rpci - Roswell Park Comprehensive Cancer Center · rpci ness Elm & Carlton ... “On average, one...

rpciness

Elm & Carlton Streets • Buffalo, NY 14263

NON-PROFIT ORG.U.S. POSTaGe

PaidBUFFalO, New YORk

PeRmIT NO. 61

Vol.

13 |

No

. 1 |

201

0

Sunday, June 13TH, 2010, 1-4pmCANCER SURVIVORS DAY

at Roswell Park Cancer Institute

AND BE A PART OF THE CELEBRATION OF LIFE

Sponsored by

Reservations Required: RSVP by calling 1-877-ASK-RPCI (1-877-275-7724),

or online at www.roswellpark.org/survivorsday

Come for a fun-filled day at the carnival*

Elm & Carlton StsBuffalo, NY 14263

E v E n t D E ta i l S

IRain or shine

IFree parking in the RPCI ramp

I“Fighter” caps for each registered

survivor, courtesy of New Era Cap Co.

*Limit survivor and three guests. No charge to attend this event.

This past February, our President & CEO Dr. Donald “Skip” Trump issued a bold challengeto the staff and faculty of Roswell Park Cancer Institute: Raise $15,000 for cancer researchby March 3 and the hair on his face and head would fall to the barber’s floor.

With the challenge being so intricately knotted to RPCI’s mission – to understand, preventand cure cancer – there was no way that Dr. Trump would be able to hold on to the mustachehe had sported since medical school. If there was one thing of which we were all confident,there was going to be a close shave!

Literally running with scissors, RPCI employees collected a hair-razoring $40,000. Our fearless leader, all too soon to become our hairless leader, joined the hundreds of otherWestern New Yorkers who have courageously and generously gone bald for bucks overthe years. This year, about 20 RPCI staffers (Trump’s Troops) also got buzzed.

The experience, part of the “Goin’ Bald for Bucks” annual fundraiser to support researchat America’s first cancer center, even garnered the attention of the “other” Donald Trump,who sent along a recorded pep talk with this characteristically unsympathetic message:“Better you than me!”

In this issue of Roswellness, you’ll be able to read more about this “hands-on” specialevent that drew a full house of cheering staff, volunteers, patients and visitors. Next year,we’re hoping to double the number of RPCI recruits, while also multiplying the number of community participants.

Also within these pages, we present a comprehensive look at colorectal cancer and thepreventive, diagnostic and treatment approaches being studied and developed by ourmultidisciplinary team of gastrointestinal specialists.

And on a final note…Beginning with this issue, Roswellness will be published only twice a year to help defraythe costs of printing and postage. Each magazine will be a few pages longer so that we’llbe able to cover all bases. We are committed to providing the most current and accurateinformation on cancer, as well as to sharing stories on the inspiring folks who walk throughour doors each day.

Wishing you a happy and healthy spring and summer!

Colleen M. Karuza

Colleen M. KaruzaManaging Editor

F R O M T H E M A N A G I N G E D I T O R

Spring/Summer ’10 | volume 13 | number 1

T A B L E O F C O N T E N T S

Roswellness is published twice a year by the Department of Marketing, Planning and PublicAffairs, Roswell Park Cancer Institute. All rights reserved. No portion of this magazine may bereproduced without written permission of RPCI. Address changes should be sent to Kim Bonds, Development Office, Roswell Park Cancer Institute, Buffalo, NY 14263, or emailedto [email protected]. Suggestions and comments regarding this publication maybe emailed to [email protected] or mailed to Colleen M. Karuza, Director ofPublic Affairs, Roswell Park Cancer Institute, Buffalo, NY 14263.

F E A T U R E2 A Comprehensive Look at Colorectal Cancer10 Anal Cancer13 Targeting the Liver

D E P A R T M E N T S

7 Case StudyFrom Diagnosis through Follow-Up: One Patient’s Experience

18 Been There, Done ThatA Forum Where Patients Share Their Stories

19 Voices CarryEmpowered and Aware

25 Nurses in ActionThey’re Everywhere!

26 Stop the Presses!Wow-Worthy News

30 SparksGen-Y All-Stars

31 Technology BuzzThe Mechanics of Innovation

32 Lab NotesPromising Research from RPCI

41 Nutrition & CancerEating Right

42 Who, When, Where?Our Photo Album

45 FrontlinersCareers at RPCI

CREATIVE STAFF

Managing Editor Colleen M. Karuza

Features Editor/Writer Sue Banchich

Development Editor John C. Senall

Creative Services Director Benjamin Richey

CONTRIBUTING WRITERS Carolyn Byrnes, Kerry Jones, Colleen Karuza, Megan Militello, Amy Zintl

Graphic Production Manager Hillary A. Banas

Photography Benjamin Richey, Bill Sheff

EDITORIAL BOARD

Christine Ambrosone, PhD, Richard Cheney, MD, Stephen Edge, MD, Irwin Gelman, PhD, Maureen Kelly, RN, MS, Richard Matner, PhD,Tracey O’Connor, MD, Michael Zevon, PhD

ADMINISTRATION

President & CEO Donald L. Trump, MD, FACP

Vice President for Marketing, Planning & Public Affairs Laurel A. DiBrog

Vice President for Development Cindy A. Eller

T

D I D Y O U K N O W . . ?

“Colorectal cancer is thethird most common cancerin both men and women,and the third leading causeof cancer-related mortalityin men and women in theUnited States.”

– The National Cancer Institute

2 | roswellness www.roswellpark.org | 3

|

fe

at

ur

efe

at

ur

e|

Who gets colon cancer—and why?

“On average, one in 11 people will be diagnosed with colon cancer,” says Kelli Bullard Dunn, MD, FACS, FASCRS, Chief, Division of Colonand Rectal Surgery, RPCI. “It’s extremely common.”

Confronting the diagnosis, many of her patients “are very concerned thatit’s because of something they did,” she says. “They ask, ‘How could Ihave gotten this? I’ve been a vegetarian all my life; I’ve done everythingright.’ But the disease is linked to several factors—genetics, environment,and, quite frankly, bad luck.”

P R E V E N T I O N“To reduce your risk of colorectal cancer, look at your lifestyle,” advisesJudy Smith, MD, FACS, Medical Director, RPCI. “Adopting a healthylifestyle is one of the best ways to reduce your risk of cancer and manyother diseases as well, including cardiovascular disease.” Get the edge byfollowing these tips:

n Don’t use any tobacco products, and if you smoke, quit now. Smoking has been linked to as many as one in five cases of colorectalcancer. Find the support and guidance you need by calling theNew York State Smokers’ Quitline at RPCI, at 1-866-NY-QUITS (1-866-697-8487), or visit www.nysmokefree.com for more information.

n Limit your intake of alcohol.n Eat a high-fiber diet and reduce your consumption of fats and red

meat. “We know that a Western diet—high in fat and red meat—correlates with colon cancer,” notes Dr. Bullard Dunn. That doesn’tmean you can’t have a cheeseburger once in a while, she adds, but do limit your intake of red and processed meats (such as pepperoniand packaged luncheon meats), and fill up on fruits and vegetables.

n Maintain a healthy weight.n Exercise regularly.

RPCI’s Colorectal Cancer Risk Management Clinic candetermine whether you and your family members are at higher-than-average risk of developing colorectalcancer. If so, you’ll be eligible for specialized servicesoffered at the clinic, including:

n A detailed medical history and physical examn Recommendations for screening tests based

on your risk leveln Genetic consultations and genetic testingn The opportunity to take part in clinical research

studies focusing on new ways of preventing colorectal cancer

The RPCI medical team will work with your own doctorsto help you manage your risk. For more information,call 1-877-ASK-RPCI (1-877-275-7724).

COLON cancer? RECTAL cancer? COLORECTAL cancer?

What’s the difference?The colon and rectum make up the large intestine, which is part of the digestive system. Cancer that begins in the colon or rectum may be called colon cancer, rectal cancer, or colorectal cancer. (The term colon cancer is used most often.)

BY THE NUMBERSThe American Cancer Society (ACS) reports:n About 106,100 new cases of colorectal cancer

were diagnosed in 2009.n Nearly 50,000 people dieof the disease every year.

The good news:death rates are on a steady decline,and the ACS projects that the 2020 death rate willbe 50% lower than the 2000 rate. That forecast isbased on the assumption that more people will takeadvantage of colon cancer screening, fewer peoplewill smoke, consumption of red meat will decline,and more effective chemotherapy drugs will beintroduced.

The fats/red meats connection: WHAT’S THE BEEF?Research suggests that a diet high in red meat and fatty foods canincrease your risk of colon cancer. The link may explain why Americans,who tend to eat a lot of meat and high-fat foods, have higher rates ofcolon cancer than people in countries that consume less red meat and fat.

Personal�history�

of�cancerYou are at higher risk for colon cancer if you have had it in the past.

Medicalhistory

Risk is greater in people who have Crohn’sdisease or ulcerative colitis, or who have hadadenomatous polyps.

Familymedicalhistory

You may be at greater risk if close familymembers have had colon cancer or adenomatous polyps. “Be aware of cancer and other medical history amongyour family members,” advises AnnetteSunga, MD, MPH, Department ofMedicine. “That will help determine your risk level and may put you, your siblings, and your children on a differentscreening schedule.”

Heritage African-Americans have the highest risk ofany ethnic group in the U.S. of developingand dying of colon cancer. Ashkenazim(Eastern European Jews) have one of thehighest risks of colon cancer of any ethnicgroup in the world.

While you can’t change your biological traits, you can take steps to manageyour risk. Talk to your doctor about your personal family medical historyand lifestyle to find out how soon and how often you should be screenedfor colon cancer.

If you’re the keeper of your family’s medical history, “spread the word,” suggests Dr. Sunga.“Let everybody in your family know, ‘We have afamily history of this.’ You’ll help not only yourselfbut your family and your family’s families.”

To ask about setting up a consultation with the Clinical GeneticsService at RPCI, please fill out the online questionnaire atwww.roswellpark.org/cgs or call RPCI ’s Cancer Information Program at 1-877-ASK-RPCI (1-877-275-7724).

[ ]

Calculate your risk online

The National CancerInstitute (NCI) now offersan online assessment tool

to help people between the ages of50-85 calculate their personal risk of colorectalcancer by answering a few questions. The toolwas developed by an NCI team co-directed byAndrew Freedman, PhD, who earned his doctoraldegree from the Roswell Park Graduate Divisionof the University at Buffalo.

Find the Colorectal Cancer Risk Assessment Toolat www.cancer.gov/ColorectalCancerRisk.

Some biological traits are also associatedwith higher risk of colon cancer.

Know your biology

Age Cancer risk rises with age; more than 90% of all cases of colon cancer occur in people over age 50.

Managing above-average risk

A COMPREHENSIVE LOOK AT COLORECTAL CANCER

RISKYBUSINESS

www.roswellpark.org | 54 | roswellness

fe

at

ur

e

| |

fe

at

ur

e

Screening Tests

When? What? Why?Unless you’re at higher-than-average risk for colon cancer (see p. 3), you should begin regular colon cancer screening at age 50.

WHAT ARE THE OPTIONS?

Screening colonoscopy, the best method for inspecting theentire colon and rectum, performed once every 10 years.A doctor will use a light and special camera on a flexible tube,inserted through the rectum, to examine the lining of your colon.Before the procedure, your doctor will give you medications tohelp clear waste from your colon, and you’ll be asked to follow aliquid diet. During the procedure, you will be mildly sedated.

Colonoscopy makes it possible to detect and remove polyps—abnormal growths that stick out from the surface—and flat lesions,or areas of abnormal cells, so they won’t develop into colon cancer. Colonoscopy can also detect colon cancer in the earlystages, when treatment will be most effective.

Fecal occult blood test (FOBT) or fecal immunochemical test(FIT), performed once a year, plus flexible sigmoidoscopy,performed every five years. FOBT and FIT involve collectingsmall stool samples (at home), which are then tested to detect colorectal cancer. If the tests show abnormal results, a colonoscopy will be needed to provide more information. You will be asked to avoid certain foods before doing theFOBT. Note that the FOBT and FIT must be done once a day for three days in a row, every year.

Flexible sigmoidoscopy, used along with FOBT and FIT, issimilar to a colonoscopy, but is used to examine only the lowerpart of the colon.

To schedule a screening colonoscopy at RPCI, call 1-800-ROSWELL (1-800-767-9355).

Signs and Symptoms

Early-stage colorectal cancer does not always cause symptoms,and that’s why screening is so important. If you experience anyof the following symptoms, make an appointment to see yourdoctor for evaluation:· A change in bowel habits—for example,

diarrhea or constipation· Blood in your stool or rectal bleeding· Abdominal discomfort, such as pain or cramping· The sensation that you need to have a bowel movement,

even after you have had one· Unexplained weight loss· Feeling weak or tired all the time

When just a few more ounces of liquid stand between youand your colonoscopy, skipping them is no big deal, right?Swallow that thought! If you don’t follow your doctor’sprep instructions exactly, you may have to reschedule theprocedure and go through the whole prep all over again.

Why? During a colonoscopy, the doctor uses a specialcamera to search the walls of the colon for polyps andother areas of abnormal cells so they can be removedbefore they turn cancerous. But if you haven’t followed thepre-colonoscopy instructions, those areas can be hiddenby waste matter left behind in your colon. Undetected,they may develop into cancer.

So stick to the liquid diet, follow your doctor’s pre-colonoscopy instructions carefully, and raise your glass—over and over—to your own good health, until your colonis squeaky clean and ready for its close-up.

Bottoms

UP! You may heard about virtual colonoscopy (VC), a non-invasiveprocedure that uses computerized tomography (CT), a type ofmedical imaging, to detect colorectal cancer and precancerouspolyps. This method was developed as an alternative to regular

colonoscopy and flexible sigmoidoscopy. It’s hoped that peoplewho don’t want to have a colonoscopy will be more willing to

be screened with VC—a move that ultimately could lead to fewerdeaths from colorectal cancer.

