers to social support that technology could help break down. Our resulting prototype, built using Facebook Connect, includes explicit features to reduce these barriers and thus, promote the healthy outcomes associated with strong social support. PMID:21654894

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



Enhancing Doctor-Patient Communication Using Email: A Pilot Study  

Microsoft Academic Search

Background: The doctor-patient relationship has been eroded by many factors. Would e-mail enhance communication and address some of the barriers inherent to our medical practices? Methods: Of our study population, 4 physicians offered e-mail communication to participating pa- tients and 4 did not. Both patients and physicians completed questionnaires regarding satisfaction, per- ceived quality, convenience, and promptness of the communication.

Shou Ling Leong; Dennis Gingrich; Peter R. Lewis; David T. Mauger; John H. George



Use of the word “cured” for cancer patients—implications for patients and physicians: the Siracusa charter  

PubMed Central

Long-term survival for adult patients with solid tumours continues to increase. For some cancers, the possibility of recurrence after a number of years is extremely low, and the risk of death becomes similar to that of the general population of the same sex and age. During the Fifth European Conference on Survivors and Chronic Cancer Patients held in Siracusa, Italy, June 2014, oncologists, general practitioners, epidemiologists, cancer patients and survivors, and patient advocates joined to discuss the possible use of the term “cured” in reference to some adult patients with solid tumours. The specific focus was the appropriateness of using the term in communicating with cancer patients, survivors, and their families. Initial results of the discussion, in concert with a review of the published literature on the subject, were later further discussed by all participants through electronic communication. The resulting final statement aims to suggest appropriate ways to use the word “cured” in the clinical and communicative setting, to highlight the potential impact of the word on patients, and to open a critical discussion concerning this timely and delicate matter.

Tralongo, P.; Maso, L. Dal; Surbone, A.; Santoro, A.; Tirelli, U.; Sacchini, V.; Pinto, C.; Crispino, S.; Ferraù, F.; Mandoliti, G.; Tonini, G.; Russo, A.; Santini, D.; Madeddu, A.; Panebianco, V.; Pergolizzi, S.; Respini, D.; Rolfo, C.; Bongiovanni, M.; De Lorenzo, F.; Spatola, C.; Di Raimondo, F.; Terenziani, M.; Peeters, M.; Castoro, C.



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

SciTech Connect

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.

Ge Jin [Perelman School of Medicine at University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States)] [Perelman School of Medicine at University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States); Fishman, Jessica [Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States) [Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States); Annenberg School for Communication at University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States); Vapiwala, Neha [Abramson Comprehensive Cancer Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States) [Abramson Comprehensive Cancer Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States); Department of Radiation Oncology, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States); Li, Susan Q.; Desai, Krupali [Department of Family Medicine and Community Health, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States)] [Department of Family Medicine and Community Health, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States); Xie, Sharon X. [Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States)] [Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States); Mao, Jun J., E-mail: [Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States); Abramson Comprehensive Cancer Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States); Department of Family Medicine and Community Health, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States)



Lung cancer in patients under age 40  

Microsoft Academic Search

A retrospective review of patients <40 years (n=91) seen at the Dana-Farber Cancer Institute and Brigham and Women's Hospital from January 1, 1983–January 1, 1993 was carried out. Of 91 patients, there were 43 men and 48 women with a median age of 36 years (range 28–39). Eighty percent of patients were cigarette smokers for a median of 25 pack

Arthur T. Skarin; Roy S. Herbst; Traci L. Leong; Allison Bailey; David Sugarbaker



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



Who is the average patient presenting with prostate cancer?  

Microsoft Academic Search

Prostate cancer screening, diagnosis, and treatment have changed dramatically in the last 20 years. Patients with newly diagnosed prostate cancer have many treatment options available. We attempted to determine how patient demographics and quality of life (QOL) have changed, and we describe the average patient with newly diagnosed prostate cancer in the early 21st century. From the Cancer of the

Kirsten L. Greene; Janet E. Cowan; Matthew R. Cooperberg; Maxwell V. Meng; Janeen DuChane; Peter R. Carroll



Partnering Against Cancer Today: A Blueprint for Coordinating Efforts Through Communication Science  

PubMed Central

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



Health literacy, health communication challenges, and cancer screening among rural native Hawaiian and Filipino women.  


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; Dela Cruz, May Rose; Heo, Hyun-Hee; Braun, Kathryn L



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



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


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



Depression and Anxiety in Colorectal Cancer Patients  

Microsoft Academic Search

Introduction  Cancer has been seen negatively by the people that disclose fear and anxiety face to the disease closely associated with distress,\\u000a aggressive treatments, and death. Colorectal cancer is one of the most prevalent cancer and few assays were developed studying\\u000a depression and anxiety in patients after surgical resection of tumor and before adjuvant therapy.\\u000a \\u000a \\u000a \\u000a \\u000a Aim  This research aims to study the

Marta Medeiros; Celina Tizuko Fujiyama Oshima; Nora Manoukian Forones



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. PMID:25276754

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



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



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



Preoperative hyperthermochemoradiotherapy for patients with rectal cancer.  


Preoperative hyperthermochemoradiotherapy (HCR therapy), consists of a combination of hyperthermia at 42 to 45 degrees C for 40 minutes (2 times per week for two weeks), 5-fluorouracil (5-FU) intravenously (total, 1000 to 1750 mg), and a total of 30 Gy irradiation. The therapy was prescribed preoperatively most recently for 11 patients with rectal cancer. The authors used a radiofrequency system involving an endotract electrode with thermosensors for the hyperthermia. The effectiveness of preoperative HCR therapy was evaluated by irrigography, fiberscopy, and histopathologic findings in the resected specimens. Reduction in tumor size and amount was evident in all patients, with all modes of assessment. Histologically, no or only a few viable cancer cells were seen in the resected specimens in six patients, a small number of viable cancer cells in three, and a fair number of viable cancer cells in two patients; there were no complications. This method of treatment is expected to play an important role in the interdisciplinary treatment for rectal cancer. PMID:2924671

Mori, M; Sugimachi, K; Matsuda, H; Ohno, S; Inoue, T; Nagamatsu, M; Kuwano, H



Patient-Perceived Barriers to the Psychological Care of Japanese Patients with Lung Cancer  

Microsoft Academic Search

Objective: Although cancer patients frequently experience psychological distress, few cancer patients with psychological distress receive appropriate psychological care. The purpose of this study was to investigate the type and frequency of barriers to receive psychological care in patients with lung cancer. Methods: Randomly selected ambulatory patients with lung cancer participated in the study. A self-administered questionnaire developed for this study

Chiharu Endo; Tatsuo Akechi; Toru Okuyama; Takashi Seto; Masashi Kato; Nobuhiko Seki; Kenji Eguchi; Takashi Hosaka; Toshiaki A. Furukawa



Effects of obstetrician gender on communication and patient satisfaction  

Microsoft Academic Search

Objective: To describe patient-obstetrician communication during the first prenatal visit and its relationship to physician gender and patient satisfaction.Methods: The first prenatal visit of 87 women with 21 obstetricians (11 male and ten female) was audiotaped and analyzed using the Roter Interaction Analysis System. Patient satisfaction was measured by postvisit questionnaire.Results: Communication during first prenatal visits was largely biomedical, with

Debra L Roter; Gail Geller; Barbara A Bernhardt; Susan M Larson; Teresa Doksum



Emotion, reason, and communication in coping with cancer.  


Researchers have sought to identify which coping styles are most conducive to recovery from cancer and other serious illnesses. The results have been equivocal. It appears that what helps one patient does not necessarily help another. This article proposes a model explaining how emotional, cognitive, and environmental conditions influence the styles of coping used by cancer patients and the likelihood that particular styles will prove helpful to these patients. The model is based on the premise that coping does not occur in isolation from the emotional makeup, cognitive predispositions, and social environment of the patient. It describes how these processes interact to influence the protective effect of various coping styles. PMID:16371003

Reardon, K K; Buck, R



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


Doctor-patient communication: a skill needed in saudi arabia.  


Doctor-patient communication is a skill essential for the satisfaction of the patients' needs and expectations. It involves an art that every practicing physician should have. The situations in health care delivery that demands good doctor-patient communication are many. Diabetes care, the management of hypertension, explaining serious disease diagnoses, prognosis, and investigative procedures are some of the common situations where good doctor-patient communication is very essential. Doctor-patient communication assumes a special status in Saudi Arabia where as a result of mixed ethnicity of the manpower in the health service and the expatriate community, there is a vast diversity of languages, health traditions and beliefs. The skill of doctor-patient communication can be developed and improved by the application of the principles of the patient-centered approach, the utilization of patient-oriented evidence that matters, and its inclusion in the undergraduate curriculum in the first few years of medical school. There should be continuous medical education programs for practicing doctors on the skills of doctor-patient communication through seminars and workshops. This would be a further step towards the improvement of the consumer's well-being. PMID:23008663

Elzubier, Ahmed G



Cancer Patients’ Understanding of Prognostic Information  

PubMed Central

Prognostic information is necessary for cancer patients to be fully informed about the likely course of their disease. This information is needed for practical planning and treatment decisions. This study sought to examine how cancer patients understand the prognosis information available to them. The setting is an urban safety net hospital. Six focus groups with cancer patients (N=39) were digitally recorded and transcribed verbatim then analyzed using phases of content analysis. Participants in all groups discussed the prognosis almost exclusively in terms of mortality and reported that their physicians and nurses mostly provided prognostic information in terms of months or years for survival. This finding held across all cancer types and stages. Patients tend to think of prognosis information as being only estimated limited survival and find the idea upsetting. Due to this view on prognosis, patients need further explanation regarding where the prognosis information comes from and what prognostic information can tell them in order to make use of it. PMID:24402976

Dumenci, Levent; Siminoff, Laura A.; Matsuyama, Robin K.



Anemia, tumor hypoxemia, and the cancer patient  

SciTech Connect

Purpose: To review the impact of anemia/tumor hypoxemia on the quality of life and survival in cancer patients, and to assess the problems associated with the correction of this difficulty. Methods: MEDLINE searches were performed to find relevant literature regarding anemia and/or tumor hypoxia in cancer patients. Articles were evaluated in order to assess the epidemiology, adverse patient effects, anemia correction guidelines, and mechanisms of hypoxia-induced cancer cell growth and/or therapeutic resistance. Past and current clinical studies of radiosensitization via tumor oxygenation/hypoxic cell sensitization were reviewed. All clinical studies using multi-variate analysis were analyzed to show whether or not anemia and/or tumor hypoxemia affected tumor control and patient survival. Articles dealing with the correction of anemia via transfusion and/or erythropoietin were reviewed in order to show the impact of the rectification on the quality of life and survival of cancer patients. Results: Approximately 40-64% of patients presenting for cancer therapy are anemic. The rate of anemia rises with the use of chemotherapy, radiotherapy, and hormonal therapy for prostate cancer. Anemia is associated with reductions both in quality of life and survival. Tumor hypoxemia has been hypothesized to lead to tumor growth and resistance to therapy because it leads to angiogenesis, genetic mutations, resistance to apoptosis, and a resistance to free radicals from chemotherapy and radiotherapy. Nineteen clinical studies of anemia and eight clinical studies of tumor hypoxemia were found that used multi-variate analysis to determine the effect of these conditions on the local control and/or survival of cancer patients. Despite differing definitions of anemia and hypoxemia, all studies have shown a correlation between low hemoglobin levels and/or higher amounts of tumor hypoxia with poorer prognosis. Radiosensitization through improvements in tumor oxygenation/hypoxic cell sensitization has met with limited success via the use of hyperbaric oxygen, electron-affinic radiosensitizers, and mitomycin. Improvements in tumor oxygenation via the use of carbogen and nicotinamide, RSR13, and tirapazamine have shown promising clinical results and are all currently being tested in Phase III trials. The National Comprehensive Cancer Network (NCCN) guidelines recommend transfusion or erythropoietin for symptomatic patients with a hemoglobin of 10-11 g/dl and state that erythropoietin should strongly be considered if hemoglobin falls to less than 10 g/dl. These recommendations were based on studies that revealed an improvement in the quality of life of cancer patients, but not patient survival with anemia correction. Phase III studies evaluating the correction of anemia via erythropoietin have shown mixed results with some studies reporting a decrease in patient survival despite an improvement in hemoglobin levels. Diverse functions of erythropoietin are reviewed, including its potential to inhibit apoptosis via the JAK2/STAT5/BCL-X pathway. Correction of anemia by the use of blood transfusions has also shown a decrement in patient survival, possibly through inflammatory and/or immunosuppressive pathways. Conclusions: Anemia is a prevalent condition associated with cancer and its therapies. Proper Phase III trials are necessary to find the best way to correct anemia for specific patients. Future studies of erythropoietin must evaluate the possible anti-apoptotic effects by directly assessing the tumor for erythropoietin receptors or the presence of the JAK2/STAT5/BCL-X pathway. Due to the ability of transfusions to cause immunosuppression, most probably through inflammatory pathways, it may be best to study the effects of transfusion with the prolonged use of anti-inflammatory medications.

Varlotto, John [Department of Radiation Oncology, Boston VA Medical Center, Boston, MA (United States) and Department of Radiation Oncology, Beth (Israel) and Deaconess Medical Center, Harvard Medical School, Boston, MA (United States)]. E-mail:; Stevenson, Mary Ann [Department of Radiation Oncology, Boston VA Medical Center, Boston, MA (United States); Department of Radiation Oncology, Beth Israel/Deaconess Medical Center, Harvard Medical School, Boston, MA (United States)



Patients’ experiences of referral for colorectal cancer  

PubMed Central

Background Outcomes for colorectal cancer patients vary significantly. Compared to other countries, Australia has a good record with patient outcomes, yet there is little information available on the referral pathway. This paper explores the views of Australian patients and their experiences of referral for colorectal cancer treatment following diagnosis; the aim was to improve our understanding of the referral pathway and guide the development of future interventions. Methods A purposive sampling strategy was used, recruiting 29 patients representing urban and rural areas from 3 Australian states who participated in 4 focus groups. Seven patients provided individual interviews to supplement the data. Recordings were transcribed verbatim, data was coded with NVivo software and analysed thematically before deductive analysis. Results Four aspects of the referral process were identified by patients, namely detection/diagnosis, referral for initial treatment/specialist care, the roles of the GP/specialist, and the patient’s perceived involvement in the process. The referral process was characterised by a lack of patient involvement, with few examples of shared decision-making and few examples of limited choice. However, patients did not always feel they had the knowledge to make informed decisions. Information exchange was highly valued by patients when it occurred, and it increased their satisfaction with the process. Other factors mediating care included the use of the public versus private health system, the quality of information exchange (GP to specialist and GP to patient), continuity of care between GP and specialist, and the extent of information provision when patients moved between specialist and GP care. Conclusions Patients described poor GP continuity, ad hoc organisational systems and limited information exchange, at both interpersonal and inter-organisational levels, all leading to sub-optimal care. Implementation of a system of information feedback to GPs and engagement with them might improve information exchange for patients, enabling them to be more involved in improved referral outcomes. PMID:23972115



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. PMID:25414902

Adib Hajbaghery, Mohsen; Rezaei Shahsavarloo, Zahra



Cancer Treatment Costs Weigh Heavily on Patients, Study Finds  


... on this page, please enable JavaScript. Cancer Treatment Costs Weigh Heavily on Patients, Study Finds Researchers say ... Cancer FRIDAY, Dec. 19, 2014 (HealthDay News) -- The cost of cancer treatment can cause financial stress that ...


Monitoring care of female breast cancer patients in  

E-print Network

Monitoring care of female breast cancer patients in Northern Ireland diagnosed 2006 (with in Northern Ireland diagnosed 2006 (with comparisons to 1996 & 2001). N. Ireland Cancer Registry 2010 .............................................................................................................. 9 OVERVIEW OF BREAST CANCER IN NORTHERN IRELAND ............................................. 12

Müller, Jens-Dominik


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



Radical cystectomy for bladder cancer: a qualitative study of patient experiences and implications for practice.  


Patients being treated for bladder cancer share issues in common with other cancer patients, but also experience issues that are unique to their surgical treatment. This study used a descriptive qualitative approach to explore the experiences of patients who had undergone radical cystectomy for bladder cancer Twenty-two participants were interviewed in-depth on one occasion and were invited to attend a focus group session following the analysis of the interview transcripts. Participants described the shock of their diagnosis, their lack of information about bladder cancer, the importance of clear communication with care providers, and the types of adjustments they had to make following surgery. Specifically, changes in bodily function, body image, sexual relationships, and intimacy presented challenges for these participants. Although there was a sense of acceptance about the treatment-related events, there were still significant adjustments required by individuals following their surgery. Information, open communication, and support from family and friends were seen as important factors in helping patients adjust after surgery. Patients require clear, concise and consistent information about their cancer, treatment options, and course of care. Nurses caring for patients following surgery for bladder cancer need to understand the unique needs of these patients. PMID:21171541

Fitch, Margaret I; Miller, Debbie; Sharir, Sharon; McAndrew, Alison



Patients’ Barriers to Receipt of Cancer Care, and Factors Associated with Needing More Assistance from a Patient Navigator  

PubMed Central

Background Racial minorities have poorer cancer survival in the United States. The purpose of this study was to better understand patients’ barriers to cancer care, and to determine which patients have a greater need for assistance from a patient navigator. Methods Community health workers assisted newly-diagnosed breast and colorectal cancer patients during a randomized trial of patient navigation, and collected information about patients’ barriers. Barriers to care were characterized, and were compared between non-Hispanic white and minority patients. A multivariate model was constructed of factors associated with increased log Navigation Time, a measure of patients’ need for assistance. Results Patients’ (n=103) most commonly-identified barriers to care included a lack of social support, insurance/financial concerns, and problems communicating with healthcare providers. Barriers differed between non-minority and minority patients, and minority patients faced a greater number of barriers (p=0.0001). In univariate analysis, log Navigation Time was associated with race/ethnicity, education, income, employment, insurance type, health literacy, marital status, language, and comorbidity. A multivariate model (R2=0.43) for log Navigation Time was created using stepwise selection, and included the following factors: minority race/ethnicity (p=0.032), non-full-time employment (p=0.0004), unmarried status (p=0.085), university center (0.0005), and months in study (p<0.0001). Conclusions Newly-diagnosed cancer patients’ most common barriers to care include lack of social support, insurance/financial concerns, and problems with healthcare communications. In this sample of patients, a greater need for assistance was independently associated with minority race/ethnicity and unemployment. These data may help in the design and targeting of interventions to reduce cancer health disparities. PMID:22046847

Hendren, Samantha; Chin, Nancy; Fisher, Susan; Winters, Paul; Griggs, Jennifer; Mohile, Supriya; Fiscella, Kevin



Parenteral nutrition in the elderly cancer patient.  


