Optimizing Treatment of Lung Cancer Patients with Comorbidities
Abstract
The overall goal of this project is to improve the management of military personnel and Veterans with localized lung cancer and coexisting medical illnesses. Lung cancer is the main cause of cancer deaths in the United States as well as among Veterans. Most Veterans with lung cancer have serious coexisting illnesses (such as lung, cardiac, or kidney disease) related to smoking and aging. Up to 30% of lung cancer cases are localized to the chest at the time of diagnosis and may be cured with appropriate treatment. However, the risk/benefit ratio of cancer therapies can be substantially altered in Veterans with serious coexisting illnesses because of differences in toxicity and life expectancy. Unfortunately, patients with comorbidities are consistently excluded from studies evaluating cancer therapies, generating an important gap in knowledge regarding their management. Lack of data relevant to Veterans with coexisting illnesses has profound negative impacts, including lower rates of treatment and increased mortality. Thus, improving the management of these Veterans is a major public health priority. In this study, we will use mathematical simulation techniques to determine the optimal treatment of Veterans with localized lung cancer and coexisting illnesses. To achieve this goal, we will generate an enhanced version of a well-validated mathematical model of lung cancer progression (the Lung Cancer Policy Model). In Aim 1, we will use Veterans Affairs data and information from other population-based registries to expand this model so it represents the development and treatment of cancer in military and Veterans populations. Then, we will use the improved model to assess the optimal management (including surgery, chemotherapy, and radiation), in terms of reducing toxicity and maximizing survival, of Veterans with localized lung cancer and coexisting illnesses. The results of the study will directly inform the management of large numbers of Veterans with lung cancer and coexisting illnesses, a vulnerable and understudied group that currently experience substantially worse lung cancer survival.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 31, 2017
- Source ID
- W81XWH1610356
Entities
People
- Juan Wisnivesky
Organizations
- Icahn School of Medicine at Mount Sinai
- United States Army