Primary care providers (PCPs) play an increasingly central role in the care of cancer survivors, however many lack formal training in survivorship care. This study evaluated the impact of a structured video-based curriculum combined with Project ECHO™ sessions on PCPs' self-efficacy and communication practices in cancer survivorship care at a community-based family practice. PCPs completed an eight-module CME-accredited video curriculum followed by at least two monthly ECHO™ case-based consultation sessions. Surveys were administered at baseline before training (Pre), post-curriculum (Post 1), and post-ECHO (Post 2) using items adapted from the Survey of Physician Attitudes Regarding the Care of Cancer Survivors (SPARCCS). Self-efficacy was assessed across three domains, and communication practices across four domains. Changes between baseline and post-ECHO were analyzed using Wilcoxon signed-rank tests with Bonferroni correction. Eighteen PCPs completed baseline surveys. Fourteen PCPs completed all assessments. Self-efficacy improved across all domains, with significant increases observed at post-ECHO for appropriate surveillance testing (p = 0.015) and addressing potential adverse psychosocial outcomes (p = 0.005). Communication practices with patients and other providers showed favorable trends, but changes were not statistically significant. These findings suggest that pairing asynchronous education with telementoring can meaningfully build PCP confidence in survivorship care, offering a practical strategy for implementing PCP-led models. Improved provider confidence and communication may ultimately enhance coordination, continuity, and quality of care as survivors transition to primary care settings.

The first medical oncology visit is a pivotal step for sarcoma patients in their cancer journey and may often be accompanied by negative feelings such as anxiety, vulnerability and loss of control. Early, tailored education before the visit with the medical oncologist may enhance understanding of diagnosis and treatment, aid decision-making, and reduce distress. Newly diagnosed English speaking sarcoma patients were asked to watch four short videos (educational intervention, EI) that were created for the purpose of this study focusing on the initial consultation, multidisciplinary team, systemic therapy and clinical trials. The main objective was feasibility, defined as successful delivery of the intervention and completion of the study procedures. Impact on knowledge was assessed by a knowledge quiz. Perceptions of diagnosis were assessed by surveys administered pre and post the EI. Improvement was measured using paired t-test, Wilcoxon Signed Rank Test and McNemar tests. Twenty patients were enrolled between May and December 2025. Most participants were aged >50 years (75%), female (55%) and had a university or higher degree of education (65%). In the knowledge quiz, knowledge improved in 8/11 questions post EI. In Survey 2, improvements were seen in the proportion of patients feeling that they had enough information on diagnosis (30 vs 10% of patients, p<0.004), sarcoma team (80 vs 5%, p<0.001), treatment options (55 vs 5%, p<0.001), administration of treatment (95 vs 10%, p<0.001), goals of care (45 vs 5%, p=0.001), toxicities (80 vs 15%, p<0.001) and clinical trials (90 vs 15%, p<0.001). Patients found the videos helpful (90%) and easy to understand (95%). At Survey 2, patients felt more informed (65 vs 5% of patients, p<0.001), more prepared (35 vs 10%, p=0.18) and less anxious (75 vs 40%, p=0.039). At Survey 3, administered after the oncology consultation, further significant improvements were seen in patient-reported perceptions and understanding of their disease. After EI, an increased proportion of patients felt hopeful about the future (Survey 2: 70 vs 45%, p= 0.029; Survey 3: 70 vs 45%, p= 0.071). The delivery of sarcoma specific EI to newly diagnosed patients before their initial medical oncology consultation is feasible. Preliminary findings show increased knowledge of sarcoma and its management, and increased optimism about the future. (NCT06805773).

Lung cancer is the leading cause of cancer death globally. This study investigated how lung cancer patients and caregivers discuss treatment experiences and seek information in online Reddit communities. We found prominent concerns and sentiment patterns across 1,214 posts from six lung cancer subreddits (June 2013-February 2024). Sentiment analysis used Valence Aware Dictionary for sEntiment Reasoning (VADER), a previously validated Python tool for social media, assigning compound scores from - 1 (most negative) to + 1 (most positive). Caregivers authored 59.88% of posts and patients authored 26.77%. Advanced-stage disease dominated discussions (76% of posts mentioning staging were stage IV). Treatment modalities included chemotherapy (25.21%), immunotherapy (12.60%), and radiation therapy (11.86%). Overall sentiment was positive in 53.79% of posts. Patients (0.22) and caregivers (0.15) had significantly more positive sentiment than medical professionals (-0.42) (p < 0.001). Primary concerns were quality-of-life impacts (21.50%), cancer progression or recurrence (18.86%), and treatment side effects (17.46%). The Reddit community appears to be a source of supplementary of support, with 59.14% sharing personal experiences and 16.72% seeking symptom validation. This work suggests a potential psychosocial value in peer-to-peer online support platforms for information-seeking in lung cancer treatment. Healthcare providers may consider integrating digital peer support resources into all aspects of cancer management from prevention to palliative care and during cancer care, to address concerns inadequately met in traditional clinical settings.

