SCRC: Can you share a brief overview of your project?

SW: Cancer related fatigue (CRF) is a distressing subjective sense of physical, emotional and/or cognitive tiredness or exhaustion, related to cancer or cancer treatment. It affects about two thirds of cancer patients and it can persist for years after treatment. It’s different from the fatigue we usually experience in that it’s not proportional to how much physical activity you have been doing and having a good rest or sleep won’t alleviate it. We don’t really have any pharmacological interventions to treat CRF but there are some management strategies which have been shown to help. This includes treating underlying problems, such as anaemia and pain, which can lead to CRF, providing psychological support, encouraging gentle exercise, and advising on the use of pacing strategies to get essential tasks done during the day.

This studentship will test if we can predict at the point of cancer diagnosis who will go on to develop significant CRF. This would allow us to target interventions to those most in need earlier, potentially reducing the negative impact of CRF.

Currently we don’t have any medical tests to identify CRF, so we have to ask the patient. This can be done systematically using patient reported outcome measures (PROMs) which are validated, reliable questionnaires. One of our goals is to identify CRF biological markers (biomarkers), which is the first step in developing new treatments for CRF. We will be using proteomic analysis to check for proteins associated with our CRF-specific PROM.

The studentship has two parts. First, the student will analyse an existing data set to identify key determinants of CRF. The data set contains PROMs and clinical data for nearly 3.5 thousand cancer patients, collected over three years. The second part is a longitudinal cohort study. Lung and breast cancer patients will be recruited in the neoadjuvant setting and asked to provide blood samples and complete PROMs before they start their treatment, just before surgery and when they have completed treatment. The aim of this study is to identify CRF biomarkers and to develop a model to predict CRF during and after treatment. By collecting both PROMs and biological samples longitudinally, our understanding of CRF will be improved and it may be possible to identify novel treatment targets.

SCRC: What was the inspiration for your project?

SW: Cancer related fatigue (CRF) is a distressing, pervasive condition for many cancer patients and has been identified as a key research priority. Health care professionals have very limited options for supporting patients who are experiencing CRF and the patients themselves report it as an unmet need. CRF is challenging to research because of its complexity but we think it is important to try, with the goal of improving outcomes for cancer patients now and in the future.

SCRC: How do you foresee your project leading to patient benefit? And when?

SW: In the shorter term, we hope that this project will provide a way of identifying the patients who are most likely to develop CRF so that the measures we know can help are targeted earlier to the people who are most at risk. This proactive approach should lead to patient benefit. In the longer term, this project could contribute to identifying potential targets for drug interventions.

SCRC: If the project is successful—what’s next?

SW: If we can successfully develop a model to predict CRF, the next stage will be to carry out an implementation project. In other words, we will need to take our findings, put them into clinical practice and test how effective it is in the real-world setting. If we are able to find some biological markers of CRF there are many potential follow on projects. For example, we could test whether the same markers appear in patients with different cancer and we could also start investigating potential drug interventions.

SCRC: Can you describe any interdisciplinary aspects of your projects?

SW: This project which will combine lab, clinical and patient-reported measures to improve understanding of CRF and identify novel treatment targets. The project is about integrating the early stages of bench-to-bedside with a patient-focussed approach, potentially improving clinical management of patients in the short term (by identifying models to target those in need of early intervention) whilst working towards a possible pharmacological intervention in the long term.

SCRC: What do you think are the main challenges we face in cancer research? How does your project help to address this?

SW: As our population ages and cancer survival increases, the number of people living with and beyond cancer continues to grow. Even when treatment has been successful, people who have had cancer are often left with long term consequences. We need to find ways to help people live well after cancer. Fatigue is one of the most common ongoing problems reported so we hope this project will lead to better outcomes for many of those people diagnosed with cancer.

SCRC: How have research mentors benefited your research?

SW: SCRC’s Cancer-Related Fatigue Group has been an excellent group to share plans for this project and we look forward to their ongoing expertise and ‘critical friend’ input as the project progresses.

SCRC: If people want to follow you and your team or get updates as the project progresses, where can they get more info?

SW: You will be able to read more about the project as it progresses at shore-c.sussex.ac.uk

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