Collaborations

Survivorship Center of Excellence Grant
Director, Principal Investigator: Scott Baker, MD MSc;
Co-Director, Principal Investigator: Karen Syrjala, PhD;
Medical Co-Director: Stephanie Lee, MD; Medical Co-Director: Julie Gralow, MD;
Program Manager: Emily Jo Rajotte, MPH

Computerized Assessment for Patients with Cancer
Principal Investigator: Donna Berry, PhD, RN; Co-Investigator: Jesse Fann, MD, MPH

This initial and renewed NIH funded study aimed to design and test the integration of a web-based symptom and quality of life assessment, ESRA-C, with the extant SCCA/UWMC information system in screening for depression, distress, pain, and quality of life. We will evaluate the clinical impact of this assessment in ambulatory cancer care in medical oncology, radiation oncology, and stem cell transplant clinics. We will also compare the impact of ESRA-C provided to patients and clinicians versus clinicians alone. The study will also assess clinician responses to patient/caregiver interactions and describe requirements for and feasibility of implementing ESRA-C on a patient-centered, internet web application.

Distress in Women Receiving Chemotherapy for Breast Cancer
Principal Investigator: Jesse Fann, MD, MPH

This American Cancer Society funded study aims to improve the understanding of depression and its treatment during the course of chemotherapy for breast cancer. Women with stage I, II, and III breast cancer receiving neoadjuvant or adjuvant chemotherapy were interviewed during consecutive chemotherapy infusions to assess depression and anxiety symptoms, use of psychological services, and depression treatment preferences. This study is one of the first to longitudinally document the course of depression and anxiety symptoms and their treatment during chemotherapy for breast cancer.

Incidence of Suicide in a National U.S. Cancer Registry
Principal Investigator: Stephanie Misono, MD, MPH; Co-Investigator: Jesse Fann, MD, MPH

This study examined the overall suicide rates in the Surveillance, Epidemiology, and End-Results (SEER) data base and determined the demographic and cancer-related characteristics associated with increased suicide risk among cancer patients.

HSCT-CHESS to Enhance Hematopoietic Transplant Recovery
Principal Investigator: Susan Parsons, MD, MRP; Site Principal Investigator: Karen Syrjala, PhD

This NCI funded project adapts CHESS, an internet Comprehensive Health Enhancement Support System, to parents of pediatric HSCT recipients. In a multicenter RCT it tests a transplant-specific web-based education and support program compared with standard care.

Virtual Reality Anesthesiology for Procedural Cancer Pain
Principal Investigator: Sam Sharar, MD

This NCI supported research designs and tests virtual reality hardware and software that incorporate multisensory input to maximize user "presence" in the virtual environment when body position and movement are restricted. We assess analgesic efficacy and side effects of the system vs. two controls in subjects experiencing laboratory pain. Current studies test clinical trials of virtual reality during painful oncologic procedures.

Modulation of Opioid Effects by Garlic Supplements
Principal Investigator: Danny D. Shen, PhD

The overall objective of this research is to explore whether a CYP3A- and Pgp-dependent interaction exists between garlic supplements and a commonly used oral opioid analgesics-oxycodone. The studies are designed to investigate the following hypotheses:

1. Chronic treatment with garlic extract up-regulates the intestinal and hepatic expression of CYP3A and intestinal Pgp, which results in a decrease in oral absorption, an increase in first-pass metabolism, and increase in systemic clearance of oxycodone.
2. Garlic-induced changes in oxycodone pharmacokinetics lead to significant changes in analgesic and side effects of oxycodone. In particular, we will assess whether the same degree of change in analgesia and side effects will result; i.e., whether there is a change in the therapeutic index. We will focus on the three most bothersome aspects of opioid side effects; i.e., the somatic, affective, and cognitive effects of oxycodone.

Garlic Metabolism and Cytochrome P450 Modulation
Principal Investigator: Danny D. Shen, PhD

A comparative study on three types of commonly used garlic products: garlic powder, steam-distilled garlic oil, or aged garlic extract in a panel of healthy volunteers to investigate the two following hypotheses:

1. The modulating effect of garlic on a CYP isoform or Pgp will depend on the type of garlic supplement used. As a corollary, the effects on CYP and Pgp activity will be correlated with the absorption and metabolism of the bioactive constituents in the garlic preparations; viz. metabolites derived from the two major classes of organosulfur compounds in garlic: γ-S-alkylcysteine sufoxides and γ-glutamyl-Sallylcysteines.
2. Garlic's effect on some CYPs and Pgp activity differ between acute and chronic treatments; for example, acute treatment of a garlic supplement inhibits CYP and Pgp activity, whereas chronic garlic intake induces CYP or Pgp expression resulting in a net increase in its activity.

Human Herpesvirus-6 and CNS Disease Following Stem Cell Transplant
Principal Investigator: Danielle Zerr, MD, MPH; Co-Investigator: Jesse Fann, MD, MPH

This ongoing NIH funded study aims to build on prior work by determining the association with and long-term outcomes of systemic and central nervous system (CNS) Human Herpesvirus-6 (HHV-6) reactivation and CNS dysfunction, particularly delirium, in patients undergoing allogeneic stem cell transplantation.

Other Collaborations
We maintain research collaborations with University of Washington investigators as well as faculty at MD Anderson Cancer Center, Dartmouth-Hitchcock Medical Center, Duke University Medical Center, Tufts New England Medical Center, Ruttenberg Cancer Center at Mt. Sinai School of Medicine, Center for Outcomes Research Education at Evanston Northwestern Healthcare and Group Health Cooperative.

	Enhancing Survival
	Neurotoxicity
	Pain Management
	Collaboration