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This intervention aims to empower patients to discuss their emotional needs, much as similar interventions have focused on helping patients with cognitive tasks such as obtaining information. The intervention will be compared with CHESS, a state-of-the-art, web-based information and support program for cancer patients.

The Need

Patients with advanced cancer suffer from a myriad of emotional concerns. Unfortunately, they do not often raise these issues with their oncologists. This project will teach them to discuss their feelings in ways that their oncologists can attend to their needs. The intervention has a solid theoretical orientation, is based on current evidence, and uses the latest technology to empower patients to get their emotional needs met. By reducing emotional distress for patients with advanced cancer, this study has the potential to improve their quality of life.


450 eligible patients with advanced cancer and access to broadband Internet will be enrolled prior to a clinic visit that will be audio-recorded, and then randomly assigned to one of four arms: control, CHESS alone, COPE alone, or CHESS+COPE. Patients in the true control will receive no intervention; however, their internet usage will be monitored via self report. Patients in the CHESS arm will have access to a discrete set of tools on the CHESS website, including static information resources and patient discussion groups. Patients in the COPE arm will have access to the guided COPE intervention (described in detail in 7.2). Finally, the last group will have access to both CHESS and COPE. Patient internet usage will be monitored on both the CHESS and COPE sites.

Partners / Participant Sites

  • Duke University Medical Center
  • University of Pittsburgh Cancer Institute

Principal Investigators:
James Tulsky, M.D
Lori DuBenske, Ph.D