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

描述（由申请人提供）：这是一份针对Anand Dhruva博士的K23奖申请，他是加州大学旧金山分校的医学肿瘤学家/血液学家。Dhruva博士正在建立自己作为补充和替代医学（CAM）和癌症症状管理的年轻研究者。这个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研究者，专注于严谨的研究并成功地将CAM模式整合到传统的肿瘤治疗中；(2)学习和应用兼容的研究方法来研究整个医学系统，重点研究阿育吠陀在肿瘤学领域的应用；(3)学习和应用先进的临床研究和定性方法进行临床研究。为了实现这些目标，Dhruva博士组建了一个指导团队，其中包括主要导师Frederick Hecht博士，他是Osher综合医学中心的研究主任，负责CAM和艾滋病毒的临床调查，以及三位共同导师：Christine Miaskowski博士，癌症相关症状和生活质量研究专家；专注于综合肿瘤学的肿瘤学家唐纳德·艾布拉姆斯（Donald Abrams）博士；以及定性研究专家谢莉·阿德勒博士。尽管获得了缓解或治愈，许多癌症幸存者发现，由于癌症和/或癌症治疗的残余症状是困难的，致残的，并损害生活质量。整体系统的健康方法，如阿育吠陀，对改善癌症幸存者的生活质量和症状有潜在的好处。复杂的、个性化的干预措施，如阿育吠陀所使用的，目前正在使用“手动化”技术进行研究，其中使用研究手册来平衡可重复性和生态有效性的竞争问题。Dhruva博士的研究将侧重于开发一种手动阿育吠陀方法来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手动阿育吠陀方法改善乳腺癌幸存者的生活质量和症状的疗效的初步估计（目标2）。这项研究将为一项更大规模的阿育吠陀随机对照试验（使用K奖中开发的人工方法）奠定基础，该试验将调查阿育吠陀对改善乳腺癌幸存者的生活质量和症状的功效，这将在随后的ROl拨款申请中提出。

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.