To improve quality of life and reduce distress in older adults with cancer and their loved ones through rigorous research and specialized clinical care.
The Psycho-Oncology in Aging and Cancer laboratory (PAC MSK) is an interdisciplinary group of researchers and clinicians dedicated to identifying and addressing the unique psychosocial needs of older adults with cancer and their loved ones. The group consists of psychologists, psychiatrists, social workers, nurses, and staff conducting research on the nature and predictors of distress in older adults with cancer. The group is also developing assessments and interventions to improve the care of older adults with cancer and their loved ones.
Jimmie Holland, MD is considered a founder of the field of psycho-oncology, which combines oncology and psychiatry. It is increasingly considered a vital part of comprehensive cancer care, largely thanks to her work. In 1977, Dr. Holland joined Memorial Sloan Kettering as the inaugural Chief of the Psychiatry Service. She was then named Chair of MSK’s Department of Psychiatry and Behavioral Sciences when it was created in 1996. The department was the first of its kind, and Dr. Holland remained in her role until 2003. One of Dr. Holland’s many efforts was to understand and meet the needs of older adults with cancer. She founded and led this group for many years, and we are forever indebted to her wisdom, knowledge, and leadership.
This protocol tests the feasibility of the Cancer and Aging: Reflections for Elders model (CARE), a novel, manualized intervention geared toward older adults undergoing cancer treatment who are experiencing distress. Patients are recruited across three groups: psychoeducational intervention, expressive writing intervention, and control. Recruitment is complete and data analyses are ongoing.
The objective of this study is to develop and pilot test an anxiety intervention for older adults with cancer and their caregivers. We are currently conducting a pilot randomized, controlled trial to examine the feasibility and acceptability of the intervention, patient and caregiver adherence to the intervention, and the preliminary efficacy relative to usual care.
(PI: Trevino; National Institute on Aging/American Federation for Aging Research K23AG048632)
The Impact of Androgen Ablation Therapy on Cognitive Functioning and Functional Status in Men with Prostate Cancer Age 65 and Older
This protocol is designed to collect pilot data on the short- and long-term cognitive effects of androgen ablation therapy in men with prostate cancer age 65 and older via neurocognitive assessments. This study also aims to investigate regionally specific differences in brain activity mediated by testosterone via neuropsychological performance during a fMRI.
The primary aim of this study is to explore the concept of depression in older people with cancer and formulate a self-reported measure for this population. The first phase of this study included patient interviews, allowing study staff to explore the phenomenology of depression in older people with cancer. The second phase of this study seeks to interview ten geriatric experts and ten to 16 patients to review the drafted measure. In the third phase, these candidate items will be administered to 300 older people with cancer, and we will conduct item analysis and internal consistency as well as check for unique content of the items.
The objective of this project is to train oncologists, primary care providers, and other healthcare providers (e.g., nurses, nurse practitioners, physician assistants, social workers, and physical and occupational therapists) to screen for and conduct an initial assessment to identify cognitive impairment or functional decline in older people with cancer, learn about factors to consider when treating older people with cancer, and improve communication between the patient and caregiver.
(MPIs: Parker and Korc)
The objective of the review is to examine geriatric (older than age 65) patient-clinician communication in oncology to describe verbal and nonverbal communication practices, communication challenges, and relevant patient outcomes.
Faculty, Staff, and Collaborators
Kelly Trevino, PhD
Dr. Trevino’s research evaluates the efficacy and implementation of psychosocial interventions to reduce distress and increase engagement in advance-care planning in older adults with cancer and their caregivers.
Christian Nelson, PhD
Dr. Nelson’s research examines depression in older adults with cancer and the psychosocial needs of people with prostate cancer.
Andrew Roth, MDAttending Psychiatrist in the Department of Psychiatry and Behavioral Sciences
Dr. Roth’s expertise is in the psychological and psychiatric problems of people with prostate cancer and other genitourinary diseases. His research examines the psychosocial needs of people with prostate cancer and bereaved individuals.
