Precision medicine: It’s here – now to make it a norm, not an exception

March 28, 2015 | by   

Precision medicine holds promise – on that doctors, especially cancer specialists, can agree. But this sophisticated approach to treatment, which incorporates knowledge about a person’s genetic profile, environment and lifestyle, isn’t yet standard for all cancers. It can’t be. Researchers and scientists are still amassing as much information as possible, in order to better understand the best avenues of research and the resulting treatment options.

Precision medicine potential

Precision medicine is here. Now we must make it the norm, not the exception. That means knowledge and information must be shared, not hoarded, among institutions.

The National Institutes of Health (NIH) sums up the status of precision medicine in this way: “While significant advances in precision medicine have been made for select cancers, the practice is not currently in use for most diseases. Many efforts are underway to help make precision medicine the norm rather than the exception.”

Steven T. Rosen, M.D., provost and chief scientific officer at City of Hope, is an expert on precision medicine, understanding the potential that comes with increased knowledge of diseases such as cancer and what it will take to help the field evolve.

Here he answers questions about the current, and future, state of precision medicine at City of Hope: » Continue Reading

Bladder cancer patient has a mission: Cure metastatic bladder cancer

March 27, 2015 | by   
Frank Di Bella, pictured with Sumanta Kumar Pal, M.D., raised more than $1.6 million for metastatic bladder cancer research led by Pal at City of Hope.

Frank Di Bella (right), pictured with Sumanta Kumar Pal, has already helped raise more than $1.6 million for metastatic bladder cancer research led by Pal at City of Hope.

Frank Di Bella, 70, is on a mission: Find a cure for metastatic bladder cancer.

It’s just possible he might.

Although Di Bella isn’t a world-renowned physician, cancer researcher or scientist, he knows how to make things happen. For more than 20 years, he served as chairman of annual fundraising galas on behalf of muscular dystrophy research, and he’s successfully raised more than $10 million toward that cause.

Now his attention is focused on his own disease: metastatic bladder cancer. The certified public accountant recently held a black-tie gala titled “Let’s Be Frank about Cancer” to help raise funds for City of Hope’s bladder cancer research, led by Sumanta Kumar Pal, M.D.

The gala was filled with distinguished leaders, such as Gov. Jerry Brown, and brought in more than $1.6 million for Pal’s research.

But for Di Bella, that’s just the start.

“I’m going to spend the rest of my life raising money to help City of Hope and Dr. Pal,” Di Bella said.

» Continue Reading

Cancer side effects: 4 tips for coping with appearance changes

March 26, 2015 | by   
beauty bus event

Cancer side effects can take a toll on self-confidence. Here, patient Veronica Bedjakian receives a makeover during a recent Beauty Bus event at City of Hope’s Positive Image Center.

The physical side effects of cancer can damage anyone’s self-confidence, but especially that of women who, rightly or wrongly, are more likely to find their appearance (or their own perception of their appearance) directly connected to their ability to face the world with something resembling aplomb.

Further, although many people may think they’re prepared for such side effects, the reality is often different.

City of Hope understands this.

  • The Positive Image CenterSM routinely sponsors complimentary events and beauty classes for patients going through treatment.
  • It hosts monthly Look Good . . . Feel Better sessions, part of a free, national program sponsored by the American Cancer Society for women currently undergoing radiation or chemotherapy. The classes are taught by specially trained, licensed cosmetologists on skin care techniques, alternatives for hair loss and much more.
  • And twice a year, City of Hope welcomes the Beauty Bus, a mobile self-confidence boost that “delivers dignity, hope and respite to chronically ill men, women and children and their caregivers through beauty and grooming services and pampering products.”

This healing-on-wheels program brings complimentary salon services to patients directly, many of whom have compromised immune systems that prevent them from going to salons.

Amy Donner, L.C.S.W., in the Department of Supportive Care Medicine at City of Hope, offers the following tips for anyone, especially women, struggling with the physical changes of cancer. » Continue Reading

As stem cell therapy research advances, so does nursing

March 25, 2015 | by   

The promise of stem cell therapy has long been studied in laboratories. Now, as medicine enters an era in which this therapy will be increasingly available to patients, the nurses who help deliver it will be in the spotlight.

stem cell

Nurses in the Alpha Clinic for Cell Therapy and Innovation at City of Hope will develop new nursing standards for stem cell therapies.

