Psycho-Oncology Lab

Trained as a clinical health psychologist, my long-term career goal is to balance my clinical and research endeavors. My research goal is to create and integrate psycho-educational interventions that are clinically beneficial and theoretically grounded while also being systemically feasible and sustainable. To this end, my research has aimed to improve access and reach of psychosocial support that is socio-culturally tailored to meet individual’s needs.

I am an associate professor and director of the Psychosocial Oncology and Cancer Integrative Medicine Service at Rush University Medical Center, which provides treatment and support to patients, caregivers, and families as they manage the stress of cancer.

Current research projects

Addressing sexual concerns among cancer patients and survivors

Considering the growing number of cancer survivors worldwide, sexuality has become recognized as a significant survivorship concern. It is estimated that between 40-100 percent of cancer survivors experience sexual difficulties after treatment, depending on the cancer site. Physical sexual side effects of cancer treatment may include erectile dysfunction, vaginal atrophy (dryness or tightness), decreased desire or motivation, pain during penetration, absent or muted orgasms as well as bowel and urinary dysfunction.

Unlike many other side effects of cancer treatment, changes to sexual function tend to linger beyond two years after treatment. As sexual functionality deteriorates, the level of anxiety and depression among cancer survivors and their partners often increases, whereas overall quality of life worsens. Thus, sexual difficulties are reported as one of the most distressing survivorship concerns.

Despite the growing evidence of sexuality difficulties amongst cancer survivors, healthcare providers commonly do not address sexuality due to embarrassment, fear of offending the patient, a lack of communication skills, and an underestimation of the impact of changes in sexual well-being on quality of life. For similar reasons, including embarrassment, lack of engagement and minimal attention to partners, the uptake of interventions by survivors as well as partners has been low. The currently inadequate provision of information and lack of access to psychosexual interventions in this population requires an urgent response.

Our research revolves around developing and testing Rekindle, a web-based resource to address sexual concerns of cancer survivors and their partners. In collaboration with the Cancer Council New South Wales (CCNSW), I received an ARC Linkage grant to develop and test Rekindle, a web-based psycho-educational resource for cancer survivors of all types and their partners. Rekindle will serve as a personalized, intelligent, web-based, psycho-educational resource that is theoretically guided to support users’ long-term learning to address sexual concerns for cancer survivors and their partners.

We will be developing a Spanish version of Rekindle that will be culturally adapted to examine how best to provide psychosexual support to Latino breast cancer survivors. We are currently conducting a study assessing the unmet sexual concerns and supportive care preferences of Latino cancer survivors and their partners.

Training clinicians in how to address psychosocial concerns

In collaboration with the University of Chicago, we are developing and testing a web-based continuing education module for primary care physicians (PCPs)to enhance communication skills and assessment of sexual concerns after cancer. Communication skills training has been shown to improve physician assessment and management of psychosocial concerns, as well as improved patient satisfaction.

Cancer survivorship is transitioning to allocate long-term management to PCPs. Unfortunately, PCPs feel ill prepared to address psychosocial issues of cancer survivors, particularly sexual concerns.Moreover, cancer survivors report inadequate assessment and treatment of sexual concerns amongst their PCPs. To date, few initiatives have aimed to improve how clinicians, specifically PCPs, assess and address sexual concerns amongst cancer survivors.

Addressing psychosocial concerns globally

This arm of my research marries my interests in addressing health disparities with integrating psychosocial support in developing countries and with vulnerable populations.

With support from the American Society of Clinical Oncology (ASCO) support, I have provided public lectures and communication skills training to oncologists, surgeons, nurses and medical students in Thimphu, Bhutan in the Himalayas at the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) as well as Hue University Medical Center (HUMC) in Vietnam. We currently have a project that is addressing psychosocial concerns and unmet needs amongst cancer patients. This project will inform the development of clinical pathways to integrate psychosocial support within cancer care in two cancer centers in Hue.

