Patient Care


Cancer in your family history? Your genes are not your destiny

November 22, 2014 | by

When it comes to cancer, your family history may provide more questions than answers: How do my genes increase my risk for cancer? No one in my family has had cancer; does that mean I won’t get cancer? What cancers are common in certain populations and ethnicities?

City of Hope experts have some guidance. “Your genes are not your destiny, but they can play a role in the decisions you make related to cancer screenings, diet and interventions that you do along the way,” said Joseph Alvarnas, M.D., director of medical quality and an associate clinical professor in the Department of Hematology & Hematopoietic Cell Transplantation at City of Hope. “You can take an active role in how you move along in life, rather than be the passive recipient of the hand that genetics happens to deal to you.” » Continue Reading


Made in City of Hope: T cells – enlisting the immune system to beat cancer

November 21, 2014 | by

The body’s immune system is usually adept at attacking outside invaders such as bacteria and viruses. But because cancer originates from the body’s own cells, the immune system can fail to see it as foreign. As a result, the body’s most powerful ally can remain largely idle against cancer as the disease progresses. Immunotherapy in general seeks to spur the immune system to action, helping the body fight cancer. One type of immunotherapy —T cell therapy — reprograms immune cells known as T cells to recognize and destroy cancer cells.

Stephen Forman

Stephen J. Forman, the head of City of Hope’s bone marrow transplant program, is leading a wave of T cell clinical trials, all of which are moving the treatment out of the lab and directly to patients.

A wave of clinical trials

Normally, T cells attack bacteria and other infectious agents. In T cell therapy, T cells are isolated from a sample of the patient’s blood, then genetically engineered to seek out and attack a specific cancer. Researchers grow millions of these engineered T cells in the laboratory. The engineered cells are reinfused into the patient, where they go to work eliminating cancer.

Stephen J. Forman, M.D., the Francis & Kathleen McNamara Distinguished Chair in Hematology and Hematopoietic Cell Transplantation, has long pursued breakthrough treatments for hematologic cancers and blood-related disorders, and heads up City of Hope’s bone marrow transplant program. Under his direction, a wave of T cell clinical trials is underway, all of which are moving the treatment out of the lab and directly to patients. » Continue Reading


One mother’s journey through adoption and neuroblastoma

November 20, 2014 | by

On Jan. 1, 2015, five City of Hope patients who have journeyed through cancer will welcome the new year with their loved ones atop City of Hope’s Tournament of Roses Parade float. The theme of the float is “Made Possible by HOPE.” The theme of the parade is “Inspiring Stories.”

Here, Kari Penner shares the inspiring story of her battle for her son. 

Kari Penner with son Adi

Kari Penner, left, fought to get the best treatment for her now-son Adi, whom she met in a Romanian orphanage and who was diagnosed with neuroblastoma before he was even 2 years old. (Photo courtesy of Kari Penner)

By Kari Penner

In 2002 at age 20, I decided to move to Romania for one year to volunteer in an orphanage. More than a year went by, but I couldn’t bring myself to leave the precious children there.

In July 2003, a newborn who had been abandoned at birth was brought to the orphanage when he was 2 months old. This was Adi.  In November 2004, Adi now 16 months old started getting sick. He had high fevers for a week and blood tests revealed severe anemia. More tests were run and in early December 2004 and Adi was diagnosed with Stage 4 neuroblastoma, a cancer of the nervous system that started on his adrenal gland and spread to his bone marrow.

I got to work researching and trying to find treatment options for him. I tried to get him to the States for treatment, but I didn’t have any luck. Children in foster care are not allowed to leave the country.

I felt like there were two options: Walk away and don’t look back, yet live with regret – or fight alongside this precious child and adopt him as my own.

I chose Adi. » Continue Reading


Thinking about e-cigs for the Great American Smokeout? Think again

November 20, 2014 | by

Are you thinking about switching from traditional cigarettes to e-cigarettes for the Great American Smokeout? Are you thinking that might be a better option than the traditional quit-smoking route? Think again.

For lung expert Brian Tiep, M.D., the dislike and distrust he feels for e-cigs comes down to this: The public has been burned by tobacco companies before.

ecig electronic cigarette

With no labeling required for e-cigs, the consumer doesn’t know for sure what’s in the products.

