A Whole Systems Approach to the Study of Ayurveda for Cancer Survivorship

描述(由申请人提供)：这是为加州大学旧金山分校的内科肿瘤学家/血液学家Anand Dhruva博士申请K23奖项。Dhruva博士在补充和替代医学(CAM)和癌症症状管理方面确立了自己作为年轻研究员的地位。K23将为Dhruva博士提供必要的支持，以实现以下目标：(1)发展成为一名独立的临床调查员，专注于将CAM模式严格研究并成功地整合到传统肿瘤护理中；(2)学习并应用兼容的研究方法来研究整个医学系统，重点是阿育吠陀在肿瘤领域的应用研究；以及(3)学习并在临床研究中应用先进的临床研究和定性方法。为了实现这些目标，德鲁瓦博士组建了一个指导团队，成员包括主要导师、奥舍整合医学中心研究主任Frederick Hecht博士(负责CAM和艾滋病毒的临床研究)和三名共同导师：研究癌症相关症状和生活质量的Christine Miaskowski博士；专注于综合肿瘤学的肿瘤学家Donald Abrams博士；以及定性研究专家Shelley Adler博士。尽管取得了缓解或治愈，许多癌症幸存者发现，由于癌症和/或癌症治疗的残留症状是困难的、致残的，并损害了生活质量。全系统的健康方法，如阿育吠陀，对改善癌症幸存者的生活质量和症状具有潜在的好处。复杂的个性化干预措施，如阿育吠陀所使用的干预措施，目前正在使用“人性化”技术进行研究，即利用研究手册来平衡可再生性和生态有效性这两个相互矛盾的问题。德鲁瓦博士的研究将集中于开发一种手册阿育吠陀方法，以改善癌症幸存者的生活质量和症状(目标1)，然后进行一项试点随机对照试验，以评估可行性，并获得对手册阿育吠陀方法改善乳腺癌幸存者生活质量和症状的有效性的初步估计(目标2)。这项研究将构成阿育吠陀更大规模随机对照试验的基础(使用在这项K奖中开发的手册方法)，该试验将调查阿育吠陀改善乳腺癌幸存者生活质量和症状的有效性，该试验将在随后的ROL拨款申请中提出。 公共卫生相关性：随着癌症幸存者数量的增加，增进对提高生活质量和残留症状的有效和安全方法的理解是重要的。鉴于CAM的广泛使用，需要从严格进行的研究中获得更多证据，以指导其成功融入现代医疗保健。

DESCRIPTION (provided by applicant): This is an application for a K23 award for Dr. Anand Dhruva, a medical oncologist/hematologist at the University of California, San Francisco. Dr. Dhruva is establishing himself as a young investigator in complementary and alternative medicine (CAM) and cancer symptom management. This K23 will provide Dr. Dhruva with the support necessary to accomplish the following goals: (1) to develop into an Independent clinical investigator focusing on the rigorous study and successful integration of CAM modalities into conventional oncology care; (2) to learn and apply compatible research methods for the study of whole systems of medicine, with focused expertise in the study of the application of Ayurveda to the oncology setting; and (3) to learn and apply advanced clinical research and qualitative methods in clinical studies. To achieve these goals, Dr. Dhruva has assembled a mentoring team comprised of primary mentor, Dr. Frederick Hecht, Director of Research at the Osher Center for Integrative Medicine, who conducts clinical investigations in CAM and HIV, and three co-mentors: Dr. Christine Miaskowski, an expert in the study of cancer-related symptoms and quality of life; Dr. Donald Abrams, an oncologist who focuses on integrative oncology; and Dr. Shelley Adler, an expert in qualitative research. Despite achieving remission or cure, many cancer survivors discover that the residual symptoms due to the cancer and/or the treatment of the cancer to be difficult, disabling, and impair quality of life. Whole systems approaches to health, such as Ayurveda, have potential benefits for improving quality of life and symptoms in cancer survivors. Complex, individualized interventions, such as those used in Ayurveda, are currently being studied using the technique of "manualization," in which a study manual is utilized to balance the competing concerns of reproducibility and ecological validity. Dr. Dhruva's research will focus on developing a manualized Ayurvedic approach to improve cancer survivor quality of life and symptoms (Aim 1) and then conducting a pilot randomized controlled trial to assess feasibility and obtain preliminary estimates of efficacy of a manualized Ayurvedic approach to improve quality of life and symptoms among breast cancer survivors (Aim 2). This research will form the basis for a larger randomized controlled trial of Ayurveda (using the manualized approach developed in this K award) that will investigate the efficacy of Ayurveda to improve quality of life and symptoms among breast cancer survivors, which will be proposed in a subsequent ROl grant application. PUBLIC HEALTH RELEVANCE: With increasing numbers of cancer survivors, improving understanding of effective and safe ways to improve quality of life and residual symptoms is important. Given the widespread use of CAM, more evidence from rigorously conducted studies is needed to guide its successful integration into modern healthcare.