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$1.5 million awarded for palliative care research to improve care of seriously ill patients

New York, NY – The American Cancer Society and the National Palliative Care Research Center (NPCRC) are awarding $1.5 million in research grants to researchers at eleven institutions for studies aimed at reducing suffering for seriously ill patients and their family caregivers.

The studies will be conducted over the next two years. The NPCRC, in collaboration with the American Cancer Society, has directed over $5 million towards supporting 38 palliative care research projects since starting this initiative three years ago.

"The physical and emotional symptoms that accompany chronic and serious illness like cancer cause so much suffering and yet have rarely been the focus of medical research or research funding" noted NPCRC Director R. Sean Morrison, M.D., who is also professor of Palliative Care, Geriatrics and Medicine at Mount Sinai School of Medicine.

"It is my belief that if we are truly going to improve the quality of life for adults and children with chronic illness, then we need to focus our energies equally on disease specific treatments and on the physical, psychological, and emotional symptoms that accompany chronic illness and cause so much distress and suffering.

"Supporting evidenced-based research is a critical first step in the right direction," he noted.

Palliative care focuses on relieving suffering and supporting the best possible quality of life for adults and children living with serious illness.

It is a field comprised of doctors, nurses, social workers, and other specialists who care for patients with chronic illnesses, functional impairment, and a high burden of family caregiving responsibilities.

It is provided at the same time as all other appropriate medical treatments.

The collaborative initiative between the American Cancer Society and the National Palliative Care Research Center is designed to support clinician investigators conducting patient-oriented research in palliative care in hopes of bringing more funding from federal agencies, which have supported some research in palliative care, but for whom it is not a priority area.

Pilot data results are typically needed before a federal agency will consider funding a research project.

"It is encouraging to see the high caliber and innovative applications being submitted by professionals interested in conducting research in palliative care," said Ronit Elk, Ph.D., cancer control and prevention research program director in the extramural grants of the American Cancer Society.

"This request for application (RFA) provides clinicians and researchers an opportunity to answer important questions they had long wanted to investigate, but without this unique funding opportunity had been unable to."

"The American Cancer Society, in its initiative with the NPCRC, is making significant contributions towards reducing suffering caused by cancer and other serious illnesses," said Otis W. Brawley, M.D., chief medical officer of the American Cancer Society.

"We strongly encourage other disease-specific organizations to follow suit and designate research dollars to further support research scientists who will advance the field of palliative care."

The 2009 Grantees:

NPCRC Pilot Project Support Grant Recipients

Harvard Medical School - Jennifer W. Mack, M.D., MPH, an assistant professor of pediatrics at Dana-Farber Cancer Institute /Children's Hospital Boston, will examine the interplay between hope, prognosis communication, and end-of-life decision-making in the pediatric oncology setting to find ways to improve how physicians communicate prognosis and support parents' hopes for their child's end-of-life period. Ultimately, this work will help parents of children with advanced cancer make meaningful, value-driven decisions for their children's lives and care.

Northeastern Ohio Universities College of Medicine – Kyle R. Allen, D.O., professor of internal medicine and family medicine, and chief of the division of geriatric medicine and medical director of the Post Acute Senior Services Service Line at Summa Health System in Akron, Ohio, will conduct a randomized pilot study along with his co-investigator, Steven Radwany, M.D., medical director of hospice and palliative care at Summa Health System to determine the feasibility of a fully powered study to test the effectiveness of an in-home interdisciplinary palliative care case management intervention in improving a global measure of quality palliative care for consumers of Ohio's community-based long-term care Medicaid waiver program, PASSPORT.

American Cancer Society Pilot Project Support Grant Recipients

University of North Carolina, Chapel Hill - Edwin B. Fisher, Ph.D., a professor in the department of health behavior and health education in the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill. Dr. Fisher's research will describe how different types of support, including nondirective (cooperative) and directive (prescriptive) support may play key roles in quality of life among patients with advanced cancer or who are receiving palliative care. This will also lead to research to develop interventions that will improve quality of life for patients with advanced cancer and to develop guides or other resources that will help their friends, family, and clinical teams to be more effective in providing them social support.