Rebecca Saracino, PhDAssistant Attending Psychologist in the Department of Psychiatry and Behavioral Sciences
Dr. Saracino’s research examines the assessment and treatment of depression in older adults with cancer, with a focus on cancer survivors.
Kristen Fessele, PhDNurse scientist in the Office of Nursing Research
Dr. Fessele works to support patient-centered research and scholarly activities in New York City and at MSK’s three regional sites in New Jersey. Her research focuses on the identification of demographic, clinical, and genomic predictors of severe cancer-treatment-related symptoms and treatment tolerance, and she has led studies using very large data sets, such as the National Cancer Institute’s SEER-Medicare and Flatiron’s national electronic health record-derived database, to uncover knowledge about patient outcomes from real-world evidence sources.
Yesne Alici, MDAssociate Attending Psychiatrist in the Department of Psychiatry and Behavioral Sciences
Dr. Alici’s expertise is in helping people with brain tumors and older adults with cancer. Her research examines ways to manage cancer- and treatment-related cognitive changes, including the dissemination of screening methods for delirium and other cognitive changes.
Caraline Demirjian, MPHClinical Research Manager for the Psychiatry Service in the Department of Psychiatry and Behavioral Sciences
Caraline Demirjian joined the Psychiatry Service since 2010 and, in that time, has worked on multiple protocols that offered interventions, surveys, and neurocognitive testing to geriatric populations.
Rebecca TutinoClinical Research Coordinator in the Department of Psychiatry and Behavioral Sciences
Rebecca Tutino graduated from Connecticut College in May 2017 with BA in behavioral neuroscience and psychology. She is interested in pursuing a degree in clinical psychology with a health emphasis.
Nisha Joshi, MPHResearch Project Associate in the Department of Psychiatry and Behavioral Sciences
Nisha Joshi manages clinical studies for men with prostate cancer and young adults with testicular cancer. She received an MPH from Rutgers School of Public Health, and her interests lie in health education and promotion for all populations.
Chrystal MarteClinical Research Coordinator in the Department of Psychiatry and Behavioral Sciences
Chrystal Marte graduated from Pace University in May 2016 with a BA in psychology and coordinated previous studies at the Center for Research on End-of-Life Care at NewYork-Presbyterian Hospital/Weill Cornell Medicine. She is interested in how potential stressors can affect the quality of life and communication between patients with advanced illness and their caregivers.
James LassenClinical Research Coordinator in the Department of Psychiatry and Behavioral Sciences
James Lassen graduated Fordham College summa cum laude and was the recipient of a Fulbright scholarship to Taiwan in 2016.
Tandeka BlackOffice Coordinator for PAC MSK
Tandeka Black provides logistical support and an administrative perspective on the research and clinical activities of PAC MSK.
Tim Ahles, PhDAttending Psychologist and leader of the Neurocognitive Research Laboratory in the Department of Psychiatry and Behavioral Sciences
Dr. Ahles’s research examines cognitive changes associated with cancer (e.g., brain tumors) and cancer treatments (e.g., chemotherapy and radiation therapy). His other research interests include cancer pain management and palliative care.
Smita Banerjee, PhDAssociate Attending Behavioral Scientist in the Department of Psychiatry and Behavioral Sciences
Dr. Banerjee’s research expertise is in message framing for cancer prevention and control, and the development, implementation, and evaluation of patient-clinician communication skills training.
Beatriz Korc-Grodzicki, MDChief of the Geriatrics Service at Memorial Sloan Kettering
Dr. Korc-Grodzicki has been responsible for the development and growth of this new service since 2009. Dr. Korc-Grodzicki is also the head of the Cancer and Aging Interdisciplinary Team and Vice Chair of the Department of Medicine Quality Assurance.
