Thriving Beyond Treatment: A Resilience-Based Approach to Improve Long-term Quality of Life in Post-treatment Lymphoma Survivorship

The overarching goal of this proposal is to improve the quality of life of lymphoma survivors. To achieve this goal, we propose to test the efficacy of a virtual, resilience group program (SMART3RP-lymphoma) for lymphoma survivors delivered during early posttreatment survivorship (0-2 years after active lymphoma treatment [surgery, chemotherapy/immunotherapy/radiation] with curative intent). Given the nature of their disease (i.e., a cancer of the immune system) and the use of intensive, multi-agent therapies, lymphoma survivors experience a broad and persistent array of psychosocial challenges after treatment that complicate their adjustment and negatively impact their quality of life.1-8 As a treatable cancer that commonly presents in younger patients (20% occur in young adults, aged 18-39), these survivors often face longer lifespans grappling with the impact of lymphoma and its treatment.3,4 Given their potential to live for decades posttreatment, how lymphoma survivors adjust to the aftermath of their disease can have a profound impact on their health and wellbeing. Unfortunately, due to perceptions of lymphoma as a “good cancer” and a general lack of attention to the posttreatment period, the needs of these survivors are often overlooked.8,11 The end result is a population left at elevated risk for experiencing significant and enduring declines in their quality of life. To address these evidence gaps, we aim to test the effects of an evidence-based, multicomponent, resilience intervention (SMART3RP-Lymphoma)7 in a randomized controlled trial with early post-treatment lymphoma survivors (n=254) from 3 NCI-designated cancer centers. Specifically, this study aims to test the efficacy of SMART3RP- Lymphoma, compared to a Health Education Program in improving quality of life (primary outcome) as well as anxiety, depression and physical functioning (secondary outcomes). We will also explore how changes in resilience impact quality of life – a critical yet understudied priority in cancer survivorship. Further, in subgroup analyses, we will examine how SMART3RP-lymphoma impacts patient subgroups. Together with stakeholder and participant qualitative data, this trial will provide critical information to guide next steps in evaluating the cost, implementation, and sustainability of SMART3RP-lymphoma across settings. The proposed research represents a substantive departure from the status quo by offering a new post-treatment psychosocial care paradigm that emphasizes strengths-based approaches to improve quality of life in survivors. If effective, this model can be adapted and tested with other survivor cohorts. This work thus has the potential to have a significant impact on clinical practice and public health.