CHHS Explores Cancer Challenges

One of the areas of research that crosses every school within the college is cancer. Various schools within the college are working to improve treatment for cancer patients, identify and eliminate disparities in treatment, to reduce the impact of cancer, and to help caregivers of all types provide the best care possible for cancer patients.

Dr. Caroline Thompson and Steven Zamora.
Dr. Caroline Thompson and Steven Zamora.

One area of interest is why some groups of people seem to get different types of cancer at different rates. School of Public Health graduate student Steven Zamora teamed up with assistant professor Caroline Thompson to take a deeper look at the mortality rates from cancer within Hispanic groups. Zamora was motived partly by his own heritage and Thompson was already looking into the disparities within ethnic groups, so this was a natural partnership.

Generally, when people are categorized by race and ethnicity, Hispanics are treated as one group. However, there are several different subgroups within the Hispanic community. Zamora wondered if there were differences in cancer mortality among those from South America, Mexico, Puerto Rico and Cuba. Using national data on cancer deaths, his research found that, yes, there were very different results based on national origin.

Thompson and Zamora’s research found that Mexican American and Puerto Rican American men are dying at twice the rate of non-Hispanic Caucasian men from stomach and liver cancers. Cuban Americans, on the other hand, tended to reflect the trends for non-Hispanics for stomach and liver cancers, but had a much higher rate of lung cancer deaths.

Zamora’s research also confirmed the “Hispanic Paradox” found in other research. Aside from stomach and liver cancers, Hispanic Americans had better outcomes and lower mortality rates than non-Hispanic Caucasian for all other types of cancer. This, despite often having lower socio-economic status, less access to health care, and other risk factors for health care disparities, such as language barriers. Zamora notes, “We don’t understand this yet, but it’s not limited to cancer mortality. There is a health advantage for Hispanics that we can’t explain. It’s not equal among all Hispanic groups and it decreases the longer each group has been in the United States.” This is obviously an area for further research.

Thompson has done similar research among Asian American populations. She looked at the rates of screening for cervical, colorectal, and breast cancer and found that there were several differences among cultural groups as well as differences between those of Asian heritage vs. Caucasians. Perhaps not surprisingly, those who spoke English well were more likely to be up-to-date on these screenings, as were those enrolled in online healthcare portals. She also found that it was important that people had a good relationship with their doctors, and that patients with a same sex doctor-patient pairing or a doctor who spoke the patient’s preferred language were much more likely to attend cancer screening.

Thompson notes that, for this type of research to be meaningful, the questions of ethnicity and national origin must be accurate. In turn, this requires accurate census data and is one reason for working diligently to ensure that each census accurately reflects the population. Census data is used widely in research, as well as for political purposes.

Around the college, other types of cancer research are taking place. Not surprisingly, the School of Public Health has the most faculty research around various areas of cancer. Many of these research studies are done in collaboration with UCSD and members of their medical school faculty. Dr. Tianying Wu, a molecular and nutritional epidemiologist, recently received a grant from the California Tobacco Research Foundation to examine the impact of past and secondhand smoking, along with diet and other factors, on breast cancer recurrence. Fellow faculty member Dr. Eunha Hoh will also be participating in this project.

Dr. Melody Schiaffino is studying healthcare delivery to diverse aging populations being treated for cancer. She is studying organizational and doctor-patient communication and societal factors to identify cancer risk factors and inform interventions that can improve intermediate treatment and overall survival outcomes. Her colleague, Dr. Elva Arredondo, studies disparities in the care cancer patients receive, as well as the cultural influences and psychosocial mediators that impact preventive practices such as cervical cancer screening, physical activity, and diet among underserved groups. In the School of Social Work, Dr. Eunjeong Ko is also looking at racial and ethnic disparities in relation to accessing health care, including cancer screenings and treatment.

Another Public Health faculty member, Dr. Humberto Parada, is an integrative cancer epidemiologist specializing in the epidemiology of breast cancer. His research aims to identify environmental, behavioral, and genetic factors that influence the development and progression of breast cancer and understand these associations within the context of health disparities.

Dr. Ignatius Nip is working with collaborators at UCSD on a project to evaluate speech and swallowing outcomes following radiation therapy for oral and pharyngeal cancer. His colleague in the School of Speech, Language, and Hearing Sciences, Dr. Laura Dreisbach Hawe, is studying how chemotherapy cancer treatments may impact a patient’s hearing — perhaps before other side effects are observed.

In the School of Nursing, new faculty member Dr. Savitri Singh-Carlson is focusing on cancer survivorship and follow-up care, palliative care, and advanced care planning in light of the global burden of cancer while being informed by the social determinants of health, especially in the Asian community. She is also working to advance oncology nursing education with an emphasis on safe standards of practice within low to middle income countries.

School of Exercise and Nutritional Sciences professor Dr. Mee Young Hong’s research goal is to determine whether dietary fish oil is protective against early stage colon cancer, as well as to understand the impact of phytochemicals in colon cancer.

Finally, the college’s work on cancer through the SDSU/UCSD Cancer Center Comprehensive Partnership grant is continuing. This collaborative effort received $13M in funding over five years. This year Dr. Hala Madanat, from Public Health, and Dr. Richard Cripps, from the College of Sciences, will be leading this effort to look at many aspects of cancer treatment.