But know the details: VC requires the same pre-test bowel preparation(medications and liquid diet) as colonoscopy, and if VC reveals any

polyps or flat lesions, traditional colonoscopy will have to be doneanyway so those areas can be removed. And be aware that

health insurance coverage for VC varies among providers; without adequate scientific data to prove its reliability, currentlythe procedure is not covered by Medicare for colorectal cancer screening.

THE BOTTOM LINEQ: SO WHICH SCREENING METHOD IS BEST?

A: “The best test is the test you do,”says Annette Sunga, MD, MPH, of RPCI’s Gastrointestinal Team. “Peopleare free to choose the method they want, as long asthey do it faithfully and follow the guidelines.”

VIRTUALColonoscopy?

What about

C O L O R E C T A L C A N C E R E V E R Y T H I N G Y O U S H O U L D K N O W

“

New “App” for Robot-Assisted Surgery

Patients with colorectal cancer may require surgery, and RPCI offersboth traditional “open” and minimally invasive laparoscopic androbot-assisted surgery as treatment options for the disease. “Themajority of the patients I see are candidates for minimally invasivesurgery,” says Kelli Bullard Dunn, MD, FACS, FASCRS, Chief,Division of Colon and Rectal Surgery, RPCI. Minimally invasive surgery is associated with less blood loss and faster recovery than open surgery, and because the small incisions result in less scar tissue,it is easier to operate a second time if necessary.

Robotic technology in particular has taken colorectal surgery to anew level at RPCI. “Robotic technology is absolutely superior foroperating in the pelvis,” adds Dr. Bullard Dunn. A miniature cameragives the surgeon a magnified, three-dimensional view of the operating site, making it “much, much easier to see down into the pelvis. If you think anatomically, the pelvis is a deep hole, and,especially in heavy men, it is very narrow. You can’t put your headinto the pelvis, but the camera on the robot can see all the waydown, and it can swivel inside the pelvic cavity. The improved visionallows for greater accuracy of tumor removal and nerve preservation.”

Dr. Bullard Dunn also points out that RPCI’s surgical team includesboth surgeons and nurses who specialize in robot-assisted surgery.

R O B O T I C

T E C H N O L O G Y

I S A B S O L U T E LY

S U P E R I O R F O R

O P E R A T I N G I N

T H E P E LV I S . ”

FOR MORE INFORMATION

ABOUT COLORECTAL CANCER, VISIT

www.roswellpark.orgor call

1-877-ASK-RPCI (1-877-275-7724).

DIAGNOSIS Colonoscopy revealed a tumor in the rectum

and biopsies showed that it was rectal

adenocarcinoma (cancer).

EVALUATION Patient underwent a multidisciplinary evaluation

to determine the extent of her disease and

guide treatment decisions. CT of the chest,

abdomen and pelvis showed that the cancer

had not spread beyond the rectum. Endorectal

ultrasound showed that the tumor had grown

through the rectal wall (stage T3).

[CASE STUDY]R E C TA L C A N C E R

From Diagnosis through Follow-Up: One Patient’s Experience

ADVANTAGES OF

ROBOT-ASSISTED SURGERY

Surgery using a robot to enhance precision is

used increasingly to perform pelvic surgery.

Although the surgeon still performs the surgery,

the robotic arms are more precise, and the

magnified view provided by the camera allows

the surgeon to see pelvic structures up close.

This minimally invasive approach allows smaller

incisions, thus improving the appearance of the

surgical site while decreasing pain and shortening

the hospital stay.

THE MULTIDISCIPLINARY APPROACH

Rectal cancer requires the care of specialists in

surgery, medical oncology and radiation oncology.

While some very early rectal cancers may be treated

with surgery alone, more advanced tumors require

the addition of chemotherapy and radiation,

either before or after surgery.

The colorectal cancer team evaluates each patient

and recommends a treatment regimen based on

the individual’s characteristics. The team approach

allows patients to obtain all of their care at RPCI.

TREATMENT RPCI’s colorectal cancer team recommended preoperative chemotherapy and

DECISION radiation, followed by surgery to remove the rectal cancer. The patient was also

& CLINICAL offered the opportunity to enroll on a clinical trial designed to evaluate the addition

COURSE of new chemotherapy agents to traditional therapy. She elected to participate and

completed six weeks of chemotherapy and radiation.

Six weeks after completing chemotherapy and radiation, she underwent robot-

assisted surgery to remove part of the rectum. She was discharged from the

hospital five days after surgery.

Specialized gastrointestinal pathologists examined the tumor and, using special

stains, determined that the patient has a genetic mutation that led to her cancer.

She was referred to the RPCI Genetic Counseling Service for further testing. This

is important, because the mutation will affect both the patient and her family.

After recovering from surgery, she went back to the medical oncology team to

complete an additional six months of chemotherapy. She is currently doing well.

PROFILE54-year-old woman,

otherwise healthy,

developed rectal

bleeding.


fe

at

ur

e

| |

fe

at

ur

e

Dr. Kelli Bullard Dunn


|

fe

at

ur

e

Inthe 1980s, RPCI pioneered a treatment forcolorectal cancer that combined 5-FU(fluorouracil)—a drug that stops cancer cells

from growing and dividing—with leucovorin (folinicacid), which boosts the power of 5-FU. Giving the two drugs together, instead of 5-FU alone, raised the treatment response rate from 10% to 20%. Today 5-FU plus leucovorin—used in combination with otheragents—is still the backbone of first-line chemotherapyin patients who have colorectal cancer.

Unfortunately, most patients with advanced colorectalcancer eventually become resistant to 5-FU. RPCIresearchers are studying whether a novel drug, vorinostat, can overcome that resistance. The newcombination is being evaluated in patients enrolled on a Phase II clinical trial underway at RPCI under the direction of Marwan Fakih, MD, Chief ofGastrointestinal Oncology.

Dr. Fakih is also principal investigator on a study focusingon high-dose cetuximab (Erbitux®), a monoclonal antibody usually given along with the drug irinotecan,for the treatment of metastatic colon cancer. The studyis testing whether higher doses of this targeted agentcan overcome resistance to FDA-approved dosing.

While gene testing available at RPCI can identifypatients who are most likely to benefit from Erbitux,some patients do not respond to the therapy, notesDr. Fakih. “There is some evidence that in selectedpatients, high doses of Erbitux may be more effectivethan standard doses,” he says. The trial in progress at RPCI is investigating “whether high doses of Erbitux with irinotecan can overcome resistance in patients who have failed standard doses of that drug combination.”

Neal Wilkinson, MD, MPH, FACS, Department ofSurgery, notes that, in addition to new drugs and newcombinations of drugs, investigators are looking atwhether outcomes change when surgery, radiation,and chemotherapy are given in a different order.

For example: “What’s the best order for chemotherapyand liver surgery?” he asks. Usually chemotherapy isgiven after surgery “to treat any disease left behind.But I think the future will be to give the chemotherapybefore the operation and remove the tumor after it’sdead. My interest is in pushing that envelope as far aswe can, with the ultimate goal that someday we canachieve a cure without an operation.”

HIPEC Offers Hope(and cure, in some cases!)Patients with carcinomatosis—metastatic cancer that has spread throughoutthe abdomen—may be potential candidates for cytoreduction and hyper-thermic intraperitoneal chemoperfusion (HIPEC). For patients with isolatedcolorectal cancer carcinomatosis that can be treated with cytoreduction,HIPEC may lead to a cure in 25-40% of cases. “Even in patients who arenot cured, cytoreduction with HIPEC can still improve survival,” say JohnM. Kane III, MD, FACS, Chief, Division of Sarcoma and Melanoma.

The treatment begins with surgery to remove all visible tumors, followedby circulation of heated chemotherapy drugs throughout the abdominalcavity. Because the drugs are restricted to the abdomen, with little beingabsorbed into the bloodstream, very high doses can be used to kill cancercells more effectively, while reducing the drugs’ side effects on healthy tissues and organs.

Cytoreduction/HIPEC is also used for the treatment of mesothelioma,some types of cancer of the appendix, and occasionally for ovarian cancerthat has recurred. Patients come to RPCI from across the U.S. and Canadafor treatment with cytoreduction and HIPEC.

Chemo-SAVVYRPCI Clinicians Take Drug Therapies to the Next Level

fe

at

ur

e

|

“Someday, we hope to achieve a cure

without an operation.”

Arecent research study led by Annette Sunga, MD, MPH,Department of Medicine, examined vitamin D levels of 315 RPCIcolorectal cancer patients, finding that chemotherapy significantly

increased vitamin D deficiency. The conclusion: Patients with colorectalcancer, especially those receiving chemotherapy, should be considered for aggressive vitamin D replacement strategies.

For information about current RPCI clinical trials for colorectal cancer, visit www.roswellpark.org/clinicaltrials or call 1-877-ASK-RPCI (1-877-275-7724).

Are genetic changes key to vitamin D response?Research led by Josephia Muindi, MD, PhD,Department of Medicine, suggests that geneticchanges can predict a colorectal cancer patient’sresponse to vitamin D-based chemoprevention and treatment.

Studying 50 patients with colorectal cancer who received daily vitamin D supplements over the course of a year, RPCI researchers discoveredthat vitamin D deficiency was common among thepatients at the beginning of the study—and thatlevels of the vitamin varied widely among patientsin the group even after they received supplements.

Researchers also identified a genetic change in the vitamin D binding protein (rs4588 SNP in DBPgene) that could explain the differences in vitaminD levels. Supplements raised the level of vitamin Din all patients on the study, but levels rose moreslowly among those who were undergoing activechemotherapy.

“Genetic changes in the vitamin D-metabolizingproteins may help explain, in part, the vitamin Ddeficiency in colorectal cancer patients,” says Dr. Muindi. Marwan Fakih, MD, co-investigatoron the study, adds, “By understanding the genesthat regulate vitamin D absorption, transportationand metabolism, we hope to improve patients’response to vitamin D-based prevention programsand treatment regimens.”

Because high doses of vitamin D can be toxic, do not take supplements without the adviceand supervision of your physician.

Vitamin D-ficiency?


Dr. Marwan Fakih, with patient

Dr. Youcef Rustum (left), part of the team that pioneered 5-FU and leucovorin for colorectal cancer.

Dr. Sunga, with Martin Mahoney, MD, PhD, Departments of Health Behavior and Medicine

10 | roswellness

fe

at

ur

e

| |

fe

at

ur

e

The Low-Down on that “Other” Lower GI Cancer

The death of actress Farrah Fawcett focused public attention on anal cancer, a relativelyrare lower gastrointestinal cancer. But while only 5,290 new cases are diagnosed annually,that number has been growing for several years. Anal cancer is more common in womenthan men, and most people are in their early 60s at the time of diagnosis.

CausesMost cases of anal cancer are linked to infection with the sexuallytransmitted strains of human papillomavirus (HPV). “It’s very similar tocervical cancer,” explains Kelli Bullard Dunn, MD, FACS, FASCRS,Chief, Division of Colon and Rectal Surgery, RPCI.

RISK FACTORS INCLUDE:· Infection with HPV· Infection with human immunodeficiency

virus (HIV), the virus that causes AIDS· Lowered immunity, often as a result of taking

immune system-suppressing drugs to prevent organ rejection after a transplant

· Having multiple sexual partners· Smoking

SymptomsSEE YOUR DOCTOR IF YOU HAVE ANY OF THE FOLLOWING:

· Bleeding, itching, and/or pain around the rectum (These symptoms may also be associated with hemorrhoids.)

· A change in the diameter of your stool· Unusual discharge from the anus· Swelling around the anus or groin· A sexual partner with HPV infection

Prevention· Take steps to avoid being infected with

HPV and HIV. For more information, visitwww.cdc.gov/STD/HPV/STDFact-HPV.htm#prevent.

· Don’t smoke. If you smoke, quit now.· Talk to your doctor about whether you

should have an anal Pap smear.

C O L O R E C T A L C A N C E R / T H E A N U S E V E R Y T H I N G Y O U S H O U L D K N O W

The anus is the opening at the lower endof the intestines. The anal canal is the tubethat connects the rectum to the anus andthe outside of the body.

TREATING PRECANCEROUS LESIONSIn the same way that polyps and areas of abnormal cells can be removed from the colon to preventthem from developing into cancer, precancerous (dysplastic) cells detected through screening can beremoved from the anus to prevent anal cancer. Treatment for anal dysplasia has come a long way inrecent years: in the past, it involved removing all the skin around the anus and creating an ileostomy, in which waste matter is diverted from its usual exit through the anus to an artificial opening in theabdomen, where it is collected in a bag.

But RPCI now offers high-definition anal microscopy, which makes it possible to remove precancerousareas with pinpoint precision, sparing healthy tissue and leaving the anus intact.

“Chemotherapy

and radiation

alone will cure

70-80% of all

patients, and

they will never

require surgery,

but they will

need close

follow-up.”

www.roswellpark.org | 11

Detection· Anal Pap smear:

Similar to a cervical Pap smear for women, thistest involves brushing the anal area to collectcells for examination. If anything suspicious isdetected, high-definition anal microscopy canbe used to remove those areas to preventthem from becoming cancerous.

Consider having an annual anal Pap smear if youare infected with HPV, if you are HIV-positive, ifyou are a man who has had sex with other men,or if you are a woman who has had an abnormalPap smear test result in the past.

Although the test is not available everywhere,Dr. Bullard Dunn notes that “a number of outstanding primary care physicians in thecommunity screen HIV-positive patients withannual anal Pap smears.”

· Digital rectal examination (DRE): Your healthcare provider inserts a lubricated,gloved finger into the lower part of the rectumto feel for lumps.

· Anoscopy: A short, lighted tube called an anoscope isused to examine the anus and lower rectum.

· Proctoscopy:A short, lighted tube called a proctoscope isused to examine the rectum.

· Endo-anal or endorectal ultrasound:A probe is inserted into the anus or rectum toproduce an image created with sound waves.

Treatment“Anal cancer is very different from rectal cancer interms of how we treat it,” says Dr. Bullard Dunn.“Chemotherapy and radiation alone will cure 70-80% percent of all patients, and they will neverrequire surgery, but they will need close follow-up.