Korean-born adults in the United States have a disproportionately high risk of gastric cancer (GC), reflecting in part early-life Helicobacter pylori exposure and familial risk. However, little is known about how individuals in this high-risk population understand their GC risk or how awareness relates to preventive behaviors. We conducted a community-based survey and urea breath testing across 14 screening events in New York, New Jersey, and Connecticut from June to October 2025. Among 315 participants, 287 completed the survey and testing. Overall, 48.8% had prior and/or current H. pylori infection, and 18.1% had active infection at screening. Preventive engagement was high, with 78.4% reporting prior upper endoscopy, most commonly for screening. In contrast, 58.9% recognized that H. pylori can cause GC, and 48.8% recognized the elevated GC risk among Koreans. Among 265 participants with complete data, prior endoscopy was more common among those aware of the association between H. pylori and GC (85.2% vs. 68.8%; OR 2.62, p = 0.0012). Current infection was less frequent among those who were aware (14.8% vs. 22.9%; OR 0.58, p = 0.13), although this difference was not statistically significant. The coexistence of high preventive engagement and incomplete risk awareness identifies an important educational gap. These findings support culturally responsive, community-based education that builds on existing preventive behaviors while strengthening understanding of GC risk and H. pylori-related prevention.

Understanding factors shaping perceptions of cancer-related information is important for public health communication. This study examined associations of three information-related predictors, understanding medical statistics, confidence in online health information, and difficulty interpreting social media information, with two outcomes: cancer information was too hard to understand (CTU) and concern about cancer information quality (CCQ). Data came from the 2022 Health Information National Trends Survey. The cross-sectional study included 1972 participants. Survey-weighted univariable and multivariable logistic regression models assessed associations between the three predictors and CTU and CCQ, adjusting for sociodemographic characteristics, health insurance, and cancer history. LASSO logistic regression, random forest, XGBoost, and support vector models were implemented to assess prediction performances for the outcomes. SHAP and variable importance plots identified influential predictors. Difficulty understanding medical statistics was associated with higher odds of agreeing CTU (AOR = 1.89, 95% CI: 1.17-3.05) and agreeing CCQ (AOR = 1.69, 95% CI: 1.11-2.57). Lower confidence in finding helpful health information online was associated with higher odds of both outcomes, whereas complete confidence was associated with lower odds relative to very confident. Greater difficulty interpreting social media information was associated with CTU (AOR = 2.92, 95% CI: 1.66-5.14) and CCQ (AOR = 1.89, 95% CI: 1.07-3.33). SHAP and variable importance identified difficulty understanding medical statistics, confidence in online health information, and difficulty interpreting health information on social media as key predictors. These findings emphasize public health communication strategies prioritizing statistical literacy, clearer cancer information, and improved evaluation of online and social media health content.

Health literacy interventions, message tailoring, and motivational strategies have substantially advanced cancer education over the past three decades. Yet persistent challenges across the cancer continuum-inconsistent screening uptake, probabilistic risk misinterpretation, and premature discontinuation of adjuvant endocrine therapy-suggest that an additional dimension, one largely absent from these otherwise sophisticated frameworks, is at work. Drawing upon constructivist epistemology, constructive-developmental theory, and extensive empirical evidence on lay meanings, this review examines the "expert's illusion of symmetry": the systematic tendency of oncology professionals to assume that patients organize health and illness meanings using the same multidimensional, integrated cognitive structures as clinicians. Empirical investigations across the adult lifespan and among breast cancer patients show that individuals distribute across qualitatively distinct socio-cognitive developmental levels regarding causal and preventive meanings, with prevention frequently construed at lower developmental levels than causation and Level 5 integration rarely attained spontaneously. Consequently, standard oncology messaging presupposes cognitive operations (e.g., asymptomatic disease detection, multifactorial risk, dynamic equilibrium) that recipients have not constructed. Evaluation methods that register mere recall or assent fail to detect this structural asymmetry. We propose a developmentally calibrated pedagogical framework that establishes educational practice in the patient's existing conceptual architecture while providing structured exposure to higher-order meanings via multi-level narratives. This framework is not proposed as a replacement for health literacy, tailoring, or motivational approaches, but as a complementary dimension-one capable of enhancing their effectiveness precisely because it has been surprisingly absent from them.

