Divisional and Research Report

Strategic Plan:

The mandate of the Division and its clinical program is to conduct counseling, research, and education in the area of psychosocial oncology. In addition to direct clinical intervention, the Division continues to develop state-of-the-art knowledge concerning the science of Psychosocial Oncology. This will enable health care providers and the public to become better informed about the impact cancer has on the individual patient and family, thus promoting the opportunity for optimal psychosocial care.

Programs:

Psychosocial Screening – Dr. Barry Bultz initiated movement toward the wide-scale recognition of the importance of emotional distress in cancer patients. His efforts, including a series of presentations, publications, and editorials, resulted in the endorsement of Emotional Distress as the 6th Vital Sign by the Council of Canadian Strategy for Cancer Control (CSCC) in 2005. In 2009, Accreditation Canada stated that all cancer patients should be routinely screened for distress. In Alberta, this Calgary-catalyzed initiative became a standard of practice through a Cancer Care Alberta provincial initiative called “Putting Patients First”. This initiative not only works to improve the patient experience but creates a better understanding of patients’ cancer journey. Globally, Screening for Distress as the 6th Vital Sign has been endorsed and implemented as a standard of practice in several countries and cancer agencies. 

Pediatric Psychosocial Oncology (including Young Adult and Survivorship) – Dr. Fiona Schulte leads The Cancer Research For Kids (CARE4Kids) Lab at the University of Calgary. The lab conducts research to enhance the patient and family experience for young people diagnosed with cancer. Research is primarily focused on those who have survived their disease and are in the experience of late effects that result from toxic therapies delivered at critical stages of development. The CARE4Kids Lab focuses on three primary areas of interest including: 1) understanding the burden of symptoms (e.g., pain, sleep) among survivors; 2) mental health (e.g., anxiety, fear of cancer recurrence); and 3) quality of life, primarily within the context of multi-site clinical trials. The ultimate goal of the CARE4Kids Lab is to enhance the quality of life of this vulnerable population.  

Cancer Related Sexual Health – The Oncology Sexual Health Lab is led by Dr. Lauren Walker, a nationally recognized expert in cancer-related sexual dysfunction. Her work is focused on research and clinical resource development for cancer patients dealing with sexual concerns during and after treatment. Dr. Walker and members of her team have established several innovative clinical research programs, including the now-provincially operated Oncology and Sexuality, Intimacy and Survivorship (OASIS) Program, and the “LowDown on Down There”: a group-based vaginal health workshop. Her work to develop programs for prostate cancer patients includes the internationally operated Androgen Deprivation Therapy Educational Program, as well as several sexual rehabilitation programming initiatives. Her efforts to create and freely disseminate these programs has led psychosocial clinicians from across the globe to travel to the University of Calgary to become trained to offer these programs at their home sites, thereby raising the international profile of the Psychosocial Oncology Department. Active research studies also include the BREAST study: a randomized controlled trial comparing supportive psychoeducation and mindfulness-based group interventions for breast cancer survivors with sexual concerns. This study, funded by the Canadian Cancer Society Research Institute, is offered in both Alberta and British Columbia. Other initiatives focus on underserved cancer patients, characterizing the fertility needs of adolescent and young adult cancer survivors, and the sexual needs of patients with multiple myeloma. Training opportunities in the lab include undergraduate and summer studentships, as well as post-doctoral fellowships. 

Exercise and Cancer – Dr. Nicole Culos-Reed, Professor and Associate Dean Graduate, Faculty of Kinesiology, leads the Health and Wellness Lab (HWL) and is the Director of the Thrive Centre. The HWL research team examines the role of exercise in cancer survivorship. This research includes national and international collaboration, including a recently awarded CIHR-CCS Research Cancer Survivorship Team Grant to bring the exercise oncology program to rural and remote cancer survivors across Canada (2020-25, $2.5m). This work builds upon the Alberta Cancer Exercise (ACE) program, designed to bring exercise into standard of care for all cancer survivors. With the goal of having all cancer survivors move more, this work directly impacts the quality of life and well-being (physical and psychosocial outcomes) of cancer survivors. The Thrive Centre is a free, safe, and supportive volunteer-run fitness centre, offering programs and open gym times specifically for cancer survivors. Numerous implementation trials (ACE, EXCEL) and projects (Cancer-related fatigue) are run out of the centre. The overall goal of the HWL and Thrive Centre is to increase the physical activity levels of all cancer survivors by moving research evidence to practice.

Psychosocial Oncology Education – The Division of Psychosocial Oncology is one of the first University Psychosocial Oncology programs in North America, and offers one of the only accredited courses in Psychosocial Oncology in Canada – MDSC 535/635. Students from various faculties at the U of C (Medicine, Social Work, Psychology and Nursing) enroll in this course. The Division’s Psychology Pre-doctoral Residency Training Program (CPA accredited since 1991) continues to attract international students. In addition, educational opportunities exist for Social Work, Clinical Psychology Practica, Psychiatry Residents, and for Pre- and Post-Doctoral Research and Clinical Fellowships.

Research Areas – Members of the Division (see Brief Bios) are involved in ongoing research activities. A few of the key study areas currently being researched in the Division include: mind-body interactions, Mindfulness Based Cancer Recovery, Pediatric Psychosocial Oncology, Cancer Related Sexual Health, Cancer Survivorship, Integrative Oncology, Medical Assistance in Dying, Exercise and Cancer as well as Palliative Care. 

Mind-body Interactions -This broad area covers a number of associations, interventions, and outcomes relevant to an oncology context. The exciting multidisciplinary field of psychoneuroimmunology and endocrinology provides methods and tools to investigate the interactions between psychological states and biological functions that may be important for cancer incidence or progression. We have just added the capacity to investigate, with state-of-the-art techniques, the impact of emotional expression in relationships, important throughout the cancer trajectory.

Survivorship 

Given that the majority of people now survive cancer treatment (over 65% of all patients will now live beyond 5 years post-diagnosis), there is a clear need to study and understand issues that arise well after the acute life threat of cancer has passed. Within survivorship, two distinct populations will be considered: survivors of childhood or adolescent cancer, and survivors of adult cancers in both rural and urban contexts.

Clinical Research

Providing evidence-based psychosocial treatment that is well-integrated into the cancer patient’s medical trajectory is a hallmark of the Psychosocial Group. Over the years, the Division has conducted numerous clinical trials validating the psychological, social, quality of life, and physiological benefits of our clinical research programs. Some examples include: mindfulness meditation, supportive-expressive group therapy, partner support groups, exercise interventions, online support groups, sexual health programs and our screening for distress initiatives. These research and training programs strive to improve quality of life and provide patients and their family members with skills and support to help them throughout their cancer journey.

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