Teresa Hagan Thomas PHD, BA, RN

In a healthcare world overflowing with test results, treatment choices, insurance forms, and medical vocabulary that occasionally seems designed by a committee of crossword-puzzle champions, patients need more than information. They need the confidence and practical skills to make that information work for them.

That challenge sits at the center of the career of Teresa Hagan Thomas, PhD, BA, RN, FAAN. An oncology nurse scientist, educator, mentor, and patient-advocacy researcher, Thomas studies how people affected by cancer can communicate their priorities, participate meaningfully in decisions, navigate complicated systems, and obtain care that reflects what matters to them.

As of July 2026, Thomas is associate dean for research and scholarship and an associate professor in the Department of Health Promotion and Development at the University of Pittsburgh School of Nursing. She also serves as associate director of mentorship and nursing research for the university’s Palliative Research Center. Her work connects nursing science, cancer survivorship, digital health, patient-centered communication, supportive oncology, and palliative care.

Who Is Teresa Hagan Thomas?

Teresa Hagan Thomas is best known for research focused on patient self-advocacy in cancer care. Rather than treating self-advocacy as a personality trait that some people magically possess, she approaches it as a collection of skills that can be understood, measured, practiced, and strengthened.

That distinction matters. Patients are frequently advised to “speak up,” but the instruction is not especially helpful when someone is frightened, exhausted, uncertain about medical terminology, or worried that asking another question will annoy a busy clinician. Thomas’s research examines what successful self-advocacy actually looks like and how clinicians, nurses, families, digital tools, and peer navigators can support it.

Her broader research interests include cancer symptom management, patient-centered care, healthcare utilization, caregiver support, financial distress associated with serious illness, measurement development, peer navigation, and the use of educational technology. The common thread is simple: healthcare should respond to the person experiencing the illness, not merely to the illness appearing in the chart.

An Educational Path Connecting People, Policy, and Nursing

Anthropology and International Peace Studies

Thomas earned a Bachelor of Arts in anthropology and international peace studies from the University of Notre Dame. At first glance, anthropology and oncology nursing may appear to be distant academic relatives who meet only at large family reunions. In practice, however, anthropology offers an especially useful foundation for patient-centered research.

Health decisions are influenced by culture, family relationships, language, trust, economic resources, social expectations, and previous experiences with institutions. Studying people and communities can therefore help a researcher understand why providing the same brochure to every patient is not the same thing as providing equitable support.

Clinical and Doctoral Nursing Education

Thomas later completed an accelerated Bachelor of Science in Nursing and a PhD at the University of Pittsburgh School of Nursing. Her doctoral work emphasized cancer survivorship and women’s health. She also earned a certificate in consumer health advocacy through the University of Wisconsin–Madison Center for Patient Partnerships.

Following her doctoral preparation, Thomas completed a postdoctoral fellowship in supportive oncology at Massachusetts General Hospital and Harvard Medical School. This combination of social-science education, clinical nursing, advocacy training, and research preparation helps explain why her work repeatedly crosses traditional boundaries between clinical care, behavioral science, health policy, communication, and technology.

Making Cancer Self-Advocacy a Teachable Skill

Self-advocacy in cancer care is sometimes misunderstood as demanding a particular treatment or arriving at an appointment carrying a three-ring binder large enough to qualify as checked luggage. Thomas’s framework is more practical and more collaborative.

Her research describes three complementary dimensions of cancer self-advocacy:

Informed Decision-Making

Patients need understandable information, opportunities to compare options, and the confidence to express their personal priorities. An informed decision is not merely a technically correct decision. It is one made with awareness of the likely benefits, risks, uncertainties, and effects on the patient’s life.

Effective Communication With Healthcare Providers

This includes asking for clarification, reporting symptoms honestly, discussing disagreements, requesting explanations, and stating preferences. Effective communication does not require a patient to become an amateur oncologist overnight. It requires a clinical environment in which reasonable questions are welcomed rather than treated like unexpected software errors.