Parenteral nutrition may be considered when oral intake and/or enteral nutrition are not sufficient to maintain nutritional status and the patient is likely to die sooner from starvation than from the cancer. A detailed assessment should be made prior to the decision about whether parenteral nutrition should be started. A follow up plan should be documented with objective and patient centred treatment goals as well as specific time points for evaluation. PMID:25770329

Orrevall, Ylva



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


Prospective study of bacteraemia in cancer patients  

Microsoft Academic Search

We performed a prospective assessment of the current epidemiology of bacteraemia in cancer patients hospitalized in 70 different\\u000a adult and paediatric haematology and oncology departments. Over a 1-month period, microbiologists from 54 hospitals collected\\u000a clinical data relating to patients with at least one positive blood culture. In addition, all strains isolated were assessed\\u000a for their in vitro susceptibility to three

M. C. Escande; R. Herbrecht



Circulating p53 Antibody in Patients with Colorectal Cancer  

Microsoft Academic Search

The presence of serum anti-p53 antibody has been reported to be associated with survival of patients with breast cancer, ovarian cancer, and hepatocellular carcinoma. To clarify prognostic significance of p53 antibody in colorectal cancer, serum p53 antibody was measured in patients with colorectal cancer. The 89 patients included 71 with colorectal cancer and 18 with colon polyp. An enzyme-linked immunosorbent

Goshi Shiota; Masato Ishida; Naoya Noguchi; Kenji Oyama; Yuji Takano; Michiko Okubo; Shunsuke Katayama; Yasushi Tomie; Kenichi Harada; Kotaro Hori; Kumiyo Ashida; Yosuke Kishimoto; Akihide Hosoda; Takeaki Suou; Takamasa Kanbe; Kiwamu Tanaka; Kimiyasu Nosaka; Osamu Tanida; Haruhiko Kojo; Kunihiko Miura; Hisao Ito; Nobuaki Kaibara; Hironaka Kawasaki



Outcomes Research Branch | Assessing Patients' Experiences of Cancer Care

Two ORB studies have addressed the need for comprehensive, psychometrically sound, cancer-specific measures of patients' experience of and satisfaction with the care they receive during the post-treatment, survivorship phase of the cancer care continuum. The Assessment of Patients' Experience of Cancer Care (APECC) Study, funded as a SEER Rapid Response Surveillance Study (RRSS), developed and pilot tested a survey instrument to assess patients' experiences and satisfaction with care for colorectal cancer, bladder cancer, and leukemia.


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

Harréus, Ulrich



Exercise rehabilitation in patients with cancer.  


Emerging evidence indicates that patients with cancer have considerable impairments in cardiorespiratory fitness, which is likely to be a result of the direct toxic effects of anticancer therapy as well as the indirect consequences secondary to therapy (for example, deconditioning). This reduced cardiorespiratory fitness is associated with heightened symptoms, functional dependence, and possibly with an increased risk of cardiovascular morbidity and mortality. Current understanding of the complex interaction between the effects of the tumour and cancer-associated therapies on the organ components that govern cardiorespiratory fitness, and the effects of exercise training on these parameters is limited; further research will be critical for further progress of exercise-based rehabilitation in the oncology setting. We assess the current evidence regarding the level, mechanisms, and clinical importance of diminished cardiorespiratory fitness in patients with cancer. The efficacy and adaptations to exercise training to prevent and/or mitigate dysfunction in conjunction with exercise prescription considerations for clinical use are also discussed. PMID:22392097

Lakoski, Susan G; Eves, Neil D; Douglas, Pamela S; Jones, Lee W



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



Patient Request for Email Communications Patient Name: Date of Birth  

E-print Network

. There is no assurance of confidentiality when communicating via email. To request that this provider/program communicate be advised that: · This request applies only to the healthcare provider or program that you indicate below will not communicate health information that is specially protected under state and federal law (e.g., HIV

Columbia University


Patient Request for Email Communications Patient Name: _____________________________ Date of Birth: _____________________________  

E-print Network

. There is no assurance of confidentiality when communicated via email. To request that this provider/program communicate be advised that: (1) This request applies only to the healthcare provider or program that you indicate below will not communicate health information that is specially protected under state and federal law (e.g., HIV

Qian, Ning


Patient Request for Email Communications Patient Name: _____________________________ Date of Birth: _____________________________  

E-print Network

. There is no assurance of confidentiality when communicating via email. To request that this provider/program communicate be advised that: This request applies only to the healthcare provider or program that you indicate below will not communicate health information that is specially protected under state and federal law (e.g., HIV

Grishok, Alla


Bone scan in the breast cancer patient  

Microsoft Academic Search

The demonstration of pathology in the breast with technetium 99m diphosphonate scans together with the well established value of demonstrating bony lesions that may not be apparent by x-ray constitutes reason for obtaining 99m technetium phosphonate bone scans pre-operatively on patients in whom breast cancer surgery is being considered.




Fewer Patients with Advanced Colon Cancer Getting Surgery, Report Finds  


... features on this page, please enable JavaScript. Fewer Patients With Advanced Colon Cancer Getting Surgery, Report Finds ... 14, 2015 (HealthDay News) -- Fewer U.S. colon cancer patients who are diagnosed in the final stages of ...


Skipping Surgery May Work for Some Rectal Cancer Patients  


... Skipping Surgery May Work for Some Rectal Cancer Patients: Study Researchers found just chemo/radiation was as ... 12, 2015 (HealthDay News) -- For many rectal cancer patients, the prospect of surgery is a worrisome reality, ...


Cancer Patients Prefer Care That Includes Their Input  


... features on this page, please enable JavaScript. Cancer Patients Prefer Care That Includes Their Input But whether ... Doctor THURSDAY, Feb. 12, 2015 (HealthDay News) -- Cancer patients who let their doctors make all the decisions ...


Colon Cancer Biomarkers To Identify Patients Suitable For Therapeutic Intervention

NCI investigators have identified an inflammatory gene and microRNA biomarker portfolio that can predict aggressive colon cancer, colon cancer patient survival, and patients that are candidates for adjuvant therapy.


Functional health literacy and the quality of physician–patient communication among diabetes patients  

Microsoft Academic Search

While patients with poor functional health literacy (FHL) have difficulties reading and comprehending written medical instructions, it is not known whether these patients also experience problems with other modes of communication, such as face-to-face encounters with primary care physicians. We enrolled 408 English- and Spanish-speaking diabetes patients to examine whether patients with inadequate FHL report worse communication than patients with

Dean Schillinger; Andrew Bindman; Frances Wang; Anita Stewart; John Piette



Functional health literacy and the quality of physician-patient communication among diabetes patients  

Microsoft Academic Search

While patients with poor functional health literacy (FHL) have difficulties reading and comprehending written medical instructions, it is not known whether these patients also experience problems with other modes of communication, such as face-to-face encounters with primary care physicians. We enrolled 408 English- and Spanish-speaking diabetes patients to examine whether patients with inadequate FHL report worse communication than patients with

Dean Schillinger; Andrew Bindmana; Frances Wang; Anita Stewart; John Piette



The evolving concept of "patient-centeredness" in patient-physician communication research.  


Over the past few decades, the concept of "patient-centeredness" has been intensively studied in health communication research on patient-physician interaction. Despite its popularity, this concept has often been criticized for lacking a unified definition and operationalized measurement. This article reviews how health communication research on patient-physician interaction has conceptualized and operationalized patient-centered communication based on four major theoretical perspectives in sociology (i.e., functionalism, conflict theory, utilitarianism, and social constructionism), and discusses the agenda for future research in this field. Each theory addresses different aspects of the patient-physician relationship and communication from different theoretical viewpoints. Patient-centeredness is a multifaceted construct with no single theory that can sufficiently define the whole concept. Different theoretical perspectives of patient-centered communication can be selectively adopted according to the context and nature of problems in the patient-physician relationship that a particular study aims to explore. The present study may provide a useful framework: it offers an overview of the differing models of patient-centered communication and the expected roles and goals in each model; it does so toward identifying a communication model that fits the patient and the context and toward theoretically reconstructing existing measures of patient-centered communication. Furthermore, although patient-centered communication has been defined mainly from the viewpoint of physician's behaviors aimed at achieving patient-centered care, patient competence is also required for patient-centered communication. This needs to be examined in current medical practice. PMID:24034962

Ishikawa, Hirono; Hashimoto, Hideki; Kiuchi, Takahiro



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



Development of a Question Prompt List as a Communication Intervention to Reduce Racial Disparities in Cancer Treatment  

PubMed Central

Racial disparities have been found in the use of chemotherapy as cancer treatment. These disparities may be, in part, due to well-documented differences in the quality of communication during clinical interactions with oncologists and Black versus White patients. In this study using a Community-Based Participatory Research (CBPR) approach, academic researchers, community members, and oncologists formed a partnership to develop a communication intervention to address racial disparities in cancer care. Partners developed a Question Prompt List (QPL), a simple tool that can be used to improve communication, and thus treatment, during clinical interactions in which oncologists and Black patients discuss chemotherapy. Partners endorsed the use of a QPL, provided specific suggestions for content and format, conducted and analyzed qualitative interviews with Black patients receiving chemotherapy, and approved the final version. The feasibility and effectiveness of the QPL that resulted from this research process are currently under evaluation in a separate study. PMID:23440665

Eggly, Susan; Tkatch, Rifky; Penner, Louis A.; Mabunda, Lorna; Hudson, Janella; Chapman, Robert; Griggs, Jennifer J.; Brown, Richard; Albrecht, Terrance



The influence of cancer impact on patients’ preparatory grief  

Microsoft Academic Search

The aims of this study were to investigate the preparatory grief and traumatic distress in advanced cancer patients in a palliative care unit. A total of 94 advanced cancer patients completed the Preparatory Grief in Advanced Cancer Patients (PGAC) scale and the Greek version of the Impact of Events Scale- Revised (IES-R-Gr). The Eastern Cooperative Oncology Group was used to

Eleni Tsilika; Kyriaki Mystakidou; Efi Parpa; Antonis Galanos; Pavlos Sakkas; Lambros Vlahos



Incidental venous thromboembolism in ambulatory cancer patients receiving chemotherapy  

Microsoft Academic Search

While the association between cancer and symptomatic venous thromboembolism (VTE) is well established, the incidence and risk factors for incidental VIE in cancer patients remain unclear The medical records of 1,921 consecutive cancer patients starting chemotherapy from January 2003 up to March 2009 were identified Patients with a positive history of VTE were excluded Pre existing signs of VIE, kind

M. Di Nisio; N. Ferrante; M. De Tursi; S. Iacobelli; F. Cuccurullo; H. R. Büller; B. Feragalli; E. Porreca



The Role of Hope in Patients With Cancer  

Microsoft Academic Search

® , CINAHL ® , and PsycINFO databases. Data Synthesis: Twenty-six research articles published from 1982-2005 met the criteria for review. Four major themes emerged: (a) exploring the level of hope in patients with cancer, (b) discovering how patients cope with a cancer diagnosis, (c) identifying strategies that patients with cancer commonly use to maintain hope, and (d) identifying nursing

Grace Chu-Hui-Lin Chi



The Factors Contributing to Death Anxiety in Cancer Patients  

Microsoft Academic Search

Suffering comes in many ways for patients confronting cancer. One of these is an unspecifiable fear about death, which is an existential issue. The aim of this study was to investigate the relationship between death anxiety and its correlates in cancer patients. Seventy cancer patients were assessed using SCID-I, Templer's Death Anxiety Scale, the Hospital Anxiety (A) and Depression (D)

Gokcen Gonen; Semra Ulusoy Kaymak; Eylem Sahin Cankurtaran; Ersin Hatice Karslioglu; Elvan Ozalp; Haldun Soygur




Microsoft Academic Search

Suffering comes in many ways for patients confronting cancer. One of these is an unspecifiable fear about death, which is an existential issue. The aim of this study was to investigate the relationship between death anxiety and its correlates in cancer patients. Seventy cancer patients were assessed using SCID-I, Templer's Death Anxiety Scale (DAS), the Hospital Anxiety (A) and Depression

Gokcen Gonen; Semra Ulusoy Kaymak; Eylem Sahin Cankurtaran; Ersin Hatice Karslioglu; Elvan Ozalp; Haldun Soygur



Sexuality and fertility in urologic cancer patients.  


With the advent of effective treatment for urologic cancer, the preservation of sexual function and fertility has become an important goal. Some cancer treatments damage the physiological systems involved in reproduction. All have a psychological impact on sexuality. For men with prostate cancer, current issues in sexual rehabilitation include the debate on nerve-sparing radical prostatectomy, the role of vascular damage in causing erectile dysfunction after radiotherapy, and the need for a better understanding of hormonal effects on central and peripheral mechanisms of sexual function. In the treatment of men and women with bladder cancer, the sexual function morbidity of radical cystectomy is described in data from prospective interview studies. Sexual desire and orgasm remain normal after surgery despite disruption of the genital vasocongestion accompanying sexual arousal. Long-term follow-up studies of testicular cancer patients suggest that some increase in sexual dysfunction does occur. Infertility remains a concern for a subgroup of younger, childless men. Attempts to modify or eliminate retroperitoneal lymphadenectomy are discussed, as is recovery of spermatogenesis after chemotherapy and radiotherapy. Sexual function in patients with penile, urethral, or renal cell carcinoma is briefly reviewed. PMID:3036334

Schover, L R



Distress in Older Patients With Cancer  

PubMed Central

Purpose To determine the predictors of distress in older patients with cancer. Patients and Methods Patients age ? 65 years with a solid tumor or lymphoma completed a questionnaire that addressed these geriatric assessment domains: functional status, comorbidity, psychological state, nutritional status, and social support. Patients self-rated their level of distress on a scale of zero to 10 using a validated screening tool called the Distress Thermometer. The relationship between distress and geriatric assessment scores was examined. Results The geriatric assessment questionnaire was completed by 245 patients (mean age, 76 years; standard deviation [SD], 7 years; range, 65 to 95 years) with cancer (36% stage IV; 71% female). Of these, 87% also completed the Distress Thermometer, with 41% (n = 87) reporting a distress score of ? 4 on a scale of zero to 10 (mean score, 3; SD, 3; range, zero to 10). Bivariate analyses demonstrated an association between higher distress (? 4) and poorer physical function, increased comorbid medical conditions, poor eyesight, inability to complete the questionnaire alone, and requiring more time to complete the questionnaire. In a multivariate regression model based on the significant bivariate findings, poorer physical function (increased need for assistance with instrumental activities of daily living [P = .015] and lower physical function score on the Medical Outcomes Survey [P = .018]) correlated significantly with a higher distress score. Conclusion Significant distress was identified in 41% of older patients with cancer. Poorer physical function was the best predictor of distress. Further studies are needed to determine whether interventions that improve or assist with physical functioning can help to decrease distress in older adults with cancer. PMID:19652074

Hurria, Arti; Li, Daneng; Hansen, Kurt; Patil, Sujata; Gupta, Ravi; Nelson, Christian; Lichtman, Stuart M.; Tew, William P.; Hamlin, Paul; Zuckerman, Enid; Gardes, Jonathan; Limaye, Sewanti; Lachs, Mark; Kelly, Eva



Metastatic breast cancer in patients with schizophrenia  

PubMed Central

Breast cancer is a major health problem worldwide. The median survival duration for patients with metastatic breast cancer is two to three years. Approximately 1% of populations worldwide have schizophrenia. The manner in which schizophrenic patients fare when diagnosed with metastatic breast carcinoma (MBC) was evaluated. We queried the National Department of Veterans Affairs (DVA) datasets using computer codes for a pre-existing diagnosis of schizophrenia and a later diagnosis of breast carcinoma. Chart-based data concerning the identified subjects were then requested. Previously determined inclusion and exclusion criteria were applied to select evaluable patients from the medical records, prior to extracting demographic details and data concerning the treatment course in each subject. Ten patients had distant metastases at initial diagnosis, while seven developed MBC following prior curative-intent treatment. Two patients refused therapy. Ten did not comply with recommended management. Five harmed or threatened physicians, other caregivers or themselves. Schizophrenic patients with MBC often fail to understand the nature of their illnesses. Often they do not accept palliative treatment, while a number of them do not comply with therapy, once initiated. They often exhibit behaviors that are detrimental to themselves or others. Formal psychiatric consultation is therefore necessary in patients. Several detrimental behaviors may be predicted reliably by history alone. PMID:24649175




Arm edema in breast cancer patients.  


The improvement in the life expectancy of women with breast cancer raises important questions about how to improve the quality of life for women sustaining complications of breast cancer treatment. In particular, attention to common problems, such as arm edema, is of critical importance. We reviewed published breast cancer guidelines and literature identified via MEDLINE(R) searches in an effort to summarize the research literature pertinent to management of breast cancer-related arm edema, including incidence, prevalence, and timing; risk factors; morbidity; prevention; diagnosis; and efficacy of nonpharmacologic and pharmacologic interventions. We found that arm edema is a common complication of breast cancer therapy that can result in substantial functional impairment and psychological morbidity. The risk of arm edema increases when axillary dissection and axillary radiation therapy are used. Recommendations for preventive measures, such as avoidance of trauma, are available, but these measures have not been well studied. Nonpharmacologic treatments, such as massage and exercise, have been shown to be effective therapies for lymphedema, but the effect of pharmacologic interventions remains uncertain. Comparing results across studies is complicated by the fact that the definitions of interventions and measures of outcomes and risk stratification vary substantially among studies. As arm edema becomes more prevalent with the increasing survival of breast cancer patients, further research is needed to evaluate the efficacy of preventive strategies and therapeutic interventions. PMID:11208879

Erickson, V S; Pearson, M L; Ganz, P A; Adams, J; Kahn, K L



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.



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

PubMed Central

Objective Cancer patients have high levels of distress, yet oncologists often do not recognize patients’ concerns. We sought to describe how patients with advanced cancer verbally express negative emotion to their oncologists. Materials and methods As part of the Studying Communication in Oncologist–Patient Encounters Trial, we audio-recorded 415 visits that 281 patients with advanced cancer made to their oncologists at three US cancer centers. Using qualitative methodology, we coded for verbal expressions of negative emotion, identified words patients used to express emotion, and categorized emotions by type and content. Results Patients verbally expressed negative emotion in 17% of the visits. The most commonly used words were: “concern,” “scared,” “worried,” “depressed,” and “nervous.” Types of emotion expressed were: anxiety (46%), fear (25%), depression (12%), anger (9%), and other (8%). Topics about which emotion was expressed were: symptoms and functional concerns (66%), medical diagnoses and treatments (54%), social issues (14%), and the health care system (9%). Although all patients had terminal cancer, they expressed negative emotion overtly related to death and dying only 2% of the time. Conclusions Patients infrequently expressed negative emotion to their oncologists. When they did, they typically expressed anxiety and fear, indicating concern about the future. When patients use emotionally expressive words such as those we described, oncologists should respond empathically, allowing patients to express their distress and concerns more fully. PMID:17960430

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



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



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.


Family Survivorship for Patients with Cancer: Existing Knowledge and Future Directions - Office of Cancer Survivorship

Cancer is a family issue; 66 percent of patients diagnosed with cancer will need family care. Despite this, there is little research describing caregivers' roles and duties and the impact cancer has on them.


