Abstract
The overall goal of the annual Transdisciplinary Research in Energetics and Cancer (TREC) Training Workshop is to provide transdisciplinary training for scientists in energetics and cancer and clinical care. The 2022 Workshop included 27 early-to-mid career investigators (trainees) pursuing diverse TREC research areas in basic, clinical, and population sciences. The 2022 trainees participated in a gallery walk, an interactive qualitative program evaluation method, to summarize key takeaways related to program objectives. Writing groups were formed and collaborated on this summary of the 5 key takeaways from the TREC Workshop. The 2022 TREC Workshop provided a targeted and unique networking opportunity that facilitated meaningful collaborative work addressing research and clinical needs in energetics and cancer. This report summarizes the 2022 TREC Workshop’s key takeaways and future directions for innovative transdisciplinary energetics and cancer research.
Indisputable evidence has linked obesity, poor diet, and physical inactivity, known in combination as energy balance or energetics, to a higher risk of developing cancer and worse prognosis. Innovative research strategies, clinical practice, and training of next-generation scientists are needed to lower the prevalence of these risk factors and, in turn, lower cancer incidence and mortality rates. The National Cancer Institute–funded Transdisciplinary Research in Energetics and Cancer (TREC) Training Workshop aims to synergize different disciplines to study and break the insidious link between energy imbalance and cancer manifesting from physical inactivity, dietary intake imbalance, and metabolic disorders such as obesity and diabetes (1,2). The most recent TREC Workshop returned in June 2022 for the first in-person meeting since 2019. This 5-day training, hosted by Yale School of Public Health, brought together 27 new early- to mid-career investigators (trainees) pursuing TREC research in basic, clinical, and population science. A matrix format was implemented in the 2022 TREC Workshop incorporating expert presentations, panel discussions about TREC science and career development, breakout sessions with intra- and inter-discipline group discussions, and networking activities among all attendees. Mentoring sessions between faculty, TREC trainee alumni, and new trainees occurred during the workshop and will continue in a remote format for 1 year post workshop to track the progress of new trainees (3).
Each day of the workshop was designated for a specific scientific area, including bench-to-bedside research; diet, body composition, and behavior change; underrepresented populations in transdisciplinary (TD) research; and survivorship, advocates, and furthering impact. Forty 2020 and 2021 TREC trainees, who participated in their respective annual TREC Workshops virtually due to the pandemic, presented their ongoing TD projects to the 2022 cohort. Faculty members and senior TREC alumni served as moderators to summarize inclusive trends and facilitate discussions. At the end of each day, 2022 trainees presented a 5-minute “elevator pitch” about their TD research projects. This resulted in a workshop packed with scientific ideas at an unprecedented level of diversity, with robust discussions and debates about the best way forward for TD research. To conclude the intensive 5-day workshop, the 2022 TREC trainees participated in a gallery walk, a unique interactive method, and a qualitative evaluation strategy to synthesize lessons learned, recognize critical strategic components for scientific and personal development, and identify ways to promote and conduct TD research. This report highlights the key takeaways of the TREC Workshop and provides practical guidance for researchers with interest in increasing their knowledge and skills regarding TD cancer energetics research.
Methods
Setting and participants
TREC 2022 trainees (n = 27) constituted early- to mid-career investigators (ie, postdoctoral, assistant, and associate professor level) representing 23 domestic and 2 international institutions. Disciplines of the 2022 trainees included 37% basic scientists, 19% clinician-scientists, and 44% population scientists. On day 5 of the TREC Workshop, trainees engaged in a gallery walk observed by program staff and faculty to summarize key takeaways related to program objectives (Table 1). Because a gallery walk is a program evaluation method, ethical approval was not required, and informed consent was not obtained. TREC trainees provided verbal agreement before engaging in activities.
Table 1.
TREC 2022 workshop program objectives
|
Gallery walk
A gallery walk is a qualitative evaluation method that provides an empirical strategy to evaluate learning and/or needs within the specifications of identified objectives (4). A gallery walk can be conceptualized in 4 parts: roles, engagement, preference, and consensus. Figure 1 presents the activity flow of the gallery walk. To our knowledge, this is the first report applying the gallery walk method to evaluate an academic training workshop.
Figure 1.
Gallery walk activity flow. 1) Facilitators summarize Transdisciplinary Research in Energetics and Cancer (TREC) objectives, and participants provide relevant topics (roles). 2) In groups, trainees rotate through 5 stations representing TREC program objectives led by a stationary facilitator and elaborate on topics of importance covered during the training (engage). 3) Participants nominally ranked topics with 3 available vote allocations; facilitators tallied to determine the top 3 topics for each objective and presented an overview (preference). 4) A subsequent round of nominal ranking with 5-vote allocations by trainees identified the 5-key takeaways of the training, which were then summarized by facilitators (consensus).
Five stations, each composed of 1 of the 5 program objectives, were set up in a large conference room using wall space, poster-sized adhesive sheets, and markers.
Roles
Each station was peer led (facilitator; n = 5). The remaining trainees (fellows; n = 22) were randomly divided into groups to rotate through each station. At each station, facilitators provided a summary of the overarching program objective, and fellows provided topics (ie, resource, action, need, and/or solution) covered during the workshop related to the program objective.
