Posts tagged ‘City of Hope’

Surgery for advanced colorectal cancer? Each patient’s needs are unique

January 21, 2015 | by

Surgery is vital in the treatment of cancer – it’s used to help diagnose, treat and even prevent the disease – so a new colorectal cancer study linking a decrease in surgeries for advanced cancer to increased survival rates may raise more questions than it answers for some patients.

advance colorectal cancer surgery

Treatment options for advanced colorectal cancer depend on the unique needs of each patient. The decision needs to individualized, said Stephen Sentovich, a board-certified colon and rectal cancer surgical expert at City of Hope.

The surgery-and-survival study, conducted by researchers at MD Anderson Cancer Center and published recently in JAMA Surgery, found that although surgery is still the most-used treatment for Stage 4 colorectal cancer, it has become less common. Surgical rates decreased from 74.5 percent in 1988 to 57.4 percent in 2010, with survival rates doubling from 8.6 percent in 1988 to 17.8 percent in 2009.

The trend reflects a greater use of new chemotherapy drugs and targeted treatment options and highlights the overall improvements made in the treatment of colorectal cancer. But Stephen Sentovich, M.D., M.B.A., a board-certified colon and rectal cancer surgical expert at City of Hope, cautions against making broad assumptions about the best treatment options.

Treatment choices aren’t always black and white, he says. Decisions needs to be individualized, based on the unique needs of each patient. » Continue Reading

Geriatric oncology nurse Peggy Burhenn: Older adults need special care

January 20, 2015 | by

Age is the single greatest risk factor overall for cancer; our chances of developing the disease rise steeply after age 50. For geriatric oncology nurse Peggy Burhenn, the meaning is clear: Cancer is primarily a geriatric condition. That’s why she is forging inroads in the care of older adults with cancer.

Nurse Peggy Burhenn

Geriatric oncology nurse Peggy Burhenn at City of Hope, has received the 2014 Advanced Oncology Certified Nurse of the Year Award.

Burhenn, M.S., C.N.S., A.O.C.N.S., is a professional practice leader in geriatric oncology in the Department of Clinical Practice and Professional Education at City of Hope. She focuses on the needs of older adults with cancer, researching better treatments for them and teaching other clinicians the best approach to caring for this important population.

Her innovative work and excellence in clinical care recently earned her the Advanced Oncology Certified Nurse of the Year Award from the Greater Los Angeles Oncology Nursing Society. The honor adds to a list of accolades and achievements that includes the Margo McCaffery Excellence in Pain Management Award and leadership roles on the National Comprehensive Cancer Center’s Older Adult Oncology Expert Panel and the International Society for Geriatric Oncology.

Burhenn earned both bachelor’s and master’s degrees in nursing from the University of Illinois in Chicago. She joined City of Hope in 2011 after nearly a decade as a nurse educator in the biotechnology industry and as a nurse oncologist at a private hematology-oncology practice. She said her work with older patients began early in her career, sparked to some degree by her own parents’ experience with aging. » Continue Reading

Sportscaster Stuart Scott’s young age is reminder: Check family history

January 19, 2015 | by
Stuart Scott

ESPN sportscaster Stuart Scott’s cancer diagnosis is a reminder to check family history. (Photo by Alan Rose)

One of American’s great sportscasters, Stuart Scott, passed away from recurrent cancer of the appendix at the young age of 49. His cancer was diagnosed when he was only 40 years old. It was found during an operation for appendicitis. His courageous fight against this disease began in 2007, resumed again with an operation for recurrent cancer in 2011, and yet again in 2013 when the cancer returned. Despite surgery, a long period of surgical healing, and then prolonged courses of different kinds of chemotherapy, he died on Jan. 4, 2015.

Scott went public with his struggle against the disease, and urged people to follow his example to fight cancer with both chemotherapy and an aggressive exercise program to keep his body strong. Because so many of my patients suffer from fatigue associated with treatments, I am sure his fitness program improved his quality of life.

But more important for all of us, we should realize that the occurrence of cancer at a young age (40 in Scott’s case) should raise a red flag to patients, families and physicians. Hereditary cancer syndromes due to mutations in our genes are the cause of 5 to 10 percent of cancers. And when we are reminded of this by the death of one of our celebrities at a young age, we should each examine our own family history and get tested for gene abnormalities.

When should we be asking for a discussion about gene testing? Family cancer syndromes are likely to be present when there are multiple family members with cancer, or when an individual patient has more than one cancer, or when a cancer occurs at a young age (less than 50). While we do not know if Scott was tested (that’s private health information), having cancer at age 40 warrants discussing gene testing with a physician.

