The Department of Psychosocial Oncology and Palliative Care provides world-class clinical care, while also conducting innovative, leading-edge research that helps us better understand the experience of living with cancer and identify novel approaches
to feeling better.
Examples of our research include:
- Interventions to improve communication between clinicians and patients
- Understanding the role of medical marijuana in treating symptoms
- Exploring the impact of spirituality on illness
- Mitigating the effects of breast cancer treatments on hot flashes
- The effect of providing child-reported symptom and quality-of-life feedback to clinicians
Current research projects include:
Serious Illness Care Program
The Serious Illness Care Program is based at Dana-Farber and Ariadne Labs. Through this work, our research team is developing an innovative, scalable system to guide discussions about preferences for patients with serious illness and their families, ensuring
personalized treatment plans for every patient.
Our intervention aims to achieve more, better, and earlier conversations about goals of care by creating a population management system to:
- Identify patients who would benefit from discussions of end-of-life preferences
- Train and coach physicians and other clinicians to use a structured communication guide to elicit patient values and goals
- Trigger clinicians to conduct conversations
- Facilitate patient communication with family members
- Document patients' wishes in a "single source of truth" in the electronic medical record
We are currently testing this program in oncology, primary care, nephrology, and chronic critical illness.
Qualitative Analysis of Oncology's Approach to Medical Marijuana
Our primary goal is to complete pilot research on the role, broadly defined, of medical marijuana in oncology. We are conducting a qualitative study, interviewing up to 15 key United States informants with expertise at the intersection of oncology and
cannabinoid use. During interviews, we inquire about their attitudes towards use of – and their clinical decision-making around – medical marijuana in oncology.
Palliative Care Integration in Children with Advanced Cancer
Under the direction of
Joanne Wolfe, MD, MPH, chief of the
Pediatric Advanced Care Team (PACT) and co-director of the
Pediatric Palliative Care Research Network (PPCRN), we are
researching methods of easing suffering and promoting wellbeing in children with serious illness and their families. Wolfe's current project aims to assess whether symptom distress in children with advanced cancer can be improved through early integration
of palliative care.
Palliative Care Needs for Children with Transplants
Christina Ullrich, MD, MPH, we are investigating the palliative care needs of children who undergo hematopoietic stem cell transplantation, with support from a K23 Career Development Award from the
National Heart, Lung, and Blood Institute. Ullrich's other research interests include symptom management in children with cancer, particularly fatigue, and the provision of palliative care concurrent with disease-directed or restorative treatment.
Improving Communication Between Patients and Oncologists Using Patient Feedback on Real Conversations
High quality cancer care depends upon physicians recognizing and responding to patients' physical and emotional concerns. As with any other skill, oncologists communicating effectively with patients requires training. Currently, the gold standard for
such teaching occurs in intensive courses using patient actors. However, these take lots of time and are expensive. To solve this problem, Dana-Farber created a computerized program in which oncologists audio-record conversations with real patients
and then receive feedback on how well they did. Doctors who used this program doubled how often they responded to patients' emotional concerns and also increased their patients' trust. In a 3-year, $1.7 million grant funded by the Patient Centered
Outcomes Research Institute (PCORI), we are enhancing this program by adding a feature whereby real patients also listen to the conversations and give feedback to these doctors. We will then have doctors who are being recertified in oncology by the
American Board of Internal Medicine (ABIM) use this program as part of that recertification process. We will test how well it increases their patients' satisfaction in their communication, and whether it improves their communication skills. If successful,
this intervention will represent an effective communication training program for physicians in which they improve their communication skills through direct feedback from patients. Because of the integration with the ABIM Maintenance of Certification
Program, if fully adopted into that program, it could have an extraordinary impact on thousands of physicians and their patients.
Measuring Palliative Care through Natural Language Processing
Led by Charlotta Lindvall, MD, PhD, of Adult Palliative Care, we are developing natural language processing tools to mine the electronic medical record for meaningful insight into patients’ symptoms, goals, and values. Through a partnership with Massachusetts
Institute of Technology, this research will help measure the success of palliative care interventions, such as palliative surgery or radiation, and make data on end-of-life conversations, health care proxies, and other important preferences easily
visible to all members of the care team. We hope to expand these methods throughout palliative care and medical oncology, and eventually across all research areas at Dana-Farber. Lindvall’s current project – creating quality measures for palliative
surgery – received recognition from the National Quality Forum’s Innovation Challenge for its new approach to quality measurement in cancer care.
Medical Marijuana in Oncology
While the scientific evidence of medical marijuana’s benefits remains in its infancy, it is important to understand marijuana’s medical utility and reservations clinicians may have about it. Led by
Ilana Braun, MD, chief of
Adult Psychosocial Oncology, we are conducting a national study of oncologists’ perspectives on the role of medical marijuana in cancer care and symptom management to explore expert opinion on this new therapeutic