Awareness

When do your Moles Require a Trip to the Dermatologist?

May 15th, 2013 By Margi McKellar, MS, PA Emory Winship Cancer Institute’s Melanoma Coordinator

Skin Cancer MolesHave you performed your monthly mole check? If not, take time today to do it and put it on your calendar for this day every month! Checking your moles monthly can help you from developing malignant melanoma. The earlier you find suspicious moles or lesions, the better your chances of being cured.

Some helpful tips to examine your moles:

  • Examine your skin after a shower, in good light, in front of a mirror without your clothes on.
  • Make sure to do a thorough, full body inspection. Start with your toes or your face and work your way over every surface of your body. Be sure to also check your scalp, underarms and genitals, parts that could be covered with hair.
  • Look for moles or skin markings that you haven’t noticed before, or areas that have changed in appearance since your last exam. Pay special attention to lesions that bleed or don’t heal.
  • Photos taken over a period of time can be helpful in determining whether a skin marking has changed.
  • Follow the ABC method for examining suspicious markings:
    • A = Asymmetry – do both sides of the mole match? If one side does not match the other, it could indicate melanoma.
    • B= Border – If the border has jagged or irregular edges, see your physician right away.
    • C = Color – Black, red, white and multi-colored moles should be seen by a professional right away. Tan and brown moles are usually ok, but make sure to watch for changes to these moles as well.
  • Diameter – Usually moles should be smaller than the end of a pen.
  • Elevation – moles should be flush with the skin around the mole. If you notice a mole is raised, visit your physician right away.
  • Do what you can to prevent skin cancer. Some ideas:
  • Wear sunscreen in the sun, in all seasons!
  • Wear a hat and sunglasses
  • Avoid tanning salons
  • Try to stay out of the sun between 10am and 3pm

Take action today to protect yourself and your family members!

Chat with Dr. Delman about Skin Cancer:

Skin Cancer Online ChatJoin Winship Cancer Institute of Emory University physician Keith Delman, MD at noon on Wednesday, May 29, 2013 for an online web chat on melanoma and other skin cancers. He will talk about skin cancer prevention and answer questions such as:

-What are signs of melanoma and skin cancer?
-How is melanoma or skin cancer treated?
-What is the latest research on treating these cancers?

Join us for an informative session that could save your life. Register by visiting emoryhealthcare.org/mdchats.

Chat Sign Up

About Margi  McKellar, MS, PA  Emory Winship Cancer Institute’s Melanoma Coordinator

Margi plays a unique role for the team as our Melanoma Coordinator. In this position, she serves as the point of contact for referring physicians and the patients and guides  them from the point of  their initial referral through long-term follow up. She helps our patients use their time efficiently, analyzing patient flow, appointment availability, clinical trial eligibility and ensures that patients see the correct complement of specialist to receive optimal care – medical oncology, surgical oncology, radiation oncology, lymphedema specialists. Margi actively interfaces with our clinical trial nurses to ensure patients have the opportunity to be considered for clinical trials while facilitating prompt screening for these programs. In addition to coordinating the care of patients, she also sees patients in our long-term follow up clinics.

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Winship Cancer Institute, Emory Break Ground on $200+ Million Emory Proton Therapy Center!

May 8th, 2013 By Walter J. Curran Jr., MD

A new era in cancer treatment in Georgia recently began as Emory Healthcare and Winship Cancer Institute broke ground on the first facility in Georgia to offer the most advanced radiation therapy possible – proton beam therapy.

Proton therapy is the next generation of radiation oncology. It uses protons to precisely treat cancerous tumors and minimize radiation to the healthy tissue surrounding the tumor. For certain cancers, and for pediatric cancer patients, it may provide more effective treatment with fewer side effects. This innovative therapy is offered at fewer than a dozen centers in the United States but is available in other countries and more than 110,000 people worldwide have received this FDA-approved therapy.  The Emory facility is being built in partnership with Advanced Particle Therapy, LLC of San Diego, CA.

Proton therapy may be most beneficial for patients with cancerous our benign tumors in certain anatomic areas, including  the brain, prostate, liver, esophagus, head and neck and the base-of-skull.  It’s also  beneficial for treating children because of the risk to growth and developmental from conventional radiation.  Studies in children have shown that proton therapy minimizes damage to healthy tissues and produces fewer side effects.

