Simulation modelling is a powerful method for modelling both small and large populations to inform policy makers in the provision of health care. It has been applied to a wide variety of health care problems. Although the number of modelling papers has grown substantially over recent years, further research is required to assess the value of modelling.

SUMMARYThis study examined whether social support might enhance health-related quality of life in men (n = 89) treated for localized prostate cancer by improving their ability to cognitively process their cancer experience. Data were collected using two, structured in-person interviews and abstracting medical records. The baseline interview was within several months (T1) after treatment for cancer, and follow-up was 3 months later (T2). Most men (61.8%) were treated by radical prostatectomy. Results showed that T1 social support was positively related to T2 mental functioning, and this relation appeared to be mediated by T1 indicators of cognitively processing, intrusive thoughts and searching for meaning. These findings suggest that supportive social relations may improve mental functioning by helping men cognitively process their prostate cancer experience.

Objective The dramatic increase in papillary thyroid carcinoma (PTC) is primarily a result of early diagnosis of small cancers. Active surveillance is a promising management strategy for papillary thyroid microcarcinomas (PTMCs). However, as this management strategy gains traction in the U.S., it is imperative that patients and clinicians be properly educated, patients be followed for life, and appropriate tools be identified to implement the strategy. Methods We review previous active surveillance studies and the parameters used to identify patients who are good candidates for active surveillance. We also review some of the challenges to implementing active surveillance protocols in the U.S. and discuss how these might be addressed. Results Trials of active surveillance support nonsurgical management as a viable and safe management strategy. However, numerous challenges exist, including the need for adherence to protocols, education of patients and physicians, and awareness of the impact of this strategy on patient psychology and quality of life. The Thyroid Cancer Care Collaborative (TCCC) is a portable record keeping system that can manage a mobile patient population undergoing active surveillance. Conclusion With proper patient selection, organization, and patient support, active surveillance has the potential to be a long-term management strategy for select patients with PTMC. In order to address the challenges and opportunities for this approach to be successfully implemented in the U.S., it will be necessary to consider psychological and quality of life, cultural differences, and the patient’s clinical status.

These findings suggest that people with cancer who are most distressed may receive the most social support, but the conveyance of support can have negative consequences for self-esteem and affect.

Patient care following thyroid cancer treatment could be improved by providing ongoing education about lifestyle factors related to cancer risk, disease surveillance, and resources for treating and coping with cancer. Health care providers should become familiar with local and Internet-based sources of information and support related to thyroid cancer to improve patient access to this information.