The Biobehavioral Sciences program at Fred Hutch aims to understand and reduce the biobehavioral and mental health impacts of cancer treatment over time. Working with physicians and clinical researchers throughout the US, we conduct large-scale studies to identify and reduce these symptoms in patients from treatment through survivorship.
Through research and direct patient services, we empower patients to participate in their own care and optimize their quality of life during and after cancer treatment.
Improving Life After Cancer

The negative impacts of cancer treatment extend beyond physiologic symptoms. These include depression, anxiety, sexual dysfunction, pain, fatigue, sleep disruption, nausea and confusion.
Early research from our group pioneered the use of unconventional therapies like hypnosis and imagery to manage pain during cancer treatment. Since then, we have conducted studies and produced seminal works describing the symptoms and needs of transplant patients during and after treatment.
Our team in Biobehavioral Sciences enhances the long-term quality-of-life for cancer survivors and collaborating with our colleagues at Fred Hutch by:
- Providing direct patient counseling services
- Consulting with physicians to manage patient symptoms
- Conducting long-term scientific studies
- Participating in nationwide cancer guidelines advisory groups
- Training and mentorship
Our Research
Having been instrumental in defining short- and long-term symptoms for cancer survivors, we are working to define programs for enhancing patients’ life after treatment. Our current work aims to assess whether technology can be used to help personalize patient care and give survivors on-demand information and tools to enhance their quality of life after cancer treatment. We also study muscle weakness and heart problems in long-term transplant recipients.
Enhancing Survival After Cancer Treatment
We have developed technological strategies to reach survivors through targeted web content, social media, text messages, and mobile health approaches. This enables individuals to participate in their care and provide for their needs in a personalized manner, whenever and wherever they may occur.
Active Studies
INSPIRE
- Integrating health informatics in a scalable stepped care self-management program for survivors after hematopoietic cell transplantation
- Internet Studies to Enhance Long Term Survivorship after Hematologic Malignancy
Providing Survivorship Care Plans for Cancer Survivors
- Individualized Care Plans for Hematopoietic Cell Transplant Survivors
- Survivorship Care Plans for Adolescent and Young Adult Cancer Survivors
- Use of Patient Reported Outcomes in Facilitating Survivorship Care and Determining Risk of Adverse Outcomes in Survivors
Survivors of Childhood Cancer
- Improving Assessment and Treatment of Cardiovascular Risk Factors among Childhood Cancer Survivors
Exercise to Improve Health, Wellness and Survival after Cancer
- Physical activity after cancer treatment (PACT): pilot study of effects of exercise on circulating microRNA biomarkers of cancer prognosis in stage II-III breast cancer survivors
Defining Long-Term Effects of Cancer Treatment for Young People and Adults
We are following young people and adults during and after cancer treatment to determine their long-term physiological, behavioral, mental and emotional symptoms. This is important work following our previous examination of adult survivors and may inform how we communicate with and treat people who have undergone cancer treatment as children and young adults.
Active Studies
- AYA: Adolescent and Young Adult Survivors Network, a cohort study
Understanding Long-Term Muscular and Heart Effects of Cancer Treatment
We collaborate with clinical researchers to understand the mechanisms underlying the muscular changes and heart problems that often occur in cancer survivors after treatment. In addition to collaborating in clinical studies, we also investigate mouse models to determine the underlying mechanisms that lead to muscle weakness and other dysfunction. We examine whether exercise can reverse this dysfunction, both in clinical studies and in mouse models.
Active Studies
Muscle changes after cancer in survivors
- Muscle, joint and bone study in 5-20 year hematopoietic stem cell transplant survivors
- Behavioral and Biologic Mechanisms Underlying Musculoskeletal Problems in Long Term Cancer Survivors
Muscle changes after chemotherapy in mice
- Mechanisms for persistent skeletal muscle dysfunction after cancer treatment in mouse and human models
- Translational mouse model of mechanisms underlying chemotherapy late effects
- Translational mouse model testing astaxanthin coupled to exercise training to reverse muscle dysfunction in mice treated with a chemotherapy regimen used in breast cancer
Cardiovascular effects of cancer treatment in long-term survivors
- Clinical trial studies noted above focus on cardiovascular effects
- Other collaborations focus on cardiovascular effects
- Dried blood spot biomarkers for screening cardiometabolic risk factors in hematopoietic stem cell transplant survivors
How exercise can improve muscle and cardiovascular health and other outcomes after cancer
Symptom and Quality of Life Measurement Tools
Our team in Biobehavioral Sciences developed tools that have been used internationally as standards for measuring symptoms and quality of life for cancer survivors.
These copyrighted tools are available for use by investigators without a charge. Please complete the contact form to request permission and receive a scoring manual.
Our Quality of Life Measurement Tools
- Sexual Function Questionnaire (SFQ); male and female versions.
- Cancer and Treatment Distress (CTXD); acute version (for during and immediately after treatment), all version (for any time point including long-term follow-up of survivors), and caregiver version.
- Muscle and Joint Measure (MJM)
- Social Activity Log (SAL)