MD Chats

How We’re Working to Cure Multiple Myeloma

Over the past ten years, I have seen the treatment of multiple myeloma dramatically improve because of new drug therapies that have come out of clinical trials. I am now leading a clinical study to learn more about the genetic components of multiple myeloma and how we can use that knowledge to come up with better, more targeted drugs and individualized therapies for patients. I think this landmark study will lead to treatments that effect long-term remission, or even cure, from the cancer.

In the CoMMpass study, launched by the Multiple Myeloma Research Foundation, we will follow 1,000 newly diagnosed patients with multiple myeloma over the course of eight years. We will study the genomic changes in their disease while they receive frontline treatments, and continue studying those changes through remission stages or relapse. One of the questions we hope to answer is why some patients do well on a specific drug, while others do not and may need multiple drugs to keep their myeloma from advancing.

The first step in the study is mapping out the molecular characterization of a patient’s tumor using sequencing at the time of initial diagnosis, and then following what happens in the sequencing information during and after treatment. If the disease comes back, we want to know if there were changes in the disease or new mutations that were influenced by the therapy or by the original mutations themselves?

As we learn more about cancer and its various types, we do less lumping them together and more splitting them into individual diseases. Lymphoma is a good example. It used to be that the disease was characterized as six or seven different types, and now we know there are at least 50 different variations of lymphoma. We look at the molecular characterization of lymphoma and create subtypes that are potentially treated in different ways. We may need to do that in myeloma. In the CoMMpass study, we will be able to have individual tumor specimens molecularly sequenced, which has never been done before, and we will learn much more about the cancer and its number of subtypes.

We are also looking at the impact of side effects on quality of life issues in this trial. There may be molecular characteristics of a patient’s tumor that can tell us whether that patient will have side effects from a specific treatment, so mapping a patient’s molecular subtype might influence the type of drugs he gets.

We have seen the life expectancy of multiple myeloma patients double in the last ten years. I think that there are probably some patients we are curing now and I believe that CoMMpass will help us to identify the best drugs and the best targets to increase the cure rate in this disease. We hope this study will help push the barrier to cure even further, but do it in a way that does not compromise a patient’s quality of life.

To learn more, watch this video as Dr. Lonial further explains Multiple Myeloma and treatment options for the diease.

Multiple Myeloma Online Chat

Multiple Myeloma Chat Sign UpWant to learn more about multiple myeloma? Join expert physician, Jonathan Kaufman, MD, for a live web chat on March 11, 2014 at 12:00 PM EST. Dr. Kaufman will be there to answers all your questions about known risks, prevention, diagnosis and treatment of multiple myeloma. Bring your questions and prepare for a great discussion!

Multiple Myeloma Chat Sign Up

About Dr. Sagar Lonial

Dr. Sagar LonialDr. Lonial is Vice Chair of Clinical Affairs for the Department of Hematology and Medical Oncology at the Winship Cancer Institute of Emory University, and Director of the Translational Research for the B-Cell Malignancy Program. He is also a professor in the Emory University School of Medicine.

Dr. Lonial’s research focuses on combination therapy in B-cell malignancies focusing on myeloma. He is a trained bone marrow transplant physician with an interest in molecular therapy for lymphoma and myeloma. His clinical interests include evaluating the combination of new molecular targeted agents for B-cell tumors as well as target discovery and validation.

Dr. Lonial has authored or coauthored over 200 publications and recently was awarded the Celgene ‘Young Investigator’ Award, the MMRF ‘Top 15 Innovator’ Award, and the MMRC ‘Center of the Year’ award.

He earned his medical degree from the University Of Louisville School Of Medicine. He completed his internship and residency at Baylor College of Medicine in Houston, Texas, followed by a fellowship in Hematology/Oncology at Emory University School of Medicine in Atlanta, Georgia.

