MINI-REVIEW Online Social Networks - Opportunities for Empowering Cancer Patients

Online social network technologies have become important to and apply in most provides suitable platform for cancer patients and families to present and share information about their medical conditions, address their educational needs, support decision making, and help to coping with their disease and improve their own outcomes. Like any other new technologies, online social networks, along with many benefits, have some negative effects such as violation of privacy and publication of incorrect information. However, if these effects are managed properly, they can empower patients to manage cancer through changing behavioral patterns and enhancing the quality of cancer patients lives This paper explains some application of online social networks in the cancer patient care process. It also covers advantages and disadvantages of related technologies.


Introduction
Because cancer diseases impose large costs to communities, so that preventing and minimizing the impact of these diseases is great challenge that modern society facing with (Mohammadzadeh et al., 2013a). Cancer is not only a personal disease and beside its great influences on many aspects of patient life (Abbasnezhad et al., 2015); it has socioeconomically impacts (Cannon et al., 2012). Raise individual awareness about cancer leads to prevention and early detection of cancer and reduce mentioned costs (Mohammadzadeh et al., 2015). Patients with cancer desire to obtain updated information about different aspects of their disease such as sign and symptoms, diagnosis, treatment, side effects of various methods of treatment, follow up and cancer effect on their life (Shahrokni et al., 2013). Modern IT based and internet solutions empower patients and provider to gain this purpose (Karver and Berger, 2010;Davoodi et al., 2015). Online social networks are an example of these solutions that have been grown dramatically in recent decades. For example in the U.S., rate of adults using these technologies has increased from 8% to 72% since 2005 (Ventola, 2014). The social networks witch link patients and health care providers have created a revolution in health care system by providing new methods of care delivery (Rowley, 2014).
In cancer care like other areas of health care, social networks have great influences in physician, nurse and patient activities. It rapidly have been adapted by people

Online Social Networks -Opportunities for Empowering Cancer Patients
Zeinab Mohammadzadeh, Somayeh Davoodi, Marjan Ghazisaeidi* and made great changes in communication processes (Cain, 2011). In this paper online social networks and their effect on various aspects of life in patients with cancer have been described.

Online social networks
In recent decades the use of online social networks increases significantly because these powerful technologies decrease face to face visits and are accessible, inexpensive, user friendly and easy to use (Sugawara et al., 2012).

Online social networks definitions
Social media are mobile or internet base applications that gather and share information to facilitate communication between people (Von Muhlen and Ohno-Machado, 2012). Online social networks are one types of social media (Courtney, 2013) and they are sets of people with webbased social relationships that can create own public or semi-public profile within web site to connect other users and interchange information (Garton et al., 1997;Ellison, 2007;Steinfield et al., 2008). Some examples of online social networks applications are Twitter, Facebook, Myspace, Flicker and Instagram (Mislove et al., 2007;Steinfield et al., 2008;De la Torre-Diez et al., 2012;Cavallo et al., 2014;Attai et al., 2015).

Social network sites categories
Social network sites are used for different purpose including social networks (connect people with common interests such as Facebook, MySpace, Google Plus, Twitter), professional and academic networks (connect people with work-related context such as LinkedIn), multimedia sharing networks (share videos and photos such as YouTube, Flickr), educational and knowledge/ information aggregation networks (Wikipedia), Content production (blogs [Tumblr, Blogger] and microblogs [Twitter]) and virtual reality and gaming environments (Second Life) Scott, 2012;Rowley, 2014;Ventola, 2014).