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Clinical trial for triple-negative breast cancer shows promise

January 16, 2015 | by

When Homa Sadat found a lump in her breast at age 27, her gynecologist told her what many doctors say to young women: You’re too young to have breast cancer.

triple negative breast cancer

Triple-negative breast cancer is diagnosed at a higher rate in patients with BRCA-related breast cancer and in African-American women. A City of Hope clinical trial for triple-negative breast cancer is proving especially promising.

With the lump dismissed as a harmless cyst, she didn’t think about it again until she was at a restaurant six months later and felt shooting pain. She went back to her doctor and asked for a biopsy. The biopsy confirmed her fear: She had breast cancer. A biopsy of a suspicious lymph node in the underarm area confirmed that the cancer had spread.

Sadat was diagnosed with what’s known as triple-negative breast cancer.

When pathologists test breast cancer cells, they look for the presence of estrogen and progesterone hormone receptors and the overexpression of receptors for a type of protein called HER2. Breast cancer that is positive for one of the hormone receptors can be targeted with hormonal therapy such as tamoxifen or aromatase inhibitors. Other therapies, like trastuzumab (Herceptin) or its newer versions, have been developed to target HER2 overexpressive – that is, positive – breast cancers.

Cancers that are negative for all three receptors are often referred to as triple-negative cancers. They’re the toughest to treat.

» Continue Reading

Esophageal cancer patient Jim Murphy: What I learned from cancer

January 12, 2015 | by
patinet riding mountain bike

Esophageal cancer patient Jim Murphy never let cancer take over his life during his treatment at City of Hope. He continued to bike ride and ski during chemotherapy and radiation.

Sales and marketing executive Jim Murphy first came to City of Hope in 2002 to donate blood for a friend who was being treated for esophageal cancer.

The disease is serious. Although esophageal cancer accounts for only about 1 percent of cancer diagnoses in the U.S., only about 20 percent of patients survive at least five years after diagnosis. Murphy wanted to do whatever he could to help.

His friend successfully beat the cancer and is still doing well today ­— 12 years after diagnosis. Then, in 2012, Murphy began to have trouble swallowing. An avid mountain biker and skier who knew how “healthy” was supposed to feel, Murphy knew something wasn’t right. He made an appointment with his physician for an endoscopy.


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The profit: $17.35 from handmade bracelets. The donation: Priceless

January 8, 2015 | by

Patient Gerald Rustad’s granddaughter Aurora helped raise funds for prostate cancer research by selling homemade bracelets.

Explaining a prostate cancer diagnosis to a young child can be difficult — especially when the cancer is incurable. But conveying the need for prostate cancer research, as it turns out, is easily done. And that leads to action.

Earlier this year, Gerald Rustad, 71, who is living with a very aggressive form of metastatic prostate cancer, found himself trying to explain his heath condition to 10-year-old granddaughter Aurora.

He told her that his cancer couldn’t be cured, but that scientists at City of Hope were busily conducting research so they could help patients like himself. His doctor, for example, Sumanta Pal, M.D., co-director of City of Hope’s Kidney Cancer Program, was working with other City of Hope researchers to develop a drug that could treat metastatic prostate cancer without targeting testosterone.

The targeting of testosterone is too arcane for most 10-year-olds, but the need for scientific answers isn’t. Aurora asked if there were any way she could help. » Continue Reading

For getting patients back to daily life, City of Hope gets a STAR

January 7, 2015 | by

Cancer and its treatment can create unexpected daily challenges for patients. Side effects from chemotherapy, surgery and radiation therapy as well as the disease itself can cause difficulty in everything from speech to movement to eating. When this happens, rehabilitation is vital; it helps patients restore their lost skills or function and become as self-sufficient as possible.

Too many hospitals and cancer centers underestimate the importance of rehabilitation; that can’t be said of City of Hope.

Rehabilitation Services

For many patients, cancer rehabilitation is vital, helping them resume normal life. City of Hope has received institutional STAR certification recognizing its rehabilitation services expertise.

Through the efforts of a team of clinicians led by the Department of Rehabilitation Services, City of Hope recently gained institutional Survivorship Training and Rehabilitation (STAR) certification, a nationally recognized cancer survivorship designation. The institution is one of only two National Cancer Institute-designated comprehensive cancer centers to do so.

Although several faculty and staff members received STAR certification as individuals last year, the current certification applies to the institution as a whole.