Connected Strength

Self-advocacy is not always an individual performance. Patients often gain strength by receiving support, sharing experiences, learning from other survivors, and helping people facing similar challenges. Social connection can make it easier to process information, prepare questions, and continue advocating during a long course of treatment.

Measuring Whether Patients Can Get Their Needs Met

One of Thomas’s important scholarly contributions is the development and testing of the Female Self-Advocacy in Cancer Survivorship Scale. The original 20-item instrument was designed to measure how effectively women affected by cancer could have their needs, priorities, and preferences addressed when facing challenges.

The scale evaluates informed decision-making, communication with clinicians, and connected strength. It asks about behaviors such as seeking information, weighing options, asking questions, voicing concerns, obtaining second opinions, reaching out to other patients, and sharing personal experiences.

Initial validation research included hundreds of adult women with a history of invasive cancer and supported the instrument’s reliability and construct validity. Later research found that an adapted Self-Advocacy in Cancer Survivorship Scale could also be used with male cancer survivors, broadening the instrument’s potential use in clinical and research settings.

Measurement may sound less glamorous than discovering a futuristic treatment, but it is foundational. Researchers cannot reliably evaluate an intervention unless they can define and measure the outcome it is intended to change. Thomas’s scale gives researchers a structured way to identify where patients feel capable and where additional support may be needed.

Strong Together: A Serious Game With a Serious Purpose

Thomas and her collaborators translated self-advocacy theory into an unusually creative educational intervention called Strong Together. It is a narrative-based serious game developed to teach self-advocacy skills to people facing advanced cancer.

A serious game is created for an educational or behavioral purpose rather than entertainment alone. In Strong Together, users encounter realistic situations through fictional characters, consider possible responses, make choices, and observe the consequences. It is not Candy Crush wearing a lab coat. The game provides a comparatively safe space in which patients can rehearse difficult decisions before facing similar conversations in real life.

A published study enrolled 78 women who had recently received diagnoses of metastatic breast cancer or advanced gynecologic cancer. Participants were assigned either to the tablet-based game or to an enhanced usual-care group. Recruitment, retention, data completion, and game participation supported the intervention’s feasibility. Most participants completed a substantial portion of the program, and the study reported preliminary improvements in self-advocacy at three and six months among women assigned to the intervention.

These findings were promising but appropriately described as preliminary. Thomas subsequently received National Cancer Institute support for a larger study evaluating the efficacy of the intervention. The long-term objective is to determine whether an accessible digital program can improve patient-centered care, symptom experiences, quality of life, and patterns of healthcare usenot simply whether participants enjoy playing it.

Why Oncology Nurses Matter to Patient Advocacy

Thomas’s work does not place the entire responsibility for better communication on patients. That would be like handing someone a map of a maze and blaming them because the walls keep moving.

Oncology nurses are well positioned to identify concerns that have not been discussed, help patients prepare questions, clarify treatment instructions, assess symptoms, and reinforce the patient’s role in shared decision-making. Research involving Thomas has examined how nurses understand self-advocacy and how nursing practice can create opportunities for patients to express priorities more confidently.

This work reinforces an essential ethical point: encouraging self-advocacy does not excuse clinicians or healthcare systems from being accessible, respectful, and responsive. Effective advocacy is a partnership. Patients may develop stronger communication skills, but professionals must still listen, invite questions, respond to concerns, and recognize the barriers created by health literacy, discrimination, disability, poverty, geography, or limited access to specialists.

Financial Toxicity and the Hidden Costs of Cancer

Thomas has also contributed to discussions of financial toxicity in cancer care. The phrase describes the economic strain associated with illness and treatment, including medical bills, travel expenses, missed work, reduced income, childcare needs, insurance complications, and prescription costs.

