Shaping the minds of future cancer researchers

Ross Mikkelsen“The more comfortable we become with being stupid, the deeper we will wade into the unknown and the more likely we are to make big discoveries,” wrote Martin A. Schwartz, Ph.D., in his popular essay The Importance of Stupidity in Scientific Research. Cancer researcher Ross B. Mikkelsen, Ph.D., member of the Radiation Biology and Oncology research program at VCU Massey Cancer Center, shares this sentiment with his students. He says, “researchers aren’t stupid because we make stupid mistakes, but because we don’t know what’s on the other side of an experiment. On the other hand, when you do find out what’s on the other side, you get a high that you can’t beat.”

Mikkelsen, professor and division chair of Molecular Radiobiology and Targeted Imaging in the Department of Radiation Oncology and associate director for the M.D./Ph.D. program at VCU School of Medicine, joined VCU over 25 years ago, only a year after the Department of Radiation Oncology was established. “I’m the oldest man in the department,” he says with a laugh. Before coming to VCU to conduct cancer research at Massey, Mikkelsen was studying another well-known illness, malaria, at Tufts University School of Medicine.

Mikkelsen’s lab currently conducts experiments aimed at gaining a better understanding of the underlying mechanisms of how tumor cells and normal cells respond to radiation. “The idea of my research is to increase the so-called ‘therapeutic ratio,’ or the act of increasing the number of tumor cells killed while decreasing the amount of toxicity to normal, healthy cells,” he says.

His research focuses on nitric oxide synthases (NOSs). Nitric oxide (NO) is a molecule that our body produces to help cells communicate with each other by transmitting signals throughout the body. Normal cells create NO, but it is potentially lethal to cancer cells. NOSs are a family of enzymes that foster the production of NO. So, Mikkelsen modifies NOS activities to kill cancer cells without harming the normal cells. “We are combining this research with radiation therapy in an effort to make the treatment more effective and safe,” he explains.

Mikkelsen has a 25-year record of funding from the National Institutes of Health to support his research, and his studies have been published in more than 30 academic journals. He has served as co-chairman for the Physical Imaging Review Panel for the Department of Defense Prostate Cancer Program and as member of many initiatives led by the National Cancer Institute and National Institute of Allergy and Infectious Diseases.

Moving forward, Mikkelsen predicts that the future of radiation therapy is in imaging and focused treatment. “Imaging is becoming so advanced, and in radiotherapy, we are getting really good at being able to focus the doses of radiation into the tumor site while minimizing the amount of normal tissue toxicity.  We are very fortunate to have excellent small animal imaging facilities here at Massey for our research,” he says.

When Mikkelsen is not working away in the lab, he is shaping the minds of future cancer researchers.  “I’ve worked with middle-schoolers—all the way up to my M.D./Ph.D. students,” he says. “Their excitement is infectious.” He recently worked with a 14-year-old, who, despite never having taken a high school chemistry class, was able to learn from Mikkelsen’s team and go on to win awards for his research. But, Mikkelsen says that his work is not all fun and awards. “I think a lot of students get discouraged because our work is so difficult. Unlike some other research where you know what the answer is and you’re working towards it; in basic science, you truly don’t know the answer. You have to keep your excitement going; otherwise, you won’t succeed.”

That enthusiasm has helped keep Mikkelsen succeeding for over 35 years. “Even after all this time, I still get excited about a new finding—just as my students do,” he says.

Mercedes’ story

perspective mercedes

Click the video to see how cancer puts life in perspective.

I was diagnosed with acute myeloid leukemia on May 1, 2013. Prior to my diagnosis, I was a very active wife and mother of a four-year-old and an 11-month-old. I was a gym rat who attended exercise classes and lifted weights several times a week. I looked forward to going to the gym because it was time to myself.