The Emory Proton Therapy Center will enable Winship researchers  to continue studying the benefits of proton therapy, with the goal of producing better outcomes for our patients.  At Winship we constantly seek out the most effective treatment available, and for many of our patients, proton therapy is that treatment.

As Georgia’s only National Cancer Institute designated cancer center, Winship is committed to cancer research projects which improve our patients’ lives.

About Dr. Curran

Walter J. Curran, Jr. was appointed Executive Director of the Winship Cancer Institute of Emory University in September 2009. He joined Emory in January 2008, as the Lawrence W. Davis Professor and Chair of Radiation Oncology and Chief Medical Officer of the Winship Cancer Institute.

Dr. Curran, who is a Georgia Cancer Coalition Distinguished Cancer Scholar, has been a principal investigator on several National Cancer Institute (NCI) grants and is considered an international expert in the management of patients with locally advanced lung cancer and malignant brain tumors. He has led several landmark clinical and translational trials in both areas and is responsible for defining a universally adopted staging system for patients with malignant glioma. He serves as the Founding Secretary/Treasurer of the Coalition of Cancer Cooperative Groups and a Board Member of the Georgia Center for Oncology Research and Education (Ga CORE). Dr. Curran is the only individual currently serving as director of an NCI-designated cancer center and as group chairman of an NCI-supported cancer cooperative group, the Radiation Therapy Oncology Group.

Dr. Curran is a Fellow in the American College of Radiology and has been awarded honorary memberships in the European Society of Therapeutic Radiology and Oncology and the Canadian Association of Radiation Oncology. In 2006, he was named the leading radiation oncologist/cancer researcher in a peer survey by the journal Medical Imaging. Under Dr. Curran’s leadership Emory’s Radiation Oncology Department has been recently selected as a “Top Five Radiation Therapy Centers to Watch in 2009” by Imaging Technology News. Dr. Curran ranked among the top 10 principal investigators in terms of overall NCI funding in 2010 and among the top 20 principal investigators in overall NIH funding in 2010.

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Prepare Yourself for Summer – Join us for a Web Chat on Melanoma & Other Skin Cancers

May 6th, 2013 By Winship Cancer Institute

Skin Cancer Online ChatIf not caught early, melanoma is the deadliest of all skin cancers. One-in-fifty Americans has a lifetime risk of developing melanoma. It develops from changes to the DNA of skin cells, which can happen when skin is over-exposured to ultraviolet light from the sun or from extended tanning bed use. Also, certain viruses can cause DNA changes that lead to skin cancer.

To prepare yourself and your family for the summer and protect yourself from any form of skin cancer, join Winship Cancer Institute of Emory University physician, Keith Delman, MD, Wednesday, May 29th for an online web chat at 12 noon.

Dr. Delman will be able to answer questions such as:

  • How to prevent melanoma and skin cancer
  • What causes skin cancer and melanoma
  • Signs of melanoma and skin cancer
  • Treatment options for melanoma and skin cancer
  • The latest research on the horizon
Chat Sign Up
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Cancer Survival Rates Expected to Rise by 37% over 10 years!

May 2nd, 2013 By Winship Cancer Institute

By the year 2022, there will be 18 million cancer survivors living in the United States, according to a recent report by the American Association for Cancer Research. The report points out that as survival rates increase and cancer survivors become an ever-growing portion of the population, a coordinated effort will become crucial to meeting long-term medical, psychosocial and practical needs.

When news of the boost in survivor numbers made headlines, CNN Newsroom anchor Brooke Baldwin brought Emory surgical oncologist Charles Staley, MD on set to interview him as both a cancer doctor, and a cancer survivor. Watch the full interview below:

As more people are living longer after a cancer diagnosis it is very important to educate survivors on the after effects, long term effects, nutrition, and fitness following cancer care. Winship Cancer Institute at Emory University has a Survivorship program to help patients get back to life after surviving cancer. Get more information about the survivorship program.

Over the course of the next few months we will highlight many different areas of survivorship on the Winship blog so make sure to follow us to get more detailed information on living after cancer.