In addition, a PhD student of mine, Ruth Wells, and I are conducting work in Jordan to address mental health concerns of Syrian refugees. We provided training to psychologists across three of the five non-governmental organizations (NGO) that provide mental and medical support to Syrian refugees. We are collaborating with NGOs in Jordan to train psychologists and the medical team in cognitive behavioral interventions to address distress. We are also working towards validating measures amongst the Syrian population. The significance of this work will serve as a model for working with ever changing refugee populations, using efficient culturally-appropriate strategies.

Current and past funding

  • Australian Research Council Linkage Grant: “Rekindle Sexuality After Cancer: Development and Testing of a Novel Web-Based Psychoeducational Resource for Both Survivors and their Partners”
  • USYD International Research Collaboration Award: “Biobehavioral Stress and Coping in Gay and Lesbian Cancer Patients and Partners”
  • National Cancer Institute: “Training Patients for HSCT – A Novel Coping Skills Intervention”
  • PSC CUNY Award: “A Qualitative Examination of Systemic and Psychosocial Factors Influencing Implementation and Utilization of Mental Health Services in the Context of Hematopoietic Stem Cell Transplantation.”
  • NIH Loan Repayment Program: “CRC Screening in Primary Care Settings: Factors for Low Income Urban Hispanics”

Publications

Ruth, W, Steel, Z, Hilal, M, Lawsin, C. (In press.) “Psychosocial Concerns Reported by Syrian Refugees Living in Jordan: A Systematic Review of Unpublished Needs Assessments.” British Journal of Psychiatry.

Dobinson, K, Seidler, Z, Lawsin, C. (In press.) “A Grounded Theory Investigation into the Psychosexual Unmet Needs of Adolescent and Young Adult Cancer Survivors.” Journal of Adolescent and Young Adult Oncology.

McMillan, K, Lawsin, C, Butow, P, Turner, J, Yates, P, White, K, Lambert, S, Stephens, M. (In press.) “Burnout and the Provision of Psychosocial Care Amongst Australian Cancer Nurses.” European Journal of Oncology Nursing.

Seidler, Z, Lawsin, C, Hoyt, M, Dobinson, K (2015). “Let’s Talk About Sex After Cancer: Exploring Barriers and Facilitators to Sexual Communication in Male Cancer Survivors.” Psycho-Oncology, Sep 25.

Lambert, S, Beatty, L, McElduff, P, Levesque, J, Lawsin, C, Turner, J, Jacobsen, P, Girgis, A. (2015). “Evaluations of Written Self-Administered Psychosocial Interventions to Improve Psychosocial and Physical Outcomes Among Adults with Chronic Health Conditions: A Meta-Analysis.” Psycho-Oncology, 24, 73.

Wells, R, Wells, D, Lawsin, C (2015). “Understanding Psychological Responses to Trauma Among Syrian Refugees: The Importance of Measurement Validity in Cross Cultural Settings.” Journal and Proceedings of the Royal Society of New South Wales, 148 (No 455, 456), 60-69.

Colomar, M, Tong, V, Morello, P, Farr, S, Lawsin, C, Dietz, P, Aleman, A, Berrueta, M, Mazzoni,Agustina, Becu, A, Buekens, P, Belizán, J, Althabe, F, Mazzoni, Agustina, Becu, A, Buekens, P, Belizán, J, Althabe, F.(2014). “Barriers and Promoters of an Evidenced-Based Smoking Cessation Counseling During Prenatal Care in Argentina and Uruguay.” Maternal and Child Health Journal, November, 1-9.

Lawsin, C, McMillan, K, Butow, P, Turner, J, Yates, P, Lamberts, S, White, K, Nelson, A, Stephens, M (2013). “Assessment of the Current Implementation and Barriers to Uptake of the Guidelines for the Psychosocial Care of Adults with Cancer According to Cancer Nurses in Australia.” Journal Clinical Oncology, 31.

