Category: Cancer Page 3 of 6

José Jerónimo and his team are transforming the face of cervical cancer screening. Jerónimo is a physician and senior advisor for the women’s cancers branch of PATH, an international nonprofit organization that uses innovative technologies to improve health outcomes in developing countries. Jerónimo, who’s work at PATH has facilitated the prevention and treatment of cervical cancer for thousands in the developing world, spoke at the Duke Institute for Global Health on Dec. 2.

Cervical cancer testing has been a point of conflict in the medical community for quite some time now, for the pap smear — for many years, the only test available to detect cervical cancer — is not very sensitive to abnormal tissue. Since skepticism with the pap smear arose a few decades ago, doctors like Jerónimo have been working tirelessly to find more effective screening strategies.

José Gerónimo, Peruvian physician and public health advocate, received his specialty training in gynecologic oncology at the National Cancer Institute in Peru.

José Jerónimo, Peruvian physician and public health advocate, received his specialty training in gynecologic oncology at the National Cancer Institute in Peru.

Cervical cancer can be acquired through the presence of HPV (human papilloma virus). Chronic infections of HPV have been proven to increase the likelihood of contracting cervical cancer, so developing primary prevention initiatives to avoid developing HPV to begin with are essential to decrease the prevalence of cervical cancer. HPV testing, unlike the pap smear, can be self-collected and does not require the complex, expensive machinery that the pap smear does. Initial self-sampling studies in India, Uganda, and Nicaragua indicated a willingness by the female community to self-test, so long as sanitary and private conditions were provided.

Studies in the Jujuy province of Argentina indicated that community health workers played a key role in facilitating the self-sampling process. When the health workers differed locals to clinics or sent them to facilities for testing, only 20 percent actually went. But, when they brought the self-sampling tests to locals’ homes directly, testing was above 80 percent. The easy accessibility of self-sampling, along with encouragement by local health volunteers, clearly showed that self-sampling was much more effective.

A group of female community health workers in Lima, Peru, educating the community about HPV testing.

Jerónimo’s current work focuses on strengthening government screening systems for HPV that are already in place. By helping ministries introduce and scale up the testing, he and others at PATH hope to decrease HPV and cervical cancer rates.

But, it goes beyond testing. Jerónimo emphasizes the need for evaluation and follow-up mechanisms after testing positive. Although testing efforts have improved significantly, the treatment provided after for those who have tested positive is still lagging. Jerónimo claims that much of this is due to minimal efforts by the local governments to really follow through beyond the testing phase.

PATH is looking for innovative ways to treat HPV that are inexpensive and effective. They recently developed their own version of the thermal coagulator, a probe that treats infected tissue using heat. Their design runs on a battery, rather than needing constant electricity, and uses a progressive heating mechanism that is only activated upon touching the cervix. There is still progress to be made, in both testing and treatment of HPV and cervical cancer, but through efforts by both local and international communities, Jerónimo shows us that is possible.

lola_sanchez_carrion_100hed Post by Lola Sanchez-Carrion

Fostering a Collaborative Research Environment in Peru

By Lola Sanchez-Carrion

On October 5, 2016

In Biomedical Engineering, Cancer, Cardiology, Field Research, Global Health

We are told time and time again that Duke is a global university, one that transcends borders and takes interdisciplinary education to the next level.

On Monday, I was able to experience this international mindset firsthand at the Peru Health Symposium, a conference that celebrated a decade of culminating research efforts by Duke in Peru.

The symposium was organized by Dr. William Pan, a professor of Global Environmental Health at Duke who has worked on many research projects in Peru ranging from reproductive health to tuberculosis. In his opening remarks, Pan said the trademark interdisciplinary nature of Duke has allowed it to succeed as a research institution in Peru, along with its affiliation to pioneers in Peruvian health/environmental research, like John Terborgh.

“We are standing on the shoulders of giants,” said Pan. During the first panel, several research projects were presented.

Helena Frischtak conducting research with Peruvian children in the field.