Dr. Charles StaleyAbout Dr. Charles Staley

Dr. Staley is the Chief of Surgical Oncology for Emory University Hospital and Chief Medical Officer for Winship Cancer Institute of Emory University. Dr. Staley specializes in treating cancers of the esophagus, pancreas, stomach, liver, small bowel and rectum. He has investigated gene therapy for metastatic colon cancer and radiofrequency ablation with intra-arterial chemotherapy for patients with colorectal liver metastases. Currently, he and his colleagues are exploring methods of using nanotechnology to treat and diagnose pancreatic and breast cancer. He joined Emory University School of Medicine faculty in 1995 after a surgical fellowship at MD Anderson Cancer Center in Houston. Dr. Staley earned his medical degree at Dartmouth University School of Medicine and conducted his residency at the University of Pittsburgh’s University Health Center. Dr. Staley is an active member of the American Society of Clinical Oncology, The Georgia Surgical Society, and the Society of Surgical Oncology.

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Prepare for Life After a Diagnosis of Cancer

April 24th, 2013 By Joan Giblin, Director of Survivorship, Winship Cancer Institute

Cancer SurvivorshipAccording to the American Cancer Society, there are over 13.5 million survivors of cancer in the US today (a cancer survivor is defined as anyone from the moment of diagnosis throughout the balance of his or her life). This number is expected to significantly increase over the next 20 years due to improved early detection, improved treatment options, aging baby boomers and longer life expectancies. With longer life expectancies, cancer survivors can experience a higher burden of illness than others not diagnosed with cancer.

Few experiences in life match the feeling patients and family members have when they complete acute treatment for cancer and begin their road to survivorship. Some patients move on quickly and experience no further challenges associated with cancer, but others experience “after effects,” or long-term or late effects. Cancer survivors, and their families, should be aware of these potential after effects so they can prepare themselves to deal with them as they get back to a more normal life.

After affects can range from mild to severe and vary from survivor to survivor.

  • Long–term effects of cancer develop during cancer treatment and may not go away.  Some long-term effects can improve such as anemia, fatigue or anxiety.  Some potentially permanent long-term effects are limb loss, weakness or nerve damage.
  • Late effects are delayed effects of cancer treatment and they can surface months to years after treatment.  Some late effects of cancer treatment are heart disease, lung disease, lymphedema, osteoporosis, depression and secondary cancers.

After effects are categorized into physical, emotional and practical after effects.

Physical after effects include:

  • Fatigue
  • Loss of limbs
  • Scars
  • Pain
  • Early menopause
  • Infertility
  • Loss of limb or use of limb
  • Lymphedema
  • Impotence
  • Loss of bladder and bowel control

Emotional after effects include:

  • Body image changes
  • Sexuality changes
  • Insomnia
  • Depression
  • Chronic fatigue
  • Anger
  • Anxiety
  • Fear

Practical after effects include:

  • Difficulty working due to physical and emotional after effects
  • Changes in relationships with loved ones, friends or co–workers
  • Problems getting or retaining health or life insurance coverage
  • Challenges communicating with healthcare team members
  • Financial stressors
  • Employment discrimination

It is very important to note that not all patients experience significant after effects of cancer, but knowing about them will help you cope and may limit the severity of these after effects with  early intervention and treatment.

Talk to your care provider about the after effects you might expect with your cancer and what you possibly could experience based on your treatment regimen. Keep a record of your symptoms to discuss with the care provider and make sure to schedule screening tests and follow up exams as recommended.

About Joan Giblin, NP

Joan Giblin, Winship Cancer Institute

Joan Giblin, NP has a total of 43 years of nursing experience, 25 as a family nurse practitioner and 16 as an oncology nurse practitioner, where she is actively involved in patient care and clinical trials.  In 2011, Ms. Giblin assumed a new role as the director of the Winship Survivorship Program with primary responsibilities for developing the program as a resource for patients and a means to facilitate continued good health and quality of life for cancer survivors.  Prior to this, she was the director of the Winship Call Center, the first point of contact for new cancer patients, and was instrumental in establishing protocols and procedures to streamline access to care at Winship.

Clinical Specialties: Ms. Giblin’s experience as an oncology nurse practitioner gives her unique perspective on the needs of cancer patients and cancer survivors. As a clinical nurse practitioner, she was part of the aerodigestive team, specializing in the care of patients with lung, head and neck and throat cancers.

Research Focus: Ms. Giblin’s current research is in the area of survivorship related to long term and late effects of cancer treatment and adherence to follow up.

