# Behavioral and Psychosocial Effects on Study Outcomes in End-Stage Cancer Treatment (BEST End-Stage Cancer Study)

> **NIH NIH R35** · WEILL MEDICAL COLL OF CORNELL UNIV · 2022 · $1,016,491

## Abstract

Behavioral and Psychosocial Effects on Study Outcomes in End-Stage Cancer Treatment
(aka, the BEST End-Stage Cancer Study)
Project Summary
Despite great strides that have been made in the understanding and treatment of cancer, the number
of cancer deaths remains on the rise and cancer remains the 2nd leading cause of death in the United
States (US). Not only is the number of people dying of cancer increasing, but the quality of those
deaths is alarmingly poor. End-of-life (EoL) care in the US has been deemed a public health crisis by
the National Academy of Medicine -- a conclusion bolstered by disturbing findings from my group. My
research has shown that end-stage cancer patients receive chemotherapy troublingly close to death,
that end-stage cancer patients are shockingly uninformed of their prognosis and the harms of EoL
treatments, that racial/ethnic minority groups receive dramatically inferior EoL cancer care, and that
severe emotional pain and suffering remain largely unchecked. The current Outstanding Investigator
Award (OIA) research has identified and targeted psychosocial factors to address these problems;
the results have proved paradigm-shifting and practice-changing. For example, we showed that: 1)
“palliative chemotherapy” does not “palliate” and may actually do more harm than good -> highlighting
the need for oncologists to recognize the harms of “overtreatment” and refrain from prescribing
chemotherapy to patients they deem close to death; 2) oncologist prognostic communication can
improve patient prognostic understanding and lead to more informed, value-concordant EoL care, but
it occurs infrequently, and ineffectively –> our Oncolo-GIST approach as a simple, effective way
oncologists can feel comfortable communicating the gist of a patient’s prognosis; 3) that “one size
does not fit all” in addressing disparities in EoL cancer care->our Divine Intervention targeting black
patients’ medical mistrust and spiritual care needs as a way to promote advance care planning
(ACP); 4) that psychosocial distress is an important influence on, as much as outcome of, EoL
decision-making->our EMPOWER psychosocial intervention targeting “experiential avoidance” to
promote caregiver psychosocial adjustment and engagement in ACP. Going forward, this OIA will
focus on: 1) oncologist communication; 2) cancer disparities; and 3) psychosocial distress. I will
leverage data, theories,and the clinical and scholarly resources (colleagues and collaborators)
developed under the auspices of the current OIA to: improve oncologist delivery of high quality EoL
cancer care; increase the frequency and effectiveness of their prognostic disclosures; promote cancer
patients’ prognostic understanding; ensure the equitable delivery of EoL cancer care; and reduce
psychosocial distress of patients and caregivers to enhance their mental health and promote their
engagement in ACP. Renewal of this OIA will enable me to conduct research helping to ensure that
dying cancer...

## Key facts

- **NIH application ID:** 10520551
- **Project number:** 2R35CA197730-08
- **Recipient organization:** WEILL MEDICAL COLL OF CORNELL UNIV
- **Principal Investigator:** Holly Gwen Prigerson
- **Activity code:** R35 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $1,016,491
- **Award type:** 2
- **Project period:** 2015-09-01 → 2029-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10520551

## Citation

> US National Institutes of Health, RePORTER application 10520551, Behavioral and Psychosocial Effects on Study Outcomes in End-Stage Cancer Treatment (BEST End-Stage Cancer Study) (2R35CA197730-08). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10520551. Licensed CC0.

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