Engagement
Fellows spent 2 minutes at each station led by a facilitator to review topics and elaborate. Fellows rotated until they completed the discussion at each station while facilitators remained stationary.
Preference
Once all fellows rotated through the 5 stations, a nominal ranking technique was used to identify the most prominent topics. All 27 trainees (fellows and facilitators) were given 3 stickers and had 2 minutes to walk around the room to place their “votes” on topics. There was no restriction on the number of stickers a trainee could allocate to an item (ie, 1 sticker on 3 different topics or 3 stickers on 1 topic, or any combination in between). The facilitators tallied the total number of stickers on each topic under their objective and rewrote the top 3 topics on a clean poster-sized adhesive sheet. Each facilitator then spent 1 minute presenting an overview of the objective and the top 3 key topics with a summary of the discussion.
Consensus
All trainees were then provided with 5 additional stickers, and the same nominal ranking technique was used to reduce the 15 topics to the 5 key takeaways. All participants were allocated 2 minutes to vote, and facilitators tallied the final votes count. After the key takeaways were identified, trainees worked in groups to develop detailed summaries and respective areas for collaboration.
Five key takeaways from the 2022 TREC Workshop were identified from the gallery walk (Figure 2), and 5 working groups were established. Each working group virtually collaborated between June 2022 and January 2023, elaborating on their experiences, lessons learned, and future directions for TD energetics and cancer research.
Figure 2.
Key takeaways and other items of emphasis identified under Transdisciplinary Research in Energetics and Cancer (TREC) program objectives. A flowchart highlights the TREC Workshop objectives, key takeaways, and additional subjects of emphasis discussed and identified throughout the 2022 TREC Workshop gallery walk.
Implementation survey
In January 2023, a brief, anonymous follow-up survey consisting of a single “yes” or “no” question for each key takeaway was sent to the 2022 TREC trainees to assess whether they had implemented any of the key takeaways identified, and 93% (25 of 27) of the trainees completed the survey. The 5 questions were: “Takeaway 1: Have you included an analysis of the relationship between lifestyle behaviors and the tumor microenvironment and immune system in your subsequent grant applications, project plans, and/or manuscripts?” “Takeaway 2: Have you worked to cultivate an abundance mindset, act more collaboratively, or establish peer-mentoring relationships?” “Takeaway 3: Have you established new collaborations with scientists in other disciplines, reached out to others for a diverse perspective on science or career development, or joined an existing transdisciplinary team?” “Takeaway 4: Have you used the 3 Rs: Relationships, Relevance, and Rigor to expand team science? Have you established a new team or expanded an existing team to improve your research's relevance?” and “Takeaway 5: Have you incorporated insights from stakeholders: patients, funders, patient advocates, or third parties into your research? Or attempted to identify and include additional stakeholders?”
Results: 5 key takeaways
Relationship between lifestyle behaviors and the tumor microenvironment (TME) and immune system
Obesity, defined as a body mass index (BMI) greater than or equal to 30 kg/m2, oversimplifies body composition and limits our ability to measure the impact of obesity on cancer risk and outcomes. Visceral adiposity does not always correlate with BMI, and a visceral fat index is a more reliable proxy for the adverse effects of inflammation and cancer progression associated with obesity (5). Body composition assessment can be improved using computed tomography or dual-energy X-ray absorptiometry scans. Areas for future research include impacts of muscle mass, sarcopenia, and other body composition measures on optimal therapeutic dosing for systemic therapies and lifestyle intervention on the TME. TME can be regulated through multiple pathways: immune system, microbiome, hormonal regulation, and diet. Factors involved in these pathways play critical roles in tumor development and therapeutic response.
Physical activity, obesity, and the immune system
Exercise modulates the immune system and TME by inducing an antiinflammatory state, increasing the presence of M1 macrophages, inducing antigen presentation, and delaying tumor growth through cluster of differentiation 8 (CD8)+ T-lymphocyte modulation (6,7). However, these effects could be negated in the presence of obesity. Trainees shared evidence that dietary-induced obesity can modulate the gut microbiome and the TME by impairing T-cell immunity, decreasing T-cell infiltration, activating regulatory T-cells, and increasing expression of T-cell checkpoint factors (eg, PD-1, PD-L1) (8,9). To mitigate the effects of obesity and inflammation, resistance training has been shown to be effective in mitigating chemotherapy side effects and promoting overall health and function in multiple cancer sites (10-12). However, the exact mechanisms by which metabolic states alter immunity, particularly in obesity and during exercise training, remain unknown and an active area of investigation in TD energetics and cancer research.
Tumor cells, adipocytes, and bacteria
The stromal composition of the tumor statistically affects cancer severity and progression and is altered in the presence of obesity. The local, primary TME, including local adipocytes and tissue microbiomes, influences initial tumor growth. Each tissue in the body, including cancerous tissue, has a distinct microbiome that is affected by diet separately from the gut microbiome, and chemotherapy can also shift microbiota populations, reducing bacterial diversity (13). These shifts in the tumor microbiome regulate drug responsiveness and metastatic development (14). Additionally, obesity increases the number of adipocytes in tissues such as bone marrow. Increased adipocyte number and adipokine secretion in the bone marrow in mice fed a high-fat diet resulted in reduced survival and increased chemoresistance in a model of B-cell acute lymphoblastic leukemia (15). These changes in the cellular and bacterial composition of the local TME with obesity need to be better understood in cancer progression and treatment.
