Awareness

Taking a Stand in Favor of E-Cigarette Regulation

e-cigarette regulationIt has taken us over 50 years of careful regulation with tremendous pushback to strip the tobacco companies of their ability to aggressively and falsely market cigarettes as safe products. The advent and popularity of e-cigarettes could wipe out much of that progress and endanger an entire generation of young people who are attracted to the slickly packaged cartridges, marketed to a youthful generation as a safe alternative to tobacco burning cigarettes.

I firmly believe that the United States Food and Drug Administration should have full authority to regulate e-cigarettes; the same full authority the agency currently has to regulate regular tobacco products. E-cigarettes are not made up of benign compounds. In fact, some of the ingredients such as formaldehyde are known carcinogens. With recent introductions of e-cigarettes from big tobacco companies such as Philip Morris, I believe they will pose some of the same risks as tobacco-burning projects unless they are regulated.

We know that nicotine is highly addictive, whether it is delivered from an e-cigarette, a regular cigarette or a patch. There is some data that nicotine may promote certain cancer signaling networks. There is also some very good evidence in young people that nicotine can cause the rewiring of the brain circuitry. Of greatest concern is recent data obtained from careful studies conducted by the Centers for Disease Control (CDC) that show that people who use e-cigarettes are twice as likely to consider smoking tobacco burning products. In my view, this makes e-cigarettes a Trojan Horse that allows tobacco products into the lives of young people without the proper FDA regulation.

The full range of health risks posed by e-cigarettes is unclear because they have not been fully studied. Just because we don’t have all the scientific evidence does not mean that e-cigarettes should get a free or easy ride. They should be held to the full high bar, especially because we don’t currently understand all of the dangers they pose.

My biggest concern about e-cigarettes is that they are easily marketed to teens and young adults. The campaigns seem to be working since e-cigarette use has almost tripled in the last three years. Only 19% of Americans are active cigarette smokers, but that’s still far too high in my book. We should be concerned as a society that smoking rates will increase as a result if e-cigarettes continue to be sold without any regulation. E-cigarettes are a step backward in our goals to move towards a tobacco free society.

About Dr. Khuri

Fadlo Khuri, MDFadlo R. Khuri, MD, deputy director of the Winship Cancer Institute of Emory University and Professor and Chairman of the Department of Hematology & Medical Oncology, Emory University School of Medicine, and executive associate dean for research of Emory University, is a leading researcher and physician in the treatment of lung and head and neck cancers. He is Editor-in-Chief of the American Cancer Society’s peer-reviewed journal, Cancer.

Dr. Khuri’s contributions have been recognized by a number of national awards, including the prestigious 2013 Richard and Hinda Rosenthal Memorial Award, given to an outstanding cancer researcher by the American Association for Cancer Research.

An accomplished molecular oncologist and translational thought leader, Dr. Khuri has conducted seminal research on oncolytic viral therapy, developed molecular-targeted therapeutic approaches for lung and head and neck tumors combining signal transduction inhibitors with chemotherapy, and has led major chemoprevention efforts in lung and head and neck cancers. Dr. Khuri’s clinical interests include thoracic and head and neck oncology. His research interests include development of molecular, prognostic, therapeutic, and chemopreventive approaches to improve the standard of care for patients with tobacco related cancers. His laboratory is investigating the mechanism of action of signal transduction inhibitors in lung and aerodigestive track cancers.

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Working During Cancer Treatment

Working with CancerTo work, or not to work, during cancer treatment is often a very real decision that patients must make. Some patients need to continue working during treatment for financial support, or to keep their insurance coverage, or just an overall desire to continue working. Working during treatment can be difficult depending on the type of treatment a patient receives, but also on the type of work a patient does. For example, a patient who can work from home may be able to continuing working whereas a patient with a job that requires more physical demands may be unable to continue working. Here are a few things to remember when working during cancer treatment:

