The Effect of Genetic Counseling on Knowledge and Perceptions Regarding Risks for Breast Cancer

In 1994, a clinic for cancer risk counseling was opened at Hadassah University Hospital in Jerusalem. Most of the counselees have been women who had breast cancer and/or a relative with breast cancer. In order to evaluate the effect of this counseling on women's knowledge and perceptions regarding the risks for breast cancer, a questionnaire was given before and after the counseling session to 60 healthy women who came to the clinic because they have relatives with breast cancer. According to the genetic counselors' estimations, most of these women had a significantly increased risk (compared to the general population) of developing cancer. Before counseling, the women overestimated the population risk for breast cancer, the contribution of heredity to morbidity of cancer, and their own risks to get cancer. After counseling session, they gave reduced estimates, closer to the real ones. The subjective perceptions regarding these risks were reduced after counseling, except for the perceptions regarding their relativerisks which have not changed after the counseling. About 90% of the women who came to the clinic wanted to be tested for genetic predisposition to cancer. For most of these women, the expectations that the test can rule out a genetic predisposition to cancer became more realistic after the counseling. The option to first test an affected relative was offered to all families, and a test was actually conducted in 75% of the families.     

Psychological Interventions and Genetic Testing: Facilitating Informed Decisions About BRCA1/2 Cancer Susceptibility

Genetic testing for inherited cancer susceptibility, based on the recently identified. BRCA1 and BRCA2 genes, will soon be available on a large scale. However, at present, genetic test results do not lead to clearly indicated diagnostic or preventive measures, and the nature of the psychological impact of BRCA1/2 testing is still largely unknown. This uncertainty, combined with preliminary evidence suggesting significant individual differences in reactions to genetic susceptibility feedback, constitutes a unique challenge for any individual contemplating such testing. We outline the nature of this challenge and then propose an intervention strategy designed to help individuals make deeply processed and psychologically well-informed decisions with regard to their genetic susceptibility. The intervention is guided by recent research findings and theory on the cognitive–emotional processing of cancer-risk information. Specifically, the goal is to prepare the individual for genetic testing by (1) cognitively and emotionally activating, or preliving, the individual's potential reactions to testing feedback; (2) facilitating accurate appraisal of the individual's cognitive–emotional reactions; and (3) enabling the individual to process these reactions through the use of well-established clinical techniques.     

Ethnocultural Influences in Cancer

Compelling evidence that ethnicity is associated with serious disparities in cancer morbidity and mortality has been documented in the medical and public health literature. In addition to the role that socioeconomic variables play in affecting cancer outcomes, health professionals are beginning to pay attention to the influence of ethnicity and culture. This paper examines the role that ethnocultural factors contribute to cancer, with particular attention to breast, cervical, prostate, and colorectal cancers. Young and Zane's adaptation of a process oriented model of how culture and ethnicity affect disease is proposed as a useful framework to understand the illness experience. It is suggested that attending to ethnocultural issues will assist health providers and researchers toward developing and implementing strategies to improve cancer outcomes among ethnic populations.     

Fatigue and Quality of Life Following Radiotherapy for Breast Cancer: A Comparative Study

Clinical reports suggest that fatigue is a common and disruptive long-term side effect of radiotherapy; however, there has been little systematic attention given to this phenomenon. The primary aim of this study was to assess fatigue its impact on quality of life in women who had completed radiotherapy for breast cancer. A key feature of this study was the inclusion of a comparison group of women of similar age with no history of cancer. The results indicated that the fatigue experienced by women after radiotherapy for breast cancer was not significantly different in intensity, duration, or disruptiveness from fatigue experienced by healthy women. In addition, radiotherapy recipients reported a quality of life similar to that of the healthy women. For both groups of women greater fatigue was related to a poorer quality of life. These findings suggest that following radiotherapy for breast cancer, women can expect to experience fatigue which is not worse than what they might normally experience. This information may be a useful part of psychoeducational interventions designed for women scheduled to begin radiotherapy for breast cancer.     

Comment on “The Impact of Cancer on Psychological and Social Outcomes (Costa et al., 2016)”

The review written by (Costa et al. 2016) summarises a broad range of topics associated with what is known about the psychosocial outcomes of cancer in patients and their families. This commentary supplements this review by expanding on three topics that were not covered in the review. First, the challenges in assessing and diagnosing anxiety, depression, and distress in cancer patients due to overlapping symptoms with the disease state are highlighted. Second, the contribution of biological pathways such as inflammation upon the genesis and maintenance of anxiety, depression, and distress is acknowledged. Third, the potential role of religion and spirituality in influencing the psychosocial outcomes of cancer is raised. These three points are used to emphasise the importance of firmly incorporating a biopsychosocial model in research and health‐care provisions with cancer patients and their families.     