“Patients who get a complete response withchemotherapy and radiation do very, very well,and the disease will recur in only a few cases,”she adds. “But if the disease doesn’t respond totreatment, it’s a more aggressive tumor, andthose patients tend to do very poorly.”

In cases involving either precancerous conditionsor cancer linked to sexually transmitted disease,both the patient and the patient’s sexual partnermust be treated for the infection. Notes Dr.Bullard Dunn: “If the partner is not treated, thepatient will get reinfected.”

TREATMENT OPTIONS OFFERED AT RPCI FOR ANAL CANCER

n Conventional surgery, as well as robot-assisted surgery

n Chemotherapyn Radiation, including “dose-painted” image-modulated radiation therapy (IMRT) (See related article, p. 12)

Medical Director and GI Surgeon Dr. Judy Smith in RPCI’s endoscopy suite


|

fe

at

ur

e

12 | roswellness

fe

at

ur

e

|

For more information about dose-painted IMRT for the treatment of anal cancer and other GI cancers,

call 1-877-ASK-RPCI (1-877-275-7724).

Most patients with anal cancerreceive radiation as part of theirtreatment plan, but the anus is

“a very sensitive area of the human body,almost like the fingertips,” notes GaryYang, MD, Director, GastrointestinalRadiation Medicine, RPCI. That’s of special concern, because radiation canburn the skin and cause other side effectsthat can bring treatments to a halt. “Andif the patient has to take a break duringtreatment, you’re giving the tumor abreak, too,” says Dr. Yang. “You want to minimize interruptions.”

Now, using “dose-painted” intensity-modulated radiation therapy (IMRT), RPCIis among only a handful of centers inNorth America that can precisely targetthe anal tumor with high-dose radiationwhile minimizing the exposure of healthytissue nearby. While IMRT is used widelyfor treating other types of cancer, “it hasnot been implemented for anal cancer

[at most institutions], due to the level oftechnology and support it requires,” says Dr. Yang. “You can have a top-of-the-line machine, but you also need highly experienced cancer specialists,dosimetrists, physicists and support staff working together to determine the best treatment plan.”

Dr. Yang and his RPCI team create a cus-tomized plan for each patient, deliveringradiation beams of varying strengths, forvarying lengths of time, to different areasof the tumor site. The patient remains stationary while the Trilogy™, the image-guided radiation therapy system, rotatesall the way around the body, bombardingthe tumor from several angles.

RPCI first offered the treatment in 2007 as part of a clinical trial, and stillprovides it through a clinical trial for eligible patients with anal cancer. Patientoutcomes tracked at RPCI since 2007

show that dose-painted IMRT “providesexcellent tumor coverage and reducesdiarrhea, bowel obstruction, and damageto the skin and small bowel, comparedwith traditional radiation treatment,”notes Dr. Yang.

“We can spare the anal sphincter so apatient doesn’t have to have a colostomybag,” he adds. “With a combination ofchemotherapy and dose-painted IMRT,75% of patients should be able to avoidlifelong colostomy resulting from anal surgery. There’s better quality of life, and a better outcome, because there are no interruptions to treatment.”

PAINTING a better

quality of life

Above, Dr. Gary Yang, with Leayn Flaherty, RPA-C,and the Trilogy Machine; at right, Dr. MatthewPodgorsak, Chief Medical Physicist, with Dosimetrystudents

“With a combination of

chemotherapy and dose-painted IMRT, 75% of patients should

be able to avoid lifelong colostomy resulting from anal surgery. There’s

better quality of life, and a better outcome, because there

are no interruptions to treatment.”

WHAT DOES THE LIVERHAVE TO DO WITHCOLORECTAL CANCER?

Colorectal cancer may spreadto the liver, an organ that purifies the blood and helpsfight infection. In fact, at thetime of diagnosis, up to 20-25% of colorectal cancerpatients already have livertumors, notes Boris Kuvshinoff,MD, MBA, FACS, Departmentof Surgical Oncology, RPCI.

Even if liver tumors are notpresent at diagnosis, theycan develop during follow-upafter treatment of the primarycancer. But even then, there’shope: “Patients with colorectalcancer that metastasizes to theliver can still be cured,” says

Dr. Kuvshinoff. “If you resect[surgically remove] the livertumors—and you can removethem all and leave the patientwith a healthy amount of normal liver—the patient doeshave a chance for a cure. Inproperly selected patients, you can have about a 50%chance of five-year survival.”

Unfortunately, about 75% ofpatients with liver tumors willnot be able to undergo surgery,due to other medical condi-

tions, or the size and locationof the tumors. And because theliver is dense with blood ves-sels—including the large hepaticartery and the portal vein—thereis a risk of significant bleedingin patients who can have surgery.Those are just two reasons“very few people want to takecare of liver tumors,” points out RPCI’s Surgeon-in-Chief,William Cance, MD, FACS.

“Liver surgery is fairly complex,”agrees Dr. Kuvshinoff. “Typicallyit’s done by surgeons who havehad additional training and afocus in that area. You need todo a lot of it, and often. It is a complex surgery, so you defi-nitely want to do it in a settingwhere you have good supportfrom an anesthesia team,

surgical team, Intensive CareUnit team, and interventionalradiology team.”

Patients with liver tumors haveaccess to a range of treatmentoptions at RPCI, where a LiverTumor Center is currently indevelopment. The Center willunite advanced technology,novel therapies, and theexpertise of clinicians fromSurgery, Medicine, Radiology,and Radiation Medicine.

“We can introduce treatmentsthat are novel to this field,including some that are veryclose to being offered throughclinical trials,” says Dr. Cance.

THE “PROTECTIVEFORCE FIELD” OF PROTECTANS

Of special interest is a class ofdrugs called protectans (seerelated article, p. 32) underdevelopment in the lab ofAndrei Gudkov, PhD, DSci,Senior Vice President of BasicScience and The GarmanFamily Chair in Cell StressBiology at RPCI.

Dr. Cance anticipates that protectans, currently beingstudied in experimental

models, “will have a profoundimpact on liver surgery.” The drugs cause liver cells to surround themselves with “a protective force field thatseals them off and makes them very resistant to noxiousstimuli,” explains Dr. Cance.“They protect against radiationand trauma from surgery.

“Our hypothesis is that if wecan give these drugs to apatient prior to liver surgery, wecan perform a more extensiveliver resection, more safely.”

The drugs’ potential may alsoextend beyond cancer care,preserving and protectingorgans before and during transplantation.

Targeting the liverNew Liver Tumor Center

unites technology and expertise

“Patients with colorectal cancer that metastasizes to the liver can still be cured.”

C O L O R E C T A L C A N C E R / T H E A N U S C O L O R E C T A L C A N C E R / T H E L I V E R

14 | roswellness

fe

at

ur

e

|

Radiofrequency Ablation (RFA)A probe, inserted into the tumor, springs open like an umbrellaand then emits radio waves that heat the tissue, killing the cancercells. RFA is a minimally invasive technique, performed as an outpatient procedure. The FDA notes that “RFA may be betterthan other ablative techniques because it is fast, easy, predictable,safe, and relatively cheap.” It is generally performed as an outpatient procedure.

Microwave Ablation Similar to RFA (see above), this minimally invasive procedure usesan antenna, inserted into the tumor, to emit microwaves that heatand kill tumor cells.

Selective Internal Radiation Therapy (SIRT)SIRT may be an option for patients with extensive metastatictumors in the liver. Millions of microscopic, radioactive beads aresent through the large artery in the liver to the tumors, where thebeads are trapped, log-jam style, in the narrow blood vessels thatsurround the tumors. There they emit very high doses of radiation,which gradually fades away over several days. SIRT is used eitherwith chemotherapy or after chemotherapy has failed.

SIRT is used to extend the patient’s survival, with limited sideeffects. Clinical research studies in Australia and Asia have docu-mented cases in which SIRT, used along with chemotherapy,shrank tumors enough to make surgery—and a cure—possible.

And on the Horizon...Boris Kuvshinoff, MD, MBA, FACS, Department of Surgery,says RPCI is taking steps toward offering isolated liver perfusion,which delivers high doses of chemotherapy directly to the liverwhile limiting the exposure of healthy tissue. Few centers in thecountry offer this treatment, which RPCI would provide through aclinical trial.

RPCI is laying the groundwork for providing TheraSphere®, a type of selective internal radiation therapy (SIRT) delivered bymicroscopic glass beads. This treatment would be availablethrough a clinical trial, adding a second treatment option to thecurrent method RPCI offers of delivering SIRT via resin beads,called SIR-Spheres®. Both types of SIRT are used for colorectalcancer patients whose disease has spread to the liver and whocannot undergo surgery.

Garin Tomaszewski, MD, Director of Interventional Radiology, isevaluating the benefits of LC Beads™ (drug-eluting beads) fortreating colon cancer that has metastasized to the liver. LC Beadsare injected into the blood vessels that feed the tumors, effectivelystarving them of oxygen while completing the one-two punchwith chemotherapy drugs. RPCI currently uses LC Beads to carrythe drug Adriamycin® to neuroendocrine tumors and tumors thatoriginate in the liver.

A glimpse at today’s

therapies andtomorrow’s

promiseAlong with surgery to remove liver tumors, RPCI currently offers these

treatments for patients with colorectal cancer that has spread to the liver.

Laparoscopic (minimally invasive) liver resection is currently possible in about 25% of patients who are able to have surgery.“The majority of liver surgeries in the U.S. are done open, with a wide incision,” explains RPCI surgeon Dr. Boris Kuvshinoff.“RPCI was one of the first centers to adopt the laparoscopicapproach. With minimally invasive surgery, we can shorten thepatient’s hospital stay and decrease recovery time afterward.”


|

fe

at

ur

e

RPCI’s Gastrointestinal Teamis working on a systemdesigned to enable surgeonsto perform surgery on apatient “virtually” beforeactually entering the operat-ing room. The goal: creatingthree-dimensional CATscans showing the precise

locations of the liver, the tumors and the blood vessels. Duringthe actual surgery, those images will show the location of thescalpel in relation to those structures, making it possible to removetumors more precisely, reduce the risk of bleeding, and providebetter outcomes for patients.

Virtual surgery

before thereal thing

The minimally

invasiveapproach

Improved chemotherapies are making it possible for more colorectal cancer patients to undergo surgery for removal ofliver tumors, reports Dr. Boris Kuvshinoff. The types ofchemotherapies administered at RPCI by Dr. Marwan Fakih,Chief of Gastrointestinal Oncology, and his team often canresult in a 70% response rate for patients, “and that’s very good news for a liver surgeon,” says Dr. Kuvshinoff. “Tumorsthat previously were too large to be removed surgically can now be shrunk with chemotherapy. So more patients withmetastatic liver tumors can now have successful liver surgery. In some cases, that makes surgery doable in a patient who mightnot otherwise have been a candidate.”

Dr. Kuvshinoff emphasizes that it’s important for the patient’smedical oncologist, who oversees the chemotherapy part oftreatment, to work closely with the surgeon who will remove anymetastatic liver tumors. “All the chemotherapy drugs can affecta normal liver,” he explains. “You don’t want the patient to geta lot of chemotherapy over a long period of time that mightharm the liver, making surgery riskier or leading to more compli-cations after surgery. Together, the medical oncologist and surgeon can come up with a plan to give enough chemotherapyto shrink the tumor but not cause too much liver damage.

“The bottom line is, for colorectal cancer, chemotherapy plussurgery results in the best outcomes, and we do cure somepatients with liver surgery. The goal is to try to shrink the tumorswith the chemotherapy—or, if the tumors can be removed surgically, to remove them right from the get-go and then give chemo to try to prevent the disease from coming back.

“We’re going for the cure. We’re trying to hit the home run.”

How chemotherapy and surgery

work together

C O L O R E C T A L C A N C E R / T H E L I V E R E V E R Y T H I N G Y O U S H O U L D K N O W

Dr. Boris Kuvshinoff


|

fe

at

ur

e

16 | roswellness

fe

at

ur

e

|

AtRoswell Park Cancer Institute, patients with colorectal cancerbenefit from care that’s coordinated and delivered in onelocation, notes Dr. Kelli Bullard Dunn. Members of the

team—from Surgical Oncology, Medical Oncology, Radiology, and RadiationMedicine—“provide that care together. We have multidisciplinary conferencesduring which we review every patient’s case, and we have clinics right next toone another.

“A large number of patients with rectal cancer will need multimodality therapy—chemotherapy plus radiation, then surgery, then chemotherapy aftersurgery,” she adds. “All of those treatments are coordinated by our dedicatedcolorectal team, so you don’t have to see your surgeon at one office anddrive across town to see your medical oncologist and drive somewhere elseto see your radiation oncologist. We have it all here, and often we can getsame-day consultations, so there’s no delay in starting therapy.”

TREATMENT OPTIONS OFFERED AT RPCI FOR COLORECTAL CANCER

3 Robot-assisted colectomy (removal of all or part of the colon) and rectal surgery

3 Laparoscopic colectomy3 Open colectomy 3 Chemotherapy, including Erbitux® targeted therapy for disease that has

spread beyond the colon—plus pre-treatment K-RAS gene testing todetermine whether the patient is likely to benefit from Erbitux

3 External radiation3 Clinical trials3 Palliative care, to relieve pain and provide the highest quality of life

possible for patients whose disease cannot be cured

FOR DISEASE THAT HAS METASTASIZED, OR SPREAD3 Open or laparoscopic liver surgery 3 Portal vein embolization prior to liver surgery3 Radiofrequency ablation (RFA) 3 Selective internal radiation therapy (SIRT)3 Microwave ablation 3 Hyperthermic intraperitoneal chemotherapy (HIPEC)

Coordinatedcare inone location

RPCI

RPCI ’s Gastrointestinal (GI) Team provides highly specialized care for patients with colorectal and anal cancer, including those with late-stage disease. Patients have access to the newest prevention, diagnostic, and treatment approaches and may have the opportunity to participate in clinical trials. For more information on treatment options offered at RPCI, please call 1-877-ASK-RPCI (1-877-275-7724).

