Acupuncture for Cognitive Health in Older Survivors of Prostate Cancer (ACHIEVE)

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PROJECT SUMMARY This career development award, Acupuncture for Cognitive Health in Older Survivors of Prostate Cancer (ACHIEVE), will train Dr. Liou to become an independent clinician-investigator with expertise in integrative therapies for cognitive health and symptom management in prostate cancer (PC) survivors. BACKGROUND: By 2030, PC survivors are expected to become the largest group of cancer survivors in the United States. Cancer-related cognitive dysfunction (CRCD) is a significant concern in this growing population, but evidence- based treatments are lacking. Most CRCD studies in PC have focused on the neuro-toxicities of androgen deprivation therapy (ADT). However, the literature on the association between ADT and CRCD remains mixed, suggesting other factors may play a role in CRCD. Growing research from other populations demonstrates that co-morbid symptoms (anxiety, depression, fatigue, insomnia, nocturia) may contribute to cognitive dysfunction. These symptoms are prevalent among PC survivors, but their role in CRCD remains poorly understood in the PC population. Expanding CRCD research beyond the non-modifiable factors (prior ADT exposure) and focusing on modifiable factors (co-morbid symptoms) has the potential to inform novel treatments approaches for CRCD. Based on Dr. Liou’s preliminary studies, acupuncture improves objective CRCD directly, but it may improve subjective CRCD indirectly through co-morbid symptoms. Informed by this prior work, Dr. Liou will test a novel acupuncture intervention that directly targets CRCD with the optionality to jointly address symptoms co-occurring with CRCD. RESEARCH: Dr. Liou will evaluate the association between co-morbid symptoms and CRCD in a cross-sectional study of PC survivors (Aim 1). Dr. Liou will then evaluate the feasibility and preliminary effects of acupuncture for CRCD and co-morbid symptoms in a pilot randomized controlled trial of PC survivors (Aim 2). CAREER DEVELOPMENT: Dr. Liou will acquire competence in CRCD evaluation, PC symptom science, clinical trial design, biostatistics, and grant-writing. His training will be supported by mentorship, coursework, independent study, workshops, conferences, and preparation of manuscripts and grants. MENTORS: Dr. Liou will be mentored by a team of internationally-recognized researchers with complementary expertise in CRCD, neuropsychological assessment, PC symptom science, integrative medicine, oncology acupuncture, clinical trial design, biostatistics, and PC medicine. ENVIRONMENT: Memorial Sloan Kettering Cancer Center will provide the institutional support and resources for the research. IMPACT: The proposed studies have potential to advance multi-factorial understanding of CRCD and expand non-pharmacological treatment options for prevalent symptoms affecting the aging PC population. Dr. Liou will acquire the preliminary data to support a competitive R01 grant application to test the efficacy of acupuncture for CRCD and comorbid symptoms in PC survivors. This award will establish the foundation for an independent research program with sustained impact in PC survivorship care, cognitive health, and integrative oncology.