Managing Communication Around Cancer Diagnosis Gives Patients Sense of Control in an Otherwise Uncontrollable Situation

Asserting control over how to communicate -- or not communicate -- about their illness helps cancer patients overcome feelings of helplessness in a traumatic situation, according to researchers at The University of Texas at Austin.

Erin Donovan-Kicken, assistant professor of communication studies, and graduate students Andrew C. Tollison and Elizabeth S. Goins, set out to examine the strategies people with cancer use to communicate with family, friends and colleagues, and explore what is meaningful about communication during cancer. Their report, "A Grounded Theory of Control Over Communication Among Individuals with Cancer," is in the August issue of the Journal of Applied Communication Research.

Donovan-Kicken and her colleagues interviewed cancer survivors about strategies they used in managing information about their illness, how they approached conversations about their cancer with various audiences, challenges they faced, and advice they received or recommendations they would make regarding communication around cancer. Research participants also were asked to evaluate existing patient literature on how to talk to family and friends about a cancer diagnosis.

The researchers found that communication is an important factor in coping with cancer in that it enables people to exert control during a highly stressful and turbulent time. However, despite best efforts to structure and control that communication, cancer patients cannot always predict or control other people's reaction.

"Our study suggests that the very act of taking steps to be protective when communicating about cancer may benefit people because doing so empowers them during a time characterized by so much helplessness," said Donovan-Kicken, who has also studied topic avoidance among breast cancer survivors.

The findings are worthwhile for oncologists and survivor advocacy groups who are counseling patients and designing interventions to distinguish between asking "Are you opening up to people?" and "Do you have people you can talk to if you want to open up?"

Based on this research, patient literature could be refined to emphasize what is meaningful about communication from patients' perspectives, including suggestions on how to manage -- and withhold -- cancer communication and establish conditions that enable patients to experience their cancer in a way that suits their sensibilities.

Research participants expressed benefits from telling well-meaning family and friends to give them the space to feel ill or fall apart in private, to focus on themselves without needing to support others and to avoid people who were sad or overly solicitous.

Communication as a control mechanism is a double-edged sword, however.

"As hard as one tries to manage their cancer communication, they cannot control the flow of information or predict other people's reaction, which ultimately places limits on survivors' control," said Donovan-Kicken.