Financial distress can influence whether patients fill prescriptions, attend appointments, report problems, or select recommended treatments. Yet money remains an uncomfortable topic in many clinical encounters. Patients may fear appearing irresponsible, while clinicians may assume cost questions belong elsewhere.

Thomas has emphasized the importance of recognizing financial hardship as part of the cancer experience rather than as an unrelated administrative inconvenience. A treatment plan cannot be genuinely patient-centered when the patient has no practical way to follow it.

Caregivers, Palliative Care, and Difficult Conversations

Thomas’s scholarship extends beyond individual patient communication. She has participated in research examining priorities for improving cancer caregiving, integrated palliative care, symptom management, and support for people navigating advanced illness.

Palliative care focuses on relief from symptoms, stress, and the wider burdens of serious illness. It can be provided alongside disease-directed treatment and is not limited to the final days of life. Thomas’s role within the University of Pittsburgh Palliative Research Center reflects her interest in improving both the experience of care and the systems through which support is delivered.

In 2024, she published the reflective essay “Three Days Was Enough” in the Journal of Clinical Oncology and discussed it through an oncology podcast focused on accepting hospice care. The piece added a personal, narrative dimension to her scientific work and illustrated how communication about serious illness involves emotion, timing, family relationships, and valuesnot only clinical criteria.

Mentorship, Teaching, and Professional Leadership

Thomas has taught subjects including oncology nursing, health policy, qualitative research, measurement, and community health. She mentors undergraduate students, graduate students, clinical trainees, and early-career investigators. Her current administrative and research-center positions place mentorship alongside scientific productivity rather than treating it as something squeezed into the five minutes between meetings.

Her professional service has included work with oncology nursing organizations, patient advocates, research teams, community partners, and national health organizations. She has also served as a Jonas Policy Scholar and contributed volunteer expertise to Oncology Nursing Foundation scholarship and research activities.

Recognition for her work has included a Gold Award from the International Serious Play Awards program for Strong Together and the 2023 Excellence in Nursing–Researcher award reported by Pittsburgh Magazine and the University of Pittsburgh School of Nursing. She has also been elected a Fellow of the American Academy of Nursing, reflected in the FAAN credential now accompanying her professional title.

Recent Directions in Thomas’s Research

Her recent work continues to explore how self-advocacy support can reach patients who may face structural or social barriers. One direction involves preparing people with personal cancer experience to serve as peer navigators. These navigators may help other patients locate resources, prepare for conversations, address practical obstacles, and communicate unmet needs.

A 2026 pilot study evaluated self-advocacy and navigation training for prospective peer navigators. Most participants who began the self-advocacy component completed it, and interview findings suggested that participants felt increasingly confident about providing support. Technical problems and time demands also emerged, offering practical guidance for improving future programs.

Thomas has additionally collaborated on work addressing rural oncology, digital interventions, cancer survivorship navigation, and exercise-based supportive programs. These projects suggest an expanding research agenda: not only teaching patients to advocate within existing systems, but also redesigning support so fewer people are left to navigate those systems alone.

Experiences That Illustrate the Importance of Her Work

The following examples are illustrative composites based on common challenges examined in cancer self-advocacy and oncology nursing research. They are not accounts of specific patients treated or studied by Teresa Hagan Thomas.

Experience 1: The Appointment That Moves Too Quickly

Imagine a patient arriving for an oncology appointment with six carefully written questions. The clinician enters, reviews scan results, introduces two treatment options, discusses possible side effects, and leaves enough new terminology in the room to assemble a small medical dictionary.

The patient smiles, nods, and asks none of the six questions.

Outside the clinic, those questions return immediately. Which option is more likely to preserve the ability to work? How often will treatment require travel? Is fatigue usually mild, or does “fatigue” mean sleeping through half the week? Can the decision wait three days?

Thomas’s self-advocacy framework shows why telling this patient to “be more assertive” is inadequate. The patient may need permission to pause, a question-prompt tool, clearer explanations, or a nurse who asks, “What matters most as you consider these choices?” Advocacy becomes possible when the environment makes room for it.

