Doing “Big Science” Outside Your Comfort Zone: Lessons from a Study on Quality of Life After the Cancer Diagnosis

In plain language, what is your project about? What questions are you trying to answer by doing this research?

With continued improvements in medicine, more cancer patients are becoming cancer survivors than in the past. The question that we asked in this study was, are there long-term effects of a cancer diagnosis on a survivor’s overall physical and psychological health? How are factors, such as social connectedness, resilience, anxiety, and depression, influencing psychological well-being (for example, people’s perception of happiness) and physical wellness (energy, fatigue, pain, and so on) in people who have been diagnosed with cancer?

The early results of our study indicate that cancer survivors experience decreased physical and psychological wellness and that this continues in the years that follow treatment. In other words, the harmful physical and psychological effects of a cancer diagnosis do not end after treatment is completed.
 
Our ultimate goal is to improve the lives of people who are diagnosed with cancer. We hope that our results will allow us to identify problems that occur in the years after treatment, to then identify and create easy to implement strategies that can improve wellness in individuals during diagnosis, treatment, and recovery. Our next step is to look at the effects of a cancer diagnosis at different stages. 

Looking at your research team members, there are people from other departments and institutions. Have you worked together before this project?

We (Tony and Lisa) were both on the 2010 Organizing Committee for Interprofessional Health Research (iHR) Day (it was Lisa's second year on the committee, and Tony was chair). In 2019, we worked together again as part of the University of New Brunswick's working group that developed the new Bachelor of Health degree program. Over the years, we had conversations about collaborating, but never really had the time due to competing projects. However, we were both interested in how psychological distress can affect physical health and the overlap between physical and psychological wellness.

My (Lisa) graduate students started to get interested in health research, broadly speaking; we attended an international conference in 2017 and listened to a keynote speaker who described a clinical trial that used mindfulness techniques to improve adherence to cancer treatment. The speaker described how the implementation of mindfulness techniques lowered overall stress and led to decreased physical side effects of chemotherapy, and for some patients, led to greater treatment adherence. 

Dr. Tony Reiman

Dr. Lisa Best

Cecile Proctor

Then, when Cecile conducted her MA research on the psychological impact of traumatic brain injury, she found that psychological distress (anxiety, depression) led to more physical complaints. The results made us think about how mindfulness might improve outcomes in different groups of patients.

We approached Tony about whether we could do research like this in a sample of people who were diagnosed with cancer. Our first studies involve individuals (primarily survivors) who are recruited online, but Cecile’s dissertation (hopefully) will focus on Horizon patients. Cecile brings the clinical expertise to the project, which will be crucial when interview data is collected.

How – if at all – has the COVID-19 pandemic changed your research project and/or collaboration?

As the current phase of our project involves an online questionnaire, COVID-19 did not really affect data collection; in fact, it has continued throughout the summer and fall. Thankfully, we were not at the stage of collecting interview data from patients, as the effects of COVID-19 could potentially affect our outcome variables (life satisfaction, subjective well-being). To that point, there is data to suggest that COVID-19 has a large impact on both psychological wellness (Lisa’s data) and clinical appointments (Tony’s experience). So, as we look to analyze the data and write up our findings, we will make sure to assess whether COVID-19 had an effect on overall physical and psychological wellness.

What advice would you give to others on building a successful research collaboration?

Teams should bring people together with common areas of interest and complementary skills. It is important that researchers have common interests, but that each also has things that they bring to the collaboration that make it better than going it on their own. Each team member brings a new perspective to a project, so it is vital that members all respect and value each other’s contributions, and find new ways to blend knowledge areas. Patience is important, too, as working in an interdisciplinary team does take planning, and research projects can take longer to carry out. 

Speaking of teams, big teams are needed to do big science. Bringing these teams together is a bigger task and requires more work to get everyone on the same page - but it is well worth the effort.  To that end, Interprofessional Health Research Day, and now AHEAD, are so important because they let people get a sense of one another, and you don't have to build that from scratch. 

And, it's important to find people you like to work with, and that the members of your team are comfortable doing research outside their own areas of expertise. We are a small research collaboration, but we enjoy working together and that makes the project fun. 

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The team continues to collect data in the current phase of their project, Life After a Cancer Diagnosis: Improving Quality of Life after Treatment; this space will be updated with references once published

Tony Reiman, MD, FRCPC
Medical Oncologist, Department of Oncology, Saint John Regional Hospital
Canadian Cancer Society Research Chair, University of New Brunswick
Professor, Department of Medicine, Dalhousie University

Lisa Best, PhD
Professor and Chair, Department of Psychology
University of New Brunswick Saint John

Cecile Proctor, MA
Doctoral Student, Department of Psychology, University of New Brunswick Saint John