It’s no secret that research is what’s going to help save more lives from cancer.
Since 2008, Pelotonia, Columbus’ annual cycling event and fundraiser for cancer research, has contributed more than $122 million to The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute (OSUCCC–James).
One hundred percent of the proceeds are used to advance research through a variety of initiatives, including Pelotonia Idea Grants and the Pelotonia Fellowship Program, both of which fund selected cancer studies.
Two separate ongoing studies funded by Pelotonia at the OSUCCC – James are looking into the link between breastfeeding and breast cancer and figuring out how to alleviate depression in cancer patients.
BREASTFEEDING AND TNBC
Pelotonia awarded a 2016 Idea Grant to Dr. Bhuvaneswari Ramaswamy, an oncologist at the OSUCCC–James, for a study exploring the link between breastfeeding and triple-negative breast cancer (TNBC) in African-American women.
Multiple studies have identified the protective effects of prolonged breastfeeding against developing breast cancer in general, but scientists have yet to fully understand the specifics of this link.
More recent data has pointed to a possible association between a lack of breastfeeding and the development of triple-negative breast cancer, prompting the need for further studies, Ramaswamy said.
TNBC is a subtype of breast cancer that’s particularly difficult to treat, as it lacks the three markers routinely used as therapeutic targets: estrogen receptors, progesterone receptors and human epidermal growth factor receptor-2 (HER2). Chemotherapy is the only treatment option.
TNBC affects about 15 percent of breast cancer patients in the U.S., with younger black women being at significantly higher risk. In fact, 39 percent of premenopausal African-American women with breast cancer have TNBC, compared with 16 percent of nonblack cancer patients of any age, according to a recent study in the Journal of the American Medical Association.
African-Americans also have one of the lowest breastfeeding rates in the nation. “The data now shows that 40 to 50 percent of African-American women breastfeed their infants,” Ramaswamy said. “So if we can take that and increase the prevalence of breastfeeding, the hope is that we would reduce the risk of them developing TNBC.”
So how does breastfeeding help prevent cancer?
Ramaswamy and her research team think that the weaning process may have something to do with it.
Whether a woman gradually lessens breastfeeding frequency over time (weaning) or does not breastfeed at all, the breasts must stop producing milk — a process known as involution. For women who don’t breastfeed, this mechanism occurs much quicker.
Ramaswamy’s research team is looking at a specific gene involved in the involution process called STAT3, which they believe is over-activated in women who don’t breastfeed. This would subsequently cause an inflammatory environment in the breast, leading to a higher risk of breast cancer.
“Obviously it would be foolish to say that if we all breastfeed we can eradicate triple-negative breast cancer,” Ramaswamy said. “But if we can even reduce the risk and save a few lives from having to endure this devastating form of cancer, that would be critical.”
Her team will test their hypothesis using several mouse models, and if their prediction holds true, they hope to repeat the study on human breast tissue.
“I think knowing a little more about the biology of breastfeeding will strengthen the message that we can take to women and the community,” Ramaswamy said. “If, as a society, we provide the time and space for women — particularly working women — to breastfeed their children, can that help in preventing this type of cancer?”
This is the second Pelotonia Idea Grant that Ramaswamy has received.
COMBATTING DEPRESSION IN CANCER PATIENTS
Cancer research often is focused on developing new knowledge and therapeutics to fight the disease, but other areas of research can be just as beneficial, such as the work being done by Dr. Marlena Ryba, postdoctoral researcher and 2015 Pelotonia Fellow at OSUCCC–James.
Ryba’s study seeks to alleviate depression in cancer patients, which is often overlooked or under-treated. Along with Dr. Barbara Andersen, a clinical psychologist and professor at Ohio State, Ryba is testing the ability of an online therapy in reducing symptoms of depression in cancer patients that have been diagnosed with Major Depressive Disorder (MDD).
The study, called Beating the Blues, is based on cognitive-behavioral therapy, which attempts to reframe maladaptive thoughts and behaviors, which is the most effective treatment for depression, Ryba said.
Beating the Blues yielded beneficial outcomes when tested in the general population, but the intervention has never been tailored to cancer patients, who are typically undergoing multiple life changes.
The prevalence of depression in cancer patients ranges from 10 to 40 percent, depending on the type of cancer, Ryba said, adding that higher percentages are seen with breast cancer.
“As you can imagine cancer patients have many competing demands, so psychosocial care takes a back burner a lot of the time” Ryba said. “The unique challenges that cancer patients encounter warrant a different approach in treatment.”
In addition to a busy schedule, patients may be reluctant to seek help, so the online nature of the therapy lends a way for people to receive treatment in the privacy of their own homes, and at their own convenience.
The intervention was designed to be more interactive than other available therapies, allowing participants to build on previous sessions and choose specific issues they want to address, Ryba said.
There are about 15 patients enrolled in the eight-week intervention, which started in August. After its completion, a wait-listed control group will begin the treatment.
“Previous studies have shown the benefit of psychosocial care over and over again,” Ryba said. “This is just another way to deliver a treatment that has already shown to be effective to a population that really needs it.”
Those interested in Beating the Blues can email beatingtheblues@osu.edu or call 614-292-6874.
The original story was published in The Columbus Dispatch’s 2016 Pink Papers special section.