To fill this critical gap, the National Cancer Institute (NCI) has awarded a six-year, $9.8 million grant to investigators at Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine. “Avanzando Caminos (Leading Pathways): The Hispanic/Latino Cancer Survivorship Study,” will examine how social, cultural, behavioral, psychosocial, biological, and medical factors may influence health outcomes following primary cancer treatment in Hispanics/Latinos. In collaboration with the Mays Cancer Center at UT Health San Antonio, a total of 3,000 cancer survivors will be recruited and followed over three years.

Cancer researchers will study how different issues — discrimination, depression, chronic stress, nutrition, biological markers of inflammation and ancestry, and many more — impact these survivors’ symptom burden, health-related quality of life, and disease activity.

“The opportunity to comprehensively assess multiple constructs among Latino cancer survivors who are diverse in regard to country of origin and geographic location in the U.S. will help us better understand how social, cultural, behavioral, psychosocial, and biological factors impact cancer outcomes, and to guide interventions that promote optimal well-being,” said Frank J. Penedo, Ph.D., professor and associate director of cancer survivorship and behavioral translational sciences at Sylvester, who is the study’s lead principal investigator (pictured on the left).

“Our study will tell us important information we can use to help future Latino cancer survivors heal, recover, and reduce the chances of cancer coming back,” said Amelie G. Ramirez, Dr.P.H., M.P.H., study co-principal investigator at UT Health San Antonio and associate director of cancer outreach and engagement at the Mays Cancer Center.

Why Latino Cancer Survivors?

• Cancer is the leading cause of death among Latina women and the second leading cause among Latino men in the U.S.
• Latinos experience a greater burden of cancer — more symptom burden, greater barriers to care, financial challenges, more advanced disease — relative to other populations.
• U.S. Latinos face a staggering 142% projected rise in cancer cases by 2030.
• Latinos face a higher risk for certain cancers, such as liver cancer, stomach and cervix.

“This is long overdue,” said project co-investigator Paulo S. Pinheiro, M.D., Ph.D., research associate professor at Sylvester and the Miller School’s Department of Public Health Sciences (pictured on the right). “We need to properly characterize the experience of Hispanic/Latino cancer survivors, so that we can help them with their survivorship experiences, and work to align our efforts with their social, economic, and cultural specificities.”

Why Latino Cancer Survivors in Miami and San Antonio?

Both Miami and San Antonio have majority Hispanic populations which represent broad diversity in regard to socioeconomic status, Hispanic country of origin and urban vs. rural communities. Sylvester’s catchment area is home to 6 million people, of whom 44% are Latino (including 44% Cubans, 18% South and 14% Central Americans, 10% Puerto Ricans, and 5% Mexicans). In contrast, the Mays’ region is home to 4.9 million people, of whom 69% are Latino and mostly Mexican Americans. Collectively, both regions represent diverse communities of cancer survivors.

How Will the ‘Avanzando Caminos’ Study Help Latino Cancer Survivors?

Dr. Ramirez and Dr. Penedo have a long history of tackling Latino cancer. Dr. Ramirez created and led the NCI-funded Redes En Acción national Latino cancer research network for 20 years. Dr. Penedo led one of the network’s regional sites for 10 years.

“Based on our Redes studies, we have learned the importance of understanding the different factors that impact Latino survivors compared to their peers, as these issues are so closely linked with the social determinants of health, genetics, and the Afro-Caribbean to European ancestry of Latinos,” Dr. Ramirez said.

The teams will now spend the next six years documenting and analyzing all aspects of the Hispanic/Latino cancer survivorship journey.

They will examine:

• Sociocultural and economic factors: acculturation, health literacy, access to care.
• Stress factors: chronic stress, discrimination, trauma.
• Psychosocial factors: emotions, family cohesion, social support.
• Lifestyle factors: diet, physical activity, substance use.
• Biological factors: cardiometabolic markers, genetic admixture, inflammatory gene expression.
• Demographic factors: age, gender, rural/urban location, Latino heritage.
• Medical factors: cancer type, stage, comorbidities.

“Until now, no national cohort study has comprehensively assessed and mapped the journey of this specific population,” Dr. Penedo said. “We expect Avanzando Caminos to provide novel, critically needed information to inform and guide cancer prevention efforts and identify modifiable psychosocial, behavioral, and biological mechanisms that may be targeted via interventions or clinical management to improve survivorship outcomes.”

For more information on the study, please call (305) 243-7777, or email caminos@miami.edu.

The Cancer Survivorship and Translational Behavioral Sciences Initiative (CS/TBSI) at Sylvester Comprehensive Cancer Center at the Miller School of Medicine brings together clinicians and scientists across multiple disciplines to foster exceptional and specialized cancer survivorship services, ensure implementation of evidence-based and state-of-the-art survivorship care, and conduct transformative research to reduce the burden of cancer and other chronic diseases in cancer survivors and their families. Visit the CS/TBSI at Cancer Survivorship at Sylvester.

Written by Amanda Torres 

Published on April 28, 2021