“It’s quite rare for a cancer center to attempt STAR certification,” said Jennifer Hayter, M.A., O.T.R./L., director of rehabilitation services at City of Hope. “We’re proud to be one of the few to successfully attain it.” » Continue Reading

Bladder cancer 2015: Personalized medicine meets ‘molecular selection’

December 28, 2014 | by

Surgery for bladder cancer isn’t what it used to be; it’s better – much better. Advances in robotic surgeries have greatly improved both the options and the quality of life for people diagnosed with bladder cancer.

bladder cancer

City of Hope is leading several innovative studies in bladder cancer, with two of them focusing on what’s known as a molecular selection process.

These advances, which are constantly giving way to even newer ones, mean that the entire bladder doesn’t always have to be removed. When it does, not only can highly skilled surgeons sometimes create an artificial bladder, they can even create an internal reservoir (different from a bladder and known as an Indiana pouch) using the large intestine and part of the small intestine. Such alternatives are usually preferred  over the need for an external bag to collect the urine.

Much work remains, however, in the understanding of bladder cancer. Sumanta Pal, M.D., co-director of the Kidney Cancer Program at City of Hope, is leading several innovative studies in bladder cancer, with two of them focusing on what’s known as a molecular selection process. » Continue Reading

Cancer 2015: Liver cancer expert offers view from the front lines

December 25, 2014 | by

Yuman Fong, M.D., is an internationally recognized expert in hepatobiliary cancer – that is liver cancer, pancreatic cancer, gallbladder cancer and cancer of the bile ducts. He’s also renowned for his use of genetically modified viruses to combat malignant disease, is a pioneer in the operating room and the laboratory, is the author of more than 600 peer-reviewed articles and 11 textbooks, and is the chair of the Department of Surgery at City of Hope. All told, he’s uniquely qualified to offer an overview of cancer advances expected in 2015.

Yuman Fong, M.D., an expert in hepatobiliary cancer.

Yuman Fong is an expert in hepatobiliary cancer, which includes liver cancer, pancreatic cancer, gallbladder cancer and cancer of the bile ducts. Here, he offers an overview of cancer advances expected in 2015, focusing on liver cancer, pancreatic cancer and viral gene therapy.

Here, Fong does just that, focusing on improved treatments expected for liver cancer, pancreatic cancer and viral gene therapy.

Liver cancer:

When it comes to liver cancer, Fong says, ablation (burning tumors with needles) and resection (surgical removal of tumors) will continue to improve, offering better prognoses for people diagnosed with the disease.

“Ablations can produce long-term remissions and potential cures for liver cancer,” Fong said, pointing to a recent article published in Advances in Surgery. That article’s key points:

  • Tumor ablation is a safe and easily performed treatment for hepatocellular carcinoma.
  • Randomized trials have shown tumor ablation to be durable and potentially curative therapy for small hepatocellular carcinoma.
  • Tumor ablation and minimally invasive therapies are changing the treatment paradigms for hepatocellular carcinoma.
  • These minimally invasive therapies are good bridge therapies to transplant for patient with advanced cirrhosis.

Further, Fong says, referring to a recent study published in PLoS One: “Combining ablation and resection can extend the number of patients who can be provided successful treatment for liver cancer.”

» Continue Reading

Kidney cancer 2015: Many clinical trials – and a growing need

December 23, 2014 | by

The need for clinical trials of new kidney cancer treatments has never been greater: Kidney cancer is one of the most common cancers in both men and women – and the rates are rising.

Sumanta Pal, M.D.,  co-director of the Kidney Cancer Program at City of Hope, says there are promising studies underway, including research into rare types of kidney cancer, such as papillary kidney cancer which makes up only about 10-15 percent of kidney cancer cases.

Many promising kidney cancer studies are underway  at City of Hope, with others in the works. They include research into rare types of kidney cancer such as papillary kidney cancer, which makes up only about 10 to 15 percent of kidney cancer cases.

Fortunately for kidney cancer patients everywhere, there’s City of Hope. “City of Hope has more active clinical trials for kidney cancer patients than any other center in the region,” said Sumanta Pal, M.D., co-director of the Kidney Cancer Program at City of Hope. Many of these trials focus on a novel method of stimulating the body’s own immune system to act against cancer.

This novel method entails use of drugs called ‘programmed death-1,’ or PD-1, inhibitors. Such drugs work with the natural checks and balances within the immune system, Pal said, explaining that PD-1 inhibitors stifle the body’s suppression of the anti-tumor immune response.

“In early phase studies, these drugs appear to be highly effective in kidney cancer, producing survival that goes well beyond traditional expectations,” Pal said. “At City of Hope, two drugs in this category, nivoluma and MDPL3280A, are being explored in patients with newly diagnosed kidney cancer with disease spread outside of the kidney.” » Continue Reading