title: Communication challenges for chronic metastatic cancer in an era of novel therapeutics.
abstract: Advances in the production of novel therapies for cancer management are creating new challenges for the support of increasing numbers of persons surviving for extended periods with advanced disease. Despite incurable and life-limiting metastatic conditions, these patients are living longer with serious disease, pushing the boundaries of what science explains and clinicians can confidently interpret using available evidence. Here we report findings from an early subset of such individuals within a longitudinal qualitative cancer cohort study on clinician-patient communication across the cancer trajectory. In these findings, we contextualize experiential accounts of communication in a changing environment of the costs and uncertainties of personalized medicine, and examine the complex psychosocial circumstances of this rapidly growing patient population. Interpretation of these findings illustrates how emerging issues in cancer treatment influence the experience of these patients, their social and support networks, their cancer care specialists, and the multidisciplinary teams charged with coordinating their care.
authors.affiliation: University of British Columbia, Vancouver, British Columbia, Canada. sally.thorne@nursing.ubc.ca
authors.forename: Sally E
authors.initials: SE
authors.lastname: Thorne
authors.forename: John L
authors.initials: JL
authors.lastname: Oliffe
authors.forename: Valerie
authors.initials: V
authors.lastname: Oglov
authors.forename: Karen
authors.initials: K
authors.lastname: Gelmon
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003142:Communication; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000473:pathology* / Q000523:psychology* / Q000628:therapy; D018802:Patient-Centered Care; D057285:Precision Medicine; D011369:Professional-Patient Relations
keywords: cancer; cancer, psychosocial aspects; communication; interpretive description; relationships, health care; survivorship