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Mesothelioma is an incurable asbestos-related cancer with a high symptom burden. Its long lead time means cases in the military context tend to be amongst veterans. Research into the lived experience of mesothelioma is sparse. Research shows British veterans and their families are likely to have particular needs accessing health services and support. This study explored the psychological effects of mesothelioma in the UK military context from the carer's perspective. It comprised a secondary data analysis of interview data plus semi-structured interviews with family carers of UK veterans with a mesothelioma diagnosis. Themes developed included ' Going the extra mile'; 'Shifts in previously robust characteristics and roles'; and 'Needing to know'. Military culture impacted both patients and carers, with participants reporting a reluctance to show weakness. Carers experienced guilt and traumatic stress symptoms. Moral injury was reported relating to carers' interactions with the Ministry of Defence (MOD) and the National Health Service (NHS). [ABSTRACT FROM AUTHOR]

Self- and family management (SFM) refers to patients' and family caregivers' activities to co-manage illness. Two barriers to SFM are low palliative care literacy and lack of goals of care communication, which potentially result in SFM activities that are unsupportive of patients' goals. Managing Cancer Care: A Caregiver's Guide (MCC-CG) aims to improve palliative care literacy and communication within a SFM training program. In this pilot randomized trial, we enrolled breast cancer family caregivers and collected data at 0, 1, and 3 months on palliative care literacy, SFM engagement, communication, transitions management, uncertainty, caregiver burden, and caregiver competence/personal gain. Participants (n = 35) had a mean age of 54 (range: 18–81) and were 66% white and 34% racial/ethnic minorities. Intervention participants improved their palliative care literacy and SFM engagement, reduced uncertainty and caregiver burden, increased competence/personal gain, and had more goals of care conversations over time. MCC-CG has preliminary efficacy, warranting further study. [ABSTRACT FROM AUTHOR]

While the supporting role of families and friends has been widely recognized in cancer care, little data exist on how they influence patients' decisions regarding clinical trial participation, accounting for patients' decisional preferences. The goal of our study was to examine the process of clinical trial decision-making from the perspective of adults with cancer and their decision partners. Semi-structured interviews were conducted with 12 patients and 12 decision partners—family and friends engaged in the medical decision-making. Themes included: (1) having the ability and confidence to make decisions; (2) gaining insight about clinical trials; (3) trusting someone in the process; and (4) realizing readiness and context. Our findings will enhance understanding of how patients make clinical trial decisions based on decisional preferences from the perspectives of patients and decision partners. The findings may also help to increase clinician awareness and inclusion of decision partners in conversations regarding clinical trials. [ABSTRACT FROM AUTHOR]