Quality of life and mental health among women with ovarian cancer: examining the role of emotional and instrumental social support seeking

The purpose of the present study was to examine the role of emotional and instrumental social support seeking in the quality of life (QOL) and mental health of women with ovarian cancer. Participants were recruited through the Pennsylvania Cancer Registry, and one hundred women took part in a mail questionnaire that collected information on their demographics, medical status, social support seeking, QOL and mental health including anxiety, depression and stress. Hierarchical linear regression analyses were conducted to assess the influence of emotional and instrumental social support seeking on QOL and mental health. After controlling for remission status, greater emotional social support seeking was predictive of higher overall QOL, social/family QOL, functional QOL and lower depression scores. Instrumental social support seeking was not significant in the models. The results illustrate that social support seeking as a coping mechanism is an important consideration in the QOL and mental health of women with ovarian cancer. Future studies should examine the psychological and behavioral mediators of the relationship to further understand the QOL and mental health of women with ovarian cancer.     

Healing Faith: A Qualitative Exploration of Latina Breast Cancer Survivors

Latina cancer survivors report higher levels of distress and depression and lower levels of social quality of life and overall health‐related quality of life when compared with all other cancer survivors. Cultural values influence cancer survivorship; however, little research to date has examined how aspects of the Latina culture may be healing during the cancer journey. Therefore, the purpose of this article is to present findings from a qualitative study exploring the influence of culture on quality of life for Latina breast cancer survivors. The authors use consensual qualitative research to understand the lived experiences of Latina breast cancer survivors.     

Changes over time in head and neck cancer patients’ and caregivers’ illness perceptions and relationships with quality of life

Objective: This study investigated changes in illness perceptions from diagnosis to six months later in patients with head and neck cancer (HNC) and their caregivers. The study also examined whether discrepancy in patient and caregiver perceptions at diagnosis predicted patient health-related quality of life (HRQL) at six months.

Design: Forty-two patient–caregiver dyads completed the Brief Illness Perception Questionnaire (Brief IPQ) at diagnosis and again six months later. Patients also completed a HRQL questionnaire at both time points. Analyses were performed using the Actor–Partner Interdependence Model.

Main Outcome Measure: Total patient HRQL assessed by the Functional Assessment of Cancer Therapy (FACT-H&N).

Results: Perceptions of emotional impact and illness concern reduced over time in patients and caregivers. Perceptions of treatment control and identity increased in caregivers only. After controlling for the effects of baseline HRQL, and the individual contribution of patient and caregiver illness perceptions, greater discrepancy in perceptions of timeline, personal control, and illness identity among dyads at diagnosis predicted lower patient HRQL at six-month follow-up.

Conclusion: Patients’ and their caregivers’ perceptions of HNC are dynamic over time. Greater discrepancy between patients’ and caregivers’ illness perceptions at diagnosis predict poorer subsequent patient HRQL.     

Nodule Detection with Eye Movements

Radiologists often miss nodules that may represent lung cancer on chest radiographs. We investigated whether eye movements collected during the search for lung nodules by large samples of laypeople may provide information that could assist radiologists in their detection. For that purpose, we developed a partially invisible Markov model with partially unobserved states and analyzed eye tracking data of over 100 laypeople who reviewed 14 chest X‐ray images, of which seven contained a potentially cancerous nodule. We used the luminance value of the pixels in the X‐ray images as prior information on the possible location of a nodule and identified six regions of interest on each image that may contain a nodule. Our study demonstrated that the eye movements recorded from laypersons contained information that may assist radiologists in the detection of nodules in chest X‐rays, which has important implications for crowdsourcing of search for pulmonary nodules, which are discussed. Copyright © 2016 John Wiley & Sons, Ltd.     

The positive contributions of hope to maintaining and restoring health: An integrative,mixed-method approach

A link between hope and physical well-being has long been suspected. To shed further light on this issue, an integrative theory of hope was used to design three health-related studies. In studies one and two, an integrative hope scale was used. In study one, greater hope was associated with depth of commitment to a healthier diet and regular exercise. In study two, the integrative hope scale was associated with a wider array of health behaviors as compared to a standard goal-oriented hope scale. In study three, a hope-centered content analysis of testimonies provided by long-term breast cancer survivors revealed a strong reliance on attachment and spirituality, dimensions typically neglected in psychological studies of this [hope] construct. An integrative approach to hope offers a framework for further research on hope and health as well as a blueprint for developing positive interventions to sustain and restore physical well-being.