Skip to main content
An official website of the United States government
Grant Details

Grant Number: 5R21CA202210-02 Interpret this number
Primary Investigator: Huang, I-Chan
Organization: St. Jude Children'S Research Hospital
Project Title: Symptom Progress and Adverse Health Outcomes in Adult Childhood Cancer Survivors
Fiscal Year: 2017


 DESCRIPTION (provided by applicant): Childhood cancer survivors are vulnerable to treatment-related late effects, which include physical and psychosocial morbidity, subsequent malignancies, and premature death. Symptoms representing one's perceptive abnormal physical, emotional, or psychosomatic state are common late effects in childhood cancer survivors. Survivors often experience multiple, concurrent symptoms, known as a symptom cluster. Although the association between symptom presence and poor quality of life in childhood cancer survivors has been reported, it is uncertain whether individual symptom domains and clusters change over time, and whether the change in individual symptom domains and clusters are associated with adverse health outcomes, including chronic conditions and premature mortality. In addition, very few studies have examined if specific cancer therapeutic exposures (e.g., cranial irradiation, anthracyclines, and alkylating agents) contribute to the change in individual symptoms and symptom clusters over time. Our long-term goal of cancer survivorship care is to identify important symptoms for early indication of adverse health events (e.g., cardiac arrest and premature mortality), and to design interventions targeting at symptoms for promotion of healthy aging in cancer survivors. To achieve this goal, the current study proposes two specific aims: 1) to investigate the presence of individual symptom domains (sensation abnormality, motor/movement problems, cardiac symptoms, pulmonary symptom, pain, anxiety, depression, and somatization) and symptom clusters across multiple time points spanning 25 years in adult survivors of childhood cancers, and investigate the transition of symptom clusters over time, and 2) to investigate the prognostic value of individual symptom domains and symptom clusters for the development of chronic conditions and premature mortality in adult survivors of childhood cancers. The proposed study will overcome the limitations of previous research by utilizing repeated symptom data collected from participants in the Childhood Cancer Survivor Study to elucidate the extent to which symptom progress is associated with mortality and with chronic conditions identified during risk-based comprehensive medical assessment in the St. Jude Lifetime Cohort Study (N>700) at St. Jude Children's Research Hospital. We will group chronic conditions by eight organ systems: cardiovascular, endocrine/reproductive, hepatic, neurocognitive, neurosensory, skeletal, pulmonary, and urinary categories. In addition, we will develop a classification methodology to identify symptom clusters based on eight individual symptom domains, and use a transition analytic method to capture the change in symptom cluster over time. Our team includes renowned researchers with expertise in patient-reported outcomes, symptom measurement, psychology, pediatric/adult survivorship care, and translational science research.


Mothers' evaluations of fathers' contributions to raising children with autism spectrum disorder in the United Arab Emirates.
Authors: Opoku M.P. , Mohamed A. , Safi M. , Belbase S. , Al Mughairbi F. , Xie Q. , Al Shatheli M. .
Source: BMC psychology, 2024-05-07; 12(1), p. 253.
EPub date: 2024-05-07.
PMID: 38715136
Related Citations

Biomechanical Stability of Femoral Neck System for Pauwels Type III Femoral Neck Fractures Based on Different Reduction Quality.
Authors: Huang D. , Wang X. , Chen B. , Hu Z. , Feng W. .
Source: Zeitschrift fur Orthopadie und Unfallchirurgie, 2024-03-19; , .
EPub date: 2024-03-19.
PMID: 38503306
Related Citations

A systematic review on the qualitative experiences of people living with lung cancer in rural areas.
Authors: Ali N. , Nelson D. , McInnerney D. , Quaife S.L. , Laparidou D. , Selby P. , Kane R. , Civello S. , Skinner D. , Pogson Z. , et al. .
Source: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2024-02-06; 32(3), p. 144.
EPub date: 2024-02-06.
PMID: 38316704
Related Citations

Test, evidence, transition projects in Scotland: developing the evidence needed for transition of effective interventions in cancer care from innovation into mainstream practice.
Authors: Gadsby E.W. , Brown C. , Crawford C. , Dale G. , Duncan E. , Galbraith L. , Gold K. , Hibberd C. , McFarland A. , McGlashan J. , et al. .
Source: BMC cancer, 2023-11-01; 23(1), p. 1049.
EPub date: 2023-11-01.
PMID: 37915009
Related Citations

Response-shift effects in childhood cancer survivors: A prospective study.
Authors: Huang I.C. , Sim J.A. , Srivastava D. , Krull K.R. , Ness K.K. , Robison L.L. , Baker J.N. , Hudson M.M. , Schwartz C.E. .
Source: Psycho-oncology, 2023 Jul; 32(7), p. 1085-1095.
EPub date: 2023-05-15.
PMID: 37189277
Related Citations

Negligible Effects of the Survey Modes for Patient-Reported Outcomes: A Report From the Childhood Cancer Survivor Study.
Authors: Sim J.A. , Hyun G. , Gibson T.M. , Yasui Y. , Leisenring W. , Hudson M.M. , Robison L.L. , Armstrong G.T. , Krull K.R. , Huang I.C. .
Source: JCO clinical cancer informatics, 2020 Jan; 4, p. 10-24.
PMID: 31951475
Related Citations

Differential Impact of Symptom Prevalence and Chronic Conditions on Quality of Life in Cancer Survivors and Non-Cancer Individuals: A Population Study.
Authors: Huang I.C. , Hudson M.M. , Robison L.L. , Krull K.R. .
Source: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2017 Jul; 26(7), p. 1124-1132.
EPub date: 2017-03-23.
PMID: 28336581
Related Citations

Emotional distress impacts quality of life evaluation: a report from the Childhood Cancer Survivor Study.
Authors: Huang I.C. , Brinkman T.M. , Armstrong G.T. , Leisenring W. , Robison L.L. , Krull K.R. .
Source: Journal of cancer survivorship : research and practice, 2017 Jun; 11(3), p. 309-319.
EPub date: 2017-01-09.
PMID: 28070769
Related Citations

Back to Top