IN FOCUS: Patient Well-Being and Survivorship in Cancer Care and Research

Posted April 13, 2023

Marcia Otto, Ph.D., University of Texas, Health Science Center at Houston
Ashlee Loughan, Ph.D., Virginia Commonwealth University
Jenny Poynter, Ph.D., University of Minnesota – Twin Cities


In fiscal year 2020 (FY20), the Peer Reviewed Cancer Research Program (PRCRP) introduced a new initiative to fund research into patient well-being and survivorship through the release of the Behavioral Health Science Award (BHSA). Now renamed the Patient Well-Being and Survivorship Award (PWSA) for FY23, the funding opportunity supports innovative research to advance studies in preservation of function, quality of life, symptom management, resilience, relief from neurocognitive deficits, and support for psychosocial issues related to cancer diagnosis, treatment, and survivorship. From FY20-FY21, the PRCRP has invested $8.5 million (M) in six BHSAs. For FY22, the PRCRP will invest an estimated $8.6M in another six awards. The research includes the topic areas of Brain, Germ Cell, Head and Neck, and Metastatic Cancers, Pediatric Brain Tumors, and Pediatric, Adolescent, and Young Adult Cancers.

There are approximately 18.1M cancer survivors in the United States, and this number is projected to increase by 24.4% in 10 years.1 Understanding survivorship needs and filling gaps in investigations into the psychological health and well-being of those affected by cancer (e.g., patients, family members) present an immediate unmet need. The FY23 PWSA provides $1M support for up to 4 years to study critical issues that impact patient care and well-being in at least one of the FY23 PRCRP topic areas. The PWSA focuses on current needs in addressing quality-of-life, well-being, decision-making and/or cognitive function, development and testing of educational interventions, and symptom management (e.g., toxicity of treatment, palliative/supportive care, psychological distress, and anxiety).

The PRCRP funds impactful research in multiple areas such as diagnosis, treatment, and now survivorship to help cancer patients thrive and to advance mission readiness of U.S. military members, Veterans, their families, and the American public. The research projects for selected BHSAs are described below.

Selected PRCRP-funded Behavioral Health Science Awards:

Uncovering the Long-Term Impact of Oropharyngeal Cancer and Dysphagia on Dietary Quality and Nutrition Among Veteran Cancer Survivors: The U-DINE Study
Marcia Otto, Ph.D.
University of Texas, Health Science Center at Houston
PRCRP Topic Area: Head and Neck Cancer

Dr. Marcia Otto
Dr. Marcia Otto
(Photo Provided)

Patients with oropharyngeal cancer (OPC), a subpopulation of survivors of head and neck cancer, often experience swallowing difficulties (dysphagia). Due to this, patients suffer changes in eating patterns that might lead to low quality diets, which, in turn, may increase risk of chronic disease and premature death after cancer treatment.2,3,4 Dr. Marcia Otto’s group at the University of Texas, Health Science Center at Houston plans to examine the patterns of low-quality diet among OPC patients during the acute, extended, and permanent stages of cancer survivorship. This project is conducted in collaboration with Dr. Kate Hutcheson (co-PI) at MD Anderson Cancer Center, Dr. Vlad Sandulache at Baylor College of Medicine, and Michael E. DeBakey at the Veterans Affairs Medical Center. The team intends to study how OPC and its treatment influence diet quality among OPC patients and survivors. This study has an impact on Veterans and Service Members, where risk factors such as tobacco usage, poor nutrition patterns, and a weakened socio-economic safety net are prevalent and represent a major concern for OPC survivors’ longevity and quality of life. Overall, this study looks to inform new dietary interventions to help Veterans afflicted with OPC.

Managing Distress in Malignant Brain Cancer
Ashlee Loughan, Ph.D.
Virginia Commonwealth University
PRCRP Topic Area: Brain Cancer
Pilot Clinical Trial

Dr. Ashlee Loughan
Dr. Ashlee Loughan
(Photo Provided)

Dr. Ashlee Loughan studies the use of an evidence-based behavioral health intervention such as Managing Cancer and Living Meaningfully (CALM), to examine the challenges faced by patients with brain cancer during stages of survivorship. With plans to adapt the CALM intervention to meet the needs of Service Members, Veterans, their beneficiaries, and the public, the research team aims to conduct a pilot clinical trial to evaluate the intervention’s effectiveness in reducing stress and readiness to fight brain cancer, compared to the standard of care. The investigators will also examine how the CALM intervention impacts changes in depression, death-related distress, life quality, post-traumatic stress, substance use, and suicidal ideation. With this research, Dr Loughan’s team (LiveNOW Lab; intends to determine CALM’s feasibility and accessibility to help meet the needs of Service Members, Veterans, and their beneficiaries in the fight against brain cancer.

Impact of Platinum-Related Hearing Loss on Quality of Life and Educational Attainment in Germ Cell Tumor Survivors
Jenny Poynter, Ph.D.
University of Minnesota – Twin Cities
PRCRP Topic Area: Germ Cell Cancer

Dr. Jenny Poynter
Dr. Jenny Poynter
(Photo Provided)

Germ cell tumors (GCT) are cancers of the reproductive system that affect approximately 600 children and adolescents per year in the United States; they are also the most common type of cancer in young adult men. After treatment for GCTs, patients may experience late effects such as ototoxicity (hearing loss), neuropathy, cardiac disease, second malignancies, and infertility. To better understand long-term adverse effects of the standard GCT chemotherapy treatment regime (cisplatin, etoposide, and bleomycin) and quality of life issues, Dr. Jenny Poynter is establishing a comprehensive survivorship study of GCT patients between the ages of 0-19 years. Within this study, Dr. Poynter is examining the impact of treatment-associated hearing loss and neuropathy on educational attainment and quality of life. Outcomes from this award will help to better understand the consequences of late effects in GCT survivors and identify targeted interventions that may benefit survivors of GCT treatment.

Group Photo
Research teams of Dr. Otto, Dr. Loughan and Dr. Poynter   (Photo Provided)

1American Cancer Society. Cancer Treatment and Survivorship Facts & Figures 2022-2024. Atlanta: American Cancer Society; 2022.

2Cristofaro MG, Barca I, Ferragina F, Novembre D, Ferro Y, Pujia R, Montalcini T. The health risks of dysphagia for patients with head and neck cancer: A multicentre prospective observational study. J Transl Med. 2021 Nov 22;19(1):472. doi: 10.1186/s12967-021-03144-2. PMID: 34809654; PMCID: PMC8607588.

3Hutcheson KA, Nurgalieva Z, Zhao H, Gunn GB, Giordano SH, Bhayani MK, Lewin JS, Lewis CM. Two-year prevalence of dysphagia and related outcomes in head and neck cancer survivors: An updated SEERMedicare analysis. Head & Neck. 2019;41(2):479-87. doi: 10.1002/hed.25412. PubMed PMID: 30536748; PMCID: 6355350

4Kamal M, Barrow MP, Lewin JS, Estrella A, Gunn GB, Shi Q, Hofstede TM, Rosenthal DI, Fuller CD, Hutcheson KA, Head MDA, Neck Cancer Symptom Working G. Modeling symptom drivers of oral intake in long-term head and neck cancer survivors. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer. 2019;27(4):1405-15. doi: 10.1007/s00520-018-4434-4. PubMed PMID: 30218187; PMCID: 6408256

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Last updated Thursday, April 13, 2023