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The Skinny on Neuroendocrine Cancer

April 19th, 2013 By Winship Cancer Institute

Neuroendocrine tumors develop in the cells of the neuroendocrine system, a network of glands throughout the body that produce hormones. Neuroendocrine tumors are rare, typically affecting 1 – 2 people per 100,000 people.

The different types of neuroendocrine tumors depend on the particular cells that are affected.  They usually develop in the digestive system and the lungs.  Approximately 38% of tumors are in the appendix, 23% in the ileum (also known as carcinoids), 13% in the rectum and 11.5% in the bronchi.

Symptoms of Neuroendocrine tumors

Neuroendocrine tumors may be slow growing (low grade or well differentiated) or rapidly growing (high grade or poorly differentiated).  They may be functional (release hormones) or nonfunctional.  When functional neuroendocrine tumors release a variety of hormones including a hormone called serotonin, a condition called carcinoid syndrome may occur. Symptoms most commonly associated with neuroendocrine tumors include flushing, diarrhea, weight loss, abdominal pain and cramping.   Patients with carcinoid syndrome may also experience cardiac changes, which are caused from fibrotic damage to the heart.  Usually a patient with carcinoid syndrome does not experience these symptoms until the tumor has spread within the body.

Other terms used for neuroendocrine tumors include
• Gastroenteropancreatic neuroendocrine tumors – tumors in the gut or pancreas
• Pancreatic neuroendocrine tumors – also known as islet cell cancer, or PNET
• Gastrointestinal neuroendocrine tumors – tumors that develop in the bowel, stomach or esophagus
• Pheochromocytoma of the adrenal gland
• Carcinoid tumors of the lung or intestinal tract
• Carcinoid Syndrome
• Gastrinoma, Insulinoma, Glucagonoma, VIPoma (vasoactive intestinal peptide tumor)

Treatment of neuroendocrine tumors

Treating neuroendocrine tumors can be a challenge due to the various types, locations in the body, the symptoms they produce and the diverse number of treatment modalities. Treatment is individualized to  each patient but can include surgery, liver directed therapy, medications, and/or radiation.

When treating a rare, challenging cancer such as neuroendocrine cancer, it is important to have a team of healthcare professionals at your side who are experts in the  disease and can collaborate to create a treatment plan individualized to each patient.

At Winship Cancer Institute of Emory University, we take this multidisciplinary approach with teams of  expert medical oncologists, surgical oncologists, interventional oncologists, gastroenterologists, pulmonologists, endocrinologists, nurses, and dieticians ( just to name a few) to create a care plan unique to each patient.

About Bonnie Josaphs, RN, BSN, OCN

Ms. Josaphs received her Bachelor of Science in Nursing from the University of Delaware, Newark, Delaware in 2002. She has been practicing within Gastrointestinal (GI) Oncology since 2004.  She specializes in gastrointestinal cancers which include cancers of the esophagus, liver, colon, rectum, pancreas, gallbladder and stomach.

Related Links

More information on neuroendocrine tumors:
Winship Cancer Institute Clinical Trials for Neuroendocrine Tumors
 The Winship Cancer Institute of Emory University is Georgia’s only NCI-designated Cancer Center.
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All About Colon Cancer

March 19th, 2013 By Dr. Bassel El-Rayes

Thank you to everyone who participated in the colon cancer live chat with me on March12. We had some excellent questions on the topics of colon cancer prevention, risk factors, treatment options and new research on the horizon.  As mentioned in the chat, early detection is key to beating colon cancer, so it is important that all people over the age of 50 receive regular screenings. If there is family history of the disease, screening should start at an earlier age.  In many cases, cancer can actually be prevented by screening;  non-cancerous polyps detected during screening can be removed during the procedure.  Also, screening detects early-stage cancer and can prevent its spread. When cancer confined to the colon or rectum (local stage) is discovered, the odds of long- term survival are high.

March is national colorectal cancer awareness month.  Take control of your destiny, and schedule your regular screening today!  It could save your life.

For more information on all the topics we discussed in the chat, please review the chat transcript.

Contact us for more information about our colorectal cancer treatment programs: 404-778-1900 or request an appointment online.

About Bassel El-Rayes

Dr. El-Rayes, Colon Cancer SpecialistDr. El- Rayes is an Associate Professor of Medicine at Emory University School of Medicine, the Director of the GI Oncology Translational Research Program and the Associate Cancer Center Director for Clinical Research at Winship Cancer Institute of Emory University.

