Professor and the Mary Lou Willard French Endowed Chair in Oncology
University of Michigan School of Nursing
Ann Arbor, MI
Co-Investigator: Charles Loprinzi, MD, Professor, Oncology, Mayo Clinic, Rochester
Drs. Barton and Loprinzi's research focuses on alleviating the negative side effects related to breast cancer treatments that are experienced by patients. Specifically, they are examining the use of natural products, such as ginseng, to relieve chemotherapy-related fatigue. In 2011, this team launched a study that sought to address the physical discomforts faced by female cancer survivors who cannot use estrogen. Vaginal atrophy, causing dryness, discomfort, itching and pain with intercourse, is a significant problem for female cancer survivors who cannot use estrogen. Even low dose estrogen can have effects on tissue outside of the vagina and can present an unknown risk with respect to breast cancer.
A form of steroid called vaginal dehydroepiandosterone (DHEA) is a potentially effective treatment for atrophy symptoms that may not have effects outside of the vagina. Drs. Barton and Loprinzi have now completed enrollment on a study evaluating the effectiveness of DHEA for vaginal dryness and pain, with 464 women enrolled. They are currently analyzing blood and vaginal tissues along with data on the primary outcomes of self-reported pain and/or dryness. In 2013-2014, the team will begin extensive analyses to determine results of this intervention but also to analyze data to plan for new studies to improve sexual health in women with a history of cancer.
Drs. Barton and Loprinzi have completed the study evaluating vaginal DHEA (dehydroepiandosterone) for vaginal symptoms of dryness or pain in women who have been diagnosed with breast or gynecologic cancer. The research team is writing up the study results for the symptoms and the hormone and vaginal health data. At this time, the researchers can say that they have important information to share that will be helpful to women and providers facing unwanted effects of hormone depletion on the vagina. These results will be shared in large cancer conferences in June, 2014. They continue to analyze the data to learn more about what issues predict more severe symptoms and more problems with decreased sexual health in women, and what issues predict which women experience relief from vaginal symptoms.
The researchers have also written a study to evaluate a cognitive behavioral intervention for self-image concerns and are getting ready to implement the intervention in a very small number of women to see whether they have all the correct components before moving to a larger, randomized study. Once they perfect the cognitive behavioral intervention, they will add this treatment to the treatment for vaginal symptoms to begin to develop a comprehensive treatment that can address the complex needs of women who suffer from decreased sexual health as a result of cancer treatment.
Debra Barton is the Mary Lou Willard French Professor of Nursing at the University of Michigan, School of Nursing, which is a position specific to advancing knowledge in care for people with cancer. She is also a clinical investigator in the Alliance, an oncology cooperative group, and a Vice Chair of the Symptom Intervention Committee in the Alliance.
Dr. Barton received her doctoral degree from Indiana University School of Nursing in Indianapolis. Dr. Barton has developed clinical trials to improve the health-related quality of life of cancer survivors in several areas including cognitive function, fatigue, sleep, hot flashes, neuropathy, sexual health, and nausea and vomiting. Her greatest contributions include the generation and dissemination of nursing knowledge which has transformed practice for cancer survivors in non-hormonal alternatives for hot flash management, sexual health, fatigue, and complementary therapies.
Dr. Barton has been a Fellow in the American Academy of Nursing since November, 2008. She is the Editor In Chief of the PDQ® (Physician Data Query) Supportive and Palliative Care Board, which summarizes evidence based care to improve supportive and palliative care outcomes.
Dr. Barton serves as an alternate member representing the Alliance to the National Cancer Institute Symptom Management/Quality of Life steering committee. She has also served as a member of review committees for the National Institute of Health, and takes an active role in committees and projects with her national specialty organization, the Oncology Nursing Society.