Chapter 16: Projects in Cancer Prevention; the Lung Cancer Moonshot; CYCORE
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Description
In this segment, Dr. Foxhall talks a cancer prevention programs and the place of the lung cancer screening trial in the Lung Cancer Moon Shot. He then talks about CYCORE, a program that uses electronic devices to address patient needs and treatments. This project was funded by stimulus money and uses a tele-monitoring device created by Time Warner. He describes some of the benefits and also mentions the video conferencing systems that can support patients. Dr. Foxhall notes that the Office tries to keep up with the latest electronic advances that can help patients.
Identifier
FoxhallLE_03_20140311_C16
Publication Date
3-11-2014
City
Houston, Texas
Interview Session
Topics Covered
The University of Texas MD Anderson Cancer Center - An Institutional Unit; The Administrator; MD Anderson Impact; Information for Patients and the Public; Education; Institutional Mission and Values; Beyond the Institution; Overview; Technology and R&D
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.
Disciplines
History of Science, Technology, and Medicine | Oncology | Oral History
Transcript
Tacey Ann Rosolowski, PhD:
What are some of the other projects? I notice that you had a couple of grants for study of selenium and vitamins. It was just only a couple, but—
Lewis Foxhall, MD:
I helped out with a couple of projects that were run through the Cancer Prevention Center, so I helped support recruitment for those projects. Dr. Cook [phonetic] was the one that was working on that. So, anyway, just kind of pitching in to help out.
Tacey Ann Rosolowski, PhD:
Mm-hmm, mm-hmm. Just scanning here. Have we covered this? Is this good? Is there something—
Lewis Foxhall, MD:
Those are the biggies. I mean, you know. I tried to help with other projects over the years that Dr. Beavers and her Star [phonetic] program, she had a role in that, and then the national [unclear] screening trial, trying to help recruit patients for that. And right now I’m helping with Dr. Hanash [phonetic] and the Moon Shot lung cancer screening trial, so trying to get the hospital district and the community clinics involved in recruiting patients for that and taking care of patients that don’t have any insurance if they having something wrong with their scans. So that’s an interesting new angle.
Tacey Ann Rosolowski, PhD:
The Moon Shots have a very different financial organization and structure. What’s your view of that? How is that different to work with that kind of structure? Maybe talk about what it is first.
Lewis Foxhall, MD:
Well, it’s primarily philanthropic support, so the institution’s identifying philanthropic dollars that they can channel into the Moon Shot Program. So they’re supporting these research initiatives. They also get some support for our cancer prevention and control platform that we’re using to help address tobacco and the skin cancers and potentially a risk of breast and ovarian cancer [unclear]. So we put that together with Dr. Hawk [phonetic] and Dr. Moreno [phonetic], are kind of the lead players in that. That was kind of an outgrowth of our cancer control initiative that we started a number of years ago. So we have the opportunity to really kind of use those cancer control sort of interventions to help facilitate the success of the Moon Shot Program. So while they’re trying to figure out how to cure things, we’re trying to help do what we know works to reduce the impact on those cancers.
Tacey Ann Rosolowski, PhD:
Interesting. There was one item here I just didn’t understand at all. (laughter)
Lewis Foxhall, MD:
Yeah?
Tacey Ann Rosolowski, PhD:
CYCORE, Cyber Infrastructure for Comparative Effectiveness Research.
Lewis Foxhall, MD:
Yeah. So this was a program that was funded through some of the stimulus monies that came after the financial crisis. They had this financial stimulus package.
Tacey Ann Rosolowski, PhD:
I didn’t know that.
Lewis Foxhall, MD:
Some of that went to research. So this was trying to look at how we could better utilize the technology in patient care, so that might be monitoring for physical activity or helping address patient needs through Internet-based interactions. So they had that. Actually, I was just—the email I was working on was with some of the folks from Time Warner who have a new home-based telemedicine gadget that they’re trying to promote, so our CYCORE people are interested in how they might use that.
Tacey Ann Rosolowski, PhD:
Could you give me an example of some of these kinds of things that are being [unclear]?
Lewis Foxhall, MD:
These are like, you know, trying to increase physical activity in cancer patients or cancer survivors potentially to see if that helps improve their situation. So you can monitor that remotely with these little accelerometers that people wear around, and they feed data into a modem and they can analyze how much people are walking.
Tacey Ann Rosolowski, PhD:
So this is sort of like a GPS kind of thing that you—
Lewis Foxhall, MD:
Well, it’s not really where they’re walking, it’s just how much they’re walking and how much activity they have. And then, you know, you can do—there’s little scales and other gadgets you can use that will kind of remotely report to you about various physical attributes of a patient. So, yeah, that’s interesting.
Tacey Ann Rosolowski, PhD:
Yeah, yeah. I’m just—what are patients’ reactions to that? I mean, does it feel like surveillance? Are they glad about it?