Helena Frischtak, a 4^th year medical student at UVA and former Doris Duke Fellow spent a year studying the neurological effects of mercury exposure on children. She performed basic neurological exams, along with cognitive tests amongst 5-11 year-old children, and preliminary data suggests potential impacts of mercury exposure on cognitive development.

Marlee Krieger of the Center for Global Women’s Health Technologies presented a cervical cancer treatment that brings colposcopy into the primary care setting. When one is screened for cervical cancer, a pap smear is first conducted and if abnormalities are detected, a colposcopy is performed and tissue is biopsied from the cervix. This multiple-step process is tedious, and the number of patients that return for the colposcopy often declines. By combining the steps into one visit and performing it with a simpler and cheaper device, testing efficiency has increased.

Maria Lazo Porras of Cayetano Heredia University (Lima’s prominent medical university) presented findings on the effects of migration from rural to urban regions on chronic disease. Her findings suggest a correlation between urbanization and obesity, but provided surprising results that indicate higher rates of hypertension and diabetes in rural communities.

Illegal mining scars the Amazon’s lush forests and flushes mercury runoff into streams.

Students doing research in the Amazon presented posters of their findings to faculty members of the Nicolas School and DGHI.

The main theme resonating throughout the conference was the need for collaboration not only to address public/environmental health concerns, but to organize symposiums like this one. The culmination of efforts by the Center for Latin American and Caribbean Studies (CLACS), DGHI, and the Nicholas School have fueled the Peru project’s palpable success.

Below is the link to the documentary shown at the symposium:

http://www.daughterofthelake.pe/ – “Hija de la Laguna” (Daughter of the Lake), 2015. The documentary tells the story of how a Peruvian woman used her powers to stop illegal mining from destroying the lake in her community; a lake that to her, represents her mother’s spirit.

lola_sanchez_carrion_100hed Post by Lola Sanchez-Carrion

In Sync

By Robin Smith

On August 25, 2016

In Animals, Biology, Cancer, Faculty

DiTalia2 The dividing red spots in this time-lapse video belong to a busily developing fruit fly embryo. A fruit fly egg can divide into some 6,000 cells in just two hours — faster division than cancer tumors. To watch them action, graduate student Victoria Deneke and assistant professor Stefano Di Talia tagged the nuclei with a protein that glows red. In a recent study, they show that the cells coordinate their rapid divisions via waves of protein activity that spread across the embryo. The waves help ensure that all the cells enter the next stage of development at the same time.

Duke graduate student Victoria Deneke has been awarded an international student research fellowship from the Howard Hughes Medical Institute.

Starting September 2016, Deneke became one of 20 graduate students from 14 countries selected for an international student research fellowship from the Howard Hughes Medical Institute.

Three-year fellowship is designed to support outstanding international graduate students studying in the United States who are ineligible for fellowships or training grants through U.S. federal agencies.

Born in El Salvador, Deneke earned her undergraduate degree in chemical engineering from the University of Notre Dame before joining Stefano Di Talia’s at Duke in 2013.

Fellows must be nominated by their institution; participation is by invitation only. Deneke is only the second student at Duke to receive an HHMI International Student Research Fellowship since the program was established in 2011.

CITATION: “Waves of Cdk1 Activity in S Phase Synchronize the Cell Cycle in Drosophila Embryos,” Victoria Deneke, Anna Melbinger, Massimo Vergassola and Stefano Di Talia. Developmental Cell, August 2016. http://dx.doi.org/10.1016/j.devcel.2016.07.023

Turning Duke Experiences into Science Fair Gold

By Karl Bates

On May 13, 2016

In Biology, Cancer, Neuroscience, Students

Do we each have our own story about science fair? Mine is about that time my grandpa and I set fire to my parents’ garage while testing out the new corn stove we had built together. We were looking into cleaner fuels. It was a small fire, easily squelched, fortunately.

Katherine Yang presenting her poster

But in the rite of passage that is the science fair, two Duke-mentored high schoolers are not embarking on half-baked projects with non-scientific relatives like mine, but are instead blazing new trails in science with all of the high-end equipment and faculty mentoring that Duke has to offer.