Quality of doctor-patient communication through the eyes of the patient: variation according to the patient's educational level.  


Good doctor-patient communication may lead to better compliance, higher patient satisfaction, and finally, better health. Although the social variance in how physicians and patients communicate is clearly demonstrated, little is known about what patients with different educational attainments actually prefer in doctor-patient communication. In this study we describe patients' perspective in doctor-patient communication according to their educational level, and to what extent these perspectives lean towards the expert opinion on doctor-patient communication. In a multi-center study (Belgium, The Netherlands, UK and Italy), focus group discussions were organised using videotaped medical consultations. A mixed methods approach was used to analyse the data. Firstly, a difference in perspective in communication style was found between the lower educated participants versus the middle and higher educated participants. Secondly, lower educated participants referred positively most to aspects related to the affective/emotional area of the medical consultation, followed by the task-oriented/problem-focused area. Middle and higher educated participants positively referred most to the task-oriented/problem-focused area. The competency of the physician was an important category of communication for all participants, independent of social background. The results indicate that the preferences of lower educated participants lean more towards the expert opinion in doctor-patient communication than the middle and higher educated participants. Patients' educational level seems to influence their perspective on communication style and should be taken into account by physicians. Further quantitative research is needed to confirm these results. PMID:25428194

Aelbrecht, Karolien; Rimondini, Michela; Bensing, Jozien; Moretti, Francesca; Willems, Sara; Mazzi, Mariangela; Fletcher, Ian; Deveugele, Myriam



Prostate cancer in the elderly patient.  


Treatment for prostate cancer (PCa) has evolved significantly over the last decade. PCa is the most prevalent non-skin cancer and the second leading cause of cancer death in men, and it has an increased incidence and prevalence in older men. As a result, physicians and patients are faced with the challenge of identifying optimal treatment strategies for localized, biochemical recurrent, and advanced PCa in the older population. When older patients are appropriately selected, treatment for PCa results in survival benefits and toxicity profiles similar to those experienced in younger patients. However, underlying health status and age-related changes can have an impact on tolerance of hormonal therapy and chemotherapy in men with advanced disease. Therefore, the heterogeneity of the elderly population necessitates a multidimensional assessment to maximize the benefit of medical and/or surgical options. Providing clinicians with the requisite health status data on which to base treatment decisions would help ensure that older patients with PCa receive optimal therapy if it will benefit them and/or active surveillance or best supportive care if it will not. We provide a review of the existing evidence to date on the management of PCa in the older population. PMID:25071137

Fung, Chunkit; Dale, William; Mohile, Supriya Gupta



Cancer surviving patients' rehabilitation – understanding failure through application of theoretical perspectives from Habermas  

Microsoft Academic Search

This study aims to analyze whether the rehabilitation of cancer surviving patients (CSPs) can be better organized. The data for this paper consists of focus group interviews (FGIs) with CSPs, general practitioners (GPs) and hospital physicians. The analysis draws on the theoretical framework of Jürgen Habermas, utilizing his notions of 'the system and the life world' and 'communicative and strategic

Thorbjørn H Mikkelsen; Jens Soendergaard; Anders B Jensen; Frede Olesen



Cost Concerns of Patients With Cancer  

PubMed Central

Purpose: Health care providers are accustomed to identifying populations for whom cost-related concerns may be a significant barrier, such as the poor, but few empiric data have been collected to substantiate such assumptions, particularly among insured patients. Methods: Patients with cancer from academic and community hospitals completed a questionnaire that included closed-ended items concerning demographic variables, optimism, numeracy, and concerns about present and future medical costs. In addition, they answered open-ended questions regarding cost concerns and medical expenses. Results: Nearly all (99%) participants were insured. In response to the closed-ended questions, 30.3% of patients reported concern about paying for their cancer treatment, 22.3% reported that their family had made sacrifices to pay for their care, and 8.3% stated that their insurance adequately covered their current health care costs, and 17.3% reported concerns about coverage for their costs in the future. On open-ended questions, 35.3% reported additional expenses, and 47.5% reported concerns about health care costs. None of the assessed patient characteristics proved to be a robust predictor across all cost-related concerns. There was a strong association between the identification of concerns or expenses on the open-ended questions and concerns on closed-ended questions. Conclusion: Cost concerns are common among patients with cancer who have health insurance. Health care providers may alleviate concerns by discussing cost-related concerns with all patients, not only those of lower socioeconomic status or those without insurance. A closed-ended screening question may help to initiate these conversations. This may identify potential resources, lower distress, and enable patients to make optimal treatment decisions. PMID:23943901

Stump, Tammy K.; Eghan, Naa; Egleston, Brian L.; Hamilton, Olivia; Pirollo, Melanie; Schwartz, J. Sanford; Armstrong, Katrina; Beck, J. Robert; Meropol, Neal J.; Wong, Yu-Ning



Public figure announcements about cancer and opportunities for cancer communication: a review and research agenda.  


Announcements by public figures and celebrities about cancer diagnosis or death represent significant events in public life. But what are the substantive effects of such events, if any? The purpose of this article is to systematically review studies that examined the impact of public figure cancer announcements on cancer-oriented outcomes. Using comprehensive search procedures, we identified k = 19 studies that examined 11 distinct public figures. The most commonly studied public figures were Jade Goody, Kylie Minogue, Nancy Reagan, and Steve Jobs, with the most common cancers studied being breast (53%), cervical (21%), and pancreatic (21%) cancer. Most studies assessed multiple outcome variables, including behavioral outcomes (k = 15), media coverage (k = 10), information seeking (k = 8), cancer incidence (k = 3), and interpersonal communication (k = 2). Results fairly consistently indicated that cancer announcements from public figures had meaningful effects on many, if not most, of these outcome variables. While such events essentially act as naturally occurring interventions, the effects tend to be relatively short term. Gaps in this literature include few contemporary studies of high-profile public figures in the United States and a general lack of theory-based research. Directions for future research as well as implications for cancer communication and prevention are discussed. PMID:23845155

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



Deciding what information is necessary: do patients with advanced cancer want to know all the details?  

PubMed Central

Communicating effectively with patients who have advanced cancer is one of the greatest challenges facing physicians today. Whilst guiding the patient through complex diagnostic and staging techniques, treatment regimens and trials, the physician must translate often imprecise or conflicting data into meaningful personalized information that empowers the patient to make decisions about their life and body. This requires understanding, compassion, patience, and skill. This narrative literature review explores current communication practices, information preferences of oncology patients and their families, and communication strategies that may assist in these delicate interactions. Overwhelmingly, the literature suggests that whilst the majority of patients with advanced cancer do want to know their diagnosis and receive detailed prognostic information, this varies not only between individuals but also for a given individual over time. Barriers to the delivery and understanding of information exist on both sides of the physician–patient relationship, and family dynamics are also influential. Despite identifiable trends, the information preferences of a particular patient cannot be reliably predicted by demographic, cultural, or cancer-specific factors. Therefore, our primary recommendation is that the physician regularly asks the patient what information they would like to know, who else should be given the information and be involved in decision making, and how that information should be presented. PMID:21792328

Russell, Bethany J; Ward, Alicia M



Informing the cancer patient and family.  


One of the questions the therapist poses himself while informing a patient is: whom shall I inform about the diagnosis, treatment and prognosis? If we unconditionally accepted the view that information belongs to the patient from an ethical and legal standpoint, we would automatically exclude the partner and the family. Therefore, the therapist should raise another question: what is the benefit to the patient? To answer the question and the resulting dilemma, we have to leverage the long experience of family therapy and tailor it to the cases we are dealing with. It should be taken into consideration that patient and family are a dynamic system which was balanced before the onset of the disease, but is now disrupted, entering into crisis. Therefore, denial mechanism and personality characteristics we have previously elaborated on, and communication among members play a crucial role in determining the information strategy and the way family should be approached. The steps to approach the patient - family are: 1) Firstly, we evaluate the patient's degree of denial and personality characteristics. Then we receive information about the patient's family so that we can have a rough idea about intrafamily dynamics. 2) Then we gather information from the nurses about the family atmosphere: simple information about the patient's and relatives' relationship like who comes to the hospital, who shows interest in the patient, whether someone is being quarrelsome or not are crucial to assess the dynamics of their relationships. 3) We summon patient and family members in our office. 4) We decide on the steps to inform the patient, and we apply them. Involving family members with the patient seems to improve the results of information and forge concession and therapeutic alliance, which are necessary parameters in the therapeutic follow-up. Usually, doctors and nurses approach patient and family using their experience. Therefore, we need a training that will equip health professionals with the necessary knowledge to approach the family. PMID:19365879

Kallergis, G



Elevated serum ribonuclease in patients with pancreatic cancer.  

PubMed Central

Serum RNase (ribonuclease) of normal persons and of patients with pancreatitis, carcinoma of pancreas, or other neoplasms was determined with poly(C) as substrate. Strikingly abnormal elevations occur in the serum RNase of patients with pancreatic cancer. There is no elevation in the serum RNase level of patients with pancreatitis. Average serum RNase values of 52 normal persons, 10 patients with pancreatitis, 30 patients with pancreatic cancer, 28 patients with breast cancer, 11 patients with lung cancer, 20 patients with colon cancer, six patients with stomach cancer, and four patients with liver cancer, respectively, were 104, 120, 383, 131, 173, 197, 194, and 152 units/ml of serum. Ninety percent of the patients with pancreatic cancer were above the level of 250 units of serum and 90% of all patients with varied cancers were below this level. In the presence of severe renal insufficiency, marked elevation of serum RNase was also observed. Serum RNase, because of its unique specificity, pancreatic origin, and its abnormal elevation in sera of patients with pancreatic cancer, serves as a reliable biochemical marker of carcinoma of the pancreas in the presence of normal renal function. PMID:1065880

Reddi, K K; Holland, J F



Why breast cancer patients seek traditional healers.  


Traditional healing is a common practice in low and middle income countries such as Malaysia. Eighty percent of Malaysians consult traditional healers or "bomoh" at some time in their life for health-related issues. The purpose of our study was to explore why breast cancer patients visit traditional healers. This is a qualitative study utilizing in-depth interviews with 11 cancer survivors who sought both traditional and Western medicine. The findings revealed the following reasons for which patients seek traditional healers: (1) recommendation from family and friends, (2) sanction from family, (3) perceived benefit and compatibility, (4) healer credibility, and (5) reservation with Western medicine and system delay. These factors work together and are strongly influenced by the Malaysian cultural context. The issue with the Western health system is common in a developing country with limited health facilities. PMID:22295249

Muhamad, Mazanah; Merriam, Sharan; Suhami, Norhasmilia



Why Breast Cancer Patients Seek Traditional Healers  

PubMed Central

Traditional healing is a common practice in low and middle income countries such as Malaysia. Eighty percent of Malaysians consult traditional healers or “bomoh” at some time in their life for health-related issues. The purpose of our study was to explore why breast cancer patients visit traditional healers. This is a qualitative study utilizing in-depth interviews with 11 cancer survivors who sought both traditional and Western medicine. The findings revealed the following reasons for which patients seek traditional healers: (1) recommendation from family and friends, (2) sanction from family, (3) perceived benefit and compatibility, (4) healer credibility, and (5) reservation with Western medicine and system delay. These factors work together and are strongly influenced by the Malaysian cultural context. The issue with the Western health system is common in a developing country with limited health facilities. PMID:22295249

Muhamad, Mazanah; Merriam, Sharan; Suhami, Norhasmilia



E-Cigarettes and Cancer Patients  

PubMed Central

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

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



Fertility preservation in young patients' with cancer.  


Preservation of fertility is an important issue in the management of young cancer patients. Though embryo cryostorage is a well-established procedure, it can only be availed by couples. Recent studies have indicated increasing success rates with mature and immature oocyte cryopreservation. Cryostorage induces injuries on the human oocytes which can be minimized by slow freezing and vitrification. Selection of candiidates is crucial so that the most suitable technique can be offered without any delay in initiation of cancer therapy. Factors affecting suitability are age of patient, assessment of ovarian reserve, hormonal status and type and stage of neoplastic disease. Encouraging results have been obtained with oocyte in vitro maturation (IVM) followed by vitrification for cryostorage. Data on the use of vitrified eggs in routine in vitro fertilization (IVF) show that pregnancy rates can be comparable to those achieved with fresh oocytes. PMID:25540565

Dudani, Sharmila; Gupta, Apurva



Fertility preservation in young patients’ with cancer  

PubMed Central

Preservation of fertility is an important issue in the management of young cancer patients. Though embryo cryostorage is a well-established procedure, it can only be availed by couples. Recent studies have indicated increasing success rates with mature and immature oocyte cryopreservation. Cryostorage induces injuries on the human oocytes which can be minimized by slow freezing and vitrification. Selection of candiidates is crucial so that the most suitable technique can be offered without any delay in initiation of cancer therapy. Factors affecting suitability are age of patient, assessment of ovarian reserve, hormonal status and type and stage of neoplastic disease. Encouraging results have been obtained with oocyte in vitro maturation (IVM) followed by vitrification for cryostorage. Data on the use of vitrified eggs in routine in vitro fertilization (IVF) show that pregnancy rates can be comparable to those achieved with fresh oocytes. PMID:25540565

Dudani, Sharmila; Gupta, Apurva



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



Effect of yoga on patients with cancer  

PubMed Central

Abstract Objective To determine whether therapeutic yoga improves the quality of life of patients with cancer. Data sources Search of MEDLINE database (1950–2010) using key words yoga, cancer, and quality of life. Study selection Priority was given to randomized controlled clinical studies conducted to determine the effect of yoga on typical symptoms of patients with cancer in North America. Synthesis Initially, 4 randomized controlled clinical studies were analyzed, then 2 studies without control groups were analyzed. Three studies conducted in India and the Near East provided interesting information on methodologies. The interventions included yoga sessions of varying length and frequency. The parameters measured also varied among studies. Several symptoms improved substantially with yoga (higher quality of sleep, decrease in symptoms of anxiety and depression, improvement in spiritual well-being, etc). It would appear that quality of life, or some aspects thereof, also improved. Conclusion The variety of benefits derived, the absence of side effects, and the cost-benefit ratio of therapeutic yoga make it an interesting alternative for family physicians to suggest to their patients with cancer. Certain methodologic shortcomings, including the limited size of the samples and varying levels of attendance on the part of the subjects, might have reduced the statistical strength of the studies presented. It is also possible that the measurement scales used did not suit this type of situation and patient population, making it impossible to see a significant effect. However, favourable comments by participants during the studies and their level of appreciation and well-being suggest that further research is called for to fully understand the mechanisms of these effects. PMID:22972739

Côté, Andréanne; Daneault, Serge



Pharmacology of amygdalin (laetrile) in cancer patients  

Microsoft Academic Search

Plasma and urine concentrations of amygdalin, whole-blood concentrations of cyanide, and thiocyanate concentrations in serum and urine were determined in cancer patients following intravenous (4.5 g\\/m2) and oral (500-mg tablet) administration of amygdalin. To measure low plasma concentrations of amygdalin following oral administration a GC\\/MS assay was developed. Following intravenous administration, concentrations of parent drug as high as 1,401 µg\\/ml

Matthew M. Ames; Thomas P. Moyer; John S. Kovach; Charles G. Moertel; Joseph Rubin



Managing breathlessness in patients with lung cancer.  


Breathlessness is one of the most common and difficult symptoms to manage in advanced cancer. Despite the development of non-pharmacological interventions and a shift away from a medical approach to its management, symptom control remains suboptimal. Practitioners need education and support to deliver the best possible care for patients experiencing breathlessness. This article provides an overview of the interventions available to improve quality of life for these patients and explores the need for greater implementation of non-pharmacological interventions. PMID:23488372

Cairns, Lindsay


Potential for drug interactions in hospitalized cancer patients  

Microsoft Academic Search

Objectives: To quantify the frequency of po- tential drug interactions unrelated to chemotherapy in cancer patients admitted to our institution, and to define risk factors for such interactions. Methods: Charts of 100 consecutive hospitalized cancer patients were re- viewed. Patients receiving chemotherapy and\\/or hor- mone therapy were excluded, as were patients admitted for intensive care. Drug-drug interactions were screened with

Rachel Pimenta Riechelmann; Frederico Moreira; Òren Smaletz; Everardo D. Saad



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



Interrelation between Patient Satisfaction and Patient-Provider Communication in Diabetes Management  

PubMed Central

The present study aims to assess how patient satisfaction with medical provider-patient communication can affect oral health, diabetes, and psychobehavioural measures among type 2 diabetes (T2DM) patients. It is part of a prospective intervention study among randomly selected T2DM patients, in Turkey. The data analyzed were Community Periodontal Need Index (CPI), HbA1c, patient satisfaction with communication, and psychobehavioural variables. Data was collected initially and at the end of the intervention. The participants were allocated to either health coaching (HC) or health education (HE). At baseline, there were no statistical differences between the HC and the HE groups on any of the measures (P > 0.05). Patients in both the HC and the HE groups had low satisfaction with communication. At postintervention, the increase in patient satisfaction with communication in the HC group was significantly higher than that in the HE group (P = 0.001). Principal component analysis revealed that patient satisfaction with communication shared the same cluster with clinical measures (CPI and HbA1c) and quality of life in the HC group. In conclusion, the present study showed, to our knowledge for the first time, that overall patient satisfaction with medical care provider-patient communication, empowered by HC approach, was interrelated with well-being of T2DM patients, in terms of psychobehavioural and clinical measures. PMID:25614885

Cinar, Ayse Basak; Schou, Lone



Survivorship in untreated breast cancer patients.  


In any disease, the knowledge of the natural history of untreated cases provides a real background against which the real advantages of a new treatment itself are judged. Fortunately, in the present days, there are scant data on outcomes in patients with untreated breast cancer. In an attempt to provide this background against which the virtues of current curative and palliative treatments can be more accurately assessed, we have reviewed the literature regarding published untreated breast cancer series. Taking into consideration all the difficulties of analyzing reports written on the last half of the nineteenth century or on the first half of the twentieth century, in most reports, patients survived almost 3-4 years without any type of treatment. Worth mentioning, approximately 5-10 % of untreated patients lived longer than 10 years. Thus, the spectrum of clinical aggressiveness of untreated breast cancer varies between virulence and chronic disease. These facts should be taken into account when considering the value of current treatments for early-stage disease. PMID:25588926

Galmarini, Carlos M; Tredan, Olivier; Galmarini, Felipe C



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.



Understanding Your Cancer Prognosis  

MedlinePLUS Videos and Cool Tools

... is also a national expert in doctor-patient communication share their perspectives on their cancer prognoses. Learn ... how to discuss prognosis with their patients. Good communication, he says, is part of providing good care. ...


Dancing Around Death: Hospitalist-Patient Communication About Serious Illness  

PubMed Central

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



Hazard function for cancer patients and cancer cell dynamics.  


