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Further deviating from a “one-size-fits-all” approach to health, UC San Diego professor Raphael Cuomo recently introduced a new field of science that he calls survival epidemiology.
Putting a greater focus on what helps people live longer after they get sick, he hopes it will lead to new cures, more effective treatments and better disease-fighting approaches.
Cuomo, an associate professor in the UCSD School of Medicine and a member of the La Jolla university’s Moores Cancer Center, said he sees survival epidemiology as “a game-changer for the future of medicinal science.”
In essence, he said, survival epidemiology does not assume an exposure that influences prevention of a disease will have the same effect on survival when one gets the disease.
“It differs from traditional epidemiology because traditional epidemiology has more of a focus on prevention in general,” said Cuomo, whose findings were published Dec. 27 in the Journal of Clinical Epidemiology. “And it differs from other kinds of science because it looks at the nuanced patterns of exposures that occur after diagnosis.
“There have been studies done previously on large datasets to look at health outcomes in patients with [certain] conditions. … But the tool kit that should be used to approach the study of survival epidemiology has not yet been defined. And this field [and] this term has not yet been defined either.”
A starting point for future studies in the field, he said, is the large volume of information in electronic databases.
“These are incredibly valuable tools for helping to understand what is beneficial for people living with disease, because there are records on millions of patients out there and we can learn quite a lot from those records about what will improve health outcomes … and survival when you compare the nuanced exposures that people experience after they receive a diagnosis,” Cuomo said.
Survival epidemiology serves as a complementary branch of science tied to another concept Cuomo introduced last year.
The Nutritional Epidemiology Risk-Survival Paradox, coined “Cuomo’s paradox,” illuminates paradoxes in patient needs based on his evaluation of scientific literature on the influence of nutritional factors on disease prevention and mortality.
He posits that factors commonly viewed as harmful to health can paradoxically predict better survival in people who later develop cancer or cardiovascular disease.
“There are instances in which … something that would increase risk of developing a disease may not be as big a concern for the survival of the disease after it has been diagnosed,” Cuomo said.
Everything from obesity and alcohol intake to high amounts of cholesterol and antioxidant supplements can pose increased risk of chronic diseases, his research states. But what can harm someone in some circumstances could help in others.
People who are considered obese, for example, are at greater risk of developing cancer or cardiovascular disease but have higher chances of survival than patients of normal or less than normal weight, according to Cuomo.
“The personalization of medicine is very much a theme consistent across both ‘Cuomo’s paradox’ and survival epidemiology,” he said. “I will say, however, that survival epidemiology takes a bigger focus on the specific post-diagnosis period.”
Cuomo said he hopes survival epidemiology will enable treatments that accommodate patients in complex health circumstances. ♦
