By Jennifer Temel, MD
A new research program to help patients transition from receiving cancer therapy to surveillance was inspired by a patient of mine who struggled to return to “normal” after having surgery, chemotherapy, and radiation for lung cancer. He felt both his physical and psychological symptoms were negatively impacting his quality and enjoyment of life and felt unprepared to feel this way after his treatment had ended. Based upon his experience and input, we developed a new intervention to give patients with lung cancer the tools and strategies to adjust to the changes in their physical health and cope with how treatment is impacting their life.
Imagine having the evidence-based interventions on hand to address every side effect our patients experience. There are so many topics that require investigation to improve our patients’ quality of life, and it is important that we develop patient-centered and population-specific interventions.
With a growing availability of grants specifically for symptom management, mentors should encourage medical students and fellows to consider a focus in supportive care. My colleague and mentee, Daniel E. Lage, MD, MSc, received a Conquer Cancer/Rising Tide Foundation for Clinical Cancer Research Career Pathway Grant in Symptom Management to identify ways to better support patients during transitions of care from hospital to home.
As Rising Tide works with Conquer Cancer, ASCO, and others in the oncology community to explore symptom management studies, I asked Dr. Lage to share his experiences and perspective on how we can encourage the next generation of scientists to focus on symptom management research.
What inspires your work to improve symptom management?
DL: I was inspired to focus on the symptoms experienced by patients with advanced cancer during and after their hospitalization while caring for many patients who experienced physical and psychological symptoms just after being discharged home, often requiring them to be readmitted to the hospital. Seeing the burdensome care transitions that they faced inspired me to develop novel approaches to supporting them in their transition home. Symptom management should go hand in hand with decision-making around cancer-directed therapy, and as an oncology fellow, I've noticed that the two are more linked than we often appreciate.
What are the main topics that urgently need more investigation to support better quality of life for patients?
DL: Researchers in symptom management must constantly bridge divides across disciplines and collaborate with others to come up with novel ways to better support diverse patient populations. It's one of the facets of this field that makes it so promising and exciting as a trainee.
I think the integration of palliative care, psychosocial oncology, and lifestyle medicine is a promising area in symptom management research. In my field of prostate cancer, for instance, studies have found that men who exercise while on prostate cancer treatment have fewer symptoms and better quality of life, but uptake of exercise is low in this population. We're currently developing interventions to help bridge this gap and encourage the management of symptoms and side effects through physical activity.
What are the main challenges for a researcher who wants to dedicate a career to cancer symptom management research?
DL: Funding is obviously vital, but finding outstanding mentors who have experience conducting rigorous research in symptom management has been crucial for my career. I have benefited so much from your dedicated mentorship for years, since I was a medical student, and for any trainee thinking of entering this field, identifying key mentors early is a crucial step to help prepare for a successful career in this area.
What career opportunities exist for early-career oncologists to specialize in symptom management?
DL: We receive some training in symptom management during medical oncology fellowship, but this can be supplemented with further clinical experiences in palliative care and psychosocial oncology during senior fellowship and/or electives. From a research perspective, attending national conferences and collaborating with researchers in this field both nationally and internationally is crucial to establish partnerships, develop new ideas, and receive mentorship in conducting high-quality, impactful studies.
Dr. Temel, a thoracic oncologist, is a professor of medicine at Harvard Medical School, director of the Cancer Outcomes Research Program at the Massachusetts General Hospital (MGH) Cancer Center, and clinical director of the Thoracic Oncology Program at MGH. She is the recipient of numerous awards, including the Walther Cancer Foundation Palliative and Supportive Care in Oncology Award, an ASCO Special Award. Dr. Temel was recently named an American Cancer Society Clinical Research Professor for her research in palliative and supportive care. Disclosure.
Dr. Lage is a fellow in medical oncology at Massachusetts General Hospital Cancer Center/Dana-Farber Cancer Institute, and a fellow in medicine at Harvard Medical School. His research focus is on improving transitions of care after hospitalization for patients with advanced cancer, and his clinical focus is the care of patients with genitourinary malignancies. His career goal is to develop innovative health care delivery models to help manage symptoms and improve quality of life for patients with cancer. Follow him on Twitter @dlage. Disclosure.