Alix Sleight, after getting her first PhD, thought she had found her dream job as a non-fiction book editor in New York City. But then, in 2006, her family experienced a dramatic plot twist: her mom was diagnosed with breast cancer.
As she helped her mother navigate care, Sleight started to learn all about the shortcomings of the modern healthcare systems. Even for a person like her mom – someone who had the ability to access outstanding services – there were gaps. As Alix watched her mother grapple with a confusing thicket of systems, she sensed a new chapter of her own life was beginning, and she heard a new calling.
She traded editing books to studying them. Her new interest in non-fiction set her on a path to become a scientist, and she went from helping authors to improving community health – especially for cancer patients.
Most recently, she and her team at Cedars-Sinai in Los Angeles have launched a new health self-management program for cancer survivors called RISE, (Re-Invent, Integrate, Strengthen, Expand) to help patients handle the medical and psycho-social aspects of a cancer diagnosis.
Long term, her goal is to establish new systems of care to address unmet needs across a range of communities. As you’ll learn, this holistic approach has much to offer.
Q: Can you describe your educational background and career path? How long have you been in your current role?
A: I started off as an Occupational Therapist (OT) doing self-management coaching for cancer survivors and others at the University of Southern California in Los Angeles. Occupational Therapy has provided me with an invaluable foundation of skills in motivational interviewing, cognitive behavioral therapy, and health behavior counseling. As an OT, I was trained to focus on what somebody does on a day-to-day basis—or how they occupy their time—as the linchpin of health. While I was working as an OT, I started wondering about the evidence base supporting what I was doing in the clinic. I found that there were only a handful of studies out there specifically looking at health behavior changes in cancer survivors. I decided to pursue an OTD (clinical doctorate) in Occupational Therapy and later a PhD in Occupational Science to help build that evidence base. After that, I continued on to a Postdoctoral Fellowship at the National Cancer Institute, where I received training in epidemiology and population health. The National Cancer Institute fellowship also provided me with the opportunity to earn a Master’s in Public Health, which taught me about the intricacies of the United States healthcare system and the huge health disparities in cancer survivor populations across the country. For almost a year now, I have been a Clinical Scientist at Cedars-Sinai with joint affiliations in the Department of Physical Medicine & Rehabilitation, the Samuel Oschin Cancer Center, and the Center for Integrated Research in Cancer and Lifestyle (CIRCL). In this new role at Cedars-Sinai, I developed and launched a new health self-management program for cancer survivors called RISE (Re-Invent, Integrate, Strengthen, Expand). Alongside my CIRCL collaborators, we are looking forward to testing the efficacy of RISE in a pilot study later this year.
Q: Can you tell us about your work at Cedars-Sinai and how it serves the cancer community?
A: RISE is a new health self-management program for cancer survivors. We define self-management as an individual’s ability to manage the symptoms, treatment, physical and psychosocial consequences, and lifestyle changes that accompany a cancer diagnosis. RISE participants work one-on-one with an Occupational Therapist to set goals and develop practical strategies in order to establish sustainable positive habits around lifestyle areas such as physical activity, nutrition, stress management, sleep, self-efficacy, and spiritual well-being. Unlike some lifestyle-based interventions for cancer survivors, RISE is not standardized, but rather tailored to each individual and reflective of each participant’s unique personal strengths, challenges, and priorities. Ongoing practice and guidance in generating and enacting SMART (specific, measurable, achievable, realistic, and time-bound) goals related to personally relevant health self-management topics is the centerpiece of the RISE program. My role at Cedars-Sinai involves both clinical work and research, and many of my research collaborators are members of the Center for Integrated Research in Cancer and Lifestyle (CIRCL). CIRCL is an amazing group of clinicians and researchers working towards better understanding the role of lifestyle in cancer outcomes. I’m excited to be working with CIRCL to launch a feasibility study of the RISE intervention later this year.
Q: How did you discover AICR and our resources/research?