Lambert, S., Regan, T, Turner, J, Chandler, H, Britton, B, Chambers, S, Smith, E, Lawsin, C, Bonevski, B,Keyser, K. (2013). “You Need Something Like This to Give You Guidelines on What to Do.” Supportive Care in Cancer, 21, 3415-3460.

Penney, E. and Lawsin, C. (2013). “Application of the MODE Model to Implicit Weight Prejudice and Its Influence on Expressed and Actual Behavior Among College Students.” The Journal of Applied Social Psychology, 43; S2, E229-36.

Lambert, S, Harrison, J, Smith, E, Bonevski, B, Carey, M, Lawsin, C, Paul, P, Girgis, A (2012). “The Unmet Needs of Partners and Caregivers of Adults Diagnosed with Cancer: A Systematic Review.” BMJ Supportive & Palliative Care, online first July 6.

Bullen, T, Sharpe, L, Lawsin, C (2012). “Body Image as a Predictor of Psychopathology in Surgical Patients with Colorectal Cancer.” Journal of Psychosomatic Research, 76, 3, 459-63.

Lawsin, C, Erwin, D, Bursac, Z, Jandorf, L (2011). “Heterogeneity in Breast and Cervical Cancer Screening Practices Among Female Hispanic Immigrants in the United States.” Journal of Immigrant and Minority Health, 13, 834-841.

DuHamel, K, Mosher, C, Winkel, G Labay, L, Rini, C, Markarian, Y, Austin, J, Greene, P, Lawsin, C, Rusiewicz, A, Grosskreutz, C, Isola, L, Moskowitz, C, Papadopoulos, E, Rowley, S, Scigliano, E,Burkhalter, J, Hurley, K, Redd, W (2010). “Randomized Clinical Trial of Telephone-Administered Cognitive Behavioral Therapy to Reduce PTSD and Distress Symptoms After Hematopoietic Stem Cell Transplantation. Journal of Clinical Oncology, 28 (23): 3754-3761.

Lawsin, C., DuHamel, K, Itzkowitz, Brown, K., Lim, H., Thelemaque, L., S. Jandorf, L. (2009). “Communication Between Colorectal Cancer Patients and Their Siblings: Discussions Regarding CRC Risk.” Cancer, Epidemiology, Biomarkers & Prevention, Nov; 18 (11): 2907-12.

Christie, J, Jandorf, L., Itzkowitz, S., Halm, E., Freeman, K., King, S., Dhulkifl, R., McNair, M., Thelemaque, L., Lawsin, C., Duhamel, K. (2009). “Sociodemographic Correlates of Stage of Adoption for Colorectal Cancer Screening in African Americans.” Ethnicity and Disease, 19: 323-329.

Lawsin, C., DuHamel, K, Itzkowitz, Brown, K., Lim, H., Thelemaque, L., S. Jandorf, L. (2007). “Demographic, Medical, and Psychosocial Correlates to CAM Use among Survivors of Colorectal Cancer.” Supportive Care in Cancer, May;15(5): 557-64.

Lawsin, C., DuHamel, K, Rakowski, W., Weiss, A., Jandorf, L. (2007). “Colorectal Cancer Screening among Low-Income African Americans in East Harlem: A Theoretical Approach to Understanding Barriers and Promoters to Screening.” Journal of Urban Health, 84(1): 32-44.

Rini, C., Lawsin, C., Austin, J. DuHamel, K., Markarian, Y., Burkhalter, J., Labay, L., Redd, W. (2007). “Peer Mentoring and Survivors’ Stories for Cancer Patients: Positive Effects and Some Cautionary Notes.Journal of Clinical Oncology, 25(1): 163-6.

Lawsin, C., Borrayo, E., Edwards, R., Belloso, C. (2007). “Community Readiness to Promote Latinas’ Participation in Breast Cancer Prevention Clinical Trials.” Health and Social Care in the Community, 15(4) July, 369-378.

