office (03) 9820 3006 or 920 3008
fax (03) 9820 3007

Cancer

Psychological morbidity, unmet needs and patterns of care in culturally and linguistically diverse cancer patients in Australia

2007-09
Butow, P., Girgis, A., Goldstein, D., Eisenbruch, M., Schofield, P., Jefford, M., and King, M.
NHMRC Project Grant 457432, $401,755
2007: $203,878
2008: $198,878

Psychosocial impact of hereditary cancer and the development and evaluation of effective patient education and decision support strategies

Meiser, B., Lobb, E., Tucker, K., Andrews, L., Kirk, J., Friedlander, M., Mireskandari, S., Kasparian, N., Wakefield, C. (CIs), Butow, P., Mann, G., Barlow-Stewart, K.,  Eisenbruch, M., Ward, R., Goldstein, D., Young, M-A, and Dudding, T. (AIs)
NSW Cancer Council, Strategic Research Partnership Grant Program, ($1,009, 982)
2006-10

2006: $249,856
2007: $250,267
2008: $250,267
2009: $129,796
2010: $129,796

Understanding barriers to effective cross-cultural communication about prognosis of metastatic breast cancer

Eisenbruch, M., Butow, P., Goldstein, D., Knight, R., Iedema, R.
National Breast Cancer Foundation, ($216,151)
2006-07

2006:   $112,812
2007:     $93,338

This research aims to:

  • increase our understanding of how culture affects understanding of the meaning of prognosis of metastatic breast cancer;
  • increase our understanding of the ways in which cultural differences between doctor and patient impact on effective communication about prognosis of metastatic breast cancer.

This research will investigate the hypotheses that:

  • communication between Anglo-Australian oncologists and patients from Chinese and Arabic-speaking backgrounds is compromised by the different cultural meanings assigned to the causes of breast cancer, the purpose of treatment, and to concepts of cure and prognosis more generally;
  • there are identifiable barriers to this communication, an understanding of which may better inform development of guidelines for culturally competent communication about breast cancer prognosis.

Chinese women at genetic risk of breast and bowel cancer

M. Eisenbruch, B.Meiser et al., Prince of Wales Hospital
SESAHS, $10,000

Hereditary cancer among Chinese families

Two studies of hereditary cancer have been developed in collaboration with the Psychosocial Research Group, Department of Medical Oncology, Prince of Wales Hospital. The aim of these projects is to identify the cultural barriers stopping Chinese families from attending familial cancer clinics. The cultural beliefs about kinship, genetics, the effects of supernatural forces upon health, and the understanding of risk, have been examined using ethnographically informed methods. The first study focused on Chinese patients and families attending the familial cancer clinics in New South Wales. The second study, in association with the SESAHS Women’s Health Service, is a study of Chinese families in the community who are not attending clinics. The findings are being used to inform health staff at familial cancer clinics, and the telephone helpline and outreach work of the NSW Cancer Council
Researchers:   Maurice Eisenbruch, Soo See Yeo, Bettina Meiser (Prince of Wales Hospital), Kristine Barlow-Stewart (NSW Genetics Education Centre), David Goldstein (Prince of Wales Hospital),  Katherine Tucker (Prince of Wales Hospital)
Publications: Optimising cancer services

Responses to recurrence of cancer among Chinese patients in Hong Kong and Australia

Calvin Chan, Elysia Thornton, David Goldstein (Prince of Wales Hospital), Maurice Eisenbruch, Michael Friedlander, Bettina Meiser (Prince of Wales Hospital), Basema Saddik

Perceptions of causality of illness are one major factor affecting the psychological demands of illness recovery, and an understanding of the causal perceptions of patients with recurrences will assist in the communication of information by health professionals to these patients, so that their psychosocial adjustment process and risk minimization behaviours can be maximized. Analysis of causality of recurrence of cancer can potentially be very different to that of the primary diagnosis. Many factors, both internal and external, come into play between the primary and secondary diagnosis to influence patients’ thought processes. Although individuals should never be categorized, a strong knowledge of cultural beliefs allows the information provider to be aware of potential conflicts and hurdles that could arise with certain patients. This study aims to ascertain whether Chinese have a more diverse view of causality of cancer with views unexplained by traditional western beliefs, or indeed, whether Anglo-Saxons may also have non-scientific theories about cancer recurrences which doctors may not be aware of. Thirty patients were recruited from the general oncology clinics at Prince of Wales Hospital in Sydney and a similar number at the Prince of Wales Hospital in Hong Kong. A semi-structured interview was performed, and the data are currently being analysed using quantitative and qualitative methodology.

Patients with hepatocellular carcinoma in New South Wales

While Australia is presently a low incidence country for hepatocellular carcinoma (HCC), this is known to be rising. Ethnic differences in incidence have been noted in other countries with diverse migrant populations. In this study, we examined the ethnic distribution and differences in behaviour of HCC in a cohort of patients treated at our hospital in New South Wales, Australia.
HCC patients (n=186) treated at the UNSW Department of Surgery from January 1990 to January 2001 were identified by retrospective review of the Liver Tumour Database.  Patients were divided into two ethnic groups, Asian and non-Asian, based on country of origin and ethnicity fields on hospital records. The two groups were examined for differences in gender distribution (chi-square test), age at diagnosis (t-test) and survival (Kaplan-Meier). 
Sixty-seven patients (36%) were of Asian ethnicity, including 44 Chinese (24%), 10 Vietnamese (5.4%), five Korean (2.7%) and three Japanese (1.6%). There were 119 non-Asian patients (64%), including 71 from Australia/UK (38%), 19 Italian (10%) and four Greek (2.2%) patients. There was no difference in gender distribution (80% male) between groups and there was no significant statistical difference in survival for ethnicity (p=0.8, log rank). Age at diagnosis was significantly younger for the Asian group (median 59 years, range 27 to 81) compared with the non-Asian group (median 66 years, range 25 to 90), (p=0.01).