Sex hormones, adipokines, and obesity
Systemic hormonal factors generated by adipose tissue can also affect the primary tumor. Differences in white adipose tissue distribution and circulating androgens and estrogens in males and females alter the endocrine TME (16). Sex hormone dysregulation, notably elevated serum estrogen in women who are overweight and obese, plays a critical role in the development of breast and ovarian cancer (17). Sex hormone regulation of adiposity also affects chemotherapy response. Further, sex differences play a role in leukemia, where visceral fat is higher in males than females, and increases in visceral fat in females reduce chemotherapy response rates (18). Although the sex hormones estrogen and androgen control white adipose tissue distribution, differentiation, and quantity, adipose tissue also functions as an endocrine organ producing adipokines, such as leptin, adiponectin, and resistin, that promote tumor progression (19,20). In breast cancer, a strong link exists between obesity, leptin, and tumor development. High circulating amounts of leptin in patients with obesity promote breast tumor development, whereas adiponectin has antiproliferative properties (21). The interaction between sex hormones, adipokines, and cancer progression requires further research.
Impact of diet on therapeutic response and metastasis
High-fat dietary patterns contribute to cancer progression, and the source of fat can alter progression, metastasis, and chemotherapy response. A Mediterranean or Western diet supplemented with fish oil reduced breast cancer metastasis, improved response to doxorubicin, and reduced cardiotoxicity (22). Ongoing work is needed to understand both the individual dietary components and cell types involved in the dietary regulation of cancer progression using animals and bioengineered devices. Intercellular communication between cancer cells and other cell types (eg, adipose cells) can be mimicked using state-of-the-art biomedical devices, such as microfluidic models, to evaluate the effects on metastasis and drug resistance in the presence of various dietary components, including fats, fatty acid ratios, and vitamin supplementation (23). Further efforts are needed to study these interactions in patients, in new animal models of primary tumor growth and metastasis, and using tissue engineering to model the TME better (24).
The field has become increasingly aware of the role that TME plays in response to therapy, most critically immune targeting therapies. As immunotherapy becomes the standard of care, there is an urgent need to support research investigating mechanistic, targetable ways that diet, physical activity, and obesity alter the TME and immune system to enhance responses to cancer treatment. TD research incorporating these subjects can benefit from researchers cultivating an abundance mindset and the power of peer mentoring.
The value of abundance mindset and peer mentoring
Investigators working in academic settings may find themselves in environments where some individuals thrive while others struggle. Evaluation systems reinforce peer comparisons and competition, making it difficult to perceive setbacks as part of a learning process. These experiences affect well-being, work performance, and longevity in academia. Furthermore, during peer comparison, only others’ successes are visible. One does not see what lies beneath those successes: the unscored grants, the rejected manuscripts, and the late nights and weekends spent making exciting opportunities happen. It can be easy to fall into the trap of comparing one’s whole experience with others’ highlight reels, a task that can simultaneously be unproductive and demoralizing.
Here, we provide a framework for addressing the academic “comparison trap”—the abundance mindset framework—and discuss practical guidance shared by TREC trainees and others to address this issue in our academic lives.
Cultivating an abundance mindset as an early-stage investigator
Mindsets are a collection of attitudes, outlooks, and beliefs that shape personality and habitual thoughts and actions. Mindsets play an important role in self-efficacy, motivation, and resilience (25). Implicit mindsets vary along a spectrum of 2 extremes: fixed and growth (26). Individuals with fixed mindsets avoid challenges, give up early when obstacles are presented, ignore criticism, and find others’ success threatening. Conversely, those with a growth mindset embrace challenges, persist through obstacles, learn from criticism, and are inspired by the success of others. A derivative of the growth mindset is the abundance mindset, where resources are abundant, including ideas, funding, employment, and other opportunities. When practicing an abundance mindset, it is easier to share power, ideas, resources, and data leading to increased innovation and productivity (27). Additionally, in times of true scarcity (eg, low paylines for federal grants), those practicing an abundance mindset are more likely to focus on finding new opportunities, ideas, interdisciplinary projects, and collaborations (28). Cultivating an abundance mindset encourages effective responses to challenges and supports resiliency, well-being, and perseverance, facilitating shared success. We propose 3 practical strategies to cultivate an abundance mindset.
Turn competition into collaboration
One approach to cultivating an abundance mindset in academia is to use a collaborative approach to research (29). Building TD teams allows us to engage in better science faster. To make a collaboration successful, each partner must commit to building trusting relationships and engaging in honest discussions about sharing responsibility and credit associated with the collaborative project.
Share with your peers
Great comfort can be found in hearing about others’ experiences. Specifically, the vulnerability to share rejections, dead-end projects, and feelings of overwhelm validate others who are experiencing the same. Open and honest dialogue helps foster a supportive community. Peer mentoring opportunities like those offered at the TREC Workshop can also help create a confidential and trusting environment (30). Peer mentoring can complement the traditional senior–junior mentorships in institutions, emphasizing the values of the development of early-career scientists.