Dr. El-Rayes completed medical school at the American University of Beirut (AUB). He subsequently joined the internal medicine residency program at Wayne State University. After completing the residency, he joined the hematology oncology fellowship program at the Karmanos Cancer Institute, Wayne State University. He then joined the faculty as an Assistant Professor in the area of GI oncology. During this time, he was involved in translational research focused on pancreatic cancer. Dr. El-Rayes joined Emory University in September 2009 as the director of the GI Oncology program. He is designated as a Distinguished Cancer Scholar by the Georgia Cancer Coalition.

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Breast Cancer Survivors at Higher Risk for Heart Disease

March 18th, 2013 By Susmita Parashar, MD, MS

Heart Disease after Breast CancerAlthough many women who have survived breast cancer are worried about the chance of recurrence, recent research suggests that risk of a heart problem is greater or equal to the risk of breast cancer reoccurring. Chemotherapy and radiotherapy treatments for breast cancer can often be toxic to the heart muscle as well as to other organs. Chemotherapy side effects may increase the risk of heart disease, including weakening of the heart muscle (cardiomyopathy).

A significant proportion of women with breast cancer have one or more risk factors for heart disease at the time of breast cancer diagnosis that further increase the risk of cardiotoxicity, including smoking, obesity, lack of activity and high cholesterol. Additionally, if a woman had radiation therapy on the area of body that includes the heart, there may be an increased risk of cardiomyopathy, coronary artery disease and heart attack. The combination of radiation and chemotherapy can further increase a woman’s risk of heart damage. Thus, after second malignancies, heart disease is the leading cause of long-term morbidity and mortality among breast cancer survivors.

If you are a survivor of breast cancer, take control of your heart and breast health by following some simple guidelines:

  • Maintain a healthy weight
  • Avoid smoking
  • Limit alcohol intake
  • Manage stress!  - Stress can shut down your immune system, making it harder for you to fight off disease. It also can prevent the body from healing, which can put you at greater risk for heart disease.
  • Exercise! Get at least 30 minutes of physical activity 3 times a week.
  • Monitor and manage diabetes.
  • Eat healthy! Your diet should be low in fat and include generous amounts of fruits and vegetables.
  • Actively monitor your blood pressure and cholesterol levels. Work with your physician to reduce your blood pressure and cholesterol if they are high.
  • Get rest. Most people need 7 to 8 hours of sleep at night to heal and keep the immune system healthy.

Importantly, if you have received chemotherapy or radiation for breast cancer, it may be useful to follow up with a preventive cardiologist on a regular basis. If you experience significant problems such as shortness of breath or chest pain, report it immediately to your health care providers.

About Dr. Parashar

Dr. Susmita Parashar, Emory HealthcareSusmita Parashar, MD, MPH, MS is a Board certified cardiologist at the Emory Heart and Vascular Center and Assistant Professor of Medicine (Cardiology) at Emory University School of Medicine. Prior to joining the Division of Cardiology, Dr. Parashar was Assistant Professor of Medicine in the Division of General Medicine at Emory for 8 years. She applies her experience as a Board certified internist in providing a holistic care to patients.

She has received several grants and awards from the National Institutes of Health (NIH) and the American Heart Association to conduct research on women and heart disease. She has served as Emory principal investigator for large NIH – funded clinical research for heart attack patients. She was also invited to participate as a co-investigator for the NIH- fnded Cardiovascular Health Study for older adults.

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Survivorship Care Plan- Are You Prepared? Take-Aways from Web Chat

March 6th, 2013 By Stephanie Zimmerman

Cancer Survivorship SupportRecently, I conducted a chat with Winship Cancer Institute of Emory University on the Effects of Chemo and Radiation on Cancer Survivors. In 1978, as a child, I was diagnosed with Ewing’s Sarcoma. I received radiation and chemotherapy at that time that resulted in my development of significant late side effects in my adult life.

The participants asked some great questions. One particular question we did not have time to answer was,

“Did you find a survivorship care plan an effective tool for you or your parents once you moved from active treatment?”

For me, a cancer treatment summary or a survivorship care plan was extremely helpful after my active treatment. Without the knowledge from my parents and their guidance, I would not have been able to properly prepare a care plan.

