Bio-behavioral Determinants of Cancer-related Fatigue
Proposed moderators and mediators of cancer-related fatigue
Cancer-related fatigue is a well-known problem during cancer treatment that is complex and poorly understood. A growing body of research has linked the experience of fatigue to inflammation. A major gap in the knowledge base is a lack of integrated understanding of the bio-behavioral processes that trigger and maintain the inflammation-fatigue relationship during and after the cancer experience. Our goal is to identify key mediators and moderators of the inflammation-fatigue relationship that determine the initiation and persistence of cancer-related fatigue over time. Cancer treatment and dysregulation of the HPA-axis and/or metabolism are known correlates of inflammation. Behavioral, personal, and medical factors are known to influence fatigue. With a clearer understanding of fatigue regulation, it will be possible to develop targeted interventions to address specific biological and/or behavioral components of fatigue.
Problems and Resources of African American Breast Cancer Survivors
Newsletter sent to study participants
African American breast cancer survivors have a lower survival rate across all disease stages (79%) compared with White survivors (92%), are more likely to have aggressive forms of breast cancer requiring multi-modality treatment, and could experience a larger burden of quality of life problems post-treatment. Our group is evaluating the number, severity, and domains of problems faced by African American survivors and identifying sub-groups most at risk for these problems. Domains of problems include emotional problems, physical problems, lack of resources, and sexuality problems. Across all four problem domains, subgroups at risk for more severe problems include those who are younger, have more co-morbid conditions, or have higher levels of medical mistrust. These results will inform future research to address problems of AABCS as they make the transition from cancer patient to survivor.
Technology as an Intervention Strategy
With a growing number of cancer survivors, the Institute of Medicine has recommended that every survivor receive a treatment summary and survivor care plan to improve the currently fragmented state of cancer survivorship care and provide a roadmap and resources to maintain optimal health and well-being. To achieve this goal, there is a need to identify more efficient methods for delivery of survivor care plans to cancer survivors. Our team is evaluating the feasibility, usability, and acceptability of the Carevive® planning system in a group of breast cancer survivors. Carevive® is a cloud-based system for the development and delivery of a customized treatment summary and survivor care plan. We have also developed and are user-testing a mobile application for breast cancer survivors to increase physical activity. This project is in collaboration with Drexel University faculty.