Thriving Beyond Treatment: Building Resilience for Lymphoma Survivors
Article Summary
- SMART 3RP Lymphoma is a clinical trial designed to improve survivors’ quality of life after treatment.
- Virtual group sessions teach stress management and healthy routines.
- Sylvester Comprehensive Cancer Center leads advances in survivorship care and Hodgkin lymphoma treatment.
In the quiet after treatment ends, many lymphoma survivors describe life as learning to steer a boat in new waters. The waves are smaller but still rock the hull.
A new, $4 million, National Cancer Institute (NCI) multisite study, SMART 3RP Lymphoma, is designed to steady that boat by teaching survivors practical skills to manage stress, strengthen coping and improve day-to-day quality of life. With groups at Massachusetts General Hospital, Huntsman Cancer Institute and Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, the trial will enroll more than 250 adults within two years of completing curative therapy and offer sessions in English and Spanish to ensure accessibility.
“Resilience isn’t a trait you either have or don’t,” said Frank Penedo, Ph.D., associate director for population sciences, the Sylvester DCC Living Proof Endowed Chair in Cancer Survivorship and director of the Sylvester Survivorship and Supportive Care Institute. Dr. Penedo is site principal investigator at Sylvester. “It’s a skill set, like learning to play a musical instrument. With guided education and practice, survivors can make everyday stress more manageable and restore confidence in their ability to manage their recovery.”
Cancer survivorship brings layered challenges: lingering fatigue, recurrent infections, financial strain and worry about recurrence. Chronic stress compounds these issues, affecting mood, sleep, social connections and even the immune system. The study’s central idea is simple and hopeful. When survivors learn to successfully adapt to challenging life experiences using mental, emotional and behavioral flexibility—the core of resilience—their overall well-being improves. The program approaches resilience as a set of teachable techniques that quiet the body’s stress response, reinforce healthy routines, improve emotional and physical well-being and rebuild confidence in daily life.
A Bold New Era for Survivorship at Sylvester
Sylvester is a national leader in survivorship care, recently launching the Sylvester Survivorship and Supportive Care Institute (SSCI), one of only a handful of dedicated survivorship institutes in the country. This institute brings together multidisciplinary teams to deliver holistic, evidence-based care and drive innovative research, from digital health to community-engaged programs.
“Programs like SMART 3RP Lymphoma are a testament to Sylvester’s commitment to whole-person care,” Dr. Penedo stated. “We aren’t just focused on survival. We’re focused on helping people thrive in every aspect of their lives and the launch of SSCI is helping us do that in a scalable way.”
Advancing Standards of Care for Lymphoma
Sylvester’s leadership in survivorship is matched by its pioneering role in clinical research. Sylvester physician-researcher Craig Moskowitz, M.D., professor in the Hematology/Oncology Division at the Miller School and director of Academic Clinician Development for Sylvester, is known for his work on ICE chemotherapy (ifosfamide, carboplatin, etoposide), a powerful regimen for relapsed or refractory non-Hodgkin lymphoma and the most common treatment combination used. He also helped brentuximab vedotin and pembrolizumab achieve approval for Hodgkin lymphoma and was a part of the research that led to the approval of loncastuximab teserine in 2024.
Dr. Moskowitz’s work has influenced treatment protocols both internationally and at Sylvester. It highlights the cancer center’s commitment to translating research into real-world impact for survivors, ensuring that the latest innovations reach those who need them most. And this is the aim of SMART 3RP Lymphoma, an evidence-based psychosocial intervention that will offer patients a roadmap toward a better quality of life.
What SMART 3RP Lymphoma Offers
Delivered virtually via HIPAA-compliant videoconferencing, the intervention consists of eight 90-minute group sessions. The curriculum blends three evidence-based strands:
• Mind–body practices (e.g., guided imagery, mindfulness, yoga) to elicit the “relaxation response”
• Cognitive behavioral strategies to identify and reframe unhelpful thoughts and reactions
• Positive psychology to cultivate growth, social support and healthy behaviors
A structurally equivalent Health Education Program (HEP) serves as the comparison arm, matching time, contact and weekly home practice while focusing on health behavior education and self-monitoring. The hypothesis is that participants in the SMART 3RP Lymphoma program will experience greater improvements in quality of life than those randomized to the HEP. Specifically, they are expected to show better outcomes in anxiety, depression, physical functioning, stress management/reactivity and social isolation. As these changes enhance resilience, they are expected to further improve quality of life and other secondary outcomes.
Our research is not just about advancing discoveries. It is about ensuring that every survivor has the resources and support backed by rigorous scientific discoveries to reclaim a full, vibrant life after cancer.
Dr. Frank Penedo
Secondary analyses will assess how increases in resilience drive changes in anxiety and depression, physical functioning, stress-management skills, social isolation and hair cortisol, a biobehavioral stress marker. By examining cortisol at six and 12 months, investigators will be able to map psychosocial effects of the program to physiological markers of stress to assess how cumulative stress changes over time.
“As oncologists, we celebrate the end of treatment,” Dr. Moskowitz, co-investigator, said. “But survivorship is a new chapter with its own vocabulary. This program is designed to help patients translate medical recovery into life recovery—fewer sleepless nights, steadier energy, better mood and stronger social ties.”
Looking Ahead
If SMART 3RP Lymphoma improves quality of life and resilience and decreases physiological stress, the team will have a strong template for scalable survivorship support. Because it is virtual, time-matched and bilingual, the model could expand efficiently, reaching survivors who live far from major centers or who juggle work and caregiving. It is like building a durable bridge from treatment to everyday living: solid footings in evidence, accessible paths and space for people to walk at their own pace.
“Our research is not just about advancing discoveries. It is about ensuring that every survivor has the resources and support backed by rigorous scientific discoveries to reclaim a full, vibrant life after cancer,” Dr. Penedo stated.
Tags: cancer research, cancer survivorship, Dr. Craig Moskowitz, Dr. Frank Penedo, lymphoma, Newsroom, Sylvester Comprehensive Cancer Center, Sylvester Survivorship and Supportive Care Institute