Reach out across departments, campus, and broadly in your field
Regardless of discipline or area of interest, academia can be lonely. By reaching out to others on campus or, more broadly, to others in your field, you may find like-minded peers with relatable shared experiences and noncompeting scientific aspirations (31). Academic institutions should consider facilitating activities that foster collaboration and networking and support opportunities for junior scientists to build meaningful connections with peers from different disciplines. Further, early-career investigators should consider availing themselves of the many opportunities to network within and outside their fields, including speaking engagements, conferences, training workshops (eg, TREC), and social and digital media to enhance research dissemination and implementation (32-34). These approaches will also facilitate the initiation of new collaborations that more effectively meet cancer’s grand challenges.
Establish new collaborations to address needs
Diverse perspectives to increase impact
As scientists, we are expected to be experts in our respective fields; however, we cannot be experts in all things. Hence, collaboration is needed to build diversified, rigorous, and comprehensive models of multi-systems research. The TREC Workshop provided an opportunity to engage with colleagues across various cancer-related fields. The workshop organizers focused on building cohorts that included trainees from basic, clinical, and population science backgrounds (3). This allowed for constructive discussions regarding ways of addressing needs from bench to bedside to population-based interventions and the role of new technologies across the TD research spectrum. By targeting basic science projects to address clinical and survivorship needs, the impact of these studies can be considerably increased. Keeping basic cellular mechanisms and biorepository generation in mind while conducting clinical and population-based studies improves access to translational samples and novel drug repurposing.
Importance of collaborations for project development
Another primary focus of the TREC Workshop was establishing and nurturing TD teams. Four priority areas were identified: 1) building a shared understanding of methodological considerations and limitations relevant to independent objectives within a project; 2) cross-training in methods relevant to shared objectives; 3) centering patient advocate perspectives in project objectives; and 4) sharing grants, data, and resources between team members to catalyze project development.
Connections for support and career development
Beyond project development, the TREC Workshop underscored the importance of networking for career development and provided access to peer mentors and senior faculty. Although the benefit of peer mentors is described above, senior mentors can directly affect a trainee’s career. Senior mentors can connect trainees with field experts; review documents; write recommendation, appointment, and promotion letters; provide study section and grant-writing insights; and sponsor trainees for awards. Additionally, senior and peer mentors can offer insights and practical tips on team management and leadership development. Having a broad network across the career spectrum enhances the recruitment, retention, and impact of trainees in science (35,36).
Ongoing peer support is crucial to career satisfaction and longevity. Most TREC 2022 trainees felt deeply inspired and emotionally supported by the camaraderie and strong connections that unfolded throughout the week. The supportive environment provided a space to work together on addressing unanswered questions in energetics and cancer. As a result, a TREC Women in Science monthly meeting has been developed to provide peer mentoring. TREC trainees were also encouraged to return to their institutions to establish informal peer-mentoring groups, such as the junior faculty networking committee piloted by TREC fellows from research institutions in North Carolina. Once new TD collaborations are established, the relationship must be buttressed and sustained, as described above.
Building the 3 Rs: relationships, relevance, and rigor to expand team science
To promote scientific innovation to achieve dynamic and impactful TD research, the necessity of the 3 Rs (relationships, relevance, and rigor) was highlighted. These 3 elements, presented by Dr Justin Brown from Pennington Biomedical Research Center, uniquely contribute to comprehensive, targeted, evidence-based, and forward-thinking research advancing scientific discovery.
Relationships
Scientific diversity is crucial to TD research. Diversity includes demographics, training background or pedigree, specialty field, career stage, and working style. Early-stage investigators should seek out mentorship from established scientists in their respective fields and tangential areas where the scientist is not formally trained. This type of cross-disciplinary and full-career spectrum range will assist in grant applications, allowing for involvement and amplifying voices underrepresented in TD research. Teamwork is a complex and dynamic process where successful teams integrate and optimize different working styles. Teams composed of different productivity archetypes that work uniquely and are compatible with each are often the most successful by validating other experiences and expertise (37). With varied characteristics on a team, synchronizing work into an effective dynamic can be difficult but not impossible. Both leadership and management skills will be necessary to develop and sustain team cohesion and productivity (38).
Relevance
In the fast-moving field of energetics and cancer research, there is a need to be vigilant about ongoing studies and current and future funding opportunities. Traditional studies often focus on 1 discipline and use conventional study methodologies. A TD approach includes aims and designs that are more likely to answer parallel translational science, clinical efficacy, and implementation goals. This also broadens opportunities available to investigators when identifying funding priorities from institutions and centers. A TD approach will enable early-career investigators to approach complex questions using expansive study methodologies, ultimately contributing to higher-quality science, improving the likelihood of receiving funding from extramural sources, and answering big cancer and energetic research questions (39,40).
Rigor
Rigor in the design and execution of TD research can be challenging, especially with the added complexities of new collaborators and working styles. Leveraging the strengths of collaborators in different phases of the TD continuum can be tremendously valuable and integrate diverse expertise (41). Rigor in separate disciplines may be more formidable due to a lack of comparable theoretical underpinnings (42). The focus on rigor in TD research can facilitate carefully constructed analytic plans, universally understood study methodology, and a strong execution plan for dissemination and implementation. Rigorous TD teams completing multilevel (eg, bench to bedside spectrum) and multidomain (eg, different sectors) research are needed to address the complex challenges faced by people living with and beyond cancer and their support network. This includes branching from the established comfort of academic hierarchies and integrating stakeholders.
