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.
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
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.
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
The understanding of the relationship between genetics and cancer risk continues to grow, with more genetic testing than ever before available to patients.
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
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.
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.
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.
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
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.
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.
March is Colon Cancer Awareness Month. How sad, yet how serendipitous, that the co-creator of “The Simpsons” Sam Simon passed away in March after a four-year battle against colon cancer. What message can we all learn from his illness that can help us prevent and overcome colon cancer in our own lives?
Colon cancer is one of the most common cancers in men and women. One out of every 20 people will get colon cancer. And it is the third-leading cause of cancer death in the country, with nearly 50,000 deaths every year from this disease.
Simon was not alone in fighting this battle. Other famous people who have had this cancer are Audrey Hepburn, President Ronald Reagan, Eartha Kitt, Vince Lombardy and Charles Schulz.
From each of these people comes the same message: This illness can be prevented and the cure rate can be high.
Misagh Karimi, M.D., assistant clinical professor, is a medical oncologist at one of City of Hope’s newest community practice locations, located in Corona in Riverside County. A recent community health report from Corona’s public health department stated that obesity rates for teens and adults in Riverside County are the highest in California.
Here, Karimi discusses the connection between obesity and cancer.
What is known about the relationship between obesity and cancer?
Multiple studies have shown correlations between obesity and a risk of cancer recurrence. There is significant evidence that obesity increases the chance of recurrence of cancer in multiple diseases, such as breast, colon, esophageal and other cancers. According to the American Society of Clinical Oncology, more than 50,000 new cases of cancer in women and 34,000 in men were due to obesity in 2007. Obesity may soon eclipse smoking as the No. 1 preventable cause of cancer.
Among obese individuals, specific biological characteristics can increase cancer risk:
· Obese people typically have increased levels of insulin (and insulin-like growth factor IGF-1), which can promote tumor growth.
· Sub-acute inflammation, which has been associated with cancer risk, is also common among obese people.
Are specific cancers more prevalent due to obesity?
Certainly, breast, colon, esophageal and stomach cancers appear to have a significant relationship with obesity. » Continue Reading