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Caroline 1
4 Plays30 days ago
Caroline 1
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Transcript
Introduction of Dr. Caroline Dorfman
00:00:01
colinyourbluff
Joining the conversation we have with Caroline Dorfman. She is an assistant professor the department.
00:00:02
Caroline Dorfman
wrap
00:00:06
Dustin Mesick_ RDN
Wait, stop, stop, stop. There's all this like feedback all of a sudden. Sorry. Did you hear all the feedback that was happening for a second?
00:00:13
colinyourbluff
I am hearing like the Joining today's conversation is Dr. Caroline Dorfman. She is an assistant professor in the Department of Psychiatry and Behavioral Services in the Duke University School of Medicine.
00:00:27
colinyourbluff
She's a licensed clinical psychologist and is the director of research and behavioral medicine for the Duke Teen and Young Adult Oncology Program. So welcome, Caroline.
00:00:37
Caroline Dorfman
Thank you so much for having me.
Interest in Cancer Research
00:00:39
colinyourbluff
Wanted to ask what has sparked your interest in ah cancer research?
00:00:44
Caroline Dorfman
Yeah, so I know I'm not unique in the sense that I have a family history of cancer. And so growing up, one of the things that I really noticed was that individuals within than my family all had very different responses to a cancer diagnosis. And I found that intrinsically interesting.
00:01:04
Caroline Dorfman
And so, um you know, that was... kind of where I started to think about kind of individual differences and behaviors and in the way in which people respond to and think about health diagnoses. And so, you know, moving along throughout my education, and always been interested in healthcare and thought maybe I'd pursue a medical degree. But when I was in college, I was trying to figure out what do I want to be when I grow up?
00:01:33
Caroline Dorfman
and So that led me to the career center at my university. I'd gone to the University of Pennsylvania for undergrad. And I'm sitting there in the career center waiting to meet with a career counselor to talk about different career options. And quite fortuitously, as I'm sitting there in the waiting area waiting for my appointment, I came across a brochure.
00:01:56
Caroline Dorfman
that was looking for undergraduate volunteers to help with research and psycho-oncology. I had never heard of psycho-oncology before. Um, but so as I picked up this brochure, I'm reading through it. I'm like, wow, this really reflects kind of some of these observations that I had seen growing up that, um,
00:02:16
Caroline Dorfman
you know, there may be different responses to a cancer diagnosis. And specifically, this research was being conducted by some folks over at the Children's Hospital of Philadelphia where they were looking at the impact of a child's cancer diagnosis on their siblings.
Career Path in Psycho-Oncology
00:02:32
Caroline Dorfman
So I thought that was interesting to see, oh, maybe we'll learn something new about how families respond to cancer. So I applied for this volunteer position and was accepted.
00:02:43
Caroline Dorfman
And from there, as I became involved in this research, I began to learn about all the different ways in which psychologists were exploring how people cope with and adapt to cancer diagnoses.
00:03:00
Caroline Dorfman
And so from there, I was like, well, let me see how many different research experiences I can pursue in this field. So I grew up outside of Washington, D.C., and I knew I was going home for a summer between um my junior and senior year of college.
00:03:17
Caroline Dorfman
So I just haphazardly began emailing folks and came across a group at Georgetown University at the Lombardi Cancer Center. And they were beginning to develop some interventions to promote shared decision making around cancer screening, um specifically um to promote shared decision making for men um around prostate cancer screening and then also looking at quality of life domains for prostate cancer survivors. And I was like, oh, well, this is a very different area than I had been working with um in the research looking at siblings of kids with cancer.
00:03:51
Caroline Dorfman
And so I ah applied to work with this group. I began working with them that summer and then continued on with them as a research assistant. um the following year after I graduated from college. And it really helped me again to explore this field of psycho-oncology and to begin to learn about all the different ways and which research was being conducted.
00:04:12
Caroline Dorfman
ah And from there, I knew that this was a field I wanted to pursue as a career. um So this really directed my decision to pursue graduate training um in clinical psychology, but looking specifically at programs that had faculty mentors who were conducting psycho-oncology research.
00:04:30
Caroline Dorfman
And so from there, I pursued my degree in clinical psychology at The Ohio State University under the wonderful mentorship of Dr. Barbara Anderson, who has a long,
00:04:42
Caroline Dorfman
career conducting research with women with breast cancer, um developing psychosocial interventions to assist them. And I really felt quite fortunate to begin to gain additional training in this area and beginning to explore and some of the unmet needs among cancer survivors and their family members.
Research on AYA Cancer Symptom Management
00:05:07
Dustin Mesick_ RDN
So you've also studied pain, fatigue, and distress in the AYA population. ah Can you tell us about your findings?
00:05:16
Caroline Dorfman
Yes, definitely. So one of the things that I found after my graduate training, I came to Duke University for my pre-doctoral clinical psychology internship.
00:05:28
Caroline Dorfman
And in conducting my clinical work, one of the things that um I began to notice was that among our cancer survivors, symptoms that they were experiencing as a result of their treatments both in kind of the the period during treatment as well as once they had completed treatment, were really impacting their lives.
