Cancer Institute A national cancer institute
designated cancer center

Major Areas of Research

Survivorship and Patterns of Cancer Care

Program members actively participate in the NCI-funded Cancer Care Outcomes Research and Surveillance (CanCORS) consortium. Established in 2001 by the National Cancer Institute and the Veterans Administration, this collection of research teams studies how different characteristics and beliefs of cancer patients, providers and health-care organizations influence cancer treatments and outcomes. The goal of this work is to identify gaps in evidence-based clinical practice, as well as disparities in cancer care by age, race/ethnicity and socioeconomic status.

The Program on Prevention Outcomes and Practices is part of the Stanford Prevention Research Center focusing on current patterns of health care, the process of behavior change, evaluation of prevention strategies, and designing interventions to facilitate evidence-based practice. This program carries out research that both informs the development of and fosters the dissemination of effective, efficient, innovative, and evidence-based prevention interventions.

Research is now showing that physical activity may decrease recurrence and increase survivorship for cancer patients. To this end researchers at the Stanford Prevention Research Center are collaborating with the Stanford Health Improvement Program and the YMCA on the Living Strong Living Well program.

Dr Paul Fisher has conducted research on the survivorship in pediatric brain tumor populations. In a recent study on quality of life, a Pediatric QOL instrument was administered to 134 children at Lucile Packard Children's Hospital in Palo Alto. Compared to controls, these children had significantly lower psychosocial, physical, emotional, social, and school functioning scores. Children with low-grade glioma had the highest total HRQOL scores and children receiving radiation had the worse scores (J Clin Oncol 23:5424, 2005). He has also examined data from the NCI Cooperative Children's Oncology Group to determine the efficacy of magnetic resonance imaging surveillance for relapse in children with diagnosed brain tumors.

Survivorship research includes intervention studies following cancer diagnosis and first course of treatment to improve cancer outcomes (reduce progression, recurrence, second primaries, and death), quality of life for those living with or dying from cancer and their caregivers. Researchers use the Surveillance, Epidemiology and End Results (SEER) program for generating research hypotheses and identifying patterns of cancer care.

The Cancer Prevention Institute of California, along with Stanford Cancer Institute and Mills-Peninsula Health Services, sponsors Cancer Survivorship Conferences where issues of employment, health and life insurance, and long term side effects of treatment are addressed. Audio versions past conference presentations, such as Dr David Spiegel´s presentation, "Living With Uncertainty", are available at the Cancer Prevention Institute of California web site.

Utilizing California Cancer Registry (CCR) patient data enhanced by geographic linkage with US Census SES data and with hospital and physician characteristics, Dr Theresa Keegan is undertaking an efficient, cost-effective, population-based secondary data analysis to examine the effects of neighborhood SES on long-term survival following Hodgkin’s Lymphoma. Her group will be evaluating both overall survival (which takes into account death associated with HL, treatment sequelae and non-cancer events) and HL-specific survival, after considering patient characteristics, including race/ethnicity and histologic subtype, and markers of health care; and comparing the survival experience of HL patients to that of comparable non-cancer patients (relative survival), adjusted for neighborhood SES and within specific racial/ethnic groups.

Dr Ingrid Oakley-Girvan is also the principal investigator for a collaborative effort with Dr Alice Whittemore and others, to evaluate the impact of racial differences in health care usage, socio-economic status and co-morbidity on prostate cancer progression and survival among 10,000 men in the Northern California Kaiser Permanente system. Dr. Oakley-Girvan's recent population-based study assessed the follow-up cancer care experience in a multi-ethnic and diverse patient population. The major findings from this study were that cancer survivors do not consistently receive health promotion messages during follow-up care.

This document was last modified: Monday, 27-Jun-2011 13:30:18 PDT

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