  • Discuss your job situation with your medical team. It is important for your medical team to be aware of your desire or need to work during treatment. This may help in determining a treatment schedule that works best for you in order to continue working. Also, discussing the type of work you do with your medical team will allow them to provide you with appropriate information about how your treatment may affect your ability to perform the duties of your job.
  • Depending on your level of comfort, talk with your employer or human resource department about your diagnosis and treatment schedule. This will allow you to discuss any accommodations you may need in order to complete your job tasks. This is also an opportunity to discuss the possibility of working from home.
  • Consider utilizing the Family Medical Leave Act, if you are eligible. This important legislation was put in place in order to protect patients when they must leave work in order to receive medical care. Consult your human resources department for additional guidance in determining if you are covered through this.
  • Consult your human resource department regarding possible short-term or long-term disability benefits you may have available. There may be times in which patients are unable to work due to lengthy hospitalizations or because their medical team advises against it. In instances such as these, you may consider utilizing your short-term and long-term disability benefits in order to continue receiving some income.
  • If you are comfortable, talk with your coworkers about your diagnosis and treatment. Coworkers can be a strong source of support and encouragement during these difficult times. This may also help in developing a work schedule that works for you during treatment.
  • Talk with the social worker at your oncology office. Social workers may be able to help problem solve any concerns or issues you may be having with your employer.

Although working during cancer treatment may be challenging, it does not have to be impossible. Just talking with others about this may help you get the assistance you need.

About Joy McCall, LCSW

Joy McCallJoy McCallJoy McCall is a Winship social worker with bone marrow transplant, hematology and gynecologic teams and their patients. She started her professional career at Winship as an intern, working with breast, gynecologic, brain and melanoma cancer patients. She graduated with a Bachelor of Science in Psychology from Kennesaw State University and a Master of Social Work from the University of Georgia. As part of her education she completed an internship with the Marcus Institute working on the pediatric feeding unit, and an internship counseling individuals and couples at Families First, supporting families and children facing challenges to build strong family bonds and stability for their future. She had previously worked with individuals with developmental disabilities for over 4 years, providing support to families and caregivers.

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Fundamental Science Can Transform Cancer Care Worldwide

World Cancer Day is February 4, and it is an important reminder that cancer is one of the leading causes of death worldwide. According to the World Health Organization, the number of new cases is expected to rise by about 70% in the next two decades. This gives us all the more reason to recognize the progress that has been made because of discoveries by fundamental, or basic, cancer researchers. Our task now is to bring the benefits of that work to patients around the world. Check out this short video where Fadlo R. Khuri, MD, Deputy Director of Winship Cancer Institute discusses these discoveries in fundamental cancer research:

The theme of this year’s World Cancer Day, “Not Beyond Us,” highlights solutions that are within our reach. In that spirit, we celebrate 2014 as a landmark year for cancer research, discovery, treatment and prevention. Important progress was made in a number of areas: screening and prevention of cancers, development of novel targeted therapies for cancers, and immunotherapy of a number of previously resistant diseases. Over the past year, we saw at least a half dozen new approvals by the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA) of new, improved, potent targeted therapies, chemotherapies, and immunotherapies for cancer, whose impact is most acutely felt in societies in North America, Europe, Eastern Asia, Australia and South America. Our therapeutic resources have been significantly advanced by these discoveries, all of which spring from major biologic breakthroughs in the laboratory. What should the next steps be in ensuring that the powerful tools of genomic medicine, immunology, and molecular imaging continue to flourish and impact cancer patients worldwide? How do we make sure that personalized, precision medicine can be practiced to benefit oncology patients globally?

Fundamental to progress in cancer diagnosis, treatment and prevention is continued investment in fundamental cancer research. In a decade in which the growth of real federal funding for basic and translational research in cancer has slowed noticeably in the United States, this challenge has been counterbalanced on some levels by substantial increases in investment in basic and translational research in Asia (China and India in particular), Europe (Germany and Great Britain in particular), and Australia. Nonetheless, research conducted in United States laboratories remains the major driver of cancer discovery in the areas of genomics, immunology, and prevention, and in the translation of these discoveries from the bench to the bedside, aided by accelerated developments in the biotech and pharmaceutical world. On-going support for researchers in the fundamental sciences will ensure that these new discoveries will continue to substantially enhance our therapeutic and preventive arsenal against cancer. Fundamental science is vital to the global war against cancer.

