[Experimental program personalized care in patients with head and neck cancer]. / Expérimentation du parcours personnalisé des patients atteints d'un cancer des voies aéro-digestives supérieures.

OBJECTIVE: Describe the implementation and preliminary results of the "Experimental Program Personalized care" in patients with Head and Neck cancer. MATERIALS AND METHODS: After being selected a graduate nurse status, called coordination, participated in the development of forms of detection needs and concerns of patients, in collaboration with various health professionals. RESULTS: Between January 2011 and December 2012, 200 new patients with head and neck cancer were included: 62% with advanced cancer and 38% of early stage. No patient refused to participate in this experiment. At least one consultation with a psychiatrist was necessary for 82% of patients with advanced cancer. Social problems were the second axis of the needs of patients. CONCLUSION: By identifying the needs of patients and organizing their support, this evaluation optimizes not only the therapeutic care for the patient but also the management of human resources within the team.

[Multidisciplinary meetings in oncology do not impact the physician-patient relationship]. / La réunion de concertation pluridisciplinaire en cancérologie ne modifie pas la relation entre le médecin et son patient.

CONTEXT: The setting of multidisciplinary meeting (MDM) by the French Cancer Plan has introduced new decisional elements in the patient-physician relationship in oncology. METHODS: To assess the potential impact of MDM on this relationship, a study was conducted at the Tours Hospital: 145 questionnaires were collected from patients whose files have been discussed in MDM, 40 questionnaires were collected from physicians attending these meetings and an analysis of 324 files was performed. RESULTS: Patients recognize the decisional process of MDM as reassuring for 80% of them. However, a majority (73%) expressed that the most important for them is the relationship with the referring physician, almost all (96%) having a total or great confidence in him. The results emphasize that trust appears to be related to the quality of communication, open dialogue and the competence of the doctor in particular in the choice of treatment. A review of files shows that in 91% of cases, the opinion of the RCP is applied and that, in 69% of cases, the referring doctor delivers the information to the patient after MDM. From the physicians' perspective, 33/40 report that the MDM do not alter their relationship with the patient. We note that 35/40 express that the consultation after MDM facilitates the presentation of the decision and 37/40 that the decision is always or often applied in accordance with the opinion of the MDM. CONCLUSION: MDM appears in most cases in this study not to modify the patient-physician relationship. Due to the patient confidence into the referring physician, the role of this one is essential in integrating the decisional multidisciplinary opinion of MDM and it is important to ensure from his/her disengagement in the decisional process.

[Psychological aspects of cancer Information dedicated to patients and relatives]. / Vivre pendant et après un cancer. Information à l'usage des personnes malades et de leurs proches.

In response to the evolution of the information-seeking behaviour of patients and concerns from health professionals regarding cancer patient information, the French National Federation of Comprehensive Cancer Centres (FNCLCC) introduced, in 1998, an information and education program dedicated to patients and relatives, the SOR SAVOIR PATIENT program (SSP). The methodology of this program adheres to established quality criteria regarding the elaboration of patient information. Cancer patient information, developed in this program, is based on clinical practice guidelines produced by the FNCLCC and the twenty French cancer centres, the National League against Cancer, The National Cancer Institute, the French Hospital Federation, the National Oncology Federation of Regional and University Hospitals, the French Oncology Federation of General Hospitals, many learned societies, as well as an active participation of patients, former patients and caregivers. The information and dialogue handbook SOR SAVOIR PATIENT Vivre pendant et après un cancer reporting on the psychological aspects of cancer was worked out and published on the Web in 2005. The guide aims to provide cancer patients with support and advice about the psychological impact of the disease. It provides information on the possible personal consequences of the disease and treatments, in every domain: psychological, emotional, interpersonal, familial or professional. Patients are also advised of the emotional challenges associated with cancer, of the support they may expect at every stage of the disease, from diagnosis to treatment, and of psychological outcome after the disease is over. The document also provides healthcare professionals with a valuable, concise source of validated information on the psychological aspects of cancer, thus facilitating communication between carers and patients. Information provided in the present article has been selected from the information and dialogue handbook SOR SAVOIR PATIENT Vivre pendant et après un cancer. The document addresses the issue of the psychological support made available to the patients during and after the disease. The SOR SAVOIR PATIENT guide can be downloaded from the FNCLCC website at: http://www.fnclcc.fr

[Breaking bad news: cancer diagnosis]. / L'annonce du diagnostic de cancer.

The announcement of cancer diagnosis is always a traumatic state. For a long time, the physicians have been embarrassed to cope with emotional behaviours of their patients and received not enough help. In France, the "Plan Cancer" tries to organize the time of announcement. It constitutes an overhang which doesn't have to lead to imagine the existence of an "easy and simple solution". Psycho-oncology tries to support patients and medical staffs and must help everyone to understand expectations and limits in this field.