- Research that brings relief
- Comprehensive Cancer Center researchers focus
their work on the cancer patient, not necessarily
the cancer itself.
As a nurse, Donna McCarthy was puzzled by the anorexia and weight loss that often weaken cancer patients, complicating their treatment and making them miserable. The standard clinical approach - using food supplements to boost protein and calorie intake and maintain weight - frequently fails. This perplexing phenomenon drew McCarthy out of the clinic and into the laboratory, where her experiments reveal the way the body regulates food intake and responds to cancer. McCarthy is one of a trio of faculty in the School of Nursing who conduct research as a part of the nationally recognized UW Comprehensive Cancer Center. Their focus is "the person who has the disease or is at risk to develop it, rather than the disease process itself," says researcher Sandra Ward. McCarthy's laboratory studies, for example, may partly explain why cancer patients struggle to overcome nutritional deficits. While studying rats
"Patients often incorrectly believe that 'good patients'
don't complain about pain or that they'll become
addicted to pain relievers."
with tumors, she found that the rats' body systems made them eat less, even when food supplements were used to boost their calorie or protein intake. She will next explore whether cancer patients have the same response when they receive food supplements. Ward and Diane Lauver are testing whether accurate health information effectively presented translates into better outcomes. A key project addresses patient's misconceptions about pain and its appropriate management - beliefs that often interfere with patients' ability to seek and receive pain relief. Up to 90 percent of patients with advanced cancer, Ward says, have moderate to severe pain that could be controlled with medication. "In many instances, however, cancer pain is not adequately managed," she says. "Patients often incorrectly believe that good patients' don't complain about pain or that they'll become addicted to pain relievers." In a study of adults with advanced cancer, Ward's research team is testing a system she devised to give patients accurate information about medication addiction, tolerance and related issues, and teach them to cope with side effects. Pain and symptoms reported by these patients will be compared with reports from a separate group of patients. One of Lauver's lead projects seeks to identify messages nurses can use to persuade women to have mammograms. The project continues several years of study by Lauver of women's early cancer-detection and care-seeking behavior. "Early detection of breast cancer is critical to control the disease, but many women don't engage in breast cancer screening as often as recommended," Lauver says. "We don't know yet what specific aspects of messages promote breast cancer screening behaviors most effectively and how these messages are effective." In Lauver's study, older cancer-free women are randomly assigned to one of three study groups: those receiving oral and printed information about screening recommendations; those receiv-ing the screening information as well as informa-tion about feelings, beliefs and costs regarding screening; and a control group to whom no messages are given. Each group is being evaluated to determine which intervention leads to in-creased screening.
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- Old and loving it
- The nation's elderly are by and large happy
and remarkably resilient in the face of the problems
of aging. UW researchers want to know why.
Psychologist Carol Ryff finds an interesting pattern in our perceptions of aging: Young people have the most negative views of growing old, while people over 55 give it the highest marks. Which begs the question: Why do we assume that aging is automatically a breeding ground for unhappiness? Ryff, director of UW-Madison's Institute on Aging, leads a research effort to discover why, in the face of the physical, social and emotional setbacks of old age, many elderly people still show a remarkable resilience. A growing body of research shows that many elderly people are able to bounce back from a litany of problems - many of them coming all at once - and remain mentally healthy and positive. "What we want to know is: Who doesn't get done in by all the negatives, and why?" Ryff says. "The answer is in learning about the protective factors that insulate people from life's difficulties."
"If we don't study the positive side of health,
all we will be able to do is treat people for disease
after the fact. There is a large preventive goal with our
approach."
Depression, a significant and well-studied problem in the elderly, often is triggered by chronic health problems, loss of loved ones or the waning of a clear purpose in life. But Ryff and a team of researchers argue that it is not enough to study the problem; the absence of a problem may be just as revealing. "If we don't study the positive side of health, all we will be able to do is treat people after the fact," she says. "There is a large preventive goal with our approach." The prevention comes from learning more about the "protective factors" in the elderly. Ryff says those can be expressed in four distinct categories: Psychological resources. People develop different coping strategies in dealing with stress and illness that help alleviate long-term depres-sion. These are teachable skills that may translate to better prevention and treatment of depression. Social resources. The network of personal and institutional support available to the elderly, from family and friends to community opportunities. Socio-demographic issues. A person's income level, education, social class and level of health care access all play a role in long-term mental and physical health. Biological resources. Biology and health are very clearly linked to the mind. Several UW researchers are studying physiological responses to stress and how the mind can actually teach the body to reduce stress and illness. Two current Institute on Aging studies strive to look at all four of these measures together. Both are long-term studies of how and why people, in the face of accumulating adversity, have either negative or positive staying power. "We are trying to map the pileup of bad stress in people's lives, as well as the positive, protective experiences," Ryff says. "We will monitor people's health records over the same period. By the end, we think we will be able to predict who will get sick and who will stay well based on what we know about their protective profile.'" Another just-completed study illustrates Ryff's case. Marsha Seltzer, a Waisman Center re-searcher and social work professor, studied mothers who, for most of their adult lives, cared for a child with mental retardation. Her hypoth-esis was that these women would be exhausted and show more signs of aging and stress than their peers. She found the opposite: The lifelong care of a child had hidden emotional benefits for the mother that translated into better-than-average health.
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