quickly through extraneous materials to find the information that fills their particular needs. As a result, many organizations and institutions have started utilizing this medium to distribute information on end-of-life cancer care issues.

Health care providers have thus far made only limited forays into cyberspace. Most independent physician offices do not integrate Web technology into their private practices. However, those physicians who are currently comfortable interacting on-line report that this communication tool allows their patients more time to ask questions and get answers about many topics, including end-of-life concerns (Davis and Miller, 1999). All of the NCI-designated cancer centers support their own Web sites, in which they detail the resources they offer and provide some basic information about end-of-life care. The Johns Hopkins Oncology Center Web site, for example, has a “Guide to Cancer Services” page, which discusses pain control expectations patients should have and the types of support services offered by the center (Johns Hopkins Medicine, 1999).

Nearly all of the cancer organizations that patients and their family members have traditionally contacted by phone or letter have now constructed Web pages to disseminate their informational resources. Some, like Cancer Care, Inc. (http://www.cancercareinc.org) and ALCASE (http://www.alcase.org), offer free on-line reprints of their publications. Others, like the National Coalition for Cancer Survivorship (NCCS) (http://www.cansearch.org), allow visitors convenient ways to order materials. Cancer Care, Inc., also provides on-line support groups. Many organizations, in addition to listing their own information on their sites, supply detailed lists of other on-line resources and hyperlinks to those Web pages, to help patients and health professionals navigate more intelligently around cyberspace and find the information they need. This hyperlink network also promotes less publicized organizations and sites that novice Web users might not find on their own. The NCCS resource database, for example, offers brief descriptions and links to organizations more specifically able to provide psychosocial support to cancer patients and those that can help deal with pain. Through this dense network, patients or their family members who reach one site can begin to broaden their expectations about the various facets of proper end-of-life care (NCCS, 1999).

For additional support, entirely Web-based sources of patient education and information have emerged. On-line clinics have emerged that offer the services of physicians to answer medical questions, as well as diagnose patients or issue prescriptions. One of them, CyberDocs (http://www.cyberdocs.com), records nearly 100,000 visitors per month, indicating its growing popularity (Melton, 1999). Among the articles on its site, to which the on-line support staff can refer inquiring visitors, are those describing hospice care and advanced directives. Other sites, such as the



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