Katherine Yang and Alisa Cui, of the North Carolina School of Science and Mathematics in Durham, are presenting their results in Phoenix this week in Intel’s International Science and Engineering Fair (ISEF), a prestigious annual science fair that convenes 1,700 of the best and brightest STEM students from around the world

Working in Qiu Wang’s group, Yang has discovered a potential new drug to treat cancer, focusing on a protein targeted called CARM1, which is known to cause breast and prostate cancers to grow uncontrollably.

Yang’s new molecule blocks CARM1. What’s more, in the process of narrowing her list of five candidates, she developed a new cell-based test that can inform the development of future screening tools for other CARM1 inhibitors.

Cui has worked in Jorg Grandl’s lab on the mechanism by which a family of proteins called Piezo ion channels allow cells to detect mechanical touch and eventually become desensitized to repeated stimulation and shut off. By recording the electrical activity of cells that express one type of Piezo, Cui determined that the channels do not use a particular type of shutdown mechanism that researchers had previously thought. Now, the group will move on to test another major mechanism.

Alisa Cui and her award-winning project.

On Friday, it was announced that Alisa had won a fourth place grand award in Cellular and Molecular Biology, which includes a $500 prize.

“I am very impressed by the impact Alisa made,” said Grandl, who is a member of the Duke Institute for Brain Sciences. “The data she collected helped starting a completely new line of research,” in understanding how these channels deal with repeated stimulations, such as vibrations.

Growing up, I was oblivious to the existence of international science fairs but my own experiences ignited a lifelong love for science. I can only hope that these young ladies felt something similar.

KellyRae_Chi_100 Guest Post by Kelly Rae Chi

A Link Between Stress and Aging in African-Americans

By Karl Bates

On March 14, 2016

In Cancer, Cardiology, Genetics/Genomics, Guest Post

A recent study finds that lifetime stress in a population of African Americans causes chemical changes to their DNA that may be associated with an increased risk of aging related diseases.

(Image: Rhonda Baer, National Cancer Institute)

Using a previously established DNA-based predictor of age known as the “epigenetic clock,” researchers found that a cohort of highly-traumatized African Americans were more likely to show aging-associated biochemical signatures in their DNA’s epigenetic clock regions at an earlier age than what would otherwise be predicted by their chronological age.

These chemical alterations to DNA’s epigenetic clock were found to be a result of hormonal changes that occur during the body’s stress response and corresponded to genetic profiles associated with aging-related diseases.

The study was performed by researchers at the Max Planck Institute of Psychiatry in Germany, including Duke University adjunct faculty and psychiatrist Dr. Anthony S. Zannas. The findings were published in a recent issue of Genome Biology.

“Our genomes have likely not evolved to tolerate the constant pressure that comes with today’s fast-paced society,” says lead author Zannas.

Though it may come as no surprise that chronic stress is detrimental to human health, these findings provide a novel biological mechanism for the negative effects of cumulative lifetime stressors, such as those that can come with being a discriminated minority.

Epigenetics is the study of how environmental factors switch our genes on or off. The epigenetic clock is comprised of over 300 sites in our DNA that are subject to a certain chemical modification known as methylation, which physically prevents those sites from being expressed (i.e., turns them off). Conversely, areas within the epigenetic clock can also be de-methylated to turn genes on. Each methylation event can be thought of as a tick of the epigenetic clock’s metaphorical second-hand, corresponding to the passing of physiological time.

During times of stress, a family of hormones known as glucocorticoids becomes elevated throughout the body. These glucocorticoids cause the chemical addition or removal of methyl groups to areas of DNA that the authors found to be located in the same regions that comprise the epigenetic clock. What’s more, the specific changes in methylation were found to correspond with gene expression profiles associated with coronary artery disease, arteriosclerosis, and leukemias.

This link between stress, glucocorticoids, and the epigenetic clock provides evidence that lifetime stress experienced by highly traumatized African Americans promotes physiological changes that affect their overall health and longevity.

