Current Projects

Research on Inflammation, Stress, and Energy (RISE), 1R01-CA160427

Fatigue is one of the most common and distressing side effects of cancer treatment and may persist for months or years after treatment completion.  This study, funded by the National Cancer Institute, was designed to identify predictors and mechanisms for cancer-related fatigue, with a focus on inflammation as a key driver of fatigue symptoms.  We enrolled 270 women with early stage breast cancer and followed them from diagnosis into survivorship with intensive biobehavioral assessments.  We are now conducting analyses of this rich data set, with initial work focusing on biobehavioral predictors of pre-treatment fatigue and using growth mixture modeling to identify distinct trajectories of fatigue over time.  We are also looking at stress, depression, and cognitive function in RISE participants. Selected references from RISE are listed below.

Do all patients with cancer experience fatigue? A longitudinal study of fatigue trajectories in women with breast cancer.

Testing a biobehavioral model of fatigue before adjuvant therapy in women with breast cancer

Childhood maltreatment, psychological resources, and depressive symptoms in women with breast cancer

Cortisol awakening response as a prospective risk factor for depressive symptoms in women after treatment for breast cancer

Moderators of inflammation-related depression: a prospective study of breast cancer survivors

 

RISE 2.0, 1R01-CA237535

This study, funded by the National Cancer Institute, is designed to examine accelerated aging in women with breast cancer.  Cancer treatments lead to a number of age-related symptoms and conditions, including problems with cognition (“chemo brain”), energy, and physical function.  We hypothesize that biological aging may be a driver of these effects, and will test this hypothesis using biological samples collected from RISE study participants.  In addition, we will examine protective factors that may buffer against treatment effects on biological and physical aging processes.  Our model of accelerated aging and biobehavioral modifiers in cancer survivors was recently published in Nature Reviews Clinical Oncology.  In a preliminary study, we found that cancer treatment was associated with accelerated epigenetic aging (see reference below), and that maintaining healthy sleep protected against this effect.

The Acute Effects of Adjuvant Radiation and Chemotherapy on Peripheral Blood Epigenetic Age in Early Stage Breast Cancer Patients 

Cancer-related accelerated ageing and biobehavioural modifiers: a framework for research and clinical care

 

Pathways to Wellness (PTW), 1R01-CA200977

Cancer is stressful for everyone, but younger women are at particular risk for depression, stress, and other negative side effects of breast cancer and its treatment.  The goal of the PTW study, funded by the National Cancer Institute, is to evaluate two specialized interventions for younger breast cancer survivors – mindfulness meditation and survivorship education.  The primary outcome is depression, and we are also evaluating intervention effects on associated behavioral symptoms (fatigue, sleep) and inflammation.  We recently completed data collection for this multi-site, randomized controlled trial and are beginning data analysis. See below for references to the PTW study as well as publications from our earlier, pilot trials of mindfulness for younger breast cancer survivors

Targeting Depressive Symptoms in Younger Breast Cancer Survivors: The Pathways to Wellness Randomized Controlled Trial of Mindfulness Meditation and Survivorship Education

Mindfulness meditation for younger breast cancer survivors: a randomized controlled trial

Improvements in emotion regulation following mindfulness meditation: Effects on depressive symptoms and perceived stress in younger breast cancer survivors

Changes in eudaimonic well-being and the conserved transcriptional response to adversity in younger breast cancer survivors.

Neural responses to threat and reward and changes in inflammation following a mindfulness intervention