As patients age, they often experience multiple comorbidities and age-related declines in physical and mental health, complicating cancer treatment decisions. These patients must weigh survival benefits against treatment toxicity, functional decline, and reductions in quality of life. Despite this complexity and the growing evidence base, significant gaps persist in developing and implementing comprehensive guidelines for cancer treatment in older adults.

Our research aims to inform the development of comprehensive guidelines for cancer treatment in older adults, particularly those with comorbidities like dementia or affected by disparities in access to and high-quality care, to ensure that care decisions prioritize both quality of life and life expectancy.

Following the tragedy of Hurricane Sandy, the Institute for Translational Epidemiology collaborated with the Renaissance School of Medicine at Stony Brook University and the Zucker School of Medicine at Hofstra/Northwell to conduct research on disaster health, trauma, and resilience. We use advanced data and surveillance methodology to aid in individual and community-level prevention and resilience and to build quicker, more effective response and intervention during and immediately after disasters and other traumatic experiences.

A recent study conducted by our team evaluated the efficacy of the Disaster Worker Resiliency Training Program among Hurricane Sandy responders. The results showed that participants reported significant improvements in healthy lifestyle behaviors, stress management, and spiritual growth. Moreover, when faced with subsequent trauma exposures, those who had participated demonstrated greater resilience with reduced incidence of stress, PTSD, and depression symptoms. In another study, we examined the relationship between flooding, socioeconomic status, and toxic site incidents during Hurricane Harvey in the Houston area. Our findings revealed that despite similar flooding across toxic sites, areas with lower socioeconomic status were more likely to experience toxic releases during the storm. This research underscores the importance of addressing socioeconomic disparities in disaster preparedness and response, and informs our efforts to develop targeted interventions that can enhance community resilience across all population segments.

As World Trade Center responders age, there is growing concern about occupational cancers caused by exposure to toxins and carcinogens at the disaster site. Complementing the Center for Disease Control’s World Trade Center Health Program, the Institute for Translational Epidemiology has enabled molecular and mechanistic studies of WTC-related cancer by collecting tumor tissues from WTC responders.  We have thus far collected more than 500 specimens from World Trade Center responders, representing a diverse range of solid cancers. Coupled with anonymous clinical information from the World Trade Center Health Program, investigators have endless possibilities for studies on cancer etiology, biology, outcomes, and gene-environment interaction. The goal is to address questions regarding specific carcinogenic exposures and cancer, molecular signatures of exposure, and specific markers of tumor aggressiveness. To collaborate with us, please fill out the World Trade Center Collaboration Request Form.

Our research extends beyond human subjects to include experimental studies using rodent models. Researchers at the Institute for Translational Epidemiology have recreated World Trade Center exposure conditions in rodents to observe systemic and local biological responses. This approach aids in interpreting epidemiological observations and understanding the carcinogenesis process in the exposed human World Trade Center cohort. Animal tissues are accompanied by detailed annotations of experimental design, World Trade Center dust concentration and exposure routes, genetic background of the rodents, and tissue isolation methods.

These combined resources offer unprecedented opportunities for high-impact studies on environmental exposures, cancer etiology, outcomes, and gene-environment interactions in this unique population. By bridging animal models with human data, we aim to advance our understanding of World Trade Center exposure-related cancers, potentially informing new treatment modalities and improving survival outcomes for affected individuals.