CARES Intervention for Lung and Head & Neck Cancers

Recruiting at 11 trial locations

Overseen By Jennifer V Gonzalez, MS

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Colorado, Denver

Disqualifiers: Children, Non-English/Spanish speakers, Other cancers, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 13

Duration: 6 months

320 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of the CARES Intervention treatment for lung and head & neck cancers?

The research highlights the importance of addressing quality of life and supportive care needs in patients with head and neck cancer, which are key components of the CARES Intervention. Although direct evidence for CARES Intervention is not provided, the focus on improving patient outcomes and quality of life aligns with the goals of this treatment. ^{1 2 3 4 5}

How does the CARES Intervention treatment for lung and head & neck cancers differ from other treatments?

The CARES Intervention is unique because it focuses on supportive care and psychosocial aspects, addressing both physical and emotional needs of patients and caregivers, unlike traditional treatments that primarily target the cancer itself. ^{6 7 8 9 10}

What is the purpose of this trial?

This study will assess if the CARES (Cancer Advocacy, Resources, Education and Support) intervention improves time to start of treatment after diagnosis and time to treatment completion for solid tumors (ex: lung, head, neck, thyroid, cervical, breast, bladder, colon, and rectal cancers) in rural patients.

Research Team

Evelinn Borrayo

Principal Investigator

University of Colorado, Denver

Eligibility Criteria

Adults over 18 with lung or head and neck cancer, who speak English or Spanish, live in rural areas with limited healthcare access, and will receive standard treatments. They must be diagnosed at specific stages and treated at certain Colorado centers. Excluded are those with other primary cancers, hearing loss without aids, already started treatment, decisionally-challenged individuals or those not treated at the specified sites.

Inclusion Criteria

Receives cancer treatment at University of Colorado Hospital (UCH), SCL-St. Mary's Medical Center, or Rocky Mountain Cancer Centers (RMCC) in Pueblo, CO

Resides in any of the rural counties served by one of the collaborating sites with Rural-Urban Continuum Codes (RUCC) codes 4-9

Provision to sign and date the consent form

Exclusion Criteria

I am under 18 years old.

Likely inability to track the individual over time

Individuals from vulnerable populations

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive the CARES intervention or usual care over a 6-month period, including navigation and counseling sessions

6 months

Up to 10 navigation and 10 counseling sessions (in-person, virtual, or phone)

Follow-up

Participants are monitored for quality of care and patient-reported outcomes

6 months

Surveys at baseline, 3 months, and 6 months

Treatment Details

Interventions

• CARES Intervention

Trial Overview The CARES intervention is being tested to see if it can shorten the time between diagnosis and start of treatment as well as the time to complete treatment for patients with Lung Cancer and Head and Neck Cancer in rural settings.

Participant Groups

Group I: Usual Care Active Control 1 Intervention

All participants will complete surveys to assess Quality of Care and Patient Reported Outcomes. Patients will receive a standardized list of resources.

Group II: CARES Intervention Active Control 1 Intervention

All participants will complete surveys to assess Quality of Care and Patient Reported outcomes at baseline, 3 months and 6 months. The CARES intervention will include a maximum of 10 navigation and 10 counseling sessions delivered over approximately a 6- month period delivered by oncology nurse navigators and master's level counselors. Sessions will be scheduled to correspond with key transition points during treatment and may be held in person, virtually, or by phone.

Who Is Running the Clinical Trial?

University of Colorado, Denver

Lead Sponsor

Trials

1,842

Recruited

3,028,000+

National Cancer Institute (NCI)

Collaborator

Trials

14,080

Recruited

41,180,000+

Findings from Research

Outcomes research is crucial for understanding the effectiveness of healthcare practices, especially in head and neck cancer (HNCA), as it helps inform better health decisions and practices during healthcare reform.

The article reviews recent studies on HNCA that focus on treatment efficacy, survival rates, complications, and quality of life, highlighting the importance of patient-centered outcomes in evaluating healthcare interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Outcomes measurement in patients with head and neck cancer. Gourin, CG.[2021]

Head and neck cancer patients experience significant quality of life disruptions due to unmet support needs during and after treatment, particularly related to coping with permanent side effects and psychological stressors like depression and anxiety.

Patients reported feeling isolated after treatment due to the loss of access to supportive hospital environments, highlighting the importance of professional and personal networks for coping during recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

"I have quality of life…but…": Exploring support needs important to quality of life in head and neck cancer. Moore, KA., Ford, PJ., Farah, CS.[2022]

In a study involving head and neck cancer patients, speech and eating were identified as the most significant factors affecting overall quality of life, with speech having the strongest impact.

The study used logistic regression to analyze responses from a disease-specific quality of life survey, highlighting the importance of addressing speech and eating issues in treatment planning for better patient well-being.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Assessing head and neck cancer patient outcome domains. Karnell, LH., Funk, GF., Hoffman, HT.[2019]

A new set of outcome indicators for lung cancer care was developed through a systematic process involving literature review and expert evaluation, focusing on survival, recovery, and quality of life for patients.

