title: A voice that wraps around the body--communication problems in the advanced stages of non-small cell lung cancer.
abstract: BACKGROUND
  Significant problems in clinician-patient communication have been described in the oncology literatures. Advanced stage non-small lung cancer a devastating disease, can cause the communication between survivors, significant others, and clinicians to falter. To date, however, no studies have used qualitative methods to examine experiential aspects of living with non-small cell lung cancer. Nor have any studies evaluated the tools survivors might use to repair some of the damage caused by living with this disease.
  
  
  METHODS
  Exploratory, two-part qualitative design.
  
  
  RESULTS
  Survivors of non-small cell lung cancer live with multiple fears and losses. These include a diminished sense of self, the loss of health, fears of pain in a future tainted by the threat of death, and increased feelings of alienation due to the loss of previous sources of meaning in life. These experiences significantly affect cancer survivors abilities to communicate with clinicians and significant others.
  
  
  CONCLUSIONS
  Survivors of non-small cell lung cancer often have difficulty sharing their experiences with others not suffering a similar affliction. Through their narratives with other survivors, however, patients are better able to initiate a biopsychosocial mechanism which enables them to create a cognitive map. This cognitive map helps survivors share their experiences with others, thereby repairing some of the damage caused by this disease, including the harm done to their communication with other people.
authors.affiliation: Department of Epidemiology, The University of Texas M.D. Anderson Cancer Center, Houston 77030, USA. rhmoore@mail.mdanderson.org
authors.forename: R J
authors.initials: RJ
authors.lastname: Moore
authors.forename: R M
authors.initials: RM
authors.lastname: Chamberlain
authors.forename: F R
authors.initials: FR
authors.lastname: Khuri
mesh_terms: D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000523:psychology*; D003142:Communication; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010146:Pain; D010817:Physician-Patient Relations; D012944:Social Support; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*