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Communicating "cure" to pediatric oncology patients: A mixed-methods study
Stefan Essig1,2, Gisela Michel1,3, Carole Dupont1
1Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Pediatric Blood & Cancer
|February 8, 2019
Summary
Not all childhood cancer survivors are told they are cured, impacting their mental health. Physician decisions depend on cancer type and late effects, affecting survivor reassurance and distress.
Area of Science:
- Oncology
- Pediatric Oncology
- Cancer Survivorship
Background:
- Childhood cancer survivors face mental distress due to uncertainty about cure.
- Communication of cure status is crucial for survivor well-being.
Purpose of the Study:
- To investigate how many childhood cancer survivors are informed about their cure.
- To explore factors associated with physicians communicating cure status.
Main Methods:
- Nationwide registry data and questionnaire survey of 301 childhood cancer survivors (≥5 years post-treatment).
- Online focus groups with 17 Swiss pediatric oncologists analyzed via thematic analysis.
Main Results:
- 78% of survivors reported being told they were cured; this varied significantly by cancer type (e.g., 49% for CNS tumors vs. 89% for lymphoma).
- Physicians cited reasons for not always communicating cure, including potential late effects, risk of relapse, individualized strategies, and reluctance to use the term 'cure'.
Conclusions:
- Physician communication of cure status to childhood cancer survivors is inconsistent.
- Decisions to communicate cure are influenced by cancer type, risk of late effects, and physician-specific strategies, impacting survivor mental health.
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