As discoveries accelerate, and increasing numbers of affordable new treatment modalities are brought into the clinic, making an impact on diseases from Africa and Australia, through Asia and Europe, and all the way to the Americas, we must continue to support, guard, and mentor our treasure trove of outstanding scientists and clinical investigators. Over the next several decades, these individuals will be the key to sustaining and accelerating the major advances that are being made against cancer. Discoveries in the labs of outstanding scientists in basic immunology, genomics, glycomics and metabolomics, and in understanding the biologic behavior of normal, pre-malignant, and cancerous cells, pave the way for clinical translations that improve the prevention and therapy of our global population as a whole.

About Dr. Khuri

Fadlo Khuri, MDFadlo R. Khuri, MD, deputy director of the Winship Cancer Institute of Emory University, professor and chairman of the Department of Hematology & Medical Oncology, Emory University School of Medicine, and executive associate dean for research of Emory University, is a leading researcher and physician in the treatment of lung and head and neck cancers. He is Editor-in-Chief of the American Cancer Society’s peer-reviewed journal, Cancer.

Dr. Khuri’s contributions have been recognized by a number of national awards, including the prestigious 2013 Richard and Hinda Rosenthal Memorial Award, given to an outstanding cancer researcher by the American Association for Cancer Research.

An accomplished molecular oncologist and translational thought leader, Dr. Khuri has conducted seminal research on oncolytic viral therapy, developed molecular-targeted therapeutic approaches for lung and head and neck tumors combining signal transduction inhibitors with chemotherapy, and has led major chemoprevention efforts in lung and head and neck cancers. Dr. Khuri’s clinical interests include thoracic and head and neck oncology. His research interests include development of molecular, prognostic, therapeutic, and chemopreventive approaches to improve the standard of care for patients with tobacco related cancers. His laboratory is investigating the mechanism of action of signal transduction inhibitors in lung and aerodigestive track cancers.

HPV-Related Head and Neck Cancers on the Rise

Head Neck CancerHead and neck cancer causes almost 200,000 deaths each year and is now recognized as one of the major health concerns both in the United States and worldwide. In particular, there has been a noted increase in the incidence of oropharynx cancer (OPC), mainly tonsil and base of tongue cancers, that are linked to infection with the human papilloma virus (HPV).

According to the National Cancer Institute, HPV infections are the most common sexually transmitted infections in the US and more than half of sexually active people are infected with one or more HPV types at some point in their lives. Most HPV infections occur without any symptoms and go away without any treatment over the course of a few years. However, HPV infections sometimes persist for many years and can increase a person’s risk of developing cancer.

The human papilloma virus 16 (HPV16) infection linked to oropharynx cancers is a sexually transmitted virus that seems to affect mostly young Caucasian males. Traditionally the non-HPV related head and neck cancers are strongly linked to smoking, but patients with HPV related cancers are usually not tobacco users. HPV-related head and neck cancers are a distinct disease entity which has particular molecular, epidemiological, and clinical characteristics. Multiple studies have shown that HPV-related oropharynx cancers are easier to cure compared to the head and neck cancers caused by tobacco and alcohol use, but smoking still seems to affect the chances of curing patients with HPV related OPC. There is also recent evidence suggesting that smoking is linked to a higher risk of having HPV-related OPC.

Still, sexual transmission of HPV is believed to be the main risk factor for HPV-related head and neck cancers and oral sexual behavior has been linked to an increased risk of HPV-related oropharyngeal squamous cell carcinoma. For example, studies have shown the odds of developing oral HPV infection among a group of college-aged men increased with increases in the number of recent oral sex partners or open-mouthed kissing partners, but not vaginal sex partners.

The Food and Drug Administration (FDA) has approved two vaccines that are highly effective in preventing infection with HPV types 16 and 18. Because research clearly shows that vaccination makes a difference in preventing cervical cancer, which is very closely linked to HPV-16, the HPV vaccine has been recommended for girls aged 11 to 12. There is also a more recent recommendation from the Advisory Committee on Immunization Practices (ACIP) for boys of the same age to receive the HPV vaccine. Even though vaccination for HPV-related oropharynx cancers has been an active area of research, the implementation of such an approach is still limited.

