Celebrating life: lessons learned from a bone marrow transplant reunion.

The number of persons undergoing bone marrow transplantation (BMT) has increased dramatically over the last decade to more nearly 15,000 each year throughout the world. Addressing the physical and psychosocial needs of this particular population is of utmost importance as greater numbers of persons face the challenges associated with surviving BMT. Most of the research to date has been with survivors of allogeneic transplants. The increasing number of autologous transplant survivors presents a new constituency to evaluate. A reunion was held at a regional cancer center to bring together former BMT patients, their families, and the staff who had cared for them. The purpose was to provide attendees with a forum in which to ask questions, to offer them a historical perspective on this treatment, and to begin to gather long-term data on their transplant experiences. The latter was done initially by mail questionnaire and continued in the day's breakout sessions. The information gained provides a strong incentive to increase research efforts on long-term effects of BMT. The reunion surpassed everyone's expectations both in terms of attendance and overall success of the program content and networking, which has continued.

Presenting a diagnosis of cancer: patients' views.

BACKGROUND: Although in general, patients in the United States are now told if they have been diagnosed as having cancer, little information is available either about the way in which this is done or about patients' satisfaction with how they are told. METHODS: Thirty-two patients were interviewed who had been given a diagnosis of cancer; one half were being treated at a comprehensive cancer center and one half at a community hospital. The study instrument, presented in a semistructured interview conducted by psychosocial clinicians, included specific questions about the setting and the manner in which the patients were told, their reactions to the diagnosis, and their suggestions of how physicians should inform others who have to be informed of a similar diagnosis. RESULTS: All patients were told of their diagnosis by a physician; 84% of the time the diagnosis was given in person. Patients said that being told with hope, information, and caring, and with respect for their privacy and wishes to have a supportive person present were particularly helpful. Almost 40% of patients reported at the time of the interview that their hopes were directed toward remission and optimal quality of life rather than toward a cure. Four of the six patients whose conditions had initially been misdiagnosed described subsequent mistrust of information received from physicians. CONCLUSIONS: These findings confirm the importance of a physician providing hope for and fostering trust in patients to whom they are presenting the diagnosis of cancer. The results indicate that physicians' help in providing treatment information contributes more to hope than does cheerfulness or optimism, and that patients who have been given a misdiagnosis require special consideration in order to reestablish trust.