The aim of the paper is to develop a procedure for an estimate of an analytical form of a hazard function for cancer patients. Although a deterministic approach based on cancer cell population dynamics yields the analytical expression, it depends on several parameters which should be estimated. On the other hand, a kernel estimate is an effective nonparametric method for estimating hazard functions. This method provides the pointwise estimate of the hazard function. Our procedure consists of two steps: in the first step we find the kernel estimate of the hazard function and in the second step the parameters in the deterministic model are obtained by the least squares method. A simulation study with different types of censorship is carried out and the developed procedure is applied to real data. PMID:18634801

Horová, Ivana; Pospísil, Zdenek; Zelinka, Jirí



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 PMID:25276094



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. PMID:25429193

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



[Supervised administration of Alzheimer's patients using information communication technology].  


Drug adherence is central to the treatment of dementia, which might reduce compliance due to memory loss, particularly among home-based patients with dementia. In order to improve drug adherence, we suggest the efficient and effective supervised administration by use of information communication technology(ICT). ICT makes face-to-face real-time communication possible, and it also enables picture sharing. Therefore, it might be useful to apply ICT to controlling and supervising medication for patients with dementia to improve drug adherence. Accordingly, we enrolled patients who were supposed to take a newly prescribed anti-dementia patch containing the choline esterase inhibitor rivastigmine(Rivastach®)and investigated the effect of ICT-based intervention for drug adherence, emotional change, and cognitive change, utilizing Skype, a free communication software program. Scheduled Skype interventions increased drug adherence ratio, levels of subjective satisfaction, and instrumental activities of daily living(IADL). Furthermore, we can provide patients and their caregivers with a feeling of safety through regular bidirectional communication, as patients can easily consult medical staff regarding the adverse effects of newly prescribed drugs. Instead of frequent visits to their primary physicians, ICT-based communications can be used as a substitute for supervision of medication, given the availability of the telecommunication system. By directly connecting the medical institution to the home, we expect that this ICT-based system will expand into the geriatric care field, including the care of elderly individuals living alone. PMID:25595075

Noda, Yasuha; Sakata, Yoshifumi; Kubota, Masakazu; Uemura, Kengo; Kihara, Takeshi; Kimura, Toru; Ino, Masashi; Tsuji, Teruyuki; Hayashi, Michiyuki; Kinoshita, Ayae




E-print Network

AMERICAN THORACIC SOCIETY PATIENT HEALTH SERIES Lung Cancer Prevention What are the chances that I will develop lung cancer? The #1 cause of lung cancer is exposure to tobacco smoke. Your chances increase others (second-hand smoke), the greater your chances of developing lung cancer. People who have never

Kaski, Samuel


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.


Web Messaging: A New Tool for Patient-Physician Communication  

Microsoft Academic Search

ObjectiveThere is a high demand by patients to communicate electronically with their doctor. This study evaluates the use of a web messaging system by staff and patients of UC Davis community Primary Care Network (PCN) clinic.DesignEight providers and their staff and patients were surveyed on use of this web messaging system, and physician productivity was measured with Relative Value Unit

Eric M Liederman; Catrina S Morefield



Health food store recommendations: implications for breast cancer patients  

Microsoft Academic Search

BACKGROUND: Many breast cancer patients use complementary and alternative medicine (CAM). We aimed to determine what advice health food store employees present to individuals seeking treatment options for breast cancer. METHODS: Eight data gatherers asked employees of all retail health food stores in a major Canadian city, what they recommended for a patient with breast cancer. The data gatherers inquired

Edward Mills; Edzard Ernst; Rana Singh; Cory Ross; Kumanan Wilson



Semen quality and cryopreservation in adolescent cancer patients  

Microsoft Academic Search

BACKGROUND: Adult cancer patients are routinely offered pre-treatment sperm cryopreservation. However, only recently has the welfare of adolescent cancer sufferers gained momentum, including their infertility, and unsurpris- ingly relatively little is known about their semen quality and feasibility of cryopreservation. METHODS AND RESULTS: A total of 238 adolescent cancer patients referred to our centre between 1991 and 2000, from post-

G. Bahadur; K. L. E. Ling; R. Hart; D. Ralph; R. Wafa; A. Ashraf; N. Jaman; S. Mahmud; A. W. Oyede



Patient attitudes, behaviours, and other factors considered by doctors when estimating cancer patients' anxiety and desire for information.  


The aim was to describe the patient attitudes, behaviours, and other factors, considered by doctors when estimating cancer patients' worry about how the disease may develop and the desire for information about the disease and its treatment. Data was gathered through semi-structured interviews with 19 doctors regarding 29 patients within endocrine oncology and haematology care, and the data were analysed by content analysis. The doctors considered the patients' verbal expressions, verbal behaviours, questions, body language, and facial expressions together with their own professional knowledge and experience, when estimating the patients' worry and desire for information. The doctors also considered contextual factors, patients' demographical factors, and medical situation when estimating the patients' worry, and also when estimating the patients' desire for information. The findings illustrate that estimating patients' worry and desire for information is a multifaceted and complex task, and that doctors consider not only the patients' verbal and nonverbal cues, but also factors, such as their own professional knowledge and experience, contextual factors, and patients' demographical variables. The findings should be communicated to doctors who meet cancer patients in medical consultations in order to illuminate the complexity of the medical consultation. The awareness of potentially important patient cues and other factors may aid doctors in their efforts to gain insight about their patients' emotions and informational needs. PMID:18036016

Fröjd, Camilla; Lampic, Claudia; Larsson, Gunnel; Birgegård, Gunnar; von Essen, Louise



Cancer-Associated Fibroblasts Connect Metastasis-Promoting Communication in Colorectal Cancer  

PubMed Central

Colorectal cancer (CRC) progression and eventually metastasis is directed in many aspects by a circuitous ecosystem consisting of an extracellular matrix scaffold populated by cancer-associated fibroblasts (CAFs), endothelial cells, and diverse immune cells. CAFs are recruited from local tissue-resident fibroblasts or pericryptal fibroblasts and distant fibroblast precursors. CAFs are highly abundant in CRC. In this review, we apply the metastasis-promoting communication of colorectal CAFs to 10 cancer hallmarks described by Hanahan and Weinberg. CAFs influence innate and adaptive tumor immune responses. Using datasets from previously published work, we re-explore the potential messages implicated in this process. Fibroblasts present in metastasis (metastasis-associated fibroblasts) from CRC may have other characteristics and functional roles than CAFs in the primary tumor. Since CAFs connect metastasis-promoting communication, CAF markers are potential prognostic biomarkers. CAFs and their products are possible targets for novel therapeutic strategies.

Tommelein, Joke; Verset, Laurine; Boterberg, Tom; Demetter, Pieter; Bracke, Marc; De Wever, Olivier



Patient Satisfaction: A Study in Communication.  

ERIC Educational Resources Information Center

The Program in Human Sexuality (PHS), an outpatient mental health clinic in the University of Minnesota Medical School that specializes in sexuality-related dysfunctions, had received a number of patient complaints in late 1992 and early 1993 about therapeutic processes and business services. The proactive approach was to survey patients about all…

Young, Laura Throckmorton; And Others


Serum neopterin levels in patients with breast cancer.  


The aim of this study was to determine the importance of serum neopterin level in female patients with breast cancer of various clinical stages. The study consisted of 75 female patients with breast cancer who were diagnosed and treated at the Gazi University Department of Medical Oncology. The patients were classified into three representative groups and a control group: group A (n = 26), patients with newly diagnosed primary breast cancer and without metastasis; group B (n = 33), patients with metastatic breast cancer who had undergone treatment for their diseases and on whom metastasis was detected during their follow-up; group C (n = 16), off-therapy patient whose cancer had been in remission for at least 5 years; group D (n = 20) healthy controls. The median serum neopterin levels of the 75 patients with breast cancer 11.0 (range, 0-23.6) nmol/L were significantly higher than those of controls (8.3 (range, 1.2-12.0) nmol/L). In group B patients, neopterin levels (12.6 (range, 0-23.6) nmol/L) were statistically significantly higher than those of controls, primary breast cancer patients, and off-therapy patients (P < .05). In group B, patients with visceral metastases had higher neopterin levels than did those with bone or local metastases; however, that difference was not statistically significant. The median serum neopterin levels of the primary breast cancer patients in group A (8.8 (range, 0-20) nmol/l) were not statistically significantly different from those in controls and off-therapy patients. Serum neopterin levels were significantly elevated in patients with metastatic breast cancer. Neopterin seems to be an indicator of metastatic cancer rather than a marker for local cancer. In patients with metastatic breast cancer, determining the serum neopterin levels may be useful in estimating survival; however, additional long-term follow-up will be needed. PMID:18320364

Yildirim, Yesim; Gunel, Nazan; Coskun, Ugur; Pasaoglu, Hatice; Aslan, Sabahattin; Cetin, Abdullah



Screening hospital patients for uterine cervical cancer.  

PubMed Central

Women patients admitted to a district general hospital with non-gynaecological conditions were offered a cervical smear test. In three years 2296 women were tested. Serious uterine pathology was detected in 13 patients (5.7 per 1000) and significant cytological abnormalities (dyskaryosis of all grades) in 46 (20.0 per 1000). Of the women screened 963 (41.9%) had never had a smear test before and 1608 (70.0%) were over 39 yr. The results show that cervical screening of non-gynaecological patients in hospital reaches many of the women at risk for cervical cancer who do not otherwise have smears taken and reveals considerable uterine pathology. PMID:6853729

Hudson, E; Hewertson, S; Jansz, C; Gordon, H



Tube feeding in the elderly cancer patient.  


In elderly cancer patients tube feeding, via a nasogastric tube or a (percutaneous) gastrostomy may be an efficient way of nutritionally supporting patients with extreme anorexia or dysphagia caused by a head&neck tumor or with an oro-pharyngeal-esophageal mucositis due to radiation therapy and/or chemotherapy. There is no definite difference, with regard to the clinical benefit, between nasogastric and gastrostomy feeding. Both procedures achieve good results in allowing the proper completion of the oncologic therapy. Whether to use a nasogastric tube or a (percutaneous) gastrostomy and whether to perform the procedure prophylactically or a la demande is a matter of controversy and depends more on the policy of the single institution and preferences of the patients than on evidence-based results. PMID:25770328

Bozzetti, Federico



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: 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


Chemotherapy Regimen Extends Survival in Advanced Pancreatic Cancer Patients

A four-drug chemotherapy regimen has produced the longest improvement in survival ever seen in a phase III clinical trial of patients with metastatic pancreatic cancer, one of the deadliest types of cancer.


Gene Mutations Linked to Colon Cancer in Black Patients  


... JavaScript. Gene Mutations Linked to Colon Cancer in Black Patients Finding might lead to better treatment of ... Preidt Tuesday, January 13, 2015 Related MedlinePlus Pages African American Health Colorectal Cancer Genes and Gene Therapy TUESDAY, ...


Multiple primary malignant neoplasms in breast cancer patients in Israel  

SciTech Connect

The data of an epidemiologic study of multiple primary malignant neoplasms in breast cancer patients in Israel are presented. During the 18-year period of the study 12,302 cases of breast carcinoma were diagnosed, and, of these, 984 patients (8%) had multiple primary malignant tumors. Forty-seven of these patients developed two multiple primary cancers. A significantly higher than expected incidence of second primary cancers occurred at the following five sites: the opposite breast, salivary glands, uterine corpus, ovary, and thyroid. Cancers of the stomach and gallbladder were fewer than expected. Treatment of the breast cancer by irradiation was associated with an increased risk of subsequent cancers of lung and hematopoietic system. The prognosis was mainly influenced by the site and malignancy of the second primary cancer. The incidence of multiple primary malignancies justifies a high level of alertness to this possibility in the follow-up of breast cancer patients.

Schenker, J.G.; Levinsky, R.; Ohel, G.



Too Few Breast Cancer Patients Getting Radiation After Mastectomy  


... enable JavaScript. Too Few Breast Cancer Patients Getting Radiation After Mastectomy: Study More than a third with ' ... 17, 2015 Related MedlinePlus Pages Breast Cancer Mastectomy Radiation Therapy TUESDAY, Feb. 17, 2015 (HealthDay News) -- Many ...


Measurement of Physician-Patient Communication—A Systematic Review  

PubMed Central

Background Effective communication with health care providers has been found as relevant for physical and psychological health outcomes as well as the patients' adherence. However, the validity of the findings depends on the quality of the applied measures. This study aimed to provide an overview of measures of physician-patient communication and to evaluate the methodological quality of psychometric studies and the quality of psychometric properties of the identified measures. Methods A systematic review was performed to identify psychometrically tested instruments which measure physician-patient communication. The search strategy included three databases (EMBASE, PsycINFO, PubMed), reference and citation tracking and personal knowledge. Studies that report the psychometric properties of physician-patient communication measures were included. Two independent raters assessed the methodological quality of the selected studies with the COSMIN (COnsensus based Standards for the selection of health status Measurement INtruments) checklist. The quality of psychometric properties was evaluated with the quality criteria of Terwee and colleagues. Results Data of 25 studies on 20 measures of physician-patient communication were extracted, mainly from primary care samples in Europe and the USA. Included studies reported a median of 3 out of the nine COSMIN criteria. Scores for internal consistency and content validity were mainly fair or poor. Reliability and structural validity were rated mainly of fair quality. Hypothesis testing scored mostly poor. The quality of psychometric properties of measures evaluated with Terwee et al.'s criteria was rated mainly intermediate or positive. Discussion This systematic review identified a number of measures of physician-patient communication. However, further psychometric evaluation of the measures is strongly recommended. The application of quality criteria like the COSMIN checklist could improve the methodological quality of psychometric property studies as well as the comparability of the studies' results. PMID:25532118

Zill, Jördis M.; Christalle, Eva; Müller, Evamaria; Härter, Martin; Dirmaier, Jörg; Scholl, Isabelle



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.



Patient-Physician Communication in the Context of Persistent Pain: Validation of a Modified Version of the Patients' Perceived Involvement in Care Scale  

Microsoft Academic Search

The purpose of this study was to evaluate the psychometric properties of a modified version of the Perceived Involvement in Care Scale (M-PICS), a measure designed to assess pain patients' perceptions of patient health care provider communication during the medical consultation. Eighty-seven breast cancer outpatients with persistent pain completed a battery of questionnaires, including the M-PICS. A factor analysis supported

Meredith Y. Smith; Gary Winkel; Jennifer Egert; Mariana Diaz-Wionczek; Katherine N. DuHamel



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



The Relationship Between Depression and Pain Language in Cancer and Chronic Non-Cancer Pain Patients  

Microsoft Academic Search

The present study investigated the relationship between depression and pain description among cancer and chronic non-cancer pain patients in a large outpatient sample. Participants consisted of 312 patients (158 men and 154 women) attending a pain management clinic at a comprehensive cancer institute. Sixty-one percent of the patients (190\\/312) were experiencing pain related to cancer and 39% (122\\/312) were experiencing

Thomas C. Sist; Gerard A. Florio; Marguerite F. Miner; Mark J. Lema; Michael A. Zevon



Changes in Bone Density after Cancer Treatment in Patients with Cervical and Endometrial Cancer  

PubMed Central

OBJECTIVE: This study aimed to evaluate the impact of cancer treatment on bone mineral density (BMD) in the lumbar spine (LS) and femur in the postmenopausal women with cervical or endometrial cancer without bone metastasis compared to normal control postmenopausal women. METHODS: We retrospectively evaluated the BMD data in the LS, femur neck (FN) and trochanter (FT) by dual-energy X-ray absorptiometry and laboratory data of bone turnover markers at baseline and after one year in 130 patients with cervical cancer, 68 patients with endometrial cancer, and 225 healthy controls. RESULTS: There were no significant differences in the T-scores of basal BMD in LS and femur between patients with endometrial cancer and controls, and only T-score of basal BMD at the fourth lumbar vertebra (L4) was significantly lower in patients with cervical cancer compared to controls. One year later, T-scores of BMD at all LS sites and FN in patients with cervical cancer and T-scores of BMD at L3, L4, FN, and FT in those with endometrial cancer after cancer treatment were significantly lower compared to controls. Lower proportions of normal BMD at all skeletal sites except L2 in patients with endometrial cancer and those at L1, L4, and FN in patients with cervical cancer were observed compared to controls after cancer treatment. CONCLUSIONS: Our results suggest that cancer treatment increase bone loss in postmenopausal women with cervical and endometrial cancer. PMID:25553092

Oh, Young Lim; Yoon, Man Soo; Suh, Dong Soo; Kim, Ari; Kim, Min Joung; Lee, Ji Young; Song, Yong Jung; Ji, Yong Il; Kim, Ki Hyung; Chun, Sungwook



Serum levels of interleukin 6 in patients with lung cancer.  

PubMed Central

Serum interleukin 6 (IL-6) levels were measured in 75 patients with lung cancer and in 20 patients with benign lung diseases. IL-6 was detectable in 29 patients with lung cancer (39%), but was not detectable in any of the patients with benign lung diseases. Serum C-reactive protein levels and plasma fibrinogen levels were significantly higher and serum albumin concentration was significantly lower in lung cancer patients with detectable serum IL-6 levels than in those without detectable serum IL-6 levels and in patients with benign lung diseases. On the other hand, no significant difference was observed in blood platelet counts in these three groups. Moreover, serum IL-6 levels were not significantly different in lung cancer patients with or without clinically demonstrated distant metastasis. These results suggest that IL-6 may be a mediator of various reactions including an inflammatory response in lung cancer patients. PMID:7734307

Yanagawa, H.; Sone, S.; Takahashi, Y.; Haku, T.; Yano, S.; Shinohara, T.; Ogura, T.



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



Recall in Older Cancer Patients: Measuring Memory for Medical Information  

ERIC Educational Resources Information Center

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…

Jansen, Jesse; van Weert, Julia; van der Meulen, Nienke; van Dulmen, Sandra; Heeren, Thea; Bensing, Jozien



Management of inflammatory bowel disease patients with a cancer history.  