Setting the National Standards in Colorectal Cancer Care

RPCI faculty are among the experts who help developNational Comprehensive Cancer Network (NCCN) guidelines that specify the best ways of preventing, detecting and treating different types of cancer. Based on scientific data, the NCCN guidelines are the mostwidely used standards for cancer care.

Kelli Bullard Dunn, MD, FACS, FASCRS,Chief, Division of Colon and Rectal Surgery, serves on the NCCN’s Colon Cancer Screening Panel.

Marwan Fakih, MD, Chief, Gastrointestinal Oncology, serves on the NCCN Guidelines Committees that oversee the treatment guidelines for colon, rectal, and anal cancer.

Visit www.nccn.org for more information. = NCCN Cancer Centers

Meet the Gastrointestinal (GI) Team

Left to right:William Cance, MD, FACS, SurgeryKelli Bullard Dunn, MD, FACS, FASCRS, SurgeryMarwan Fakih, MD, MedicineJohn Gibbs, MD, FACS, SurgeryJorge Gomez, MD, Radiation MedicineNikhil Khushalani, MBBS, Medicine

Boris Kuvshinoff, MD, MBA, FACS, SurgeryCharles LeVea, MD, PhD, PathologyAlan Litwin, MD, Diagnostic RadiologyPeter Loud, MD, Diagnostic RadiologyWen Wee Ma, MBBS, MedicineHector Nava, MD, Surgery and Endoscopy

Remedios Penetrante, MD, PathologyMichael Schiff, MD, FACP, EndoscopyJudy Smith, MD, FACS, Surgery and EndoscopyAnnette Sunga, MD, MPH, MedicineNeal Wilkinson, MD, MPH, FACS, SurgeryGary Yang, MD, Radiation Medicine


18 | roswellness www.roswellpark.org | 19

|

vo

ic

es

c

ar

ry

E M P O W E R E D A N D A W A R E

NFL Hall-of-Famer Mike Haynes thought he was in perfect health—nothing to worryabout. But after taking advantage of free

screening offered as part of the 2008Pro Football Hall of Fame induction,

he was referred for further testingand found out he had prostate

cancer. Only later did he learnthat his grandfather had diedof the disease, which strikes

more African-American men thanCaucasian men.

Following treatment, Mr. Haynes wasinspired to educate other men about prostate cancer and theimportance of early detection. “My wife and I wanted to get theword out, to increase awareness, encourage people to talk totheir doctors and know their own health history,” he says.

In recognition of his public education efforts, Mr. Haynes was honored with the Gilda Radner Courage Award duringRPCI’s 19th annual All-Star Night, presented by HSBC last fall at Shea’s Performing Arts Center. More than 400 guestsattended the event, which raised $345,000 to support innovative cancer research and the Western New York Robotic Surgical Center at RPCI.

Mr. Haynes recalls that, after undergoing robotic prostatec-tomy, he joined the American Urological AssociationFoundation, the NFL and other pro football players, both past and present, in launching the campaign “Know Your Stats About Prostate Cancer” (www.KnowYourStats.org).The campaign helps spread the word through public serviceannouncements at NFL stadiums and nationally televisedinterviews.

“People need to talk about this more,” says Mr. Haynes. “I don’t think men know the importance of catching the disease early, and that it’s treatable. If it’s caught early, your life can be pretty normal.”

Also on stage at All-Star Night: James Marshall, PhD, SeniorVice President for Cancer Prevention and Population Sciences,who received the Thomas B. Tomasi, MD, PhD AchievementAward for his far-reaching work in cancer prevention.

Ride, Captain, RideRoswell Park Cancer Institute and prostate cancer patientsacross Western New York lost a dear friend and championwith the death of William McLaughlin on Christmas Eve 2009.After learning 14 years ago that he had advanced prostatecancer, Bill focused much of his energy on improving the livesof others who were facing the disease. He became generalchairman of Us TOO of Western New York, a prostate cancersupport group; served as a patient advocate with the Buffalo/Niagara Prostate Cancer Consortium at RPCI; starred in publicservice announcements about prostate cancer; and was a cancer “coach” for the Cancer Wellness Center. Knowing that he was approaching the end of his life, in June 2009 herode 12 miles in the annual Ride for Roswell, raising more than $16,000 to support research and patient care.

On the evening of October 24, although he was under hospicecare at home, Bill summoned the strength to attend the RoswellPark Alliance Foundation’s annual All-Star Night, where hereceived the 2009 Katherine Anne Gioia Inspiration Award. “I’m not leaving anything on the table,” Bill had said earlier.“I’ve had a great life, so we’re ready.”

TOUCHDOWN!

Watch the Foundation’s video tribute to Bill at

http://tinyurl.com/yaqkpft.

*Partners for Prevention: Cancer Services Program of Erie County offers free breast and cervical cancer screening to uninsured women age 40 and over, and free colon cancer screening to uninsured men and women over 50. For more information, call 716-886-9201; email [email protected] or visit www.cspwny.org.

Last year, Betty Green was doing her best totake care of her health.

Although a job layoff had lefther without health insurance,she sought no-cost healthscreenings through a programcalled Partners for Prevention:Cancer Services Program ofErie County.* Among otherprocedures, she underwent afecal occult blood test (FOBT)to check for traces of blood in the stool, which can be an indication of colorectal cancer.

But when the FOBT detectedblood, she resisted having acolonoscopy and was especiallyreluctant to have it done atRPCI. “I was scared,” she says.“I was afraid they’d find some-thing, and I was afraid thatgoing to Roswell meant I’dhave cancer. But my family con-vinced me I had to do it,because if it was cancer, theycould catch it early. And it hadto be Roswell, because I’d havethe best doctors there.”

Now 53, Betty feels lucky that she followed her family’swishes. Doctors found severalpolyps, including a very large,suspicious polyp that could not be removed during thecolonoscopy. “The doctorswere surprised that I didn’thave any symptoms or pain,because of how large the polypwas,” she says. Kelli BullardDunn, MD, FACS, FASCRS,Chief, Division of Colon andRectal Surgery, recommended minimally invasive (laparoscopic)

surgery to removeup to half of Betty’scolon.

RPCI’s minimallyinvasive surgical systems, both roboticand laparoscopic,enable surgeons to operate throughmuch smaller

incisions than traditionally used.The minimally invasive approachinvolves small “ports” ratherthan large incisions, translatinginto shorter hospital stays andrecovery times, and fewer complications. Betty marvels atthe four tiny incisions on herabdomen—three that were half an inch long, and anotherabout an inch long.“Otherwise,they would have done a tradi-tional large incision on mybelly, like a smile. I had had

two children through C-sections,and I was really dreading a surgery like that. I was sohappy they were able to do it this way.”

Betty admits to being a littlesore for a few days after hersurgery, which involved a week-long stay at RPCI. She was able to come home a couple of days beforeThanksgiving, and even feltwell enough to brave the stores for some shopping on Black Friday.

Even better, Betty’s polyp wasfound to be pre-cancerous; it was not yet malignant, butwould likely have become cancerous had it not been

removed. “I think they were as happy as I was,” she saysof her RPCI medical team.“Everybody was clapping and cheering when the tests came back.”

Before she had her screeningtests, Betty was not aware thatbeing African-American andover age 50 were two factorsthat put her at increased riskfor colon cancer. As a result of her own experience, she has become an advocate of colonoscopy for others. “I see what they do therenow,” she says of RPCI. “I tell my friends not to beafraid, and go have it done.”

D I D Y O U K N O W . . ?

. . . A F O R U M W H E R E P A T I E N T S T E L L T H E I R S T O R I E S

“When colorectal cancer is discovered in theearly stages, chance ofa cure is nearly 90%.

Just Do It!”“DON’T BE AFRAID!

be

en

t

he

re

,

do

ne

t

ha

t|

Betty Green, with Drs. Kelli Bullard Dunn and Joseph Skitzki


vo

ic

es

c

ar

ry

|

Tony George is a history teacher, whichmakes it just a little less surprisingthat when he headed toward the RPCI

campus on March 3 and caught sight of theRoswell Park sign high atop the hospital,he thought of a sermon delivered in 1630 by John Winthrop, Governor of theMassachusetts Bay Colony. Rallying his small band of pilgrims for the challengesahead, Winthrop told them, “…Wee mustConsider that wee shall be as a Citty upon a Hill, the eies of all people areuppon us.”

The eyes of many people were on RPCI that morning. TV cameras were trained onthe stage in the Hohn Auditorium as RPCIPresident and CEO Donald “Skip” Trump,MD, prepared to have his head and mus-tache shaved in front of hundreds of peo-ple. In the preceding weeks, he had issued adare: if donors contributed a minimum of$15,000 to the “Trump’s Troops Challenge”for the Institute’s annual “Goin’ Bald forBucks” fundraiser, he would submit to the

shaving. RPCI Board Chairman MichaelJoseph upped the ante by pledging a dollarfor every $2 donated by others.

There was a lot on the table: Dr. Trump’smustache took root when he was in medicalschool more than 40 years ago, and it hashelped define his physiognomy ever since.But the potential payoff was great: “Goin’Bald” proceeds help fund RPCI researchand quality-of-life programs for cancerpatients. “Wee must be willing to abridgeour selves of our superfluities, for the supply of others necessities…”

“On the surface, my challenge was basedin fun,” said Dr. Trump. “But the causebehind it means so much more. I amdoing this to honor the memory of my parents, who both died from cancer; torecognize the many students and otherswho are setting a positive examplethrough their participation; and to paytribute to every patient RPCI has the privilege of caring for.”

GOIN’ BALD FOR BUCKSMore than a close shave

The whole concept of “Goin’ Bald”began in 2002

when Tony Georgeshaved his head as

an expression of solidarity with his sister, Cathleen,

who had lost herhair during treatment

for breast cancer.

Dr. Donald L. Trump and Friends


|

vo

ic

es

c

ar

ry


Twenty-one other RPCI staffers joined Dr. Trump and bared their crania for a good cause. “Wee must be knit together in this worke.”

Kelvin Lee, MD, the Jacobs Chair ofImmunology at RPCI, emceed the event.Recalling his own participation a couple ofyears ago, he told the audience that hiswife had quipped, “You’re going bald forfree; why don’t you raise some money?” He elicited shouts of laughter with a PowerPoint history of Dr. Trump’s hairstylesthrough the years, introduced with a photoof a curiously mustachioed tot. “Wee mustentertaine each other in brotherlyAffeccion…”

The program also included a surprise video message from “the other” DonaldTrump—magnate and star of NBC’s “TheApprentice”—who congratulated his RPCInamesake and made a substantial donationthat pushed the “Trump’s Troops” effortover the $40,000 mark.

“The Donald” also praised RPCI for its stellar reputation and expertise, noting that he had recently referred a friend’s son to RPCI for treatment.

The whole concept of “Goin’ Bald” began in 2002 when Tony George shaved his headas an expression of solidarity with his sister,Cathleen, who had lost her hair during treat-ment for breast cancer. “Wee must… makeothers Condicions our owne…”

Encouraged by his students at Lake ShoreSenior High School, Mr. George turnedthat first head-shaving statement into afundraiser that has raised a total of morethan $600,000 to date.

Cathleen George died in 2004, but herbrother told the audience that she tookcourage in knowing that “a lot of peoplehere were working very hard to find a curefor cancer.” Looking up at the Roswell Parksign high atop the hospital, that’s what

Tony George remembers.“…For wee must Considerthat wee shall be as a Cittyupon a Hill, the eies of all

people are upponus…”

Goin’ Bald for Bucks is coming to a school, business or organization near you!

It’s easy for you and your colleagues or classmates to raise money for

research and patient care programs with a quick snip of the

scissors. Plan your event, collect pledges, and raise support for

Roswell Park; then shave your head or

cut 10 inches of your hair—it’s that sim-

ple and fun! (Exceeding your pledge

goal is even easier when you sign up for

a personalized fundraising page.)

Warm up the clippers

Goin’ Bald events are being held across Western New

York and the nation.

Plan yours today, or join one in your community by vis

iting www.BaldforBucks.org

or contacting Misha Russo at 716-845-8164 or at Mish

[email protected].

Tony George


vo

ic

es

c

ar

ry

|


In October 2009, leaders ofreligious groups from all overWestern New York convergedat RPCI to help the PastoralCare Department better under-stand their respective faiths.The program was organized byElizabeth Lenegan, PhD,Director of Pastoral Care, whosaw the need to build a net-work of religious consultantswho could answer questions orprovide advice and support forpatients from outside theJudeo-Christian tradition.Today the network she created

includes 34 volunteers from thelocal Muslim, Hindu, Buddhist,Native American, and Jehovah’sWitness communities, amongmany others.

Their insight reaches beyonddirect clergy-to-patient contact,thanks to a new resource guideDr. Lenegan has compiled forRPCI nurses and the Psychologyand Social Work departments.

The guide explains dietaryrestrictions—kosher meals forobservant Jews, halal meals forMuslims, vegetarian meals formost Hindus—as well as beliefs“about surgery, donatingorgans, end-of-life and modestyissues,” says Dr. Lenegan. It also touches on traditionsthat straddle the line between religious faith and culture,sometimes in conflict with normal hospital policy. Forexample, Roman Catholicsfrom Vietnam tend to stay with

a hospitalized family memberaround the clock, outside visitorhours. Because Vietnamesepatients tend not to complainand may not volunteer informa-tion about pain or other symp-toms they’re experiencing, the

constant presence of someonefamiliar with Vietnamese lan-guage and culture is critical.

The Rev. Thunder Silk, a NativeAmerican of the Diné (Navajo)and Muckleshoot tribes,became involved with thePastoral Care Departmentwhen Dr. Lenegan asked her tovisit a Native American patient.She notes that drumming isoften incorporated into thehealing process, “so if the

patient is drumming or havingsomeone drum for them aspart of a ceremony, youshouldn’t interrupt that.”