For the majority of cancers of the head and neck that do not originate from the area of the oropharynx (non-OPC), HPV does not seem to be a significant risk. However, of interest, HPV is still apparently linked to some patients who have non-OPC. The significance of this link is not clearly known and more studies are needed to understand the role of HPV in patients with non-OPC.

About Dr. Saba

Nabil Saba, MDNabil Saba, MD, FACP, is a nationally recognized expert in the treatment of head and neck and esophageal cancer. As principal investigator on several head and neck cancer trials, he has initiated studies focusing on novel approaches for treating these diseases. Dr. Saba is a member of the ECOG Head and Neck Cancer steering committee, and an elected member of the American Head and Neck Society (AHNS). He also serves on the American College of Radiology appropriateness criteria panel for Head and Neck Cancer.

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Getting the Best Cancer Treatments into Outlying Communities

Cancer Treatment in CommunitiesThe purpose of the community outreach program I oversee at Winship Cancer Institute of Emory University is to bring our clinical and population-based research to communities throughout Georgia and surrounding states in order to benefit patients in those areas. By partnering with community oncologists, we can offer our expertise and best practices to help them successfully treat patients with types of cancer that are less common or more difficult to treat.

A great example of this is a program we’ve developed to treat patients with acute promyelocytic leukemia (APL), an uncommon but highly aggressive disease. We actually call it the heart attack of leukemias because a third of the patients do not survive the first month of treatment. We have chemotherapeutic drugs that are very effective in treating APL, but because it is a rare condition, physicians who treat it in the community may not be familiar with the potential complications that patients may develop during treatment.

Yet it is a highly curable disease, and at Winship we have come up with a simple approach that is keeping these patients alive during the first, most crucial month. This method decreases mortality from an estimated 30 percent to less than five percent.

We started by taking a very complicated treatment algorithm and simplifying it to a page and a half, and then used that to develop a three-step process to help community oncologists treat patients quickly and effectively. As soon as we get a call from a community physician, we send the simplified algorithm via smart phone. Then we talk to the physician on the phone and figure out what the patient is going through. Lastly, we give them a treatment plan to get them through the first month and follow up with emails, phone calls or text messages.

We’re grateful that community doctors are receptive to the guidance offered by Winship. By taking swift action, they are giving their APL patients the best chance of survival. It’s extremely gratifying to see people in outlying parts of Georgia and South Carolina receive this treatment protocol and survive this disease.

Watch Dr. Jillella explain the way Winship is helping save patients’ lives following diagnosis of acute promyelocytic leukemia in the video below:

About Dr. Jillella

Anand Jillella, MDAnand Jillella, MD, is a national leader in bone marrow transplantation and has led the development of a strategy to decrease induction mortality for acute promyelocytic leukemia. He leads the efforts of the Winship Cancer Network and is expanding Winship’s role in bringing clinical and population-based cancer research to communities throughout Georgia and surrounding states.

Latest in Breast Cancer Research

According to the National Breast Cancer Foundation, 10%-20% of diagnosed breast cancers are determined to be triple negative breast cancer. It tends to primarily affect younger, premenopausal women and is more aggressive than other types of breast cancer. Studies show that African-American and Hispanic women are more likely to be diagnosed with triple negative breast cancer than white women. Triple negative breast cancers don’t have the three types of receptors that most commonly fuel breast cancer growth — estrogen, progesterone and the HER2 gene — so they don’t respond to hormonal therapies and treatments that target those receptors. Chemotherapy is typically used for treatment, but there is an urgent need to find more precise therapies.

LaTonia Taliaferro-Smith, PhD, is one of the Winship Cancer Institute of Emory University’s scientists who have taken up the challenge to develop more targeted therapies. In her lab research, Taliaferro-Smith searches for alternative targets in the triple negative breast cancer cell. She works closely with Winship physician-researchers toward the goal of developing drugs that will benefit patients with this disease.

“I’m very hopeful about the research we’re doing here and what Winship is offering to triple negative breast cancer patients,” says Taliaferro-Smith. “Oftentimes when patients hear a triple negative diagnosis, they think there are no options and ultimately their endpoint is death. But we’re very encouraged here at Winship because we do have active research that is trying to find alternative therapies for these particular patients, so we can let them know that you will have treatment options available hopefully in the near future.”

