Cunningham Lab

About Dr. Cunningham

Carrie Cunningham (Lubitz), MD, MPH

• Principal Investigator, Mass General
• Associate Professor of Surgery, Harvard Medical School
• Section Head, Endocrine Surgery Unit, Mass General
• Associate Director, Institute for Technology Assessment, Mass General
• Assistant Surgeon, Division of Gastrointestinal and Oncologic Surgery, Mass General

Research Projects

Optimization of Treatment of Patients with Papillary Thyroid Cancer

Thyroid cancer is common and is increasing in incidence, prevalence and societal cost. Yet, the effects of current clinical practice are unknown. Moreover, most of the increased incidence is in low-risk smaller tumors and in younger patients, making the potential for consequences of overtreatment greater. Our group is in the process of developing a comprehensive, dynamic computer simulation model of the U.S. population to evaluate the impact of current interventions and future advancements in the diagnosis, treatment and surveillance strategies on patients with thyroid cancer. We aim to identify those strategies that have the most promise for increasing both length and quality of life. Ultimately, our work can aid in the appropriate allocation of resources while optimizing care and minimizing harm to our patients. Additionally, we plan to integrate our own primary data on risk-stratified treatment strategies and patient-reported quality of life measures into the work. This work is currently funded by an NIH/NCI R37 Merit Award. 

Assessment of Patient-Reported Health Related Quality of Life in Patients with Thyroid Cancer

Given the longevity of the vast majority of patients with thyroid cancer, addressing patient quality of life is essential in assessing treatment and surveillance strategies. Complications of diagnosis and therapy for thyroid cancer have significant impact on patients. These include anxiety, recurrent laryngeal nerve injury (causing permanent hoarseness), hypoparathyroidism (causing parasthesias and need for lifelong calcium/vitamin D supplementation), salivary and lacrimal dysfunction and secondary malignancies from radioactive iodine. Our prior work has shown that conventional generic instruments used to assess the quality of life of patients do not work effectively in the thyroid cancer population. We are therefore in the process of developing a patient-reported quality of life instrument specific to thyroid cancer patients. This is a multi-institutional study supported by the American Cancer Society.

Cost-Effectiveness of Screening Resistant Hypertensive Patients for Primary Aldosteronism

Hypertension affects one in four adults and is the leading cause of heart disease, stroke and death. Resistant hypertensive patients are a subset of patients who remain above target blood pressure on three antihypertensive medications—placing them at an even higher risk. While the majority of patients have primary or essential hypertension, there are also secondary, potentially curable, causes, the most common of which is primary hyperaldosteronism (PA). PA, seen in up to 23% of resistant hypertensive patients, is caused by excess aldosterone released from one or both adrenal glands. Guidelines vary on who and how to screen patients for PA. Our group has developed a decision-analytic model to compare the costs and effectiveness of screening strategies to identify surgically correctable disease in this population. We are currently expanding the model to explore the lifetime secondary differential effects of continued hypertension in primary aldosteronism versus essential hypertension.

Publications

View a list of peer-reviewed publications

Group Members

Research Associates

• Catherine DiGennaro
• Tina Watson