Roles of online social networks in cancer patient care
Online social networks have a great potential for applying in the field of health according to some reasons including large amount of audiences, messages with greater impact than traditional strategies and high level on patient activity and participation (Maher et al., 2014). They are used for appointment setting, reporting test results, prescription notifications, and answering questions (Centola, 2013). In addition, advent of new generation of phones such as smart phones, mobile sensing devices and software applications with capability to share online and automatically information help online social networks to apply for cancer prevention and early detection programs (Cavallo et al., 2014).
Online social networks are modern technologies that help understanding people interactions and their activities and provide a fast way to find people who have the same experiences with cancer. The networks are used to online and simultaneously share information and experiences of sign and symptoms, diagnosis, treatment, adverse effects, care outcomes, medical evidences and life styles among individuals (Bakshy et al., 2012;Griffiths et al., 2012).
Cancer patients need information about their illness that help to improve treatment outcomes and increase patient participation in care process (Chelf et al., 2001). Addressing informational needs and patients education are the main parts of cancer patients care process (Harris, 1998). In recent years, use of the Internet and online social networks for quick access to health information among patients with cancer has been increased significantly (Azadmanjir et al., 2015). As well as social isolation reduces access to cancer care and health services for cancer patients; also studies show that high social relationship via social networks has positive effects on health status and treatment outcomes (Suarez et al., 2000;Yoon and Tourassi, 2014;Perkins et al., 2015).
In result due to rising cancer rates in the world, particularly in developing countries because of individual lifestyles (Haghdoost et al., 2014), policymakers should looking for innovative solutions such as social networks to define health priorities and effective cancer control by changing people's behavioral patterns (Mohammadzadeh et al., 2013b).

Online social network advantages in cancer patient care
Online social networks have many benefits for people and organizations. The main advantage of the social network is their capacity to transfer of best practices and usable experiences; in the other hand it can lead to behavioral changes in cancer patient for managing and controlling cancer (Suarez et al., 2000;Maher et al., 2014). Some examples of behavioral changes are having a healthful diet, leaving dangerous behavior such as smoking, alcohol consumption, inactivity, following regular and scheduled visits (Pinquart and Duberstein, 2010;Kim et al., 2015). All mentioned items can lead to enhance quality of life in cancer patients (Sapp et al., 2003;Kroenke et al., 2013).
Other benefits of online social networks for patient include, provide information in a similar situation for patients and their families, emotional support, share experiences of treatment between patients and their families, encouraging other cancer patients (Fernsler and Manchester, 1996), increase patient knowledge, decrease patient anxiety (Attai et al., 2015), present skill training with lower cost compared to other methods (DuBenske et al., 2010) and facilitate the communication between patients and providers (Griffiths et al., 2012).
Social networks by providing information resources help to rapid screening of cancer patients and lead to early detection of disease (Suarez et al., 1994;Ogedegbe et al., 2005;Lee et al., 2013). Studies show that providing different supportive activities through social networks may be able to increase survival rate and decrease mortality, disabilities and recurrence in cancer patients (Vogt et al., 1992;Kroenke et al., 2006;Lutgendorf et al., 2012).

Online social network advantages in cancer patient education
One of the main application of online social network in the health area is quick dissemination of education among patients. Health education has been reported to cause behavioral changes and performance promotion in both clinicians and patients (Glanz et al., 2008). Providing education for patient from cancer care providers can support cancer patient through reducing patient stress (Dunkel-Schetter, 1984) and have positive effects on treatment process and outcomes (Rainey, 1985;Chelf et al., 2001;Oliver et al., 2001).
Some educational benefits of online social networks for patients include provide educational information for population groups by using video and text sharing. These educational efforts empower patients self management, increse patient participation in care process, provide emotional supports and enhance patient safety (Ell, 1984;Househ et al., 2014).

Online social networks disadvantages
Although using online social networks have many advantages in the field of health especially in cancer care, but there are some negative aspect that need to regard. For example low and unsufficient quality of shared data and information (Ventola, 2014), Patient privacy and information confidentiality breach (Hader and Brown, 2010), problems of patient and provider relationships and legal issues (Centola, 2013;Ventola, 2014).Therefore it should be noted that unsuitable management and control of social networks may have adverse influence in cancer patients (Kroenke et al., 2012). DOI:http://dx.doi.org/10.7314/APJCP.2016.17.3.933 Online Social Networks -Opportunities for Empowering Cancer Patients

Conclusions
Increasing patient access to medical information by modern technological methods such as online social networks have important influence on the decisions and behavior of patient with cancer (Shahrokni et al., 2013). These networksalso provide the required information for people in remote areas, increase accessibility and reducing social disparities (Freeman, 2004). Online social networks can empower cancer patients and extend patient community and facilitate discovering useful information.
In result online social networks help cancer patients to coping with their disease andempower them to make safer and healthier decisions and finally improve outcomes of care process.Since the people's health are tied together, policy makers and health care providers should use online social network to identify these relationships and its impacts on people's health and then find appropriate ways to promote society's health.