City of Hope, which has launched its Alpha Clinic for Cell Therapy and Innovation (ACT-I), is among the first to have a dedicated clinic for leading-edge stem cell therapy. The clinic’s nurses will bridge two disciplines that have long been separate: compassionate care, for which City of Hope is known worldwide, and protocol-heavy stem cell clinical trial research.

“In the Alpha Clinic, we will have staff who are seasoned in working with inpatient units for stem cell transplants, and we will combine that with excellent clinical research nursing support in a much more coordinated fashion than we’ve seen in any place else to date,” said Shirley Johnson, R.N., senior vice president, chief nursing and patient services officer at City of Hope. » Continue Reading

Not all conditions should be treated at end of life, study suggests

March 24, 2015 | by   

Just because you can treat a condition, such as high cholesterol, at the end of life — well, that doesn’t mean you should. That’s the basic lesson of a study to be published March 30 in JAMA Internal Medicine. The ramifications go far beyond that.

drugs and end-of-life care

Some conditions, such as high cholesterol, might not need to be treated at the end of life. A new study found that stopping statin treatment for high cholesterol actually improved quality of life.

The research, in which City of Hope’s Betty Ferrell, Ph.D., R.N., participated, found that stopping the use of statins in patients with late-stage cancer and other terminal illnesses can actually improve quality of life, without doing harm to the patient. That’s no small finding. Statins are one of the most commonly prescribed medications in the United States, as the press release about the study points out, and many patients for whom cure is no longer an option will be affected if doctors take the lesson to heart.

To summarize: The study on end-of-life care involved 381 patients — with a mean age of 74.1 years — about half of whom continued their cholesterol medication and about half of whom stopped. More than a fifth were cognitively impaired, and almost half had cancer. The researchers found that the number of study participants who died within 60 days was about the same for both the statin-taking and statin-forgoing groups but, of special significance, the quality of life was better for those who stopped taking statins. » Continue Reading

Discovering tools for genetic testing – and teaching others to use them

March 23, 2015 | by   

The understanding of the relationship between genetics and cancer risk continues to grow, with more genetic testing than ever before available to patients.

genetic testing

City of Hope leaders have created a program to teach clinicians nationwide and worldwide how to use available genetic testing tools.

However, the adage that a little knowledge is a dangerous thing is applicable: Without context for what a test result means, and without meaningful guidance from genetic counselors, genetic tests don’t do patients much good.

Case in point: In addition to those better-known mutations contributing to breast cancer, such as BRCA1 and BRCA2, researchers have identified about 20 other genes that may be implicated in causing cancer, many of them rare or having more discreet effects. People who carry those other mutations – and who test negative for the BRCA mutations – may face a higher risk than they realize.

The doctors and counselors who deal with patients every day need training in order to help as many people as possible benefit from such knowledge and from today’s scientific advances. Scientists, clinicians and genetic experts at City of Hope are committed to bridging the gap between the technology that’s available and the number of professionals who know how to use and interpret the results of that technology.

Led by Jeffrey Weitzel, M.D.,  director of the Division of Clinical Cancer Genetics, City of Hope recently hosted a cancer genetics and genomics conference, “From Evidence to Action: Next-Generation Approaches to Cancer Risk Assessment and Research.” Nearly 200 physicians and clinicians from across the nation and abroad attended the conference.  » Continue Reading

Prostate cancer: Jonathan Yamzon on MRI/ultrasound fusion biopsy

March 21, 2015 | by   

Standard prostate biopsies haven’t changed significantly in the past 30 years – nor have the problems inherent with them. Regular biopsies have an expected error rate: Tumors may potentially be undersampled and, 30 percent of the time, men who undergo a radical prostatectomy are found to have more aggressive tumors than expected based on the initial biopsy.

Here, Jonathan Yamzon, M.D., assistant clinical professor in the Division of Urology and Urologic Oncology, explains some of the pitfalls of prostate biopsies, as well as the potential benefits of a magnetic resonance imaging (MRI)/ultrasound fusion biopsy.