In inflammatory bowel disease (IBD) patients, thiopurines promote carcinogenesis of Epstein-Barr Virus (EBV)-related lymphomas, non-melanoma skin cancers and urinary tract cancers, while anti-TNF agents could promote carcinogenesis of melanomas. Patients with IBD and previous cancer are at a higher risk of developing new or recurrent cancer than IBD patients without a history of cancer, irrespective of the use of immunosuppressants. In transplant recipients, the use of thiopurines is associated with a high rate of cancer recurrence, particularly within the first two years following transplantation. In patients with chronic inflammatory disease, limited data suggest that no dramatic incidence of cancer recurrence is associated with the use of thiopurines or anti-TNF agents. However, there is a rationale for a two-year drug holiday from immunosuppressants after the diagnosis and treatment of the majority of incident cancers, as often as possible. Extending the duration of the immunosuppressant drug holiday to 5 years in patients with previous cancers associated with a high risk of recurrence in the post-transplant state should be considered. The immunosuppressants that can be initiated or resumed after cancer treatment should be chosen according to the type of the previous cancer. All individual decisions should be made on a case-by-case basis, together with the oncologist, according to characteristics and expected evolution of the index cancer, expected impact of the immunosuppressants on cancer evolution, and intrinsic severity of IBD, with its associated risks. PMID:25146698

Beaugerie, Laurent



Breaking Bad News in Cancer Patients  

PubMed Central

Objective: In a regional hospital, many patients are newly diagnosed with cancer. Breaking the bad news in these patients and their relatives is a tough task. Many doctors are not experienced in talking to patients about death or death-related diseases. In recent years, there have been great efforts to change the current situation. The aim of this study was to investigate the experience and education of medical personnel in breaking bad news in a secondary hospital. Materials and Methods: 59 doctors from General Hospital of Komotini, Greece were included in the study. All the doctors were in clinical specialties that treated cancer patients. A brief questionnaire was developed based on current guidelines such as Baile/SPIKES framework and the ABCDE mnemonic. Results: Residents are involved in delivering bad news less frequently than specialists. Only 21 doctors (35.59%) had specific training on breaking bad news. 20 doctors (33.90%) were aware of the available techniques and protocols on breaking bad news. 47 doctors (79.66%) had a consistent plan for breaking bad news. 57 (96.61%) delivered bad news in a quiet place, 53 (89.83%) ensured no interruptions and enough time, 53 (89.83%) used simple words and 54 (91.53%) checked for understanding and did not rush through the news. 46 doctors (77.97%) allowed relatives to determine patient's knowledge about the disease. Conclusions: There were low rates of specific training in breaking bad news. However, the selected location, the physician's speech and their plan were according to current guidelines. PMID:25709183

Konstantis, Apostolos; Exiara, Triada



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.



Living Alone During Cancer Treatment: An Exploration of Patients' Experiences.  


The social environment is an important determinant in the overall experience of having cancer. The purpose of this article is to identify how patients experience living alone during their cancer treatment. Using qualitative methods based on grounded theory techniques, we interviewed a sample of 32 cancer patients. Living alone was an ambiguous experience during cancer treatment: patients experienced both a lack of support as well a gain in privacy, freedom, and know-how. Living alone was also seen as a constitutive element of the patients' identity. Consequently, patients saw living alone as either a threat or as a resource for their adjustment to cancer treatment. These divergent meanings of living alone did share one common attribute, which was that staying independent was their key goal during cancer treatment. Health care providers should be attentive to the heterogeneous aspects of the experience of living alone when critically appraising the independence of patients. PMID:25028157

Benoot, Charlotte; Bilsen, Johan; Grypdonck, Maria; Deschepper, Reginald



Measuring patient-centered communication in Patient–Physician consultations: Theoretical and practical issues  

Microsoft Academic Search

The goal of patient-centered communication (PCC) is to help practitioners provide care that is concordant with the patient's values, needs and preferences, and that allows patients to provide input and participate actively in decisions regarding their health and health care. PCC is widely endorsed as a central component of high-quality health care, but it is unclear what it is and

Ronald M. Epstein; Peter Franks; Kevin Fiscella; Cleveland G. Shields; Sean C. Meldrum; Richard L. Kravitz; Paul R. Duberstein



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



Recruiting terminally ill patients into non-therapeutic oncology studies: views of health professionals. |

Several themes emerged when interviews were conducted with clinician-researchers regarding their attitudes and concerns when recruiting terminally ill cancer patients into non-therapeutic research. The prominent themes were ethical considerations, patient-centered issues, and health professional issues. Promoting communication and autonomy and fostering familial support are important elements for overcoming patient-centered issues. Facilitating the doctor-patient relationship, using teamwork, and implementing educational programs were seen as key factors for dealing with health professional issues.


Why differences exist? an interpretive approach to nurses’ perceptions of cancer patients’ quality of life  

PubMed Central

BACKGROUND: Based on the literature review that was conducted, no research study has been found in Australia to provide a detailed understanding of why nurses differ in their perceptions about cancer patients’ Quality of Life (QoL) when they communicate with patients in oncology wards. METHODS: This descriptive exploratory qualitative study was completed in 2007 in two major public hospitals in Adelaide, South Australia. 10 nurses from different inpatient and outpatient oncology services and a palliative setting took part in semi-structured interviews. RESULTS: After the data collection and analysis six main themes were identified. Differences in nurses’ perceptions about cancer patients’ QoL were discussed in the light of the sub theme “relationship and rapport”. CONCLUSIONS: In general, participants commented that differences existing between patients’ and nurses’ perceptions about cancer patients’ QoL were due to a poor relationship and rapport between cancer patients and their nurses. Therefore, nurses need to have a genuine interest to make an open relationship with patients in a non-judgmental way. This rapport needs to go beyond the patient and include other health care professionals as well as the patient's family. PMID:22039389

Bahrami, Masoud



GUCY2C molecular staging personalizes colorectal cancer patient management  

PubMed Central

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



Cancer supportive care, improving the quality of life for cancer patients. A program evaluation report  

Microsoft Academic Search

Goals of workAs medical care for cancer has become more specialized in diagnosis, treatment has become more technical and fragmented. In order to help cancer patients and their families, we developed a coordinated program called the Stanford Cancer Supportive Care Program (SCSCP) at the Center for Integrative Medicine at Stanford Hospital and Clinics. The Stanford Cancer Supportive Care Program was

Ernest Rosenbaum; Holly Gautier; Pat Fobair; Eric Neri; Bernadette Festa; Margaret Hawn; Alexandra Andrews; Nama Hirshberger; Sabrina Selim; David Spiegel



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.


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

Lymphedema; Stage IA Cervical Cancer; Stage IA Uterine Corpus Cancer; Stage IA Vulvar Cancer; Stage IB Cervical Cancer; Stage IB Uterine Corpus Cancer; Stage IB Vulvar Cancer; Stage II Uterine Corpus Cancer; Stage II Vulvar Cancer; Stage IIA Cervical Cancer; Stage IIIA Vulvar Cancer; Stage IIIB Vulvar Cancer; Stage IIIC Vulvar Cancer; Stage IVB Vulvar Cancer



Using solution-focused communication to support patients.  


Nurses want to help patients; it is one of their main roles and a key source of job satisfaction. However, finding the time despite low staffing levels and a heavy workload is a constant challenge. This article provides an overview of solution-focused communication -an approach valued by an increasing number of nurses because of its brevity and effectiveness in empowering patients to find the solutions that will help them to deal with their health challenges. PMID:21941806

Smith, Steve; Adam, Dorothy; Kirkpatrick, Pamela; McRobie, Gillian


The working patient with cancer: implications for payers and employers.  


Cancer is seen today more often as a manageable chronic disease, resulting in changing workplace characteristics of the patient with cancer. A growing number of employees continue to work while being treated for cancer or return to work shortly after their cancer treatment is completed. To respond to these changes and the potential impact on the working patient's attitude, employers need updated, factual information related to this patient population. This type of information will support future benefit considerations by employers on employee contributions and future employee health and productivity. In 2005, Amgen launched a 3-year initiative to better understand cancer as a chronic disease, as well as the impact on the working patient with cancer and on the employer. The data from this initiative described in this article provide insights into cancer as a chronic and manageable disease in the workforce, and the broader implications to payers and employers. PMID:25126288

Lawless, Grant D



Patient-Physician Social Concordance, Medical Visit Communication and Patients’ Perceptions of Health Care Quality  

PubMed Central

Social characteristics (e.g. race, gender, age, education) are associated with health care disparities. We introduce social concordance, a composite measure of shared social characteristics between patients and physicians. Objective To determine whether social concordance predicts differences in medical visit communication and patients’ perceptions of care. Methods Regression analyses were used to determine the association of patient-provider social concordance with medical visit communication and patients’ perceptions of care using data from two observational studies involving 64 primary care physicians and 489 of their patients from the Baltimore, MD /Washington, DC/Northern Virginia area. Results Lower patient-physician social concordance was associated with less positive patient perceptions of care and lower positive patient affect. Patient-physician dyads with low vs. high social concordance reported lower ratings of global satisfaction with office visits (OR=0.64 vs. OR=1.37, p=0.036) and were less likely to recommend their physician to a friend (OR=0.61vs. OR=1.37, p=0.035). A graded-response was observed for social concordance with patient positive affect and patient perceptions of care. Conclusion Patient-physician concordance across multiple social characteristics may have cumulative effects on patient-physician communication and perceptions of care. Practice Implications Research should move beyond one-dimensional measures of patient-physician concordance to understand how multiple social characteristics influence health care quality. PMID:21840150

Johnson Thornton, Rachel L.; Powe, Neil R.; Roter, Debra; Cooper, Lisa A.



Physician Communication Styles in Initial Consultations for Hematological Cancer  

PubMed Central

Objective To characterize practices in subspecialist physicians’ communication styles, and their potential effects on shared decision-making, in second-opinion consultations. Methods Theme-oriented discourse analysis of 20 second-opinion consultations with subspecialist hematologist-oncologists. Results Physicians frequently “broadcasted” information about the disease, treatment options, relevant research, and prognostic information in extended, often-uninterrupted monologues. Their communicative styles had one of two implications: conveying options without offering specific recommendations, or recommending one without incorporating patients’ goals and values into the decision. Some physicians, however, used techniques that encouraged patient participation. Conclusions Broadcasting may be a suboptimal method of conveying complex treatment information in order to support shared decision-making. Interventions could teach techniques that encourage patient participation. Practice Implications Techniques such as open-ended questions, affirmations of patients’ expressions, and pauses to check for patient understanding can mitigate the effects of broadcasting and could be used to promote shared decision-making in information-dense subspecialist consultations. PMID:24035463

Chhabra, Karan R.; Pollak, Kathryn I.; Lee, Stephanie J.; Back, Anthony L.; Goldman, Roberta E.; Tulsky, James A.



Strengthening student communication through pediatric simulated patient encounters  

PubMed Central

As medical students enter the role of physician, clinical outcomes not only rely on their mastery of clinical knowledge, but also on the effectiveness in which they can communicate with patients and family members. While students typically have numerous opportunities to practice clinical communication with adult patients, such practice in pediatric settings is limited. This study examines if simulated patient (SP) encounters strengthen third-year medical students’ communication skills during the pediatrics clerkship. During 2011-2013, three SP encounters (comprising 3 pediatric scenarios) were incorporated into a pediatrics clerkship at one United States medical school to give students a safe venue to practice advanced communication with observation and direct feedback. Third-year medical students engaged in the scenarios and received both written and oral feedback from an evaluator observing the encounter. With IRB approval, students’ self-perceived confidence and abilities at performing the advanced communication skills were measured using an eightitem, Likert scale questionnaire administered pre and post the SP encounter. Pre- and post-questionnaires (n=215; response rate, 96%) analyzed using a Wilcoxon-matched pairs signed-rank test demonstrated statistically significant increases in students’ perception of their confidence and abilities regarding their performance (P<0.05; Bonferroni correction, P<0.006). There was an increases in student confidence and self-perceived ability in: first, communicating with children and family members of young patients; second, managing confrontational situations involving parents; third, performing a thorough psychosocial history with an adolescent; and fourth, using Evidence Based Medicine to motivate parents. PMID:25112449



Strengthening student communication through pediatric simulated patient encounters.  


As medical students enter the role of physician, clinical outcomes not only rely on their mastery of clinical knowledge, but also on the effectiveness in which they can communicate with patients and family members. While students typically have numerous opportunities to practice clinical communication with adult patients, such practice in pediatric settings is limited. This study examines if simulated patient (SP) encounters strengthen third-year medical students' communication skills during the pediatrics clerkship. During 2011-2013, three SP encounters (comprising 3 pediatric scenarios) were incorporated into a pediatrics clerkship at one United States medical school to give students a safe venue to practice advanced communication with observation and direct feedback. Third-year medical students engaged in the scenarios and received both written and oral feedback from an evaluator observing the encounter. With IRB approval, students' self-perceived confidence and abilities at performing the advanced communication skills were measured using an eightitem, Likert scale questionnaire administered pre and post the SP encounter. Pre- and post-questionnaires (n=215; response rate, 96%) analyzed using a Wilcoxon-matched pairs signed-rank test demonstrated statistically significant increases in students' perception of their confidence and abilities regarding their performance (P<0.05; Bonferroni correction, P<0.006). There was an increases in student confidence and self-perceived ability in: first, communicating with children and family members of young patients; second, managing confrontational situations involving parents; third, performing a thorough psychosocial history with an adolescent; and fourth, using Evidence Based Medicine to motivate parents. PMID:25112449

Whitt, Ryan; Toussaint, Gregory; Bruce Binder, S; Borges, Nicole J



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:



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.


Inequalities in reported cancer patient experience by socio-demographic characteristic and cancer site: evidence from respondents to the English Cancer Patient Experience Survey.  


Patient experience is a critical dimension of cancer care quality. Understanding variation in experience among patients with different cancers and characteristics is an important first step for designing targeted improvement interventions. We analysed data from the 2011/2012 English Cancer Patient Experience Survey (n = 69,086) using logistic regression to explore inequalities in care experience across 64 survey questions. We additionally calculated a summary measure of variation in patient experience by cancer, and explored inequalities between patients with cancers treated by the same specialist teams. We found that younger and very old, ethnic minority patients and women consistently reported worse experiences across questions. Patients with small intestine/rarer lower gastrointestinal, multiple myeloma and hepatobiliary cancers were most likely to report negative experiences whereas patients with breast, melanoma and testicular cancer were least likely (top-to-bottom odds ratio = 1.91, P < 0.0001). There were also inequalities in experience among patients with cancers treated by the same specialty for five of nine services (P < 0.0001). Specifically, patients with ovarian, multiple myeloma, anal, hepatobiliary and renal cancer reported notably worse experiences than patients with other gynaecological, haematological, gastrointestinal and urological malignancies respectively. Initiatives to improve cancer patient experience across oncology services may be suitably targeted on patients at higher risk of poorer experience. PMID:25327713

Saunders, C L; Abel, G A; Lyratzopoulos, G



Inequalities in reported cancer patient experience by socio-demographic characteristic and cancer site: evidence from respondents to the English Cancer Patient Experience Survey  

PubMed Central

Patient experience is a critical dimension of cancer care quality. Understanding variation in experience among patients with different cancers and characteristics is an important first step for designing targeted improvement interventions. We analysed data from the 2011/2012 English Cancer Patient Experience Survey (n = 69 086) using logistic regression to explore inequalities in care experience across 64 survey questions. We additionally calculated a summary measure of variation in patient experience by cancer, and explored inequalities between patients with cancers treated by the same specialist teams. We found that younger and very old, ethnic minority patients and women consistently reported worse experiences across questions. Patients with small intestine/rarer lower gastrointestinal, multiple myeloma and hepatobiliary cancers were most likely to report negative experiences whereas patients with breast, melanoma and testicular cancer were least likely (top-to-bottom odds ratio = 1.91, P < 0.0001). There were also inequalities in experience among patients with cancers treated by the same specialty for five of nine services (P < 0.0001). Specifically, patients with ovarian, multiple myeloma, anal, hepatobiliary and renal cancer reported notably worse experiences than patients with other gynaecological, haematological, gastrointestinal and urological malignancies respectively. Initiatives to improve cancer patient experience across oncology services may be suitably targeted on patients at higher risk of poorer experience. PMID:25327713

Saunders, CL; Abel, GA; Lyratzopoulos, G



Urologic emergencies in the cancer patient.  


Urologic emergencies are common in the cancer patient and relate mainly to complications of bladder hemorrhage, upper or lower urinary tract obstruction, urinary tract infection, and priapism. Hemorrhagic cystitis is commonly due to bladder injury from radiation therapy, viral infection, or metabolites of chemotherapeutic agents. Treatments aimed at ameliorating the effects of theses metabolites, such as mesna and intravenous (IV) hydration, coupled with cystoscopy, evacuation of clots, and formalin instillation, have given clinicians an effective means of avoiding exsanguinating hemorrhage from the bladder. Malignant ureteral obstruction is an ominous sign in the cancer patient and may be due to tumor compression, retroperitoneal adenopathy, or direct tumor invasion. The endourologic procedures of ureteral stenting and percutaneous nephrostomy are effective means of palliation; however, complications of infection, stent obstruction, and stent migration can result in hospital admission and a decline in quality of life. Median survival for patients with malignant ureteral obstruction is less than 7 months, regardless of the tumor of origin. Bladder outlet obstruction leading to urinary retention can be due to mechanical factors involving the bladder neck or prostate, or to a breakdown in the neurophysiologic function of the bladder. Every attempt is made to avoid surgical intervention or the placement of chronic in-dwelling catheter in these often debilitated patients. Patients are often effectively treated with a variety of pharmacologic agents, such as alpha-adrenergic receptor blockers or by the initiation of chronic intermittent catheterization. Urinary tract infections are particularly dangerous in neutropenic and bone marrow transplant patients, with bladder catheters the most common portal entry. The colonization and later infection by resistant nosocomial organisms, such as Pseudomonas aeruginosa and Candida albicans, can rapidly lead to life-threatening sepsis. On rare occasions, emergency surgical intervention with adequate open drainage or nephrectomy is required to control such infections. Priapism can be caused by hematologic malignancy with hypercoagulation, metastatic disease involving the corpora cavernosa with thrombosis of the venous outflow from the penis, or rarely from intracavernous injections used for the treatment of impotence. If effective treatment exists for the primary tumor, improvement or resolution of the state of priapism may occur. Radiation therapy may be required to decrease the pain associated with malignant priapism, but surgical shunting procedures are rarely effective. PMID:10864217

Russo, P



Communicating about cancer through facebook: a qualitative analysis of a breast cancer awareness page.  


Social media channels are increasingly being used for health communication and promotion. Social networking sites such as Facebook have become popular platforms for organizations to communicate health messages and encourage user participation around health topics. While the evaluation of social media's effectiveness in health promotion is beginning to emerge in the literature, few studies have examined actual interactions and user behaviors on Facebook Pages hosted by health organizations. The authors present a qualitative case study of a popular Facebook Page from a nonprofit organization devoted to raising awareness about breast cancer. With the goal of identifying the functions and uses of the Page, our study analyzes the content of Wall posts during Breast Cancer Awareness Month, October 2010. Common themes and characteristics are identified, including open mic communication, scarcity of health information, the commodification of breast cancer, unpredictable locations of conversation, and the use of gendered images and language. The findings have potential implications for health promotion efforts using social media platforms. PMID:25495200

Abramson, Karley; Keefe, Brian; Chou, Wen-Ying Sylvia



Are Too Many Prostate Cancer Patients Receiving Treatment?  


... please enable JavaScript. Are Too Many Prostate Cancer Patients Receiving Treatment? Study also raises concerns about possible ... significant side effects, experts have been debating which patients need treatment and who can wait, the study ...


Communication in dental medicine: importance in motivating elderly dental patients.  