The authors make an important distinction between cumulative lifetime stress and current stress. A small number of instances of acute stress may result in a correspondingly small number of methylation changes in the epigenetic clock, but it is the cumulative methylation events from chronic stress that give rise to lasting physiological detriments.

Though the authors make no direct claims regarding the physiological effects of racial inequities prevalent in today’s society, the findings perhaps shed light on the health disparities observed between disadvantaged African American populations and more privileged demographics, including increased mortality rates for cancer, heart disease, and stroke.

Glucocorticoids become elevated during the body’s stress response and lead to changes in DNA methylation that promote the expression of genes associated with aging.
Illustration by Katy Riccione

Interestingly, the epigenetic effects of lifetime stress were blunted in individuals who underwent significant childhood trauma, suggesting that early trauma may trigger mechanisms of physiological resilience to chronic stress later in life. In other words, if racial minorities are more likely to face hardships during their upbringing, perhaps they are also better prepared to cope with the chronic stress that comes with, for instance, losing a job or ending a marriage.

Though the study relies on data from an African American cohort, Dr. Zannas believes that the same conclusions are likely applicable to other highly stressed populations: chronic stress leads to lasting changes in our epigenome that may increase our likelihood of aging-related diseases, while acute stress was not found to have any long-term epigenetic effects.

So a single tough calculus exam won’t shave years off of your life, but consistent 80-hour work weeks just may.

In a world where everyday stress is unavoidable, whether it be from the hardships faced as a minority or the demands of being a full-time student, what lifestyle choices can we make to limit the detriments to our health? Dr. Zannas emphasizes that the “solution is not to avoid all stressors, but to prevent excessive stressors when possible and to learn to live with unavoidable stress constructively.”

The study underscores the importance of stress management on our general well-being. Future research may highlight the direct chemical benefits to our epigenome that are afforded by mindfulness, psychotherapy, diet/exercise, and other modes of stress relief. “Learning to better cope with stress is the best way to reduce our physiological response to it and the resultant harmful effects.”

Guest Post by Katy Riccione, Ph.D. Candidate in Biomedical Engineering

3-D Movies of Life at Nanoscale Named Best Science Paper of the Year

By Robin Smith

On February 19, 2016

In Animals, Biology, Cancer, Computers/Technology, Physics

If you’ve ever wanted to watch a killer T cell in action, or see human cancer make new cells up-close, now is your chance.

A collection of 3-D movies captured by Duke biology professor Dan Kiehart and colleagues has won the 2015 Newcomb Cleveland Prize for most outstanding paper in the journal Science.

The paper uses a new imaging technique called lattice light-sheet microscopy to make super high-resolution three-dimensional movies of living things ranging from single cells to developing worm and fly embryos.

https://www.youtube.com/watch?v=fwzIUnKNw0s

Cutting-edge microscopes available on many campuses today allow researchers to take one or two images a second. But the lattice light-sheet microscope, co-developed by 2014 Nobel Prize winner Eric Betzig, lets researchers take more than 50 images a second, and in the specimen’s natural state, without smooshing it under a cover slip.

You can watch slender antennae called filopodia extend from the surface of a human cancer cell, or tiny rods called microtubules, several thousand times finer than a human hair, growing and shrinking inside a slide mold.

Daniel Kiehart and former Duke postdoctoral fellow Serdar Tulu made a video of the back side of a fruit fly embryo during a crucial step in its development into a larva.

Chosen from among nominations submitted by readers of Science, the paper has been viewed more than 20,000 times since it was first published on October 24, 2014.

The award was announced on February 12, 2016, at an award ceremony held during the annual meeting of the American Association for the Advancement of Science (AAAS) in Washington, D.C.

Winners received a commemorative plaque and $25,000, to be shared among the paper’s lead authors Eric Betzig, Bi-Chang Chen, Wesley Legant and Kai Wang of Janelia Farm Research Campus.