University of Oklahoma Health Sciences Center - Marianne Matzo, Ph.D., a professor and the Frances E. and A. Earl Ziegler Chair in Palliative Care Nursing at The University of Oklahoma Health Sciences Center College of Nursing in Oklahoma City, Oklahoma, will focus on developing and pilot testing a coached communication intervention for sexual health promotion in women with recurring ovarian cancer (OVCA). This is a significant research area because it is an important concern of hospice patients which has not been well studied. This study will pave the way toward a larger, interventional study of palliative care patients and their sexual health.

University of California, San Francisco - Michael Rabow, M.D., an associate professor of clinical medicine in the division of general internal medicine at the University of California, San Francisco, will evaluate the clinical efficacy, family caregiver outcomes, and health care utilization impacts of a surgical oncologic/palliative care co-management model for patients with bladder cancer to determine an intervention able to decrease suffering and improve well-being among bladder cancer patients and families. Elucidating the benefits of concurrent disease and symptom care may provide an innovative model that is broadly useful in the outpatient care of patients with other life-threatening cancers.

Harvard Medical School - Jennifer Temel, M.D., an assistant professor of medicine at Harvard Medical School and an attending physician in thoracic oncology at Massachusetts General Hospital, will conduct a study to encourage oncology clinicians to discuss and document their patient's goals of care and end-of-life care wishes. The intervention will involve an electronic reminder, sent via email, which contains pertinent information about the patients' disease and prognosis and resources to assist the clinician with the conversation.

Northwestern University, Feinberg School of Medicine – Jamie H. Von Roenn, M.D., a professor of medicine at Northwestern University, Feinberg School of Medicine, is a medical oncologist and expert in palliative medicine. She is Medical Director of the Palliative Care and Home Hospice Program at Northwestern Memorial Hospital and a full member of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, will conduct a randomized study to examine the effects of a tailored physical therapy program on patients with advanced cancer newly hospitalized on the inpatient oncology unit for acute care. Such rehabilitation might maintain or improve these patients' physical function, compared to patients who receive the usual care.

NPCRC Junior Faculty Career Development Award Recipients

Harvard Medical School – Jane L. Givens, M.D., MCSE, an instructor of medicine within the division of gerontology at Beth Israel Deaconess Medical Center and Hebrew SeniorLife Institute for Aging Research will conduct one of the first detailed studies of family members of nursing home residents with advanced dementia to promote understanding of the mental health burdens facing over 4 million US families whose loved ones are experiencing the end-stage of dementia in nursing homes, and set the foundation for future research aimed at developing strategies to lessen that burden.

Brown University – Ramona Rhodes, M.D., MPH, an assistant professor of medicine within the division of geriatrics at Lifespan/Rhode Island Hospital, Alpert Medical School, Brown University will conduct a study to improve hospice care for minorities. Specifically, she will describe and examine hospice-level variability associated with African Americans' perceptions of the quality of hospice services as well as identify processes of care and interventions that have resulted in improved quality of care for African Americans, through a nationwide survey of hospice providers.

San Diego Hospice and Palliative Care – Scott A. Irwin, M.D., Ph.D., is an assistant clinical professor of psychiatry at University of California, San Diego, a diplomate of the American Board of Psychiatry and Neurology and is the Director of Psychiatry Programs at the Institute for Palliative Medicine at San Diego Hospice. Dr. Irwin will assess the feasibility of conducting a randomized, controlled, safety and efficacy trial of rapidly treating major depressive episodes with methylphenidate monotherapy in patients receiving hospice care. This trial will lay the groundwork for future multi-site randomized controlled trials in patients receiving hospice care and their caregivers, which are lacking for many psychiatric interventions used in this population.

University of California, San Francisco – Alexander K. Smith, M.D., MPH, is an assistant professor of medicine. Dr. Smith will conduct a study using a nationally representative survey linked with Medicare Data to describe the characteristics of elderly patients seen in the emergency department in the last 6 months of life and will use direct observation and survey methodology to examine communication about goals of care among a diverse group of seriously ill elders, their family caregivers, and emergency department providers.

"We are truly enthusiastic over the large number of qualified and promising investigators that have applied for the pilot project support grants and junior faculty career development awards over the past three years," said Dr. Diane E. Meier, Chair of the NPCRC's Scientific Advisory Board, Director of the Center to Advance Palliative Care, and the Hertzberg Palliative Care Institute at Mount Sinai School of Medicine.

 "Based on the progress and achievements of the current NPCRC and American Cancer Society grantees, we now look forward to opening more doors for additional investigators to advance the scientific field of palliative care."