Dental services for elderly patients are characterized by a series of particularities related to the vulnerability of this age group, which is affected by various co morbidities, and the diminished physical, cognitive and financial capacities. Finding ways to keep elderly patients coming to a dental office is possible by improving the dentist-patient relationship and implicitly the quality of care by increasing the self-esteem of the elderly and their place in society, by increasing the role of oral health in the quality of life, and here we refer to the pleasure of eating, the pleasant physical aspect and normal diction. The present paper presents the psychological aspects that interfere in the communication process between the dentist and the elderly patient and the changes motivation undergoes when people are in pain. These data can sometimes change the reticent attitude of the dentist towards the elderly patient which is often considered to be a risk patient. PMID:24502052

Scutariu, Mihaela Monica; Forna, Norina



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.




E-print Network

OPTIMIZING THE DELIVERY OF RADIATION THERAPY TO CANCER PATIENTS \\Lambda DAVID M. SHEPARD y therapy, much of the research is aimed at developing new and innovative techniques for treating cancer growing and dividing. This is true of both cancer cells and normal cells. Radiotherapy is a useful tool

Ferris, Michael C.


The therapeutic effects of the physician-older patient relationship: Effective communication with vulnerable older patients  

PubMed Central

There is growing evidence that the outcomes of health care for seniors are dependent not only upon patients’ physical health status and the administration of care for their biomedical needs, but also upon care for patients’ psychosocial needs and attention to their social, economic, cultural, and psychological vulnerabilities. Even when older patients have appropriate access to medical services, they also need effective and empathic communication as an essential part of their treatment. Older patients who are socially isolated, emotionally vulnerable, and economically disadvantaged are particularly in need of the social, emotional, and practical support that sensitive provider-patient communication can provide. In this review paper, we examine the complexities of communication between physicians and their older patients, and consider some of the particular challenges that manifest in providers’ interactions with their older patients, particularly those who are socially isolated, suffering from depression, or of minority status or low income. This review offers guidelines for improved physician-older patient communication in medical practice, and examines interventions to coordinate care for older patients on multiple dimensions of a biopsychosocial model of health care. PMID:18044195

Williams, Summer L; Haskard, Kelly B; DiMatteo, M Robin



Promoting therapeutic communication and patient-centered care using standardized patients.  


This article describes an assignment designed to incorporate the Quality and Safety Education for Nurses (QSEN) competency of patient-centered care into a simulation activity aimed to improve therapeutic communication skills in psychiatric nursing. During this pilot activity, students engaged in an interaction with an actor trained to portray an individual with mental illness. Students viewed their video-recorded interaction to identify communication techniques used and completed a self-evaluation examining their strengths and areas for improvement. Faculty and actors provided feedback to students during a faculty-led debriefing held to discuss the use of therapeutic communication and care focused on the knowledge, skills, and attitudes necessary to provide quality patient-centered care. Desired learning outcomes included the demonstration of therapeutic communication and assessment skills, empathy and caring, and addressing patient values, preferences, and beliefs. PMID:24127180

Webster, Debra



Giving and Receiving Emotional Support Online: Communication Competence as a Moderator of Psychosocial Benefits for Women with Breast Cancer.  


This study examines the moderating role of emotional communication competence in the relationship between computer-mediated social support (CMSS) group participation, specifically giving and receiving emotional support, and psychological health outcomes. Data were collected as part of randomized clinical trials for women diagnosed with breast cancer within the last 2 months. Expression and reception of emotional support was assessed by tracking and coding the 18,064 messages that 236 patients posted and read in CMSS groups. The final data used in the analysis was created by merging (a) computer-aided content analysis of discussion posts, (b) action log data analysis of system usage, and (c) baseline and six-month surveys collected to assess change. Results of this study demonstrate that emotional communication competence moderates the effects of expression and reception of emotional support on psychological quality of life and breast cancer-related concerns in both desired and undesired ways. Giving and receiving emotional support in CMSS groups has positive effects on emotional well-being for breast cancer patients with higher emotional communication, while the same exchanges have detrimental impacts on emotional well-being for those with lower emotional communication competence. The theoretical and practical implications for future research are discussed. PMID:24058261

Yoo, Woohyun; Namkoong, Kang; Choi, Mina; Shah, Dhavan V; Tsang, Stephanie; Hong, Yangsun; Aguilar, Michael; Gustafson, David H



Giving and Receiving Emotional Support Online: Communication Competence as a Moderator of Psychosocial Benefits for Women with Breast Cancer  

PubMed Central

This study examines the moderating role of emotional communication competence in the relationship between computer-mediated social support (CMSS) group participation, specifically giving and receiving emotional support, and psychological health outcomes. Data were collected as part of randomized clinical trials for women diagnosed with breast cancer within the last 2 months. Expression and reception of emotional support was assessed by tracking and coding the 18,064 messages that 236 patients posted and read in CMSS groups. The final data used in the analysis was created by merging (a) computer-aided content analysis of discussion posts, (b) action log data analysis of system usage, and (c) baseline and six-month surveys collected to assess change. Results of this study demonstrate that emotional communication competence moderates the effects of expression and reception of emotional support on psychological quality of life and breast cancer-related concerns in both desired and undesired ways. Giving and receiving emotional support in CMSS groups has positive effects on emotional well-being for breast cancer patients with higher emotional communication, while the same exchanges have detrimental impacts on emotional well-being for those with lower emotional communication competence. The theoretical and practical implications for future research are discussed. PMID:24058261

Yoo, Woohyun; Namkoong, Kang; Choi, Mina; Shah, Dhavan V.; Tsang, Stephanie; Hong, Yangsun; Aguilar, Michael; Gustafson, David H.



Endometrial cancer occurence five years after breast cancer in BRCA2 mutation patient  

PubMed Central

We recently experienced a case of endometrial cancer 5 years after the diagnosis of breast cancer in a patient with a mutation in the BRCA2 gene. A 55-year-old Korean woman who had a past history of breast cancer in her 50s underwent an operation for endometrial cancer. Final pathology confirmed stage Ia, and no adjuvant treatment was performed. After surgery, considering her history of sequential cancer occurrence, genetic counseling was offered. The result showed the BRCA2 variation of unknown significance mutation. This is the first case report of sequential cancers (endometrial and breast) in a patient with a BRCA2 mutation among a Korean population.

Oh, Sang Eun; Kim, Soo Hyun; Kim, Mee Seon



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



Qualitative interview study of communication between parents and children about maternal breast cancer  

Microsoft Academic Search

AbstractObjective: To examine parents' communication with their children about the diagnosis and initial treatment of breast cancer in the mother.Design: Qualitative interview study within cross sectional cohort.Setting: Two breast cancer treatment centres.Participants: 32 women with stage I or stage II breast cancer with a total of 56 school aged children.Main outcome measures: Semistructured interview regarding timing and extent of communication

Jacqueline Barnes; Leanda Kroll; Olive Burke; Joanna Lee; Alison Jones; Alan Stein



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. PMID:25278629

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



Pain control in cancer patients in tertiary care setting  

Microsoft Academic Search

Objective: To investigate the prevalence of significant pain and the appropriateness of analgesics treatment prescribed among cancer patients with pain in tertiary care hospitals. Material and Method: A cross-sectional study was conducted between October 2007 and June 2008 on 228 cancer patients with pain in the outpatient pain clinic of a university hospital and the inpatient ward of a regional

Naiyana Patcharapisarn; Penkae Ketumarn


Estrogen replacement therapy in patients with early breast cancer  

Microsoft Academic Search

Objective: Most physicians believe that estrogen replacement therapy is contraindicated once a patient is diagnosed with breast cancer. Recently, several studies have shown that estrogen replacement therapy may be safely used in patients with early breast cancer that has been treated successfully. These women can have severe menopausal symptoms and are at risk for osteoporosis. We reviewed the current status

Puthugramam K. Natrajan; R. Don Gambrell



Estrogen replacement therapy in patients with early breast cancer  

Microsoft Academic Search

OBJECTIVE: Most physicians believe that estrogen replacement therapy is contraindicated once a patient is diagnosed with breast cancer. Recently, several studies have shown that estrogen replacement therapy may be safely used in patients with early breast cancer that has been treated successfully. These women can have severe menopausal symptoms and are at risk for osteoporosis. We reviewed the current status

Puthugramam K. Natrajan; R. Don Gambrell


Managing Anemia in the Cancer Patient: Old Problems, Future Solutions  

Microsoft Academic Search

Anemia and associated symptoms commonly mani- fest in cancer patients and may have a considerable impact on outcomes. Preliminary studies suggest that overall survival and locoregional control following radi- ation therapy may be compromised by anemia, and recent preliminary data also suggest that anemia may be related to poorer outcomes following chemotherapy. Health-related quality of life of cancer patients is



Quality of life in patients with oral and oropharyngeal cancer  

Microsoft Academic Search

Quality of life (QoL) is an important aspect in the clinical assessment and management of patients with cancer. The aim of the present study was to evaluate QoL at the time of diagnosis in patients with oral and oropharyngeal cancer and to establish the influence of variables such as gender, age, tumor location and tumor staging. The authors studied 149

P. Infante-Cossio; E. Torres-Carranza; A. Cayuela; J. L. Gutierrez-Perez; M. Gili-Miner



Managing Coronary Artery Disease in the Cancer Patient  

Microsoft Academic Search

The cancer patient with coronary disease presents particular challenges that directly impact on the management of coronary disease, both stable and acute. The frequent need for surgery in the cancer patient is an important consideration in avoiding a coronary artery stent or any percutaneous coronary intervention for management of chronic stable angina, which will delay surgery or pose of risk

Ronald J. Krone



Concerns, coping and quality of life in head and neck cancer patients.  


This study was conducted to explore the concerns and coping mechanisms used by patients with head and neck cancer and assess their quality of life. A group of 50 consecutive patients with oral and laryngeal cancers were interviewed using a coping and concerns checklist and a semistructured interview proforma to elicit the common concerns in relation to head and neck cancers and their surgical treatment. The Hospital Anxiety and Depression Scale was used to detect anxiety and depression. Concerns were compared between oral and laryngeal cancers and between preoperative and postoperative patients. Commonest concerns were about the future (64%), subjective physical evaluation (60%), finances (56%), being upset (54%), communication (54%), current illness (52%) and inability to do things (50%). The commonest coping mechanisms used were helplessness and fatalism. Resolution was noted in less than 40% of the frequent concerns. As compared to laryngeal cancer patients, those with oral cancer significantly more often had concerns about current illness, subjective evaluation of health, eating and chewing, social interactions, pain and disfigurement (P < 0.05). Most subjects had numerous unresolved concerns. Mainly ineffective coping mechanisms such as helplessness and fatalism were employed leading to incomplete resolution. Interventions to minimise these concerns and to handle associated anxiety and depression would improve their quality of life. PMID:8739650

Chaturvedi, S K; Shenoy, A; Prasad, K M; Senthilnathan, S M; Premlatha, B S



Management of patients with lung cancer and poor performance status.  


Patients who are able to care for themselves but are unable to perform most work-related activities are considered to have a poor performance status (PS). Individuals who fulfill these criteria constitute a significant proportion of all patients with lung cancer. Patients with lung cancer and a poor PS, irrespective of age, have an increased incidence of adverse effects with therapy and poorer outcomes. Thus, although these individuals must be treated differently, data on optimal approaches for these patients are lacking, because this cohort is underrepresented in conventional clinical trials due to enrollment restrictions. This article presents the available evidence on the treatment of this group of patients with lung cancer. Although patients with PS 2 have worse overall outcomes than those with good PS, a selected proportion may still benefit from standard therapy. Further trials are needed to identify optimal strategies to treat this group of patients with lung cancer. PMID:24994922

Gajra, Ajeet; Marr, Alissa S; Ganti, Apar Kishor



Doctor-patient communication in the e-health era  

PubMed Central

The digital revolution will have a profound impact on how physicians and health care delivery organizations interact with patients and the community at-large. Over the coming decades, face-to-face patient/doctor contacts will become less common and exchanges between consumers and providers will increasingly be mediated by electronic devices. In highly developed health care systems like those in Israel, the United States, and Europe, most aspects of the health care and consumer health experience are becoming supported by a wide array of technology such as electronic and personal health records (EHRs and PHRs), biometric & telemedicine devices, and consumer-focused wireless and wired Internet applications. In an article in this issue, Peleg and Nazarenko report on a survey they fielded within Israel's largest integrated delivery system regarding patient views on the use of electronic communication with their doctors via direct-access mobile phones and e-mail. A previous complementary paper describes the parallel perspectives of the physician staff at the same organization. These two surveys offer useful insights to clinicians, managers, researchers, and policymakers on how best to integrate e-mail and direct-to-doctor mobile phones into their practice settings. These papers, along with several other recent Israeli studies on e-health, also provide an opportunity to step back and take stock of the dramatic impact that information & communication technology (ICT) and health information technology (HIT) will have on clinician/patient communication moving forward. The main goals of this commentary are to describe the scope of this issue and to offer a framework for understanding the potential impact that e-health tools will have on provider/patient communication. It will be essential that clinicians, managers, policymakers, and researchers gain an increased understanding of this trend so that health care systems around the globe can adapt, adopt, and embrace these rapidly evolving digital technologies. PMID:22929000



Benefits and challenges perceived by patients with cancer when offered a nurse navigator  

PubMed Central

Introduction Lack of communication, care and respect from healthcare professionals can be challenges for patients in trajectories of cancer, possibly accompanied by experienced fragmentation of the care, anxiety and worries. One way to try to improve delivery of care is additional help from nurse navigators (NN) offered in a predefined shorter or longer period, but patients’ experiences with this have seldom been investigated. Aims To explore experiences of nurse navigation offered in a short period of a longer subsequent part of cancer trajectories by patients who can use the help on offer. Methods The NNs worked from one hospital department with patients in the transition between primary care and a university hospital before admission. A phenomenological-hermeneutical longitudinal study was performed from referral and until two months after discharge from the hospital. Semi-structured interviews with five patients who could use the help from an NN provided data for the analysis, which started open-minded. Results Affectional bonds were made to the NN and patients felt that they benefited from her presence and her help, which they requested until one month after discharge. They were disappointed and felt rejected when the contact to the NN stopped. Conclusion In efforts to increase quality of care for patients with cancer we recommend an increased awareness of cultural areas within the healthcare system, which may be an impediment to good communication. Moreover, we recommend paying special attention to critical periods in cancer patients’ trajectories, as well as to the theory of attachment to supplement thoughts of continuity of care and coordination in the care for women. In short, it is fine to offer additional help to those who can use it, but in practice as well as in research we recommend awareness of how and when to stop the help, to prevent patients from feeling hurt. PMID:22128278

Thygesen, Marianne K; Pedersen, Birthe D; Kragstrup, Jakob; Wagner, Lis; Mogensen, Ole



75 FR 9913 - Request for Measures of Patient Experiences of Cancer Care  

Federal Register 2010, 2011, 2012, 2013, 2014

...Research and Quality Request for Measures of Patient Experiences of Cancer Care AGENCY: Agency...researchers, survey firms, cancer care providers, patient advocacy groups, individual cancer patients, and other stakeholders who are...



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.



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.



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



Affective and Instrumental Communication in Primary Care Interactions: Predicting the Satisfaction of Nursing Staff and Patients  

Microsoft Academic Search

Verbal and nonverbal communication between nursing staff and patients has received scant research attention. This study examined patients' and nursing staff members' global affective and instrumental communication, mutual influence, and relationship to postvisit satisfaction. This study employed ratings of videotaped primary care visits of 81 nursing staff members with 235 patients, and assessed communication in 2 channels: nonverbal visual and

Kelly B. Haskard; M. Robin DiMatteo; John Heritage



Addressing the sexual health needs of patients with gynecologic cancers.  


Research indicates that sexual health and function frequently are overlooked by healthcare professionals despite being identified as an essential aspect of patient care. This article discusses the topic of sexuality as it pertains to women with gynecologic cancers, highlights barriers to addressing sexuality with patients with cancer, and provides nurses with a framework to guide them in providing information and support to patients who are experiencing sexual difficulties or who need information about sexual function. A case study addresses the challenges a woman with cervical cancer faces and the role of the nurse in supporting the patient and her partner within the PLISSIT model. PMID:18515244

Stilos, Kalli; Doyle, Catherine; Daines, Patricia



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 challenge of effectively communicating patient safety information.  


Rational use of drugs and patient safety are seriously compromised by a lack of good information, education and effective communication at all stages of drug development and use. From animal trials through to dispensing, there are misconceptions and opportunities for error which current methods of drug information communication do not adequately address: they do not provide those responsible for prescribing and dispensing drugs with the data and information they need to pass on complex and often changing messages to patients and the public. The incidence of adverse reactions due to the way drugs are used; the variable impact of regulatory guidelines and warnings on prescribing behaviour; drug scares and crises suggest a great gap between the ideals of the safe use of medicines and the reality in homes, clinics and hospitals around the world. To address these challenges, the authors review the several levels at which safety information is generated and communicated, and examine how, at each stage, the content and its significance, and the method of communication can be improved. PMID:16774488

Hugman, Bruce; Edwards, I Ralph



Microarray Profiling in Breast Cancer Patients  

Microsoft Academic Search

\\u000a Breast cancer is the most common cancer among women. It arises from a variety of genetic, epigenetic, and chromosomal alterations.\\u000a The traditional prognostic and predictive factors in breast cancer mainly focus on the clinical–pathological parameters, which\\u000a are unable to reveal the diverse molecular alterations of breast cancer and are imprecise in predicting breast cancer progression\\u000a and clinical outcomes. In recent

Yong Qian; Xianglin Shi; Vincent Castranova; Nancy L. Guo


Oxaliplatin Plus Irinotecan in Treating Patients With Metastatic Gastrointestinal Cancer

Anal Cancer; Colorectal Cancer; Esophageal Cancer; Extrahepatic Bile Duct Cancer; Gallbladder Cancer; Gastric Cancer; Gastrointestinal Carcinoid Tumor; Liver Cancer; Pancreatic Cancer; Small Intestine Cancer



The use of complementary and alternative medicine by cancer patients  

PubMed Central

The use of Complementary and Alternative Medicine (CAM) among cancer patients is widespread and appears to be increasing. However, it is not clear whether patients use CAM as an 'alternative' to standard oncology care or as an adjunct to the conventional treatment they receive. This study reviews the role of CAM therapies in the management of cancer, from the view of both patients and health professionals and it highlights issues relating to the efficacy of CAM used by cancer patients. Most patients use CAM to 'complement' the conventional therapies of radiotherapy, chemotherapy, hormone therapy and surgery. Health professionals in general have expressed positive views when CAM is used 'complementarily' and not as an 'Alternative'. Results so far published have shown that CAM can contribute to improving the quality of life of cancer patients and their general well-being. PMID:17470282

Adams, Mariama; Jewell, Andrew Paul



An evaluation of nursing care in cancer patients.  


