Meet our doctors: Oncologist Misagh Karimi on obesity and cancer

March 14, 2015 | by   

Misagh Karimi, M.D., assistant clinical professor, is a medical oncologist at one of City of Hope’s newest community practice locations, located in Corona in Riverside County. A recent community health report from Corona’s public health department stated that obesity rates for teens and adults in Riverside County are the highest in California.

Here, Karimi discusses the connection between obesity and cancer.

What is known about the relationship between obesity and cancer?

Dr. Karimi on obesity and cancer

Misagh Karimi practices at City of Hope | Corona. Here, he explains the connections between obesity and cancer.

Multiple studies have shown correlations between obesity and a risk of cancer recurrence. There is significant evidence that obesity increases the chance of recurrence of cancer in multiple diseases, such as breast, colon, esophageal and other cancers. According to the American Society of Clinical Oncology, more than 50,000 new cases of cancer in women and 34,000 in men were due to obesity in 2007. Obesity may soon eclipse smoking as the No. 1 preventable cause of cancer.

Among obese individuals, specific biological characteristics can increase cancer risk:

· Obese people typically have increased levels of insulin (and insulin-like growth factor IGF-1), which can promote tumor growth.
· Sub-acute inflammation, which has been associated with cancer risk, is also common among obese people.

Are specific cancers more prevalent due to obesity?

Certainly, breast, colon, esophageal and stomach cancers appear to have a significant relationship with obesity. » Continue Reading

Ovarian cancer treatment: New guidelines reflect better outcomes

March 13, 2015 | by   

In 1975, the median survival for patients with ovarian cancer was about 12 months. Today, the median survival is more than 5 years.

ovaries and ovarian cancer

Cancer of the ovaries, illustrated here on the left and right, is, in fact, a treatable illness. Newly released ovarian cancer treatment guidelines highlight just how much progress has been made. City of Hope’s Robert Morgan has been instrumental in establishing guidelines for best possible treatment.

Although researchers and clinicians are far from satisfied, the progress in ovarian cancer treatment is encouraging, said Robert Morgan, M.D., F.A.C.P., professor of medical oncology in the Department of Medical Oncology and Therapeutics Research at City of Hope. Morgan is also chair of the National Comprehensive Cancer Network’s Guidelines Panel for Ovarian Cancer, which recently released its 20th annual edition of the guidelines.

“This is a very treatable illness,” Morgan said. “I’m frustrated that I still hear from women who are diagnosed and told to get their affairs in order. That’s exactly the wrong advice. Much of the time, these patients are curable.”

In fact, ovarian cancer responds to drug treatment as often as 90 percent of the time. While fewer than 40 percent of women are cured, overall survival is improving – and so are treatments. » Continue Reading

Colorectal cancer: What our experts have to say

March 12, 2015 | by   

Colorectal cancer may be one of the most common cancers in both men and women, but it’s also one of the most curable cancers. Today, because of effective screening tests and more advanced treatment options, there are more than 1 million survivors of colorectal cancer in the United States.

Here, colorectal cancer experts Donald David, M.D., clinical professor and chief of City of Hope’s Division of Gastroenterology, and Stephen Sentovich, M.D., a clinical professor of surgery at City of Hope, explain the importance of colorectal screening and the growing list of treatments for the disease.

On who is most at risk:

Sentovich: “In the U.S., we are all at risk of colon and rectal cancer. It can occur at any age, but the incidence increases as we age, particularly as we get over 50 years of age. For both men and women here in the U.S., the lifetime chance of getting colon and rectal cancer is about 5 percent. In some families, the risk is much higher due to genetic risk factors.” » Continue Reading

Drug could boost chance of pregnancy after breast cancer, study suggests

March 11, 2015 | by   

Breast cancer treatment can damage a woman’s ability to become pregnant, making the impact on fertility one of the key factors that many consider when choosing a therapy regimen. Now a study has found that breast cancer patients treated with a hormone-blocking drug in addition to chemotherapy were less likely to experience ovarian failure and more likely to have successful pregnancies.

breast cancer treatment's effect on fertility

Breast cancer  and fertility: Breast cancer patients treated with a hormone-blocking medication in addition to chemotherapy were less likely to have ovarian failure and more likely to become pregnant after treatment.

Although the study on breast cancer and fertility has some limitations, it could suggest an alternative strategy for women who hope to become pregnant after breast cancer treatment, said George Somlo, M.D., a professor of breast oncology and staff physician at City of Hope. He was not involved in the study, but provided outside expert commentary in an interview with Medpage Today.