The same companies that claimed cigarettes were safe, he says, now claim that electronic cigarettes – which aren’t regulated by the Food and Drug Administration – are safe.

“I was opened-minded initially,” said Tiep, a physician in pulmonary and critical care medicine at City of Hope. “Then the tobacco companies started buying out the e-cigarette companies. These products have no regulations whatsoever right now. You’re trusting them to do the right thing by you. They claimed tobacco was safe, and it turned out not to be.”

As for tobacco cigarettes, a recent study in the Journal of the American Medical Association tied smoking among U.S. adults to 14 million health conditions. Further, a U.S. District Court judge who in 2006 found tobacco companies guilty of lying to the public about the dangers of smoking, ordered the companies to admit their wrongdoing. The judge ruled they defrauded the public in five key ways: lying about the health damage caused by smoking, lying about the addictive nature of nicotine, marketing “low tar” and “light” cigarettes as healthier with no evidence that they are, deliberately making their products as addictive as possible and hiding the dangers of secondhand smoke. » Continue Reading


If you fit these three criteria, you should get lung cancer screening

November 18, 2014 | by

lung cancer screening

Great strides have been made in treating cancer – including lung cancer – but by the time people show symptoms of the disease, the cancer has usually advanced. That’s because, at early stages, lung cancer has no symptoms.

Only recently has lung cancer screening become an option. (Read more about the risks and benefits.) The U.S. Preventive Task Force recommends screening with low-dose computed tomography (more commonly called a low-dose CT scan) for individuals who meet the following guidelines:

- Age 55 to 80
– Have a 30 pack-year smoking history. That is, the person smoked a pack a day for 30 years, or two packs a day for 15 years.
– Currently smoke or quit within the last 15 years. » Continue Reading


Couples and cancer: 10 tips for better communication

November 15, 2014 | by

Cancer is a couple’s disease. It affects not just the person diagnosed, but his or her partner as well. It also affects the ability of both people to communicate effectively.

Couples and cancer: Tips for coping

Cancer affects not just the person but his or her partner, too. City of Hope helps couples overcome their communication problems and work together during cancer treatment.

The Couples Coping with Cancer Together program at City of Hope teaches couples how to communicate and solve problems as a unit. Here are some practical behavior tips from that program:

Advice for the nonpatient:

•    Actively encourage the sharing of emotional concerns and fears.
•    Be open to her expression of concerns as often as she needs.
•    Listen to her concerns without trying to “fix,” minimize or give advice (unless asked).
•    Be physically present at all medical appointments, even when not asked.
•    Talk with the breast cancer patient about how the illness is impacting you. » Continue Reading


Lung cancer is a silent killer of women; if you’re at risk, get screened

November 13, 2014 | by

During October, everything seems to turn pink – clothing, the NFL logo, tape dispensers, boxing gloves, blenders, soup cans, you name it – in order to raise awareness for what many believe is the most dangerous cancer that affects women: breast cancer. But, in addition to thinking pink, women should also think pearl. That color represents lung cancer.

Lung cancer specialist Karen Reckamp, M.D.

Lung cancer isn’t just a smoker’s disease, or a male disease. Karen Reckamp, lung cancer specialist, gives her perspective on lung cancer in women.

Lung cancer is the No. 1 cancer killer of women, killing almost twice as many women as any other cancer. This year alone, it is estimated that lung cancer will claim the lives of 72,330 women.

When asked about the increasing rate of lung cancer in women, Karen Reckamp, M.D., M.S., co-director of the Lung Cancer and Thoracic Oncology Program at City of Hope, summed it up this way: “The main reason for the increase is due to smoking. The smoking trend began later among women, so we are now seeing the result. While there has been and overall lung cancer decline in the last decade, there are some places in the country, like the South, where rates for women are still increasing.”

But, Reckamp quickly points out that lung cancer is not just a smoker’s disease. Although smoking is the leading cause of lung cancer, other factors increase risk of the disease as well, such as exposure to radon, air pollution, even genetics. » Continue Reading


13-year-old leukemia survivor has one true hero: her brother

November 12, 2014 | by

In February 2003, when she was only 16 months old, Maya Gallardo was diagnosed with acute myelogenous leukemia (AML) and, to make matters much worse, pneumonia.