The study analyzed data from 5922 lung cancer patients across six hospitals, revealing variations in care quality and outcomes, which can help compare hospital performance and improve patient information regarding treatment results.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

'Care for Outcomes': systematic development of a set of outcome indicators to improve patient-relevant outcomes for patients with lung cancer. Cramer-van der Welle, CM., van Loenhout, L., van den Borne, BE., et al.[2021]

Patients treated for head and neck cancer often experience significant functional impairments that can greatly affect their quality of life, highlighting the need for intensive post-treatment follow-up.

There are currently no clear guidelines on the frequency of follow-up visits, but these visits are crucial for early detection of issues and initiating rehabilitation to optimize patient recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Monitoring and Evaluation of Late Functional Outcome in Post-treatment Follow-Up in Clinical Routine Setting. Zebralla, V., Meuret, S., Wiegand, S.[2023]

A study involving 33 participants, including 20 head and neck cancer survivors and 13 healthcare providers, highlighted the need for tailored supportive care interventions for HNC survivors, as they face unique and persistent symptoms affecting their quality of life.

Participants emphasized the importance of offering these interventions throughout the treatment and survivorship journey, with a preference for group-based support, while also recognizing that not all survivors may benefit from this format due to potential social comparison and anxiety issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Considerations for developing supportive care interventions for survivors of head and neck cancer: A qualitative study. Oswald, LB., Arredondo, B., Geiss, C., et al.[2023]

A significant 70.3% of informal caregivers for head and neck cancer patients reported at least one unmet supportive care need at the start of the study, primarily related to healthcare and illness, highlighting the high burden they face.

Despite a decrease in unmet needs over a 2-year follow-up, 28.3% of caregivers still reported unmet needs, particularly those caring for patients with advanced disease or severe comorbidities, indicating a need for ongoing support and resources for caregivers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Unmet supportive care needs among informal caregivers of patients with head and neck cancer in the first 2 years after diagnosis and treatment: a prospective cohort study. van Hof, KS., Hoesseini, A., Dorr, MC., et al.[2023]

The EASE study demonstrated that a tailored telephone-based coping and stress management intervention is feasible and acceptable for head and neck cancer patients, with high satisfaction reported by participants and counselors.

While the small sample size (24 participants) limits definitive conclusions about efficacy, preliminary results suggest that the EASE intervention may help reduce the negative emotional and physical impacts of cancer treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility of EASE: a psychosocial program to improve symptom management in head and neck cancer patients. Kilbourn, KM., Anderson, D., Costenaro, A., et al.[2022]

The dyadic survivorship care planning (SCP) intervention, which involved a one-session care plan and follow-up, was found to be acceptable to head and neck cancer survivors and their caregivers, with over 80% positive ratings on session length and content.

However, the SCP intervention did not lead to significant improvements in depression, unmet needs, or caregiver burden after 6 months compared to usual care, indicating that while the approach was well-received, it was ineffective in enhancing the outcomes for the dyads involved.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A pilot randomized controlled trial to evaluate a survivorship care planning intervention for head and neck cancer survivor-caregiver dyads. Sterba, KR., Armeson, K., Zapka, J., et al.[2022]

Stepped care (SC) significantly reduced psychological distress in head and neck cancer and lung cancer patients compared to care-as-usual, with a recovery rate of 55% in the SC group versus 29% in the CAU group after treatment.

The SC approach was particularly effective for patients with existing depressive or anxiety disorders, indicating that tailored psychological support can enhance recovery outcomes in cancer patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Stepped care targeting psychological distress in head and neck cancer and lung cancer patients: a randomized, controlled trial. Krebber, AM., Jansen, F., Witte, BI., et al.[2020]

References

1. United States pubmed.ncbi.nlm.nih.gov

Outcomes measurement in patients with head and neck cancer. [2021]

2. Scotland pubmed.ncbi.nlm.nih.gov

"I have quality of life…but…": Exploring support needs important to quality of life in head and neck cancer. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Assessing head and neck cancer patient outcome domains. [2019]

4. England pubmed.ncbi.nlm.nih.gov

'Care for Outcomes': systematic development of a set of outcome indicators to improve patient-relevant outcomes for patients with lung cancer. [2021]

5. Switzerland pubmed.ncbi.nlm.nih.gov

Monitoring and Evaluation of Late Functional Outcome in Post-treatment Follow-Up in Clinical Routine Setting. [2023]

6. England pubmed.ncbi.nlm.nih.gov

Considerations for developing supportive care interventions for survivors of head and neck cancer: A qualitative study. [2023]

7. Germany pubmed.ncbi.nlm.nih.gov

Unmet supportive care needs among informal caregivers of patients with head and neck cancer in the first 2 years after diagnosis and treatment: a prospective cohort study. [2023]

8. Germany pubmed.ncbi.nlm.nih.gov

Feasibility of EASE: a psychosocial program to improve symptom management in head and neck cancer patients. [2022]

9. United States pubmed.ncbi.nlm.nih.gov

A pilot randomized controlled trial to evaluate a survivorship care planning intervention for head and neck cancer survivor-caregiver dyads. [2022]

10. England pubmed.ncbi.nlm.nih.gov

Stepped care targeting psychological distress in head and neck cancer and lung cancer patients: a randomized, controlled trial. [2020]