Engage stakeholders: patients, funders, and third parties
The TREC Workshop also emphasized the need to include viewpoints outside the scientific community in the research process. Meaningful involvement of stakeholders in TD projects is critical to ensure the research approach and solutions are patient centered and truly connected to the people it aims to help. A 3-step approach to including stakeholders in research is described below.
Identification
The term “stakeholders” describes any individual, organization, or community that has a direct interest in the process and outcomes of a research project (43). In the origination phase of a research project, it is important first to identify the appropriate stakeholders. One tool to provide guidance is the 7Ps of stakeholder engagement: patients, the public, providers, purchasers, payers, public policymakers, and policy advocates (44). When identifying patient advocates, it is important to ensure they reflect the target participant population, ensuring the representativeness of their diverse needs. Additionally, all stakeholders should have lived experience with some aspect of the issue being investigated and, if possible, be directly tied to the people and places the project aims to impact (45).
Engagement
Once the specific characteristics of the stakeholder groups are clarified, one should engage by reaching out to groups who might have existing stakeholder panels or expertise to guide you in establishing one de novo. Examples of places to find existing groups include an institutional Community Outreach and Engagement Office (46). The University of North Carolina Lineberger Comprehensive Cancer Center provides an exemplar for patient-led engagement in research through their Office of Community Outreach and Engagement and Patient Advocates for Research Council (47,48). Without an existing panel appropriate for your research, one may consider the assembly of an ad hoc panel.
Inclusion
There are 3 ways for researchers to include stakeholders: consult, engage, and partner. Some stakeholders are engaged as bona fide members of the team throughout the entire project: planning and grant writing, protocol development, and dissemination of findings. Some research teams partner with stakeholder groups in an ongoing relationship beyond a single project. Regardless of how a stakeholder is involved, fair financial compensation demonstrates that stakeholders’ contributions of time, effort, and experience are valuable in research. Offices such as the Community Outreach and Engagement Office at National Cancer Institute–designated cancer centers or other community outreach teams can assist with choosing the best method for stakeholder engagement and help determine compensation levels. To obtain the most value out of stakeholder-involved research, researchers should have a well-developed stakeholder engagement strategy that considers the 6 principles of engagement for patient-centered outcomes research: 1) reciprocal relationships, 2) colearning, 3) partnership, 4) trust, 5) transparency, and 6) honesty (49). Following these principles will help stakeholders to feel valued and make a meaningful contribution to the research.
These core components of identification, engagement, and inclusion hold true regardless of the research position in the TD continuum. However, although population-level researchers may not use the implementation and approaches used by a basic scientist, the intentionality and patient-centered approach are still required. For example, a scientist studying a microRNA aberration in organoids could benefit from consulting with a patient advocate to frame the public health impact of their work and ensure that their science can be understood and valued by a lay audience. On the other hand, a public health researcher designing a community-based dietary program for adolescent and young adult populations may engage patient advocates and members of this community throughout the process of intervention development to ensure all relevance and acceptability by this patient group. Although TD researchers each use different systems, methods, and measurements, meaningful engagement of consumers across the research continuum will help to produce intentional and patient-centered research (38).
Terminology acknowledgement
Although the term stakeholder has been widely used across the literature, we acknowledge different terminology is being advised (eg, working partners, community partners) (50). We recommend research teams use culturally sensitive language that respectfully reflects the people in the audience of focus.
Discussion
The 2022 TREC Workshop left trainees with new perspectives, camaraderie, and renewed enthusiasm for their TD research programs. The gallery walk provided an innovative way to conduct program evaluation, synthesize training, and prioritize new directions in TD energetics and cancer research. Besides acknowledging the importance of the current state of science in TREC (takeaway 1), trainees recognized 4 areas (takeaways 2-5) critical for continuous professional development and successful execution of research projects beyond scientific concepts. Maintaining a growth mindset, valuing peer mentoring and collaboration, embracing research around societal impact, and effectively communicating with various stakeholders highlight the roadmap to conduct impactful and sustainable TD research. This realization, in combination with workshop networking, community building, collaborations, and calls to action, will ultimately contribute to our collective effort to reduce the cancer burden.
In a follow-up survey completed 6 months after the workshop (fielded January 2023), trainees reported increased engagement and incorporated many key takeaways into their research programs. The percentage of trainees who included key takeaways 1, 2, 3, 4, and 5 in their project, personal, and career development were 32%, 100%, 79%, 80%, and 68%, respectively. Because key takeaway 1 mostly pertains to basic research, the 32% implementation was in line with the 37% of basic scientists in the 2022 TREC cohort. This report depicts the 2022 TREC Workshop trainees’ commitment to TD research in energetics and cancer. It aims to inspire anyone pursuing TD research with actionable keys to maximize collective impact on cancer outcomes.
