According to Nathalie Moise, MD, MS, the time to focus on patients’ mental health is now.
“It has often been said that there is a 17-year lag between when scientists demonstrate a significant finding and when healthcare practitioners change patient care,” says Dr. Moise, a member of the Herbert Irving Comprehensive Cancer Center (HICCC) at NewYork-Presbyterian/Columbia and assistant professor of medicine at Columbia’s Vagelos College of Physicians and Surgeons. “There have now been numerous trials demonstrating that distress, particularly symptoms of depression, after a cancer diagnosis increase the chance of dying and that treatment for distress could help improve remission rates and reduce mortality for patients with cancer.”
As a 2019-2022 Irving Scholar, Dr. Moise is working to take this finding into the clinics, rapidly implementing a new, personalized approach to improve psychological distress treatment in cancer patients. The prestigious Irving Scholar award, announced last spring and administered by Columbia’s Irving Institute for Clinical and Translational Research, gives substantial salary support to investigators for their work in clinical research.
At the HICCC, Dr. Moise is a member of the Cancer Population Science Program, which centers on research exploring primary prevention, early detection, health outcomes, and the delivery of cancer care to diverse communities. An internal medicine physician, Dr. Moise also earned an MS in epidemiology from the Mailman School of Public Health and currently directs Implementation Science Research at Columbia’s Center for Behavioral Cardiovascular Health.
Q: What do you find most exciting about your research?
A: I am particularly excited about bridging the silos between heart disease and cancer research. I think that so much of what we have learned from behavioral cardiovascular medicine can be translated to cancer patients, and I’m especially motivated by the urgency around targeting distress in cancer patients, given the close tie to disparities in cancer outcomes.
Q: What are you currently working on?
A: My research focuses on using technology to personalize treatment and improve psychosocial distress (e.g., stress, depression, anxiety) in patients with chronic illnesses. My early work demonstrated that symptoms of depression can increase your risk of dying from both cardiovascular disease and cancer, even in patients who report their health otherwise as "very good or excellent". Treating distress in patients with heart disease can improve quality of life, but treating distress in cancer patients improves both quality of life and prolongs survival. Despite this research finding, only a third of cancer patients with psychological distress receive treatment for that distress. With the Irving Scholar award, I am working to understand what contributes to suboptimal distress treatment rates and to develop and test personalized, interactive digital health solutions to distress symptoms in cancer patients.
Q: Where do you see your work having an impact?
A: First, I hope to improve our understanding of the different ways distress affects heart disease and cancer outcomes. Ideally, my work will also help develop and implement feasible strategies or improving outcomes in cancer patients, informed by technology and precision medicine and able to be shared across disciplines. Ultimately, doing detective work to understanding why certain health outcomes exist while also having the potential to immediately impact the way we deliver care is very rewarding to me as a researcher.
Q: What drew you to Columbia and to the HICCC?
A: I came to NewYork-Presbyterian/Columbia nearly 10 years ago for my internal medicine training. I have stayed here because of the strong commitment to excellent patient care, scientific discovery, and community service, all of which I see happening daily at the HICCC.
-Interview by Melanie A. Farmer