Personalised cancer medicine

Kerr, Anne; Chekar, Choon Key; Ross, Emily; Swallow, Julia; Cunningham‐Burley, Sarah

doi:10.7765/9781526141019

Cited by 31 publications

(27 citation statements)

References 125 publications

(164 reference statements)

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“…Our study of cancer patient, carer, and advocate efforts to access targeted therapies not freely available on the NHS developed from a wider ethnographic study of cancer patienthood and genomic medicine, which was largely based around case studies of NHS trials, feasibility studies, and standard care involving molecular profiling, Whole Genome Sequencing and/or targeted therapies (see Kerr et al . 2021 ). We identified instances of access advocacy for targeted therapies for cancer in interviews with some patients, carers, and professionals and we conducted online searches of UK press coverage, social media, charity websites, and patient forums.…”

Section: The Studymentioning

confidence: 99%

Accessing targeted therapies for cancer: self and collective advocacy alongside and beyond mainstream cancer charities

Kerr

Chekar

Swallow

et al. 2021

New Genetics and Society

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As precision oncology has evolved, patients and their families have become more involved in efforts to access these treatments via fundraising and campaigning that take place outside of the larger cancer charities. In this paper, we explore the solidarities, networks, and emotional work of the UKbased access advocates, drawing on the stories of nine advocates, which included interviews and content analyses of their social media posts and coverage of their case in news, commentary, and fundraising websites. We consider the emotional and knowledge work of building networks that spanned consumerist and activist agendas, forged individual and collective goals, and orientations toward the public, private, and third sectors as part of securing support and access. Through these various practices, the actors we have studied cultivated personal advantage and solidarities with other patients and advocates, and in so doing engaged in self and collective advocacy alongside and beyond mainstream cancer charities.

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Section: The Studymentioning

confidence: 99%

Accessing targeted therapies for cancer: self and collective advocacy alongside and beyond mainstream cancer charities

Kerr

Chekar

Swallow

et al. 2021

New Genetics and Society

Self Cite

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“… 4 This is despite the fact that targeted/immunotherapies, when viable and accessible, have radically transformed survivorship (eg, duration of treatment, types of side effects and symptoms) 8 and associated informal caring roles. While some attention has been paid to the emergence of ‘precision survivorship’ (surviving with/beyond targeted treatments/immunotherapy), 8 9 including initial studies of patient perspectives, 5 10–12 no research has foregrounded informal caregivers’ experiences and their interpretations of the precision turn in oncology. In this paper, we begin to fill this gap by delving into caregivers’ accounts of the relational, affective and societal dimensions of hope in the context of precision therapeutics.…”

Section: Introductionmentioning

confidence: 99%

“…The advent of precision oncology has led to a paradigm shift in cancer research, trials and care. 5 7 For example, in advanced/metastatic non-small cell lung cancer (NSCLC), precision therapies have increased the median overall survival (OS) rate to 18–36 months (compared with 8–17 months with chemotherapy), 25 and for ALK-positive NSCLC the median OS has reached 6–8 years. 26 27 Similarly in metastatic breast cancer the introduction of trastuzumab in 2000 improved 5-year survival rates for HER2 positive patients from 2% to 31%.…”

Section: Introductionmentioning

confidence: 99%

“… 39 Discourses of hope are intrinsic to the clinical trials industry 32 where the relational work of generating hope keeps the ‘promissory bioeconomy’ of medical innovation moving forward. 5 In this way, hope can unify—binding people (patient, professional, carer, support network, researcher, regulator) together in pursuit of common purpose—but it can also become a source of disagreement, conflict and disorientation. 40–42 Hope’s perceived therapeutic value can place emotional demands on caregivers (and others), who must work to generate, maintain and protect hope as a way of contributing to the patient’s care and potential survival 13 43 44 as well as to the potential survival of future patients.…”

Section: Introductionmentioning

confidence: 99%

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Hope in the era of precision oncology: a qualitative study of informal caregivers’ experiences

et al. 2023

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ObjectivesTo explore informal caregivers’ perspectives on precision medicine in cancer care.DesignSemi-structured interviews with the informal caregivers of people living with cancer and receiving targeted/immunotherapies. Interview transcripts were analysed thematically using a framework approach.SettingRecruitment was facilitated by two hospitals and five Australian cancer community groups.ParticipantsInformal caregivers (n=28; 16 men, 12 women; aged 18–80) of people living with cancer and receiving targeted/immunotherapies.ResultsThematic analysis identified three findings, centred largely on the pervasive theme of hope in relation to precision therapies including: (1) precision as a key component of caregivers’ hope; (2) hope as a collective practice between patients, caregivers, clinicians and others, which entailed work and obligation for caregivers; and (3) hope as linked to expectations of further scientific progress, even if there may be no personal, immediate benefit.ConclusionsInnovation and change in precision oncology are rapidly reconfiguring the parameters of hope for patients and caregivers, creating new and difficult relational moments and experiences in everyday life and in clinical encounters. In the context of a shifting therapeutic landscape, caregivers’ experiences illustrate the need to understand hope as collectively produced, as emotional and moral labour, and as entangled in broader cultural expectations of medical advances. Such understandings may help clinicians as they guide patients and caregivers through the complexities of diagnosis, treatment, emerging evidence and possible futures in the precision era. Developing a better understanding of informal caregivers’ experiences of caring for patients receiving precision therapies is important for improving support to patients and their caregivers.

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“…Bourret & Cambrosio, 2019 ; Cambrosio et al, 2021 ; Chorev, 2020 ; Kuch et al, 2020 ); and commercialisation versus contested assessments of patient benefit (Gavan et al, 2018 ; Gyawali & Sullivan, 2017 ). Few have sought to explore precision as it is subjectively experienced day to day, especially by those working at the frontline of patient care (though see Bergeron et al, 2021 ; Crabu, 2021 ; Kerr et al, 2021 ). Here, we build on and expand on this growing corpus of work—drawing on both classical and contemporary social and political theory—to help widen the analytic lens and better capture some of the affective and temporal complexities that are accompanying precision medicine as it is implemented in everyday clinical settings.…”

Section: Introductionmentioning

confidence: 99%

A sociology of precision‐in‐practice: The affective and temporal complexities of everyday clinical care

Kenny

Broom

Page

et al. 2021

Sociology Health & Illness

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The idea of 'precision medicine', which has gained increasing traction since the early 2000s, is now ubiquitous in health and medicine. Though varied in its implementation across fields, precision medicine has raised hopes of revolutionary treatments and has spurred the proliferation of novel therapeutics, the alteration of professional trajectories and various reconfigurations of health/care. Nowhere is the promise of precision medicine more apparent, nor further institutionalised, than in the field of oncology. While the transformative potential of precision medicine is widely taken for granted, there remains scant attention to how it is being experienced at the coalface of care. Here, drawing on the perspectives of 54 cancer care professionals gleaned through eight focus group discussions in two hospitals in Australia, we explore clinicians' experiences of the day-to-day dynamics of precision-in-practice. We illustrate some of the affective and temporal complexities, analysed here under the rubrics of enchantment, acceleration and distraction that are emerging alongside the | 2179

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Personalised cancer medicine

Cited by 31 publications

References 125 publications

Accessing targeted therapies for cancer: self and collective advocacy alongside and beyond mainstream cancer charities

Accessing targeted therapies for cancer: self and collective advocacy alongside and beyond mainstream cancer charities

Hope in the era of precision oncology: a qualitative study of informal caregivers’ experiences

A sociology of precision‐in‐practice: The affective and temporal complexities of everyday clinical care

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