Patricia Parker, PhDAssociate Attending Psychologist and Director of the ComSkils laboratory in the Department of Psychiatry and Behavioral Sciences
Dr. Parker’s research examines effective communication strategies for medical encounters, focusing on training physicians and other healthcare providers in effective communication.
James Root, PhDNeuropsychologist in the Department of Psychiatry and Behavioral Sciences
Dr. Root’s clinical expertise is in the assessment of cognitive abilities (e.g., memory, attention, language, and executive functioning) in adults and adolescents following cancer diagnosis and treatment. His research focuses on the cognitive effects of cancer diagnosis and treatment, including surgical intervention, anesthetic treatment, and chemotherapy treatment.
Publications (2015 through 2019)
Alexander, K., Banerjee, S. C., Manna, R., Alici, Y., Nelson, C., Gangai, N., Shen, M. J., Parker, P. A., & Korc-Grodzicki, B. (2019). Addressing communication challenges in older patients with cancer and geriatric syndromes: A communication skills training module for health care providers. European Geriatric Medicine, 10, 319-326.
Saracino, R.M., Cham, H.C., Rosenfeld, B., & Nelson, C.J. Confirmatory factor analysis of the Center for Epidemiologic Studies Depression Scale in oncology with examination of invariance between younger and older patients. European Journal of Psychological Assessment. 2019.
Saracino, R.M., & Nelson, C.J. Identification and treatment of depressive disorders in older adults with cancer. Journal of Geriatric Oncology. 2019. https://doi.org/10.1016/j.jgo.2019.02.005
Trevino, K.M., Nelson, C., Saracino, R., Korc-Grodzicki, B., Sarraf, S., Shahrokni, A. (in press). Is screening for psychosocial risk factors associated with mental health care in older adults with cancer undergoing surgery. Cancer.
Bevilacqua, L.A., Dulak, D., Schofield, E., Starr, T.D., Nelson, C.J., Roth, A.J., Holland, J.C., and Alici, Y. (2018) Prevalence and predictors of depression, pain, and fatigue in older- versus younger-adult cancer survivors. Psycho-oncology;27(3):900-7. Epub 2017/12/15. doi: 10.1002/pon.4605. PubMed PMID: 29239060.
Kolva, E., Rosenfeld, B., & Saracino, R. (2018). Assessing the decision-making capacity of terminally ill patients with cancer. Am J Geriatr Psychiatry, 26, 523-531.
Nelson, C.J., Saracino, R.M., Roth, A.J., Harvey, E., Martin, A., Moore, M., Marcone, D., Poppito, S.R., Holland, J. 2018 Cancer and Aging: Reflections for Elders (CARE): A pilot randomized controlled trial of a psychotherapy intervention for older adults with cancer. Psycho-oncology. Epub 2018/10/09. doi: 10.1002/pon.4907. PubMed PMID: 30296337.
Saracino, R.M., Cham, H.C., Rosenfeld, B., & Nelson, C.J. Latent profile analyses of depressive symptoms in younger and older oncology patients. Assessment. 2018: 1-16.
Saracino, R.M., Bai, M., Blatt, L., Solomon, L., & McCorkle, R. (2018). Geriatric palliative care: Meeting the needs of a growing population. Geriatric Nursing, 39(2), 225-229. doi: 10.1016/j.gerinurse.2017.09.004. PMID: 29042070. PMCID: PMC6352970.
Saracino, R.M., Rosenfeld, B., and Nelson, C.J. (2018). Performance of four diagnostic approaches to depression in adults with cancer. General hospital psychiatry. 2018;51:90-5. Epub 2018/02/11. doi: 10.1016/j.genhosppsych.2018.01.006. PubMed PMID: 29427869; PMCID: PMC5869111.
Trevino, K.M., Healy, C., Canin, B., Moran, S., Trochim, W.M., Martin, P., Pillemer, K., Sirey, J., Reid, M.C. (2018). Bridging the gap between aging research and practice: A new strategy for enhancing the consensus workshop model. Journal of Applied Gerontology, 2018 Jul 30:733464818791433. doi: 10.1177/0733464818791433. [Epub ahead of print]. PMID: 30058433.
