MD Anderson study finds sensor-based monitoring of cancer patients at home during radiation treatment may identify problems in their early stages

Study followed head and neck cancer patients looking for signs of dehydration, a common and sometimes dangerous side-effect

MD Anderson News Release 01/15/14

MD Anderson researchers may have found a high-tech solution to detect a common side effect of cancer treatment in its early stages, before it becomes a serious problem.

A new feasibility study shows that equipping head and neck cancer patients with home-based sensors to identify potential risks of dehydration during radiation treatment is attainable and acceptable to patients as well as their physicians.

These new findings were published in the Journal of the National Cancer Institute Monographs’ special issue, “Cancer Prevention and Control in the Changing Communication Landscape.”   

“We used sensor-based technology to monitor and evaluate potential signs for dehydration in the patients’ home environment,” said Susan Peterson, Ph.D., M.P.H., lead investigator on the study and behavioral scientist at The University of Texas MD Anderson Cancer Center.

The study monitored head and neck cancer patients to determine if they would be willing to use sensors daily to record their blood pressure, weight, pulse and symptoms at home while undergoing  radiation treatment – an effective treatment that often triggers inflammation and sores in the mouth and throat.

During the study, physicians reviewed their patients’ information daily to identify early indicators of possible dehydration – another side effect of radiation for head and neck cancers – using CYCORE (CYberinfrastructure for COmparative Effectiveness REsearch) – a novel software-based platform to collect and manage data from multiple systems through a suite of home-based and mobile sensors.

Although radiation treatment is common and typically successful for this type of cancer, treatment can last up to six or seven weeks.

“Radiation treatment often damages some of the muscles and other tissues in that area and can result in decreased saliva production and mucositis – inflammation of mucus membranes,” said Peterson. “This can make it difficult for patients to swallow, so eating and drinking even small amounts can be painful, which can put patients at risk for dehydration.”

Peterson says the onset of dehydration during radiation treatment can be fairly rapid and life-threatening, resulting in hospitalization which can cause interruptions in treatment and recovery.

Researchers followed 48 patients during two five-day periods. Sensors were used to monitor weight and blood pressure fluctuations daily because changes might indicate a patient’s risk for becoming dehydrated.  Patients also reported daily food and drink servings, degree of pain with swallowing and other side effects using a smartphone.  

Patients’ sensor readings and symptom information were automatically transmitted to the CYCORE system.  Their doctors viewed this information daily to determine if any steps were needed to reduce the risk of dehydration in their patients.

More than 90 percent of patients in this study rated CYCORE as extremely easy to use during a challenging treatment regimen. Clinicians working with these patients were highly satisfied with the ease of monitoring their patient’s progress using CYCORE.

Based on patients’ information transmitted using CYCORE, 60 percent of patients had at least one event that would suggest risk for dehydration and would warrant clinical intervention, and 35 percent had two or more events.

“There are a number of critical changes that can occur during that time,” said Peterson. “Our study showed that it is feasible to use sensor technology to monitor patients during their treatment, and that both patients and their doctors find it easy and valuable to do so.  We were able to collect important data for our research while possibly helping with clinical decision-making as well.”

This feasibility study was part of a Grand Opportunity grant funded by the National Cancer Institute to explore the use of patient-based sensor technology to broaden the scope and quality of information that might improve cancer research, treatment and prevention.   

Other researchers contributing to this study include Eileen Shinn, Ph.D., Karen Basen-Engquist, Ph.D., M.P.H, Alexander Prokhorov, M.D., Ph.D., Stephanie Martch , all of Behavioral Science at MD Anderson; Adam Garden, M.D. and Beth Beadle, M.D., Ph.D., of Radiation Oncology at MD Anderson;  Wendy Demark-Wahnefried, Ph.D., of the University of Alabama at Birmingham; Kevin Patrick, M.D., Chaitan Baru, Ph.D., Ingolf Krueger, Ph.D., Phil Rios, Emilia Farcas, Ph.D., Kai Lin, Ph.D., and Yan Yan, all of the University of California, San Diego.

This research was funded by a grant from the National Cancer Institute (RC2A 148263-01).