A: During my Postdoctoral Fellowship at the National Cancer Institute, I met a wonderful nutritional epidemiologist (and now good friend), Dr. Marissa Shams-White. At the time, Dr. Shams-White was leading a team of experts in the development of the 2018 WCRF/AICR Cancer Prevention Score, a standardized tool to measure adherence to health behavior recommendations. Dr. Shams-White knew about my work in health self-management counseling for cancer survivors, and she suggested that the WCRF/AICR scoring tool could be a great fit for measuring the impact of my work. I have been using the WCRF/AICR Cancer Prevention Recommendations as the foundation for my health behavior counseling in the RISE clinic.
Q: How does Cedars-Sinai utilize AICR’s resources?
A: AICR’s Cancer Prevention Recommendations have been a fantastic resource for RISE participants. The recommendations are easy to understand for patients—I print them out in color and hand them to my participants—and as a researcher I appreciate that it is easy to measure adherence to the recommendations using the scoring tool. The AICR guidelines really benefitted me as I designed the RISE program and will allow me to communicate with participants in a really clear, straightforward way. That clarity and straightforwardness is not reserved for the cancer prevention guidelines. All of the materials and web resources created by AICR are designed to be clear and understandable by people from all walks of life.
Q: How do the cancer patients and survivors that you work with benefit from AICR’s resources?
A: Many of the cancer survivors I work with receive broad advice about lifestyle change from their healthcare providers. They understand that it’s important to be more physically active and eat more healthfully. However, they often don’t get as much detailed information about the specifics of those lifestyle recommendations. AICR’s Cancer Prevention Recommendations are both clear and specific, making them perfect to use in the clinic. It’s particularly helpful to direct RISE participants to the AICR website for more detailed information about some of the more nuanced dietary recommendations like avoiding processed and “fast” food. There is a wealth of information accompanied by clear text and pictures—extremely helpful when we are trying to build new habits for health self-management in the RISE clinic.
Q: Is there any one story in particular that you can share about AICR’s work helping a member of your community- A success story involving a cancer patient or survivor utilizing AICR’s resources?
A: One of my patients was curious about alcohol consumption. She drank alcohol socially several times a week and wanted to understand whether it was important to cut down after her breast cancer diagnosis. She had heard mixed information about alcohol—weren’t there some studies out there indicating that alcohol was actually good for your health? Together, we turned to the AICR website, where we looked at the “What the Science Says” section of the AICR alcohol guidelines. This detailed and clear information helped her understand the science behind the recommendation to avoid alcohol—specifically for people with a history of breast cancer. She decided after that experience to cut down drastically on her alcohol consumption in an effort to prevent recurrence.
Q: Have you seen the public awareness around nutrition/lifestyle and cancer risk evolving? If so, how?
A: People—particularly cancer survivors—are feeling more empowered than ever to manage their own health through lifestyle choices. In particular, we are seeing an increasing awareness of the risks of alcohol with regard to cancer. You can see this change reflected in the growing range of non-alcoholic beverage offerings at restaurants and bars. Alcohol consumption is fundamental to much of American culture, so we still have a long way to go. But I do think that public awareness is growing, and that’s fantastic news for cancer prevention.
I also think it speaks volumes that large healthcare organizations like Cedars-Sinai are supporting new work in lifestyle and cancer. CIRCL is certainly producing cutting edge research in this area. My goal with RISE is to create a new, evidence-based paradigm for health self-management after cancer—and to see this adopted by other healthcare systems across the country. This way, we can help all cancer survivors succeed in following AICR’s Cancer Prevention Recommendations and, in doing so, achieve better health outcomes after cancer.
Q: How do AICR’s resources help your organization fulfill its mission?
A: CIRCL and I focus on translational science, the goal of which is to improve the health of individuals and communities by “translating” evidence-based research into protocols, medicines and therapies for use in-clinic. AICR consistently assists us in that mission by analyzing enormous amounts of data, generating clear summaries of the analytic results, and creating actionable resources that patients can benefit from immediately upon receipt.
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