Acknowledgements
The authors acknowledge TREC trainee Andrea Stroud for participating in the gallery walk exercise and engaging in helpful discussions throughout the training. We thank the 2022 TREC speakers, specifically Justin Brown, Tara Sanft, and Patty Spears, whose presentations inspired key takeaways in this report. We also thank TREC alumni and faculty for providing feedback and mentoring before, during, and after the training. We thank Linda Nebeling for her role in launching the TREC initiative from the National Institutes of Health and the exemplary mentoring and guidance she continues to offer to TREC trainees. We want to express our sincerest gratitude to all TREC staff, especially Diana Lowry, for organizing and coordinating the entire TREC experience, including the in-person workshop and virtual networking events.
The funding agency was not involved in the writing of the manuscript or the decision to submit it for publication.
Where authors are identified as personnel of the International Agency for Research on Cancer/World Health Organization, the authors alone are responsible for the views expressed in this article, and they do not necessarily represent the decisions, policies, or views of the International Agency for Research on Cancer/World Health Organization.
The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or their respective institutions.
The methods presented in this manuscript are considered program evaluation and not human subjects research, and therefore did not require review by an institutional review board.
Contributor Information
Che-Pei Kung, Division of Molecular Oncology, Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA.
Meghan B Skiba, Division of Biobehavioral Health Science, College of Nursing, University of Arizona, Tucson, AZ, USA.
Erika J Crosby, Department of Surgery, Duke University, Durham, NC, USA.
Jessica Gorzelitz, Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA.
Mary A Kennedy, Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.
Bethany A Kerr, Department of Cancer Biology, Wake Forest University School of Medicine, Winston Salem, NC, USA; Wake Forest Baptist Comprehensive Cancer Center, Winston Salem, NC, USA.
Yun Rose Li, Departments of Radiation Oncology and Cancer Genetics and Epigenetics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA; Division of Quantitative Medicine and Systems Biology, Translational Genomics Research Institute, Phoenix, AZ, USA.
Sarah Nash, Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA.
Melanie Potiaumpai, Milton S. Hershey College of Medicine, Public Health Sciences, Pennsylvania State University, Hershey, PA, USA.
Amber S Kleckner, Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, MD, USA; University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA.
Dara L James, Community Mental Health Nursing Department, College of Nursing, University of South Alabama, Mobile, AL, USA; Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA.
Michael F Coleman, Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Ciaran M Fairman, Exercise Science Department, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
Gloria C Galván, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
David O Garcia, Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.
Max J Gordon, Department of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Mathilde His, International Agency for Research on Cancer (IARC/WHO), Nutrition and Metabolism Branch, Lyon, France.
Lyndsey M Hornbuckle, Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, TN, USA.
So-Youn Kim, Olson Center for Women’s Health, Department of Obstetrics and Gynecology, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA.
Tae-Hyung Kim, Department of Pathology, School of Medicine, University of New Mexico, Albuquerque, NM, USA; University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA.
Amanika Kumar, Department of Obstetrics and Gynecology and Oncology, Mayo Clinic, Rochester, MN, USA.
Mélanie Mahé, Department of Microbiology, New York University Grossman School of Medicine, New York, NY, USA.
Karen K McDonnell, Cancer Survivorship Research Center, College of Nursing, University of South Carolina, Columbia, SC, USA.
Jade Moore, Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA, USA.
Sangphil Oh, Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Xinghui Sun, Department of Biochemistry, University of Nebraska—Lincoln, Lincoln, NE, USA.
Melinda L Irwin, Department of Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, CT, USA; Yale Cancer Center, New Haven, CT, USA.
Data availability
This manuscript was based on the experiences of the 2022 TREC Training Workshop trainees. Data collected were for program evaluation purposes. Therefore, no data are available related to this manuscript.
Author contributions
L.M.H., M.H. (visualization; writing—original draft; writing—review and editing); S-Y.K., T-H.K., D.O.G., M.J.G., M.M., A.K., S.O., X.S., K.K.M., J.M., G.C.G., D.L.J., M.F.C., C.M.F., A.S.K. (writing—original draft; writing—review and editing); M.L.I. (conceptualization; funding acquisition; writing—original draft; writing—review and editing); J.G., M.A.K., E.J.C., Y.R.L., S.N., M.P. (project administration; writing—original draft; writing—review and editing); B.A.K. (data curation; project administration; writing—original draft; writing—review and editing); C-P.K. (conceptualization; project administration; visualization; writing—original draft; writing—review and editing); M.B.S. (data curation; methodology; project administration; visualization; writing—original draft; writing—review and editing).
Funding
This work was supported by the National Cancer Institute (R25CA203650 to MI; 3R01CA218093-04S1 to LMH; K22CA262340 to EJC; 5F32CA247263-03 to MP), National Institute of Child Health and Human Development (5R01HD096042 to SK), and National Institute on Minority Health and Health Disparities (K01MD014761 to DOG) at the National Institutes of Health, American Cancer Society (MRSG-17-152-01 to KKM), and Maryland Department of Health's Cigarette Restitution Fund Program (to ASK).
Conflicts of interest
All authors are participants in the 2022 TREC Workshop. No authors have conflicts of interest to report.