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive interstitial lung disease associated with a substantially increased risk of lung cancer. Yet IPF is still primarily conceptualized and communicated as a disease of progressive fibrosis. This creates an important diagnostic challenge: worsening cough, breathlessness, fatigue, functional decline, or weight loss may be attributed to progression of fibrosis even when malignancy is also a possibility. In the absence of standardized cancer surveillance guidelines for IPF, ensuring that patients understand their elevated cancer risk becomes particularly important. We argue that cancer-risk education can serve an important epistemic function. Drawing on the concept of hermeneutical injustice, we suggest that patients taught to understand their symptoms primarily through the framework of progressive fibrosis may lack an important interpretive resource for recognizing changes in their illness experience. Cancer-risk education should therefore be incorporated into initial and follow-up counseling for patients with IPF. The goal is not to make patients responsible for diagnosing cancer or to generate anxiety around every new symptom. Rather, education can close an interpretive gap, helping patients recognize that fibrosis and malignancy are not mutually exclusive explanations for clinical change and allowing them to participate as knowledgeable interpreters of their illness.

An expanding shortage in the oncology workforce alongside a declining physician-scientist pipeline underscores the urgency to engage medical students in oncology research early in training. At the [redacted] Comprehensive Cancer Center (CCC), a multidisciplinary working group of clinical faculty, medical students, graduate students, and staff developed and implemented a structured framework to improve the feasibility and accessibility of oncology research for medical students. Significant barriers limiting access were identified, including unclear expectations, difficulty identifying mentors, and limited familiarity with research process amongst trainees. This initiative demonstrates how NCI-designated Comprehensive Cancer Centers (CCCs) can leverage existing infrastructure to connect students with meaningful oncology research opportunities and, in doing so, build a more inclusive and representative oncology workforce. The approach described here is adaptable to other specialties and institutions seeking to improve medical student participation in research, broaden participation in academic medicine, and strengthen physician-scientist development.

Recovery after extremity sarcoma surgery is customarily judged by the visible evidence of healing. Yet for patients whose tumor involved an arm or a leg, recovery is also a psychological process of adapting to altered function, dependence, changed appearance, and continuing uncertainty. This reflection argues that cancer education may prepare patients thoroughly for the physical trajectory of healing while leaving the emotional trajectory less explicitly addressed, and that screening identifies depressive symptoms without helping patients understand what those symptoms may mean for their recovery. We propose psychological recovery literacy as a longitudinal educational goal that helps patients and families understand emotional change, recognize when support may be needed, and know where to seek it. A healed wound should not be mistaken for a recovered person.

Indigenous people affected by cancer often encounter services that do not reflect their languages, relationships, knowledge systems, or community priorities. Survivor narratives are used in cancer education, yet the educational work undertaken by survivors has not been mapped. This scoping review examined the roles, formats, reported outcomes, and conditions shaping implementation when Indigenous cancer survivors participated in peer education and community knowledge exchange. Following Joanna Briggs Institute guidance and the reporting guideline for scoping reviews, six databases were searched from inception through July 2026. Twenty-one reports published between 2005 and 2026 were included. Survivor knowledge moved in three overlapping directions: between survivors through reciprocal support, outward to communities through education and storytelling, and toward organizations through co-design, navigation, advocacy, and service learning. Survivors served as peer educators, storytellers, advisors, advocates, resource co-creators, and knowledge stewards. Their activities produced peer sessions, performances, videos, digital stories, service priorities, navigation guidance, and community archives. Program evaluations reported cancer learning, greater comfort discussing cancer, reduced treatment anxiety, increased confidence sharing information, information seeking, and higher screening intention. Other reports described feeling less alone, healing and affirmation, culturally safer engagement, community-defined priorities, and survivor or community control over the representation and circulation of stories. Resourcing survivor leadership may strengthen cancer education while protecting reciprocity, cultural authority, and community control.

Cancer fatalism-beliefs that cancer is inevitable, unpreventable, and closely associated with death-has been identified as a barrier to cancer prevention and early detection behaviors. Although socioeconomic disparities in cancer fatalism are well documented, most studies have relied on objective indicators of socioeconomic status, potentially overlooking the role of perceived financial circumstances. This study examined the association between subjective financial strain and cancer fatalistic beliefs among U.S. adults. Data were obtained from the 2024 Health Information National Trends Survey (HINTS 7), a nationally representative survey of U.S. adults (n = 5,824). Subjective financial strain was measured using respondents' perceived ability to live on their present income. Cancer fatalism was assessed using three widely used items reflecting beliefs that everything causes cancer, that cancer prevention is not possible, and that thinking about cancer automatically evokes thoughts of death. Survey-weighted ordinal logistic regression models were estimated for each outcome. Models were first estimated unadjusted and subsequently adjusted for age, sex, race/ethnicity, educational attainment, annual household income, family history of cancer, personal history of cancer, and health insurance status. Average marginal effects and predicted probabilities were calculated to facilitate interpretation. Fatalistic cancer beliefs were common among U.S. adults. Greater subjective financial strain was consistently associated with stronger endorsement of fatalistic beliefs. In fully adjusted models, compared with respondents living comfortably, those reporting greater financial difficulty had significantly higher odds of agreeing that everything causes cancer (OR = 1.53-3.11), that there is not much that can be done to lower cancer risk (OR = 1.21-1.41), and that thinking about cancer automatically evokes thoughts of death (OR = 1.54-2.43). Predicted probabilities showed a graded association, with stronger fatalistic beliefs observed among respondents reporting greater financial difficulty. Associations were most pronounced for beliefs concerning cancer ubiquity and cancer-related mortality. Subjective financial strain was independently associated with stronger cancer fatalistic beliefs among U.S. adults after accounting for objective socioeconomic status and other sociodemographic and health-related characteristics. These findings suggest that perceived financial circumstances may represent an important socioeconomic correlate of cancer fatalism and highlight the need for longitudinal research to clarify the temporal relationship between financial strain and cancer fatalistic beliefs.

