First NCI Award at UT Knoxville Funds Family-Based Pain Care for Appalachian Breast Cancer Survivors

A two-year project led by Assistant Professor Patricia N. E. Roberson at the University of Tennessee, Knoxville, College of Nursing has become the first funded award from the National Cancer Institute ever received at the Knoxville campus. The study, titled “Conquering Pain Together: Family-Based Pain Intervention for Appalachian Breast Cancer Patients Taking Adjuvant Endocrine Therapies,” will test whether pairing breast cancer survivors with a chosen family caregiver can help both people manage the persistent pain that can follow primary cancer treatment. Although the College of Nursing had previously participated in NCI-related work through a contract, this award marks a milestone in the university’s expanding cancer research portfolio and signals a deliberate investment in survivorship science for a campus that sits at the edge of the Appalachian region. For Roberson, the significance extends well beyond the institutional milestone, reaching into a practical problem that shapes daily life for many survivors.

The timing of the announcement coincides with Breast Cancer Awareness Month, observed each October to raise awareness of breast cancer and to recognize the experiences of people living with and beyond the disease. For many survivors, the challenges of breast cancer do not end when primary treatment is complete. Lingering symptoms, particularly pain associated with ongoing treatment, can affect quality of life and make the survivorship period more difficult. Roberson’s project is designed squarely around that problem, with the stated aim of ensuring that people in survivorship can achieve the best possible quality of life. “This project is really focused on making sure that when you’re in survivorship, you can have the best quality of life as possible,” Roberson said.

The National Cancer Institute is one of 27 institutes within the National Institutes of Health and serves as the federal government’s principal agency for cancer research. Receiving a funded award from the institute represents an important step for UT Knoxville as it seeks to broaden its NCI-funded research and strengthen collaborations aimed at improving cancer outcomes and the patient experience. The project draws on partners across Tennessee: the University of Tennessee Medical Center in Knoxville, the University of Tennessee Health Science Center College of Medicine in Chattanooga, and East Tennessee State University will all support participant recruitment and help extend the research into communities throughout the state. For a university located at the edge of the Appalachian region, the opportunity to conduct NCI-funded research focused specifically on Appalachian cancer survivorship carries particular significance for the research team and the institution.

The clinical problem at the heart of the study concerns a widely used class of medications. Breast cancer treatment has made significant advances, and many patients now live cancer-free for years after completing primary treatment, but survivorship can bring its own challenges. For patients with estrogen receptor-positive breast cancer, adjuvant endocrine therapies, or AETs, are commonly prescribed following primary treatment to reduce the risk of recurrence and improve overall survival. These medications work by blocking or reducing the levels of estrogen, a hormone that can fuel the growth of certain breast cancers. While AETs play an important role in preventing recurrence, they can also produce side effects that include joint pain, muscle aches and increased sensitivity to pain. For some patients, those symptoms become difficult enough to make continuing treatment a challenge, which is precisely the scenario the intervention is built to address through a non-pharmacological approach centered on the patient and the person supporting them.

The central premise of “Conquering Pain Together” is that patients do not experience pain in isolation. Each participating breast cancer survivor will take part in the intervention alongside a primary caregiver, defined as a family member or other significant source of support. The pair will participate in the program together and complete research surveys throughout the study. Notably, the caregiver does not have to be a spouse or biological family member; participants may identify a sibling, adult child, friend, daughter-in-law, spouse or another trusted person as their caregiver. “Family is however you can find it,” Roberson said. “We leave it up to the patients to tell us who that supportive person is for them.” That flexibility reflects the study’s broader philosophy, which treats the patient’s own social world as an active ingredient in pain care rather than an afterthought to clinical treatment.

