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“Train the trainers” program spreads the practice of palliative care
Palliative care, once considered a treatment of last resort when no more can be done, has seen its worth proven in recent years by numerous studies. Research has shown that quality palliative care can improve patients’ quality of life, benefit treatment outcomes and prolong survival. It can also lower costs by reducing the length of hospital stays and number of readmissions.
City of Hope will be developing a “train the trainers” program that helps nursing school faculty create a curriculum that includes the research, practice and improvement of palliative care.
Given these benefits, many health care programs are looking to hire or provide staff with palliative care training, and City of Hope is on the forefront of empowering them with these skills. And thanks to a $1.5 million grant from the National Cancer Institute, it is developing a “train the trainers” program with the American Association of Colleges of Nursing (AACN) for nursing school faculty.
The four-year program, called “Integrating Palliative Oncology Care into Doctor of Nursing Practice (DNP) Education and Clinical Practice,” will train faculty in DNP programs about the research, education and practice of evidence-based palliative care, addressing topics such as pain and symptoms management, communication and cultural issues, and assessing and treating quality-of-life matters.
“DNP graduates play a pivotal role in leading change and transforming care for the 1.6 million Americans who will be diagnosed with cancer this year, plus the 13.7 million Americans who are living with a history of cancer,” said Betty Ferrell, Ph.D., R.N., professor in City of Hope’s Division of Nursing Research and Education and principal investigator of this project. “As we near full implementation of the Affordable Care Act, DNPs will have unprecedented opportunities to promote excellent care to those with cancer.” Continue reading ““Train the trainers” program spreads the practice of palliative care” »
Fast-talking stem cell scientists compete in elevator pitch contest
A stem cell researcher steps into an elevator, followed by his congressman, a Wall Street Journal science writer and a wealthy philanthropist. As the doors close and the scientist pushes the button for his floor, the trio turns to him and asks, “So what do you do?”
Stem cells offer vast potential for curing diseases, but can scientists do a quick elevator pitch of their promising studies? Three City of Hope scientists gave it a shot. (photo credit: City of Hope)
The next 30 seconds of that scientist’s life could change his career; each of his elevator mates might be crucial to advancing his work. But he’s got to give a clear, comprehensible answer that will have them yearning for more before those doors open again.
When it comes to stem cell research — and the potential breakthroughs that could result — creating a so-called elevator speech is no easy feat. But that was exactly the challenge posed by the California Institute for Regenerative Medicine (CIRM), the state’s stem cell agency. The institute asked attendees of its recent grantee meeting in San Francisco to give their best 30-second speeches about their work. They recorded the pitches and posted them on YouTube.
According to the CIRM contest webpage, the best three would receive “fame, the admiration of their colleagues, and a small prize.”
John A. Zaia, M.D., Aaron D. and Edith Miller Chair in Gene Therapy and chair of City of Hope’s Department of Virology, placed second in the principal investigator (PI) category.
Coming in at exactly 30 seconds, Zaia cut straight to the chase. “Our goal is to cure AIDS,” he said, “so that people with HIV infection don’t have to take medicines for the rest of their life.” Continue reading “Fast-talking stem cell scientists compete in elevator pitch contest” »
With hysterectomies, consider leaving the ovaries in, study suggests
In the U.S., approximately 600,000 hysterectomies are performed each year and about half of them are accompanied by a bilateral oophorectomy, the removal of both ovaries. The rationale is that their removal will practically eliminate the risk of ovarian cancer and substantially lower the risk of breast cancer, too.
For women planning for a hysterectomy, a new study suggests it may be better to leave your ovaries in.
However, a new study published in the April issue of Obstetrics & Gynecology may prompt women planning a hysterectomy to reconsider ovarian removal, too; it showed that women who chose to keep their ovaries actually lived longer.
In the paper, the authors tracked over 30,000 women from the Nurses’ Health Study who have had undergone a hysterectomy without a gynecologic cancer diagnosis. Of those, almost 17,000 also had a bilateral oophorectomy while the others elected for ovarian conservation.
