• Use of non-internet cancer information [ Designated as safety issue: No ]
  
• Use of the internet for cancer resources [ Designated as safety issue: No ]
  
• Use of interactive technologies [ Designated as safety issue: No ]
  
• Communication with treatment team and family members [ Designated as safety issue: No ]
  
• Evaluation of internet resources [ Designated as safety issue: No ]
  
• Changes in internet use over the course of treatment [ Designated as safety issue: No ]
  
• Cross-sectional associations between patients' internet use and their individual, social, and professional network characteristics [ Designated as safety issue: No ]
  
• Internet use and changes in patients' beliefs and emotional functioning [ Designated as safety issue: No ]
  

OBJECTIVES:

• To document the proportion of women who use the internet to access treatment and symptom management information and to seek emotional support after diagnosis of metastatic recurrent breast cancer.
• To evaluate the association of treatment stage and effectiveness with internet use.
• To evaluate the association of individual differences in patients' demographics, beliefs, emotional functioning, and social and professional support with internet use.
• To evaluate the association of patients' use of the internet to seek resources with their beliefs, emotional functioning, and relationship functioning.

OUTLINE: Patients undergo assessments consisting of paper and pencil questionnaires at four time points. The timing of these assessments is linked to the patient's treatment course and her presumed need to access internet resources for information on cancer, treatment, symptom management, and emotional support. Patients who discontinue regular care at the Cancer Institute of New Jersey site during the course of the study may complete study assessments through phone interviews conducted by a member of the study team.

Patients undergo a baseline survey prior to deciding on a treatment course for their newly progressive disease. Patients complete the first part of the survey to provide information on demographics, beliefs about cancer, mood states, somatic symptoms, and available resources for cancer information and emotional support. Patients complete the second part of the survey, if they have used the internet previously to obtain information and resources about cancer or if they have received cancer information that someone else located on the internet for them, which inquires about patients' internet use, any internet resources they have received from family members, friends, or other people they know, and their own evaluation of these internet resources.

Patients undergo the second study assessment after completion of the first course of treatment and prior to initiating course 2 (i.e., 3 to 4 weeks after initiating treatment). The third study assessment occurs within the first 2 weeks after the medical oncologist's first evaluation of treatment response (i.e., 6-9 weeks after initiating treatment). The fourth assessment occurs after the medical oncologist's second evaluation of the patient's response to treatment, following tumor re-staging.

Patients complete several questionnaires during these assessments to provide information about personal characteristics (demographics, physical and psychological well-being, beliefs about cancer and treatment, optimism), social and healthcare networks (perceived social support, social network composition, beliefs about treatment team), and outcomes (use of non-internet cancer information, use of the internet for cancer resources, use of interactive technologies, communication with treatment team and family, evaluation of internet resources).

The following information is extracted from the patients' medical record: stage and node status at primary diagnosis, previous oncology surgeries, previous adjuvant treatments, current menopausal status, treatment at time of recurrence, disease free interval, site(s) of metastasis, and response to current treatment.