Experience 2: Asking for a Second Opinion

Another patient may understand the proposed treatment but remain uncertain. A second opinion could help, yet the patient worries that requesting one will offend the oncologist.

This hesitation is common because the patient-clinician relationship contains an unavoidable power difference. The clinician has specialized knowledge, institutional authority, and control over access to treatment. The patient may feel that disagreeing is equivalent to being difficult.

Self-advocacy reframes the request. Asking for another perspective is not an accusation. It can be a responsible form of informed decision-making, especially when choices involve major differences in side effects, timing, fertility, function, or quality of life. A supportive clinician can normalize the process and explain how records should be transferred.

Experience 3: The Side Effect Nobody Sees on a Scan

A patient begins missing work because of treatment. Parking costs accumulate. A spouse uses unpaid leave to provide transportation. An insurance notice arrives containing the alarming phrase “patient responsibility,” followed by a number that appears to have been selected during a game show.

None of these burdens is visible on an MRI, but each can affect health. The patient may delay filling a prescription, skip supportive therapy, or avoid reporting symptoms because an additional visit seems unaffordable.

Research on financial toxicity encourages healthcare teams to ask about these pressures before they become emergencies. A nurse, social worker, navigator, pharmacist, or financial counselor may identify assistance programs, transportation resources, insurance options, or less costly ways to manage symptoms. The experience demonstrates why economic well-being belongs in conversations about treatment feasibility.

Experience 4: The Nurse Who Notices the Unasked Question

During an infusion visit, a nurse notices that a patient becomes quiet whenever pain is mentioned. Instead of assuming that silence means everything is fine, the nurse asks a more specific question: “Are you worried that reporting pain will change how the team sees you?”

The patient admits to fearing opioid stigma and worries that discussing pain will make clinicians suspicious. That admission changes the conversation. The nurse can provide education, document the concern, involve the treatment team, and make clear that reporting symptoms is part of safe care.

This is advocacy support in action. The patient speaks, but the nurse creates the opening. Thomas’s work highlights how communication is shaped by trust and by the signals professionals send before a patient ever decides whether to disclose a concern.

Experience 5: When the Goal of Care Changes

For a person living with advanced cancer, there may come a time when additional treatment offers little benefit or creates burdens that no longer align with personal priorities. The patient may want comfort, time at home, fewer emergency visits, or the ability to remain mentally present with family.

These conversations can feel like surrender when they are framed only around what medicine can no longer do. A patient-centered approach instead asks what care should accomplish now.

Hospice or palliative care discussions require precision, honesty, and compassion. Patients and families need realistic information without feeling abandoned. They also need time to process what the information means. Thomas’s scholarship and reflective writing remind readers that even technically correct recommendations can fail when they ignore relationships, fear, identity, or the patient’s definition of a meaningful day.

Conclusion

Teresa Hagan Thomas, PhD, BA, RN, FAAN, has built a nursing research career around a deceptively straightforward question: How can people facing cancer obtain care that reflects their needs, priorities, and values?

Her answer is not limited to asking patients to speak louder. It includes creating reliable measures of self-advocacy, developing practical interventions, improving clinician communication, supporting oncology nurses, training peer navigators, confronting financial distress, strengthening mentorship, and designing healthcare environments that listen more effectively.

Through projects such as the Self-Advocacy in Cancer Survivorship Scale and the Strong Together serious game, Thomas has helped turn patient empowerment from a pleasant slogan into a field of measurable, testable, and teachable practices. Her work demonstrates that patient-centered care is not achieved simply by placing the patient in the room. It requires giving that person a meaningful role in what happens there.

Editorial note: This profile was prepared from publicly available institutional biographies, peer-reviewed publications, federal research records, professional nursing resources, and oncology research materials available through July 7, 2026. Illustrative experiences are educational composites and should not be interpreted as personal stories from identifiable patients.