Borrayo, E., & Lawsin, C., Coit, C. (2005). “Latinas’ Appraisal of Enrollment and Adherence to Breast Cancer Prevention Clinical Trials.” Cancer Control, Cancer, Culture and Literacy Supplement, 107-110.

Borrayo, E., Thomas, J.J., and Lawsin, C. (2004). “Cervical Cancer Screening Among Latinas: The Importance of Referral and Parallel Cancer Screening Behaviors. Women & Health, 39, 13-29.

Papers under review/in progress

Graham, L, Hullmann, S, Lawsin, C, Wilson, N, Wood-Molo, M, Ording, J, Ginder, C, Daley, K, Kent, P. (under review in Women’s Reproductive Health) “Pediatric Oncology Provider Perceptions of Fertility Preservation in Adolescent and Young Adult Females with Cancer.”

Scott, I, Lawsin, C, Ballard, A (under review). “Expanding on the IEMSS: Exploring the Additional Contributions of Attachment Style, Sexual Compliance and Sexual Communication on the Relationship between Social Anxiety and Sexual Satisfaction.”

Lawsin, C, Seidler, Z, Butow, P, Kay, J, Lambert, S, Kay, J, McGeechan, K, Miller, A, Brotto, L, Ritterband, L, Beuamont, A. Robinson, K, Dhillon, H (in preparation). “Development and Usability of Rekindle, a Web-Based Psychosexual Resource for all Cancer Survivors and Their Partners.

Lawsin, C, Seidler, Z, Butow, P, Juraskova, I, Kay, J, Lambert, S, Kay, J, McGeechan, K, Boyle, F, Miller,A, Brotto, L, Ritterband, L, Beuamont, A. Robinson, K, Dhillon, H, (in preparation for BMJ). “A Randomized Clinical Trial Testing Rekindle, A Web-Based Psychosexual Resource for All Cancer Survivors and Their Partners.”

Lawsin, C, Ballard, A, Dillhon, H, Hobbs, K, Scott, I (in preparation). “Validation of the PROMIS Sexual Satisfaction Scale Amongst Australian Breast Cancer Survivors.”

Lawsin, C, Ballard, A, Dillhon, H, Hobbs, K., Lambert, S, Boyle, F, Juraskova, I, Butow, P (in preparation). “Talking Sex(y) – Does Sexual Communication, Sexual Self-Disclosure, Sexual Function and Coital Intercourse Beliefs Contribute to Sexual Satisfaction Amongst Female Cancer Survivors?”

Lawsin, C, McMillan, K, Butow, P, Turner, J, Yates, P, Lamberts, S, White, K, Nelson, A, Stephens, M (in preparation). “Dissemination Does Not Equate to Implementation: Assessment of the Current Implementation and Barriers to Uptake of the Guidelines for the Psychosocial Care of Adults with Cancer According to Cancer Nurses in Australia.”

Team collaborators

Catalina Lawsin, PhD, is associate professor and director of Psychosocial Oncology & Cancer Integrative Medicine. She has special interests in creating and integrating psycho-educational interventions that are clinically beneficial and theoretically grounded while also being systemically feasible and sustainable.

Stephanie Hullmann, PhD, is a postdoctoral fellow in psychosocial oncology in the Department of Behavioral Sciences. Her career goal is to enhance the quality of life of patients with cancer and their families, and she has a particular interest in adolescents and young adults with cancer.

Lauren Wiebe, MD, is an assistant professor who is board certified in medical oncology, hospice and palliative medicine and internal medicine. Her research addresses quality of life of cancer survivors, supportive cancer care and electronic patient-reported outcomes.

Steven Rothschild, MD, is an associate professor and vice chairperson of the Department of Preventive Medicine. His research takes a community-based participatory approach to improve health care delivery to the medically underserved and elderly populations.

In addition to working with colleagues at Rush, Lawsin collaborates with faculty at the University of Sydney, Northwestern University, the University of Chicago, Georgetown University and San Francisco State University.

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