All of a sudden I didn’t want to do anything and I had absolutely zero energy. I kept going back and forth to the doctor several times over a two-month period explaining what was happening to me. I was told that I had allergies or that I had the flu. On my final visit to the doctor, a student doctor suggested he take my blood. I received a call at 2:15 a.m. the following morning from a nurse. She asked how I was feeling and told me that my hemoglobin count was three. She advised me to get to the ER immediately. Once in the ER, they ran a bunch of tests and finally one test smear came back indicating that I had leukemia. I was transported to VCU Massey Cancer Center the next day. I would not return to my home for 38 days. I received four rounds of chemotherapy and recently had a bone marrow transplant. At this point, I’m in remission, and although it has been a long road, I know that I’m in good hands at Massey.

My perspective on life has changed greatly since being diagnosed. I’ve learned that life is short and you must live every day to the fullest. I now realize that I can’t control everything and that patience is a virtue. My friends and family are my life, and surrounding myself with them has made this journey easier to navigate.

-Mercedes

$2.1 million Grandis family gift to fund endowed chair and research at Massey

The Harry and Harriet Grandis Family Foundation announced a $2.1 million gift this month that will endow a full-tuition scholarship in the Virginia Commonwealth University School of Medicine and an endowed chair to support lung cancer research.

In their lifetimes, Harry and Harriet Grandis were devoted to supporting medical education and cancer research. To honor the legacy of the longtime Richmond philanthropists, their daughters, Betty Sue Grandis LePage and Nancy Grandis White, announced the gift Nov. 9 at a luncheon.

Their decision to support cancer research also was inspired by their late sister, Linda Grandis Blatt.

An endowed chair and research fund at VCU Massey Cancer Center will bear Blatt’s name. The family’s gift brings Massey’s total funds raised through the ongoing $100 million Research for Life Campaign to more than $85 million.

“Our sister Linda died of lung cancer in 2006,” LePage told the luncheon audience of friends, family and university leaders. “She was a tenacious child. She fought her battle with cancer with the same tenacity. Her idea was that maybe one day, or the next day, or the next day, someone would find a cure. After her death, our father established a fund in her name with the hope of developing novel research.”

“The Grandis family’s decision to honor the memory of Linda Grandis Blatt is not only inspiring, but highly significant to the mission of Massey Cancer Center,” said Gordon Ginder, M.D., director of VCU Massey Cancer Center. “Expanding our research efforts related to lung cancer is one of our top priorities as we seek to understand, prevent and treat this particularly deadly form of cancer.”

In accepting the family’s gift on behalf of the university, William Ginther, rector of the VCU Board of Visitors and friend of the Grandis family, commented, “My grandson asked me not too long ago ‘what was polio?’ I hope one day our grandchildren, or their children, will ask ‘what was cancer?’”

Scholarships for medical students were a priority for Harry and Harriet Grandis, who in the 1990s began making yearly gifts to fully cover the cost of tuition for deserving students. They supported more than a dozen young doctors in this way, the last of whom will graduate in May.

“Our mother and father took special pride in the accomplishments of all their students,” White said. “We’re so honored to be able to carry on this legacy.”

To preserve Mr. and Mrs. Grandis’ yearly gift, the Grandis Family Foundation has directed $1 million of its total gift to endow the Harry and Harriet Grandis Scholarship Fund. Each year, the fund’s investment earnings will produce a full in-state scholarship for a deserving medical student. The gift launches the medical school’s new $25-million campaign to expand the medical school’s scholarship endowment.

“In their lifetimes, Harry and Harriet Grandis took a sincere and personal interest in giving our medical students the best possible start in their careers,” said Jerome Strauss III, M.D., Ph.D., dean of the VCU School of Medicine. “Their family has now ensured that Harry and Harriet’s generosity and dedication to society will continue. Generations of future physicians will graduate free of tuition debt and go on to care for patients in Virginia and all over the United States. This gift establishes an enduring legacy.”

From coast to coast, and representing a range of specialties including pediatrics, ophthalmology and palliative care, the dozen Grandis Scholars tell stories of how the family’s past generosity enabled them to choose fields they were passionate about without the worry of a heavy burden of debt. In testimony to how the Grandis’ generous friendship impacted their lives, a half dozen Grandis Scholarship recipients returned to VCU for the announcement of the Grandis family’s gift.

