Robert H. Carlson
Harnessing the Internet to Improve Cancer Care
new york citythe enormous potential internet improve cancer care obvious estimated one third cancer patients families developed world already going online information related disease statistic found 2003 first international conference cancer internet one year later percentage doubt even higher prevention patient education support physicianpatient physicianphysician communication could improved harnessed latest information communications technologies oncologists health communications experts attending recent actionoriented second conference oncologists health communications experts realized pick choose carefully among many possible projects goal meeting held rockefeller university sponsored european school oncology eso held auspices uicc international union cancer year since first conference working groups exploring suggestions bridging digital divide barrier separating people take advantage internet cannot important barriers digital divide appear differences language since healthrelated web sites english culture healthcomputer literacy said conference cochair alex jadad md dphil prof j gordon mcvie md senior consultant research european institute oncology milan health literacy computer literacy overcome people given sufficient support computer access said professor mcvie chair editorial board ots uk edition contrast language barrier bigger problem difficult overcome conference organizers hope convey return investment cancerrelated internet projects good terms improving cancer care want people recognize investment internet nonclinical variables improve oncology outcomes said conference coordinator matti aapro md kathy redmond msc rgn milan health care consultant european school oncology organizations former president european oncology nursing societyfigure conference cochair prof j gordon mcvie md health literacy computer literacy overcome people given sufficient support computer access contrast language barrier bigger problem difficult overcomeprojects projects conference organizers mind would foster digital inclusion patients public overcome barriers clinical use internet everyday practice foster global collaboration help consumers identify highquality web sites conference leaders also pragmatic projects continue working challenges leave others proactive attending meeting recognized need identify internet service providers software developers commercial telecommunications interests potential partners conferences work attendees also believed important find ways deal cognitive visual problems elderly disabled want use internet cancerrelated health information improving computer literacy core goal help patients public search internet information also physicians keep date oncology research communicate patients physicians undertake straw vote attendees organizers also identified projects believe undertaken example years conference recommended make guidelines quality cancerrelated web sites priority group proposed 2003 meeting policing internet enforcing guidelines big task group handle said impossible police internet guidelines exist efforts focus encouraging people use said ms redmond also editor esos new cancer world magazine formerly published different format cancer futures attendees believed resources might better invested programs educate patients identify quality sites raise awareness poorquality sites exist show cancerrelated site developers improve product straw vote also recommended working new programs increase enrollment cancer clinical trials good initiatives already way area duplication efforts avoided thinking less optimistic one speaker decidedly less optimistic internet cancer education david gustafson phd research professor director technology enhancing cancer communications tecc center excellence cancer communication research university wisconsin even though killing people information internet helping many said may good cancer information internet people finding many different interfaces noted hard people find theyre looking learn navigate web sites get discouraged leave dr gustafson described comprehensive health enhancement support system chess others developing limitedaccess information communications system offering highquality cancer information 5000 cancer patients families chess participants receive hour training use system search cancer information communicate support groups study conducted comparing online experiences chess participants controls access internet special training internet users received hour instruction using internet chess internet users links highquality web sites national cancer institute wwwcancergov american cancer society wwwcancerorg oncolink wwwoncolinkupennedu susan g komen breast cancer foundation site wwwkomenorg others put desktop computers chess participants got value time computer internet users controls internet users increase use health care sites controls chess users improved either controls internet users reported five months women breast cancer given access chess logged frequently women given access nonchess cancer patients spent far online time nonhealth sites aol yahoo amazon altavista especially email overusing internet communication gathering information analysis lead positive results patient education support dr gustafson said internet lot potential opportunities incredible think shouldnt get high yet long way go dr gustafson said dr gustafsons presentation ms redmond acknowledged internet work everyone works lot people said smoking affects feel good brain chemical system heroin brain scan study suggests nicotine alters smokers brain chemistry ways could help explain craving satisfaction smokers often say lighting cigarette calm nerves satisfy craving help relax team university michigan scientists found new evidence might smoking produces major changes flow feel good chemicals brain cells temporarily longterm changes flow match changes smokers say feel smoking news release notes first time smoking shown affect human brains endogenous opioids known play role quelling painful sensations heightening positive emotions creating sense reward system stimulated heroin morphine results presented annual meeting society neuroscience data come pilot study involving small group young male packaday smokers nonsmoking comparison subjects despite studys small size researchers say surprisingly large effect opioid levels found suggests promising road discovery appears smokers altered opioid flow time compared nonsmokers smoking cigarette alters flow 20 30 percent regions brain important emotions craving explained david j scott graduate student neuroscience program presented results change flow seen brain scan correlated changes smokers reported feeling smoking colleagues used pet imaging allowing see activity endogenous opioid system study participants first smoked special cigarette almost nicotine smoked regular cigarette scans participants rated relaxed alert sick nervous felt much craving tobacco findings confirm previous animal studies add previous understanding smoking affects flow dopamine team studying interaction dopamine opioids brains smokers nonsmokers hope also look underlying genetic differences might explain variations people response nicotine perhaps differences easily people become addicted cigarettes quit smoking interaction tobacco especially nicotine brain chemistry fascinating area beginning understand especially comes correlating neurochemistry behavior noted study leader jonkar zubieta md phd psychiatrist neuroscientist hard drugs abuse heroin cocaine phenomena pleasure addiction increased tolerance craving tobacco firmly rooted neurochemistry