The Cleveland Clinic study, published in the New England Journal of Medicine, found that women who received goserelin – a synthetic version of a naturally occurring hormone – during chemotherapy experienced an 8 percent ovarian failure rate, compared to 22 percent among women who did not receive the drug. In addition, 21 percent of women who received goserelin became pregnant within five years post-treatment, compared to 11 percent of women in the control group during the same time frame.

Somlo elaborated on his perspective in this Q and A. » Continue Reading

Cancer Insights: The real link between prostate cancer and hair loss

March 10, 2015 | by   
Sumanta Pal, M.D.

Sumanta Kumar Pal: The connection between prostate cancer and hair loss is not coincidence, but it might not be exactly what many men think either.

My colleagues in the clinic know I’ve got a soft spot. Last week, a patient of mine offered me a fantastic compliment. “You’re looking younger these days, Dr. Pal!” she said, offering me a big hug as she proceeded out of the clinic room.

Lovely, I thought. The early morning workouts are paying off.

She continued: “Now if you’d just consider using some Rogaine, I think you’d set the dial back about 10 years!”

Ouch. My nurse gave me a somber look, understanding the pain these words had inflicted. I wouldn’t consider myself to be vain by any means, but my hair loss has created increasing conflict between me and my bathroom mirror. With every passing morning, I notice a little less hair up front, and a bit less up top. This pattern, termed frontal and vertex balding respectively, plagues nearly half of American males, albeit to different degrees. Until recently, the major toll of this hair loss for me has been cosmetic, chipping away at my self-image as a youthful oncologist.

A recent study published in the Journal of Clinical Oncology, however, suggests a more significant price. The study authors, based at several U.S. institutions, utilized a database of over 39,000 male patients who were involved in a trial to assess cancer screening. These men were asked to recall their pattern of hair loss at the age of 45, characterizing the degree of frontal and vertex balding. » Continue Reading

Specific protein may be powerful indicator of liver cancer, study finds

March 9, 2015 | by   

Liver cancer is terribly difficult to cure. Despite significant treatment advances, five-year survival rates remain at about 15 percent overall — and they rapidly approach zero when the disease is found too late. Findings by City of Hope’s Peiguo Chu, M.D., Ph.D., and a team of scientists may help better those odds.

protein glypican 3

Those at risk of liver cancer may find hope of early detection in a protein called glypican 3.

Scarring of the liver, called cirrhosis, is a major risk factor for liver cancer. It’s caused most often by infection with the hepatitis B or C viruses, alone or together, as well as alcohol abuse and a build-up of fat in the liver known as fatty liver disease.

Determining if cancer has developed in a cirrhotic liver is difficult, and early detection is particularly challenging. Unlike breast and colon cancers, liver cancer appears to have no precancerous lesions that might indicate cancer is imminent, according to Chu, a professor in the Department of Pathology. Various abnormal cells in the scarred liver can hint at the presence of disease, but they are unreliable.

Chu believes a protein called glypican 3 may offer a better answer. In a study recently published in the journal Carcinogenesis, his research team found that glypican 3 was present at much higher levels in liver cancer than in normal liver tissue and in cirrhotic liver tissue that was not cancerous.

» Continue Reading

Meet our doctors: Christiane Querfeld on cutaneous lymphoma

March 7, 2015 | by   
Christiane Querfeld

Christiane Querfeld discusses how new cutaneous lymphoma therapies and physician collaboration lead to better patient outcomes

Cutaneous lymphoma, a form of non-Hodgkin lymphoma, is a rare type of cancer that begins in the white blood cells and attacks the skin. It can cause rash-like skin redness and, sometimes, skin tumors. Although cutaneous lymphomas are rare, accounting for about 5 percent of all non-Hodgkin lymphomas, approximately 20,000 people in the United States are estimated to have cutaneous lymphoma.

Here, dermatologist/dermatopathologist and cutaneous lymphoma expert Christiane Querfeld, M.D., Ph.D., director of City of Hope’s Cutaneous Lymphoma Program, discusses how new therapy options and continued collaboration among physicians have contributed to better care and outcomes for cutaneous lymphoma patients, and helped many to return to a normal life.

What is cutaneous lymphoma and what causes it?