References
- 1. Patterson RE, Colditz GA, Hu FB, et al. The 2011-2016 Transdisciplinary Research on Energetics and Cancer (TREC) initiative: rationale and design. Cancer Causes Control. 2013;24(4):695-704. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2. Schmitz KH, Gehlert S, Patterson RE, et al. TREC to WHERE? Transdisciplinary research on energetics and cancer. Clin Cancer Res. 2016;22(7):1565-1571. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3. Irwin ML, Lowry D, Neuhouser ML, et al. Transdisciplinary research in energetics and cancer early career investigator training program: first year results. Transl Behav Med. 2021;11(2):549-562. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4. Rodenbaugh DW. Maximize a team-based learning gallery walk experience: herding cats is easier than you think. Adv Physiol Educ. 2015;39(4):411-413. [DOI] [PubMed] [Google Scholar]
- 5. Barbi J, Patnaik SK, Pabla S, et al. Visceral obesity promotes lung cancer progression-toward resolution of the obesity paradox in lung cancer. J Thorac Oncol. 2021;16(8):1333-1348. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6. Koelwyn GJ, Quail DF, Zhang X, et al. Exercise-dependent regulation of the tumour microenvironment. Nat Rev Cancer. 2017;17(10):620-632. [DOI] [PubMed] [Google Scholar]
- 7. Zhang X, Ashcraft KA, Betof Warner A, et al. Can exercise-induced modulation of the tumor physiologic microenvironment improve antitumor immunity? Cancer Res. 2019;79(10):2447-2456. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8. Wang Z, Aguilar EG, Luna JI, et al. Paradoxical effects of obesity on T cell function during tumor progression and PD-1 checkpoint blockade. Nat Med. 2019;25(1):141-151. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9. Newman TM, Shively CA, Register TC, et al. Diet, obesity, and the gut microbiome as determinants modulating metabolic outcomes in a non-human primate model. Microbiome. 2021;9(1):100. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10. Fairman CM, Kendall KL, Newton RU, et al. Examining the effects of creatine supplementation in augmenting adaptations to resistance training in patients with prostate cancer undergoing androgen deprivation therapy: a randomised, double-blind, placebo-controlled trial. BMJ Open. 2019;9(9):e030080. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11. Gorzelitz J, Costanzo E, Gangnon R, et al. Feasibility and acceptability of home-based strength training in endometrial cancer survivors. J Cancer Surviv. 2021. doi: 10.1007/s11764-021-00990-3. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 12. Parker NH, Gorzelitz J, Ngo-Huang A, et al. The role of home-based exercise in maintaining skeletal muscle during preoperative pancreatic cancer treatment. Integr Cancer Ther. 2021;20:1534735420986615. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13. Shively CA, Register TC, Appt SE, et al. Consumption of Mediterranean versus western diet leads to distinct mammary gland microbiome populations. Cell Rep. 2018;25(1):47-56.e3. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14. Chiba A, Bawaneh A, Velazquez C, et al. Neoadjuvant chemotherapy shifts breast tumor microbiota populations to regulate drug responsiveness and the development of metastasis. Mol Cancer Res. 2020;18(1):130-139. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 15. Lee M, Hamilton JAG, Talekar GR, et al. Obesity-induced galectin-9 is a therapeutic target in B-cell acute lymphoblastic leukemia. Nat Commun. 2022;13(1):1157. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16. Newell-Fugate AE. The role of sex steroids in white adipose tissue adipocyte function. Reproduction. 2017;153(4):R133-R149. [DOI] [PubMed] [Google Scholar]
- 17. Cleary MP, Grossmann ME.. Minireview: obesity and breast cancer: the estrogen connection. Endocrinology. 2009;150(6):2537-2542. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 18. Jaswal S, Sanders V, Pullarkat P, et al. Metabolic biomarkers assessed with PET/CT predict sex-specific longitudinal outcomes in patients with diffuse large B-cell lymphoma. Cancers (Basel). 2022;14(12):2932. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 19. Deb A, Deshmukh B, Ramteke P, et al. Resistin: a journey from metabolism to cancer. Transl Oncol. 2021;14(10):101178. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 20. Pham DV, Park PH.. Tumor metabolic reprogramming by adipokines as a critical driver of obesity-associated cancer progression. Int J Mol Sci. 2021;22(3):1444. doi: 10.3390/ijms22031444. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 21. Grossmann ME, Ray A, Nkhata KJ, et al. Obesity and breast cancer: status of leptin and adiponectin in pathological processes. Cancer Metastasis Rev. 2010;29(4):641-653. [DOI] [PubMed] [Google Scholar]
- 22. Ramirez MU, Clear KYJ, Cornelius Z, et al. Diet impacts triple-negative breast cancer growth, metastatic potential, chemotherapy responsiveness, and doxorubicin-mediated cardiac dysfunction. Physiol Rep. 2022;10(8):e15192. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 23. Rahman SM, Campbell JM, Coates RN, et al. Evaluation of intercellular communication between breast cancer cells and adipose-derived stem cells via passive diffusion in a two-layer microfluidic device. Lab Chip. 2020;20(11):2009-2019. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 24. Jinnah AH, Zacks BC, Gwam CU, et al. Emerging and established models of bone metastasis. Cancers (Basel). 2018;10(6):176. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 25. Rhew E, Piro JS, Goolkasian P, et al. The effects of a growth mindset on self-efficacy and motivation. Cogent Educ. 2018;5(1):1492337. [Google Scholar]
