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
Few people might recognize the word xerostomia, but its effect is familiar. Conservative estimates suggest that 20 percent of the U.S. population suffers from this malady, known more commonly as dry mouth.
The disorder arises when the mouth stops producing enough saliva. For many patients with cancers of the head and neck, the symptoms are all too common. Radiation therapy often is used to treat these cancers, and while highly targeted, the treatment can damage salivary glands. The result leads to difficulty swallowing and a lower quality of life.
There currently is no way to restore salivary gland function permanently. Artificial saliva is available, but clinicians generally don’t regard it as an effective long-term solution.
David K. Ann, Ph.D., professor in the Department of Molecular Pharmacology, collaborating with Kirsten Limesand, Ph.D., of the University of Arizona’s Department of Nutritional Sciences, aims to find better answers for these patients. The scientists recently received a five-year, $1.6 million grant from the National Institute of Dental & Craniofacial Research, a part of the National Institutes of Health, to study stem cells that may restore salivary gland tissue damaged by cancer treatment. » Continue Reading
Less invasive treatments. More cures.
Yuman Fong, M.D., chair of the Department of Surgery at City of Hope, has adopted this as more than a mantra. He’s made it his life’s work. Penning the leading textbooks and manuals in liver surgery, delving into gene therapy to find innovative new approaches to use viruses to attack cancer, and exploring robotic means to improve surgeries and make them less invasive, Fong doesn’t limit himself to a single medical discipline in his quest to fight cancer.
“Many advanced cancers are curable,” he says. “Seeing an expert makes a difference.”
Fong uses the example of liver cancer, saying that often patients who have multiple tumors don’t recognize effective treatments are available for even advanced and complex cancers. About half of patients who have had colorectal cancer will develop a tumor in their liver. Of these, Fong estimates as many to 50 percent to 60 percent of these cases are curable – if patients can get to surgeons with the expertise to handle their disease.
He has been a leader in performing liver cancer surgeries that primarily use a needle to ablate the tumor – often allowing patients to go home on the same day.
While currently no broad screening regimen exists for liver cancer, doctors know two groups who are at highest risk, he says: colorectal cancer survivors and hepatitis C patients – especially those who have liver cirrhosis.
Fong’s point is that where you seek treatment for cancer care matters. That point is backed up by recent City of Hope research finding that being treated at a comprehensive cancer center does, in fact, improve survival. The study, recently presented at the American Society of Clinical Oncology’s annual meeting, also found that ethnicity, insurance type and socioeconomic status could all be barriers to getting treatment at a comprehensive cancer center.
The first step is for people to recognize that cancer is often more curable than they think, says Fong, and to seek the experts in curing it.
Learn more about becoming a patient or getting a second opinion at City of Hope by visiting us online or by calling 800-826-HOPE (4673). Our staff will explain what previous medical records we’ll need for your first appointment and help you determine, before you come in, whether or not your insurance will pay for the appointment.
Learning and memory are regulated by a region of the brain known as the hippocampus. New research from City of Hope has found that stimulating a specific gene could prompt growth – in adults – of new neurons in this critical region, leading to faster learning and better memories.
Understanding the link between this gene and the growth of new neurons – or neurogenesis – is an important step in developing therapies to address impaired learning and memory associated with neurodegenerative diseases and aging. The new research was published June 9 in the Proceedings of the National Academy of Sciences.
The study, which used an animal model, found that overexpressing the gene – a nuclear receptor called TLX – resulted in smart, faster learners that retained information better and longer.
“Memory loss is a major health problem, both in diseases like Alzheimer’s, but also just associated with aging,” said Yanhong Shi, Ph.D., lead author of the study and a neurosciences associate professor at City of Hope. “In our study, we manipulated the expression of this receptor by introducing an additional copy of the gene – which obviously we cannot do outside the laboratory setting. The next step is to find the drug that can target this same gene.”
The discovery creates a new potential strategy for improving cognitive performance in elderly patients and those who have a neurological disease or brain injury. » Continue Reading
A quarter of children in remission from acute lymphoblastic leukemia, or ALL, are tripling their risk of a relapse because they are missing too many doses of an essential maintenance medication, according to findings from a recent City of Hope study .
The research, published in the journal Blood, also reports maintenance medication adherence was lower in minority groups. About 46 percent of African-American children and 28 percent of Asian children are not taking enough doses to prevent relapse, compared with 14 percent of white children.
Acute lymphoblastic leukemia, a cancer of the white blood cells, is the most common form of childhood cancer. While more than 95 percent of children with ALL enter remission within a month of receiving initial cancer therapy, one in five will relapse. Additionally, relapsed disease is often harder to treat and may involve costlier, most toxic therapies.
In order to remain cancer-free, children in ALL remission must take a form of oral chemotherapy, called 6-mercaptopurine(6MP), every day for two years to protect against the disease coming back.
Despite 6MP’s proven benefit, previous studies have suggested pediatric ALL patients have difficulty taking it consistently. Other studies reported survival rates vary greatly among racial groups – prompting investigators to begin studying race-specific patterns of adherence in children with ALL.
“While we don’t yet know why children of different races have significantly different survival rates for ALL, we know that their adherence to their maintenance medication is a critical factor in their survival,” said first author Smita Bhatia, M.D., M.P.H. “With this in mind, we sought to explore the potential linkages that may exist between several key race-specific sociodemographics of these children and their adherence to 6MP.”
Bhatia, who is also the Ruth Ziegler Chair in Population Sciences, and her team began their research studying differences in medication adherence among different racial groups of children in remission from ALL in 2012, reporting that Hispanic children did not follow their prescribed maintenance regimen as consistently as non-Hispanic whites. » Continue Reading