Linda Riley has been awarded a grant from the Cancer Center Support Grant pilot study initiative and the Robert J. Kleberg, Jr. and Helen C. Kleberg Foundation to study families coping with an advanced lung cancer diagnosis of a loved one.
Riley, Ph.D., R.N., research associate, postdoctoral fellow-oncology nursing, will follow over four months in a pilot study 50 family members of lung cancer patients who provide care, using a questionnaire that was designed to examine the key role of coping and adjustment.
“The questionnaire will be given upon entry into the study, at two months and four months, and some will do an interview by phone or in person at three months to gather other information not captured by the paper and pencil-type scales,” said Riley.
The coping questionnaire is known as the Responses to Stress Questionnaire, and it was developed by Bruce Compas, Ph.D., Patricia and Rodes Hart Professor of Psychology and Human Development and Pediatrics, but it has never been used before in the context of how people cope with lung cancer.
“Dr. Riley's study will provide important information to help us understand how patients and caregivers cope with the many stressful aspects of lung cancer. Her findings have great potential to contribute to the development of more effective programs to help families with this difficult process,” Compas said.
Currently more than 15 million adults are providing care to relatives with cancer in the United States, according to a recent article in the Journal of Supportive Oncology. The role of the caregiver has evolved to become a demanding role. Caregivers are expected to control pain management, function as a home health aide, make decisions about treatment options, and more.
Yet some researchers say the health care system has done little to address the needs of caregivers. A study of terminally ill adults and their caregivers found 87 percent of patients had unmet needs.
“We know how difficult it is to be the caregiver of a person with advanced lung cancer, but we don’t know how best to help them cope with cancer’s escalating demands,” said Riley. “This is an opportunity to get a more realistic picture of how families are dealing with the demands of the illness and what works and what doesn’t work for them.”
The questions family caregivers will answer range from asking their perspective on the illness of their loved one to describing the strain or burden delivering care has caused. Riley said so much has been written on the stress of caring for someone with cancer and the overwhelming negative aspects, but she also wants to focus on the positive side of caregiving.
“These questionnaires also look at positive experiences of delivering care and coping strategies that are beneficial. Many people want to be there for their spouse or parents during illness and the family learns to pull together to deliver quality care,” said Riley. “It’s exciting to look at the positives and to see those people who can look at a devastating event and find a benefit or strength. I’m a nurse, I always look for the positive piece of dealing with a health crisis,” she added.
Riley said she hopes her study will reveal a different point of view when examining how caregivers cope with illness.
“When you talk to someone during an illness it is possible to more clearly define their experience. We need prospective information, not just retrospective points of views. I want to know how the experience of providing care before the death of the patient affects the bereavement of the caregiver over the long term,” she said.
Riley hopes to use the information she gathers to identify characteristics or risk factors that might help signal people who need more assistance in coping, education, emotional support, or referral for counseling.
“If we know who is most in need of support we will be better able to design specific supportive interventions to help them.”
Patients and family caregivers will be enrolled in the study through the Vanderbilt Ingram Cancer Center and the Tennessee Valley Health Systems lung cancer clinics beginning in September. Riley said though this research is only funded for a year, she is currently drafting a subsequent study to follow family members of lung cancer patients over a longer period of time.
Fifteen other grants were given for pilot projects. See sidebar below for the full list.
Private and public sources fund VICC pilot projects
by Cynthia Floyd Manley
The Vanderbilt-Ingram Cancer Center has funded 16 innovative pilot projects with $427,000 in support from a variety of private and public sources.
The awards include a total of $70,000 from the American Cancer Society/Sartain-Lanier Foundation (ACS/Sartain), $80,000 from the National Cancer Institute Cancer Center Support Grant (CCSG), and $170,000 in Discovery Grant funding from private donations.
Project funding was also augmented by $47,000 in private donations to the Herb Shayne Cancer Research Fund and $60,000 from the Robert J. Kleberg, Jr. and Helen C. Kleberg Foundation.
“This was the largest response to any set of solicitations we have extended for pilot project funding, and we were very fortunate to have the resources available to fund so many of them,” said Jennifer Pietenpol, Ph.D., Ingram Professor of Cancer Research and VICC’s associate director for basic science programs.
“Seed funding to get innovative science off the ground is so critical for generating the data needed to compete for funding from the National Institutes of Health and other public sources. Without private philanthropy, many opportunities would be lost.”
Projects, investigators and funding sources are:
• “Components of Unintentional Weight Loss in Older Head and Neck Cancer Patients Undergoing Concurrent Chemo-Radiation Therapy,” Heidi J. Silver, Ph.D., ACS/Sartain
• “Adult Tissue Growth Regulation in the Drosophila Ovary,” Daniela Drummond-Barbosa, Ph.D., ACS/Sartain
• “Cyclooxygenase-1 Derived Prostacyclin Enhances Ovarian Cancer via Peroxisome-Proliferator-Activated Receptor-Gamma,” Takiko Daikoku, Ph.D., ACS/Sartain
• “The Role and Prognostic Significance of the Transcriptional Co-Factors, Cited1 and 2, in Wilms’ Tumor,” Harold Lovvorn, M.D., ACS/Sartain
• “Increasing Colorectal Cancer Screening in Vulnerable Populations: A Pilot and Feasibility Study for the Design of a Tailored Web-Based Educational Tool,” Neeraja Peterson, M.D., ACS/Sartain
• “Cell Contact and Acidity Induced Novel Transcription Regulator in H. pylori,” Andrzej M. Krezel, Ph.D., CCSG
• “Identification of Novel Tumor Antigens in Breast Cancer” Ingrid A. Mayer, M.D., CCSG/Kleberg
• “Bladder Cancer Detection Using Optical Methods,” Anita Mahadevan-Jansen, Ph.D., CCSG
• “Families Coping with Lung Cancer: A Pilot Study,” Linda P. Riley, Ph.D., CCSG/Kleberg
•“MALDI Mass Spectrometry of Urine for the Diagnosis of Bladder Cancer,” Neil Bhowmick, Ph.D., CCSG/Kleberg
•“Genome-Wide Screen for Chk1 and Chk2 Substrates,” Ethan Lee, M.D., Ph.D., Discovery Grant
• “Enzyme-activated Therapeutic Molecular Imaging Agent,” Darryl J. Bornhop, Ph.D., Discovery Grant
• “Biomarkers for Gastric Preneoplasia,” James R. Goldenring, M.D., Ph.D., Discovery Grant
• “Development of Methylated Tumor-Specific DNA in Plasma as a Biomarker in Patients with Malignant Glioma,” Kyle D. Weaver, M.D., Discovery Grant
• “Proteomics and Acute Leukemia: Taxonomy and Prognosis,” Mary M. Zutter, M.D., Discovery Grant
• “Novel Serum Biomarkers for Head and Neck Carcinomas,” Robert J.C. Slebos, Ph.D., Discovery Grant/Shayne Fund©2013 Vanderbilt University Medical Center