- 26. Wolcott MD, McLaughlin JE, Hann A, et al. A review to characterise and map the growth mindset theory in health professions education. Med Educ. 2021;55(4):430-440. [DOI] [PubMed] [Google Scholar]
- 27. Hope J. Adopt an abundance mindset to boost your leadership potential. Dean Provost. 2022;23(6):8-11. [Google Scholar]
- 28. Westover J. Abundance mindset: leading from a place of possibility. In: Forbes; 2021. www.forbes.com/sites/forbescoachescouncil/2021/06/09/abundance-mindset-leading-from-a-place-of-possibility/?sh=2bd3276866db
- 29. Bodewits K. Turn your competitors into collaborators. In: Science; 2022. science.org/content/article/turn-your-competitors-collaborators
- 30. Levy-Tzedek S, Moran GS, Alon U, et al. Peer power: a women's peer-mentoring program at the workplace: example from the academia. EMBO Rep. 2018;19(12):e47246. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 31. van der Wal JEM, Thorogood R, Horrocks NPC.. Collaboration enhances career progression in academic science, especially for female researchers. Proc Biol Sci. 2021;288(1958):20210219. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 32. Pain E. How to network effectively. In: Science; 2015. science.org/content/article/how-network-effectively
- 33. Fronczak A, Mrowinski MJ, Fronczak P.. Scientific success from the perspective of the strength of weak ties. Sci Rep. 2022;12(1):5074. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 34. Naff DB. Podcasting as a dissemination method for a researcher-practitioner partnership. Int J Educ Pol Leadership. 2020;16(13):1-18. [Google Scholar]
- 35. DeCastro R, Sambuco D, Ubel PA, et al. Mentor networks in academic medicine: moving beyond a dyadic conception of mentoring for junior faculty researchers. Acad Med. 2013;88(4):488-496. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 36. Sorkness CA, Pfund C, Ofili EO, et al. ; NRMN Team. A new approach to mentoring for research careers: the National Research Mentoring Network. BMC Proc. 2017;11(suppl 12):22. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 37. Vickberg SMJ, Christfort K. Pioneers, drivers, integrators, and guardians. In. Harvard Business Review; 2017. hbr.org/2017/03/pioneers-drivers-integrators-and-guardians
- 38. Bennett LM, Gadlin H, Marchand C.. Collaboration and Team Science Field Guide. 2nd ed. National Institutes of Health Publication; 2018. [Google Scholar]
- 39. Elmore LW, Greer SF, Daniels EC, et al. Blueprint for cancer research: critical gaps and opportunities. CA Cancer J Clin. 2021;71(2):107-139. [DOI] [PubMed] [Google Scholar]
- 40. Alfano CM, Bluethmann SM, Tesauro G, et al. NCI funding trends and priorities in physical activity and energy balance research among cancer survivors. J Natl Cancer Inst. 2016;108(1): djv285. [DOI] [PubMed] [Google Scholar]
- 41. Hansson S, Polk M.. Assessing the impact of transdisciplinary research: the usefulness of relevance, credibility, and legitimacy for understanding the link between process and impact. Res Evaluation. 2018;27(2):132-144. [Google Scholar]
- 42. Gnyawali DR, Song Y.. Pursuit of rigor in research: illustration from coopetition literature. Ind Market Manag. 2016;57:12-22. [Google Scholar]
- 43. Boaz A, Hanney S, Borst R, et al. How to engage stakeholders in research: design principles to support improvement. Health Res Policy Syst. 2018;16(1):60. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 44. Concannon TW, Meissner P, Grunbaum JA, et al. A new taxonomy for stakeholder engagement in patient-centered outcomes research. J Gen Intern Med. 2012;27(8):985-991. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 45. Kok G, Gurabardhi Z, Gottlieb NH, et al. Influencing organizations to promote health: applying stakeholder theory. Health Educ Behav. 2015;42(Suppl 1):123S-132S. [DOI] [PubMed] [Google Scholar]
- 46. Gilmore NJ, Canin B, Whitehead M, et al. Engaging older patients with cancer and their caregivers as partners in cancer research. Cancer. 2019;125(23):4124-4133. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 47. Patient Advocates for Research Council (PARC) at UNC Lineberger Comprehensive Cancer Center. https://unclineberger.org/research/patient-research-advocacy-group/. Accessed October 15, 2022.
- 48. Office of Community Outreach and Engagement (COE) at UNC Lineberger Comprehensive Cancer Center. https://unclineberger.org/community-outreach/. Accessed October 15, 2022.
- 49. Frank J. National MTM Advisory Board comments on stakeholder proceedings on community pharmacy and managed care partnerships in quality. J Am Pharm Assoc. 2015;55(1):4. 2015 [DOI] [PubMed] [Google Scholar]
- 50.Center for Disease Control and Prevention. Gateway to health communication/inclusive communication principles - preferred terms for select population groups and communities. https://www.cdc.gov/healthcommunication/Preferred_Terms.html. Accessed October 15, 2022.
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
This manuscript was based on the experiences of the 2022 TREC Training Workshop trainees. Data collected were for program evaluation purposes. Therefore, no data are available related to this manuscript.