A Pilot Study of Acupuncture for Pain Management for AYA with Cancer
Adolescents and young adults with cancer (AYA) are underserved and understudied. Importantly, complex biopsychosocial characteristics predispose AYA to higher risk cancers, requiring more intense and longer treatments, and greater morbidity than other age groups. Their pain is often undertreated, leading to impaired quality of life (QOL) and health-related hindrance (HRH) of personal goals, as well as possible alteration or delay in life-saving medications. Acupuncture has a growing evidence base to treat pain and other symptoms in adult oncology, but is rarely utilized in pediatric oncology. This study aims to: 1) develop and pilot test a tailored acupuncture intervention for AYA (13 to 24 yrs) that will target cancer-related pain; 2) assess acceptability, feasibility, and safety in AYA who opt in to acupuncture for pain management relative to those who opt out, and 3) measure the preliminary effects of acupuncture for pain management. Acupuncture is expected to be acceptable, feasible, safe, and linked to lower pain severity, pain interference, HRH, and symptom distress, and better QOL. Effects of acupuncture will be tested in a non-randomized design: AYA with distressing cancer-related pain will choose either to opt-in to a 10 session/8 week course of acupuncture (ACU group) or to enroll in the treatment-as-usual (TAU) group. Assessments of symptoms and indices of QOL will occur at baseline, 4, 8, and 12 weeks for both groups, and will be tracked daily via text message prompts and responses. By establishing an AYA acupuncture protocol and identifying benefits/barriers, this study will add to the current body of knowledge on acupuncture and potentially provide AYA with an effective palliative treatment to manage pain and improve QOL. This study also serves as important pilot data for a future randomized controlled trial.
Dr. Schwartz is an Assistant Professor of Pediatrics in
the Perelman School of Medicine at the University of Pennsylvania, a
pediatric psychologist in oncology at CHOP, and a behavioral scientist at the
CHOP Center for Childhood Cancer Research. Dr. Schwartz received her
undergraduate degree from Cornell University, her PhD in clinical psychology
(specialty in pediatric psychology) from Case Western Reserve University, and
conducted her internship and post-doctoral training at CHOP. She has focused
her career on adolescents and young adults (AYA) with chronic illness, especially
cancer. Her federal and foundation-funded research includes intervention
research, development of patient reported outcomes and descriptive studies.
Variables targeted in her program of research include quality of life,
adjustment, pain, health promotion, disease self-management, and transition to
adult care. In 2008, she received the Aflac Young Investigator Award in
Adolescent/Young Adult Oncology from the Children’s Oncology Group. Dr.
Schwartz has also engaged in other scholarly activities related to AYA health,
including many invited chapters and invited roles on related national
committees, as well as invited editorial positions such as co-editing two
special issues in Journal of Pediatric Psychology (transition to adult care,
and AYA health).