- Long-term Impact of Surviving Breast Cancer: (University of South Florida, Tampa, Fla., Thomas N. Chirikos, principal investigator, $150,000 over two years.) The ultimate aim of this research is to ascertain whether cancer exacts a long-term or continuing economic toll from survivors and their families. In order to facilitate the design of cost minimizing interventions, key factors that either raise or lower that toll will be identified.
- Managing Uncertainty in Older (Over age 65) Breast Cancer Survivors:
(University of North Carolina, Chapel Hill, N.C., Merle Mishel, Ph.D., principal investigator, $2 million over five years.) An estimated 97 percent of women with localized breast cancer and 77 percent with regional disease are expected to be alive five years after diagnosis. Many in the understudied population of those over age 65 will experience uncertainty about a cancer recurrence and secondary cancers. This study will test an intervention designed to help women manage long-term treatment-related side effects such as arm swelling, cosmetic changes, and fatigue.
- Learning Impairments among Survivors of Childhood Cancer: (St. Jude Children's Research Hospital, Memphis, Tenn., Raymond K. Mulhern, Ph.D., principal investigator, $2 million over five years.) Children surviving some types of cancer, particularly leukemia and brain tumors, have an increased incidence of learning impairments compared to their healthy peers in the general population. These impairments, for which there is no known effective treatment, inhibit normal academic achievement, vocational attainment, and quality of life. This study will test the validity of a model in which treatment-induced lesions of the brain, especially the white matter, are examined as an underlying cause of learning difficulties.
- Testicular Cancer Survivors' Adjustment and Health Behavior: (M.D. Anderson Cancer Center, Houston, Texas, Karen M. Basen-Engquist, Ph.D., principal investigator, $151,000 over two years.) This cancer represents only about 1 percent of all male cancers, but it is the most common cancer in men between ages 15 and 44. Because of the young age at diagnosis and very high success rate in testicular cancer treatment, survivorship issues become tremendously important. This study will compare quality of life and health behaviors, such as diet and exercise, of the survivors to a member of their family of similar age who will act as research controls. It will assess quality of life, mental health, sexual functioning and relationship satisfaction, and their association with better adjustment to help tailor interventions to reduce the stress of this disease.
- Economic Consequences of Cancer Survivorship: (Pennsylvania State University, University Park, Pa., Pamela F. Short, Ph.D., principal investigator, $2 million over five years.) This study is designed to answer the following research questions: what changes in employment, earnings, and health insurance do cancer patients experience shortly after diagnosis and treatment; what is the effect of cancer survival on trajectories of employment, earnings, and health insurance over the long-term; how do economic effects of cancer vary by type of cancer, patient characteristics, pre-diagnosis employment and insurance; what adjustments in the employment and health insurance of spouses are made as a consequence of the diagnosis; and what are the implications of the economic consequences for the pyschosocial well-being and quality of life of cancer survivors.
Underscoring its commitment to the growing population of cancer survivors, OCS launched a newly designed Web site in late 1999. The site can be reached at NCI's Division of Cancer Control and Population Sciences' homepage: http://dccps.nci.nih.gov by clicking on the "Survivorship Research" button.
Researchers, clinicians, and survivors and their families are able to communicate directly with NCI staff through the Web site. Consumers will also learn how to become involved in the research direction and oversight process. In addition, the user-friendly site has a resource list of programs for survivors that will expand over the next year, and includes links to related articles, data, and press releases.
OCS sponsored workshops in 1998 and 1999, bringing together experts on the medical and psychosocial aspects of cancer survivorship to help educate researchers, clinicians, and consumers about the impact of cancer on patients and families after treatment ends, and to stimulate new research.
In addition, OCS is collaborating with other NCI researchers in a working group on diet, weight, and physical activity to review the state of the science in these key areas and develop recommendations to address research needs and priorities.
Rowland, who had been on the faculty of Georgetown University, became director of OCS in September 1999. Founding director of the office, Anna Meadows, M.D., who served part-time since the establishment of the office in June 1996, has returned to academia at the University of Pennsylvania and the Children's Hospital of Philadelphia.
Rowland received her Ph.D. in Developmental Psychology from Columbia University Teachers College and served a post doctoral fellowship in the Psychiatry Service, Department of Neurology, Memorial Sloan-Kettering Cancer Center from 1984-86. She later joined Memorial's attending staff and helped establish, and became the first director of, their
post-treatment research program, a ground-breaking center for providing non-medical services to cancer survivors and their families. Most recently, she served as an associate professor in the Department of Psychiatry, Georgetown University School of Medicine, where she established the Psychooncology Program. She has conducted extensive research on the psychological, social, and sexual effects of breast cancer on survivors, and was co-editor of the first textbook of psychooncology, with Jimmie Holland, M.D., entitled Handbook of Psychooncology.
For more information about cancer visit NCI's Web site for patients, public, and the mass media at http://www.nci.nih.gov.