Jen Erdrich receives NIH funding to explore pre-op health in Native American cancer patients

Jennifer Erdrich, MD, MPH, was recently awarded a 1.3 million Mentored Clinical Scientist Research Career Development Award (K08) from the National Cancer Institute to study the effectiveness of lifestyle interventions in American Indian patients with obesity-related solid tumor cancers who are preparing for surgery. 

The NCI career development award given to Dr. Erdrich provides support and protected time to junior clinician-scientists practicing in the United States for intensive mentored research and career development activities in basic, translational, and patient-oriented cancer-focused research. 

“In a supportive, structured program, I have the opportunity to transition into an independent investigator,” Erdrich said. “I could not do this without the career development award since my time is very clinically busy.”

Erdrich is a UArizona Cancer Center member, assistant professor in the UArizona College of Medicine – Tucson’s Department of Surgery and surgical oncologist in the Division of General Surgery who specializes in melanoma, sarcoma, and breast cancers. She also provides general surgical oncology care to tribal populations throughout Southern Arizona.

Significance of prehabilitation for cancer surgery success

Building on her preliminary qualitative research, Erdrich will address health promotion for patients diagnosed with one of the 13 cancers linked to obesity. These cancers account for an estimated 40% of all cancers diagnosed annually in the United States.

American Indian and Alaska Native populations are more than 1.5 times more likely to be obese than the general population and have some of the lowest cancer survival rates in the nation. Many factors influence this elevated risk including poverty, related adverse social determinants of health, nontraditional foods and physical inactivity.

A small handful of studies have shown significant effects of prehabilitation—healthy diet and exercise before cancer surgery—in non-American Indians and Alaska Native populations. Erdrich will be among the first to test a prehabilitation lifestyle intervention following diagnosis of obesity-related cancer. The intervention will be implemented during the short window of opportunity (WOO) before cancer surgery, setting a trajectory for potentially better outcomes after surgery. 

“There has recently been a paradigm shift where we are interested in how we can improve the health of patients prior to surgery so the shock of recovery is not as great,” Erdrich said.

She said that though earlier studies have shown that using preoperative time to improve patients’ health is an effective strategy in cancer patients with obesity-related inflammation, no research has been done yet on American Indian and Alaska Native populations.

Her project, “Nutrition and Exercise Prehabilitation Intervention on Inflammatory Biomarkers in American Indian Cancer Patients,” will finalize, adapt and implement a prehabilitation translational clinical trial for American Indian patients with obesity-related solid tumor cancers who are preparing for surgery. She said that most importantly, the study does not delay care for patients. 

“There is a short window of opportunity, about three weeks, when these preoperative measures could improve inflammatory biomarkers in American Indian cancer patients and potentially improve patient outcomes,” said Erdrich. 

Erdrich, a descendant of the Turtle Mountain Band of Chippewa, developed a clinical and research interest in serving tribal populations after witnessing disparities in Native American health care, especially in the areas of surgical care and cancer treatment.

Importance of training the next generation of scientists

“The research being done at the Cancer Center has the potential to help Indigenous people living not only in southern Arizona, but all over the United States,” said UArizona Cancer Center Director Joann Sweasy, PhD. “We’re fortunate to have such a talented scientist as Dr. Erdrich on our team; it’s important to invest in researchers like her. They’re the innovators that will lead the next generation.” 

Erdrich’s mentor is Cynthia A. Thomson, PHD, RDN, the Cancer Center Shared Resource co-director and the director of Zuckerman Family Center for Prevention and Health Promotion. Thomson is a doctoral trained nutrition scientist and registered dietitian who leads a focused research program in lifestyle behaviors and cancer survivorship.  She specializes in obesity-related cancers and novel behavior interventions.

“It is exciting to have Dr. Erdrich receive this highly competitive career development award,” said Dr. Thomson. “As an oncology clinician scientist, the potential for this research, and the research programming she will lead going forward, to have profound impact on the health and well-being of Indigenous cancer survivors is real. I am privileged to guide her through this process, along with other key UA faculty including Drs. [Taylor] Riall, [Francine] Gachupin, [Jennifer] Bea, [William] Monfort, [Denise] Roe, and [Cindy] Kin.”

Clinicians who receive the K08 career development award must devote 75% of their full-time professional work to the K08 award, and their parent institution must agree to support their protected time. Erdrich said that the protected time allows her to do needed training and work on her prehabilitation study.

This study is funded by the National Cancer Institute, a division of the National Institutes of Health, under award no. 1K08CA276137-01A1.