Chemotherapy is a major tool in the fight against cancer. This method of using drugs to destroy cancer cells has successfully treated many patients. Yet while chemotherapy has been proven to effectively attack cancer cells, it can cause serious side effects that can severely impact a patient’s quality of life.
Here M. Houman Fekrazad, M.D., an associate clinical professor of medical oncology at City of Hope | Antelope Valley, discusses ongoing research, including a new chemotherapy patch he is currently developing. Such research has considerable promise not only to increase chemotherapy’s efficacy, but to reduce the toxic side effects that often accompany this form of treatment.
How does chemotherapy work? Chemotherapy works by stopping or slowing the growth of cancer cells. At the same time, it can damage normal healthy cells of the human body, such as those in the bone marrow, liver, kidney, nerves, hair or the lining of your mouth and intestines. Damage to healthy cells may cause side effects. Most are temporary while the patient is on treatment. However, long-term side effects of chemotherapy need to be discussed with patients prior to initiating therapy.
You own a patent on a patch that can deliver chemotherapy through the skin. Can you tell us more? Sure. By today’s standards, there has only been two ways to administer anti-cancer drugs – intravenously (IV) and orally. In this project (which is still in the planning stages), we aim to put chemotherapy into nanoparticles and then pass it through the skin. The chemotherapy will then be released in the bloodstream to target the cancer cells. There are several issues that can potentially be eliminated when chemotherapy is administered through the skin. For example: » Continue Reading
If DNA contains the code of life, epigenetics is the code on top of the code. It works through small molecular “control knobs” called methyl groups placed either directly on the DNA or on closely linked proteins. These methyl groups control the activity of genes, turning some on and others off.
Certain genes, however, fall into a special category. These “bivalent” genes can be both turned on and turned off depending on what part of them is methylated. So they find a balance, neither fully active nor completely shut down, but perfectly poised and controlled epigenetically.
Researchers led by City of Hope’s Gerd Pfeifer, Ph.D., the Lester M. and Irene C. Finkelstein Chair in Biology, recently pinpointed a key molecular change in cells that can inadvertently tip the genetic balance in favor of cancer. The findings may be the first to use human tissue samples to positively link an epigenetic code to the development and spread of colon cancer. » Continue Reading
Advances in the fight against cancer have many measures. Grant dollars received. Papers published. New targets for medication discovered. New therapies unveiled. These all matter because they lead to the ultimate measure of success in treating cancer: people alive and families intact.
“One moment, they might be a healthy 25- or 35-year-old, and the next they are wondering how many years they have left,” says Yuman Fong, M.D., chair of the Department of Surgery at City of Hope. “The reason folks like me come to work every day, and we work so hard, is I have seen the progress that has been made in the last three decades at comprehensive cancer centers.”
If obesity raises the risk of cancer, it might stand to reason that weight-loss surgery could reduce the risk.
Brazilian researchers are convinced – at least the ones who recently analyzed the results of 13 studies on cancer rates in the wake of weight-loss surgery. The studies, which included more than 54,000 people total, found that cancer rates among people who had undergone weight-loss surgery were about the same as cancer rates among normal weight people. Cancer rates among obese people were almost twice that.
The results were published recently in Obesity Surgery and summed up by HealthDay. The connection makes sense to Cy A. Stein, M.D., Ph.D., the Arthur & Rosalie Kaplan Chair in Medical Oncology at City of Hope and the institution’s Deputy Director of Clinical Research.
“The evidence that obesity is related to an increased risk of cancer is significant, even in the modestly obese,” Stein told HealthDay. “There is an association [between obesity and cancer]. It is a risk factor for cancer development.” » Continue Reading
Quality of care is becoming an increasingly critical factor in how institutions are evaluated as health care providers. The more that medical centers can show how they adhere to the highest standards, the more successful they’ll be in the evolving climate. City of Hope has long been well-positioned in this regard, and its standing among peer institutions recently received a major boost.
The American College of Surgeons Commission on Cancer (COC) recognized our exceptional level of cancer care by awarding us with its highest level of accreditation, “Three-Year with Commendation.” This is the second consecutive time — surveys take place every three years — that City of Hope has received the rating. The survey results underscore the scope and excellence of City of Hope’s clinical cancer care. They also speak to the hard work of the Clinical Cancer Committee, comprising administrators and clinicians, to ensure the standards of the college continue to be met and exceeded. To receive this exceptional mark, programs must comply with all of the commission’s standards and receive a commendation rating for at least one of those standards. City of Hope received commendations for its performance on five:
- Clinical trials accrual
- Public reporting of outcomes
- Adherence to College of American Pathologists protocols
- Rapid Quality Reporting System participation
- Accuracy of data submission
Cancer is a daunting diagnosis, and patients need to be confident in their treatment decisions. Often that means they have to be their own advocates and get a second opinion.
That’s easier said than done. Some patients fear that seeking a second opinion will alienate their doctor, the person in whom they’ve placed their trust. Others simply don’t know how to begin.