I recommend that every cancer survivor become well informed and secure a treatment summary and survivorship care plan.  Consider it the first step in accepting responsibility for your personal health and well-being after cancer treatment.

A Cancer Treatment Summary should include the following information at a minimum:

  • Identifiers for you (name, medical record number and birthdate)
  • A description of your cancer diagnosis including pathology and staging information
  • A list of all treatments you have received (surgery, chemotherapy, biological therapy, hormonal therapy, and/or radiation therapy)
  • All dates and doses of treatment you received  (i.e. cumulative doses of anthracyclines)
  • Any significant side effects you experienced during treatment
  • Contact name and phone number of a member of your family or close friend
  • Names and Contact information of all providers involved in your care

A Survivorship Care Plan should include the following information at a minimum:

  • A Treatment Summary
  • A plan for long term follow-up including appointments and testing you will need and when you should have them
  • A list of any long term side effects that you need to be aware of and ways to handle them (including physical issues as well as emotional and social issues you may experience)

For more information on how to prepare your survivorship plan and the benefits of having one, check out the chat transcript.

About Stephanie Zimmerman

Stephanie’s personal experience as a child diagnosed and treated for Ewing’s Sarcoma in the late 1970’s led her to become a nurse serving the physical and psychosocial needs of children and their families along the cancer trajectory. In April 2008, Stephanie’s heart failed because of the chest radiation and Doxorubicin used to cure her Ewing’s Sarcoma three decades prior. Unable to return to clinical practice following a heart transplant, yet unwilling to abandon her passion for the survivor population, Stephanie partnered with Judy Bode of Grand Rapids, MI in the founding of myHeart, yourHands, Inc. [MHYH]

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Colon Cancer Prevention Begins with Education and Screenings!

February 22nd, 2013 By Winship Cancer Institute

Colon Cancer Online ChatScreening tests like the colonoscopy often find polyps in the colon that can be removed before they turn to cancer. Regular screening also helps find cancer in an early stage, when it is very treatable! According to the Centers for Disease Control and Prevention (CDC), regular colon cancer screenings for everyone over the age of 50 would prevent about 60% of deaths from the disease!

The CDC also states that of cancers affecting both men and women, colorectal cancer (cancer of the colon and rectum) is the second leading cancer killer in the United States. It affects men and women of all different ethnicities and races and is most often found after the age of 50. Winship Cancer Institute of Emory University highly recommends that men and women at average risk for developing colon cancer get regularly screened for the disease.

March is national awareness month for colorectal cancer. To learn more about how to prevent your risk of colon cancer join us on March 12, 2013 at 12 noon EST, for a live web chat with a Winship expert on colorectal cancer. Dr. El-Rayes will answer your questions about preventing colorectal cancer, and tell you about Winship Cancer Institute of Emory University’s approach to diagnosing and treating it. Some of the questions he can answer:

  • What is colon cancer?
  • How important is colon cancer screening?
  • What are the symptoms of colon cancer?
  • What are the risk factors of colon cancer?
  • Can inflammatory bowel disease cause colon cancer?
  • Do gender, ethnicity, race, obesity, environment and/or social status impact colon cancer risk?
  • Does exercise help prevent colon cancer?
  • Do polyps increase colon cancer risk?
  • Does a family history of colon cancer increase my risk?
  • What is Emory’s approach to colon cancer treatment and care?
  • What new colon cancer research is on the horizon?

About Dr. El – Rayes:
Dr. El-Rayes, Colon Cancer SpecialistDr. El- Rayes is an Associate Professor of Medicine at Emory University School of Medicine, the Director of the GI Oncology Translational Research Program and the Medical Director of the Clinical Trials Office at Winship Cancer Institute of Emory University.

Dr. El-Rayes completed his medical school at the American University of Beirut (AUB). He subsequently joined the internal medicine residency program at Wayne State University. After completion of the residency, he joined the hematology oncology fellowship program at the Karmanos Cancer Institute, Wayne State University. He then joined faculty as an Assistant Professor in the area of GI oncology. During this time, he was involved in translational research focused on pancreatic cancer. Dr. El-Rayes joined Emory University in September 2009 as the director of the GI Oncology program. He is designated as a Distinguished Cancer Scholar by the Georgia Cancer Coalition. Dr. El-Rayes is currently the medical director of the Clinical Trials Office.

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