Trevino, K.M., Healy, C., Martin, P., Canin, B., Pillemer, K., Sirey, J.A., & Reid, M.C. (2018). Improving implementation of psychological interventions to older adult patients with cancer: Convening older adults, caregivers, providers, researchers. Journal of Geriatric Oncology, 9(5): 423-429. PMID: 29759913. PMCID: PMC6162051.
Edelstein, A., Pergolizzi, D., & Alici, Y. (2017). Cancer-related cognitive impairment in older adults. Current Opinion Supportive Palliative Care, 11(1): 60-69. PMID: 28030446
Maggiore, R., Zumsteg, Z., BrintzenhofeSzoc, K., Trevino, K.M., Gajra, A., Korc-Grodzicki, B., Epstein, J., Bond, S.M., Parker, I., Kisk, J.A., Murphy, B., & VanderWalde, N.A. (2017). The older adult with locoregionally advanced oropharyngeal squamous cell carcinoma: Knowledge gaps and future direction in assessment and treatment. Journal of Radiation Oncology, Biology, Physics, 98, 868-883.
Saracino, R. M., Weinberger, M. I., Roth, A. J., Hurria, A., & Nelson, C. J. (2017). Assessing depression in a geriatric cancer population. Psychooncology,26(10):1484-1490. doi:10.1002/pon.4160. PMCID: PMC5112141
Saracino, R. M., Rosenfeld, B., & Nelson, C. J. (2016). Towards a new conceptualization of depression in older adult cancer patients: A review of the literature. Aging & Mental Health. Dec, 20(12): 1230-1242.
Dunn, L.B., Alici, Y., & Roberts, L.W. (2015). Ethical challenges in the treatment of cognitive impairment in aging. Current Behavioral Neuroscience Reports, 2(4), 226-233.
Korc-Grodzicki, B., Root, J., & Alici, Y. (2015). Prevention of post-operative delirium in older cancer patients undergoing surgery. The Journal of Geriatric Oncology, 6(1):60-69. PMID: 25454768 PMCID: PMC5627364
Presentations (2017 through 2019)
Alexander, K., Walters, C. B., & Banerjee, S. C. (2019, September). Older cancer patients’ understanding of and comfort with sexual orientation and gender identity (SOGI) questions. Poster presented at the European Geriatric Medicine Society’s (EUGMS’) 15th Annual Conference, Krakow, Poland.
Saracino, R.M., Ayturk, E., Cham, H., Rosenfeld, B., & Nelson, C.J. (March 2019). Substitutive Depression Criteria in Oncology Outperforms DSM Criteria Using IRT Analyses. Annual Meeting of the Society of Behavioral Medicine. Washington, DC.
Trevino, K.M., Nelson, C., Saracino, R., Korc-Grodzicki, B., Sarraf, S., Shahrokni, A. (2019). Does distress screening lead to mental health care in older adult surgical patients? (Poster). Annual conference of the American Society of Clinical Oncology. Chicago, IL.
Trevino, K.M. & Saracino, R. (2019). Recognizing and treating depression in older cancer patients. Presentation as part of education session, A Practical Guide to Geriatric Syndromes in Patients With Cancer. Annual conference of the American Society of Clinical Oncology. Chicago, IL.
Tutino, R., Saracino, R.M., Nelson, C. & Rosenfeld, B. (March 2019). Depressive Symptom Severity Does Not Vary by Age in Outpatients with Cancer. Annual Meeting of the Society of Behavioral Medicine. Washington, DC.
Banerjee, S. C., Manna, R., Gangai, N., Alici, Y., Nelson, C. J., Alexander, K., Parker, P., & Korc-Grodzicki, B. (2018, May). Geriatric communication skills training for oncology clinicians to improve the care of older cancer patients. Poster presented at the American Geriatric Society Annual Conference, Orlando, FL.
