Get access

Self-Advocacy Training for Cancer Survivors

The Cancer Survival Toolbox


  • Katherine Walsh-Burke msw, ph d,

    1. Katherine Walsh-Burke, MSW, PhD, Associate Professor, Springfield College School of Social Work, Springfield, Massachusetts.
    Search for more papers by this author
  • Carol Marcusen msw, lcsw

    1. Carol Marcusen, MSW, LCSW, Director of Social Services, University of Southern California/Norris Comprehensive Cancer Center and Hospital, Los Angeles, California.
    Search for more papers by this author

  • The Cancer Survivor Toolbox is available, without cost, in English and Spanish. To obtain the Toolbox, you may dial 1-887-TOOLS4U (1-887- 866-5748) or contact the National Coalition for Cancer Survivorship, Oncology Nursing Society, or Association of Oncology Social Work web sites (,, or

  • The Cancer Survival Toolbox was made possible through an educational grant from Genentech BioOncology.

Address correspondence to: Katherine Walsh-Burke, MSW, PhD, Springfield College School of Social Work, 263 Alden Street, Springfield, MA 01109.


objectives: With the advent of managed healthcare, self-advocacy has been identified as an essential skill for cancer survivors. This article describes a self-advocacy training program, the Cancer Survival Toolbox, developed through a unique collaborative effort by the National Coalition for Cancer Survivorship, the Association of Oncology Social Work, and the Oncology Nursing Society.

materials and methods: Self-advocacy training is provided in audiotape format, as well as through the Internet and in interactive groups. The need for this training was established through surveys completed by 569 cancer survivors and 833 oncology professionals. Essential skills were identified through a literature review, and the content of the training was pilot tested with bicoastal groups of cancer survivors and with feedback from representatives of 15 national cancer organizations.

results: While the majority of the 569 respondents to the survivor survey were highly educated and between the ages of 31 and 60 years, fewer than half reported that when they first received a diagnosis of cancer they were able to communicate their needs effectively, had the skills necessary to make decisions, or were able to negotiate with healthcare providers, insurers, and employers. Results of the survey of professional oncology nurses and social workers also supported the need for self-advocacy training. Fewer than one third of the 833 respondents to the professional survey reported that their patients who had received new diagnoses of cancer had essential self-advocacy skills.

conclusions: This self-advocacy training program is currently available on audiotape in English and Spanish. It is available in print in Chinese on the Internet. Data from the pilot groups indicate the program effectively addresses the self-advocacy skills of communication, information seeking, problem solving, decision making, and negotiating. Data are currently being collected to assess the efficacy of the audiotape format and the impact of the training on survivors and professionals. Future plans include training oncology professionals to teach these skills and to work collaboratively with survivors in advocacy efforts. Additional programs designed to address the needs of the uninsured as well as older adult and pediatric survivor populations are in development.

Get access to the full text of this article