Lewis Foxhall, MD:
I don’t know. I mean, it’s like these little Fit Bit [phonetic] things that people wear around. It’s very similar to that. You know, you’re sharing it with your clinical team. It’s not like you’re broadcasting it out on Facebook or—
Tacey Ann Rosolowski, PhD:
Right. Putting it on Facebook. “I’ve been a real slug today.” (laughs)
Lewis Foxhall, MD:
Ten thousand steps [unclear]. So it’s a way to just kind of keep track of what people are doing. They did a lot of studies that try to intervene with people getting exercise more or whatever, that people’s self-reports tend to be somewhat less than accurate, so having a way to really kind of objectively measure those sorts of things is helpful in trying to figure out if this is really useful or not, or if the people are adhering to the program or not, report—everybody wants to tell the clinician they’re doing what they’re doing, but sometimes it’s not quite exactly right. So, just another way to kind of get information about what’s really going on with a person.
Tacey Ann Rosolowski, PhD:
So it’s, again, simultaneously you’re doing something to help, you know, effect patient behavior or care in a certain way, but also collecting information too.
Lewis Foxhall, MD:
Right, right, right. So there’s [unclear] studies, and this gadgetry has a little camera, you know, you stick it next to your TV, and you can do two-way videoconferencing with an individual. So that might be helpful in, like, smoking cessation counseling or things like that, or monitoring patients after surgery, things of this sort. So there may be some applications for it. But the technology is gradually improving and getting a little less expensive over time, so it’s something that I think we’ll probably do more of down the road.
Tacey Ann Rosolowski, PhD:
It’s interesting, I do a chat room, and it really is kind of incredible how much interaction you can feel in those environments. And, in fact, in one of these chat rooms, there was a woman who is a cancer survivor, and she was talking about how she had a bone sarcoma a number of years ago. She was quite young; she was nineteen when she had it. And she has to have very regular screenings, and she says she feels like she lives her life in three-month increments. And I said, “Can you check out and see if there are some survivorship support things in your Cancer Center?” And I don’t know what happened with that. She kind of came and went. But I can really see that something like that videoconferencing or even an online where someone could go on and, you know, talk to a peer group about these kinds of issues being enormously helpful, enormously helpful. Yeah.
Lewis Foxhall, MD:
So we’ll see, but anyway, that’s some kind of interesting technology just kind of coming up.
Tacey Ann Rosolowski, PhD:
Yeah. So how do you keep track of all that? I mean, what’s—you know, obviously you’ve always got feelers out, you know, like what’s new, what’s possible, how do we leverage this, to make what MD Anderson does better.
Lewis Foxhall, MD:
Right, sure.
Tacey Ann Rosolowski, PhD:
So what’s that process like?
Lewis Foxhall, MD:
Well, I mean, there’s just, you know, the usual reading of journals and other publications and staying up on Internet news services, and participate in a number of groups that also try to acquire information and share [unclear] so the medical society or the health department or the cancer society, all those groups are kind of doing the same thing and feeding information to us to kind of help us stay abreast of what’s happening and what the new opportunities are. So, yeah, that’s kind of the fun part.
Tacey Ann Rosolowski, PhD:
Yeah, sounds like it.
Lewis Foxhall, MD:
Seeing what’s popping up, what might fit, what might be useful.
Tacey Ann Rosolowski, PhD:
Yeah. And kind of creative too.
Lewis Foxhall, MD:
Sure.
Tacey Ann Rosolowski, PhD:
Like think outside the box here. Yeah.
Lewis Foxhall, MD:
Mm-hmm, exactly.
Tacey Ann Rosolowski, PhD:
Very fun. Very fun. Anything else from this section, grants and projects that you’ve worked on you want to share?
Lewis Foxhall, MD:
No, I think those are sort of the highlights, and I think we’re just hopefully going to see a lot more impact from these waiver projects that we have going on right now. So that’s really kind of the exciting thing, is to see how they all work out. So it’ll either be really great or a lot of people will be really irritated. (laughter) See what happens.
Tacey Ann Rosolowski, PhD:
Well, shall we leave it here for today since it’s almost ten?
Lewis Foxhall, MD:
Yeah, that’s probably good.
Tacey Ann Rosolowski, PhD:
Good stopping place. And then I can talk to Robbie [phonetic] about another time.
Lewis Foxhall, MD:
[unclear] the next time, sure.
Tacey Ann Rosolowski, PhD:
Thank you very much for your time this morning.
Lewis Foxhall, MD:
Oh, you bet. Thanks.
Tacey Ann Rosolowski, PhD:
This has been really interesting.
Lewis Foxhall, MD:
All right. Very good.
Tacey Ann Rosolowski, PhD:
And I’m turning off the recorder at—boy, I’m glitching out on time here—9:56. (laughs) Thanks. (end of session three)
Recommended Citation
Foxhall, Lewis E. MD and Rosolowski, Tacey A. PhD, "Chapter 16: Projects in Cancer Prevention; the Lung Cancer Moonshot; CYCORE" (2014). Interview Chapters. 865.
https://openworks.mdanderson.org/mchv_interviewchapters/865
Conditions Governing Access
Open