Banerjee, S. C., Alexander, K., Manna, R., Alici, Y., Nelson, C., Gangai, N., Shen, M. J., Parker, P. A., & Korc-Grodzicki, B. (2018, November). Implementation and evaluation of a geriatric communication skills training program for oncology health care providers. Poster presented at the International Society of Geriatric Oncology (SIOG) 18TH Annual Conference, Amsterdam, The Netherlands.
Saracino, R.M., Avildsen, I., Emanu, J., Rosenfeld, B., & Nelson, C. (April 2018). Depressive Symptom Profiles of Adult Oncology Patients. Annual meeting of the Society of Behavioral Medicine. New Orleans, LA.
Nelson, C.J. (2017) Conceptualizing Depression in Older Cancer Patients: Diagnosis and Psychotherapeutic Approaches. Staten Island University Hospital, Norwell Medical Center. New York, NY.
Nelson, C.J. (2017) Depression In Older Adults With Cancer. Asia-Pacific Prostate Cancer Conference, Melbourne, Australia.
Nelson, C. (2017). Exploring the conceptualization of depression in older adults with cancer. Annual conference of the American Psychosocial Oncology Society, Orlando, FL.
Nelson, C.J. (2017) Identifying and Measuring Depression in Older Cancer Patients. Annual Meeting of the American Psychosocial Oncology Society. Orlando, FL.
Nelson, C.J. (2017) Improving How We Communicate with Older Adults with Cancer. Annual Meeting of the American Psychosocial Oncology Society. Orlando, FL.
Nelson, C.J. (2017) Improving How We Communicate with Older Adults with Cancer. Annual Meeting of the American Psychosocial Oncology Society. Orlando, FL.
Roth, A. (2017). Achieving Wisdom: A Psychotherapy for Aging and Cancer. Montefiore Medical Center Grand Rounds, Bronx, NY.
Roth, A. (2017). A Telephone Psychotherapy to Help Achieve Wisdom in Older Cancer Patients: The CARE Project. Symposium on Care for the Elderly with Cancer, American Psychosocial Oncology Society, Orlando, FL.
Roth, A. (2017). Can We Help People Achieve Wisdom? A Psychotherapy for Aging with Cancer. John T. Mather Memorial Hospital Grand Rounds, Jefferson, NY.
Roth, A. (2017). Psychotherapy for Older Cancer Patients: The CARE Project. Symposium on Psychotherapies in Oncology, The 2nd Sapporo Conference for Palliative and Supportive Care in Cancer, Sapporo Japan.
Saracino, R.M., Lazenby, M., Bai, M., McCorkle, R., & Kapo, J. (March 2017). Trends in Inpatient Palliative Care Consultation Services for Older Adults. Annual meeting of the American Psychosocial Oncology Society. Orlando, FL.
Saracino, R.M., Rosenfeld, B., & Nelson, C. (March 2017). Depressive Symptom Profiles of Younger and Older Adult Patients in Oncology: A Confirmatory Latent Profile Analysis. Annual meeting of the American Psychosocial Oncology Society. Orlando, FL.
Saracino, R.M., Rosenfeld, B., & Nelson, C. (May 2017). Performance of Three Diagnostic Approaches to Depression in Oncology. Annual meeting of the European Association of Palliative Care. Madrid, Spain.
Trevino, K.M., Healy, C., Moran, S., Martin, P., Reid, C., Pillemer, K., & Sirey, J.A. (2017). Improving implementation of psychological interventions to older adult cancer patients: Convening older adults, caregivers, providers, researchers. Annual National Cancer Institute conference on the Science of Dissemination and Implementation. Arlington, VA.
Trevino, K.M., Prigerson, H. & Lachs, M. (2017). Managing anxiety from cancer: Initial development of a psychological intervention for anxiety in older adults with cancer. Annual conference of the American Psychosocial Oncology Society, Orlando, FL.