As kidney cancer treatments improve, oncologist’s optimism is growing

June 25, 2014 | by   

Treatments for kidney cancer have improved dramatically in recent years, with new therapies already in use and others on the near horizon. The need has never been greater: Incidence rates for kidney cancer are rising.

Cancer of the kidneys, shown here, is on the rise.

Kidney cancer is on the rise. Fortunately, so are treatment advances. City of Hope’s Sumanta Pal explains his optimism when it comes to treatment of kidney cancer.

This year, nearly 64,000 new cases of kidney cancer will be diagnosed in the United States, and approximately 13,860 people will die from the disease, according to the American Cancer Society.

Sumanta Kumar Pal, M.D., co-director of the Kidney Cancer Program at City of Hope, is confident that these new treatment advances will not only change kidney cancer statistics, but also improve the overall well-being of patients diagnosed with the disease.

City of Hope is at the forefront of this field. Its researchers are exploring an array of techniques and therapies to improve survival and quality of life for people with kidney cancer. Their investigations include the use of drugs (including PD-1 inhibitors, mentioned below, and S1PR1 inhibitors) to stimulate the body’s immune system, as well as the use of stem cell antibodies to target “bad” stem cells. » Continue Reading

‘I begin to consider what our patients experience at City of Hope…’

June 24, 2014 | by   

It is mid-afternoon on a Sunday at the cosmetics counter at Macy’s. A woman approaches with smiling eyes and dewy skin in a crisp white lab coat. I feel at ease as she offers me a seat.

With a soft touch she applies eye makeup and powder to my forehead and chin. She is charming, attentive and eager to please as she hands me a mirror. I look and see a new subtle glow on my cheeks. And now I feel delighted, refreshed.

The presentation and delivery of customer service is excellent. The experience matters to me.

quality of patient care

The quality of patient care can be, and is, measured in ways both large and small. But some of the most important aspects of the patient experience simply can’t be quantified. Patients at City of Hope know this. So do their doctors, nurses and everyone else who works to make City of Hope different.

I begin to consider what our patients experience at City of Hope. What is it like to navigate through a cancer diagnosis and treatment? As an anesthesiologist, I often wonder what it might be like if it were me on the gurney waiting to be wheeled into the operating room.

Medicine is science. It is procedures, algorithms and check boxes. But for our patients it is perceived differently.

The Centers for Medicare and Medicaid Services (CMS) have developed specific quality measures that are a fundamental part of medical care. These measures, or indicators, translate into cost of care and ultimately payment for both hospitals and individual physicians. CMS monitors this by way of the check box. This is a deliberate, substantive list of indicators that are used as a kind of measuring stick to be sure we have not omitted critical details in patient care and health care processes. » Continue Reading

Children with cancer, Part 1: How family members and friends can help

June 23, 2014 | by   

John Cloer became a teenager in May, an ordinary rite of passage made extraordinary because he is a cancer survivor – one of an estimated 370,000 pediatric cancer survivors in the U.S.

Childhood cancer patient John Cloer

The parents of John Cloer, now a childhood cancer survivor, learned many lessons during his treatment for leukemia. Photo courtesy of the Cloer family.

He was three months shy of his third birthday in 2004 when what his parents Bill and Gina Cloer assumed was the flu was diagnosed as acute lymphoblastic leukemia. For the next three and a half years, John received chemotherapy – eventually leading to his long-term remission.

John finally became well enough to attend kindergarten and enjoy normal pursuits like T-ball. In fact, his perseverance (from staying late to practice, to reveling in teammates’ progress) earned the 6-year-old an invitation to play T-ball on the White House lawn and meet President George Bush. He has long raised awareness for City of Hope, from presenting an award to singer Miley Cyrus to riding on the hospital’s 2014 Tournament of Roses float as his sister Heather, a City of Hope nurse, walked alongside.

When John was embarking on cancer treatment, Bill and Gina were given well-tested roadmaps from oncologists adept at keeping children alive. On the comparatively uncharted path of cancer survivorship, they have longed for a similar roadmap. Along with regular follow-up visits with doctors such as Clarke Anderson, M.D., the Cloers are being helped in their survivorship journey by City of Hope’s Childhood Cancer Survivorship Program, led by Smita Bhatia, M.D., M.P.H., the Ruth Ziegler Chair in Populations Sciences, and nurse practitioner Karla Wilson, M.S.N., R.N.

In this program, John and his family receive a comprehensive medical summary of his diagnosis and treatment, as well as an individualized review of his potential late-effects from treatment.

Bill, Gina, John and his younger brother, Steve, recently sat down around their dining room table and offered some advice to parents of children with cancer, along with well-meaning family and friends.

In this first of a three-part series, they answer the question:

What can family/friends do to help parents whose children have cancer?

» Continue Reading

Meet our doctors: M. Houman Fekrazad on a potential chemotherapy patch

June 21, 2014 | by   

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.

Dr. Fekrazad says a chemo patch may help decrease side effects for patients.

Medical oncologist M. Houman Fekrazad is developing a chemotherapy patch that he believes will reduce side effects for cancer patients.

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

Cancer and DNA: Imbalance in genetic controller may be key to cancer

June 20, 2014 | by   

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.

DNA strands

City of Hope researchers 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. Shown here: Illustration of DNA

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

Comprehensive cancer centers like City of Hope save lives; here’s why

June 19, 2014 | by   

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.”

» Continue Reading

Weight-loss surgery might reduce cancer risk; a look at the reasons

June 18, 2014 | by   

If obesity raises the risk of cancer, it might stand to reason that weight-loss surgery could reduce the risk.

Obesity may increase the risk of death in some breast cancers.

Obesity may increase the risk of death for some women with breast cancer, research finds.

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: City of Hope receives highest level of accreditation

June 17, 2014 | by   

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.

cancer care

Quality of care is crucial for cancer patients – and City of Hope has again received the highest level of accreditation possible. Make an appointment today.

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

» Continue Reading

In cancer, expertise is crucial: Tips on getting a second opinion

June 16, 2014 | by   

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.

second opinions on cancer care

Cancer patients must be confident in their treatment decisions. Often that means they need 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.

Here are a few tips on getting a second opinion from the experts at City of Hope.

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 411: Tips on protecting your skin from the sun

June 16, 2014 | by   

sun safetysun safetysun safetysun safetySunscreen – 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.

sunscreen and skin cancer risk

Read those sunscreen labels closely. A City of Hope expert explains how to maximize your protection.

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