“I will never be able to say ‘thank you’ enough to the Grandis family,” said the Class of 1995’s Jennie Webb-Wright, who was the first medical student to receive a Grandis Scholarship and now works in the field of palliative medicine. “Without it, not a single thing in my life today would be the same. This is my special place in medicine. It’s the perfect fit. Working with dying patients, and those with long chronic illnesses, is really tough. People in the palliative medicine field will tell you that it’s not possible to do it full time for long without burning out. I have prevented burnout by working part time, which of course I couldn’t do if I had debts to pay.”

Re-purposed from an article by Eric Peters, University Public Affairs

Making the decision to quit smoking

nastyAccording to the surgeon general, 10 years after a smoker quits, his/her risk of
dying from lung cancer is half that of a person who is still smoking. For anyone
who has tried quitting, 10 years can seem like a lifetime away, but it is important
to remember that after even just minutes of quitting your body begins to restore
itself and puts you on the path to a healthier life.

Only you can make the decision to quit smoking. Find out what is important to
you, what motivates you and then make it happen.

The American Cancer Society (ACS) recommends smokers to set a “quit day.”
Picking a date and marking it on your calendar will give you a commitment or
goal. Here are a few suggestions that the ACS recommends to get you ready for
your “quit day”:

  • Make a plan. Is your plan to quit “cold turkey” or do you think you will need assistance from medication? Do you want to try nicotine replacement therapies such as nicotine gum, patches, nasal spray, inhalers or lozenges? Keep in mind that if you are thinking about using a prescription drug, you will need to talk to your doctor about getting the medication and starting it in time for your quit day. Cessation medications are like shoes! If one doesn’t work, keep trying until you find one that meets your needs.
  • Set up a support system. There are many programs and online resources available that can be your support system. Family and friends are also good choices. Make sure to ask the people around you not to smoke or leave cigarettes around you where you can see them.
  • Get rid of the evidence. Throw away all cigarettes and ashtrays in your home and car or at work.
  • Tell everyone. Tell your friends and family, to give you a sense of accountability.
  • Prepare. Stock up on oral substitutes such as sugarless gum, carrot sticks, hard candy, cinnamon sticks or toothpicks. Also, practice saying, “No, thank you, I don’t smoke.”
  • Avoid temptation. Stay away from people and places that tempt you to smoke.
  • Get active. Try exercising, needlework, hobbies or anything else that will distract you and your hands from the urge to smoke.
  • Reward yourself. If you’re doing well, you deserve a reward. Put the money you were going to spend on tobacco and use it to go out to dinner, buy a book, see a movie or do something you enjoy.

Quitting isn’t easy, so try not to get discouraged. As Mark Twain once said, “Quitting smoking is easy. I’ve done it a thousand times.” Even if you slip or relapse, move forward and keep your eye on your goal.

If you are a smoker and would like to talk to someone about quitting, call 1-800-QUIT-NOW (1-800-784-8669).

For more information on tobacco cessation, visit massey.vcu.edu/smoking-cessation.htm.

About the author
Linda Hancock, Ph.D., is the director of the Virginia Commonwealth University Wellness Resource Center. She specializes in smoking cessation and leads a campus-wide social marketing campaign to reduce substance abuse.

The importance of breast self-awareness in early detection

nci-vol-2574-300As part of their routine health care, women of all ages should be familiar with their bodies. Being aware of breast changes is especially important because many breast cancers are found by women themselves. To promote breast self-awareness, many advocacy groups encourage breast self-exams (BSE) on a routine basis.

So, how do you properly perform a BSE and what should you look for? It is
suggested that the exam be performed at the same time every month because of
the hormonal fluctuations that can affect breast tissue. Premenopausal women
should perform their exam toward the end of their menstrual period and postmenopausal women should be consistent with the time of the month they choose.

