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Archna Sarwal and Andrew J. Roth

Optimism about improved survival from cancer has increased. However, even with tremendous improvements in screening techniques and treatment, a cancer diagnosis may shatter the dream of a dignified old age for elderly patients. Cancer diagnosis and treatment often produce psychological stresses resulting from the actual symptoms of the disease, as well as the patient and family's perceptions of the disease and its stigma. Concerns related to cancer have particular meaning for aging individuals who undergo these situations in the context of retirement, widowhood, other medical disabilities, and other losses. Today, patients and families are more interested in treatment issues and quality of life, both during and after treatment. In this article we discuss late life depression, anxiety, and delirium and treatments related to elderly patients coping with cancer.

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Neal J. Meropol, Joanne S. Buzaglo, Jennifer Millard, Nevena Damjanov, Suzanne M. Miller, Caroline Ridgway, Eric A. Ross, John D. Sprandio and Perry Watts

Although clinical trial research is required for the development of improved treatment strategies, very few cancer patients participate in these studies. The purpose of this study was to describe psychosocial barriers to clinical trial participation among oncologists and their cancer patients. A survey was distributed to all medical oncologists in Pennsylvania and a subset of their patients. Relevant background information and assessment of practical and psychosocial barriers to clinical trial participation were assessed. Among 137 oncologists and 170 patients who completed the surveys, 84% of patients were aware of clinical trials, and oncologists and patients generally agreed that clinical trials are important to improving cancer treatment. However, oncologists and patients were more likely to consider clinical trials in advanced or refractory disease. When considering 7 potential barriers to clinical trials, random assignment and fear of receiving a placebo were ranked highly by both patients and oncologists. Patients identified fear of side effects as the greatest barrier to clinical trial participation, whereas oncologists ranked this psychosocial barrier as least important to their patients. Overall, the study found that although oncologists and patients are aware of clinical trials and have favorable attitudes toward them, psychosocial barriers exist for patients that may impact participation in clinical trials. Furthermore, important discrepancies exist between the perceptions of oncologists and those of patients regarding what the psychosocial barriers are. We concluded that characterizing oncologist and patient perceived barriers can help improve communication and decision making about clinical trials, such that participation may be optimized.

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Lon Hays, Kenneth L. Kirsh and Steven D. Passik

Printing Office , DHHS Publication No. (ADM) 92–1887 , 1991 . 9 Bishop G . Health Psychology: Integrating Mind and Body. Boston : Allyn and Bacon , 1994 . 10 Brannon L Feist J . Health Psychology: An Introduction to

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Maura Chandler, Rebecca Cook, Alexandra Liu, Cindy Tran, Brittany Pike, Amy Chieng, Matthew Kendra and Judith Prochaska

including: (a) medication consultation with discounted or free cessation medications (nicotine replacement therapy, varenicline, bupropion) delivered to patients’ homes by Alto Pharmacy; (b) behavioral counseling with supervised clinical psychology practicum

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Chadi Nabhan and Bruce A. Feinberg

recognizes limitations of conducting expensive confirmatory randomized studies for every indication in every disease stage. 4 Behavioral economics is a discipline that combines insights from psychology, economics, judgment, and decision-making to better

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Alicia K. Matthews, Patrick W. Corrigan and Judith Lee Rutherford

psychology on discrediting psychiatric stigma . Am Psychol 1999 ; 54 : 765 – 776 . 25 Wahl OF . Mental health consumers' experience of stigma . Schizophr Bull 1999 ; 25 : 467 – 478 . 26 Corrigan PW Kleinlein P . The impact

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Doralina L. Anghelescu, Jennifer Harman Ehrentraut and Lane G. Faughnan

vs standard risk). Concordance was seen between the psychology interview and the SOAPP-R for identifying risk category in patients who received both assessments. Figure 1 presents the relationship of the risk category to the subsequent aberrant

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Alyssa A. Schatz, Thomas K. Oliver, Robert A. Swarm, Judith A. Paice, Deepika S. Darbari, Deborah Dowell, Salimah H. Meghani, Katy Winckworth-Prejsnar, Eduardo Bruera, Robert M. Plovnick, Lisa Richardson, Neha Vapiwala, Dana Wollins, Clifford A. Hudis and Robert W. Carlson

), anesthesiology, nursing, medical oncology, hematology oncology, internal medicine, neurology/neuro-oncology, radiotherapy/radiation oncology, psychiatry or psychology, complementary and alternative medicine, and pharmacology. The NCCN Guidelines are updated at

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Lucille A. Leong

specializing in psychiatry or psychology. Because the primary charge of the committee is to focus on the well-being and needs of the physician in question, members should not serve on other medical staff committees with disciplinary functions. WBC members often

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also noted the multidisciplinary composition of the NCCN Guidelines Panel for Adult Cancer Pain, which includes anesthesiology (pain), medical oncology, neurology, nursing, palliative and supportive care, clinical pharmacy, psychology, and radiation