Aaron Gallardo hugs his little sister Maya, while she was sick with acute myelogenous leukemia.

Aaron Gallardo hugs his little sister Maya, while she was sick with acute myelogenous leukemia. Aaron’s stem cell donation cured Maya of the disease. (Photo courtesy of the Gallardo family.)

The pneumonia complicated what was already destined to be grueling treatment regimen. To assess the extent of her illness, Maya had to endure a spinal tap procedure; the pneumonia meant it had to be done without anesthesia. Her parents could do nothing but watch, and try to comfort her.

The spinal tap revealed such severe leukemia that doctors at the children’s hospital where she was being treated said she would likely live only a few weeks.

Nonetheless, they stabilized her, and began treating her with chemotherapy. Normally, chemotherapy is not given to pneumonia patients, but because Maya’s leukemia was so advanced, she had no option but to undergo simultaneous treatment for both. If the chemotherapy went well, she would need a bone marrow transplant, the only option for curing her AML. » Continue Reading


Medicare will pay for lung cancer screening for many longtime smokers

November 11, 2014 | by

Former smokers age 55 to 74 who rely on Medicare for health care services have just received a long-hoped-for announcement. Under a proposed decision from the Centers for Medicare and Medicaid Services, they’ll now have access to lung cancer screening with a low-dose CT scan.

lung cancer screening

Medicare may cover lung cancer screening with low-dose CT scans for smokers ages 55 to 74 with a 30-year pack history.

The proposed decision, announced Monday, comes about seven months after a nonbinding panel shocked lung cancer doctors and experts nationwide by recommending against paying for the potentially lifesaving screening. The U.S. Preventive Services Task Force had already embraced such screening in the wake of the National Lung Screening Trial, which determined that the scans are effective in detecting early-stage lung cancer. Private plans were (and still are) expected to cover the screening beginning in 2015.

“I think it’s great Medicare is going to be covering lung cancer screening,” said Dan Raz, M.D., co-director of City of Hope’s Lung Cancer and Thoracic Oncology Program. “Lung cancer is such an important disease and education is so important to predicting death.”

While the Centers for Medicare and Medicaid Services (CMS) news is mostly good, it’s not without drawbacks. First, Medicare is covering people only up to age 74 – not age 80, as the U.S. Preventive Services Task Force recommended. Second, Medicare is mandating that all participating centers must submit data to a CMS-approved registry to get reimbursement – and there is no such registry right now. » Continue Reading


7 diabetes facts for World Diabetes Day

November 10, 2014 | by

City of Hope has a longstanding commitment to combating diabetes, a leading national and global health threat. Already, it’s scored some successes, from research that led to the development of synthetic human insulin – still used by millions of patients – to potentially lifesaving islet cell transplants.

diabetes blood sugar test

For World Diabetes Day, City of Hope shares some of the diabetes facts that drive the institution to keep looking for better treatments and a cure for this growing national and global health threat.

Diabetes researchers here continue to push forward in the fields of epigenetics, immunology, developmental biology, translational medicine, obesity, nutrition and metabolism. A pioneer in translational research for diabetes, City of Hope serves as the West Coast’s leading center for islet cell therapy, and is a leader in epigenetics and molecular research. Its diabetes program is built on a rich history that started with its founder, Rachmiel Levine, M.D. He was the first scientist to describe the role of insulin in regulating glucose entry into the cell. That work led to an understanding of what’s now known as “insulin resistance,” the hallmark of type 2 diabetes.

Diabetes comes in two basic types. Type 1 diabetes is usually diagnosed in children and young adults. In this disease, the body attacks its own pancreatic islet cells, which produce insulin, a hormone needed to convert sugar, starches and other food into energy the body needs. In type 2 diabetes, the body doesn’t use insulin properly, leading to blood sugar levels that are higher than normal – also called hyperglycemia. At first, the pancreas produces extra insulin to compensate, but over time it isn’t able to keep up and can’t maintain normal glucose levels.

To mark World Diabetes Day on Nov. 14, consider these diabetes facts. They drive our researchers year-round to keep looking for cures: » Continue Reading