Vijay Chakravarthy, formerPresident of the Hindu Templeand Cultural Center in Amherst,New York, and President of the Network of ReligiousCommunities, hopes his connection with RPCI willenlighten hospital staff about the religious beliefs ofHinduism. “For a Hindu, illnessis undergoing punishment or suffering due to our ownpast deeds, so it is a way of

purifying ourselves of our sins. The best medicine ischanting God’s name.”

Awareness of different faith traditions is an essential part of RPCI’s comprehensive andpersonalized approach to treatment. “These programsare very important,” says Mr.Chakravarthy. “They make itpossible for us to extend ourcare and help to people whomight need it.”

Holly Pascale is a trailblazer. The resident of Port Allegany, PA, is the first breast cancer patientto enroll on a national clinical trial being conducted at the Cancer Care Center of the BradfordRegional Medical Center (BRMC) in Bradford, PA, part of the regional clinical network

of Roswell Park Cancer Institute. Through this affiliation, BRMC is giving cancer patients theopportunity to take part in clinical trials in the Bradford area, without having to travel to Buffalo.

Ms. Pascale is enrolled on a study underway at RPCI and across the nation that’s designed to helpresearchers determine whether drugs called bisphosphonates can prevent breast cancer from spreading to the bone, while protecting against bone problems associated with standardbreast cancer treatments. The trial is being overseen at BRMC by Eyad Al-Hattab, MD, MedicalDirector of Oncology/Hematology at BRMC’s Cancer Care Center and Staff Physician in MedicalOncology at RPCI. Through the affiliation agreement between RPCI and BRMC, Dr. Al-Hattab practices full time in Bradford, but also works with his RPCI colleagues to improve access to qualitycancer care for patients in Northwest Pennsylvania and the Southern Tier of New York State.

Ms. Pascale’s diagnosis of Stage II breast cancer came in May 2009. She underwent surgery,chemotherapy, and radiation before enrolling on the trial. “I hope it will prevent me from having arecurrence, and I encourage other women with breast cancer to participate in this clinical trial,” saysMs. Pascale.

For information about participating in the trial (identified as SWOG S0307) at RPCI, call 1-877-ASK-RPCI(1-877-275-7724). For information about participating in the trial at BRMC in Bradford, PA, callAnne Zimbardi at 1-814-362-8425.

One Mission,

ManyFaiths

Awareness of different faith traditions isan essential part of RPCI’s comprehensiveand personalized approach to treatment.

Taking the Road Less

Traveled

|

vo

ic

es

c

ar

ry

”

“I hope it will

prevent me from having a

recurrence, and I encourage

other women with breast cancer

to participate in this clinical trial.

Father Ray Corbin, Catholic Chaplain at RPCI

Holly Pascale and Dr. Eyad Al-Hattab


vo

ic

es

c

ar

ry

| |

n

ur

se

s

in

a

ct

io

n

For cancer patient Raphael Waters, PhD, the American Cancer Society’sRoad to Recovery program provided more than valuable transporta-tion—it literally saved his life. When Waters’ volunteer Road to Recoverydriver arrived to pick him up for a routine trip to RPCI for radiation treat-ment, Waters did not answer the door, so an ACS dispatcher called hishome. When there was no answer, police were called. They discoveredthat Waters had fallen the night before. He was rushed to the hospital,where he spent five weeks recovering. Today he fondly refers to his ACSdrivers as “ordinary fellows doing an extraordinary job” and is very grate-ful for the service they provide.

Finding transportation to and from doctors’ appointments and treat-ments is a common worry for many cancer patients. Road to Recoverymeets that need, thanks to a team of volunteer drivers. “Cancer patientsoften need treatment daily or weekly over the course of several months,”explains Donald L. Trump, MD, RPCI’s President and CEO. “Drivers whovolunteer provide an essential service by helping patients receive treat-

ments on a timely basis—and that leadsto better treatment results.”

Walter Wozniak is among the ACS volunteers behind the wheel. Since 2004,

he has driven patients to their appointments two to three times perweek, on average. “It’s a very rewarding experience,” he says. Watchingpatients progress through treatment and into recovery makes him “feelgood to be part of helping that person get better.”

Nancy Hanavan, Senior Director of Cancer Control and Patient andFamily Services at the Western New York ACS Office, notes that patientswho would like to arrange for transportation through Road to Recoverymust be able to get in and out of a car without assistance. Rides are provided to and from cancer treatments only, and must be scheduled atleast one to two weeks in advance. Rides are available depending onvolunteer availability.

For more information, contact the American Cancer Society at 1-800-227-2345, or visit www.cancer.org.

Roswell Park Cancer Institute employsmore than 600 nurses. In differentdepartments and centers throughout

the Institute, they administer chemothera-py, collect blood donations, help conductclinical research studies, educate patientsand families, serve on surgical teams, andassume a wide range of other roles—all ofwhich affect patient care.

The Nursing Executive Council unites thisexpertise across departments, focusingattention on common challenges and waysof doing things better. Now in its third year,the 15-member Council took root with the encouragement of RPCI’s nursingadministrators, led by Maureen Kelly,RN, MS, OCN, Vice President of PatientCare Services and Chief Nursing Officer,and Mary Ann Long, RN, MS, OCN,Director of Patient Care Services. “We wantto encourage nurses to provide feedback,”says Mary Colleen House, RN, CouncilPresident. “Maureen wants the Council to be empowering for nurses, so they’llknow they can change their environmentthrough their input.”

The Council’s top priority: identifying projects that could have the greatestimpact on nursing, “to establish the needsof nurses and the things they’re doing wellthat maybe another unit should try,” Ms. House explains. Central to that effortis a survey that the Council distributedrecently to nurses to identify “the needsin their departments so they can providethe best care to their patients.”

But Michele Cooper, RN, BSN, CCRC,OCN, Clinical Research Coordinator andCouncil Vice President, emphasizes that the survey isn’t intended as a call for com-plaints. Rather, it’s a way of soliciting “ideasfor what we can do better for patients.Where is there a need?” The agenda iswide open: patient advocacy, delivery ofmedications, infection control, ethics, continuing education for nurses—whateverthe nurses themselves identify as mostimportant to their work across the board.

“The nursing administration has said,‘You’re the grassroots nurses; you’re thehands-on clinical staff. You see the patients

and have a good sense of what’s workingand not working. Help us help you do abetter job,’” says Ms. House.

Council members, who meet once amonth, are elected by the nursing staff.They include representatives of both inpa-tient and outpatient units; nurse administra-tors who work outside the Department ofNursing, including Michele Cooper; a rep-resentative of the nurses’ bargaining unit;and two physicians, including Judy Smith,MD, RPCI’s Medical Director. “It’s criticallyimportant that we empower nurses tomake decisions and share in the leadershipof the organization,” says Dr. Smith.

Ms. Cooper sees a far-reaching benefitfrom the Council’s goal of “getting outthere, talking with nurses face-to-face. It’shelping us be a better team, and the resultis better patient care.”

INTERESTED IN A CAREER IN NURSING?

Visit our website at www.roswellpark.org

24times a year, for the past 35 years, SonjaReitberger has traveled to RPCI to donateplatelets for cancer patients. Add it up:

that’s 840 trips, 2,520 hours of donation time, thou-sands of hours on the road—and a lifesaving gift forhundreds of people. Her journeys are even moreremarkable because she lives in Portageville, NewYork, and drives an hour each way to donate at RPCI.

Ms. Reitberger’s donations began in 1974, when shegave blood to help her mother, who was then under-going treatment for breast cancer at RPCI. She keptcoming even after her mother’s treatment ended,redirecting the flow of platelets to other cancerpatients in need. Now 69 and retired, she tries toschedule her donations so that they begin to taper offat the beginning of December, when winter weathermay get in the way of traveling. “Sometimes I can’tmake it,” she says, “and they understand; I can goanother day.”

Along with the satisfaction of helping patients whoneed her platelets to survive, she has found lifelongfriends among the RPCI nurses and her fellow donors,including one woman whose daughter died ofleukemia and who has been traveling to RPCI fromCanada to donate ever since.

“My health is very good,” says Ms. Reitberger, “and Ifeel this has contributed to my good health, because Itake care of myself better so I can donate. I enjoycoming here.”

Driving with Care


Many HappyReturns

“ordinary fellows doing an extraordinary job”

24 | roswellness

“It’s critically important that we empower nurses to makedecisions and share in the leadership of the organization.”

A Shared VisionT H E Y ’ R E E V E R Y W H E R E !

RPCI’s Nursing Executive Council

Kevin Lennon, RN, BSN, CCM

Dr. Raphael Waters


|

st

op

t

he

p

re

ss

es

!st

op

t

he

p

re

ss

es

!

|

26 | roswellness

W O W - W O R T H Y N E W S

Multiple myeloma patients who received the oral drug lenalidomide after a blood stem cell transplant had their cancer controlled longer thanpatients who did not take the drug, according to a national clinical trial

led by Philip McCarthy, Jr., MD, Director of RPCI’s Blood & Marrow Transplant(BMT) Program. The trial was stopped early after an independent data and safetymonitoring committee overseeing the trial found that study participants whoreceived the drug had a longer time until their cancer progressed than participantswho received a placebo.

Half of the patients who received a placebo instead of the drug experienced a worseningof their disease within a median time of 778 days. Among those who took lenalidomide,however, fewer than half had worsening of their disease—an outcome representing a58% reduction in the risk of disease progression. The trial has not yet shown evidence ofan overall survival benefit.

The study was conducted by a network of researchers led by the Cancer and LeukemiaGroup B (CALGB) in collaboration with the Eastern Cooperative Oncology Group(ECOG) and the Blood and Marrow Transplant Clinical Trials Network. The NationalCancer Institute sponsored the trial.

Multiple myeloma is a cancer of the blood and bone marrow. Autologous blood stemcell transplantation, a common procedure for multiple myeloma patients, involvesremoving the patient’s own blood stem cells, treating the patient with high doses ofchemotherapy and/or radiation therapy to kill the cancer, and then returning the bloodstem cells to the patient.

GRANT: $2.8 MILLION From: National Cancer InstituteGoal: Understanding the link between

regulatory T cells and ovarian cancer

By comparing levels of regulatory T cells in healthy women andwomen with ovarian cancer, RPCI researchers hope to generatedata that will be useful in understanding the causes of ovarian cancer and in developing novel treatment options for this seriousdisease, notes Kirsten Moysich, PhD, of Cancer Prevention and Population Sciences, and her co-investigators Kunle Odunsi,MD, PhD, Gynecologic Oncology, and Lara Sucheston, PhD,University at Buffalo.

GRANT: $2.5 MILLION From: National Cancer InstituteGoal: Gauging the effects of diet on the

course of low-risk prostate cancer

James Mohler, MD, Senior Vice President for TranslationalResearch and Chair of Urology, and James Marshall, PhD, Senior Vice President for Cancer Prevention and PopulationSciences, are co-investigators of the five-year Men’s Eating andLiving (MEAL) study, which focuses on the link between dietary changes and the progression of prostate cancer.

GRANT: $2.1 MILLION From: National Institutes of HealthGoal: Estimating the attraction of “smokeless”

tobacco products

Richard O’Connor, PhD, of Health Behavior, is weighing smokers’ interest in using “smokeless” tobacco products, whensmoking is prohibited. The study will try to determine whethersmokers would use the products only as temporary substitutes for smoking, or whether they might switch completely from cigarettes to smokeless tobacco. Dr. O’Connor says study results could inform FDA decisions about products advertised as having a lower risk than cigarettes.

GRANT: $1.8 MILLION From: National Institutes of HealthGoal: Overcoming relapsed, treatment-resistant B-NHL

More than half of all patients with B-cell non-Hodgkin’s lymphoma(B-NHL) who relapse develop disease that is resistant to therapy. A five-year study led by Myron S. Czuczman, MD, Chief of theLymphoma/Myeloma Section and Head of the LymphomaTranslational Research Laboratory, will examine novel ways of treating refractory and/or relapsed disease in patients with diffuselarge B-cell lymphoma.

GRANT: $1.7 MILLION From: National Institute for Allergies and Infectious DiseaseGoal: Preventing and reducing side effects of radiation

treatment and nuclear accidents

A study of treatments for acute radiation syndrome, led by Andrei Gudkov, PhD, DSci, Senior Vice President, Basic Science and the Garman Family Chair in Cell Stress Biology, may provide critical information about an emerging class of radiation antidotes that may one day be used to reduce and prevent side effects of radiotherapy. These drugs may also beused for biodefense applications to reduce radiation damageassociated with nuclear accidents.

Can Lenalidomide Help Control Myeloma? Major

G r a n t s

Lung SuffusionAnother RPCI first

Dr. Moysich Dr. Odunsi Dr. Mohler Dr. Marshall

Dr. O’Connor Dr. Czuczman Dr. Gudkov

Todd Demmy, MD, Chair of ThoracicSurgery, has developed a surgical techniquefor treating lung cancer that allows directdelivery of chemotherapy, as reported in theAugust 2009 issue of Annals of ThoracicSurgery. The technique is designed to benefitpatients who cannot undergo traditional curative surgery for non-small cell lung cancerbecause the tumor has progressed to a moreadvanced stage. RPCI surgeons have foundin their initial clinical experience that thetechnique, which they call “lung suffusion,”is safe and merits further study.

The technique uses the chemotherapy drugcisplatin to treat lung tumors. But ratherthan circulating the drug throughout theentire body, it is used to temporarily replaceblood only in the main artery of the lung, to help protect healthy, non-cancerous tissue.When the 30-minute infusion is complete,the cisplatin is flushed out and normal blood flow resumes.

If this research continues to show promise, it may be expanded to cover patients withother tumor types, different classes of drugs,and patients with earlier stages of cancer.

N E W L E A D E R S H I P

John Kane III, MD Chief, Division of

Sarcoma and Melanoma

Kelli Bullard Dunn, MD, Chief, Division of Colon

and Rectal Surgery

st

op

t

he

p

re

ss

es

!

|


|

st

op

t

he

p

re

ss

es

!

