Outlook | A Quarterly Newsletter of the Society of Behavioral Medicine

From the Cancer SIG

In the past decade, continued medical advancements have seen further improvements in the detection and treatment of various types of malignancies. Notwithstanding these efforts, being diagnosed and treated for cancer continues to be a challenging life experience associated with potential debilitating immediate and longer-term side-effects for over 1 million people who are diagnosed with cancer each year in the U.S alone. As a result, multidisciplinary oncology programs throughout the U.S. continue to prioritize efforts in the advancement of cancer control research, ranging from cancer prevention, screening, treatment decision-making processes, understanding mechanisms responsible for maintaining and improving overall quality of life including emotional well-being, as well as conducting innovative interventions to manage and ameliorate grueling side-effects. This article will focus on reviewing two cancer research programs [The Mount Sinai School of Medicine (MSSM) Integrative Behavioral Medicine Program, and the Kentucky Behavioral Oncology Research Group (KYBORG)], current objectives and progress in the advancement of cancer control research in a number of these domains.

Maria Kangas, PhD
Assistant Editor to Outlook Newsletter
Cancer SIG

(1) Integrative Behavioral Medicine Program, (MSSM) New York

Guy H. Montgomery, PhD, Director
Julie B. Schnur, PhD, Co-Director
The goal of our Integrative Behavioral Medicine Program is to ameliorate the side effects of cancer and its treatment, in the service of improving patients' overall quality of life. Specifically our program aims to: 1) develop theoretically-based and clinically-informed cognitive-behavioral interventions, 2) to empirically test clinical effectiveness of these interventions, 3) to examine underlying psychological mechanisms responsible for clinical benefits, and 4) to establish the cost-effectiveness of our interventions. To date, we have developed clinically effective interventions (cognitive-behavioral therapy, hypnosis) to reduce pre-surgery distress and improve post-surgical recovery (i.e., reduced pain, nausea, fatigue, emotional distress) in breast cancer surgical patients; to reduce fatigue and emotional distress in breast cancer radiation oncology patients; and to improve patient satisfaction among women undergoing image-guided breast biopsy. Mechanisms responsible for these intervention effects include cognitive (response expectancies) and emotional (distress) factors. Cost-effectiveness analyses have indicated that our brief pre-surgery hypnosis intervention reduces operating room time and anaesthetic use, resulting in cost-savings of $772 per patient (JNCI, 99, 1304-1312).

With these clinical and cost benefits established, the next phase of our research is to deliver these interventions to patients in need. Specifically, we seek to study the dissemination of these interventions. To accomplish this goal, current projects seek to understand decision-making regarding the adoption of these interventions into standard clinical care for cancer patients, and to explore means of intervention delivery which can fit seamlessly into busy medical environments. It is not enough to empirically demonstrate, one must also actively disseminate.

Contact: guy.montgomery@mssm.edu

(2) The Kentucky Behavioral Oncology Research Group (KYBORG)

Michael Andrykowski, PhD
The Kentucky Behavioral Oncology Research Group (KYBORG) is based in the Department of Behavioral Science in the University of Kentucky's College of Medicine. Headed by Michael Andrykowski, PhD and Jamie Studts, PhD, KYBORG participants include a half dozen predoctoral and postdoctoral research trainees. KYBORG research and training activities are devoted to the understanding and control of physical and psychosocial morbidity associated with cancer screening, diagnosis, treatment, and recovery and the enhancement of quality of life and well-being in all individuals affected by a cancer diagnosis.

At the present time, a variety of research projects are in progress. In collaboration with colleagues Paul Jacobsen, PhD and Brent Small, PhD at the Moffitt Cancer Center and the University of South Florida, Dr. Andrykowski heads a project examining the development of fatigue and cognitive dysfunction in early stage breast cancer patients. The project uses a prospective, longitudinal case-control design and includes the collection of DNA to enable analysis of genes potentially linked to both fatigue and cognitive dysfunction. Dr. Andrykowski also leads a team conducting several studies collectively examining the affective, cognitive, and behavioral impact of abnormal, yet benign, test results received during the course of routine screening and diagnostic tests for breast and ovarian cancers. Most recently, Dr. Andrykowski, in collaboration with the statewide, SEER Kentucky Cancer Registry, has led a team examining the nature, magnitude and etiology of disparities in mental health outcomes in rural and nonrural cancer survivors.

Dr. Studts' research efforts are generally focused on psychosocial factors associated with the prevention, early detection, treatment and rehabilitation of tobacco-related malignancies. With collaborators at the University of Louisville, Dr. Studts continues to analyze behavioral outcomes associated with lung cancer screening, and he is embarking on a new collaboration with Dr. Margaret Byrne at the University of Miami to study lung cancer screening decisions using conjoint methodology. Dr. Studts has nearly completed accrual on a study exploring the role of numeracy and quantitative communication in treatment decisions regarding adjuvant chemotherapy for early stage lung cancer, and he is actively involved in a telehealth intervention for symptom management among head and neck cancer survivors. His interests in cancer prevention and tobacco control have also produced a study exploring the potential utility of nicotine vaccines for prevention and treatment of nicotine dependence. Recently, Dr. Studts has extended his research efforts to include exploring factors that influence physician and patient decision making in follicular lymphoma and other hematologic malignancies.

