Cheryl Ramos has survived four bouts with cancer. She now wants to know more about how the diagnosis and similar stressful events affect the lives of cancer survivors.

The associate professor of psychology at the University of Hawai'i-Hilo is looking for 200 volunteers to participate in a study targeting residents of rural communities who may have limited access to medical care and fewer support networks.

Ramos, 47, who was raised in the former plantation village of Pa'auilo, said cancer survivorship in rural areas is under-researched. Her personal experience has given her "a special passion for this project," she said.

Ramos suffered two episodes of Hodgkin's lymphoma in the 1970s and was treated with high-dose radiation that carried the long-term risk of secondary tumors.

Side-effects of the treatment materialized in 1997 when she was diagnosed with thyroid cancer. In 2003, she learned she also had breast cancer. Ramos underwent a double mastectomy and breast reconstruction on the Mainland.

"Surviving multiple bouts of cancer is a sobering reminder that each day of life is a gift, and that makes any additional knowledge obtained from this research even more meaningful," Ramos said, noting that she is healthy today.

Nationally, there are more than 10 million cancer survivors in the United States, according to the American Cancer Society.

"As survivor rates go up, so too does the interest and concern about the quality of life and related issues that confront the cancer survivor prior to and after their cancer diagnosis," Ramos said.

One goal of the study is to see whether a patient's cancer diagnosis may have been preceded by stressful events, particularly the traumatic loss of a spouse or other close relation.

Ramos said such events could be a predictor of cancer, perhaps because of the effect of extreme stress on the immune system. The study also will consider the effects of financial and psychological burdens tied to seeking treatment far from home.

Ramos hopes to sign up 100 Big Island volunteers who have been diagnosed with cancer within the past year.

They will be asked to fill out a questionnaire on their quality of life before and after diagnosis, stressful life events, traumatic grief, social support and use of complementary and alternative medicine. She also needs an equal-sized sample group with no cancer history.

UH-Hilo provided a seed grant to get her study off the ground, and Ramos said she is hoping to secure more substantial funding from government, nonprofit or private groups.

Reach Christie Wilson at cwilson@honoluluadvertiser.com.