Read more: “Lattice light-sheet microscopy: Imaging molecules to embryos at high spatiotemporal resolution,” Chen, B.-C., et al. Science, October 2014. DOI:10.1126/science.1257998

Post by Robin A. Smith Robin Smith

Measuring the Mechanical Forces of Disease

By Karl Bates

On January 5, 2016

In Biology, Biomedical Engineering, Cancer, Cardiology, Guest Post, Physics

“All these complicated diseases that we don’t have a good handle on — they all have this mechanical component. Well why is that?”

Brent Hoffman is an assistant professor of biomedical engineering

This is exactly the question Brent Hoffman, Duke biomedical engineering assistant professor, is helping answer. Many of the common diseases that we fear have a mechanical component. In asthma attacks, a chemical or physical stimulus causes the air channels in the lung to shut as the muscles that control the width of the channel contract– the mechanical component.

Another example is atherosclerosis, commonly known as the hardening of the arteries, the leading killer in developed countries. Instead of air flow, blood flow is affected as the walls of the blood vessels get thicker. Factors such as smoking, being overweight, and having high cholesterol increase the chance of getting this disease. However, examining the mechanical portion, the plaques associated with atherosclerosis tend to occur at certain parts of the blood vessels, where they branch or curve. You can think of it like a hose. When you kink a hose or put your thumb over the nozzle, the fluid flows in a different way. Hoffman said there are similar stories concerning mechanical portions of major diseases, such as muscular dystrophy and breast cancer.

Hoffman’s lab is building tension sensors to measure forces during collective cell migration.

This all sounds very biological, so why is he in the engineering department? As mechanobiology is a new field, there are few tools available for reporting a protein’s shape or its forces inside living cells. Hoffman makes the tools enabling the study of mechanobiology. During Hoffman’s postdoctoral research, he worked on recording forces across proteins in living cells, their natural environment. Now, he’s expanding that technology and using it to do basic science studies to understand mechanobiology.

Hoffman said he hadn’t planned this. From high school, he knew he wanted to be an engineer. As an undergraduate, Hoffman interned at IBM, where he worked on the production of chip carriers using copper-plating. Hoffman was able to apply knowledge, such as changing pH to get various amounts of copper, and make everything perform at optimal performance, but he wanted to know more about the processes.

So he set out to get his Ph.D in process control, which involves deciding how to set all the numbers and dials on the equipment, how large the tank should be, what pressure and temperature should be used, etc. in chemical plants. Hoffman was set on the path to become a chemical engineer. However, during the first week of graduate school, he attended a biophysics talk, in which he understood very little. Biophysics interested Hoffman, so he went from intending to do research on one of the most applied engineering projects on campus to arguably one of the least applied in a week. This was the beginning of his biophysics journey. However, as his Ph. D was much more heavily interested in the physics aspect, Hoffman chose to do his postdoc in cell biology to balance his training. Mixing everything together, he got biomedical engineering.

Hoffman reflects that his decisions were logical, but he had not planned to take the route he did. Hoffman cautions that it is better to have a plan than not because if you do not plan, you won’t know where you are going. However, he advises that since a person learns more about likes and dislikes as one proceeds on their route, students should not be afraid to incorporate what they learn into their plans.

Hoffman’s journey is characterized by finding and doing what he enjoyed. Trained in both the worlds of physics and biology, but never intending to pursue a future in either, Hoffman is uniquely suited for his current position in the revolutionary emerging field of mechanobiology. He is able to put his biology hat on and his physicist hat on for a bit, while the engineer in him is thinking, “is any of this practical?”
“If you had to pick out the key to my success, it would be doing that,” Hoffman said.

Guest Post by Amanda Li, a senior at the North Carolina School of Science and Math

Mapping the Pathways of Least Resistance

By Karl Bates

On November 18, 2015

In Cancer, Guest Post, Lecture, Medicine

Cancer is a notoriously slippery target. It can assume multiple genetic identities, taking a different pathway whenever it needs to dodge the latest treatment. A recent study found that just a single, tiny tumor can contain more than a million distinct mutations, priming it for resistance.