The aim of the present study was to identify what hospitalized cancer patients expect from nurses in terms of the care they receive. The specific aims of this study were: (i) to identify those individuals to whom the patients felt closest in the hospital setting and (ii) to evaluate nurses' management of cancer patients during their stay in the hospital. The sample included patients hospitalized at Ege University Hospital and Suat Seren District Hospital, Izmir, Turkey. We found significant differences between the scores of satisfaction and dissatisfaction and gender age, education, occupation, type of cancer and the mode of treatment (p < 0.05). The majority of the cancer patients reported that nursing management was unsatisfactory. Some demographic factors such as cultural and social status affected patients' expectations. PMID:15575174

Karadeniz, G; Yanikkerem, E; Altiparmak, S; Sevil, U; Ertem, G; Esen, A



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



Management of heart failure patients using telemedicine communication systems  

Microsoft Academic Search

Heart failure (HF) continues to place significant demands on health care resources because of the large number of hospital\\u000a admissions for HF, the growth of the elderly population with HF, and the improved survival of patients with chronic heart\\u000a disease who develop HF that requires continuous care. Because HF is best managed using a disease management approach, frequent\\u000a communication is

Abul Kashem; Robert C. Cross; William P. Santamore; Alfred A. Bove





... the cancer when diagnosed. Some cancers can be cured. Other cancers that are not curable can still be treated effectively. Some patients can live for many years with cancer. Other tumors are quickly life threatening.


Exercise in patients coping with breast cancer: An overview.  


Breast cancer is the most common type of cancer in women, but fortunately has high survival rates. Many studies have been performed to investigate the effects of exercise in patients diagnosed with breast cancer. There is evidence that exercise after the diagnosis of breast cancer improves mortality, morbidity, health related quality of life, fatigue, physical functioning, muscle strength, and emotional wellbeing. Based on scientific data, breast cancer patients should be recommended to participate in rehabilitation programs including aerobic and strength training. The aim of this article is to review the recently published data on the effect of exercise in patients with breast cancer in order to present the current perspective on the topic. PMID:25114855

Eyigor, Sibel; Kanyilmaz, Selcen



Exercise in patients coping with breast cancer: An overview  

PubMed Central

Breast cancer is the most common type of cancer in women, but fortunately has high survival rates. Many studies have been performed to investigate the effects of exercise in patients diagnosed with breast cancer. There is evidence that exercise after the diagnosis of breast cancer improves mortality, morbidity, health related quality of life, fatigue, physical functioning, muscle strength, and emotional wellbeing. Based on scientific data, breast cancer patients should be recommended to participate in rehabilitation programs including aerobic and strength training. The aim of this article is to review the recently published data on the effect of exercise in patients with breast cancer in order to present the current perspective on the topic. PMID:25114855

Eyigor, Sibel; Kanyilmaz, Selcen



Sigmoid Perforation Following Radiation Therapy in Patients with Cervical Cancer  

Microsoft Academic Search

Objective. We describe the clinical presentation, evaluation, management, and outcome of patients experiencing sigmoid perforation following radiation therapy for cervical cancer.Methods. A database consisting of over 5000 patients with stage IB–IIIB cervix cancer treated between 1963 and 1992 revealed 35 patients with sigmoid perforation. Twenty-seven were diagnosed and managed at one institution, and they form the study group.Results. The median

Pedro T. Ramirez; Charles Levenback; Thomas W. Burke; Patricia Eifel; Judith K. Wolf; David M. Gershenson



Multiple Serum Markers in Patients with Endometrial Cancer  

Microsoft Academic Search

Serum levels of carcinoembryonic antigen (CEA), CA 125 and CA 15–3 were measured in 47 patients with endometrial cancer and 20 with endometrial hyperplasia. Before treatment elevated serum levels of CEA, CA 125 and CA 15–3 were found in 14, 43 and 32% of cancer patients, respectively. In the 20 patients with endometrial hyperplasia, CEA and CA 15–3 values were

Pierluigi Benedetti Panici; Giovanni Scambia; Gabriela Baiocchi; Lidia Perrone; Stefano Greggi; Francesco Battaglia; Salvatore Mancuso



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


Psychosocial Stress in Cancer Patients during and after Radiotherapy  

Microsoft Academic Search

Background and Purpose: The aim of this study was to investigate stress in tumor patients by means of a cancer-specific questionnaire in the course of radiotherapy. Material and Methods: Disease-specific aspects of psychosocial stress (Herschbach's Questionnaire on Stress in Cancer Patients, QSC) were self-assessed by patients with different tumor types before radiotherapy (ti1), after radiotherapy (ti2), and 6 weeks after

Susanne Sehlen; Helmuth Hollenhorst; Beatrice Schymura; Peter Herschbach; Uelker Aydemir; Martina Firsching; Eckhart Dühmke



Measurement of Cancer Health Literacy and Identification of Patients with Limited Cancer Health Literacy  

PubMed Central

Health literacy is related to a broad range of health outcomes. This study was designed to develop a psychometrically sound instrument designed to measure cancer health literacy along a continuum (CHLT-30), to develop another instrument designed to determine whether a patient has limited cancer health literacy (CHLT-6), and to estimate the prevalence of limited cancer health literacy. The Cancer Health Literacy Study involving 1,306 Black and White cancer patients was conducted between April 2011 and April 2013 in the Virginia Commonwealth University Massey Cancer Center and surrounding oncology clinics. A continuous latent variable modeling framework was adopted to dimensionally represent cancer health literacy, whereas discrete latent variable modeling was used to estimate the prevalence rates of limited cancer health literacy. Self confidence about engaging in health decisions was used as the primary outcome in external validation of new instruments. Results from a comprehensive analysis strongly supported the construct validity and reliability of the CHLT-30 and CHLT-6. For both instruments, measurement invariance tests ruled out item/test bias to explain gender and race/ethnicity differences in test scores. The limited cancer health literacy rate was 18%, a subpopulation consisting of overrepresented Black, undereducated, and low-income cancer patients. Overall, the results supported the conclusion that the CHLT-30 accurately measures cancer health literacy along a continuum and that the CHLT-6 efficiently identifies patients with limited cancer health literacy with high accuracy. PMID:25315594

Dumenci, Levent; Matsuyama, Robin; Riddle, Daniel L.; Cartwright, Laura A.; Perera, Robert A.; Chung, Harold; Siminoff, Laura A.



Anxiety and depression in patients with gastrointestinal cancer: does knowledge of cancer diagnosis matter?  

Microsoft Academic Search

BACKGROUND: Gastrointestinal cancer is the first leading cause of cancer related deaths in men and the second among women in Iran. An investigation was carried out to examine anxiety and depression in this group of patients and to investigate whether the knowledge of cancer diagnosis affect their psychological distress. METHODS: This was a cross sectional study of anxiety and depression

Azadeh Tavoli; Mohammad Ali Mohagheghi; Ali Montazeri; Rasool Roshan; Zahra Tavoli; Sepideh Omidvari



Patient-Physician Colorectal Cancer Screening Discussion Content and Patients’ Use of Colorectal Cancer Screening  

PubMed Central

Objective The US Preventive Services Task Force recommends using the 5As (i.e., Assess, Advise, Agree, Assist and Arrange) when discussing preventive services. We evaluate the association of the 5As discussion during primary care office visits with patients’ subsequent colorectal cancer (CRC) screening use. Methods Audio-recordings of N=443 periodic health exams among insured patients aged 50-80 years and due for CRC screening were joined with pre-visit patient surveys and screening use data from an electronic medical record. Association of the 5As with CRC screening was assessed using generalized estimating equations. Results 93% of patients received a recommendation for screening (Advise) and 53% were screened in the following year. The likelihood of screening increased as the number of 5A steps increased: compared to patients whose visit contained no 5A step, those whose visit contained 1-2 steps (OR=2.96 [95% CI 1.16, 7.53]) and 3 or more steps (4.98 [95% CI 1.84, 13.44]) were significantly more likely to use screening. Conclusions Physician CRC screening recommendations that include recommended 5A steps are associated with increased patient adherence. Practice Implications A CRC screening recommendation (Advise) that also describes patient eligibility (Assess) and provides help to obtain screening (Assist) may lead to improved adherence to CRC screening. PMID:24094919

Lafata, Jennifer Elston; Cooper, Greg; Divine, George; Oja-Tebbe, Nancy; Flocke, Susan A.



Ethics of Clear Health Communication: applying the CLean Look approach to Communicate Biobanking Information for Cancer research  

PubMed Central

Cancer innovations, such as biobanking technologies, are continuously evolving to improve our understanding and knowledge about cancer prevention and treatment modalities. However, the public receives little communication about biobanking and is often unaware about this innovation until asked to donate biospecimens. It is the researchers’ ethical duty to provide clear communications about biobanking and biospecimen research. Such information allows the public to understand biobanking processes and facilitates informed decision making about biospecimen donation. The aims of this paper are 1) to examine the importance of clear communication as an ethical imperative when conveying information about cancer innovations and 2) to illustrate the use of an organizing framework, the CLEAN (Culture, Literacy, Education, Assessment, and Networking) Look approach for creating educational priming materials about the topic of biobanking. PMID:23124500

Koskan, Alexis; Arevalo, Mariana; Gwede, Clement K.; Quinn, Gwendolyn P.; Noel-Thomas, Shalewa A.; Luque, John S.; Wells, Kristen J.; Meade, Cathy D.



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



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.


Comprehensive geriatric assessment in the older cancer patient: coming of age in clinical cancer care  

PubMed Central

Cancer care at the extremes of life, in the young and the old, is characterized by unique issues associated with pediatrics and geriatric medicine, accentuated by the special vulnerabilities of these groups. In response to these needs, the field of pediatric oncology has been well honed to deal with the special problems associated with juvenile cancer patients. While most adult oncologists consider themselves well prepared to deal with older cancer patients, the current expansion of the geriatric population – their variable levels of fitness, frailty and vulnerability, the fact that cancer is primarily a disease of older adults, the significant expansion of agents and approaches to treat cancer, as well as their resultant toxicities and complications – has led to the development of specialized geriatric oncologists. Moreover, the special characteristics and needs of these patients have led to the evolution of new guidelines for evaluation, management and the conduct of research in older patients with cancer. PMID:25642321

Owusu, Cynthia; Berger, Nathan A



Cancer patient and survivor research from the cancer information service research consortium: a preview of three large randomized trials and initial lessons learned.  


The authors describe 3 large randomized trials from the Cancer Information Service Research Consortium. Three web-based multimedia programs are being tested to help newly diagnosed prostate (Project 1) and breast cancer patients (Project 2) make informed treatment decisions and breast cancer patients prepare for life after treatment (Project 3). Project 3 also tests a telephone callback intervention delivered by a cancer information specialist. All participants receive standard print material specific to each project. Preliminary results from the 2-month follow-up interviews are reported for the initial wave of enrolled participants, most of whom were recruited from the Cancer Information Service (1-800-4-CANCER) telephone information program (Project 1: n =208; Project 2: n =340; Project 3: n =792). Self-reported use of the multimedia program was 51%, 52%, and 67% for Projects 1, 2, and 3, respectively. Self-reported use of the print materials (read all, most, or some) was 90%, 85%, and 83% for Projects 1, 2, and 3, respectively. The callback intervention was completed by 92% of Project 3 participants. Among those using the Cancer Information Service Research Consortium interventions, perceived usefulness and benefit was high, and more than 90% reported that they would recommend them to other cancer patients. The authors present 5 initial lessons learned that may help inform future cancer communications research. PMID:23448232

Marcus, Alfred C; Diefenbach, Michael A; Stanton, Annette L; Miller, Suzanne M; Fleisher, Linda; Raich, Peter C; Morra, Marion E; Perocchia, Rosemarie Slevin; Tran, Zung Vu; Bright, Mary Anne



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



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



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.


Psychosocial Concerns in Patients With Advanced Cancer: An Observational Study at Regional Cancer Centre, India  

Microsoft Academic Search

Introduction: The diagnosis and treatment of cancer is associated with substantial physical, psychological, and social morbidity. The objective of this study was to identify the prevalence of psychosocial concerns in the patients with advanced cancer admitted to our institute. Materials and Methods: A total of 100 patients admitted to the inpatient palliative care unit of our institute were enrolled in

Seema Mishra; Sushma Bhatnagar; Freeny Ann Philip; Vasudha Singhal; Shiv Pratap Singh Rana; Surjya Prasad Upadhyay; Govindi Chauhan



Psychosocial Determinants of Cancer-Related Information Seeking Among Cancer Patients  

Microsoft Academic Search

This study explores the utility of using the Integrative Model of Behavioral Prediction as a framework for predicting cancer patients' intentions to seek information about their cancer from sources other than a physician, and to examine the relation between patients' baseline intentions to seek information and their actual seeking behavior at follow-up. Within 1 year of their diagnosis with colon,

Aaron Smith-McLallen; Martin Fishbein; Robert C. Hornik



Factors affecting 30-month survival in lung cancer patients  

PubMed Central

Background & objectives: Age adjusted incidence rate of lung cancer in India ranges from 7.4 to 13.1 per 100,000 among males and 3.9 to 5.8 per 100,000 among females. The factors affecting survival in lung cancer patients in India are not fully understood. The current study was undertaken to evaluate the factors affecting survival in patients diagnosed with lung cancer attending a tertiary care cancer institute in Bangalore, Karnataka, India. Methods: Consecutive patients with primary lung cancer attending Bangalore Institute of Oncology, a tertiary care centre at Bangalore, between 2006 and 2009 were included. Demographic, clinical, radiological data were collected retrospectively from the medical records. Results: A total of 170 consecutive subjects (128 males, 42 females) diagnosed to have lung cancer; 151 non-small cell lung cancer (NSCLC) and 19 small cell lung cancer (SCLC) were included. A higher proportion of never-smokers (54.1%) were observed, mostly presenting below the age of 60 yr. Most subjects were in stage IV and III at the time of diagnosis. More than 50 per cent of patients presented with late stage lung cancer even though the duration of symptoms is less than 2 months. The 30-month overall survival rates for smokers and never-smokers were 32 and 49 per cent, respectively. No significant differences were observed in 30 month survival based on age at presentation, gender and type of lung cancer. Cox proportional hazards model identified never-smokers and duration of symptoms less than 1 month as factors adversely affecting survival. Interpretation & conclusions: Our results showed that lung cancer in Indians involved younger subjects and associated with poorer survival as compared to other ethnic population. Studies on large sample need to be done to evaluate risk factors in lung cancer patients. PMID:23168702

Mahesh, P.A.; Archana, S.; Jayaraj, B.S.; Patil, Shekar; Chaya, S.K.; Shashidhar, H.P.; Sunitha, B.S.; Prabhakar, A.K.



Risk of cancer among rheumatoid arthritis patients in California  

PubMed Central

Objective The objective of this retrospective cohort study was to evaluate cancer risk among rheumatoid arthritis (RA) patients in California. Methods The study cohort derived from statewide patient discharge records was followed via linkage with cancer registry data over the period 1991–2002. Age and sex adjusted standardized incidence ratios (SIRs) and 95% confidence intervals were calculated to compare observed to expected numbers of cancers based on age, race, and sex specific incidence rates in the California population. Results Among the 84,475 RA patients, who were observed for 405,540 person-years, 5,533 incident cancers were diagnosed during the observation interval. The risk of developing lymphohematopoietic cancer was significantly higher in the cohort for both sexes. Males had significantly higher risks of lung, liver, and esophageal cancer, but a lower risk of prostate cancer. Females were at significantly decreased risk for several cancers including breast, ovary, uterus, cervix, and melanoma, with the risk reduction ranging from 15 to 57% lower than the general population. Hispanics had increased risks of leukemia, vagina/vulva, lung, and liver cancers. Conclusion Studies investigating the mechanisms that underlie the reported associations between RA and specific cancer types are needed. PMID:19184473

Parikh-Patel, A.; Allen, M.; Cress, R.; White, R. H.



The Fertility-Related Treatment Choices of Cancer Patients: Cancer-Related Infertility and Family Dynamics  

Microsoft Academic Search

\\u000a Cancer does not just affect the person battling the disease, but the patient’s family as well. Cancer can impact a broad range\\u000a of family relationships from sexual relations with a partner to how someone parents their child. Family members are also often\\u000a involved in the treatment decisions that someone with cancer makes, such as showing support for a particular medical

Karrie Ann Snyder; May Kyaw Thazin; William B. Pearse; Mehwish Moinuddin


Micronucleated lymphocyte rates from head-and-neck cancer patients.  


We investigated whether head-and-neck cancers are associated with an increased micronucleated cell rates (MN cell rates) and whether risk factors for these cancers are associated with alterations in micronucleated lymphocytes. MN cell rates were assessed in cytokinesis-blocked lymphocytes of 57 head-and-neck cancer patients (CP) before any anticancer treatment and of 198 male and female healthy subjects (HS). In the HS group, only smoking status significantly affect MN cell rates. In CP group age, sex, tobacco status, alcohol status, tumor stage, family history of cancer had no significant effect. For the non-smokers, the comparison between MN cell rates in HS and CP adjusted for age and sex showed a significant difference. The increase of MN cell rates in non-smokers patients may be attributable to cancer status. For the smokers, the comparison of MN cell rates in HS and CP matched for age and sex showed no significant difference. Pathological status could mask the smoking effect on peripheral blood lymphocytes in patients. Moreover, it probably could partly explain why MN cell rates in matched-CP smokers and HS smokers were similar. The authors do not recommend the CBMN assay in this present form to study smoking DNA-damage effects in peripheral blood lymphocytes of cancer patients, especially for patients with upper aero-digestive tract cancers or lung cancers for which tobacco is the major risk factor. PMID:10023078

Duffaud, F; Orsière, T; Digue, L; Villani, P; Volot, F; Favre, R; Botta, A



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



Cancer patient perceptions about biobanking and preferred timing of consent.  