IN PLAINSIGHTNursing Coverage/Content on RPCI Web Site Deemed“Most Comprehensive”

RPCI is one of just two of the 40 National Cancer Institute-designatedComprehensive Cancer Centers that can lay claim to a “broad representationof oncology nursing” on its public Web site, www.roswellpark.org, accordingto a recent study (“The Invisibility of Nursing: Implications from an Analysisof NCI-Designated Comprehensive Cancer Center Web Sites”) published inOncology Nursing Forum.

The study focused on four areas: • Recognition of nursing on the home page• Citations and/or descriptions of nursing personnel,

programs or recognition• Existence of a dedicated nursing Web page• Acknowledgment of the Chief Nursing Officer

According to the study results, only two Comprehensive Cancer Center Websites – RPCI’s and Dana Farber Cancer Institute’s – “revealed broad repre-sentation of oncology nursing throughout” and were deemed "most com-prehensive" in terms of nursing coverage and content. The study also foundthat nearly 63% of peer institutions had no or minimal content about nursing.

RPCI ranks in the 96th percentile nationwide for overall patientsatisfaction, according to the 2009 Press, Ganey InpatientSatisfaction Survey, which rates more than 1,000 hospitalsacross the country. The score was even higher when comparedto other nationally top-ranked cancer hospitals and MagnetNursing-certified hospitals that took part in the survey.

“Press, Ganey is the leading—and largest—organization in the country that surveys patient satisfaction,” says DanaJenkins, RPCI’s Vice President of Organizational PerformanceImprovement. “Partnering with them gives us the ability tocompare RPCI against a large number of community, academicand ambulatory-care providers.

“Most important, we worked with other top National CancerInstitute-designated comprehensive cancer centers to developa Press, Ganey comparison group. This allows us to identifybest practices, learn from one another, and improve our patient care.”

RPCI patients rated the Overall Rating of Care Received andLikelihood of Recommending the Hospital to Others in the 99thpercentile. The Physician and Nursing sections of the surveyalso earned scores in the 99th percentile. The rating meansRPCI scored higher than 99% of the other organizations includ-ed in the survey. Ms. Jenkins says the survey results are oneway RPCI stays focused on the goal of working continually “toprovide better care, more efficiently and with more kindness.”

Smart Kids!Tobacco, alcohol and other drug use rates by ninth-graders in Erie Countyhave declined, with the most substantial decreases occurring for tobaccouse, according to a study conducted by RPCI researchers. Lead investigatorAndrew Hyland, PhD, Department of Health Behavior, said, “Tobaccoused to be cool, but now it’s not. Policy changes such as the increase in cigarette taxes, passage of the Clean Indoor Air Law, and education about tobacco have helped shift attitudes about tobacco use.”

Arising number of women who have cancer in onebreast are choosing to have the other, healthybreast removed, reveals a recent study of New

York State data. The trend raises concerns because removalof a healthy breast to prevent cancer—a procedure calledprophylactic mastectomy—has not been shown to lowerthe risk of dying for patients who already have breast can-cer, according to Stephen B. Edge, MD, FACS, the AlfieroFoundation Endowed Chair in Breast Oncology, MedicalDirector of the Breast Center, Chair of Breast Surgery, andclinical leader on the study.

Dr. Edge and his colleagues from the New York StateDepartment of Health discovered that the number of prophylactic mastectomies more than doubled between1995 and 2005 among women who already had breastcancer. Edge stresses that women who have breast cancershould receive careful counseling about the risks and benefits of surgery before undergoing prophylactic mastectomy of the other breast.

Hannelore Heemers, PhD, a researcher inthe Department of Urology, received one of21 Young Investigator Awards given by theProstate Cancer Foundation. Designed toencourage the most innovative minds in cancer research to focus their careers onprostate cancer, the $225,000 grant awardsprovide recipients with three years of funding.

Kudos, Dr. Heemers!

3High�Marks�in�PatientSatisfaction

“Press,�Ganey�is�the�leading—andlargest—organization�in�the�countrythat�surveys�patient�satisfaction.”

PROPHyLACTIC MAsTeCTOMy on the Rise in Nys?

The number of prophylactic mastectomies more than doubled between 1995 and2005 among women whoalready had breast cancer.

W O W - W O R T H Y N E W S

ROSWELL PARK CANCER INSTITUTE

ROSWELL PARK CANCER INSTITUTE


|

te

ch

no

lo

gy

b

uz

zs

pa

rk

s

|G E N - Y A L L - S T A R S

Ever since its debut in 2007, the Yroswell campaign has grown right alongside its target audience—Generation Y. The grassroots program centers on a vibrant network of

young people from ages 12 to 26, all working toward “a world without cancer.”

To move us closer to that goal, Yroswell creates, sponsors, and supports programsand projects centered on three main themes: learning, giving, and coping. It alsoworks to cultivate and inspire Gen Y’ers who are interested in careers in healthcare,while motivating them to volunteer, fundraise, and advocate for a cancer-freetomorrow. Yroswell supports and connects people who are directly or indirectly affected by cancer, helping them cope with the emotional impact of the disease.Yroswell helps demystify cancer—to make it less intimidating, remove the stigma,and open it for discussion for the next generation of cancer professionals, patients,and advocates.

Photodynamic therapy (PDT) technology,developed at RPCI, is now beinglicensed to pharmaceutical companies

in India and China, reports RichardMatner, PhD, MBA, Director of RPCI’sTechnology Transfer Office. “Cancer, andcancer treatments, have no national bound-aries, so we think globally when it comes tolicensing our discoveries,” explains Matner.“That strategy promises better medical carefor people around the world, as well as aneconomic return that can drive future discov-eries at RPCI.”

PDT is a treatment that uses intense dosesof red light to active light-sensitive, cancer-killing drugs. It was pioneered by RPCI sci-entist Thomas J. Dougherty, PhD, ChiefEmeritus of the Photodynamic TherapyCenter. The licensing agreements covertechnology developed by Dr. Doughertyand Ravindra Pandey, PhD, DistinguishedMember of Clinical Research in Cell StressBiology at RPCI.

PDT is used to treat skin, lung, andesophageal cancers, as well as other medical conditions. A light-sensitive compound is either applied directly to the skin or injected intravenously. Healthycells shed the compound within a fewdays, but it remains heavily concentratedin cancer cells. The tumor is then exposedto red light, which causes the compoundto selectively kill the cancerous cells.

RPCI’s Technology Transfer Office was created to market discoveries generated at the Institute, with profits reinvested incancer research at RPCI. Dr. Matner workswith researchers and clinicians to identifydiscoveries that have commercial potentialand to market that potential to prospectivebusiness partners.

At a time of growing concern about theoverseas transfer of American jobs andresources, RPCI is helping reverse the trendthrough agreements in which the Institutegarners licensing fees and royalties from

other countries for rights to its products and technologies. Over the lasttwo decades, licensing and royalty fees for PDT alone have generated millions of dollars to support research at RPCI.

Traditionally, institutes like RPCI patentedtheir research results and then licensed thepatents to someone else—for example, apharmaceutical company—who then manufactured and sold a product based on the patent. The company took the lion’sshare of the profits, and the institutereceived a small royalty.

But that is changing, says Dr. Matner, asmore researchers are bringing their inven-tions to RPCI’s Tech Transfer Office for helpin moving them to the marketplace.“International commercialization can beespecially beneficial to RPCI as we extendour associations to Asian pharmaceuticalcompanies,” he says.

OpportunityKnocks

P D T L I C E N S I N G G O E S G L O B A L

Y r o sw ell? Y n o t?T H E M E C H A N I C S O F I N N O V A T I O N

Yteam CureIn September 2009, Yroswell teamed up with the Roswell ParkAlliance Foundation’s Team Cure program to create Yteam Cure.Team Cure helps individuals and organizations raise funds forresearch at RPCI; Yteam Cure encourages young people to planand manage fundraising events of their own.

The Yroswell website includes a complete package of informationabout Yteam Cure, including fundraising steps, videos of eventsother Gen Y’ers have organized, and customizable poster templatesthat students can use to publicize their own fundraising events.Find out how to get started by visiting www.teamcure.com orwww.yroswell.com.

Yroswell Street TeamMembers of Generation Y relate best to their peers. That’s theidea behind the Yroswell Street Team, which brings high schooland college students together to spread the Yroswell message.Students in this rapidly growing group lead by example, attendingschool and community events in the Western New York area toencourage others to get involved. “It’s a great way for us to reachthe public and get young people excited about creating a worldwithout cancer,” says Team Captain Josephine Ossei-Anto.t

“We’re promoting a great cause and making

a difference all at the same time. What could

be better than that?”

If you know a high school or college student who might want to join us, if you’d like the Street Team to attend one of your upcoming events, or if you have questions about

the Street Team, contact Megan Militello at 845-1671 or [email protected].

W h a t ’s N ew ?

Pop sensation Jason Derulo, with Carly’s Club member Jimmy Szafranski

Drs. Pandey and Matner


|

la

b

no

te

sla

b

no

te

s

|P R O M I S I N G R E S E A R C H F R O M R P C I

32 | roswellness

Researchers at Roswell Park Cancer Institute are moving toward the nextexciting step—clinical trials—with a new cancer drug candidate, CBLB502.It’s part of a family of drugs called “protectans” being developed by

Cleveland BioLabs, Inc., a biotech company closely associated with RPCI.CBLB502 was designed to prevent side effects and increase survival and tolerance to radiation treatment. The compound was developed originally with the military in mind, to prevent or reduce the type of radiation sicknessassociated with bomb fallout, and to protect against the effects of nuclear accidents of the kind that occurred in 1986 at the Chernobyl Nuclear Power Plant in the Ukraine. However, CBLB502 is also expected to be effective in preventingmany side effects of radiotherapy cancer treatments.

Andrei Gudkov, PhD, DSci, Senior Vice President of Basic Science and GarmanFamily Chair of Cell Stress Biology at RPCI, explains that protectans “selectivelyprotect the normal, healthy tissues of the body, without protecting tumor cellsfrom the radiation.” The importance of this discovery is profound and far-reaching.“We’ve known for a hundred years that ionizing radiation is dangerous,” says Dr.Gudkov. “And we’ve known exactly what kind of sickness radiation may cause,

but there is not a single drug to prevent it that is approved for use anywherein the world.” Indeed, the closest thing we have to such a drug is potassiumiodide, which is administered after radiation exposure to protect the thyroidgland from just one specific radioactive isotope. What’s needed is somethingto protect the rest of the body from radiation of any kind.

The difficulty with radiotherapy is that when radiation is given at a dose highenough to kill cancer cells, even with precise and targeted application, it also kills some healthy cells, notably those of the skin, gastrointestinal tract,mouth, throat and hair follicles, causing such side effects as red, irritated skinresembling burns, dysfunction of the gastrointestinal tract, mouth and throatsores, damage to salivary glands, and hair loss.

By the end of 1990s, researchers concluded that massive cell loss occurringin radiosensitive organs after exposure to severe radiation is not the resultof irreparable cell damage, but rather cell death caused by activation of asuicidal program—a cell process called apoptosis. “Many cells of the body’sorgans give their lives voluntarily with radiation exposure,” explains Dr. Gudkov. “They behave this way to protect the organism from the riskof dealing with their progeny, which may acquire dangerous mutations as a result of DNA damage caused by irradiation. We thought if we couldconvince the cells not to die—with drugs to block apoptosis, if only for acouple of hours—the cells would have a chance to activate their own DNArepair program, and survive.” Protectan CBLB502 appears to do just that.

To find protectans, RPCI scientists looked to nature, specifically the typesof bacteria that live in all of us as our natural, healthy microflora. Thehuman body is home to numerous species of bacteria. Researchers havediscovered that, during millions of years of co-evolution with our bodies,those bacteria have learned how to survive and how to protect their ownenvironment (the gastrointestinal tract, for example) from their presence.Protectan CBLB502 was developed from a modified protein, flagellin, ofone such type of microorganism, which resides naturally in the gut. Similarto antibiotics (fungal products used by fungi to suppress bacteria), themechanism of action of protectan CBLB502 was “borrowed” from nature.

Researchers recently completed the first phase of clinical trials involvinghealthy participants to determine the drug’s side effects and estimate the dose that would likely be needed for humans in the event of radiationexposure. According to Dr. Gudkov, encouraging results from that trial will inform future planned testing of the drug in cancer patients who areundergoing radiotherapy.

RPCI hopes to begin clinical trials of CBLB502 in Buffalo in the comingyear. Protectans would be given to patients by injection prior to irradiation.Dr. Gudkov expects that protectans could be useful as part of the treatmentplans for cancers typically treated with radiotherapy, including those of thehead, neck, prostate, breast and lung. Farther down the road, experts mayexplore whether protectans could reduce the side effects associated withchemotherapy, which are similar to those caused by radiation.

Ever wonder what happens when a light

bulb goes on in a scientist’s head? For

Dr. Andrei Gudkov, discovery grew from

his curiosity about salmonella, a potentially

deadly type of bacteria often associated

with food poisoning, that is found in the

intestinal tract. His RPCI colleague,

Surgeon-in-Chief Dr. William Cance,

describes what happened: “He reasoned

that in order for the salmonella bacterium

to live in the gut, it would have to secrete

something that protected the cells of

the gut, because if it killed the gut cells,

everybody would die.” Through further

study, Dr. Gudkov pinpointed the secretions

that salmonella produces to protect the

intestinal tract, dubbing them “protectans.”

On the DefenseCombating Radiation Sickness

“Protectans selectively

protect the normal, healthy

tissues of the body,

without protecting

tumor cells from the

radiation.”

PROTECTANS:the “aha!” moment


la

b

no

te

s

| |

la

b

no

te

s

About eight to 10 weeks after beginningchemotherapy, patients with metastaticcancer undergo follow-up imaging (radiog-raphy or CT scan) to determine whether thetreatment was successful: Did the tumor(s)shrink or not?

