For cancer survivors, taking oral medication may be more convenient than spending hours undergoing infusions, but it could come with trade-offs, according to a Michigan State University researcher and her colleagues.
By taking these oral medications, survivors may see their oncology teams less often, requiring them to deal with symptoms like fatigue, depression or skin rashes on their own. Unmanaged symptoms can result in cancer treatment interruptions or even lead to emergency room visits, said Alla Sikorskii, a professor in the MSU College of Osteopathic Medicine’s Department of Psychiatry.
Sikorskii and her collaborators have received a five-year, $3.2 million grant from the National Institutes of Health to provide cancer survivors with tools to manage their symptoms, improve their well-being and reduce costs associated with unscheduled health services, such as visits to the emergency department or urgent care.
Sikorskii will lead this project with Terry Badger from the University of Arizona’s College of Nursing and Tracy Crane from the University of Miami’s Department of Medical Oncology. The research will be done within the National Cancer Institute Community Oncology Research Program, or NCORP, which brings cancer clinical trials and care delivery studies into the communities where people with cancer receive their treatment.
“As survivors go through treatment, the ultimate goal is to beat cancer, however, survivors’ well-being during months and years of cancer treatment is very important,” Sikorskii said. “Managing symptoms can help people stay on treatment and out of the emergency department.”
There are currently more than 50 U.S. Food and Drug Administration-approved oral anti-cancer agents, and their use is increasing. Many of the newer oral agents have long regimens and can cost $15,000 to $100,000 per year. Sikorskii noted that, in comparison, a course of traditional infusion chemotherapy for non-small cell lung cancer was estimated at around $9,449 per course, with three to six courses in the treatment.
Sikorskii added that to reduce the risk of treatment interruptions, symptom monitoring and management are necessary, but are not implemented routinely. Further, psychological distress, such as depressive and anxiety symptoms, can interfere with information processing and motivation, which may affect symptom self-management.
Adaptive intervention for managing symptoms
The research will include a randomized trial, during which all survivors will receive automated telephone monitoring of symptoms, and a weekly summary report will be sent to their health care providers. In the intervention group, the project will provide cancer survivors with a symptom self-management guide. When symptoms are elevated, cancer survivors can use self-management strategies from the guide. If depression or anxiety persists for at least two weeks, the survivor will receive interpersonal counseling intervention.
“We are aiming to address the gap between evidence-based and existing care delivery in the community oncology settings,” Sikorskii said. “This project provides scalable tools for symptom monitoring in oncology settings and engages people with cancer in symptom self-management, both of which are critical for optimal cancer care delivery.”
This study builds on three previous NIH R01 grants — a grant category that supports NIH mission-related health research and development — that established the efficacy of the self-management intervention for symptoms.
The project will progress in collaboration with NRG Oncology, a nonprofit organization committed to improving the lives of people with cancer by conducting practice-changing multi-institutional clinical and translational research.
The study team is supported by the NRG Cancer Care Delivery Research Committee and includes co-investigators from MSU: Jennifer Johnson, C.S. Mott Endowed Professor of Public Health in the Department of Public Health, and Charles Given, professor emeritus in the College of Nursing.
This story originally appeared on the College of Osteopathic Medicine's website.