During the intervention, participants will learn evidence-based strategies for coping with pain and psychological distress. Depending on individual preferences, those strategies may include meditation, contemplative prayer and other approaches intended to help patients manage pain and reduce pain catastrophizing, the self-reinforcing cycle of worry and distress that can accompany persistent or recurring pain. The researchers emphasize that the goal is not necessarily to make pain disappear. Instead, they hope to equip patients and caregivers with tools to navigate pain when it occurs while strengthening communication and support within the relationship. “When you’re in horrible pain, having somebody who understands that and can be comforting can also help you better cope with the pain experience,” Roberson said. The intervention also deliberately addresses the well-being of the caregiver, not just the patient, making support for both members of the pair an important component of the design.

Roberson’s earlier research has shown that stress experienced by family caregivers can contribute to a patient’s pain experience, a finding that shapes the two-person structure of the intervention. “We’re giving them both, the patient and the family member, skills to help them improve coping,” she said. “It’s almost like having someone constantly by your side, a coach or a supportive figure, to help you through the times when the pain is greatest.” The Appalachian focus of the study is intentional rather than incidental. While the region faces significant challenges related to cancer outcomes, Roberson argues that research in Appalachia should also recognize and build on the strengths of its communities, chief among them close family relationships. “Appalachia so often gets a bad rap,” she said. “One thing that’s always missing is how close-knit our families are and how important that is.”

That perspective is woven into the intervention itself: rather than treating family support as something that happens alongside cancer care, the project incorporates it directly into pain management. The study also accounts for the geographic realities of Appalachian communities by delivering the intervention through telehealth, allowing participants to take part without routinely traveling to Knoxville. The project will unfold in phases. The first phase will gather feedback from patients, family caregivers, clinicians and other community stakeholders, and those perspectives will be used to refine the intervention so that it meets the needs of the people it is intended to serve. The team will then conduct a pilot trial involving 30 patient-caregiver pairs. The primary goals of the pilot are to determine whether participants find the intervention acceptable and whether researchers can deliver it consistently. These are feasibility and acceptability outcomes, not efficacy results; the pilot is not designed to prove that the intervention reduces pain.

If the pilot succeeds on those measures, the findings could provide the foundation for a larger clinical trial and, ultimately, integration of the intervention into clinical practice. “If we can demonstrate that people like the study and that we can consistently implement it, the hope is to do a full trial and hopefully improve the lives of more cancer survivors in our region,” Roberson said. The potential reach of the work may extend beyond breast cancer. Roberson and her collaborators, breast surgical oncologist Jillian Lloyd and medical oncologist Sarah Jenkins, are also exploring how family-based pain interventions could eventually be adapted for people with other types of cancer and for patients receiving other maintenance therapies with other oncology clinicians at UT Medical. Such adaptations remain exploratory at this stage and would depend on the results of the current project and any future trials it enables.

For the University of Tennessee, the award represents more than a new line of funding; it signals an opportunity to expand NCI-funded research while addressing a critical component of cancer survivorship, namely helping patients live well after treatment. For the College of Nursing, the project demonstrates how nursing research can bring together clinical expertise, family science and community partnerships to tackle complex health challenges. By placing patients and the people who support them at the center of the research design, “Conquering Pain Together” reflects a growing recognition that cancer care does not end at the conclusion of primary treatment, and that the path through survivorship may be shaped as much by family relationships and community context as by the medications and clinical protocols that follow a cancer diagnosis.

Subject of Research: A family-based, telehealth-delivered pain management intervention for Appalachian breast cancer survivors on adjuvant endocrine therapy

Article Title: College of Nursing Faculty receives first NCI-funded award at the University of Tennessee Knoxville

Article References: College of Nursing Faculty receives first NCI-funded award at the University of Tennessee Knoxville. Original publication (Bibliographic details unavailable.)

Image Credits: AI Generated

DOI: Not provided

Keywords: breast cancer, cancer survivorship, National Cancer Institute, adjuvant endocrine therapy, pain management, family caregivers, Appalachia, telehealth, University of Tennessee Knoxville, College of Nursing, pilot trial, quality of life