ASTROnews: Seed grant provides continuing opportunities for inaugural recipient

By Nicole Napoli, publications specialist

Ajay Bhatnagar, M.D., M.B.A., a radiation oncologist at Cancer Treatment Services International in Casa Grande, Ariz., is still reaping the benefits of an ASTRO grant he was awarded in his third year of residency.

“[The grant] tremendously helped my career,” he said.

Dr. Bhatnagar applied for an ASTRO Resident/Fellows in Radiation Oncology Research Seed Grant in 2005, the award’s inaugural year, while he was a resident at the University of Pittsburgh Cancer Institute. The one-year grant is awarded to residents or fellows who are planning a career focusing primarily on basic science or clinical research.

With his award, Dr. Bhatnagar conducted a study to determine whether radiation oncologists can improve patient satisfaction by attempting to meet patient preferences. He surveyed approximately 500 prostate, breast and lung cancer patients at the University of Pittsburgh Cancer Institute, which includes 18 radiation oncology centers.

“It is fairly rare for someone in training to conduct a randomized, prospective trial given all that it entails,” he said. “One is funding. I doubt I would have been able to do the study without the seed grant.”

He said his department is very generous in giving out research time but it is not usually able to fund projects. Most residents work with a faculty member who has already been funded. Dr. Bhatnagar also said that he didn’t have enough time to apply for a formal National Institutes of Health grant because of the timing of his blocked research time; however, the seed grant application process fit perfectly into his schedule.

Dr. Bhatnagar’s study was the first patient preference study for radiation oncologists conducted in the United States.

Patients completed a questionnaire before meeting their radiation oncologist, midway through treatment and at the completion of treatment and were asked whether they agree, disagree or neither with the following types of questions:

• How should the radiation oncologist address them (first name or Mr./Mrs.)?
• Should the radiation oncologist wear a white coat?
• Should the radiation oncologist discuss their prognosis and survival with them?
• Should the radiation oncologist have physical contact with the patient? (e.g., hand holding or hugging).
• Should the radiation oncologist inquire about their religious beliefs to help cope with their cancer?

Radiation oncologists were divided into two groups. The first read their patients’ responses and tried to adapt to patient preferences and the second did not see their patients’ responses. The initial results involving 182 out of the 500 total patients to be accrued, which had to be compiled for a mid-term report to ASTRO per the requirements of the grant, were published in a 2007 issue of the Red Journal.

“I thought the initial results would be an interesting concept to report on,” he said.

Once the 500 patients were accrued and the study was complete, two and a half years after he received the grant, Dr. Bhatnagar submitted the abstract of his final research results for ASTRO’s 51st Annual Meeting scientific program and was selected for inclusion in a scientific session on outcomes.

“The process was a wonderful experience because it allowed me at such an early part of my career to get insight into what is involved in conducting a study,” he said. “I’m really in debt to ASTRO to allow me to get this exposure of being a principal investigator.”

Dr. Bhatnagar’s study also caught the attention of ASTRO’s Communications Department and was chosen for the 2009 Annual Meeting press program. His study was covered by CNN, WebMD, Reuters and National Public Radio, along with TV and radio stations in Arizona and Oregon, among many other publications and news outlets.

“It was a very good experience to learn how to handle and deal with the media because medical information being publicized to the lay public is extremely important, especially when we are dealing with cancer information,” he said. “It also needs to be dealt with sensitively so that we are accurately conveying the correct information.”

In all, what started as a seed grant for residents evolved into two published studies – the final results will likely be published later this year – a presentation at the 2009 Annual Meeting and numerous national media opportunities. Dr. Bhatnagar also said the research he conducted helped him narrow down what he wanted to do for a career.

“The grant gave me true insight into what a career in academic medicine involved, and I realized at that point that that is probably not exactly what I wanted to focus completely on,” he said. “I got to realize that my primary passion is with patient care; it saved me a lot of years.”

Dr. Bhatnagar said applying for a seed grant is “an absolute must” for any resident interested in pursuing an academic career.

“Although it seems like an overwhelming task ... the learning experience you will gain will help you for the rest of your career,” he said.

Since its inception in 2005, 14 residents and fellows have been awarded ASTRO Resident/Fellows in Radiation Oncology Research Seed Grant. In 2010, the grant was reduced from up to three $30,000 awards to three $25,000 awards due to budget constraints. Applications for 2010 are due April 16, 2010. For more information visit www.astro.org/AboutUs/Awards/ResearchGrants/YoungScientistAward.