$A series of brain-scans on one patient whose brain tumor bounced back repeatedly despite surgery, chemotherapy and radiation. (Fujimaki T et al. “Effectiveness of interferon-beta and temozolomide combination therapy against temozolomide-refractory recurrent anaplastic astrocytoma.” doi:10.1186/1477-7819-5-89)$

A series of brain-scans on one patient whose tumor (white) bounced back repeatedly despite surgery, chemotherapy and radiation. (Fujimaki T et al. “Effectiveness of interferon-beta and temozolomide combination therapy against temozolomide-refractory recurrent anaplastic astrocytoma.” doi:10.1186/1477-7819-5-89)

So, while one treatment might be able to wipe out most of the cancer cells, the few that remain with the right genetic makeup will go on to forge a resistance.

Such resistance is a huge problem and one of the reasons that cancer is on its way to becoming the number one killer disease in the United States. By the end of this year, cancer will kill nearly 600,000 Americans and millions more around the world.

Kris Wood, Ph.D., spoke about the challenges of combating cancer drug resistance at the Basic Science Day on Nov. 16. The annual event brought together faculty, staff, trainees, and students to celebrate basic science research and to encourage collaborations. During the day, attendees heard TED-length talks from faculty members studying a wide range of topics, from vocal learning to asexual reproduction.

“My lab is most interested in the basic question of what are the things that cancer cells can do that allow them to survive in what should be toxic environments created by drug treatments,” said Wood, an assistant professor of pharmacology and cancer biology. “By understanding how cancer cells survive in drug environments, we might be able to both predict those patients who will respond well and respond poorly to treatments, and also design combination therapies that could work more effectively.”

Kris Wood is an assistant professor of pharmacology and cancer biology.

Wood said that knowing that so many different genetic alterations can lead to resistance might make researchers wonder what chances they have of ever stopping a tumor.

But he thinks there is reason to be optimistic, because these myriad mutations seem to function by altering a discrete set of pathways. In turn, many of these pathways seem to create the same kinds of effects in cells – chiefly, fueling growth and shirking death. Targeting the effects that enable resistance could bring about better ways to treat cancers.

For example, half of melanomas are driven by mutations in a gene called BRAF. Wood began to map out the different drug resistance pathways that are controlled by the BRAF signaling molecule. He found that many of these pathways converge on another signaling molecule called MYC, which is known to promote cell proliferation.

When Wood blocked MYC in drug-resistant melanoma cells, he found that it could make them sensitive to further rounds of chemotherapy. He also found that suppressing MYC in melanoma cells before treatment could dramatically delay the time that it takes for resistance to emerge.

Mutant tumor cells (brown) in a brain metastisis of malignant melanoma. BRAF is stained. (Image by Jensflorian via Wikimedia Commons.)

“MYC is a complicated beast, and there are lots of things it can do,” said Wood. “I think there are some promising strategies for inhibiting MYC, which could lead to intelligent therapies that target resistance.”

Guest post by Marla Vacek Broadfoot Ph.D.

E-cigarettes might help smoking cessation

By Madeline Halpert

On September 10, 2015

In Behavior/Psychology, Cancer, Cardiology, Global Health, Lecture, Medicine

Research has shown that nicotine replacement therapies such as the patch, gum lozenges and nasal spray are only 25 percent effective in smoking cessation within the first year of use.

Jed Rose, Ph.D.

Jed Rose, Director of the Duke Center for Smoking Cessation, thinks the use of e-cigarettes, or electronic nicotine delivery systems (ENDS) could be a better way to quit smoking.

Rose spoke Tuesday in a session sponsored by the Center on Addiction and Behavior Change.

He said nicotine replacement is delivered at a slower rate and a lower dose than in actual cigarettes, so it fails to curb craving among smokers. Replacements also don’t replicate one of the main sensory behaviors of smoking: inhalation.

Rose discussed a study in which he and his colleagues anesthetized participants’ airways to see if they could detect the smoke, while keeping the same dose of nicotine to the brain. When participants couldn’t feel the smoke as much, there were more cravings for cigarettes and less satisfaction.

