Simon Floss (Host): Hello, and welcome to ‘Innovations,’ a podcast series brought to you by the experts at Sanford Health. You’re listening to our 19th episode, ‘a connection to fight cancer.’ I’m your host Simon Floss with Sanford Health News.
The practice of medicine goes far beyond clinic walls. The Innovations podcast looks at the biggest issues facing healthcare today. Each one of these episodes offers the opportunity to see the ever-changing world of health and wellness through new eyes. Our leaders offer out of the box solutions to some nagging questions.
Today we are talking about a disease that’s affected everybody in one way or another: cancer. Recently, Sanford Health has become heavily involved with the ‘Connect For Cancer Prevention Study,’ a research study from the National Cancer Institute aimed at better understanding the causes of cancer, and how to prevent it.
Here to help explain what we need to know is a distinguished panel of guests, Chun-Hung Chan, Deann Witte, and Amanda Mensing. Dr. Chan and Amanda are joining us from Sioux Falls and Deann Witte is joining us from Fargo.
Host: Thank you all so much for being here today. We’ll get right to it because this is a big topic with a lot to unpack Chun, we’ll first start with you. What exactly is the connect study?
Chun-Hung Chan, PhD: The connect study is a new innovative study that the National Cancer Institute has started that basically is looking at causes of cancer and developing a new resource for researchers nationwide to basically look at things like how your lifestyle, or where you lived, your genetics, and other factors might affect your risk for developing cancer. The goal really is to identify these new potential risks and help prevent cancer.
Host: Amanda, if someone was going to ask you why this study is important, what would you say?
Amanda Mensing: Well, I would say that the study is one of the first that enrolls people before they ever get cancer. I know a lot of research studies focus on patients when they get cancer. Whereas this one looks at people before with no indication that they would get cancer.
We’re also looking at, as Chun said, environmental factors, such as where a person grew up, where they currently live where they work, any social factors and their lifestyle choices in terms of how that could lead them to either develop or not develop cancer later.
Host: So, this is just incredibly useful. Deann, in your mind, what’s the most unique thing about the connect study?
Deann Witte: I think for the most part it’s such a large study. They’re looking to enroll up to 200,000 people and it’s a long-term study over the course of, at least 10+ years of healthy individuals. Most of the studies as Amanda said deal with treatments rather than trying to find cause. So this is kind of in my mind, what would be the most unique thing I guess.
Host: Chun, how did Sanford Health become a part of this study?
Chun-Hung Chan, PhD: So, through my work with the Sanford biobank I got to know the folks at the National Cancer Institute, and many years ago, they invited me to present. I presented to them on what we do at Sanford as far as research and bio-banking is concerned. That led to them inviting us to submit an application to participate in this study. And we were successful in being awarded that contract. That’s how we got here.
Host: What was that experience like? I mean, one being asked to present that and then two, just having that direct connection with the Institute.
Chun-Hung Chan, PhD: It was actually an interesting experience in the sense that I was not expecting them to reach out to us. Generally in research, normally we look for the funding opportunities, but in this case, the NCI actually directly approached us which was unexpected, but also quite an honor, I think for us.
I think obviously whatever we were doing here, they were impressed with and, and saw the value of including Sanford Health in this important new study. And I think that definitely having those relationships with the national cancer Institute and the leadership there definitely benefited us.
Host: The old expression ‘don’t call us, we’ll call you.’ They actually called us, you know? So, what’s that say about Sanford Health in general?
Chun-Hung Chan, PhD: I think that basically says that you know, Sanford Health has started to become recognized as a leader in research.
Host: Amanda, how can a person join the study?
Amanda Mensing: So, there’s a few different ways that we’re looking for our participants. If there are, if someone is eligible they may get an invitation from Sanford research through either my chart or also in the mail. Otherwise we do welcome people to go to the website for the study cancer.gov/connect study. And then we’re also going to be placing posters, working on recruitment there. We’re going to be working with some of our Sanford physicians to see how they can get their patients involved as well.
Host: Why would you recommend that someone get involved and join the study?
Amanda Mensing: I think this is a really unique opportunity to be able to input the way a person chooses to, you know, live as far as social life, or location and provide that information and just basically give it out as a bank to try to help our future generations try to find potential causes of cancer that we may not have even thought of.
Host: And speaking of potential causes these, these outliers as far as the study where someone lives, their genetics just a reminder for people listening, what are some of the biggest causes if you will, or just those outer layers that might contribute to a cancer diagnosis later in life?
Amanda Mensing: I think a lot of what people think of right now are causes of cancer are the obvious ones smoking for one. So, this is really looking at, is where you live a potential? Do you have a higher risk depending on what part of the country you live in? Which I think is the main reason that it’s so important that we’re working with so many different locations throughout the country is we can try to determine that.
Host: How many locations? Sorry to interrupt. If you have a ballpark number, too.
Amanda Mensing: We have nine right now, I believe. Am I right on that, Chun?
Chun-Hung Chan, PhD: Sanford is one of nine institutions nationwide that are working together to recruit for this study.
Host: And I’m assuming it’s, like you said, nationwide coast to coast, Midwest, down south?
Chun-Hung Chan, PhD: There is representation from the east coast, the Midwest, the Pacific Northwest. We even have a location in Hawaii.
Host: Well, Aloha. Deann, say a person wants to join the study. What are some things that they need to know? What’s going to be expected of them, and what are the responsibilities of participants?
Deann Witte: After you consent and join the study, you’ll just be asked to complete variety of questions in the form of surveys, answering questions about your health history, environmental questions, about where you work and live among others, of course just all background information that might help assist researchers.
