July 2, 2008
John Wayne Cancer Institute Receives Grant to Study Long-Term Health Effects of Traumatic Brain Injuries
The John Wayne Cancer Institute at Saint John's Health Center announced today that it has received a grant from the National Operating Committee on Standards for Athletic Equipment to study pituitary hormonal failure (hypopituitarism) in retired football players.
The research, which will be conducted in collaboration with the University of North Carolina's (UNC) Department of Exercise and Sport Science, and the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, will be directed by Daniel F. Kelly, MD, director of the Neuro-Endocrine Tumor Center at the John Wayne Cancer Institute, and Kevin M. Guskiewicz, PhD, chairman of the Department of Exercise and Sport Science at UNC.
In a cohort of retired National Football League (NFL) players, the study will examine the relationship between the number of concussions sustained in players' NFL careers, and their subsequent pituitary hormonal function and post-retirement quality of life. The investigators hypothesize that players sustaining multiple concussions are at increased risk of developing pituitary hormonal dysfunction which may in turn contribute to problems of obesity, fatigue, impaired metabolism, depression, sexual dysfunction and a general poor quality of life.
According to Dr. Kelly, the new study will focus on a relatively unexplored area of traumatic brain injury (TBI)--the potential correlation between recurrent concussions and pituitary hormonal dysfunction. More than 1.2 million Americans sustain a TBI annually, the majority of which are cerebral concussions. Repeat concussions have been shown to be a risk factor for neurodegenerative dementing disorders, including mild cognitive impairment and Alzheimer's Disease. However, little is known about the impact of single or multiple concussions on hormonal function and quality of life. Only in the sport of boxing, have a few small studies shown that boxers are at increased risk of developing pituitary failure. In contrast, it is well known that a single severe head injury can lead to pituitary damage and hormonal abnormalities in up to one third of individuals.
The pituitary is a small bean-shaped gland located immediately below the brain and behind the nasal cavity in the skull base; it is connected to the brain by the thin delicate vascular pituitary stalk. Weighing less than one gram, the pituitary is often called the "master gland" since it controls the secretion of the body's hormones. These essential substances when released by the pituitary into the blood stream have a broad range of effects on growth and development, sexuality and reproductive function, metabolism, the response to stress and overall quality of life.
"This research is long overdue," Dr. Kelly said. "Millions of young people and professional athletes participate in sports that put them at risk of concussion; not just football, but also hockey, rugby, soccer, baseball and basketball. We need to know more about how these so-called "minor head injuries" impact their lives in subsequent years, and in particular, whether multiple concussions can lead to pituitary hormonal failure and poor quality of life."
Using the database of the Center for the Study of Retired Athletes at University of North Carolina and in cooperation with the National Football League Players' Association, 90 study participants will be categorized based on the number of concussions they sustained during their NFL career. The retired players will then be assessed utilizing pituitary hormonal blood tests, body composition testing and neurobehavioral, quality of life and sexual function surveys. Retirees found to be deficient in any hormones such as thyroid, testosterone or growth hormone will be treated with physiological replacement doses of the appropriate hormone and will then have repeat quality of life testing. Hormonal testing assays will be conducted by the General Clinical Research Center at Harbor-UCLA Medical Center under the direction of Professor Christina Wang, an endocrinologist and a study co-investigator.
"The problem of sports-related concussions is increasingly recognized as a major contributor to long-term disability in many retired athletes," said Bob Klein, vice president at Saint John's Health Center and a ten-year NFL veteran with the Los Angeles Rams and San Diego Chargers. "However, the potential impact of concussions on quality of life is not well understood. This research will fill that gap in our knowledge. I have spoken with many of my former colleagues in the NFL, and they share my belief in the critical importance of this study."
The Neuro-Endocrine Tumor Center (www.neuro-endo.org) is housed at Saint John's Health Center and the John Wayne Cancer Institute in Santa Monica, California. The Center's focus of activities is the treatment of pituitary tumors, brain tumors, and other neuro-endocrine disorders including pituitary hormonal deficiencies.
The Center for the Study of Retired Athletes at the University of North Carolina works in close affiliation with the National Football League Players Association. Since 2001, the Center has been investigating a spectrum of physical and mental disabilities common to retired athletes. The research team will begin work in July 2008, with initial research results expected in 2010.
Since its founding in 1942 by the Sisters of Charity of Leavenworth, Saint John's Health Center has been providing the patients and families of Santa Monica, West Los Angeles and ocean communities with compassionate, advanced medical care. Saint John's provides a spectrum of treatment and diagnostic services with distinguished areas of excellence in cancer care, cardiac care, orthopedics and women's health. Saint John's Health Center is also dedicated to bringing to the community the most innovative advances in technology and patient care available in a healing environment.
Since 1981, the John Wayne name has been committed by the Wayne family to groundbreaking cancer research in memory of the much-loved actor who died of cancer. The John Wayne Cancer Institute has received worldwide acclaim for advances in understanding the disease, focusing on melanoma (skin cancer), breast, prostate, colon, pancreatic, lung and liver cancer, as well as lymphoma and leukemia. With its unique ability to rapidly turn scientific breakthroughs into innovative approaches to treatment and early detection, JWCI provides immediate hope to cancer patients from around the globe.