Outcomes Research

The goal of the Division of Outcomes Research is to better understand the after-effects (physical, emotional, and social) of cancer and its treatment. These after-effects may include things such as fatigue, worry, sadness, problems with the heart and lungs, learning difficulties, problems with memory, and second cancers. Gaining a better understanding of these after-effects will help to identify people who are at high risk for having these types of complications after cancer treatment, and ways to reduce that risk.

Key research studies include:

Monitoring Heart Function in Kidney Cancer Patients

Chemotherapy and other treatments (such as radiation) can have side effects on the heart muscle. In an effort to better understand how certain treatments affect the heart muscle, we are currently recruiting individuals with kidney cancers (such as renal cell carcinoma) to have an evaluation of the heart. The evaluations in this study are done using an ultrasound test called an echocardiogram; this non-invasive exam allows us to see the internal structures of the heart and evaluate any changes that might occur due to cancer treatments. The goals of this study are to determine the frequency of these side effects, and to develop better screening guidelines for individuals undergoing treatment for kidney cancers.

Reducing Congestive Heart Failure Risk in Survivors of Childhood Cancer

Congestive heart failure is a condition that occurs when the heart muscle has been weakened and can’t pump blood as well as it should. Many people who were treated for cancer as children received a type of chemotherapy called anthracyclines; those survivors are at a much higher risk of congestive heart failure. Saro Armenian, D.O., M.P.H., is leading a clinical research study to determine whether a low dose of the drug carvedilol can reduce the risk of congestive heart failure in childhood cancer survivors who received chemotherapy with anthracyclines.

Key Adverse Events Studies

The use of hematopoietic stem cell transplant (HCT) to treat various medical conditions has improved over the last 20 years. There are now over 100,000 long-term survivors who have received HCT and the number is growing. Most of these survivors are doing well, but some may develop problems after receiving their transplant. The study looks into how certain complications, such as diabetes, heart conditions, lung conditions, stroke, bone problems, hormonal imbalances, and second cancers develop, and to see if certain lifestyle factors, treatments, or genes (factors that pass inherited traits from parent to child) are related to an increased risk of getting such complications. Read more about the Key Adverse Events after Hematopoietic Cell Transplantation study.

BMT Study

Blood or Marrow Transplant (BMT) is used to treat many life-threatening illnesses. More than 70% of those who survive the first two years after BMT become long-term survivors. The BMT Long-term Follow-up Study, a collaborative research effort between City of Hope and University of Minnesota, examines detailed information regarding the long-term health of those treated with BMT. The researchers first assembled a group of 2500 patients who had undergone BMT between 1974 and 1998. Findings from this study helped the researchers to understand the physical and psychological health of people who had received BMT. The original BMT Long-term Follow-up Study is now including more patients (transplanted up to 2010) and continuing for a longer time period (adding longer follow-up of the original patients in the study) to form the Expanded BMT Long-term Follow-up Study. This study will continue to look at the health and well-being of individuals undergoing BMT, extend the length of follow-up after transplant, and, by collecting blood or saliva samples, pinpoint genetic (inherited) factors that will allow us to identify people at high risk for developing after-effects of cancer treatment and to individualize their preventive care to help ease the burden of cancer and its after-effects.

The goal of the Expanded Blood or Marrow Transplant Long-term Follow-up Study is to:
Understand the long-term health issues faced by patients undergoing BMT
Describe the burden of cancer and its after-effects in people who have had a BMT compared to their brothers or sisters of similar age who have not had cancer
Describe lifestyle factors, such as the use of tobacco and heavy drinking, that can increase the risk of health problems, and describe how BMT survivors use health care compared to their brothers or sisters of a similar age who have not had cancer
Describe the risks of developing long-term after-effects in people undergoing BMT
Create a bank of genetic (DNA) specimens for future study to help identify people at the highest risk for developing long-term complications of cancer treatment, and how best to treat these conditions

Donors, recipients and friends and family join City of Hope staff at a BMT reunion. A collaborative research effort between City of Hope and University of Minnesota examines detailed information regarding the long-term health of those treated with BMT.

Childhood, Adolescent And Young Adult Survivorship Program

An important part of the Division of Outcomes Research is the Childhood, Adolescent And Young Adult Survivorship Program, a clinical long-term follow-up program designed to create a bridge between cancer treatment and community medical care.

The growing number of cancer survivors (estimated at almost 14 million adults in the U.S. alone), need individualized survivorship-focused care. Development of Survivorship Care Plans is an important part of this care. These care plans are designed to empower cancer survivors, and to encourage health-promoting behavior. City of Hope’s Childhood Cancer Survivorship Program creates plans that address the chronic effects of cancer and its therapy (such as pain, fatigue, premature menopause, worry, and sadness) and provide recommendations for monitoring so that problems can be caught early. That way problems that may develop, such as thinning of the bones (osteoporosis), heart disease and second cancers, can be identified and treated earlier, when treatments are often most effective.

The overall goal of the Childhood, Adolescent And Young Adult Survivorship Program is to provide specialized long-term follow-up care for cancer survivors, and, in the process, to carry out much-needed research in cancer survivorship. The program fulfills these goals by providing individualized, comprehensive follow-up care for cancer survivors in a clinical research setting. The program continually strives to improve the overall quality of life for cancer survivors.

Outcomes Research Faculty

Saro H. Armenian, D.O., M.P.H.

Pediatric Hematologist-Oncologist

Pediatric hematologist-oncologist Saro Armenian, D.O., M.P.H., is the Barron Hilton Chair in Pediatrics, with expertise in pediatric cancer, epidemiology and cancer survivorship.

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Rusha Bhandari, M.D., M.S.

Pediatric Hematologist-Oncologist

Rusha Bhandari, M.D., M.S., is an assistant professor in the Department of Pediatrics and Department of Populations Sciences at City of Hope.

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Lee W. Jones, Ph.D.

Director, Exercise Oncology Program, Beckman Research Institute

My academic career has focused on a translational approach to elucidating the effects and mechanisms of controlled exercise therapy on cancer pathogenesis.

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Kyuwan Lee, Ph.D.

Assistant Professor, Division of Outcomes Research, Department of Population Sciences

Kyuwan Lee, Ph.D., is an assistant professor in the Division of Outcomes Research/Intervention, Department of Population Sciences.

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Sunita Patel, Ph.D.

Psychologist

Sunita Patel, Ph.D., is an associate professor in the departments of Supportive Care Medicine and Population Sciences.

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Florence Lennie Wong, Ph.D.

Associate Professor, Departments of Population Sciences and Computational and Quantitative Medicine, Division of Biostatistics, Scientist, Outcomes Research

F. Lennie Wong, Ph.D. is an Associate Professor in the Departments of Population Sciences and Computational and Quantitative Medicine and a scientist in the Division of Outcomes Research.

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