Contact: mandry@uky.edu


Winter 2009	Return to Outlook Main page >>
From the Cancer SIG In the past decade, continued medical advancements have seen further improvements in the detection and treatment of various types of malignancies. Notwithstanding these efforts, being diagnosed and treated for cancer continues to be a challenging life experience associated with potential debilitating immediate and longer-term side-effects for over 1 million people who are diagnosed with cancer each year in the U.S alone. As a result, multidisciplinary oncology programs throughout the U.S. continue to prioritize efforts in the advancement of cancer control research, ranging from cancer prevention, screening, treatment decision-making processes, understanding mechanisms responsible for maintaining and improving overall quality of life including emotional well-being, as well as conducting innovative interventions to manage and ameliorate grueling side-effects. This article will focus on reviewing two cancer research programs [The Mount Sinai School of Medicine (MSSM) Integrative Behavioral Medicine Program, and the Kentucky Behavioral Oncology Research Group (KYBORG)], current objectives and progress in the advancement of cancer control research in a number of these domains. Maria Kangas, PhD Assistant Editor to Outlook Newsletter Cancer SIG (1) Integrative Behavioral Medicine Program, (MSSM) New York Guy H. Montgomery, PhD, Director Julie B. Schnur, PhD, Co-Director The goal of our Integrative Behavioral Medicine Program is to ameliorate the side effects of cancer and its treatment, in the service of improving patients' overall quality of life. Specifically our program aims to: 1) develop theoretically-based and clinically-informed cognitive-behavioral interventions, 2) to empirically test clinical effectiveness of these interventions, 3) to examine underlying psychological mechanisms responsible for clinical benefits, and 4) to establish the cost-effectiveness of our interventions. To date, we have developed clinically effective interventions (cognitive-behavioral therapy, hypnosis) to reduce pre-surgery distress and improve post-surgical recovery (i.e., reduced pain, nausea, fatigue, emotional distress) in breast cancer surgical patients; to reduce fatigue and emotional distress in breast cancer radiation oncology patients; and to improve patient satisfaction among women undergoing image-guided breast biopsy. Mechanisms responsible for these intervention effects include cognitive (response expectancies) and emotional (distress) factors. Cost-effectiveness analyses have indicated that our brief pre-surgery hypnosis intervention reduces operating room time and anaesthetic use, resulting in cost-savings of $772 per patient (JNCI, 99, 1304-1312). With these clinical and cost benefits established, the next phase of our research is to deliver these interventions to patients in need. Specifically, we seek to study the dissemination of these interventions. To accomplish this goal, current projects seek to understand decision-making regarding the adoption of these interventions into standard clinical care for cancer patients, and to explore means of intervention delivery which can fit seamlessly into busy medical environments. It is not enough to empirically demonstrate, one must also actively disseminate. Contact: guy.montgomery@mssm.edu (2) The Kentucky Behavioral Oncology Research Group (KYBORG) Michael Andrykowski, PhD The Kentucky Behavioral Oncology Research Group (KYBORG) is based in the Department of Behavioral Science in the University of Kentucky's College of Medicine. Headed by Michael Andrykowski, PhD and Jamie Studts, PhD, KYBORG participants include a half dozen predoctoral and postdoctoral research trainees. KYBORG research and training activities are devoted to the understanding and control of physical and psychosocial morbidity associated with cancer screening, diagnosis, treatment, and recovery and the enhancement of quality of life and well-being in all individuals affected by a cancer diagnosis. At the present time, a variety of research projects are in progress. In collaboration with colleagues Paul Jacobsen, PhD and Brent Small, PhD at the Moffitt Cancer Center and the University of South Florida, Dr. Andrykowski heads a project examining the development of fatigue and cognitive dysfunction in early stage breast cancer patients. The project uses a prospective, longitudinal case-control design and includes the collection of DNA to enable analysis of genes potentially linked to both fatigue and cognitive dysfunction. Dr. Andrykowski also leads a team conducting several studies collectively examining the affective, cognitive, and behavioral impact of abnormal, yet benign, test results received during the course of routine screening and diagnostic tests for breast and ovarian cancers. Most recently, Dr. Andrykowski, in collaboration with the statewide, SEER Kentucky Cancer Registry, has led a team examining the nature, magnitude and etiology of disparities in mental health outcomes in rural and nonrural cancer survivors. Dr. Studts' research efforts are generally focused on psychosocial factors associated with the prevention, early detection, treatment and rehabilitation of tobacco-related malignancies. With collaborators at the University of Louisville, Dr. Studts continues to analyze behavioral outcomes associated with lung cancer screening, and he is embarking on a new collaboration with Dr. Margaret Byrne at the University of Miami to study lung cancer screening decisions using conjoint methodology. Dr. Studts has nearly completed accrual on a study exploring the role of numeracy and quantitative communication in treatment decisions regarding adjuvant chemotherapy for early stage lung cancer, and he is actively involved in a telehealth intervention for symptom management among head and neck cancer survivors. His interests in cancer prevention and tobacco control have also produced a study exploring the potential utility of nicotine vaccines for prevention and treatment of nicotine dependence. Recently, Dr. Studts has extended his research efforts to include exploring factors that influence physician and patient decision making in follicular lymphoma and other hematologic malignancies. Contact: mandry@uky.edu