John Libbey Eurotext

Bulletin du Cancer

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Therapeutic education in oncology : involving patient in the management of cancer Volume 94, issue 3, Mars 2007

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Département de santé publique, Centre Léon-Bérard, 28 rue Laennec, 69373 Lyon Cedex 08, Centre régional de ressources pour l’information, la prévention et l’éducation sur les cancers, Institut de cancérologie de la Loire, 108 bis avenue A. Raimond, 42270 Saint-Priest-en-Jarez, Département interdisciplinaire de soins de support du patient en oncologie, Centre Léon-Bérard, 28 rue Laennec, 69373 Lyon Cedex 08

The notion of therapeutic education was only recently introduced in cancer. Although the term is commonly used, no standard definition exists for the concept and principles of therapeutic education and its efficacy remains to be assessed. Therapeutic education is complementary to the healthcare approach and aims to get the patients more involved in their disease and the treatment decision-making process. This discipline, placed at the interface of human and social sciences, was first developed for the management of chronic diseases (diabetes, asthma). It derives from the principle that involving patients in their own care and management can help them better adjust to life with a chronic disease. The lengthening survival time of cancer patients, which contributes to making cancer a chronic disease, as well as changes in the patient-caregiver relationship contribute to the development of therapeutic education in cancer. Pilot studies, conducted principally in the United States, evaluating the side effects of chemotherapy and the management of pain, have demonstrated that such educational programs could improve patient quality of life and decrease the side effects of treatments. The success of these programs depends on several parameters : taking into account patient’s opinion in the elaboration and preparation of the programs ; involving skilled multidisciplinary teams engaged in iterative educational actions ; having recourse to methodological tools to evaluate the impact of implemented programs. Consistent with the World Health Organization guidelines, research should be conducted in France in order to elaborate and implement cancer-specific education programs and evaluate their potential benefit. Patient education programs on pain, fatigue, nutrition and treatment compliance are currently being developed at Saint-Etienne Regional Resource Centre for cancer information, prevention and education, within the framework of the Canceropole Lyon Auvergne Rhône-Alpes.