PAIN, FATIGUE, AND SLEEP ALTERATIONS IN CANCER PATIENTS

The primary purpose of this exploratory center is to investigate three
symptoms commonly observed in cancer patients: pain, fatigue, and sleep
alterations. The interrelationships of these symptoms will be studied
using a common conceptual framework emphasizing physiologic, psychologic,
behavioral, and sociocultural dimensions. These endeavors will provide
fundamental information about pain, fatigue, and sleep alterations that
will be used as a basis for developing and implementing multimodal
therapeutic interventions aimed at eliminating or mitigating the
symptoms. The primary aim of the center is to expand the knowledge base
of these biobehavioral symptoms by implementing a series of related
studies that progress from descriptive to interventional designs as the
science progresses. Secondary aims are to: 1) promote common
theoretical, methodologic, and analytic dimensions across studies, 2)
develop interdisciplinary teams of investigators to study characteristics
and interrelationships of the symptoms, 3) relate this program of
clinical studies to other relevant programs at The Johns Hopkins
University and Hospital, and 4) Provide research support services for
investigators in the center. In the initial year of the center, four
descriptive studies will be initiated that examine the pain experience of
bone marrow transplant patients; the relationships among pain, fatigue,
and emotional distress in patients with solid tumors; the biologic basis
of chronic fatigue in cancer patients; and sleep alterations in cancer
patients. In subsequent years, the nature of these symptoms and their
interrelationships will be further elucidated in pediatric, surgical, and
other patients, and interdisciplinary, multimodal therapeutic approaches
will be developed and tested.