Check out the video below as Dr. Taliaferro- Smith discusses the continuous work research teams at Winship are doing to develop more precise treatment therapies for triple negative breast cancer:

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Learn more about breast cancer care at Winship at Emory. October is Breast Cancer Awareness Month and our breast care teams want you to know that early detection is key to survival. Have questions about the role of screening in early breast cancer detection? Join us for a live web chat with a breast imaging expert on October 21, 204.

Winship’s Win the Fight 5K Exceeds Fundraising Goal to Help Battle Cancer

Winship Win the Fight 5K RecapThis past weekend,  Winship Cancer Institute of Emory University raised a record amount of money towards cancer research in Georgia. Fundraising support, through the 4th annual Winship Win the Fight 5K, which was held on Saturday, September 27, 2014, surpassed its half-million dollar goal and brought in more than $582,000. Over three thousand runners and walkers gathered Saturday morning to participate in the event that started and ended on the Emory campus and wound its way through the surrounding Druid Hills-area.

“We are so grateful to all the supporters who joined us at this year’s Winship 5K,” says Walter J. Curran, Jr., MD, executive director of Winship. “The money raised will support more than a dozen cancer research projects at Winship and will lead us to more and more success stories in our fight against cancer.”

The Winship Win the Fight 5K is a unique event because it allows participants to select the specific area(s) of cancer research they want their tax-deductible donations to benefit. Donations are still being accepted until November 14, 2014. For more information, visit the Winship Win the Fight 5K website.

And make sure to mark your calendars for the 5th annual Winship Win the Fight 5K, which will be held on Saturday, October 3, 2015.

Advancements in Imaging for Early Breast Cancer Detection

Advancements in Breast Imaging ChatBreast cancer is the most common cancer among American women, according to the Centers for Disease Control and Prevention (CDC). October is Breast Cancer Awareness month and the breast care specialists across Emory Healthcare want you to know the importance of screening and early detection.

The American Cancer Society recommends that women (without breast cancer symptoms), age 40 and older should have a mammogram every year as long as they are in good health. Getting yearly screening mammograms increases the chance of detecting cancers in the early stages, before they start to cause symptoms. By detecting cancer early, screening exams also help increase the chance of survival and lower the risk of mortality.

At Emory Healthcare, we are proud to offer patients with leading breast screening techniques, including the latest in breast imaging technology, called tomosynthesis, or 3D mammography.

Learn more about breast screening guidelines and advancements in breast imaging by joining us on Tuesday, October 21 at 12:00 pm EST for a live web chat on “Advancements in Imaging for Early Breast Cancer Detection.” Dr. Michael Cohen, Director, Division of Breast Imaging for Emory’s Department of Radiology, will be available to answer questions such as: what is the latest in breast imaging technology? When should I start getting screened? To register for the chat, click here.

Also, during October, the Emory Breast Imaging Centers are offering extended and weekend hours for women needing a screening mammogram. Dates and details are below:

Extended Hours: Thursday, October 9, Tuesday, October 21, Thrusday October 23; 7:30 a.m – 7:00 p.m. at the Emory Breast Imaging Center on Clifton Road.

Saturday Hours: October 18, 8 a.m. – 2 p.m. at Emory University Hospital Midtown.

Registration: To schedule an appointment, call 404-778-PINK (7465). Standard rates apply.

Chat Details:

Date: Tuesday, October 21, 2014
Time: 12:00- 1:00 pm EST
Chat Leader: Dr. Michael Cohen
Chat Topic: Advancements in Imaging for Early Breast Cancer Detection

Chat Sign Up

Winship Win the Fight 5K

Winship Fight 5KThe Winship Win the Fight 5K is this Saturday, September 27, 2014 and already a HALF A MILLION DOLLARS has been raised towards cancer research at Winship Cancer Institute of Emory University.

There’s still time to be a part of this special event! Today is the last day to register online for Saturday’s event. If you cannot be present to run or walk this weekend, register as a “Sleep-In Warrior” to support cancer research from wherever you will be this weekend.

