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Cancer prevention clinical trials seek to enroll individuals at increased risk for cancer. Little is known about attitudes among physicians and at-risk individuals towards cancer prevention clinical trials. We sought to characterize barriers to prevention trial participation among medical oncologists and first-degree relatives of their patients.Physician participants were practicing oncologists in Pennsylvania. Eligible first-degree participants were adult relatives of a cancer patient being treated by one of the study physicians. The influence of perceived psychosocial and practical barriers on level of willingness to participate in cancer prevention clinical trials was investigated.Response rate was low among physicians, 137/478 (29%), and modest among eligible first-degree relatives, 82/129 (64%). Lack of access to an eligible population for prevention clinical trials was the most commonly cited barrier to prevention clinical trials among oncologists. Nearly half (45%) of first-degree relatives had not heard of cancer prevention clinical trials, but 68% expressed interest in learning more, and 55% expressed willingness to participate. In the proportional odds model, greater information source seeking/responsiveness (i.e., interest in learning more about clinical prevention trials from more information sources) (p = 0.04), and having fewer psychosocial barriers (p = 0.02) were associated with a greater willingness to participate.Many individuals who may be at greater risk for developing cancer because of having a first-degree relative with cancer are unaware of the availability of clinical cancer prevention trials. Nonetheless, many perceive low personal risk associated with these studies, and are interested in learning more.

Background. We previously reported that doctor-patient communication in the cancer context may be suboptimal. We therefore developed measures to assess patient communication preferences and established feasibility of an Internet-based intervention to improve communication. Methods. Cancer patients completed an Internet-based survey about communication preferences, with a summary provided to the physician before the consultation. Patients completed a follow-up survey to assess consultation content and satisfaction. Results. Study procedures were feasible, measures exhibited strong internal consistency, and patients expressed satisfaction with the intervention. Conclusion. The Internet offers an opportunity to assess patient preferences and prompt physicians about individual patient informational needs prior to the clinical encounter. J Cancer Educ. 2007;22:233–240.

Stressors presented during the late prenatal and early postnatal periods can have long-term effects on offspring behavior, due to the sensitive periods in the formation of brain circuitry associated with early development. This study investigated the long-term effects of prenatal (restraint during the last week of gestation) and postnatal (daily handling for 14 days postnatal) stress, alone and in combination, on adulthood pain behavior, analgesic responses to stress and morphine, and on behavioral indices of stress reactivity. We found that all of the adult responses measured were altered by perinatal manipulations. Nociceptive thresholds were increased by prenatal or by postnatal stress in males and females; application of both stressors in combination negated these effects. Elevations in morphine analgesia were also observed in animals undergoing either perinatal stressor, but not in those who received both stressors. Behavioral and analgesic responses to stress were consistent with previous observations of reduced stress responsiveness following neonatal handling, with some sex-specific findings. Male and female handled subjects exhibited decreases in stress behavior, and both groups of female handled subjects (regardless of prenatal stress [PS] condition) exhibited decreases in stress-induced analgesia (SIA). Males, on the other hand, exhibited decreases in SIA only if they were prenatally stressed (regardless of handling condition). Thus, prenatal and postnatal stressors have differing effects on the neural circuitry underlying pain, pain inhibition, and stress behavior.