France's national cross-specialty oncology training program (Transversal Specialized Training, FST) includes 6-month rotations in medical oncology and radiation oncology. For selected specialties, a mixed-stage pathway may replace the standard radiation oncology rotation with 3 months in radiation oncology plus 3 months in medical oncology or an oncology-certified parent-specialty service. We explored this alternative pathway's educational outcomes. We conducted an exploratory subgroup analysis of 19 residents who completed mixed-stage FST training within a nationwide FST evaluation cohort (n = 203). Outcomes included satisfaction across nine radiation oncology domains, pedagogical evaluations, organization preferences, perceived adequacy of a 3-month radiation oncology placement, and subsequent oncological engagement. Mixed-stage participants (mean age 30.5 ± 1.6 years; 10 males) were residents in urology (n = 7), dermatology (n = 5), hepato-gastroenterology (n = 3), endocrinology (n = 2), and pulmonology (n = 2). Most completed sequential training (16/19), which was also the preferred organization (17/19). Overall, six residents (31.6%) achieved high general satisfaction, defined as a composite score ≥ 7/10. Satisfaction varied substantially by specialty: both pulmonology residents achieved high satisfaction, whereas no hepato-gastroenterology resident did. Patient communication scored highest (6.47 ± 2.61), while clinical research training was lowest-rated (3.79 ± 2.27). High oncological engagement was reported by 8 of 19 residents. Mixed-stage radiation oncology training showed heterogeneous educational outcomes and variable implementation across specialties. Within the limits of this small exploratory analysis, these findings support prioritizing standardized 6-month radiation oncology rotations, or at minimum strictly auditable criteria when mixed-stage pathways are authorized.

The French Formation Spécialisée Transversale in oncology (FST), introduced in 2017, aims to provide oncological competencies to residents from non-oncology specialties through a one-year curriculum combining theoretical oncology teaching with two mandatory six-month rotations in medical and radiation oncology. Evidence regarding the educational outcomes of the radiation oncology part of the program remains limited. We conducted a national cross-sectional mixed-methods study between June and August 2025 among physicians who had completed the FST radiation oncology rotation between 2018 and 2025 (n = 203 respondents) and radiation oncology supervisors (n = 16 respondents). Primary outcomes included trainee satisfaction across nine radiation therapy (RT) learning domains (10-point scale), supervisor-assessed competencies, and post-training professional engagement. Multivariable analyses explored predictors of satisfaction and outcomes. Participants had a mean age of 29.6 ± 2.4 years, 65.5% were female, and the most represented specialties were hepato-gastroenterology (33.5%) and pulmonology (30.5%). Satisfaction varied markedly across domains, with highest ratings for patient communication (7.45 ± 2.47; 75.4% ≥7) and lowest for clinical research training (4.02 ± 2.68; 24.1% ≥7). General satisfaction differed by specialty, ranging from 7.90 ± 1.15 in neurology (85.7% high satisfaction) to 5.67 ± 2.05 in hepato-gastroenterology (32.4%). In retrospective supervisor assessments, theoretical RT knowledge was rated at 3.06 ± 1.39 for the beginning of the rotation and 7.19 ± 1.05 for rotation completion. Specialty-relevant RT competencies received the highest ratings (8.00 ± 1.26; 87.5% ≥7). High oncological engagement (≥ 70% clinical time) was observed in 55.7% of participants and showed no significant association with rotation satisfaction (r = 0.08, p = 0.25). The FST radiation oncology rotation was associated with heterogeneous trainee experiences across domains and specialties. Trainees reported strong satisfaction for communication and toxicity management but limited satisfaction for research training and autonomy, while supervisors reported favorable assessments of theoretical knowledge and specialty-relevant competencies at rotation completion. These findings support the development of specialty-adaptive curricula within a standardized national training framework.