Major Areas of Research
Cancer Prognosis
Using SEER data and other epidemiological resources, program researchers are working to identify the biological and environmental determinants of reoccurrence and survival in patients across a range of cancers. Cancers of interest include breast, ovarian, corpus uterine, lung, colorectal and hepatic cancers as well as pediatric brain tumors and other childhood cancers. Studies to date have explored:
- The impact of peer relationships on children recovering from cancer.
- Treatment variations for ovarian cancer across geographic region, with rural women having decreased survival Diet and Risk of ovarian cancer health disparities grant.
- The Breast-Cancer Family Registry to test the use of BRCA1 as a prognosticator in carriers with and without a family history of breast cancer.
- The cost-effectiveness of novel vaccines, screening programs, and outreach interventions to encourage multi-ethnic women to get mammography and Pap smear screening.
- The causes of racial/ethnic and socioeconomic disparities in cancer stage at time of diagnosis and the impact of this disparity on survival.
- Patients’ use of the Internet for health information.
- Strategies employed by chronically ill patients who are unable to afford medication.
Dr Joseph Presti is involved in a trial to determine if an autologous tumor vaccine can decrease the risk of recurrence in high-risk renal cancer patients. In another study, he is investigating whether a fluorescent analog to amino acid levulinic can better identify bladder tumors at the time of surgical resection, resulting in a more thorough resection and hopefully reducing recurrence of superficial bladder cancer.
Dr Marcia Stefanick and Dr Robert Carlson are collaborating with seven other academic institutions in the Women's Healthy Living and Eating (WHEL) trial to determine whether a low-fat, plant-based diet, which is high in nutrient dense foods and fiber, can prevent recurrence of breast cancer. The study will follow 3100 women who have been diagnosed with breast cancer (Stage I-IIIa) over an average 6-year period. The Stanford WHEL site was originally developed at the Cancer Prevention Institute of California (CPIC) and was later moved to Stanford under the leadership of Dr Marcia Stefanick, with Dr Dee West as a consultant. Over 500 participants were accrued to WHEL by the Stanford/CPIC( formerly NCCC) site, half of whom were identified through the SEER registry and the other half through media and community outreach activities. Two-thirds are completing required clinical activities through the Stanford General Clinical Research Center (GCRC), while the other third are being followed through the UC San Francisco GCRC, as a collaborative effort with UCSF investigators.
Dr David Spiegel and colleagues have developed an extensive research program linking psychiatry, psychology, endocrinology, immunology and oncology in the systematic examination of the effects of stress and support on living with cancer: facing and working through end-of-life concerns, managing co-morbid depression and anxiety, and dealing with factors influencing disease progression. Dr Spiegel and his team have worked closely with Dr Robert Carlson, Dr Joseph Presti and other Stanford clinicians as well as Dr Dee West and Dr Esther John.
Diurnal cortisol rhythm is a predictor of breast cancer. Dr David Spiegel and colleagues found that loss of normal diurnal variation is associated with shorter survival in women with metastatic breast cancer (JNCI 92:994, 2000). A current program project grant from the NCI and the NIA is designed to continue this work to examine the mediating role of diurnal cortisol in the progression of breast cancer.
This document was last modified: Monday, 27-Jun-2011 13:30:13 PDT
Trial Administration