How to perform a breast self-exam

  • In the shower. Use the pads of your fingers to move around your entire breast in a circular pattern, moving from the outside to the center. Make sure to check the entire breast and armpit area.
  • In front of a mirror. Visually inspect your breasts in front of a mirror. Place your arms at your sides and then raise them high overhead, because this will show you different angles. Also, place your palms on your hips and press firmly to flex your chest muscles.
  • Lying down. When lying down, the breast tissue spreads out evenly along the chest wall. With a pillow under your right shoulder and your right arm behind your head, use your left hand to move the pads of your fingers around your right breast just as you did in the shower. Repeat these steps for your left breast.

Symptoms and signs to look for

  • Lumps. Look for lumps or unusual thickness. Most lumps are pea-size. It is important to remember that all lumps should be investigated by a health care professional, but not all lumps are cancerous.
  • Nipple changes. Look for tenderness, changes in shape/direction or discharge.
  • Skin changes. Look for any unexplained change in the size/shape of the breast, dimpling or swelling, unexplained shrinkage or asymmetry (although it is common for women to have one breast that is slightly larger than the other), or change in appearance, such as redness.

If you do see or feel something, remember not to panic, because eight out of 10 lumps are noncancerous. If you notice any of the above signs or symptoms, visit your health care provider for further evaluation.

Early detection of breast cancer leads to better treatment outcomes and survivorship. Being aware of your body and its changes is very valuable, but the most effective screening tool is mammography. Mammograms can detect the tumors before they can be felt through a BSE, so they are critical for early detection. The National Cancer Institute recommends that women aged 40 and older have mammograms every 1 to 2 years. Women with a higher than average risk of breast cancer, such as those with a family history of breast cancer or those who are carriers of the BRCA1 or BRCA2 gene, should talk with their doctors about when to begin mammograms and how often to have them.

To learn more about breast cancer, visit massey.vcu.edu.

About the author
Mary Helen Hackney, M.D., is associate professor of hematology-oncology and palliative care at VCU Massey Cancer Center. She specializes in the treatment of all stages of breast cancer and also teaches residents and health professionals about prevention, long-term patient management and survivorship issues.

 

Massey’s palliative care clinical director named a visionary in his field

Pat Coyne PortraitPatrick Coyne, M.S.N., A.P.R.N., F.A.A.N., clinical director of the Palliative Care Program at VCU Massey Cancer Center, has been named one of the 30 most influential leaders in hospice and palliative medicine, the medical specialty focused on relieving suffering and improving quality of life for people with serious illnesses.

Coyne was recognized as a visionary by his professional peers for his role in advancing hospice and palliative medicine.

“I am honored and humbled to receive this recognition,” Coyne said. “Thank you to my fellow hospice and palliative care colleagues for this incredible vote of support.”

In celebration of 25 years serving the profession, the American Academy of Hospice and Palliative Medicine (AAHPM) asked its 5,000 members to nominate who they thought are the top leaders and visionaries in the field.

“This program recognizes key individuals who have been critical in building and shaping our field over the past 25 years,” noted Steve R. Smith, AAHPM executive director and CEO. “These individuals represent thousands of other health care professionals in this country who provide quality medical care and support for those living with serious illness – each and every day.”

A world-renowned pain specialist, Coyne co-founded Massey’s Palliative Care Program and co-leads it as an international award-winning pioneer that is transforming the standards of palliative care through clinical practice, education and research. To learn more, visit massey.vcu.edu/palliative-care.htm.

Bacterial cells in the gut found to produce steroid hormones that could have implications for prostate and colon cancer

gutstudy

The figure is a model of how cortisol is converted to androgen by the bacterium. The bacteria are converting the glucocorticoid to androgen at least in part to obtain energy and building blocks for growth. Figure courtesy of Jason Ridlon, Ph.D., and published on the cover of the September 2013 issue of the Journal of Lipid Research, a journal of the American Society for Biochemistry and Molecular Biology.

The human gut is home to trillions of bacteria, many of which play an important role in helping the body strike a healthy balance. In the gut, bacteria are involved in the synthesis of vitamins, as well as metabolizing bile acids, cholesterol and other chemicals found in the body that are not typically produced by the body. Bacteria in the gut also can produce a plethora of new hormones.