00:05:52
Caroline Dorfman
um Additionally, in this clinical work, in conducting this clinical work, I should say, um I also began to have some younger patients on my caseload and began to really understand some of the unique characteristics impacts that pain and fatigue and distress was having on their lives in particular.
00:06:14
Caroline Dorfman
And so, you know, one of the things that we think about with our younger patients is that when they're diagnosed, they're really diagnosed during a critical developmental period.
00:06:26
Caroline Dorfman
So when I think about adolescents and young adults, I'm referring to patients who've been diagnosed between the ages of 15 and 39. And if we think about what happens during that time period, there's a lot going on. There are these really complex age-related goals that are happening, things like working to finish their education, working to build their careers, working to establish and foster peer relationships and romantic relationships, and working to build their families. And so one of the things that we have found in our research is that symptoms like pain and fatigue and emotional distress are incredibly impactful for interfering with AYA's abilities to achieve these life goals.
00:07:12
Caroline Dorfman
And when we dive deeper into the literature, um looking at the needs of adolescent and young adults, one of the things that we have found is that symptom management is rated as a really critical and significant issue in their transition to survivorship.
00:07:29
Caroline Dorfman
But these symptom management needs have largely gone unmet. um We found in our work that AYAs who have high physical and emotional symptom burden really lack confidence in their ability to manage their symptoms.
00:07:46
Caroline Dorfman
And they may have more difficulty coping with these challenges than older or younger survivors, in part because of this really significant interference that the symptoms can have on important areas of their life.
00:07:59
Caroline Dorfman
So not only kind of our own research, but our prior, kind of looking at the literature and prior research, suggested that there was an unmet need to develop um some interventions for adolescents and young adults to better help them manage symptoms like pain and fatigue and emotional distress, especially given that these symptoms can be quite persistent and, as I mentioned before, because they can be impactful.
Developing Interventions for Young Cancer Survivors
00:08:29
Caroline Dorfman
So I was really fortunate to receive a career development award from the National Cancer Institute to begin to develop an intervention to address the symptom management needs of patients who were diagnosed between the ages of 18 and 39 for this particular study.
00:08:47
Caroline Dorfman
So this study um is being conducted under the mentorship of Dr.
00:08:49
Dustin Mesick_ RDN
you
00:08:52
Caroline Dorfman
Kevin Effinger, and Dr. Rebecca Shelby, who are both here at at Duke, um to help us to not only develop, but begin to evaluate an intervention to um address pain, fatigue, and emotional dis distress in our young adult survivors.
00:09:09
Caroline Dorfman
And one of the first formative steps that we did was we interviewed young adult survivors and their oncology providers. As well, we kind of knew anecdotally and we knew um ah from prior literature that pain, fatigue, and emotional distress were problematic for our young survivors. We wanted to confirm that in our own population.
00:09:32
Caroline Dorfman
And so we asked survivors and providers to rank order post-treatment concerns. And one of the things that we found was 91% of our survivors 81% of providers um acknowledged pain, fatigue, or emotional distress as the primary or secondary concern um that they had experienced.
00:09:52
Caroline Dorfman
And so we knew at that point, um quantitatively, right, it was a problem. Then qualitatively, we talked to these survivors and providers to find out more about their symptom burden. And the qualitative data really spoke to the level of interference of symptoms for patients.
00:10:09
Caroline Dorfman
So we knew we were on the right track. So we began to then develop an intervention, which we're currently evaluating as a part of this study, um that will target pain, fatigue, and emotional distress in the service of helping survivors get back to important life goals.
00:10:26
Dustin Mesick_ RDN
So, uh, Dr. Dorfman, you've studied pain, fatigue and distress in the AYA population. Can you tell us about your findings?
Technical Issues Encountered
00:12:24
colinyourbluff
you
00:14:06
colinyourbluff
Carolyn, am so sorry. Okay,
00:14:12
colinyourbluff
okay so it didn't look on my end like your mic was picking up. And it's...
00:14:24
colinyourbluff
Yeah, I'm not sure if that part was recorded because I was just looking at... like It shows me the streaming line of ah the audio here and, and that does, know, each sound is picked up with a, you know, like the,
00:14:44
Dustin Mesick_ RDN
Yeah, I see what you're saying. i yeah I'd say that Carolyn's mic is a little quiet on my end. Like our voices sound like really loud and your voice sounds quieter.
00:14:57
colinyourbluff
But on my end, I also saw that the microphone wasn't ah highlighted and it didn't show like there was anything being picked up as far as ah the vocal track.
00:15:10
Dustin Mesick_ RDN
Wow, your voice got loud, Colin. And I can see like a lot of bars.
00:15:15
colinyourbluff
Yeah, I mean,
00:15:16
Dustin Mesick_ RDN
and And almost little bars on mine. You got like the big.
00:15:19
colinyourbluff
that's what I was kind of expecting, but maybe it's just that I'm closer to my mic or...
00:15:23
Dustin Mesick_ RDN
Okay, yeah.
00:15:25
colinyourbluff
um Geez. So...
00:15:39
Dustin Mesick_ RDN
Sure. If it, if he thinks that'll help,
00:15:46
Dustin Mesick_ RDN
you could use your computer, Mike, your computer, Mike too. it It shouldn't really matter if you have a special mic or not.