Now a test available at RPCI can provideadditional information, much earlier—justthree or four weeks after chemotherapy hasended—to find out if any cancer cells arestill circulating in the blood. Those resultsmay indicate whether the current chemoregimen is working, and, if not, provideearly warning that it might be time to trysomething else. Studies are underway toevaluate the clinical value of the test.

Called CellSearch, the test (manufacturedby Veridex, LLC), is the first automated,FDA-approved system for detecting andcounting circulating tumor cells (CTCs) inthe blood of patients with metastaticbreast, prostate and colorectal cancers. It requires just 7.5 milliliters of blood—lessthan two teaspoons—and is sensitiveenough to detect a single CTC in that small

sample. Ongoing research is aimed atdetermining whether the test, when used inconjunction with imaging, could help guidetreatment decisions.

“Seeing the tumors shrink doesn’t tell thewhole story,” explains Dan Iancu, MD, ofthe Department of Pathology and LaboratoryMedicine. “Even if you shrink the tumor,you could still have CTCs or cancer stemcells that are not destroyed.” If CTC levelsremain high after chemotherapy has ended,chances are that the prognosis is poor andthe cancer may recur.

While CellSearch is used in the U.S. andEurope only for monitoring metastatic dis-ease, in Germany, scientists are studyingthe effectiveness of tracking CTC levels tomonitor disease progression in patientswith early-stage breast cancer. Results todate indicate that after adjuvantchemotherapy [given in addition to anothertreatment], about 10-15% of early-stagebreast cancer patients still have CTCs intheir blood. Could they be among the 20%whose disease eventually recurs? If so,could CellSearch help identify them earlierto inform treatment decisions? Furtherresearch conducted through clinical trialsmay help answer those questions.

Dr. Iancu says CellSearch is another toolthat might help clinicians create the besttreatment plans for their patients withmetastatic disease. “We cannot use just a single technology to monitor disease pro-gression,” he emphasizes.

He and collaborator Ronald Gottlieb, MD,MPH, Medical Director of UniversityMedical Imaging at the University ofArizona, are studying how CellSearch couldbe used with imaging to monitor treatmentresults in patients with non-small-cell lungcancer. The goal, says Dr. Gottlieb, is to“see if the two together could predict earlier than traditional measures if patientsare going to do well on a particular therapy.” With earlier warning of treatment failure, he says, patients might be sparedthe expense and unpleasant side effects ofcontinuing with a chemotherapy regimenthat is not working.

Renuka Iyer, MD, Department of Medicine, has been using CellSearch both for the care ofpatients with metastatic disease and for researchinto better ways of managing it. “I treat patientswith bile duct [biliary] cancer, which is a rare disease of the gallbladder,” she explains.

After the CellSearch equipment was delivered to RPCI, Joanne Becker, MD, Clinical Chief of Laboratory Medicine, contacted Dr. Iyer andasked her to send over some blood samples fromseveral patients so the lab could confirm that theequipment was working properly. “I sent samplesfrom several patients with biliary cancer, includingpatients with both early-stage and late-stage disease,” Dr. Iyer recalls. Imaging had alreadyshown which patients belonged in which category,and the lab needed to see some results fromCellSearch.

The equipment did work properly, and it wentone step farther, showing that the disease was still progressing in one woman who had alreadycompleted two different courses of chemotherapy.With that information, in Dr. Iyer started thepatient on a third, different type of drug, usingboth CellSearch and medical imaging to monitorher progress during treatment.

The patient’s prospects didn’t seem bright:Gallbladder cancers have a very aggressivebehavior, because at the time of diagnosis, mosthave spread to the biliary lymph nodes or liver,and/or have spread throughout the peritonealcavity and distant parts of the body.

Notes Dr. Iyer, “Usually when the first and secondlines of chemotherapy don’t work, the odds ofthe third one working are almost zero.” But afterthe third-line treatment began, “the response ofthe circulating tumor cells told me she wouldprobably do well, and she did really well.

“It is unheard of that anyone would have such a dramatic response. Her disease shrank and continued to shrink, and is now stable, and she’sworking one year later, which is amazing.”

Dr. Iyer is taking her research further, with plans tolaunch a prospective clinical research study thatwill examine the value of CellSearch in monitoringpatients with metastatic biliary cancer.

CellSearchA Measure of

Treatment Success?

P R O M I S I N G R E S E A R C H F R O M R P C I

With earlier warning of treatment failure, he says, patients might be spared the expense andunpleasant side effects of continuingwith a chemotherapyregimen that was not working.

For one patient, a dramatic turnaround

Dr. Dan Iancu with Jill Citron, Clinical Lab Technologist

Using CellSearchDr. Renuka Iyer

“It is unheard of

that anyone

would have such

a dramatic

response. Her

disease shrank

and continued

to shrink, and

is now stable,

and she’s working

one year later,

which is amazing.”

36 | roswellness

la

b

no

te

s

|


|

la

b

no

te

sP R O M I S I N G R E S E A R C H F R O M R P C I

Premenopausal women at high risk for breast cancer areinvited to participate in a study to determine if flaxseed will reduce their risk for the disease. Swati Kulkarni, MD,Department of Surgery, is the principal investigator.

Flaxseed, a commonly available food often consumed as a dietary supplement, is a rich source of lignan, a phytoestrogen. Lignans have been shown to reduce tumorgrowth and metastasis in laboratory models and reducemarkers of cell growth in human tumors. Flaxseed is safeand has no known serious side effects.

Tamoxifen is the only drug approved by the U.S. Food and Drug Administration for chemoprevention of breast cancer in premenopausal women. However, tamoxifen has a number of side effects including hot flashes, irregular menstruation and increased risk for endometrialcancer. For this reason, many healthy women choose notto take tamoxifen, while others are ineligible for this drugtreatment due to their medical histories. As a result, the vast majority of premenopausal women who are at significant risk of developing breast cancer are not taking any risk-reducing agents.

For more information about the study, call 1-877-ASK-RPCI (1-877-275-7724).

Most cases of ovarian cancer are diagnosed after the disease hasspread beyond the ovaries and is more difficult to treat. But nowthere’s hope: a vaccine developed at RPCI that has already shownpromising results in patients is being produced for clinical testing at a facility in Ithaca, New York. The vaccine’s developer, Kunle Odunsi,MD, PhD, a Surgeon in Gynecologic Oncology and Co-Leader ofRPCI’s Tumor Immunology and Immunotherapy Program, is principalinvestigator of an open Phase I clinical trial of the vaccine.

The vaccine is designed to trigger an immune response in the significant number of ovarian cancer patients whose tumors testpositive for the antigen NY-ESO-1. As reported previously inRoswellness, Christine Sable of Lancaster, PA, enrolled on an earlyPhase I trial of the vaccine in February 2004 after undergoing surgeryand chemotherapy elsewhere for ovarian cancer that had spread toother areas of the abdomen. The vaccine induced a strong immuneresponse, and today she has reached the sixth anniversary of herdiagnosis cancer-free. Donations to RPCI helped fund early researchof the vaccine.

In a separate trial at the New York University Medical Center, the vaccine is also being evaluated for the treatment of melanoma.

For more information about the ovarian cancer trial at RPCI, call 1-877-ASK-RPCI (1-877-275-7724).

New Down Syndrome Research Program Launched Eugene Yu, PhD, of the Cancer Genetics Department, received a $250,000 grant from TheChildren’s Guild Foundation of Buffalo to identify the causative genes for Down syndrome-associated mental retardation. The grant also will be used to establish The Children’s GuildFoundation Down Syndrome Research Program at RPCI.

Down syndrome is the most common genetic cause of mental retardation in children.Children with Down syndrome also are at increased risk for developing certain leukemias.Despite this, relatively little is known of the molecular mechanism of mental retardation inDown syndrome and no treatments have yet been proven effective.

Can Flaxseed Prevent Breast Cancer in Premenopausal High-Risk Women?

Ovarian cancer vaccine in production

New blood cells form in the soft marrow that fills our bones.Acute myelogenous leukemia (AML) cells can form andthrive there, too, despite the fact that bone marrow is

a low-oxygen environment. Against all logic, they “grow very rapidly, and rapidly outgrow their blood supply,” explains EuniceWang, MD, of the Leukemia Service.

How is that possible when there is so little oxygen to feed them? Dr. Wang theorizes that they have adapted to survive under hypoxic,or low-oxygen, conditions.

The key could be a protein called hypoxia-inducible factor-1a (HIF-1a). Normal cells rely on HIF-1a to help them survive underhypoxic conditions by triggering the growth of new blood vessels

to increase the blood—and oxygen—supply, and by alteringtheir metabolism to require lessoxygen. If AML cells use thesame mechanism, could scien-tists “knock out” the HIF-1a inthose cells to make them more

vulnerable to chemotherapy and other treatments? Dr. Wang’s labis pursuing that strategy.

It’s an unusual approach: “Most people study leukemia cells undernormal oxygenation, when in reality, in patients they’re probably living under low oxygenation,” explains Dr. Wang. Using AML cellsthat have been modified so that they don’t express HIF-1a, shehopes to learn “what happens to them when we put them underhypoxia. Do they now die, because they don’t have this factor thatallows them to survive?”

Better understanding of the role of HIF-1a could help identifynew drugs to treat AML and other types of cancer more effectively.

Funding for the HIF project comes from the WES (When Everyone Survives) Foundation.

Knocking out AML’s defense strategy

Better understanding of therole of HIF-1a could help

identify new types of drugsto treat AML and other types

of cancer more effectively.

Breast cancer is not a single form of cancer;there are many different subtypes, whichare generally diagnosed based on the presence or absence of three receptors that are known to fuel most breast cancers.But some women have a subtype of thedisease that lacks all those receptors—asubtype known as “triple-negative” breastcancer, which can be difficult to diagnoseand treat.

Thanks to a pledge of $250,000 from theVincent and Harriet Palisano Foundation,drug research is underway at RPCI to target a specific enzyme, TAK1, found inwomen with triple-negative breast cancer.Development of the drug could mean a

less toxic, more effective method of treating women with this type of cancer.The research grant will be administered byIrwin H. Gelman, PhD, The John andSanta Palisano Chair of Cancer Genetics, to support research conducted by AndreiV. Bakin, PhD, Department of CancerGenetics, and Huw Davies, PhD, of Emory University.

“My grandmother died of breast cancer,and many of our aunts and uncles andother family members have been afflictedby cancer,” says Foundation TrusteeBeverly Palisano Leek. “It’s our hope that new discoveries in genetics will help other families.”


|

do

no

r

do

ll

ar

s

38 | roswellness

do

no

r

do

ll

ar

s

| RPCI celebrated National BreastCancer Awareness Month inOctober in a special way, receiving

a $1.5 million gift to create the AlfieroFoundation Endowed Chair in BreastOncology. The gift, from the AlfieroFamily Charitable Foundation of WesternNew York, supports the Institute’s breastcancer research and treatment programs.Stephen B. Edge, MD, FACS, Chair ofBreast Surgery and Medical Director ofthe RPCI Breast Center, was named thefund’s first endowed chairholder.

“It’s important that Roswell Park haveevery resource to not only recruit, but alsoretain top doctors for the care of Western

New York’s residents,” says Sal Alfiero,President of the Foundation. “This issomething we wanted to do despite thecurrent challenges of the economy. We

must continue to support the inspiringadvances being made by Roswell Park.”

Dr. Edge says the gift is particularly important because it gives the chair-holder flexible dollars that may be usedfor a department’s most pressing priorities

—including research with high potentialbut without a dedicated funding stream.”

Dawn Hamilton, an RPCI patient withadvanced breast cancer, shared her personal thoughts about the news. “I am extremely touched by this gift, as I know other women facing breast cancerare. Total strangers with big hearts havestepped up to help people like me battlefor life, and it is forever appreciated.”

Most adults suffer from occasional heartburn. But when acid reflux takes a seriousturn, it may be an indication of Barrett’s esophagus, a chronic condition closely linked to cancer of the esophagus. Irwin Gelman, PhD, The John and SantaPalisano Chair of Cancer Genetics, is leading an investigation into the connectionbetween Barrett’s esophagus and the development of this sometimes-deadly form of cancer.

Rates of esophageal cancer have increased more than 300% in recent decades,and 95% of cases occur in patients with Barrett’s esophagus. But so far, researchhas been unable to explain why and how the condition increases the likelihoodthat cancer will occur.

Thanks to a new grant funded by donations to RPCI, Dr. Gelman’s team is workingto develop genetic tests aimed at identifying which cases of Barrett’s esophagusare likely to progress into esophageal cancer—and why. Dr. Gelman’s research will also investigate the roles of certain bacteria or viruses, including the humanpapilloma virus (HPV), in the development of esophageal cancer.

In Memory, In Hope

After surgery, chemotherapy andaggressive radiation treatment following the spread of cancer to

the brain, in July 2009 Jayne Hubbell lost her valiant four-year fight againstbreast cancer. To ensure that her memory will endure, and to help other women facingthe disease, her husband, Phil, has madea leadership gift of $250,000 to fund a three-pronged effort being led by investigators Christine Ambrosone, PhD,Chair, Department of Cancer Prevention and Control; Stephen Edge, MD, FACS, The Alfiero Foundation Chair in BreastOncology; and Gokul Das, PhD,Co-Director, RPCI Breast Disease SiteResearch Group. “If we could help scien-tists match a woman’s DNA with the besttreatment for her, and develop a databaseof this information, we would improvecare across our country,”says Mr. Hubbell.

“I am extremely touched by this gift, as I know other women facingbreast cancer are. Total strangers with big hearts have stepped upto help people like me battle for life, and it is forever appreciated.”

$1.5 million endowment celebrates Breast Cancer Awareness Month(Left to right) Dr. Cynthia Swain and husband Dr. Stephen Edge celebrate the news with Jeanne and Sal Alfiero.

To learn more about individual and foundation giving opportunities with RPCI, please call (716) 845-4444 or visit www.RoswellPark.org/giving.