With all its metabolic activities, it comes as no surprise that some researchers view the gut as an organ.

Recently, a team of VCU researchers, including VCU Massey Cancer Center researchers Gregory Buck, M.S., Ph.D., and Phillip Hylemon, Ph.D., member of Massey’s Cancer Cell Signaling research program, provided additional evidence that the bacteria found living inside the human gut may represent an endocrine organ. For example, the VCU team discovered that specialized gut bacterial cells produce steroid hormones – much like specialized cells in the pancreas produce the endocrine molecule insulin.

In their study, featured on the cover of the September 2013 print issue of the Journal of Lipid Research, the researchers used advanced technology to identify genes of a bacterium called Clostridium scindens. C. scindens is found in the gut and encodes for a class of enzymes that cause a profound change in the structure of cortisol, a hormone produced by the adrenal gland. Small changes in shape and structure of steroids can have profound effects on the human body.

“Finding the genes involved in production of androgens from cortisol by gut bacteria is a big step toward figuring out what role these bacteria and the androgens play in human health,” said lead author Jason M. Ridlon, Ph.D., affiliate assistant professor in the Department of Microbiology and Immunology in the VCU School of Medicine.

While it is known that these androgens re-enter the bloodstream from the gut, the implications of this are not completely clear, Ridlon said.

One possibility is that these androgens may enter the male prostate, which presses against the colon, he said. Exposure of this nature that takes place during the course of many years could result in disease, such as prostate cancer, in some individuals.

“Prostate, as well as colon, cancer is related to diet, with risk increasing with a high fat, high animal protein diet,” Ridlon said. “This same diet favors the bacteria that convert these stress hormones into androgen. The androgen produced by these bacteria may pass through the colonic wall into the prostate and represent one environmental factor in the etiology of the disease. This is an avenue that is worth exploring.”

“Furthermore, the androgen produced by this one bacterium can be further modified by other gut microbes yielding a cocktail of androgens, which may affect the prostate or perhaps other tissues of the body. We may also find that these molecules are part of the normal crosstalk between microbe and human and may be part of our normal physiology. We are keeping an open mind here and letting the data tell us the significance of this interesting phenomenon.”

Moving forward, the team will continue their investigation of the bacterium with the hopes of uncovering additional genes.

“It turns out that the bacterial equivalent of fraternal twins of this bacterium is capable of further modifying the androgen produced,” Ridlon said. “These steroids seem to ’ping-pong’ from one bacterium to another and new variants are made.”

The team is in the process of collecting the steroids that these bacteria make and testing their effects on human cells so that they can determine any potential effects they have on the human body.

This work was supported by the Department of Veterans Affairs, grant number BX001328.

The study is titled: “Clostridium scindens: a human gut microbe with a high potential to convert glucocorticoids into androgens.”

The Journal of Lipid Research is a publication of the American Society for Biochemistry and Molecular Biology, Inc.

Re-purposed from an article by Sathya Achia Abraham, VCU Public Affairs

VCU Massey researchers receive $18.1 million grant to lead a public health study on tobacco

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Thomas Eissenberg, Ph.D., and Robert Balster, Ph.D.

VCU Massey Cancer Center researchers have received an $18.1 million federal grant – VCU’s third largest to date – to study so-called modified risk tobacco products and other novel tobacco products, such as electronic cigarettes, and to develop an evaluation tool to help inform United States tobacco regulatory policy.

Co-principal investigators Thomas Eissenberg, Ph.D., and Robert Balster, Ph.D., both members of the Cancer Prevention and Control research program at Massey and faculty of the VCU Department of Psychology’s Center for the Study of Tobacco Products in the College of Humanities and Sciences, will lead a VCU-wide initiative to study methods for evaluating modified risk tobacco products, or MRTPs. VCU is one of 14 institutions that provide vital scientific evidence to the Tobacco Centers of Regulatory Science, a new program launched by the U.S. Food and Drug Administration (FDA) and the National Institutes of Health.

