Research Highlights - Archives FY12

August 2012

Duncan Family Institute Strategic Research Initiatives

The Duncan Family Institute Executive Committee has identified a potential source of funding for new strategic research initiatives that could further the Institute’s mission to support cancer prevention research and education across                   MD Anderson’s campus.  

Susan Peterson, Ph.D., M.P.H.
Navigating Familial Cancer Risk in Colorectal Cancer Syndromes

 
Navigating Familial Cancer Risk in Colorectal Cancer Syndromes

Improved understanding of the genetic basis of major hereditary CRC syndromes has enabled the use of clinical genetic testing for guiding disease diagnosis, risk assessment, cancer surveillance and prevention interventions.  The two most common hereditary CRC syndromes are familial adenomatous polyposis (FAP) and hereditary non-polyposis CRC syndrome (HNPCC or Lynch syndrome).  The first individual, or proband, identified in a family that has a hereditary CRC syndrome requires coordinated cancer surveillance for all organs at risk and cancer prevention strategies that complement their cancer treatment.  The dedicated Familial High Risk Gastrointestinal Cancer Clinic (FHRGICC) was established in May 2010 to help achieve these goals.  However, a significant gap in our current program exists in our ability to reach greater numbers of at-risk family members due to a number of well-established barriers that hamper the extension of cancer genetic information to these groups.  Our limited ability to reach and recruit family members represents a significant missed opportunity for cancer prevention.

This work will advance translational research through the implementation of a new care delivery model in cancer genetics and will also create a scalable platform for this delivery model that can be expanded across high risk families at MD Anderson and potentially adopted nationwide.  It provides an opportunity for synergistic, multidisciplinary research encompassing clinical genetics, behavioral science and cancer prevention and establishes a model with the potential for long-term sustainability, given a robust electronic support system that may eventually allow for a “virtual patient navigator”.

January 2012

Seed Funding Research Program Grant Awards

We congratulate the four investigators who received awards this round.

The fifth round of Duncan Family Institute Seed Funding Research Program awards have been completed. These awards will provide funding at $50,000 per year for two years for a total of $100,000 to support research in the broad topic of cancer prevention and risk assessment in order to allow faculty to obtain preliminary data to improve competitiveness of cancer prevention and risk assessment research grant proposals submitted to external agencies.

Cindy Carmack, Ph.D.
Feasibility of a Couple vs an Individual-Oriented Mood Management Intervention for Distressed Lung Cancer Patient

Jae-Il Park, Ph.D.
Blocking a Novel Wnt Agonist for Cancer Prevention

Susan Peterson, Ph.D., M.P.H.
A social network approach to improve genetic risk communication

Leslie Schover, Ph.D.
Preventing Sexual Dysfunction in Women on Aromatase Inhibitors

Feasibility of a Couple vs an Individual-Oriented Mood Management Intervention for Distressed Lung Cancer Patient

Psychosocial interventions are important to the care of cancer survivors because of the negative effects psychological distress can have on patient quality of life and health status. Including the spouse in the delivery of psychosocial interventions may have benefits for both the patient and the spouse. Patients may adopt new health behaviors and follow treatment recommendations more reliably, resulting in a positive impact on their health. Spouses may experience health benefits in the form of reduced caregiver burden, improved health behaviors (e.g., smoking) and promotion of a healthy bereavement following the patient’s death. Using a web-based counseling approach to deliver psychosocial intervention may result in greater outreach for underserved couples, and may be easily integrated into cancer care. In this study, we will pilot test a web-based couple-oriented counseling intervention compared to a web-based patient only counseling intervention in 40 lung cancer patients who are experiencing psychological distress. We will explore the effects of both interventions on patient psychological functioning, health behaviors, treatment adherence, and symptom burden and on spouse psychological functioning, health behaviors, and caregiver burden.

Blocking a Novel Wnt Agonist for Cancer Prevention

We will study a novel molecule that is only detected in colon cancer and positively controls tumor promoting Wnt signaling pathway. This research is relevant to public health because elucidating the fundamental mechanism of cancer development is expected to provide a valuable basic concept and new model for cancer prevention, diagnosis, and treatment. The proposed research addresses the central issues that are important to understanding the underlying mechanisms of colon cancer development. In this project, we will (1) determine the role of a newly identified Wnt agonist in regulating tumor development and (2) further develop the efficient neutralizing methods.

