SOUTHWEST PROGRAM FOR PANCREATIC CANCER

Pancreatic cancer is a difficult disease to manage given its highly advanced state when patients present with symptoms. Few cancers are perceived as more fatal among physicians who treat cancer patients resulting in:

perceptions of fewer treatment opportunities,

more frequent terminal prognoses (course and outcome of the disease), and

increased willingness to recommend end-of-life strategies such as hospice and palliative care (relieving the symtoms without effecting the cure).

For the pancreatic patient and her/his family, the timeframe for securing information and making decisions about treatment is uniquely accelerated (NCI Pancreatic PRG Report, 2000). Breast, colorectal, and especially prostate cancer patients are often encouraged to take time to investigate their disease and associated treatment options. However, pancreatic patients are under pressure to hasten the information management and decision making process due to the advanced stage of the disease and its rapid progression. This situation is particularly prevalent when physicians possess a “fatalism bias” about this disease. Education and provision of information to health care providers focused on new data regarding pancreatic cancer and current therapeutic options is imperative. Information-sharing is one of the goals of the OU ~ Southwest Program for Pancreatic Cancer.

To address these issues, researchers under the direction of Dr. H. Dan O’Hair in the Department of Communication at the University of Oklahoma are developing a model whereby patients can understand the decision-making process for pancreatic cancer care more fully and in a shorter time frame. Initial projects have resulted in a preliminary model termed CSAM or the Cancer Survivorship and Agency Model. Through information provided by this model, patients gain understanding and insight revealing that it is normal to experience anger, frustration, doubt, and uncertainty about their diagnosis and prognosis. The model emphasizes how patients and their families can move beyond these feelings and begin to experience empowerment and eventually responsibility and self-advocacy for taking control of their lifes. Continued research, improving the usability and practicality of the model will result in:

expansion of physician awareness relative to provision of information and patient decision-making,

environmental enrichment for patient decision-making,

improved understanding of communication mechanisms to obtain clarity blended with sensitivity

during physician–patient discussions regarding the diagnosis and probable course and outcome of

the disease, and

enhancement of communication skills relating to physician–patient interactions regarding potential therapeutic interventions to beneficially alter the course and outcome of the disease.

This page will be used to track the development and practical application of this program focused on communication and decision-making for pancreatic cancer patients.

For further information contact Dr. Dan O’Hair at the Norman campus (hdohair@ou.edu).

Related references:

O’Hair, D., Wittenberg, E., Brown, K., Hall, T., Ferguson, M., Doty, T., & Villagran, M. (in press). Cancer survivorship and agency model (CSAM): Implications for patient decision making. Health Communication.

O’Hair, D., Villagran, M. Wittenberg, E., Brown, K., Hall, T., Ferguson, M., & Doty, T. (2002). Cancer advocacy and liaison model (C.A.L.M.). Paper presented at the National Communication Association convention, New Orleans.

O’Hair, D., Kreps, G., & Sparks, L. (Eds.). (in press). Cancer care and communication. Cresskill, NJ: Hampton Press.