The group will develop and test a multidisciplinary approach that uses engineering, clinical behavioral research and randomized control trials to study the effects of novel tobacco products. The information learned from this research will help implement the 2009 Family Smoking Prevention and Tobacco Control Act, which gave the FDA the authority to regulate the manufacturing, distribution and marketing of tobacco products to protect public health.

“This historic grant signifies that Virginia Commonwealth University is a national leader in our unique commitment to human health,” said Michael Rao, Ph.D., president of VCU and VCU Health System. “It is the result of the multidisciplinary collaborative spirit that is ubiquitous at VCU and the VCU Health System, and it serves to remind us that our focus is really on people.”

“For the first time, under the Family Smoking Prevention and Tobacco Control Act, the federal government, through the FDA Center for Tobacco Products, is able to bring science-based regulation to the manufacturing, marketing and distribution of tobacco products,” said FDA Commissioner Margaret A. Hamburg, M.D. “The FDA is committed to a science-based approach that addresses the complex public health issues raised by tobacco product regulation.”

The multi-year grant will involve four components — examination of factors that influence MRTP nicotine and toxicant yield; comparison of short-term effects of MRTP to other products; a randomized control trial; and MRTP use and misuse on user’s attitudes, beliefs and perceived effects.

“While the focus of the Center for the Study of Tobacco Products is on novel tobacco products generally, this grant will also allow us to provide a wealth of information regarding electronic cigarettes and is designed to have the flexibility and capacity to begin new research to address issues raised in today’s rapidly evolving tobacco marketplace,” Eissenberg said.

“I am especially pleased that one of the missions of the new center is to develop training programs for a new generation of tobacco regulatory scientists,” Balster said. “Support is provided for both graduate students in behavioral and biomedical sciences as well as for post-doctoral research fellows.”

VCU’s center is part of a network of Tobacco Centers of Regulatory Science that includes Yale, Ohio State, the University of North Carolina and the University of Southern California, Los Angeles. The program will be coordinated by the National Institutes of Health Tobacco Regulatory Science Program. The VCU grant that forms the Center for the Study of Tobacco Products includes two partner institutions: Penn State-Hershey, with Jonathan Foulds, Ph.D., and the American University of Beirut, with Alan Shihadeh, Sc.D.

Re-purposed from an article by Cheryle Rodriguez, University Public Affairs

Prostate cancer screening: the ongoing debate

bloodcellsSince its adoption by the FDA in 1994, the prostate-specific antigen (PSA) test has reduced prostate cancer mortality rates by 39 percent. Despite the lives saved, whether or how the PSA test should be used for screening is at the center of an ongoing debate.

In 2012, the U.S. Preventative Services Task Force (USPSTF) recommended against the use of PSA-based screening after new studies showed that the test led to overdiagnosis and overtreatment. In 2013, the American Urological Association changed its guidelines to recommend against screening for men under the age of 55 who are at average risk of prostate cancer and for men over the age of 70 who have a life expectancy of less than 10 to 15 years. The American Cancer Society recommends that men make an informed decision with their health care provider about prostate cancer screening; it does not take a stance for or against PSA testing. The National Cancer Institute makes no formal recommendation, but presents information on its website helpful for decision making.

Is the PSA test right for you? The answer to this question varies person to person, so I recommend that you talk to your doctor about your individual risk and educate yourself about the pros and cons of testing.

Here are a few important questions to ask your doctor:

What is my risk of developing prostate cancer?
Common risk factors include: age, race/ethnicity, nationality, family history of prostate cancer, genetics, diet and smoking.

Is PSA testing appropriate for me and if so, when should I begin testing?
Your doctor may or may not recommend testing, but if you are at high risk, he/she may advise testing at a younger age.

What is the purpose of a PSA test and how is it done?
A PSA test measures the level of PSA, a protein that is produced by the prostate gland, in a man’s blood. The higher your PSA level, the more likely it is that you have prostate cancer. The test requires a blood sample that is sent to a laboratory for analysis.