Cutaneous lymphomas, also known as lymphomas of the skin, are rare forms of cancer of the lymphocyte (a type of white blood cell that fights infection in the body) that primarily manifest in the skin, but may spread to the lymph nodes, blood and other organs. All cutaneous lymphomas are non-Hodgkin lymphomas.

Most cases of cutaneous lymphoma have no known cause, and therefore, they are difficult to prevent. Understanding why the lymphocytes on the skin become cancerous in the skin is a current research focus here at City of Hope. » Continue Reading

Curing HIV is the goal. New stem cell clinical trial could get us there

March 6, 2015 | by   

Curing HIV, not simply controlling its replication, is the ultimate goal of HIV researchers. A new clinical trial at City of Hope could put that goal within reach.

The trial will test an innovative new therapy that modifies the stem cells of patients with HIV to make them resistant to infection with the virus. Here’s how it works:


A novel treatment for HIV will be offered via clinical trial at City of Hope. The therapy edits a patient’s stem cells to prevent production of a protein the virus needs to infect healthy cells.

The AIDS virus relies on a protein called CCR5 to penetrate and infect cells. For the trial, researchers will use a zinc finger nuclease, or ZFN, to modify blood stem cells from patients infected with HIV. The ZFN acts as a pair of molecular scissors that cuts the CCR5 gene out of the cells. Without the gene, there is no CCR protein – and researchers hope that when these cells are infused back into the patient, their immune system will be resistant to HIV.

“It’s erasing the gene, and once it’s erased, it never can reappear,” said John Zaia, M.D., in an interview with BuzzFeed News. Zaia is the Aaron D. Miller and Edith Miller Chair in Gene Therapy at City of Hope, chair of the Department of Virology and principal investigator of the trial. » Continue Reading

Elder care skills (and training) are vital at cancer hospitals

March 5, 2015 | by   

Bustling from room to room, bed to bed, patient care assistants are among those health care workers most intimately involved in the daily care of patients. They work closely with nurses by preparing rooms, bathing patients, assisting with skin care and providing other essential living needs. They also perform medically oriented work, such as obtaining specimens and checking vital signs.

geriatric training course

Gloria Vazquez-Amadeo proudly displays the button she earned after graduating from a geriatric training course for patient care assistants.

With patient care assistants so closely involved with patients’ day-to-day lives during treatment, it’s vital that they have the right skills to meet patients’ needs, especially as it relates to elder care. Because cancer is primarily a disease of the elderly, cancer patients are likely to be older adults.

The need for elder care skills will only grow. The overall U.S. population is aging, and projections show a 67 percent increase in cancer incidence by 2030 for people over 65. Further, many younger cancer patients develop symptoms and treatment side effects that can mimic conditions that older patients experience.

To help ensure that City of Hope is ready to meet cancer patients’ specialized needs, a group of personal care assistants recently undertook a special geriatric training program offered by the Department of Professional Practice and Education. The course included 16 hours of online work followed by two hours of classroom work per month for five months, providing participants with in-depth, interactive training in important skills needed to ensure the highest quality care. » Continue Reading

The future of colorectal cancer screening? It might be in your DNA

March 4, 2015 | by   

We’ve all heard the mantra: Cancer screening saves lives. And it does, especially with colorectal cancer.

DNA tests for colorectal cancer

A new colorectal screening that tests stool for DNA may persuade some colonoscopy-phobic people to be screened. It doesn’t detect all polyps, but as Dr. James Lin points out: “The best colon cancer screening test is the one the patient is using.”

Regular colonoscopies have been proven to reduce the risk of colorectal cancer death by up to 70 percent. Screening for colorectal cancer using the even simpler fecal occult blood tests has been found to reduce the risk of death by up to 33 percent.

Yet, despite the proven benefits of colorectal cancer screening, many people still put it off – or skip it altogether. To raise awareness of the very real need for colorectal cancer screening, March has been deemed Colorectal Cancer Awareness Month.

The American Cancer Society estimates there will be more than 132,700 new cases of colorectal cancer in the United States this year and that approximately 49,700 patients will die from this disease.

The U.S. Preventive Services Task Force currently recommends that adults begin colorectal cancer screening at age 50 and continue until they are 75 years old. Depending on which test is used, screening only need happen as little as once every 10 years.

New screening and prevention tools for colorectal cancer continue to evolve. In August of 2014, the Food and Drug Administration approved a new DNA stool test that can be used to screen for colorectal cancer.

» Continue Reading