Meet our doctors: Hematologist Leslie Popplewell on clinical trials

March 2, 2014 | by   

Research studies known as clinical trials have led to countless advances in the diagnosis, treatment and prevention of cancer. These studies test the effectiveness of new medical approaches that can lead to fewer treatment-related side effects and, in some cases, improved outcomes for patients with certain cancers.

Leslie Popplewell, M.D., says clinical trials can offer additional treatment options for patients.

Leslie Popplewell says clinical trials can offer additional treatment options for patients.

But many patients know little about clinical trials, much less what’s involved to participate. Here,  Leslie Popplewell, associate professor in the Department of Hematology & Hematopoietic Cell Transplantation at City of Hope, explains how clinical trials work and how patients and their families can make informed decisions about participating in trials.

What are clinical trials, and why are they important?

Clinical trials are a way of delivering a promising new drug or combination of drugs to patients.  Trials typically have a strict set of guidelines on which patients can be treated (“are eligible”), and they’re carefully controlled so that the results can be recorded and the outcomes reported in a scientific way.

Usually clinical trials are designed to test new drugs, or drugs that have been in use for a while, but are now used in a different setting or patient population than previously. A clinical trial may also offer a new drug combination that hasn’t been used before. » Continue Reading

Kidney cancer rates are rising: Expert explains risks, outcomes

March 1, 2014 | by   

Many cancer incidence rates decline over time, but kidney cancer is one of the few cancers with incidence rates that continue to rise year after year. 


Kidney cancer is on the rise. A City of Hope expert explores the risks and the treatments.

Currently, nearly 64,000 new cases of kidney cancer are diagnosed in the United States each year, and approximately 13,860 people die from it, according to the American Cancer Society. Men are much more likely than women to be diagnosed with the disease and to die from it.

But unlike other cancers, there is no formalized way to detect kidney cancer, which is why it’s important to know the disease’s risk factors and symptoms. Here Sumanta Kumar Pal, M.D., co-director of the Kidney Cancer Program at City of Hope, explores both the factors behind the rise in kidney cancer and the disease’s current treatments.

While most cancer incident rates continue to drop each year, kidney cancer is one of the few that continue to increase. Why is this?

Unlike breast cancer or colon cancer, kidney cancer is a disease for which we have no good screening modalities. At the moment, there’s no formalized way to actually detect kidney cancer before the onset of the disease. But as time has gone on, our imaging modalities have gotten better and better  — what I’m referring to here are CT scans and MRIs — and as that happened, we’ve found more and more incidental diagnosis of kidney cancer. » Continue Reading

HPV and cancer: 2 physicians explain links (W/VIDEO)

February 28, 2014 | by   

Once unknown to most people, HPV, or human papillomavirus, has become a subject of both worry and debate. It’s directly linked to cervical cancer, head and neck and other cancers, but many parents are reluctant to vaccinate their daughters against the disease.

City of Hope’s recent “Ask the Experts” session “HPV and Links to Cancer” brought some clarity to the issues surrounding this now-common virus, answering questions about the connection between HPV and cancer.

Ellie Maghami, M.D., chief of head and neck surgery at City of Hope, and Lily Lai, M.D., associate clinical professor of colorectal surgery, discussed HPV vaccines, how HPV is contracted and the relationship between HPV and cancer. They also explored the changing patient profile of people affected by HPV-related cancers.

A few highlights:

  • Up to 25 percent of oropharyngeal cancer (throat cancer) cases in the United State are not related to tobacco and alcohol abuse.
  • Sexually transmitted oral HPV infection is the principal risk factor for the distinct form of head and neck cancer.
  • HPV is linked to 80 to 95 percent of all anal canal cancers.
  • A total of 90 percent of women with cervical dysplasia have anal HPV infection.

Watch the full presentation above.


Sign up for our next “Ask the Experts” program, “Colon Health,” on March 19 to learn about the importance of screenings, colon cancer risk factors, cancer treatments and much more.

To view past Ask the Experts programs that feature several cancer related topics, visit our “Ask the Experts” video series.

