Prostate cancer radiation therapy without fatigue? Nursing researcher seeks answers to common side effect

Researcher Chao-Pin Hsiao, an assistant professor in the Frances Payne Bolton School of Nursing
Researcher Chao-Pin Hsiao, an assistant professor in the Frances Payne Bolton School of Nursing

Fatigue from prostate cancer and its treatment can be debilitating.

The symptom, which can’t be relieved with rest, can lead to increased depression, impaired cognitive function, sleep disturbance and health-related quality-of-life issues.

To treat—and ultimately prevent—cancer-related fatigue, Case Western Reserve University cancer researcher Chao-Pin Hsiao will develop and test a novel mechanism of mitochondrial bioenergetics and radiation-induced fatigue using molecular-genetic approaches. The research is supported with a $272,970 grant from National Institute of Nursing Research (K01NR015246).

The American Cancer Society estimates that 220,800 new cases of prostate cancer will be diagnosed this year. Localized radiation therapy (XRT) is the standard treatment for non-metastatic prostate cancer, and although proven effective for increasing survival rates, fatigue is often a side effect during and after treatment.

Hsiao, an assistant professor at the university’s Frances Payne Bolton School of Nursing, hypothesizes that cancer-related fatigue is linked to the reduced production of adenosine triphosphate—a molecular compound that provides energy for physiological processes—triggered by radiation-induced cellular damage from XRT. The research project, which began in August, is expected to be completed in 2018.

Hsiao has researched genes associated with cancer-related fatigue since 2009, as a post-doctoral fellow at the National Institute of Nursing Research in Bethesda, Md.

“After coming to the school of nursing (in 2013), I developed hypotheses based on the discovery of these genes, which regulate mitochondria (an organelle found in cells, in which the energy production occurs),” Hsiao said. “Since, I’ve spent a lot of energy in the lab trying to understand why mitochondria dysfunction causes fatigue and how to measure it.”

Based on her findings, Hsiao will develop and test pharmacological and nutraceutical interventions to treat cancer-related fatigue—and maybe even prevent it entirely.

“This project is an essential step to understanding the biological basis of radiation-induced fatigue,” she said.

Her motivation to improve the quality of life of cancer patients stems from caring for her cancer-stricken father, King-Long Hsiao, as a teenager in Taipei, Taiwan—a battle he ultimately lost.

The experience inspired Hsiao to enter the health care field as a registered nurse and cancer researcher. Her passion for research on symptom science and management (i.e. cancer-related fatigue) is reinforced through direct interaction with patients and the experience of caregivers.

“Caring for my dad and patients reminds me how you can improve people’s quality of life by decreasing symptoms and suffering,” Hsiao said. “And that’s the ultimate goal.”