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Dr. Tom Hack
Professor and CIHR/NCIC Research Scientist
Psychosocial Oncology and Cancer Nursing Research
Research Focus
The purpose of the Psychosocial Oncology and Cancer Nursing Research Group is to generate new knowledge and transfer existing knowledge into policy and practice to reduce the burden of cancer.
Our research group came into being in 1992 with the assistance of a development grant from the Medical Research Council and the generous provision and development of space at the St. Boniface Hospital Research Centre.
The scientists in this group are dedicated and successful researchers studying ways of enhancing the well-being of adults and children diagnosed with cancer, and the individuals who serve as their caregivers. Dr. Lesley Degner is known internationally as an expert in fostering patient involvement in decisions about their treatment and care, and has extensively researched the areas of patient information needs, and symptom management of lung cancer patients. Dr. Tom Hack, a recipient of the Queen’s Golden Jubilee medal, is committed to enhancing the coping and adjustment effort of cancer patients, and strengthening communication between cancer patients and health professionals. Dr. Roberta Woodgate, a Dorothy J. Lamont Scholar, has dedicated her career to addressing the illness needs of children and adolescents with cancer, and ways to enhance health promotion among the young. Dr. Michelle Lobchuk, a research scientist with the National Cancer Institute of Canada, is an accomplished scholar who is developing theories and interventions to better explain and assist caregivers who are tending to the needs of cancer patients. Dr. Susan McClement, an award-winning teacher, has research projects in the areas of ethics and end-of-life, the nutritional needs of late-stage cancer patients, and the psychosocial needs of dying patients.
About Dr. Tom Hack
Dr. Tom Hack is an Associate Professor in the Faculties of Medicine, Nursing, and Graduate Studies at the University of Manitoba, and a clinical psychologist with CancerCare Manitoba.
Dr. Hack received a Bachelor of Commerce degree with distinction from the University of Saskatchewan, and a Bachelor of Science degree with honours from the University of Calgary. He went on to pursue graduate studies at the University of Manitoba, where he obtained both his Master's degree and Ph.D. in clinical psychology. He completed his clinical internship at Harvard Medical School, being the first and only Canadian to ever receive a fully paid scholarship to the program.
Dr. Hack is the Principal Investigator of a national research team, funded by the Sociobehavioural Cancer Research Network of the National Cancer Institute of Canada (NCIC), examining communication between patients and health professionals in the context of cancer. He has received research grants from the Canadian Institutes of Health Research and the NCIC to examine the effectiveness of using consultation recordings of primary treatment consultations to enhance the well-being of persons diagnosed with cancer. He also studies aspects of coping and adjustment to cancer. He has numerous publications and research presentations to his credit.
In addition to his research activities at the University of Manitoba, Dr. Hack maintains a clinical practice in the Department of Patient and Family Support Services at St. Boniface General Hospital.
In the year 2000, Dr. Hack was named the first recipient of the Dorothy J. Lamont Research Scientist award from the National Cancer Institute of Canada and the Canadian Institutes of Health Research. In 2002, Dr. Hack received the Queen’s Golden Jubilee Medal in recognition of his contributions to those affected by cancer. In 2006, he received the University of Manitoba Merit Award for research accomplishment.
For more information, please contact:
Dr. Tom Hack
[t]: (204) 235-3791
[f]: (204) 233-7214
Email:
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In Detail
AN OPPORTUNITY TO LISTEN AGAIN
Dr. Hack has extensively explored coping and adjustment issues in breast cancer patients. He and his colleagues have found that the nature of a patient’s coping responses around the time of diagnosis is significantly predictive of adjustment and quality of life 3 years later. Patients who demonstrated avoidance and denial responses at the time of diagnosis were significantly worse off in terms of adjustment. While it is important to acknowledge and respect individual differences in the extent to which women want be involved in treatment decision-making, this finding has pointed out the need for interventions to enhance patients’ involvement in their care.
Dr. Hack has conducted a series of studies examining the value of providing newly diagnosed cancer patients with an audio-taped recording of their primary treatment consultation. This consultation is one during which treatment alternatives are discussed and patients are provided with a great deal of information, often including their prognosis. Frequently, due to fear and anxiety, they have difficulty retaining this information. Dr. Hack speculated that providing an audiotape could, in a sense, bring the doctor home to the kitchen table and thus improve recall and satisfaction with communication. Indeed, findings of his study of over 600 patients in Winnipeg, Calgary, Edmonton and Vancouver showed that the consultation audiotape enhanced patient perception that treatment information was discussed during the consultation. This finding was repeated in a similar study that provided consultation audiotapes to men diagnosed with prostate cancer. Over 1,000 patients participated in these two audiotape studies, and patients rated the audiotape intervention highly.
In a subsequent study involving the use of consultation recordings to enhance informed consent to clinical trials in breast oncology, results showed that most women with breast cancer preferred a consultation audiotape over a standardized letter providing trial-relevant information. Plans are now underway for an implementation trial that will evaluate the consultation recording intervention with additional oncologists and cancer patients from across Canada. If the findings of Dr. Hack’s future consultation recording studies are consistently positive, he hopes his work will result in patients with a variety of diagnoses of cancer being provided with an recording of their primary treatment consultation so they can be better equipped to play an informed role in their treatment decisions.
ENHANCING QUALITY OF LIFE
Dr. Hack is also involved in a number of studies that look at the quality of life of patients who have undergone cancer treatment. The results of this research will be valuable for both patients and caregivers when treatment options are being considered, and follow-up care is provided.
In a landmark study, Dr. Hack and his colleagues systematically documented the psychological and the physical morbidity associated with the axillary lymph node dissection procedure in the treatment of breast cancer. This treatment can involve severing intercostobrachial nerves, a major nerve battery affecting motor and sensory activity in the arm. They found a significant relationship between the extent of invasiveness of the surgery and the patient’s quality of life and mental well-being years later. This research informed alternative surgical approaches that are being developed now, including sentinel node biopsy. Dr. Hack is now involved in a national, prospective, and longitudinal study of arm lymphedema following breast cancer surgery. This is the largest study of its kind ever conducted.
Another study of Dr. Hack’s compared breast cancer patients who had undergone a lumpectomy to those who received a mastectomy. After two years, researchers found a significant difference in mental health between these two groups of women. The women who received the lumpectomy exhibited poorer mental health – greater distress – than the mastectomy group. Dr. Hack hypothesizes that this could be due to greater fears of recurrence.
STRENGTHENING THE PATIENT-PROFESSIONAL ALLIANCE
Dr. Hack leads a national team of researchers mandated to conduct research to understand and improve communication between cancer patients and the professionals who provide them with cancer care. A national research study launched by this team involves examining the provision of information about treatment options to men newly diagnosed with prostate cancer. The goal of this research program is to help these men understand their treatment options so they can make informed treatment decisions. A second national study this team is launching involves establishing a national website for men diagnosed with prostate cancer and the oncologists who provide care to them. One goal of this on-line community will be the provision of treatment and support information that men can access in a secure, private, and confidential manner by way of the computer. A related goal is the integration of patients’ care plan into the website for use by health professionals and patients.
In summary, Dr. Hack’s overall goal is to reduce the patient burden of cancer diagnosis and treatment by developing interventions that will help them to be better informed treatment consumers, to strengthen their relationships with health professionals, and to reduce their emotional distress.
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