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Erin Barthel Receives Zucker Grant

Dr. Barthel, the Reid R. Sacco Adolescent and Young Adult (AYA) Cancer Program’s newest pediatric hematologist/oncologist has been awarded the 2015 Natalie V. Zucker Research Grant for her project entitled, Evaluating Cardiac Function in the Adolescent and Young Adult Cancer Survivor.

Currently in its sixteenth year, the Zucker Research Grant is given by the Natalie V. Zucker Research Center for Women Scholars. The Center’s focus is to further the research careers of female basic and clinical scientists at Tufts University School of Medicine and Sackler School of Graduate Biomedical Sciences.

The project stems from Dr. Barthel and the AYA Cancer Clinic’s Program Director Dr. Susan Parsons discovering a discrepancy in adolescent and young adult patients’ echocardiogram (ultrasound test of the heart) results as they transitioned from pediatric- to adult-based imaging. Shaped by meetings held with pediatric and adult cardiologists at Tufts Medical Center, the cardiac late effects project will serve not only to answer questions within the AYA Cancer Clinic, but will hopefully direct future guidelines for cardiac monitoring of patients who are both on and off therapy. This type of investigation is of great import as research has shown by the age of 45 years, the cumulative incidence of heart failure among childhood cancer survivors is 4.8%, a risk that is several fold higher than healthy siblings (risk, 0.3%).1

The adolescent and young adult is a unique type of patient. Patients in the 18-25 year old range are considered old for pediatrics and very young when compared to many adults who are seen for cardiac health. It is possible that a pediatric echocardiographer accustomed to seeing young, healthy hearts may estimate the heart to be stronger than it really is, whereas, the adult echocardiographer, accustomed to seeing older, unhealthy hearts, may be biased to think the heart is weaker than is the case. Additionally, both may be biased based on the history of cancer and drug exposure.

In the study, 45 echocardiograms recently obtained from adolescent and young adult patients in the AYA Cancer Clinic will be examined by echocardiographers. Each echocardiographer will be blinded to patients’ age and medical history. A pediatric and adult echocardiographer will read each echocardiogram. Any abnormal new findings will be reported back to the patient and a referral will be made to the Preventive Cardiac Health Clinic or Heart Failure Clinic at Tufts Medical Center.

This project allows Dr. Barthel to build on the limited AYA oncology research as well as leverage one of the strengths of Tufts Medical Center—the ability to collaborate with both pediatric- and adult-trained providers. This is especially important in the care of patients who span both systems of care.