After 28 years of follow-up, they have found that 13.3 percent of women who opted for ovarian conservation had died from any cause, versus 16.8 percent of women who opted for ovarian removal during their hysterectomy. Continue reading “With hysterectomies, consider leaving the ovaries in, study suggests” »
Odds for pediatric cancer patients have improved, but not enough
Thirty years ago, children with cancer had only a 30 percent chance of surviving. Now, not only are more patients with pediatric cancers surviving, they’re also living longer and healthier lives than in generations past.
The odds for children diagnosed with cancer have improved in recent decades, but much work remains to be done.
Research and care at City of Hope have helped make that possible. Here’s a look at some of that work:
Ewing’s sarcoma: A new approach to treatment
Ewing’s sarcoma, the second most-common primary bone tumor in children and adolescents, represents 3 percent of all pediatric malignancies. Tumors usually develop in the bones of the arms, legs, pelvis or chest.
In rare cases, some tumors may develop in the skull. As many as 30 percent of children diagnosed with these tumors do not respond to conventional therapies and ultimately die. Continue reading “Odds for pediatric cancer patients have improved, but not enough” »
Could new treatment conquer type of leukemia? Study suggests yes
Leukemia researchers reported a significant, but still experimental, stride against blood disease this week. In a small trial, they achieved remission in adults with relapsed B-cell acute lymphoblastic leukemia by reprogramming patients’ own T cells to fight the disease.
In B-cell acute lymphoblastic leukemia, the body produces too many immune cells, crowding out other blood cells. (Photo credit: VashiDonk)
A common form of childhood cancer, this type of leukemia is rare but often deadly in adults; the study’s authors describe the prognosis as “dismal.” In the disease, the body drastically overproduces white blood cells that normally protect from infection, crowding out other blood cells.
The study, led by Memorial Sloan-Kettering scientists, found that in each participant, the treatment left the disease undetectable in the bloodstream. Continue reading “Could new treatment conquer type of leukemia? Study suggests yes” »
Rising anal cancer cases may be linked to the ’80s HIV epidemic
Anal cancer represents only a small portion of digestive tract cancers — 7,080 out of 290,200 cases, according to American Cancer Society estimates — but its incidence rate has more than doubled since the mid- to late 1990s.
Anal cancer may be linked to the human papillomavirus (shown above) but a new study suggests that its recent rate and growth spike is also related to the HIV epidemic of the 1980s.
This has caught the attention of several City of Hope researchers, who are curious about the alarming trend and its potential causes. So they delved into the figures compiled by the National Cancer Institute’s Surveillance, Epidemiology and End Results database to seek answers.
The study and its results were published online in the Journal of Clinical Oncology on March 18. In the article, the researchers found that for squamous cell carcinoma in the anal canal (SCCA) — the most common type of anal cancer — the average incidence rate until 1997 was 1.2 cases per 100,000 Americans, with an annual increase of 2.4 percent. After 1997, that went up to 2.8 cases per 100,000 Americans with an annual increase of 7.2 percent.
“The dramatic rise may be partly due to early detection through patient screening,” said lead researcher Rebecca Nelson, Ph.D., assistant research scientist in the Division of Biostatistics. “But this time point also coincides with HIV’s impact on the acquisition and persistence of HPV, the primary cause of SCCAs.” Continue reading “Rising anal cancer cases may be linked to the ’80s HIV epidemic” »
For maximum impact, donate blood platelets – and save three lives
Drives for blood donations are a common occurrence, but platelet apheresis — in which the platelets are filtered out of the bloodstream for donation — is considerably less well-known. City of Hope hopes to change that.
The blood-clotting components are essential to cancer patients being treated with a bone marrow transplant.