1. For starters, be assured that an informed patient is a good patient. Top doctors understand this. Also, it’s not necessary to ask your doctor for an authorization to get a second opinion. Simply call any one of your doctors and ask for your records to be sent to you. It’s that simple – and it’s your right.
2. Be aware that specialized institutions such as City of Hope may have treatment options that are not available elsewhere, such as IORT, short for intraoperative radiation therapy. With IORT, one dose of radiation during surgery reduces treatment from six weeks to just one day. Such therapies are worth investigating, and you deserve to know about them.
3. Inquire about the chance you could participate in a clinical trial. You will still get gold standard treatment – that’s mandatory – but you might also be able to get additional treatment that improve your odds of remission, reduce your side effects or enhance your quality of life. At City of Hope, we offer an array of clinical trials for many types and stages of cancer.
4. Come prepared to your second-opinion appointment – and ask many questions, particularly about treatments, options and where to find them. Also, ask about details of your diagnosis. Diagnostic errors affect about 12 million people in the U.S. each year. One former City of Hope patient, for example, was urged by her physician to undergo a hysterectomy for a benign cyst. Instead she had ovarian cancer. She sought care at City of Hope and is now living cancer free.
5. Understand that getting a second opinion is simply a search for information. Ultimately, City of Hope experts may agree with your doctor’s treatment plan. If they do, and you maintain your original course of therapy, you can do so with increased confidence. If our doctors make different recommendations, you’ll know that their advice is based on extremely specialized expertise and experience in your specific disease.
Learn more about getting a second opinion at City of Hope by visiting us online or by calling 800-826-HOPE (4673). City of Hope staff will explain what’s required for a consult at City of Hope and help you determine, before you come in, whether or not your insurance will pay for the appointment.
Sunscreen – we know it’s essential in reducing the risk of skin cancer, but we skimp on it, forget to reapply it or forgo it altogether before hitting the outdoors. That helps explains our skin cancer numbers.
Skin cancer is the most common cancer in the United States, with more than 3.5 million people diagnosed with basal and squamous cell skin cancer each year. Melanoma, the most deadly type of skin cancer, accounts for more than 76,000 cases of skin cancer.
With summer just around the corner – and an increased likelihood of excessive sun exposure – now’s the perfect time to brush up on sun safety.
City of Hope surgical oncologist Vijay Trisal, M.D., who helps formulate melanoma treatment guidelines both nationally and internationally, shares some sunscreen tips to help you get the best protection against the sun. » Continue Reading
In an intimate ceremony with family, friends and faculty gathered near the Rose Garden, a dozen of City of Hope’s brightest young people embarked recently on the next phase of their scientific careers.
The 16th commencement ceremony of the Irell & Manella Graduate School of Biological Sciences took place June 6 on the institution’s Duarte campus. Sharing the culmination of years of intensive study and training, the students received their Doctor of Philosophy degrees from their laboratory mentors.
The event marked the beginning of what are sure to be great works of discovery, according to Robert Stone, City of Hope’s president and chief executive officer.
“While it’s true that today marks the completion of countless hours in the lab and the library, these pursuits were not ends in themselves,” Stone said. “Rather, they were preparation for careers of greatness …
“Thanks to this great institution — and thanks to the careers that now lie before you — progress will be made against diseases that cause untold suffering and death,” he added.
A new approach to treating HIV could free patients from the virus’ tyranny once and for all. That approach will now advance to clinical trials, led by City of Hope researchers, through a $5.6 million grant from the California Regenerative Medicine Institute.
Under the leadership of John A. Zaia, M.D., chair of the Department of Virology and the Aaron D. Miller and Edith Miller Chair in Gene Therapy, a team of investigators at City of Hope, Sangamo Biosciences and Keck School of Medicine of USC have been developing a combination stem cell and gene therapy approach. Sangamo will provide an equal amount of funding to advance the project.
In the collaboration, AIDS patients from USC will receive treatment at City of Hope and then return to USC for follow-up.
“This is an important start that could one day change the way HIV/AIDS is treated,” Zaia said.
Although drug therapies aimed at holding back HIV, the virus that causes AIDS, have advanced significantly, they do not prevent continued virus growth and they have significant side effects. A cure remains elusive.
Several years ago, a surprise development gave hope that a genetic modification of blood stem cells could provide that cure. An AIDS patient became free of HIV infection after he received a bone marrow transplant to treat his leukemia. Dubbed the “Berlin patient,” he received marrow from a healthy donor who had a rare mutation that prevents the production of a key protein that the virus needs to infect cells. Essentially, the donor marrow was immune to HIV infection. » Continue Reading
Changes in health care coverage are making it harder for some cancer patients to get high-level care. City of Hope is making it easier with the opening of a new community clinic in Arcadia, California.
City of Hope | Arcadia, located next to Methodist Hospital of Southern California, opened its doors for service this month. The clinic represents City of Hope’s latest efforts to strategically address the rapidly changing health care environment by expanding access to high-level cancer care. The facility makes it easier for patients in the community to obtain the general cancer surgery and medical oncology services they need.
At 3,000 square feet, the clinic houses seven exam rooms. Two of the rooms can be used for minor procedures, including those addressing prostate cancer. » Continue Reading