In the long run as far as looking back, you’ll be asked to make an appointment to complete sample collection of blood urine and saliva. And after that first initial round of survey and sample collection, participants will be contacted periodically to complete additional surveys and provide additional sample collection.
Host: And you said this is a long study. 10+ years, what’s kind of the timeframe on that again?
Deann Witte: The timeframe on the biospecimen collections?
Host: No, just the length of the study.
Deann Witte: Chun, maybe you could answer that better than I could. I know a 10 plus years, as far as following people in the most the age group, more likely to develop, I guess?
Host: Sure, Chun if you want to take that?
Chun-Hung Chan, PhD: As designed right now with the study the NCI are hoping to follow participants for at least 10 years with the idea that over the course of those 10 years, and with the age group that we’re actually looking at between the ages of 40 and 65, based on national statistics they would expect a proportion of them to develop cancer during that 10-year period.
However, the NCI have also indicated to us that if this study is a success in terms of recruitment, that they would consider extending it beyond 10 years and possibly up to 20 years in length. And this will really be probably the most comprehensive study for looking at the causes of cancer anywhere in the world because most studies generally do not do a long-term 10 to 20 year follow up.
Host: What information will be collected from a person and then how will it be used?
Chun-Hung Chan, PhD: In addition to the survey questions that Deann mentioned we will also ask participants to give us permission to access their medical records. So, Sanford will provide medical record information to the NCI that will be associated with this, the survey questions, as well as the samples that have been collected. And all of this information will be collated together. Then, they will also draw upon additional information such as geographic location. So, they may look at things like, particularly in the Midwest, they might look at you know the type of industry that occurs around here.
So, obviously in the Midwest there’s a lot of farming. They might look at farming and potential exposures to agricultural chemicals. Then tie that back with where you actually live, and see whether there’s a potential that you were exposed to some sort of pesticide or something like that, and if there’s maybe a link between that and developing cancer. So, really they’re using a variety of different information, as well as the information that we provide and that the participant provides themselves to really get a comprehensive picture of, what is it that the participant may have been exposed to at some point that may result in developing cancer.
Host: This is just fascinating. Amanda, what are the benefits of joining ‘Connect’?
Amanda Mensing: In terms of direct benefits, there’s not really any direct benefits to the participant. But, overall we’re looking at a benefit to the general knowledge of cancer in terms of how it could develop and that could impact future generations and help prevent cancer by determining causes and the risks associated with it. So much of it is a long-term impact looking at doing a study that could impact future generations and the participants, children, or grandchildren.
Host: Deann say that there’s someone with no history of cancer. What would compel them to participate in the study, or why should they still participate?
Deann Witte: More than likely someone has been touched somehow by cancer? Whether it be through a relative or close friend or coworker we all kind of know people that have had to go through cancer treatment. This is a way for, for those people to feel like they’re helping and feel like they’re contributing to the cause. I think it’s a feel-good way of saying, “you know, what. I’m involved in this. I’m going to try to help in whatever way I can.”
Host: Like you said, cancer truly has impacted everyone in one way or another. Chun, how is this study impacted if a participant develops.
Chun-Hung Chan, PhD: If a participant develops cancer it will actually not impact the study in the sense that you know, the participants can still continue to be part of this study. The sad reality is that out of the 200,000 people that they hope to enroll, a proportion of them will probably develop cancer in their lifetime. That’s actually one of the kind of goals of this study is that they want to look at those people who do go on and develop cancer. Because, then the NCI will actually have kind of like a before and after picture of what does that participant look like before they’ve had the cancer, and then after they develop cancer? What the NCI are really hoping to do is work with Sanford and identify those participants that do go on to develop cancer.
Then, we will provide them with additional information from their medical records treatment information may be some samples from pathology so that they can really study what type of cancer the participant has developed, and link that back to any kind of potential pre-cancer data that they have in terms of exposures, and really see if there’s any sort of link there between what they might be exposed to or genetics, or things like that and the cancer that they end up developing. So, like I said, this is really a comparison of before and after. And they do actually expect a number of participants to develop cancer in order for them to be able to study those risk factors.
Host: Deanna and Amanda, I’ll ask you both the same question and allow both of you to respond. Deann, we’ll first start with you. Why should the study matter to Sanford providers?
Deann Witte: I think that for providers you know, some of our providers work in research and some don’t, but it’s a way for them to refer people to a study that could benefit them and down the road and contribute to their knowledge and maybe changing the course of their treatments or their treatment decisions making changes down the road for people rather than just thinking about the here and now. What are we treating particular cancers with now more so looking like how, how can that change by looking back at these things? And, maybe just making strides to make that better for people.
Amanda Mensing: What we learn from this study could help provide new insights into risk factors for developing cancer, as we’ve said. And, that could definitely help providers in the future by giving them new tools and insights to prevent cancer. It could also assist in new screening guidelines. I know the screening guidelines for particular types of cancers seem to change quite often. And this could kind of give providers a little better direction as far as what the best screening guidelines are.
Host: Awesome. Well, thank all three of you for taking the time and joining us here today.
Before we wrap up, I’d like to remind you that Sanford Health Innovations podcast is now available on your favorite podcast apps like Apple and Spotify, as well as our website, Sanford Health News. If you enjoyed this conversation, follow us, give us a thumbs up and share your comments. We love hearing from you and hope that you find these conversations insightful.
Thanks again for listening. I’m Simon Floss with Sanford Health News.