What are common side effects or risks of PSA testing?
The PSA test itself doesn’t have side effects, but overdiagnosis and overtreatment are the risks that have caused the screening debate. Some tumors found through PSA testing grow so slowly that they are unlikely to threaten a man’s life. Detecting non-life-threatening tumors is called overdiagnosis, and treating those tumors is called overtreatment. Overdiagnosis and eventual overtreatment, with procedures such as biopsies, radiation and hormone therapy, can lead to unnecessary complications such as urinary incontinence, problems with bowel function, erectile dysfunction and infection. Also, one of the greatest “risks” for patients who have a high PSA test is their tendency to panic after they hear the word “cancer” and to seek aggressive treatment whether or not it’s warranted, so it is important to thoroughly consider all of your options before taking action.

As with any test, there are both benefits and harms of prostate cancer screening. An important benefit of testing includes catching the cancer before it metastasizes (grows) or becomes life-threatening.

By identifying the cancer early, less-aggressive treatment is needed and outcomes are generally better. By discussing the test with your doctor, you will know more about your options and will be less likely to make hasty decisions out of fear. I also recommend receiving a second opinion from another physician before making any decisions about treatment.

About the author
Paul G. Goetowski, M.D. (known as “Dr. G.”), is assistant professor at VCU Massey Cancer Center and the director of radiation oncology at Community Memorial Healthcenter (CMH) Cancer and Specialty Care on behalf of Massey. He has extensive experience in using radiation to treat many cancer types and noncancerous diseases.

Communication in cancer care

SIMINOFF_L_240x160_092211Communication between cancer patients, caregivers, health care teams and researchers is critical to building trust, sharing information and making informed decisions.

Laura A. Siminoff, Ph.D., Theresa A. Thomas Memorial Foundation Chair and associate director for cancer prevention and control at Virginia Commonwealth University Massey Cancer Center, was recently awarded two multi-million dollar grants to study how communication affects specific cancer outcomes.

Communication between patients and caregivers

The first grant is awarded by the National Cancer Institute and offers more than $3.4 million over five years to support Siminoff’s study to assess whether communication between cancer patients and their family caregivers is an important and independent factor in specific cancer care outcomes, such as economic outcomes, quality of life and decisional outcomes.

“Our study will primarily focus on adult patients with hematological malignances (cancers such as leukemia and lymphoma that affect the blood, bone marrow and lymph nodes), because these cancers have been steadily increasing in the United States and, despite this increase, their social and psychological challenges and outcomes have not been adequately studied,” Siminoff says. “Hematological cancers are also particularly challenging due to their chronicity and are often the most costly in terms of productivity loss due to premature death.”

Her study will follow 250 pairs of employed cancer patients and their family caregivers over a two-year period to assess how they communicate about treatment and care decisions and how their way of communicating leads to specific psychosocial, economic and healthcare outcomes.

“We aim to see how the communication between patients and their caregivers is associated with short- or long-term outcomes, as well as to examine if there are certain characteristics that are associated with decreased levels of cancer communication,” adds Siminoff.

Communication with families of the deceased about donating tissue for medical research

The second grant was awarded by the National Institutes of Health and provides more than $1.6 million over three years. The grant will help support Siminoff’s work with the Genotype-Tissue Expression Project (GTEx). GTEx collects tissues from postmortem donors to study gene expression and its relationship to disease. Every donor is genotyped and the end result will be a comprehensive biobank and database available to researchers. The aim of GTEx is to increase our understanding of how changes in our genes contribute to common human diseases, including cancer, in order to improve health care for future generations.

Researchers from all over the globe are participating in the GTEx project. Siminoff’s involvement includes co-designing and co-conducting the Ethical, Legal and Social Implications (ELSI) sub-study that specifically examines the process of obtaining informed consent from the families of deceased potential donors.

“After a loved one’s death, it is a very stressful, grief-filled time. We hope to identify the optimal way for health care staff to explain to family members of the deceased the importance of donating while being sensitive to their situation,” says Siminoff.