An e-cigarette vaporizes nicotine with battery power, avoiding the combustion byproducts of burning tobacco. (via Wikimedia Commons)

They’ve also found that replacement treatments, when given on a temporary basis of just one year, often resulted in relapse.

So what does an e-cigarette actually do? The battery of this electronic cigarette heats an oil that vaporizes the nicotine with a substance called propylene glycol. The gas is released and condenses immediately into a cloud of smoke.

Why is the e-cigarette safer? It’s the combustion products in smoke, rather than the nicotine, that are responsible for most smoking-related disease. Rose cited the 2010 Surgeon General’s Report that backs up this claim that nicotine itself is not responsible for cardiovascular problems or cancers.

Rose thinks that e-cigarettes could be the best of both worlds, allowing smokers the same sensory effects they enjoy, while possibly avoiding other health hazards of regular cigarette smoking.

Rose also addressed concerns about formaldehyde being present in e-cigarettes. He says this is rare, and only occurs with e-cigarettes that have higher voltages which causes overheating to occur. While there is evidence from two trials that the new devices help smokers to stop smoking long-term compared with placebo, unfortunately, very few studies have looked at this issue. Rose also shares concerns that the new product could be picked up by youth who wouldn’t normally smoke cigarettes, or serve as a gateway between e-cigarettes and real ones.

In the end, however, he thinks this product has the potential to be highly effective in treating addiction, and hopes it will be evaluated further.

“The agency that has to sort through this is the FDA,” he said. “They have to prove that it will help society as a whole. It has to benefit the health of the population.”

By Madeline Halpert

Maintaining a Healthy Sex Life While Living with Cancer

By sa160@duke.edu

On April 14, 2015

In Biology, Cancer, Faculty

By Nonie Arora

Dr. Kevin Weinfurt. Credit: DCRI

“In the last seven days, how much difficulty have you had with sexual activity?” Dr. Kevin Weinfurt asks his research participants. A psychologist by training who works in medical research for the the Duke Clinical Research Institute, Weinfurt studies the best ways to measure patient health using self-report.

His most recent collaborative project involved developing a self-report sexual health instrument funded by the National Cancer Institute (NCI) at the National Institutes of Health. Many cancer patients are struggling with serious sexual side effects from their cancer treatments, and we lacked a good self-report scale for sexual function, Weinfurt explained.

Weinfurt and his colleagues ask questions like, “In the past seven days (or 2 weeks, 2 months) how much difficulty have you had with X action?” They are finding that while people prefer to report long time periods and think they are more accurate, they actually can’t recall the specific details over a long period of time. It’s an open question whether people really remember what happened a month ago, Weinfurt said.

In a recent study, they had people participate in a 30-day diary of their sexual activity. Each time they engaged in an activity, they noted how well everything worked, he said. At the end of the 30 days, the researchers checked how well the average daily rating of participants matched what they remembered happening. Weinfurt agrees that asking patients to record their activity could change the activity itself or the quality of their recall, but he says that the scale should still be fairly accurate.

Sexual Health. Credit: NHS

They found that the mood that the person is in when they complete the measure greatly affects what they report. Men in a positive mood recalled having excellent erectile function, even if that was not the case.

Measuring sexual function is important because it affects the quality of life for many patients, Weinfurt said. Many patients are eager to talk about sex-related issues because they feel isolated and alone with some of these struggles.

Overall, sexual health is not widely recognized as a priority by clinicians and clinical researchers and sexual ignorance is more common than we would think, so participants often require education before they can participate in studies successfully, he said.

Following the people and events that make up the research community at Duke

Category: Cancer Page 3 of 6

José Jerónimo – Innovations in Cervical Cancer Screening

Fostering a Collaborative Research Environment in Peru

In Sync

Turning Duke Experiences into Science Fair Gold

A Link Between Stress and Aging in African-Americans

3-D Movies of Life at Nanoscale Named Best Science Paper of the Year

Measuring the Mechanical Forces of Disease

Mapping the Pathways of Least Resistance

E-cigarettes might help smoking cessation

Maintaining a Healthy Sex Life While Living with Cancer