For more information, or to register, visit the Winship Win the Fight 5K website. Also, check out this inspiring video below featuring WSB-TV’s Mark Winne’s wife, Kate, a cancer survivor and Winship patient. Mark and Kate’s story not only shows the crucial role cancer research plays in the continuous fight for a world without cancer, but also the hope it beings to patients and families, here and now.

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Cancer Researchers, Patients Support Winship 5K Side-by-Side
Why I Run: To Raise Awareness & Funding For My Dad’s Cancer
Running to Carry Forth a Father’s Passion to Make a Difference…

Take Steps to Prevent Skin Cancer

Skin ExamI am a dermatologist in the Emory Clinic and my focus is medical dermatology with a monthly melanoma clinic. I see patients of all skin types but a large part of my practice is seeing patients for total body skin exams (TBSE). We recommend that patients with all skin types get a total body skin exam, but patients who have a family history of melanoma, atypical mole syndrome or non-melanoma skin cancer should be particularly proactive about scheduling their skin checks. As a broad rule, once a year skin checks should suffice. These checks become more frequent in patients who have a personal history of melanoma or non-melanoma skin cancer.

A skin exam entails wearing a gown at the dermatologist’s office and getting all parts of your skin looked at for moles that may appear abnormal or growths that may be non-melanoma skin cancers such as basal cell skin cancer or squamous cell skin cancer. If we see anything suspicious, the spot is biopsied, which involves removing a small sample of skin tissue. It takes five minutes or less to perform a biopsy and the results are usually available in a few days.

During this visit, we educate patients to be good about self-examination. I recommend that patients pick the first of every month and put it on their calendar to examine their skin head to toe. They should look for any changing moles or any new bumps that may have come up. It can be difficult to know what to worry about or not, but in general a melanoma can show up as a new mole or a changing or bleeding mole. A basal or squamous cell generally presents as a new bump or flat lesion that can bleed, or hurt, or just be new and growing. If you are worried about something, you should make an appointment to be checked by your dermatologist right away.

Sun protection is a big part of preventing skin cancers. The AAD (American Academy of Dermatology) recommends everyone use sunscreen that is broad spectrum (protects against UVA and UVB), has a sun-protection factor (SPF) of 30 or greater and is water resistant. And you need to apply an adequate amount of sunscreen for it to be effective: generally one ounce (enough to fill a shot glass) for the exposed parts of your body for each application. This needs to be repeated every 2 hours on continued sun exposure. Remember to apply sunscreen at least 15 minutes before going outdoors.

You can use any type of sunscreen that works for you, such as lotions, creams, gels, sticks or even sprays. Sprays, though, have the disadvantage of accidental inhalation and it’s sometimes hard to know when using a spray if you have applied an adequate amount.

Tanning bed use has been proven to increase the risk of melanoma and also accelerate photo-aging. It should be avoided at all cost. Sunbathing and a history of blistering sunburns also increase your risk of skin cancer. It is very important to avoid the sun between 10 am and 2 pm, when the rays are the strongest, and to use additional protective clothing such as long sleeved shirt, pants, a wide-brimmed hat and sunglasses.

As you get ready for fun summer weekends, here’s a checklist to help you prevent skin cancer: avoid the sun when it’s at its strongest, use sunscreen and protective clothing any time you are out in the sun, never use a tanning bed, and when in doubt, check it out! Schedule an appointment with a dermatologist along with your annual physical visit, and for accurate information about safe sun practices, check the AAD website.

About Dr. Bhandarkar

Sulochana Bhandarkar, MDSulochana Bhandarkar, MD, is an assistant professor of dermatology at the Emory School of Medicine. She completed her medical school education from her home country, India, at Kasturba Medical College in Mangalore, where she also did a three-year dermatology residency with a special interest in vitiligo, a condition affecting skin pigmentation. After moving to the U.S., she did a clinical research fellowship at the University of California San Francisco, as well as a melanoma research fellowship at Emory University. She did her residency in dermatology at Emory University and became a faculty member at Emory in 2011. Her clinical interests are vitiligo and melanoma.

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