This is an application for a K23 award for Dr. Anand Dhruva, a medical oncologist/hematologist at the University of California, San Francisco. Dr. Dhruva is establishing himself as a young investigator in complementary and alternative medicine (CAM) and cancer symptom management. This K23 will provide Dr. Dhruva with the support necessary to accomplish the following goals: (1) to develop into an Independent clinical investigator focusing on the rigorous study and successful integration of CAM modalities into conventional oncology care;(2) to learn and apply compatible research methods for the study of whole systems of medicine, with focused expertise in the study of the application of Ayurveda to the oncology setting;and (3) to learn and apply advanced clinical research and qualitative methods in clinical studies. To achieve these goals, Dr. Dhruva has assembled a mentoring team comprised of primary mentor, Dr. Frederick Hecht, Director of Research at the Osher Center for Integrative Medicine, who conducts clinical investigations in CAM and HIV, and three co-mentors: Dr. Christine Miaskowski, an expert in the study of cancer-related symptoms and quality of life;Dr. Donald Abrams, an oncologist who focuses on integrative oncology;and Dr. Shelley Adler, an expert in qualitative research. Despite achieving remission or cure, many cancer survivors discover that the residual symptoms due to the cancer and/or the treatment of the cancer to be difficult, disabling, and impair quality of life. Whole systems approaches to health, such as Ayurveda, have potential benefits for improving quality of life and symptoms in cancer survivors. Complex, individualized interventions, such as those used in Ayurveda, are currently being studied using the technique of """"""""manualization,"""""""" in which a study manual is utilized to balance the competing concerns of reproducibility and ecological validity. Dr. Dhruva's research will focus on developing a manualized Ayurvedic approach to improve cancer survivor quality of life and symptoms (Aim 1) and then conducting a pilot randomized controlled trial to assess feasibility and obtain preliminary estimates of efficacy of a manualized Ayurvedic approach to improve quality of life and symptoms among breast cancer survivors (Aim 2). This research will form the basis for a larger randomized controlled trial of Ayurveda (using the manualized approach developed in this K award) that will investigate the efficacy of Ayurveda to improve quality of life and symptoms among breast cancer survivors, which will be proposed in a subsequent ROl grant application.

Public Health Relevance

With increasing numbers of cancer survivors, improving understanding of effective and safe ways to improve quality of life and residual symptoms is important. Given the widespread use of CAM, more evidence from rigorously conducted studies is needed to guide its successful integration into modern healthcare.

National Institute of Health (NIH)
National Center for Complementary & Alternative Medicine (NCCAM)
Mentored Patient-Oriented Research Career Development Award (K23)
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Special Emphasis Panel (ZAT1-LD (30))
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Sorkin, Barbara C
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University of California San Francisco
Internal Medicine/Medicine
Schools of Medicine
San Francisco
United States
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Aouizerat, Bradley E; Dhruva, Anand; Paul, Steven M et al. (2015) Phenotypic and Molecular Evidence Suggests That Decrements in Morning and Evening Energy Are Distinct but Related Symptoms. J Pain Symptom Manage 50:599-614.e3
Doong, Sy-Huey; Dhruva, Anand; Dunn, Laura B et al. (2015) Associations between cytokine genes and a symptom cluster of pain, fatigue, sleep disturbance, and depression in patients prior to breast cancer surgery. Biol Res Nurs 17:237-47
Miaskowski, Christine; Cataldo, Janine K; Baggott, Christina R et al. (2015) Cytokine gene variations associated with trait and state anxiety in oncology patients and their family caregivers. Support Care Cancer 23:953-65
Dhruva, Anand; Aouizerat, Bradley E; Cooper, Bruce et al. (2015) Cytokine gene associations with self-report ratings of morning and evening fatigue in oncology patients and their family caregivers. Biol Res Nurs 17:175-84
Merriman, John D; Aouizerat, Bradley E; Cataldo, Janine K et al. (2014) Association between an interleukin 1 receptor, type I promoter polymorphism and self-reported attentional function in women with breast cancer. Cytokine 65:192-201
Dhruva, Anand; Hecht, Frederick M; Miaskowski, Christine et al. (2014) Correlating traditional Ayurvedic and modern medical perspectives on cancer: results of a qualitative study. J Altern Complement Med 20:364-70
Stephens, Kimberly; Cooper, Bruce A; West, Claudia et al. (2014) Associations between cytokine gene variations and severe persistent breast pain in women following breast cancer surgery. J Pain 15:169-80
Langford, Dale J; West, Claudia; Elboim, Charles et al. (2014) Variations in potassium channel genes are associated with breast pain in women prior to breast cancer surgery. J Neurogenet 28:122-35
Merriman, John D; Aouizerat, Bradley E; Langford, Dale J et al. (2014) Preliminary evidence of an association between an interleukin 6 promoter polymorphism and self-reported attentional function in oncology patients and their family caregivers. Biol Res Nurs 16:152-9
Leung, Geraldine; Baggott, Christina; West, Claudia et al. (2014) Cytokine candidate genes predict the development of secondary lymphedema following breast cancer surgery. Lymphat Res Biol 12:10-22

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