Reported by Peggy Vaughn
July 25, 2003
The National Cancer Institute (NCI) funds dozens of clinical trials
related to palliative care. The variety and scope of these trials
reflect the important role palliative care plays in a cancer patient's
life from the moment of diagnosis and throughout the cancer trajectory.
Whether investigating new drugs to control pain, testing for possible
neurological effects of chemotherapy, or researching quality of
life issues among cancer survivors, NCI is investigating ways to
eliminate suffering due to cancer.
Databases
Since NCI-sponsored trials in palliative care
are too numerous to list here and cover a wide variety of topics,
this guide will only touch on a few examples of current clinical
trials involving palliative care, supportive care, and survivorship.
To fully explore NCI's palliative care clinical trials, visit the
following databases:
- CRISP, a searchable database of federally funded biomedical
research projects conducted at universities, hospitals, and other
research institutes, at http://crisp.cit.nih.gov/.
The database includes work in this area funded by various NIH
components, including the lead NIH Institute for end-of-life research---the
National Institute for Nursing Research (NINR). Use the search
terms "palliative," "supportive," or "survivorship." To find just
what NCI is funding, narrow the search by selecting NCI under
the "Institutes and Centers" category.
- A new web page was recently added to the NCI's cancer.gov Web
site that announces funding opportunities and areas of encouraged
research in the broad areas of symptom management and palliative
care. This listing includes announcements from other NIH Institutes
and Centers and other government agencies at
Cancer.gov
- Funding Opportunities in Symptom Management and Palliative Care
Research.
- Current research in cancer survivorship by NCI's Cancer Control
& Population Sciences Division can be found at http://cancercontrol.cancer.gov/ocs/portfolio.asp.
The list contains grants carried over from prior fiscal years
and new grants awarded in the current fiscal year.
- The PDQ (Physician Data Query) is NCI's comprehensive cancer
database and contains information about over 14,000 open and closed
cancer clinical trials from around the world. Visit PDQ at http://www.cancer.gov/clinical_trials. Use the "advanced search form" and narrow the search to "supportive
care" type trials sponsored by NCI.
Examples of palliative care trials
Symptom management
NCI is investigating a wide variety of cancer symptoms, including
weight loss or gain, fatigue, hot flashes, pain, nausea, and vomiting.
For example, one trial is determining if ginger can help reduce
or prevent nausea caused by chemotherapy (Study of Ginger for Chemotherapy-Related Nausea in Patients With Cancer).
Another approach under investigation is evaluating the use of acupuncture
in relieving chemotherapy-induced nausea among breast cancer patients
(Treating
Chemotherapy Induced Nausea with Acupressure).
Other investigations into symptom management include, but are by
no means limited to: constipation (
Reversal of Opioid Constipation), hot flashes
(Study of Gabapentin for Management of Hot Flashes), wasting (Docetaxel and Wasting in Patients with Small Cell Lung Cancer), and altered taste (Zinc Sulfate for Prevention of Altered Taste).
Survivorship
Two trials are examining the quality of life of women surviving
cervical cancer and breast cancer. The first is studying 144 women
receiving treatment and follow-up surveillance for cervical cancer.
Researchers hope to develop culturally sensitive, short-term interventions
to improve sexual functioning and overall quality of life (Sexual
Functioning and QOL in Women with Cervical Cancer). The second
study is examining the effects of exercise and raloxifene in postmenopausal
breast cancer survivors. The researchers hope to reduce the negative
impact of the complications of chemotherapy, such as osteoporosis,
increases in heart disease, and declines in the quality of life
(Breast
Cancer Survivors: Exercise and Raloxifene).
Many breast cancer patients report problems with attention span,
memory, and concentration following chemotherapy. One current trial
involves a treatment program to help 33 breast cancer survivors
compensate for cognitive deficits; the results may help in the development
of a program suitable for use in a clinical setting (Cognitive Behavioral Treatment of Memory Problems).
For more information on survivorship research at NCI, go to
Survivorship Research at NCI.
Childhood cancers
Survivors of childhood cancers often face increased risk for developing
subsequent cancers, so smoking cessation intervention is especially
important among this group. One study to reduce smoking among childhood
cancer survivors is examining the impact of peer-delivered telephone
smoking cessation counseling compared to the use of a self-help
manual on smoking cessation (Smoking
Cessation Among Childhood Cancer Survivors).
Another trial is investigating the effectiveness of a program aimed
at improving the cognitive ability of childhood cancer survivors
with damaged central nervous systems. This randomized study involves
children aged 6 to 17 treated for leukemia, brain tumor, or non-Hodgkin's
lymphoma. The program involves 20 two-hour training sessions aimed
at improving cognitive abilities in such areas as focusing attention,
memory recall, learning, school behavior and self-esteem (Cognitive
Remediation for Childhood Cancer Survivors).
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