Tip for parents of children with cancer: ‘Be the parent’ (VIDEO)

February 27, 2014 | by   

Parenting a child isn’t easy. Parenting a child with cancer can be infinitely more difficult. But parents can’t give up on their basic responsibilities to raise a child properly.

In this video, Jeanelle Folbrecht, Ph.D., associate clinical professor of psychology in the Department of Supportive Care Medicine at City of Hope, offers parents of young cancer patients some perspective. “You still have to be the parent. This is still a developing person,” she says. “You need to be engaged in that development.”

Folbrecht adds: “That will create for your child a sense of safety that things aren’t so bad that all of a sudden I don’t get parented and I get everything I want in the world.”


Read the Wolfrank family’s advice to parents of children with cancer.

Brisk walking is enough to lower stroke risk, study finds (w/VIDEO)

February 26, 2014 | by   

When it comes to working out, harder and faster may not always be better. That’s what Sophia Wang, Ph.D., associate professor at City of Hope’s Department of Population Sciences, found about exercise and stroke risk when she looked into the connection between the two.

Examining data from more than 133,000 women in the California Teachers Study, Wang and her team found that participants who regularly exercise at a moderate level (which includes brisk walking, recreational tennis, golf and bicycling on flat surfaces) are 20 percent less likely to suffer a stroke than those who do not exercise at all. Additionally, moderate exercise offsets some of the increase in stroke risk caused by hormone replacement therapy.

Further, Wang found that women who engage in strenuous activity (such as jogging, bicycling on hills, basketball and aerobics) at the same frequency do not experience additional benefits against stroke compared to the moderate level group. » Continue Reading

Is an epidemic of thyroid cancer really an epidemic of diagnosis?

February 25, 2014 | by   

An epidemic of thyroid cancer in the U.S. is actually an epidemic of diagnosis, conclude the authors of a new report. Their analysis pointed out that, although thyroid cancer diagnoses have nearly tripled during the past 30 years, mortality rates have remained the same. To them, this means the disease has been dramatically overdiagnosed.

Screening for thyroid cancer

Thyroid cancer is overdiagnosed, a new study bluntly claims. A City of Hope expert disagrees, pointing to mortality data as proof that screening works. Here, a woman undergoes screening for thyroid abnormalities.

City of Hope thyroid cancer expert John Yim, M.D., associate professor of surgery, strongly disagrees.

“I think ‘overdiagnosis’ is an inappropriate term,” said Yim, who was not involved in the research published recently in JAMA Otolaryngology-Head & Neck Surgery. “All of the patients are presumed to have been accurately diagnosed with thyroid cancer, primarily papillary thyroid cancer [the most-common, least-aggressive kind]. The question is whether the thyroid cancer identified, particularly when small, will progress to become symptomatic or deadly.”

That remains the nettlesome question both for physicians and for patients. Is watching and waiting – dubbed “active surveillance” – as safe for small tumors as surgical removal of them?  » Continue Reading

Peer program helps black women during, and after, breast cancer

February 24, 2014 | by   

After adjusting to the rigors of a cancer patient’s schedule – a barrage of appointments with surgeons, oncologists, radiologists, chemotherapy treatments, surgeries, tests – cancer survivors have large adjustments to make.

Kommah McDowell, a breast cancer survivor, serves as a mentor for black women who recently completed breast cancer treatment and are transitioning into the follow-up stage of their care.

Kommah McDowell, a breast cancer survivor, serves as a mentor for black women who recently completed breast cancer treatment and are transitioning into the follow-up stage of their care.

“You get into this system where you’re seeing multiple doctors a week – you’re in a groove, and you’re comfortable with it,” said Kommah McDowell, a 37-year-old breast cancer survivor. “Then, it’s over. There’s this gap. In one word: Life.”

Through its African-American Breast Cancer Coalition, City of Hope is seeking ways to make sure black women don’t fall into a gap, but back into the groove of their lives while getting all the support they need along the way. McDowell serves as a peer navigator, helping women who have completed their treatment transition to the follow-up stage for a research study that aims to improve quality of life, survivorship care and the well-being of African-American women who have survived cancer.

