Emotion Work during Colorectal Cancer Treatments

An interpretative phenomenological analysis of the psychosexual identity development in adolescent and young adult survivors of testicular cancer

BACKGROUND

Qualitative research has explored how some testicular cancer survivors (TCS) experience the psychological impacts of diagnosis and treatment. More research into the impacts of testicular cancer (TC) on adolescent and young adults (AYA) is needed due to the critical period of identity development. The present study aimed to explore how AYA with TC appraise and make sense of their experience and to develop a greater understanding of psychosexual identity development in AYA TCS.

METHOD

Eight AYA TCS were interviewed. The results were analysed using Interpretative Phenomenological Analysis. The questions explored the experiences relating to diagnosis and treatment, how it affected their psychosexual identity development (e.g., sexual relationships and self-image) and the meanings attached to the experiences.

ANALYSIS

Four Group Experiential Themes were developed from the data; 'Dealing with the shock', 'Fear and weight of responsibility', 'those closest to me' and 'sense of change'.

DISCUSSION

The AYA TCS experiences may result in adoption of traditional masculine traits (e.g., stoicism) or abandonment of traditionally masculine traits (E.g. violence and aggression). AYA TCS also described feelings of insecurity when compared to other men. Psychology input could help manage stoicism and feelings of inferiority when compared to men with two testicles.

Ambivalent Speculations: Learning to Live with Barrett's Esophagus in the UK Using Facebook Support Groups

Drawing on fieldwork in Facebook support groups, in this article I explore how people, now patients, learnt to live with Barrett's esophagus, a risk state or "precancer" for a type of esophageal cancer. This diagnosis brought the possibility of both facing and averting cancerous futures into the present. Far from passive recipients, members worked to foreground speculations of "wanted futures" in which prompt surveillance successfully prevented cancer deaths, transforming cancer risk into an opportunity for hope. Speculation here was an ambivalent and active process, involving not only the "observation of potentiality," but the opening up and foreclosing of both desirable and undesirable potentialities.

Single-cell RNA sequencing reveals that the immunosuppression landscape induced by chronic stress promotes colorectal cancer metastasis

The high prevalence of depressive disorders in individuals with cancer and their contribution to tumour progression is a topic that is gradually gaining attention. Recent evidence has shown that there are prominent connections between immune gene variants and mood disorders. The homeostasis of the tumour immune microenvironment (TIME) and the infiltration and activation of immune cells play a very important role in the antitumour effect. In this study, we established a compound mouse model with chronic unpredictable mild stress (CUMS) and orthotopic colorectal cancer to simulate colorectal cancer (CRC) patients with depression. Using 10✕Genomics single-cell transcriptome sequencing technology, we profiled nearly 30,000 cells from tumour samples of 8 mice from the control and CUMS groups, revealed that immune cells in tumours under a chronic stress state trend toward a more immunosuppressive and exhaustive status, and described the crosstalk between the overall inflammatory environment and immunosuppressive landscape to provide mechanistic information or efficacious strategies for immune-oncology treatments in CRC with depressive disorders.

To share or not to share: communication of caregiver-reported outcomes when a patient has colorectal cancer

BACKGROUND

The importance of patient-centered measurement in cancer care has led to recognition of the potential for caregiver-reported outcomes to improve caregiver, patient and healthcare system outcomes. Yet, there is limited evidence to inform caregiver-reported outcome implementation. Our purpose was to generate evidence to inform the meaningful and constructive integration of caregiver-reported outcomes into cancer care to benefit caregivers, including exploration of the question of the extent to which these assessments should be shared with patients. We focused on caregivers of patients with colorectal cancer (CRC) because CRC is common, and associated caregiving can be complex.

RESULTS

From our Interpretive Description analysis of qualitative interview data from 78 participants (25 caregivers, 37 patients, and 16 healthcare providers [HCPs]), we identified contrasting perspectives about the sharing of caregiver-reported outcome assessments with patients with CRC. Those who preferred open communication with both the patient and caregiver present considered this essential for supporting the caregiver. The participants who preferred private communication without the patient, cited concern about caregiver- and patient-burden and guilt. Recognizing these perspectives, HCPs described strategies used to navigate sensitivities inherent in preferences for open versus private communication.

CONCLUSIONS

The integration of caregiver-reported outcomes into cancer care will require careful consideration of caregiver and patient preferences regarding the communication of caregiver assessments to prevent additional burden.

Cancer, COVID-19, and the need for critique

In this open letter we examine the implications of the coronavirus disease 2019 (COVID-19) pandemic for cancer research and care from the point of view of the social studies of science, technology, and medicine. We discuss how the pandemic has disrupted several aspects of cancer care, underscoring the fragmentation of institutional arrangements, the malleable priorities in cancer research, and the changing promises of therapeutic innovation. We argue for the critical relevance of qualitative social sciences in cancer research during the pandemic despite the difficulties of immersive kinds of fieldwork. Social science research can help understand the ongoing, situated and lived impact of the pandemic, as well as fully underline its socially stratified consequences. We outline the risk that limiting and prioritising research activities according to their immediate clinical outcomes might have in the relational and longitudinal understanding of cancer practices in the UK. Finally, we alert against potential distortions that a "covidization" of cancer research might entail, arguing for the need to maintain a critical point of view on the pandemic.

Game-changing? When Biomarker Discovery and Novel Forms of Patient Work Meet

I analyze the promised efficacy of Pembrolizumab, an immunotherapy regime under clinical trial for patients with metastatic colorectal cancer. Drawing on anthropological fieldwork with patients and health professionals in a gastrointestinal cancer clinic in London, UK, I tease out the dynamics through which scientists and clinicians assemble personalized technologies to halt cancer growth in patients' bodies; what patients undergo in order to participate in these innovations; and the constraints that restrict the efficacy of these treatments. Beyond examining the treatment possibilities that clinical trials offer, I illuminate some of the gaps made visible when personalization happens from below.

Cancer, COVID-19, and the need for critique

In this open letter we examine the implications of the coronavirus disease 2019 (COVID-19) pandemic for cancer research and care from the point of view of the social studies of science, technology, and medicine. We discuss how the pandemic has disrupted several aspects of cancer care, underscoring the fragmentation of institutional arrangements, the malleable priorities in cancer research, and the changing promises of therapeutic innovation. We argue for the critical relevance of qualitative social sciences in cancer research during the pandemic despite the difficulties of immersive kinds of fieldwork. Social science research can help understand the ongoing, situated and lived impact of the pandemic, as well as fully underline its socially stratified consequences. We outline the risk that limiting and prioritising research activities according to their immediate clinical outcomes might have in the relational and longitudinal understanding of cancer practices in the UK. Finally, we alert against potential distortions that a "covidization" of cancer research might entail, arguing for the need to maintain a critical point of view on the pandemic.