A social network approach to improve genetic risk communication

Genetic testing for hereditary cancers is now part of standard oncology care, yet there are barriers to realizing its full benefits for patients and families. Studies consistently show that information about genetic risk may not be completely or accurately disseminated within families, and that families may grapple with the nuances and complexities of conveying genetic risk information. To address these issues, we propose an intervention, called My Family Garden, a web-based, secure social networking tool to enable the collection and sharing of family history and cancer risk information in families with hereditary cancer. Funding from the Duncan Family Institute will support the development, testing, and evaluation of a prototype system for My Family Garden. Long-term scientific goals include evaluating the efficacy of My Family Garden in enabling comprehensive communication of cancer risk information and adoption of cancer risk reduction strategies in high risk families.

Preventing Sexual Dysfunction in Women on Aromatase Inhibitors

Aromatase inhibitors have become the hormone therapy of choice for postmenopausal women with estrogen-positive breast cancer and will increasingly be prescribed to prevent breast cancer after menopause. Yet, 10% to 25% of women discontinue aromatase inhibitors in the first year of treatment because of negative side effects. Sexual problems are among the most distressing symptoms. Our study will survey women who began aromatase inhibitors in the past 12 to 18 months about changes in their sex lives. Their experiences will be compared to those of sexually active women assigned randomly when they start treatment to one of two groups: 1) usual care plus some brief, written brochures about sexual function or 2)access to an internet-based sexual counseling program supplemented with phone counseling. Two new vaginal moisturizers will also be compared in the counseled group. We want to see if staying sexually active and avoiding painful vaginal dryness will prevent more severe sexual problems and improve women’s ability to keep taking their aromatase inhibitors.

2012 Cancer Survivorship Research Seed Grants

Congratulations to the winners:

Anecita Fadol, Ph.D.
REcovery of the left ventricular dysfunction in CAncer Patients (RECAP trial) Health Status and Health Behaviors among Cancer Survivors: A Population Based Study

Angeles Lopez-Olivo, M.D., Ph.D.
Educational Website for Bone Health in Cancer Survivors

Susan K. Peterson, Ph.D.
Mobile Health Applications to Improve Survivorship Self-Management for Cancer Survivors The Role of Tryptophan Metabolism in the Chronic Fatigue Experienced by Chronic Myelogenous Leukemia (CML) Survivors

Nancy You, M.D.
Developing Quality Measures for Survivorship Care in Colorectal Cancer

REcovery of the left ventricular dysfunction in CAncer Patients (RECAP trial) Health Status and Health Behaviors among Cancer Survivors: A Population Based Study

The REcovery of left ventricular dysfunction in CAncer Patients (RECAP trial) is a pilot study about cancer survivors who developed heart failure while receiving cancer treatment. Some patients recover from heart failure with heart medicines. The current practice is for patients to take these heart medicines for life, because there is no data as to what will happen if patients stop taking the heart medicines after heart function improves. This study will examine if it is safe to stop these heart medicines in cancer survivors after the heart function returns to normal. The findings from this study will provide baseline information for a future large study to provide evidence to potentially change clinical practice and improve the cancer survivor’s quality of life.

Educational Website for Bone Health in Cancer Survivors

Bone health can prevent osteoporosis, one of the most frequent and potentially serious complications of cancer and cancer therapy. This project will develop an interactive web page containing bone health information tailored to the needs of breast and prostate cancer survivors. The goal of the project is to improve patients’ knowledge, self-management and awareness of bone health issues, and ultimately reduce the risk of fracture in cancer survivors.

Mobile Health Applications to Improve Survivorship Self-Management for Cancer Survivors”The Role of Tryptophan Metabolism in the Chronic Fatigue Experienced by Chronic Myelogenous Leukemia (CML) Survivors

The need for improved survivorship care to prevent the recurrence of cancer among survivors and to improve their quality of life has been widely recognized. The use of patient navigators is a promising approach to help survivors manage their survivorship care; however, relatively little is known about the efficacy of cancer survivorship navigation programs. Our project assesses breast cancer survivors’ navigation needs and preferences for a navigation program within the Survivorship Clinic at Lyndon B. Johnson Hospital in Houston. We also will interview clinic stakeholders to get their perspectives on the integration of this kind of program without disrupting clinic flow. Because the degree to which clinical staff can take on navigator roles is limited due to time and patient care demands, we also will assess whether personal health information systems and e-Health Technology (specifically, the HealthATM platform) can be leveraged to increase the effectiveness and sustainability of navigator efforts.

Developing Quality Measures for Survivorship Care in Colorectal Cancer

Providing high-quality care to cancer survivors represents a new challenge in cancer care. However, we know little about how patients do and what cares they receive once they finish the often intense cancer-directed treatments and enter what is termed "the extended phase of survivorship". Our project will help us learn these patient experiences and then develop ways that will help us measure the quality of care being delivered to survivors.