A platelet donation can support up to three lives and may be as valuable as 18 units of whole blood. (Photo credit: Keith Brofsky)
“Platelets are the lifeline for our patients during their transplants,” said Kasie Uyeno, manager of City of Hope’s Blood Donor Recruitment Program. “Until the new marrow engrafts and starts producing blood cells and platelets, the patients are dependent on transfusions … some require multiple platelet transfusions every day for weeks.”
Maintaining a supply of platelets is not easy. Unlike other blood products that can be chilled or frozen, platelets have to be stored at room temperature; this gives them a notoriously short shelf life of five days.
Given City of Hope’s stellar reputation in hematology and bone marrow transplants, it’s no surprise that there is a continuously high need for platelets. Continue reading “For maximum impact, donate blood platelets – and save three lives” »
Earlier, more frequent mammograms equal more false-positive results
Start at 40 or start at 50? Once a year or every other year? These are the questions women — and their doctors — are asking about mammograms as screening guidelines and recommendations are continually revised and debated.
According to the latest studies, earlier and more frequent mammograms result in more false-positive results, which can have long-lasting psychosocial effects.
The latest round of studies is far from the final word, but it highlights an issue associated with earlier, more frequent screenings: False-positive mammograms lead to unnecessary worries and invasive biopsies.
The first study, published online in JAMA Internal Medicine on March 18, analyzed data from more than 900,000 women who underwent screening mammograms from 1994 through 2008. The data were sorted for screening frequency, breast density, age and hormone therapy use and evaluated for late-stage breast cancer diagnoses and false-positive cancer diagnoses.
Even after accounting for breast density and hormone therapy use, researchers found that for women ages 50 to 74, having a mammogram every other year did not lead to a higher likelihood of detecting an advanced-stage breast cancer compared to women who received an annual mammogram. In fact, only women ages 40 to 49 with extremely dense breasts showed a benefit of having annual examinations. Continue reading “Earlier, more frequent mammograms equal more false-positive results” »
Tumor DNA test could assess efficacy of breast cancer treatment
Just as diabetics have to check their blood sugar levels and HIV patients people have to monitor their viral loads, cancer patients and their doctors have to rely on regular, accurate testing to determine whether their therapies are working.
Testing blood for DNA with tumor-specific alterations could help breast cancer patients and their doctors assess the effectiveness of treatment.
For women with advanced breast cancer, the current blood tests miss the mark about a third of the time, but scientists might have found a more powerful and accurate way to track disease progression. This could help oncologists evaluate, or switch, treatments for maximum effectiveness as early as possible. The results were published in the March 14 issue of The New England Journal of Medicine. In the study, 30 women with metastatic breast cancer underwent CT scans and provided blood samples. The blood was analyzed for circulating DNA with tumor-specific alterations; it was also assessed with two standard tests that look for tumor cells and CT 15-3, a breast cancer-specific antigen. Continue reading “Tumor DNA test could assess efficacy of breast cancer treatment” »
High-fat dairy foods linked to lower breast cancer survival
For women, dairy intake is often associated with building and maintaining strong bones, but its connection to breast cancer risk is more nuanced. Some research suggests that consumption of dairy foods is linked to a higher risk of the disease; other research suggests a preventive effect.
For breast cancer survivors, consuming high-fat dairy products is linked to worse survival, but this link is not seen with low-fat dairy intake.
But what if it’s dairy foods’ fat content that matters? That potential connection was explored in a March 14 article in the Journal of the National Cancer Institute based on a survey and follow-up of nearly 1,900 women diagnosed with breast cancer.
Because estrogenic hormones are found in fat, the authors hypothesized that higher-fat dairy products (made primarily by pregnant and nursing cows) would contain more of these compounds, thereby fueling breast cancer cells’ growth and recurrence.
For the study, the participants’ dietary habits were analyzed and divided according to how much high-fat and low-fat dairy products they consumed each day. The participants’ were then tracked for breast cancer recurrence or mortality. Continue reading “High-fat dairy foods linked to lower breast cancer survival” »
