The goal of this study will be to assess whether cancer communication between patients and their family caregivers is an important and independent factor in specific cancer care outcomes, including economic outcomes, especially labor market participation, quality of life and decisional outcomes. This study focuses on patients with hematological malignancies in adults which are important to study for a number of reasons. These cancers have been steadily increasing in the U.S. with an estimated 137,266 new cases in 2010. In addition, hematological cancer patients'social and psychological challenges and outcomes have not been adequately studied. Hematological cancers are particularly challenging because of their chronicity. How patients survive with this disease, including their ability to maintain their social and family commitments is critical. Few studies, however, have examined how hematologic cancers affect patients'and their caregivers'labor market participation. Strikingly, in comparison to the productivity cost of other cancers, hematological cancers are among the most costly cancers in terms of productivity loss due to premature death. This study will follow 250 pairs of employed hematologic cancer patients and their family caregivers over a two-year period to assess how they communicate about treatment and care decisions, which lead to specific psychosocial, economic, and healthcare outcomes. This study has the following aims:
Aim 1. Test longitudinally how cancer communication between caregivers and patients are associated with short and long-term economic, psychosocial, and healthcare outcomes.
Aim 2. Examine patient and family characteristics that are associated with decreased levels of cancer communication. !
This study will examine whether families and patients with blood cancers communicate well with each other about treatment and care decisions. These cancers can disrupt patient and caregivers'lives and can cause patients and caregivers stress and make it difficult from them to continue to work or meet their family obligations. This study will examine whether and how their communication is associated with these outcomes and how we can intervene in the future to improve their quality of life and is important because a growing number of people are affected by these diseases, many of whom are working age adults.