Prevalence of cancer is up to 2.1 times higher among lesbian, gay, bisexual, and transgender (LGBT) persons than heterosexuals, yet LGBT cancer survivors are virtually invisible in cancer research in the United States. This invisibility, as wel as real and expected discrimination, leads LGBT cancer patients and survivors to experience 1.7 times higher rates of psychological distress than heterosexual survivors. Given these rates of distress, the unique sociocultural factors acting on LGBT survivors, and the fact that distress is linked with increased cancer-related morbidity and mortality, tailored interventions to reduce distress among LGBT cancer survivors are needed. Our preliminary research shows that care partners of LGBT survivors want to be included in interventions to support survivors and that social support is strongly linked to psychological distress among LGBT adults. Our novel dyadic framework incorporates support from care partners and a standardized exercise intervention, Exercise for Cancer Patients (EXCAP(c)(r), a 6 week, home-based progressive walking and resistance training program), and may be effective in reducing distress among LGBT survivors. In this K07 Career Development Award application, Dr. Charles Kamen, a clinical psychologist with a background in health disparities and dyadic intervention research, proposes to conduct a Phase II RCT randomizing 70 LGBT cancer survivors (all cancer types, 1-24 months post treatment) plus their 70 care partners (broadly defined) to: Arm 1, a novel, partner-assisted version of EXCAP(c)(r) (called EXCAP-PA), in which both survivors and care partners will receive EXCAP(c)(r) materials and instruction together, or Arm 2, a survivor-only version of EXCAP(c)(r), i which only the LGBT cancer survivor will receive EXCAP(c)(r) materials. The overall hypothesis of this study is that among LGBT survivors, EXCAP-PA, incorporating care partner support, will be more efficacious than survivor-only EXCAP(c)(r) in improving biopsychosocial aspects of distress. Dr. Kamen is well positioned as a junior faculty member in an exceptional environment at the University of Rochester. He needs additional training in three core competency areas in order to launch an independent research career: 1) clinical trials for LGBT health, 2) integration of biological endpoints, and 3) design of exercise interventions. His mentors have over 30 years of experience conducting cancer control intervention trials and include: Dr. Karen Mustian, PEAK Lab Director and exercise oncology expert; Dr. Gary Morrow, Director of Cancer Control research; Dr. Kathi Heffner, psychoneuroimmunologist; Dr. Deborah Bowen, community intervention expert; and advisors Dr. Supriya Mohile, medical oncologist; Dr. James McMahon, dyadic intervention expert; and Dr. Charles Heckler, biostatistician. The career development goals and protected time provided by this training award will prepare Dr. Kamen to become an expert in cancer-related health disparities and dyadic interventions for LGBT cancer survivors and care partners. Further, if successful, this study will address a critical disparity (distress) n the underserved population of LGBT survivors.

Public Health Relevance

Lesbian, gay, bisexual, and transgender (LGBT) cancer survivors experience more psychological distress than heterosexual survivors. Very few studies have examined this population and no treatments have been delivered to them specifically. This project will provide information about using exercise, along with support from care partners, to treat distress among LGBT cancer survivors, and will assess LGBT survivors' and their care partners' well-being after cancer diagnosis and treatment.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Academic/Teacher Award (ATA) (K07)
Project #
5K07CA190529-02
Application #
9112953
Study Section
Subcommittee I - Transistion to Independence (NCI)
Program Officer
Perkins, Susan N
Project Start
2015-07-17
Project End
2020-06-30
Budget Start
2016-07-01
Budget End
2017-06-30
Support Year
2
Fiscal Year
2016
Total Cost
Indirect Cost
Name
University of Rochester
Department
Surgery
Type
School of Medicine & Dentistry
DUNS #
041294109
City
Rochester
State
NY
Country
United States
Zip Code
14627
Asare, Matthew; Peppone, Luke J; Roscoe, Joseph A et al. (2018) Racial Differences in Information Needs During and After Cancer Treatment: a Nationwide, Longitudinal Survey by the University of Rochester Cancer Center National Cancer Institute Community Oncology Research Program. J Cancer Educ 33:95-101
Kamen, Charles S; Alpert, Alison; Margolies, Liz et al. (2018) ""Treat us with dignity"": a qualitative study of the experiences and recommendations of lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients with cancer. Support Care Cancer :
Kamen, Charles (2018) Lesbian, Gay, Bisexual, and Transgender (LGBT) Survivorship. Semin Oncol Nurs 34:52-59
Palesh, Oxana; Kamen, Charles; Sharp, Susan et al. (2018) Physical Activity and Survival in Women With Advanced Breast Cancer. Cancer Nurs 41:E31-E38
Lin, Po-Ju; Peppone, Luke J; Janelsins, Michelle C et al. (2018) Yoga for the Management of Cancer Treatment-Related Toxicities. Curr Oncol Rep 20:5
Kleckner, Ian R; Kamen, Charles; Gewandter, Jennifer S et al. (2018) Effects of exercise during chemotherapy on chemotherapy-induced peripheral neuropathy: a multicenter, randomized controlled trial. Support Care Cancer 26:1019-1028
Kamen, Charles; Scheiber, Caroline; Janelsins, Michelle et al. (2017) Effects of childhood trauma exposure and cortisol levels on cognitive functioning among breast cancer survivors. Child Abuse Negl 72:163-171
Peoples, Anita R; Garland, Sheila N; Perlis, Michael L et al. (2017) Effects of cognitive behavioral therapy for insomnia and armodafinil on quality of life in cancer survivors: a randomized placebo-controlled trial. J Cancer Surviv 11:401-409
Asare, Matthew; Flannery, Marie; Kamen, Charles (2017) Social Determinants of Health: A Framework for Studying Cancer Health Disparities and Minority Participation in Research Oncol Nurs Forum 44:20-23
Jabson, Jennifer M; Patterson, Joanne G; Kamen, Charles (2017) Understanding Health Information Seeking on the Internet Among Sexual Minority People: Cross-Sectional Analysis From the Health Information National Trends Survey. JMIR Public Health Surveill 3:e39

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