| Program Leader: R. Bergan, MD |
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Program Co-Leader: B. Spring, PhD |
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The Cancer Prevention Program of the Robert H. Lurie Comprehensive Cancer Center is a multi-disciplinary program focusing on four thematic areas: epidemiology, early detection, chemoprevention, and behavioral science. The Program Leader is Raymond Bergan, MD, an accomplished molecular pharmacologist whose research focuses on cancer chemopreventive agents, and the Program Co-Leader is Bonnie Spring, PhD, a distinguished psychologist who studies behavioral risk factors. The objective of the Cancer Prevention Program, which is comprised of 30 faculty members from 10 departments and three schools is to facilitate and focus research on primary and secondary cancer prevention within the Cancer Center. Between 1/1/2001 and 9/15/2006, there were 369 cancer-relevant publications from the Cancer Prevention Program members. Forty-three (11.6%) of these publications represent intra-programmatic collaborations and 74 (20.0%) of these publications represent inter-programmatic collaborations. Total current cancer relevant peer reviewed funding for the Cancer Prevention Program is $6,177,072 (direct) with $3,215,306 (direct) from NCI, and $2,961,766 (direct) from other peer reviewed sources. Specific areas of research include: molecular epidemiological methods to investigate cancer risk factors, development and characterization of new biomarkers and other state-of-the-art technologies for early detection, development of new chemopreventive agents particularly targeting breast, prostate, skin and colorectal cancer, and development of evidence-based approaches for modification of high-risk behaviors. The contribution of prevention efforts to recent declines in cancer mortality, the demonstrated success of cancer chemopreventive agents, and evidence indicating that the large majority of cancers are caused by environmental factors (many of which are linked to behavior), coupled with the inherent humanitarian and economic logic of preventing cancer, all support the importance of this work. This Program actively seeks to expand the capabilities and efficacy of cancer prevention by developing and employing cutting edge technology, measurement tools and methods, and drug- and behavior-based interventional strategies. Program members' interests and capabilities span many disciplines. Their integrated focus upon cancer prevention fosters an environment of intra- and inter-program collaboration.
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Members of this group are conducting research to better understand the role of genes, cytogenetic alterations, hormones, obesity, diet and lifestyle, and environmental factors involved in cancer risk. The primary focus of these studies is on breast, prostate, and colon cancer, and on non-Hodgkin lymphoma (NHL), with additional studies being conducted on lung cancer. This work involves a variety of approaches, including conventional and molecular epidemiological methods to study intermediate endpoints in multi-ethnic populations (Gapstur), established cohorts (Gapstur, Chiu), case-control studies (Chiu, Pasche, Kaklamani), or in high-risk individuals (Benson, Pasche, Kaklamani, Locker, Rubenstein, Catalona). Other ongoing research includes longitudinal analyses of genetic and lifestyle determinants of hormone profiles (Gapstur), analyses of the effects of dietary and reproductive factors on biomarker levels in novel media such as saliva, breast and nipple aspirate fluid (Chatterton), and mechanistic studies to provide insight into the biologic mechanisms underlying the effects of asbestos exposure on lung pathophysiology. The long-term goal is to open new avenues for primary prevention of cancer through modification of lifestyle or environment exposures, and to understand the role of genetic factors in cancer risk.
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Chemoprevention is a very promising strategy which involves pharmacologic intervention at very early stages in the disease process or in high-risk individuals to reduce the development of clinically overt cancer. Members of this group focus on breast (Bulun, Khan), prostate (Bergan), skin (Pelling), ovarian (Rodriguez), and colorectal cancer (Backman, Barrett, Roy, Yang). The principal agents of interest include COX-2 inhibitors and anti-hormonal drugs such as selective estrogen response modulators (SERMs) or tamoxifen (breast), genistein/soy (breast and prostate), inositol and aspirin (GI), methyl-selenium (prostate), oltipraz (lung), photodynamic therapy (head and neck), progestins (ovarian) and apigenin (skin). Ongoing studies cover the spectrum from basic science, to directed preclinical cell culture and animal models, to human clinical trials. Clinical trials range from small phase I (e.g., Oltipraz in Smokers (Bergan)), to large phase III (e.g., Study of Tamoxifen and Raloxifene (STAR) (Khan) studies. Of particular note is the Phase I and II Chemoprevention NCI Contract directed by Dr. Bergan. This contract provides a venue for investigators to develop and investigate chemoprevention agents in the context of small, translational-based clinical trials.
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The American Cancer Society estimates that 50% of cancers could be prevented through lifestyle modification (tobacco use, diet and obesity, and physical inactivity) and increased screening. Consequently, behavioral research aimed at understanding cancer risk behaviors, improving methods to promote cancer-preventive behavioral change, and improving screening behavior is vitally important. Members of this research group focus on modification of dietary patterns in adults and children (Spring, Van Horn), studies of tobacco dependence, smoking cessation, and marketing practices used by the tobacco industry (Spring, Derry), development of interactive computer-based media for patient education and decision support (Spring), and physical activity promotion (Spring, Craft). Other research focuses on understanding and improving racial/ethnic disparities in cancer screening behavior (Goel, Spring), establishing evidence-based clinical standards for cancer screening physical examinations (Pugh), and exploring the role of dyadic learning and partner affiliation in skin self-examination (Robinson).
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