Little is known about how cancer patients feel about donating their tissue, especially in a multiethnic population. Structured interviews were conducted with 30 patients recently diagnosed with cancer, referred to the study by six cancer surgeons and oncologists and by other patients in the study. The participants reported a variety of cancers, and the sample reflected the racial distribution of Hawai`i, including Caucasians (23%), Native Hawaiians and Pacific Islanders (27%), Asians (37%), Hispanics (7%), Native Americans (3%), and African Americans (3%). The interview questions and analysis were guided by the Framework Approach, with interview questions based on pre-set aims. Findings suggest that most cancer patients would donate cancer tissue to science, especially if informed that doing so could help researchers find causes of and cures for cancer. Patients varied on when in their cancer journey they would be most receptive to being asked for a donation, however two-thirds thought they would be more receptive if approached after surgery. Only three of the 30 patients said they would want to be re-consented each time their tissue is requested for research. They identified their physician as the preferred messenger regarding tissue donation. No obvious differences were seen by race. Findings confirm those of other researchers who have reported broad support for biobank participation if informed consent and confidentiality could be assured. Given that the physician was seen as the key messenger about biobanking, more education is needed around cancer tissue collection for physicians, as well as for cancer patients. PMID:24749877

Braun, Kathryn L; Tsark, Joann U; Powers, Amy; Croom, Kristen; Kim, Robert; Gachupin, Francine C; Morris, Paul



Cancer Patient Perceptions about Biobanking and Preferred Timing of Consent  

PubMed Central

Little is known about how cancer patients feel about donating their tissue, especially in a multiethnic population. Structured interviews were conducted with 30 patients recently diagnosed with cancer, referred to the study by six cancer surgeons and oncologists and by other patients in the study. The participants reported a variety of cancers, and the sample reflected the racial distribution of Hawai`i, including Caucasians (23%), Native Hawaiians and Pacific Islanders (27%), Asians (37%), Hispanics (7%), Native Americans (3%), and African Americans (3%). The interview questions and analysis were guided by the Framework Approach, with interview questions based on pre-set aims. Findings suggest that most cancer patients would donate cancer tissue to science, especially if informed that doing so could help researchers find causes of and cures for cancer. Patients varied on when in their cancer journey they would be most receptive to being asked for a donation, however two-thirds thought they would be more receptive if approached after surgery. Only three of the 30 patients said they would want to be re-consented each time their tissue is requested for research. They identified their physician as the preferred messenger regarding tissue donation. No obvious differences were seen by race. Findings confirm those of other researchers who have reported broad support for biobank participation if informed consent and confidentiality could be assured. Given that the physician was seen as the key messenger about biobanking, more education is needed around cancer tissue collection for physicians, as well as for cancer patients. PMID:24749877

Tsark, JoAnn U.; Powers, Amy; Croom, Kristen; Kim, Robert; Gachupin, Francine C.; Morris, Paul



Optimizing Chemotherapy for Patients with Advanced Breast Cancer  

Microsoft Academic Search

Chemotherapy is offered to almost all patients with metastatic breast cancer. Optimization of treatment has four major goals: (1) To improve access to chemotherapy. Orally active chemotherapy is an attractive option for those patients when access to hospital is limited by financial considerations, long journeys or patient reluctance. In the past, only alkylating agents (cyclophosphamide, chlorambucil, melphalan) could be administered

M. Marty; M. Espie; P. H. Cottu; C. Cuvier; F. Lerebours



The significant unmet needs of cancer patients: probing psychosocial concerns  

Microsoft Academic Search

'Significant unmet needs' are those needs that patients identify as both important and unsatisfied. In this article we ask whether the overall needs of cancer patients are actually being met. We believe that the range of unmet need, and the kinds of patients who are more likely to claim unmet need, should be carefully identified. The needs responses of a

K. Soothill; S. M. Morris; J. Harman; B. Francis; C. Thomas; M. B. McIllmurray



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



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


Silent Partners to Cancer Patients: Formal Caregivers and Oncologists.  


Given the worldwide aging of the population, the projected increase of older people diagnosed with cancer, and the changes in the structure of society and family, it is predictable that larger numbers of aged cancer patients will be supported by formal caregivers. This exploratory study attempts to gain insight into and to make recommendations to oncologists based on the comparison of two groups of foreign formal caregivers-those providing care to elderly cancer patients and those providing care to the elderly suffering from other chronic illnesses. Our sample included 108 Filipino formal caregivers to older persons (age 65+) suffering from cancer or other chronic diseases. Participants completed a short questionnaire targeting background information, subjective perception of distress, attachment to the care recipient family, and the Distress Thermometer. Participants reported extreme levels of distress, with only seven (6.48 %) scoring less than 5 on the Distress Thermometer. Caregivers to cancer patients reported significantly higher levels of distress and tended to feel less attached to the family of the patient in comparison to caregivers to patients with other chronic illnesses. Cultural differences regarding cancer among the elderly may explain the higher levels of distress reported among Filipino formal caregivers and need to be acknowledged by oncologists. As a precondition for simultaneously improving the caregiver's well-being and the patient's quality of care, it is recommended that oncologists relate directly to formal caregivers, specifically to their extreme distress and apprehension regarding cancer. PMID:25316613

Goldzweig, G; Rottenberg, Yakir; Peretz, Tamar; Baider, Lea



Toward a greater understanding of breast cancer patients’ decisions to discuss cancer related internet information with their doctors: An exploratory study  

PubMed Central

Objective To investigate differences between breast cancer patients who do and do not discuss cancer-related internet information (CRII) with their doctors. Methods 70 breast cancer patients completed questionnaires regarding internet use, discussions about CRII, and the doctor-patient relationship. Results No significant differences were noted across patient, disease, or visit characteristics, or physician reliance between those who intended to discuss CRII and those who did not. Patients who intended to discuss CRII rated significantly higher pre-consultation anxiety levels. No significant differences in satisfaction, anxiety reduction, or trust in physician were found between patients who had discussed and those who had not. Patients’ reasons for discussing or not discussing are detailed. Conclusion Factors influencing patients’ decisions to discuss CRII are complex and differ from those identified as leading patients to seek internet information. Future research about internet discussions should investigate the impact of patients’ preferred role in treatment, the doctor-patient relationship, anxiety level, attributes of CRII, and physician trust. Practice Implications Understanding the characteristics of patients who do and do not discuss internet information is important given the impact internet information has on healthcare communication and the doctor-patient relationship, including the development of interventions aimed at improving such interactions. PMID:22722063

D’Agostino, Thomas A.; Ostroff, Jamie S.; Heerdt, Alexandra; Dickler, Maura; Li, Yuelin; Bylund, Carma L.



Teaching and Assessing Doctor-Patient Communication Using Remote Standardized Patients and SKYPE: Feedback from Medical Residents  

ERIC Educational Resources Information Center

Teaching and assessing doctor-patient communication has become a priority in medical education. This pilot study evaluated resident physicians' perceptions of teaching and assessing doctor-patient communication skills related to pain management using a web-based format. Fifty-nine resident physicians completed four doctor-patient clinical…

Horber, Dot; Langenau, Erik E.; Kachur, Elizabeth



[To be a gastroenterologist who communicates well with patients].  


There are many reasons why doctors would not to be able to communicate with patients. First, medicine is science or humanity? Although object of medicine is human, modern medicine tends to regard human as broken machine. Second, gastroenterologists are overloaded by treatment of patients, providing education, attending academic conference, and writing papers. Above all things, it is much worse for gastroenterologists because of endoscopic procedures. The other problem is attitude of modern society about human suffering. Sufferings come from not only body but also mind or spirit. Although there are may difficult problems, if doctors listen to patients' history by their side, it will help to restore their faith. In addition, we need humanity education and improvement plans for medical service system. PMID:23018537

Park, Seun Ja



Cancer Pain Control for Advanced Cancer Patients by Using Autonomic Nerve Pharmacopuncture  

PubMed Central

Objectives: The purpose of this study is to report a case series of advanced cancer patients whose cancer pain was relieved by using autonomic nerve pharmacopuncture (ANP) treatment. ANP is a subcutaneous injection therapy of mountain ginseng pharmacopuncture (MGP) along the acupoints on the spine (Hua-Tuo-Jia-Ji-Xue; 0.5 cun lateral to the lower border of the spinous processes of vertebrae) to enhance the immune system and to balance autonomic nerve function. Methods: Patients with three different types of cancer (gastric cancer, lung cancer, colon cancer with distant metastases) with cancer pain were treated with ANP. 1 mL of MGP was injected into the bilateral Hua-Tuo-Jia-Ji-Xue on the T1-L5 sites (total 12 ? 20 mL injection) of each patient’s dorsum by using the principle of symptom differentiation. During ANP treatment, the visual analogue scale (VAS) for pain was used to assess their levels of cancer pain; also, the dosage and the frequency of analgesic use were measured. Results: The cancer pain levels of all three patients improved with treatment using ANP. The VAS scores of the three patients decreased as the treatment progressed. The dosage and the frequency of analgesics also gradually decreased during the treatment period. Significantly, no related adverse events were found. Conclusion: ANP has shown benefit in controlling cancer pain for the three different types of cancer investigated in this study and in reducing the dosage and the frequency of analgesics. ANP is expected to be beneficial for reducing cancer pain and, thus, to be a promising new treatment for cancer pain. PMID:25780711

Kang, Hwi-joong; Yoon, Jung-won; Park, Ji-hye; Cho, Chong-kwan; Yoo, Hwa-seung



Stress and weight gain in parents of cancer patients  

Microsoft Academic Search

OBJECTIVE:To investigate the effects of chronic stress on weight changes and related behavioral changes in parents with a child who had just been diagnosed with cancer compared to parents with healthy children.DESIGN:Longitudinal case–control study with assessments occurring over a three-month period following the child's diagnosis of cancer.SUBJECTS:In total, 49 parents of healthy children and 49 parents of cancer patients aged

A W Smith; A Baum; R R Wing



Management of complications from estrogen deprivation in breast cancer patients  

Microsoft Academic Search

In the United States today, more than 2 million women live as breast cancer survivors. As the number of cancer survivors grows,\\u000a the unique long-term side effects of cancer treatment and aging play an increasingly prominent role in the routine care of\\u000a these patients. Of special concern are the short- and longterm effects of sex hormone deprivation. This article reviews

Dawn L. Hershman; Christina Cho; Katherine D. Crew



Micronucleated lymphocyte rates from head-and-neck cancer patients  

Microsoft Academic Search

We investigated whether head-and-neck cancers are associated with an increased micronucleated cell rates (MN cell rates) and whether risk factors for these cancers are associated with alterations in micronucleated lymphocytes. MN cell rates were assessed in cytokinesis-blocked lymphocytes of 57 head-and-neck cancer patients (CP) before any anticancer treatment and of 198 male and female healthy subjects (HS). In the HS

F Duffaud; T Orsière; L Digue; P Villani; F Volot; R Favre; A Botta



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.


Onco-Nephrology: AKI in the Cancer Patient  

PubMed Central

Summary AKI is common in patients with cancer, and it causes interruptions in therapy and increased hospital length of stay, cost, and mortality. Although cancer patients are susceptible to all of the usual causes of AKI in patients without cancer, there are a number of AKI syndromes that occur more frequently or are unique to this patient population. AKI also confers substantially increased risk of short-term death, and the ability to reverse AKI portends a better outcome in some cancers, such as multiple myeloma. Several trends in oncology, including increased survival, better supportive care, older patients who have received multiple chemotherapy regimens, and new therapeutic options, are driving an increase in the numbers of cancer patients who develop AKI. As a result, nephrologists should be increasingly familiar with the diagnosis, management, and treatment of AKI in this setting. Here, we summarize recent data on epidemiology of AKI in cancer patients, describe the most common AKI syndromes in this population, and highlight emerging areas in the growing field of onconephrology. PMID:22879433

Lam, Albert Q.



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 in the intensive monitoring unit. New perspectives.  


In recent years, there has been a significant improvement in the survival of patients with cancer in intensive care units (ICUs). Advances in medical and surgical treatments and better selection of patients has helped improve the life expectancy of this type of patient. An appropriate and early resuscitation in the ICU, without initial limitations on the life support techniques, has been shown to also decrease the mortality of patients with cancer. At present, we should not deny admission to the ICU based only on the underlying neoplastic disease. However, the mortality rate for patients with cancer in the ICU, especially those with hematologic disease, remains high. In some cases, an ICU admission test (ICU test) is required for at least 3 days to identify patients who can benefit from intensive treatment. We would like to propose a decision algorithm for ICU admission that will help in making decisions in an often complex situation. PMID:24776089

Prieto Del Portillo, I; Polo Zarzuela, M; Pujol Varela, I



Clinical Significance of Early Detection of Esophageal Cancer in Patients with Head and Neck Cancer  

PubMed Central

Background/Aims The efficacy of surveillance for esophageal squamous cell neoplasia (ESCN) in patients with head and neck squamous cell carcinoma (HNSCC) remains controversial. Our study aimed to provide clinical data concerning the necessity of surveillance for detecting early ESCN in patients with HNSCC. Methods We retrospectively reviewed the data from 714 patients who were pathologically confirmed as having HNSCC (n=236 oral cavity cancers, 137 oropharyngeal cancers, 87 hypopharyngeal cancers, and 254 laryngeal cancers). Results Of 714 patients, during a median follow-up of 31 months, 48 ESCNs (37 synchronous and 11 metachronous) were detected in 36 patients (5%). Fifteen synchronous lesions (40.3%) were early ESCN, whereas nine metachronous lesions (81.8%) were early ESCN. The 3-year survival rates of HNSCC only and HNSCC combined with ESCN were 71.2% and 48.2%, respectively (p<0.001). Among 36 patients with ESCN, the 3-year survival rates for early and advanced ESCN were 77.7% and 21.7%, respectively (p=0.01). In the multivariate analysis, alcohol consumption and hypopharyngeal cancer were significant factors associated with the development of ESCN. Conclusions HN-SCC patients with early ESCN were similar in prognosis with patients without ESCN, in contrast to patients with advanced ESCN. Therefore, surveillance for the early detection of ESCN in patients with HNSCC, especially in alcohol drinkers and those with hypopharyngeal cancer, is warranted. PMID:25167869

Lim, Hyun; Kim, Do Hoon; Jung, Hwoon-Yong; Gong, Eun Jeong; Na, Hee Kyong; Ahn, Ji Yong; Kim, Mi-Young; Lee, Jeong Hoon; Choi, Kwi-Sook; Choi, Kee Don; Song, Ho June; Lee, Gin Hyug; Kim, Jin-Ho



Retrospective review of cancer patients ? 80 years old treated with chemotherapy at a comprehensive cancer center  

PubMed Central

Context The percentage of cancer patients ?80 years old is expected to increase in the next few years. However data on the use of chemotherapy in these patients are limited. Objective We conducted a retrospective review to define the profile of patients ? 80 years old who received chemotherapy at our center and assess their survival. Design, Setting and Participants Patients ? 80 years treated with chemotherapy between 1/1/2000 to 12/31/2004 were included in this analysis. Results Of the 4689 patients treated with chemotherapy over the 5 year period, 133 patients (3%) were ? 80 years old. The median age was 83 years. 61% were females and 39% were males. 16% had hematologic tumors and 84% had solid tumors. Gynecological (32%) and aerodigestive cancers (27%) were the most common sites, and lung cancer (22%) was the most common cancer. During the first regimen, 512 cycles of chemotherapy were delivered with a median of 3 cycles (range 1–24 cycles). 49% received single and 51% multidrug regimens. Carboplatin was the most common single agent and carboplatin and paclitaxel was the most common combination among solid tumor patients. 19% of solid tumor patients received radiation with chemotherapy. The 1 year survival among hematologic cancer and solid tumor patients was 65% and 48%, respectively. Stage of disease was the only statistically significant factor predicting survival. Conclusions In cancer patients ? 80 years old selected for chemotherapy, both single and multi-agent therapy appeared to be feasible. PMID:18599305

Choi, Minsig; Jiang, Peter Q; Heilbrun, Lance K.; Smith, Daryn W.; Gadgeel, Shirish M.



Secure Email Communication: A Short Guide for Patients WHEN TO USE EMAIL  

E-print Network

Secure Email Communication: A Short Guide for Patients WHEN TO USE EMAIL Many UConn Health Center with their patients. Your provider may choose to use secure email to communicate with you. This fact · Email can There are a number of risks that you should consider: providers welcome secure email communication

Oliver, Douglas L.


Does gender have an influence on the patient-physician communication?  

Microsoft Academic Search

Does gender have an influence on the patient-physician communication? Obviously yes is the answer, but this influence may be quite different depending on the specific circumstances in the patient-physician encounter. In this review the starting point are the differences in male and female communication in general. Furthermore the literature regarding the question if female and male physicians communicate differently with

Alexander Kiss



A Week of Excitement and Hope: Communicating the Story of Cancer

As an employee of the National Cancer Institute, I take great pride in the fact that our researchers conduct science that is necessary for improving the treatment, prevention, and diagnosis of the diseases we call cancer. As the leader of NCI’s communications efforts, I am honored to have the opportunity to support my scientific colleagues by communicating the work that we do to a global audience.


Pain and Its Treatment in Patients with Cancer in Korea  

Microsoft Academic Search

Substantial pain is experienced by a lot of patients with cancer, and undertreated pain significantly undermines their quality of life. Despite international and national guidelines on cancer pain management, the practical effectiveness of management is still problematic. We did a prospective cross-sectional survey on pain prevalence, pain intensity, its impact on daily activity, and adequacy of pain management in 823

Myung Soo Hyun; Jae Lyun Lee; Kyung Hee Lee; Ki Young Kwon; Hong Suk Song; Ok Bae Kim; Sang Kyun Sohn; Kyu Bo Lee; Hun Mo Rhu; Gun Wook Park; Dong Gun Shin; Jeong Lim Lee



Serum Levels of CA 125 in Patients with Gastrointestinal Cancers  

Microsoft Academic Search

Serum levels of CA 125 and markers reputed as specific for cancers in relevant locations (squamous cell carcinoma, SCC, carcinoembryonic antigen, CEA, CA 19.9, ?-fetoprotein, AFP) were determined in 107 patients with gastrointestinal (GI) carcinomas. The aim of this study was to assess their individual and combined sensitivities, and the power of CA 125 in excluding primary ovarian epithelial cancer

Y. T. Omar; N. Al-Naqeeb; S. A. El Nas; A. H. Awwad; M. O. Foudeh; N. B. Safadi; M. Y. Nasralla; M. A. A. Ali; J. J. Szymendera



Cancer patients' needs during hospitalisation: a quantitative and qualitative study  

Microsoft Academic Search

BACKGROUND: The evaluation of cancer patients needs, especially during that delicate period when they are hospitalized, allows the identification of those areas of care that require to be improved. Aims of the study were to evaluate the needs in cancer inpatients and to improve the understanding of the meanings of the needs expressed. METHODS: The study was conducted during a

Marcello Tamburini; Laura Gangeri; Cinzia Brunelli; Paolo Boeri; Claudia Borreani; Marco Bosisio; Claude Fusco Karmann; Margherita Greco; Guido Miccinesi; Luciana Murru; Patrizia Trimigno



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


Psychological Correlates of Survival in Nursing Home Cancer Patients.  

ERIC Educational Resources Information Center

Analyzed demographic, cancer, physical functioning and psychological data for late-stage cancer, newly admitted nursing home patients (n=90). Concluded that, compared to survivors, those who died within a three-month period more often acknowledged their condition as terminal, anticipated greater environmental stress and adjustment problems and had…

Stein, Shayna; And Others



Spouses of Cancer Patients: A Review of the Literature.  

ERIC Educational Resources Information Center

Discusses impact on the spouse when his or her partner is being treated for cancer. Defines the disease, outlines treatment effects, and describes issues affecting psychological and marital adjustment of spouses. Offers implications for counselors who work with spouses of cancer patients. (Author/NB)

Keitel, Merle A.; And Others



Breast Cancer Patients Concerned about Genetic Risk, Survey Finds  


... sharing features on this page, please enable JavaScript. Breast Cancer Patients Concerned About Genetic Risk, Survey Finds But ... Preidt Monday, April 6, 2015 Related MedlinePlus Pages Breast Cancer Genetic Testing MONDAY, April 6, 2015 (HealthDay News) -- ...