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Getting to Know Kathrin Milbury, Ph.D.

Born and raised in Germany, Kathrin Milbury immigrated to the U.S. with her family. Her life experiences as a caregiver to two ailing parents had a profound influence on her becoming a "relationship researcher." Today, her work focuses on how cancer affects the family unit, and caregivers, in particular.

"We know that family caregivers are the backbone for support, yet they are often as tired, anxious, depressed and fatigued as the patients they care for," she explains. "My work is designed to demonstrate the need for a more family-focused context for care."

Dr. Milbury earned her B.A. in Psychology from Winthrop University (Rock Hill, SC), and her M.A. and Ph.D. in Social Psychology from the University of Houston. She joined M.D. Anderson in 2009, and currently serves as Associate Professor (tenured), Department of Behavioral Science, Division of Cancer Prevention and Population Sciences. She began her career as a Graduate Research Assistant, became a Postdoctoral Fellow in two departments, and Assistant Professor in both the Department of General Oncology and Department of Palliative, Rehabilitative and Integrative Medicine.

A competitive athlete, Dr. Milbury had an accident which sent her down a path to yoga and other mind-body interventions for her own recovery. "I realized that yoga's approach to gentle, compassionate care and its focus on the breath might be perfect for lung cancer patients experiencing late diagnosis and poor outcomes. These patients, as well as those with brain cancer and head and neck cancers, have high symptom burdens requiring massive support. We are now designing and conducting studies which focus on patients' spiritual well-being, and incorporating mindfulness-based interventions for late-stage cancers. Through meditation, and dyadic interventions, patients and caregivers create a safe environment to discuss loss and savor their time together. Using positive psychological interventions with terminal patients and their caregivers, we are helping diminish their depressive symptoms and improve their overall quality of life."

Dr. Milbury has completed pilot controlled trials of a dyadic yoga program for patients undergoing thoracic radiotherapy and their family caregivers. The RCT targeted patient physical function and patient and caregiver depressive symptoms and quality of life. "We were encouraged to see notable improvements in the six-minute-walk test. The longer the distance, the better patient prognosis and longevity. Focusing on breath-work can also distribute to greater cardio-pulmonary capacity. Ultimately, we hope to find a way to measure the body's entire energy field."

Her research has also included families coping with high-grade glioma. "With brain cancer patients, the focus has been on finding cures, not on caregiver support," she explains. "But given the interdependence of patients and their caregivers, we need to look for different treatment modalities."

"Attempting to specifically address the needs of patients with metastatic lung cancer, we conducted a pilot test focusing on mindfulness, interpersonal connection, gratitude and purpose. We also completed measures of depressive symptoms, cancer distress, spiritual well-being and sleep disturbances before and after the intervention. Both patients and caregivers rated the intervention as beneficial and useful, particularly if both participate on a regular basis.

"Given our promising findings, a larger trial is warranted that not only measures efficacy but also includes greater participant diversity," concludes Dr. Milbury. "Plus, a head-to-head comparison between dyadic and patient-solo intervention is needed to establish empirical evidence. We are currently testing this comparison. We have laid a good foundation for study. Increased understanding of the impact of dyadic interventions on patient and partner symptom burden has the potential to change the standards for behavioral palliative care interventions."