Searching for clues

Targeting triple-negative breast cancerPalisano Foundation Pledges $250,000 Support

Thanks to the generosity of the Western NewYork community, the campaign to purchase acritically needed new DaVinci® surgical roboticsystem for the collaborative Western New YorkRobotic Surgical Center at RPCI successfullyreached its $2.2 million goal. The new roboticsystem will allow the program to expand to serve patients with a variety of cancers,including prostate, bladder, gynecological,colorectal, thoracic and upper gastrointestinal.

Campaign funds also will pay for infrastructuresupport to continue research and education inthe Center’s surgical training laboratory; andhave supported the production of a video/DVDtextbook of robotic surgeries that has beendistributed internationally.

RPCI expresses its sincere appreciation to alldonors for their gifts, especially the John R.Oishei Foundation for its leadership supportof $708,210; the Patrick P. Lee Foundationfor its gift of $100,000; and Mrs. MarjorieBuyers for her gift of $100,000.

Additional thanks are extended to the following generous donors*:

$75,000-$100,000James H. Cummings Foundation

$50,000–$75,000 Robert and Patricia Colby Foundation Mrs. Dorothy T. Ferguson Mr. and Mrs. Paul T. HarderWest Herr Automotive Group

$25,000–$50,000 Mr. George E. DeckerFirst Niagara BankMr. and Mrs. Daniel R. Gernatt, Jr.Carlos and Elizabeth Heath FoundationMr. and Mrs. Christopher H. KochMulroy Family FoundationMr. and Mrs. Gerald C. SaxeMr. and Mrs. Lewis J. ServentiMr. Matthew W. SitekMr. Carl J. Yerkovich

*Gifts over $25,000

Gift says,“Thanks forMom’s 90th birthday!”

How do you say “thank you” to someone for saving yourmother’s life? For Pat and DickFors, the choice was easy: anendowed fund in honor of Dick’s mother, Arlene Fors. Mrs. Fors recently finished treatment for lymphoma—just in time to celebrate her 90thbirthday. The Fors FamilyEndowed Fund for LymphomaResearch will support life-saving new treatment methods being explored by an RPCI team led by Myron Czuczman, MD.

Investing in the future ofrobot-assisted surgery


pr

of

il

es

i

n

gi

vi

ng

|

For two decades, The Paint Box Project has been a sourceof support and an outlet for creative expression for kids andtheir families who are dealingwith cancer. The program hasgrown and flourished, but thebasic principles that drive itremain the same: using thehealing power of art to helpyoung cancer patients, and raising support for research andpatient care programs.

To celebrate its 20th anniversary,The Paint Box Project’s 2009collection featured some of the

most popular cards and giftsfrom the program’s history.These Paint Box “classics” gave the community a chanceto reflect on how far many ofRPCI’s patient-artists have comein their journeys with cancer.

One survivor, Corrie O’Hara,says her life was changed bythe support she received fromRPCI. At 18, she was diagnosedwith Hodgkin’s lymphoma, andfound a caring community atThe Paint Box Project’s art parties. “When you’re therewith other kids, drawing andpainting, it’s easy to forget

about the cancer,” Corrie says,“even if it’s just for a few hours.”

Inspired by the care she receivedat RPCI, Corrie went on to nurs-ing school and now works as aregistered nurse. “The nurses atRPCI are the best in the world,” she says. “I wanted to dosomething where I could havethat connection with patientson a daily basis.”

The Paint Box Project was pre-sented by Upstate Pharmacyand was supported by the purchases of many generous

individuals and businesses during the 2009 holiday season.

Sponsorships are now availablefor our 2010 collection! Seeour ad below for details.

Get your company involved today as a sponsor or in-kindsupporter of The Paint Box Project’s 2010 holiday collection!Opportunities are available from $500 to $1 5,000 with manymarketing benefits for your organization. Sponsor a card or

chocolate item or help with our promotional efforts.

Call Jennifer Seth-Cimini for details at 716-845-8119 or email [email protected].

MistletoePeace Dove City Buffalo

Become a 2010 Sponsor!This winter, coffee fanatics across Western New York cheered the arrivalof the Dunkin’ Donuts Mug of Hope, a gift offering from The PaintBox Project. Response was overwhelming for the limited-edition mug,sold through a philanthropic partnership with Dunkin’ Donuts.

Available for $100, the mugs entitle customers to unlimited free coffeerefills from Western New York Dunkin’ Donuts locations throughDecember 31, 2010. The stainless-steel travel mug showcases colorfulartwork from five Paint Box Project artists.

Dunkin’ Donuts and its franchisees raised $100,000 for RPCI throughthe effort. Special thanks to all partners in this caffeine-fueled success!

Celebrating 20 Years of crayons, markers,

smiles, and hopeCorrie O’Hara (second from left) joined other Paint Box Project artists past and present tokick off the 2009 program. O’Hara is now working as a nurse to help other patients.

|

nu

tr

it

io

n

&

ca

nc

er

E A T I N G R I G H T

INGREDIENTS:n 15 oz can black beans, drained and rinsedn 14-1/2 oz can low sodium Mexican stewed

tomatoes, undrainedn 14-1/2 oz can low sodium diced

tomatoes, undrainedn 11-oz can whole kernel corn, drainedn 4 green onions, slicedn 1 small green pepper, slicedn 4 ribs celery, dicedn 3 Tbsp chili powdern 1 tsp ground cuminn 1 garlic clove, minced

Preparation Time: 6 hoursNumber of Servings: 8Cups of Fruits and Vegetables Per Person: 1.00

Black Bean& Corn Soup

DIABETIC EXCHANGE:Fruit: 0Vegetables: 2Meat: 0Milk: 0Fat: 0Carbs: 1Other: 0

Diabetic exchanges are calculated based on the American Diabetes Association Exchange System. This site rounds exchanges up or down to equal whole numbers. Therefore, partial exchanges are not included.

Enjoy a taste of the Southwest! This recipe, prepared by RPCI Chef John Velardo,delivers a lot of taste and a healthy dose of vitamin C. It’s quick and easy: combine the ingredients in a slow cooker in the morning, let it simmer all day,and the savory aroma will greet you when you come in the door.

Recipe and nutritional information courtesy of FruitsandVeggiesMatter.gov

Paintbox Project artist Joseph Westphal (whose artwork was featured on the mug) and RPCI’s Dr. Irwin Gelman accept the checkfrom Dunkin’ Donuts franchisee representative Mike Minigell.

SLAMDUNK!


|

wh

o,

w

he

n,

w

he

re

?wh

o,

w

he

n,

w

he

re

?

|

oNE-SToP SHoP oF INFo FoR mdS - That's the idea behind

Partners in Practice, an online educational tool launched in early

May by RPCI and BlueCross BlueShield of Western New York. A hub

of business know-how and cancer care resources, the website can

be viewed at RoswellPark.org/Partners-In-Practice. In photo, Joyce

Persch, Physician Relations & Provider Contracting, BlueCross

BlueShield of WNY, and Pam Germain, Vice President for Managed

Care, RPCI.

O U R P H O T O A L B U M

mETTlE To THE PEdal — The Ride For Roswell, set

for June 26 at UB’s North Campus, kicked off its 15th

anniversary fundraising season on March 27 at the Buffalo

Marriott Niagara. In attendance were (left to right) Mitch

Flynn, Ride founder; Lynsey Zimdahl, Ride Director; and

Adam Benigni, Sports Anchor, WGRZ-TV.

FamIlIaR FacE — Hockey Analyst Mike Robitaille (with Dr. Willie

Underwood) was the voice of RPCI’s Prostate Club for Men, co-sponsored

by WGRZ-TV Channel 2, BlueCross BlueShield of Western New York and

WBEN Radio, 930 AM. To date, the “Club” has 360 members. Mike was

also featured in the primetime TV Special, “Living with Fear,” which

followed him through real-time visits to RPCI’s Prostate Clinic.

The show aired twice in March on WGRZ-TV.

HoW BIG IS YoUR HEaRT? — A hip-hop song and video to show

young people that they can help build a world without cancer?

You bet! “How Big Is Your Heart,” an MTV-like commercial created

by RPCI, featured nurses and cancer patients dancing alongside

professional dancers through the halls of the hospital. The video

premiered at the KISSmas Bash concert in December. Check it out

on Yroswell.com and YouTube.com.

THINK WE’RE NUTZ? — During April, Testicular Cancer Awareness

Month, students from Canisius College, with a little assistance from

RPCI urologists and Marketing team, launched Western New York’s

first campus-based testicular cancer awareness campaign: “Check Yo’

Nutz.” Through the use of accurate, relatable and humorous messaging,

the campaign promoted testicular self-exam for young men, ages 15-40.

BEHINd THE RHEToRIc — Leonard A. Zwelling, MD, MBA, a

nationally recognized expert on health policy, presented the 2010

Dr. David C. Hohn Lecture: “Red Kool-Aid, Blue Kool-Aid: A Doctor’s

Odyssey on Capitol Hill.” Dr. Zwelling – a Robert Wood Johnson

Foundation Health Policy Fellow with the Health, Education, Labor

and Pensions Committee of the US Senate in 2009 – shared a unique

insider’s perspective of the healthcare reform battle.

RoSS TaKES FlIGHT — Meet RoSS, one of the world’s first Robotic

Surgical Simulators, developed through a collaboration between RPCI

and University at Buffalo. Called a “flight simulator for surgeons,”

the RoSS will play an integral role in the training of surgeons for

robot-assisted surgery. Pictured are RoSS developers Dr. Khurshid

Guru, Director of RPCI’s Center for Robotic Surgery, and Dr.

Thenkurussi Kesavadas, Professor of Mechanical

and Aerospace Engineering at UB.

EXPERT WITNESS — In March, Dr. James Mohler, Senior Vice

President for Translational Research and Chair of Urology, was

invited by the House Committee on Oversight and Government

Reform to give expert testimony at the "Prostate Cancer: New

Questions About Screening and Treatment” hearing. Dr. Mohler

presented RPCI’s position on the use of PSA and the early detection,

treatment and overtreatment of prostate cancer; and provided

recommendations based on current best practices.


|

fr

on

tl

in

er

s

Cancer’s effects aren’t limited to the body. This life-threatening illness reaches deep into the spirit, often affecting relationshipswith other people and even the ability to cope with everyday

life. Clinical psychologist Megan Pailler, PhD, is there to help. She andher colleagues in the Department of Psychology are available around the clock to assist patients and families, who either ask for assistancedirectly or are referred by medical staff.

Some people are reluctant to talk to Dr. Pailler at first. “I think there’sstill a stigma associated with talking with a mental-health professional,”she says. She makes it clear that she isn’t there to make a diagnosis, butto help guide them through a maze of overwhelming stresses and emotions.

Many of the patients she sees have leukemia. “Often leukemia patientshave very limited time between the diagnosis and the initiation of treatment, which may involve a month-long hospitalization,” sheexplains. “I meet with all these patients, explain what psychosocial services we have to offer, and help them manage the stress surroundingtheir diagnosis and treatment.

“Some phases of treatment are more critical than others,” she adds. “The first is shortly after diagnosis, during the initial adjustment period.Another critical period occurs if treatment is not going as expected—people have a change in their prognosis, or didn’t achieve the remissionthey hoped for. Each stage of the treatment process can create new stressors that challenge the patient and family.”

The clinical care Dr. Pailler provides also guides her research on howleukemia patients adjust to their diagnosis over time, and how social

C A R E E R S A T R P C I

“supports and relationships help. “Research shows that distress amongcaregivers is as high, if not higher, than it is among patients,” shenotes. In collaboration with social worker Teresa Johnson, LMSW,she’s developing an intervention for caregivers of newly-diagnosedleukemia patients, to better prepare them for the experience aheadand promote better quality of life for caregivers and patients alike.Outside the clinical setting, she and her colleagues speak with professional and community groups about the psychological challenges that come with a diagnosis of cancer.

A doctoral degree and medical license are required for becoming aclinical psychologist, but what other qualities are important?“Psychologists need a good set of analytical skills — being able tostudy problems in a systematic way,” says Dr. Pailler.

“But first and foremost is empathy — fundamental compassion forthe human experience. People ask me all the time, ‘How do you do what you do?’ because sometimes we bear witness to a lot of theemotional suffering that people go through, in a very intimate way.

“But it’s the times I’m most involved in people’s lives that I find themost personally rewarding, because I have the opportunity to helpthem through one of the most difficult and stressful events they’llever encounter. That’s what makes me feel good about what I do.”

Dr. Pailler holds a master’s degree in Applied Child Development from TuftsUniversity and a PhD in Clinical Psychology from the State University ofNew York at Binghamton.

Each stage of the treatmentprocess can create newstressors that challenge the patient and family.”e

ve

nt

s

|E V E N T S B E N E F I T I N G R O S W E L L P A R K

Megan Pailler, PhDCLINICAL PSYCHOLOGIST

Profile:

BenefitingBig Wheel Sponsors

Activities include:• 9 Routes—from 3 Miles to 100 Miles

• Family Fun Town

• Post-Ride Picnic

• Team T-Shirt Contest & Fundraising Prizes!

Saturday, June 26U n i v e r s i t y a t B u f f a l o N o r t h C a m p u s , A m h e r s t , N Y

Visit our website today for all details, and to register or donate!

www.RideForRoswell.orgor call 716-The-Ride (843-7433)

Dr. Pailler with RPCI patient Dan DeCarlo

Sunday, August 15Gallagher Beach, Buffalo

One-mile and 600-yard swims benefiting pediatric cancer research and care

Register or donate …www.CarlysCrossing.org

716-845-8788

August 28 Tops 5K and 10K Run/Walk,

Williamsville, NY

September 22–26 Lake Tahoe 5K, ½ and Full Marathon

October 24 Niagara Falls International Challenge,

5K, 10K, ½ and Full Marathon

Register or donate …www.TeamCureChallenge.org

716-845-8788

Riding Together to Cure Cancer!

rpci - Roswell Park Comprehensive Cancer Center · rpci ness Elm & Carlton ... “On average, one...

Documents

Transcript of rpci - Roswell Park Comprehensive Cancer Center · rpci ness Elm & Carlton ... “On average, one...