Patient real-time and 12-month retrospective perceptions of difficult communications in the cancer diagnostic period.

Communication is a notoriously complex challenge in the cancer care context. Our program of research involves exploration of patient-provider communications across the cancer trajectory from the patient perspective.Toward this end, we have been following a cohort of 60 cancer patients, representing a range of tumor sites, from immediately after diagnosis through to recovery, chronic, or advanced disease.

Cancer care communication: the power to harm and the power to heal?

Objective: This study was designed to examine the belief held by many cancer patients that communication with their care providers has a meaningful part to play in shaping their disease outcomes.

Methods: From a large qualitative interview data set in which cancer patients described their perceptions of helpful and unhelpful heath care communication; we extracted the accounts of 69 patients and 13 focus group participants who specifically articulated a perceived relationship between communication and cancer outcomes. Through secondary analysis of that subset, we generated an interpretive description of patterns and themes within their accounts of a relationship between communication and cancer survivorship.

Prognosticating futures and the human experience of hope.

Objectives: Communication between health care providers and patients with cancer and other chronic diseases typically references probabilities that certain future events will or will not occur. Beyond the context of diagnostic encounters and the transmission of "bad news," such "prognostic" communications take place in various forms throughout the illness trajectory. It is well known that such information transmitted badly can have devastating psychosocial consequences for patients and their families and, conversely, that difficult information exchanged with sensitivity can lend tremendous support.

"Truth telling" and cultural assumptions in an era of informed consent.

Patient and healthcare provider communication is vital in cancer care and aspects of the patients' experiences provide valuable insight to what constitutes effective cancer communication. In this article we describe the communication experiences of patients from nondominant cultures who accessed Canadian-based cancer services. The findings enabled us to thoughtfully reflect on Western ideals about autonomy and responsibility and their relationship to informed consent in the context of cancer communication.

Hope and probability: patient perspectives of the meaning of numerical information in cancer communication.

Although the complexities inherent in human communication make it a difficult target for empirical investigation and systematic interpretation, it is well recognized that patient-provider communication can have either a powerfully negative or positive influence on the experience of cancer. Drawing on an extensive data set derived from interviews with 200 cancer patients, the authors examine the impact of information provided in numerical form within cancer care communications from the patient perspective. In this context, they present findings related to various uses and abuses of numbers within cancer care communication, and illustrate how numerical information constitutes a specialized communication form with considerable potency for shaping the cancer experience.

'Being known': patients' perspectives of the dynamics of human connection in cancer care.

In the context of a large study of effective and ineffective cancer care communications from the perspective of patients with cancer, the authors documented the pervasiveness of the desire for human connection. Analyzing accounts from 200 patients with diverse cancer experiences, they concluded that, while anonymity is generally antithetical to a comfortable cancer care encounter, there are wide variations in what it means to 'be known' in a meaningful way. In this discussion, a description of the dynamics of being known and not being known within the cancer care encounter is presented, and a range of variations considered.