“We’re finding out that African-American women need a little more support in terms of educating them in the follow-up phase of treatment,” said Kimlin Tam Ashing, Ph.D., director of the Center of Community Alliance for Research & Education, in a recent CBS Los Angeles interview. Ashing heads studies examining the effectiveness of peer navigators in improving outcomes for minority women both in active treatment as well as in the follow-up stages of care.

Black women have a five-year survival rate of 78 percent after a breast cancer diagnosis, compared to a 90 percent survival rate for white women. The coalition believes that early detection, appropriate treatment and follow-up care can save lives and close that gap. » Continue Reading

What to say? What to do? Helping parents of cancer patients (VIDEOs)

February 20, 2014 | by   

A friend’s child has been hospitalized for cancer treatment. You want to visit, but don’t know what to say. You want to help, but don’t know what to do. City of Hope has some advice.

In this video series, Jeanelle Folbrecht, Ph.D., associate clinical professor of psychology in the Department of Supportive Care Medicine at City of Hope, explains what to say – and not say – to parents of young cancer patients; provides some do’s and don’ts when visiting a child in the hospital; and stresses the need to stay engaged with the family, even after treatment. » Continue Reading

Weight gain can be an unexpected side effect of cancer treatment

February 19, 2014 | by   

A side effect of cancer treatment many people don’t expect? Weight gain.

Weight gain is an often unexpected side effect of cancer treatment that can expose survivors to higher risk. Foods like fruits and vegetables, high in nutrients and fiber while low in calories, can help weight control.

Weight gain is an often unexpected side effect of cancer treatment that can expose survivors to higher risk. Foods like fruits and vegetables, high in nutrients and fiber while low in calories, can help weight control.

People with certain cancers – such as breast, prostate and colon cancer – are more likely to gain weight during treatment due to the therapies used to combat their disease. Hormone therapy, some chemotherapy regimens and medications such as steroids  all can cause weight gain, as well as water retention.

Other treatments can increase appetite or cause fatigue – which can lead to eating more and moving less, a common formula for weight gain. In other cases, old-fashioned stress and “comfort” food could be triggers for weight gain.

Some studies of cancer patients have linked obesity to an increased risk of recurrence and death in several common cancers, including breast, colorectal and prostate cancer. The California Teachers Study, led by City of Hope’s Leslie Bernstein, showed that being obese was associated with a significant increase of dying from breast cancer for many women.

Patients currently in treatment, however, shouldn’t go on a diet – even if they find themselves gaining weight – without speaking to their physician. A doctor can help determine why weight is increasing and discuss the options.

The population of cancer survivors in the U.S. is on the rise at the same time as the obesity rate is increasing – to the point that two-thirds of adults are obese or overweight – so naturally, the number of cancer survivors struggling with their weight also has increased. » Continue Reading

Antidepressant Paxil boosts estrogen activity, new study finds

February 18, 2014 | by   

Humans are exposed to countless chemicals every day, so identifying the ones that can impact their health – specifically the ones that can increase cancer risk – is akin to looking for a sugar crystal in a salt shaker.

chemicals and estrogen

Many common chemicals can affect estrogen activity in the body. A new test created by City of Hope researchers can identify whether chemicals promote or inhibit estrogen activity in the body.

But that process has now been made much less arduous by researchers at City of Hope. They’ve developed a screening test that can analyze 16 times as many chemicals as conventional means. The test — called AroER tri-screen™ — can quickly analyze up to 1,536 compounds’ effect on estrogen and aromatase, an enzyme that converts androgen to estrogen.

The results verifying this novel screening method — and discovering that the antidepressant paroxetine (Paxil) acts as an estrogen promoter —are published ahead of print online in Toxicological Sciences.

“Approximately 70 percent of breast cancers are sensitive to estrogen, and exposure to estrogen-disrupting compounds — especially during the critical periods of pregnancy, childhood and adolescence — can have an irreversible impact on still-developing bodies,” said Shiuan Chen, Ph.D., professor and chair of City of Hope’s Department of Cancer Biology and lead author of the study. “Thus, it makes sense to develop this test, which can assess many chemicals at once, to help us quickly identify which environmental compounds are disrupting estrogen functions.”

» Continue Reading