What happens during a prostate biopsy?

In a standard prostate biopsy, an ultrasound probe is placed into the rectum to visualize the prostate. Local anesthesia is applied, and biopsy samples are taken systematically across the prostate, with the minimum standard being 12 cores.

Prostate cancer expert Jonathan Yamzon

Jonathan Yamzon explains the basics of prostate biopsies and how an MRI/ultrasound fusion biopsy can improve accuracy.

A pathologist evaluates the tissue samples, assesses the aggressiveness of the cancer and gives the individual samples a Gleason score ranging from 3 to 5.

The sum of the Gleason scores is achieved by combining the two most prevalent scores seen in the tissue, ranging from 6 (least abnormal and aggressive) to 10 (most abnormal and aggressive). For example, if the reported Gleason is 3+4=7, a pathologist assigned a 3 to the most prevalent grade, followed by a 4, the second most-prevalent grade. The sum totals up to a Gleason score of 7.

Physicians use the Gleason score, among other clinical variables, to assess the aggressiveness of the cancer and recommend follow-up treatment. » Continue Reading

Stem cell therapy clinic will fight incurable disease in new ways

March 20, 2015 | by   

In the field of cancer, patients have had surgery, chemotherapy and radiation therapy as options.

Now, as City of Hope officially opens the Alpha Clinic for Cellular Therapy and Innovation, patients battling cancer and other life-threatening diseases have another option: stem-cell-based therapy.

stem cell clinic

City of Hope’s Alpha Clinic for Cell Therapy and Innovation will bring stem cell and other cell-based therapies to patients through clinical trials. The clinic opened officially March 19.

The Alpha Clinic, which officially opened March 19, is funded by an $8 million California Institute for Regenerative Medicine (CIRM) grant. It will combine the uniquely patient-centered care for which City of Hope is known with the most innovative, stem-cell based therapies available to date. In short, the stem cell therapy clinic is expected to revolutionize not just the treatment of cancer, but also AIDS and other life-threatening diseases.

“We are in a new era of cellular therapy,” said John Zaia, M.D., the Aaron D. Miller and Edith Miller Chair in Gene Therapy, chair of the Department of Virology at City of Hope, and principal investigator for the stem cell therapy clinic. “The California Institute for Regenerative Medicine recognizes this, and they have been leading the field. Alpha Clinics like ours aim not only to provide research to benefit patients in the future, but get these innovative treatments running in real-life clinics to benefit patients now.” » Continue Reading

The environment and cancer: Are you at risk? (w/VIDEO)

March 19, 2015 | by   

How does the environment affect our health? Specifically, how does it affect our risk of cancer?

City of Hope physicians and researchers recently answered those questions in an Ask the Experts event in Corona, California, explaining the underlying facts about how the environment can affect our health.

Moderator Linda H. Malkas, Ph.D., associate chair and professor of molecular and cellular biology, led the discussion, giving voice to the concerns that many people have about the environment and cancer risk, and asking tough questions of the panelists.

» Continue Reading

End-of-life nursing care has evolved worldwide. Here’s how …

March 18, 2015 | by   
Betty Ferrel

Betty Ferrell, director and professor of nursing research and education at City of Hope, is the principal investigator of ELNEC, a palliative-care education program that has helped end-of-life care evolve worldwide.

Nurses and other medical professionals have come to understand that it’s not enough just to fight disease. They also must provide pain relief, symptom control, and an unrelenting commitment to improve patients’ quality of life — especially at the end of life. Not too long ago, this was a relatively novel concept.

That’s why ELNEC matters.

ELNEC is the End-of-Life Nursing Education Consortium, pioneered by City of Hope in partnership with the American Association of Colleges of Nursing. It was created in 2000 after groundbreaking research at both institutions pointed to a serious lack of comprehensive, rigorous, systematic and high-quality, end-of-life care education.

The training raises awareness of patients’ end-of-life needs, even as it teaches the specialized nursing skills required when patients’ goals shift from a cure to ensuring that their remaining days hold as much meaning as possible for themselves and their families.

» Continue Reading