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Study of the Therapeutic Use of Language in Patients With Metastatic Colorectal Cancer

This study has been completed.
Sponsor:
Information provided by:
Hematology and Oncology Associates of NE Pennsylvania
ClinicalTrials.gov Identifier:
NCT00711672
First received: July 7, 2008
Last updated: June 10, 2011
Last verified: June 2011
History of Changes
  Purpose

The purpose of this study is to determine if the degree of agreement between patients and their physicians regarding the "story" of the illness correlates with improved patient symptom control and quality of life. Another goal of the study is to examine the actual language used by patients and physicians in a specific clinical situation.


Condition
Colorectal Cancer

Study Type: Observational
Study Design: Observational Model: Cohort
Time Perspective: Prospective
Official Title: Critical Negotiations: Narrative Agreement, Negotiation, and Register Use in Encounters Between Patients With Metastatic Colorectal Carcinoma and Their Oncologists

Resource links provided by NLM:

U.S. FDA Resources

Further study details as provided by Hematology and Oncology Associates of NE Pennsylvania:

Primary Outcome Measures:
  • Correlation of degree of "narrative agreement" with validated quality of life measures [ Time Frame: 6-8 weeks ] [ Designated as safety issue: No ]

Enrollment: 5
Study Start Date: July 2008
Study Completion Date: October 2009
Primary Completion Date: October 2009 (Final data collection date for primary outcome measure)
Groups/Cohorts
1
Medical Oncologists treating patients with metastatic colorectal cancer
2
Patients with metastatic colorectal cancer receiving re-staging CT scans

Detailed Description:

The purpose of this study is to investigate the co-created therapeutic narrative in scheduled office visits between adult patients with metastatic colorectal carcinoma and their medical oncologists in a community practice setting. The study will focus on the negotiation of the illness narrative and the semiotic (primarily linguistic) tools employed. The study will involve patients from a large community cancer center from Northeastern Pennsylvania (this center sees about 3,000 new patients each year). About 85% of patients with cancer in the United States are treated in this type of setting (National Cancer Institute, 2007), and so many results from this population are applicable to most cancer patients in the United States. The location of this study makes it very different from the majority of medical anthropological studies that are usually performed in urban academic medical centers or in sites outside of the United States or Western Europe. Although community cancer centers are the location of most of the treatment of patients with cancer in the United States, there are few to no studies published studying this patient population.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population

Patients with metastatic colorectal carcinoma and their physicians at a large community cancer center in Northeastern Pennsylvania.

Criteria

Inclusion Criteria:

  • Patients and Physicians at Hematology and Oncology Associates of NE Pennsylvania
  • Patients must have metastatic (stage IV) colorectal carcinoma
  • Patients must be on treatment for their disease
  • Patients must be scheduled for re-staging CT scans
  • Patients must be older than 18 years old

Exclusion Criteria:

  • Patients with a diagnosis other than metastatic colorectal carcinoma
  • Patients not receiving active treatment or not having re-staging CT scans
  • Patients younger than 18 years old
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00711672

Locations
United States, Pennsylvania
Hematology and Oncology Associates of Northeastern Pennsylvania, PC
Dunmore, Pennsylvania, United States, 18512
Sponsors and Collaborators
Hematology and Oncology Associates of NE Pennsylvania
Investigators
Principal Investigator: Christian S Adonizio, MD Hematology and Oncology Associates of NE Pennsylvania
  More Information

Publications:
Agha, A. (2007). Language and Social Relations. Studies in the Social and Cultural Foundations of Language. Cambridge, Cambridge University Press. 24: 242-244.
Ainsworth-Vaughn, N. (1998). Claiming Power in Doctor-Patient Talk. New York, Oxford University Press.
Austin, J.L. (1975) How to do things with Words. Ed. J.O. Urmson and Marina Sbisa. Cambridge, MA, Harvard University Press.
Cassell, E. J. (1991). The Nature of Suffering and the Goals of Medicine. New York, Oxford University Press: 37-43.
Charon, R. (2006). Narrative Medicine: Honoring the Stories of Illness. New York, Oxford.
Csordas, T. J. ed. (1994). Embodiment and experience: The existential ground of culture and self. Cambridge Studies in Medical Anthropology. Cambridge: Cambridge University Press.
Gee, J.P. (2005) An Introduction to Discourse Analysis: Theory and Method, 2nd ed. New York, Routledge.
Ferrell BR, Hassey-Dow K, Grant M. "Measurement of the QOL in Cancer Survivors." Quality of Life Research, 1995; 4:523-531.
Foucault, M. (1994). The Birth of the Clinic: An Archaeology of Medical Perception. New York, NY, Vintage Books.
Frank, A. W. (1995). The Wounded Storyteller: Body, Illness, and Ethics. Chicago, Chicago University Press.
Goffman, E. (1963) Stigma: Notes on the Management of Spoiled Identity. Englewood Cliffs, Prentice Hall.
Good, B. J. (1994). Medicine, Rationality, and Experience: an anthropological perspective. Cambridge, Cambridge University Press.
Laderman, C. and M, Roseman eds (1996) The Performance of Healing. London, Routledge.
Linde, C. (1993) Life Stories: The Creation of Coherence. New York, Oxford University Press.
Lock, M. and N. Scheper-Hughes (1996). A Critical-Interpretive Approach in Medical Anthropology: Rituals and Routines of Discipline and Dissent. Medical Anthropology: Contemporary Theory and Method. C. F. Sargent and T. M. Johnson. Westport, CT, Praeger Publishers: 47.
Mattingly, C. (1998). Healing dramas and clinical plots: the narrative structure of experience. Cambridge, Cambridge University Press
Mehan, H. (1996). The Construction of an LD student: A case study in the politics of Representation. Natural Histories of Discourse. M. Silverstein and G. Urban. Chicago, The University of Chicago Press: 253-276.
Mishler, E. G. (1984). The Discourse of Medicine: Dialectics of Medical Interviews. Norwood, NJ, Ablex Publishing Corporation.
National Cancer Institute (2007). "NCI Community Cancer Centers Program Pilot 2007-2010." from http://ncccp.cancer.gov/Media/FactSheet.htm.
Riessman, Catherine Kohler. (1993) Narrative Analysis. Newbury Park, Sage University Paperback
Ross, N. (2004). Culture and Cognition: Implications for Theory and Method. Thousand Oaks, CA, Sage
Sontag, S. (2002). Illness as Metaphor and AIDS and Its Metaphors. New York, Penguin Books.
Webb, M. (1999). The Good Death: The New American Search to Reshape the End of Life. New York, Bantam.

Responsible Party: Christian S Adonizio MD, Hematology and Oncology Associates of Northeastern Pennsylvania, PC
ClinicalTrials.gov Identifier: NCT00711672     History of Changes
Other Study ID Numbers: 808231
Study First Received: July 7, 2008
Last Updated: June 10, 2011
Health Authority: United States: Institutional Review Board

Keywords provided by Hematology and Oncology Associates of NE Pennsylvania:
Personal Communication
Doctor Patient Relations
Narrative Medicine

Additional relevant MeSH terms:
Colorectal Neoplasms
Intestinal Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Neoplasms
 Digestive System Diseases
Gastrointestinal Diseases
Colonic Diseases
Intestinal Diseases
Rectal Diseases

ClinicalTrials.gov processed this record on May 22, 2013