Related Links
Understanding Multiple Myeloma
Phase I Trials – Where All Anticancer Drugs Begin

 

Understanding Multiple Myeloma

While still a relatively uncommon cancer, multiple myeloma has recently received attention surrounding the diagnosis of popular news reporter, Tom Brokaw. This year, an estimated 24,000 people in the United States will be diagnosed with multiple myeloma, and there are about 77,600 people now living with this blood cancer.

About Multiple Myeloma

Multiple myeloma is a type of cancer that forms because of a disorder in the plasma cells, which live in the bone marrow and are the producers of antibodies. These antibodies are what provide protection from infections after vaccination, but in myeloma, the plasma cells become malignant and grow out of control, crowding out the normal bone marrow.

When plasma cells grow uncontrolled by the normal immune system, the consequences can include:

  • Anemia, a condition caused by low red blood cell counts due to crowding in the bone marrow.
  • Bone lesions, as myeloma cells like to create “holes” in the bones.
  • Kidney problems, because the antibodies produced by the plasma cells can clog up the kidneys.
  • Elevated blood calcium level, typically as a consequence of the bone issues.

Multiple Myeloma Symptoms

The most common symptoms for patients are typically fatigue, weakness, bone pain, anemia, or frequent unexplained infections. Multiple myeloma affects both men and women but is more common in men and there is a higher occurrence of multiple myeloma among African Americans than among Caucasians.  It is a disease typically seen in patients who are older than age 65, although it occurs in African-American patients about ten years earlier, and it affects a fair number of younger patients.

Multiple Myeloma Treatment

Treatment for patients with multiple myeloma has changed dramatically over the past decade. As we have developed more effective drugs to target the plasma cells, we also have significantly improved overall survival. Fifteen years ago, the average survival was 3 to 4 years, whereas the average survival is now over 7 years, and for many patients, expected survival is more than 10 years.

The keys to this improvement in overall survival are related to several factors. First, we have better tools to combat myeloma. There have been 6 new drugs approved for treating myeloma over the past decade, and these agents are more effective at treating the disease than the standard mixtures of chemotherapy we had before. The second factor that has improved survival for certain patients is the use of high-dose chemotherapy and autologous stem cell transplantation, in which the patient’s own stem cells are given back to the patient’s body after receiving high-dose chemotherapy. Finally, we now have a better understanding of the biological changes that occur in a myeloma cell and this is helping us to better target treatment needed among these patients.

As we discover new tools and expand the options available for treating multiple myeloma, we see encouraging advancements in both survival and quality of life for these patients. The multidisciplinary treatment team at Winship at Emory has been recognized as a national and international leader in both transplant and non-transplant based approaches to treatment therapies, patient outcomes and clinical trials.

Multiple Myeloma Online Chat

Multiple Myeloma Chat Sign UpWant to learn more about multiple myeloma? Join expert physician, Jonathan Kaufman, MD, for a live web chat on March 11, 2014 at 12:00 PM EST. Dr. Kaufman will be there to answers all your questions about known risks, prevention, diagnosis and treatment of multiple myeloma. Bring your questions and prepare for a great discussion!

Multiple Myeloma Chat Sign Up

About Dr. Sagar Lonial

Dr. Sagar LonialDr. Lonial is Vice Chair of Clinical Affairs for the Department of Hematology and Medical Oncology at the Winship Cancer Institute of Emory University, and Director of the Translational Research for the B-Cell Malignancy Program. He is also a professor in the Emory University School of Medicine.

Dr. Lonial’s research focuses on combination therapy in B-cell malignancies focusing on myeloma. He is a trained bone marrow transplant physician with an interest in molecular therapy for lymphoma and myeloma. His clinical interests include evaluating the combination of new molecular targeted agents for B-cell tumors as well as target discovery and validation.

Dr. Lonial has authored or coauthored over 200 publications and recently was awarded the Celgene ‘Young Investigator’ Award, the MMRF ‘Top 15 Innovator’ Award, and the MMRC ‘Center of the Year’ award.

He earned his medical degree from the University Of Louisville School Of Medicine. He completed his internship and residency at Baylor College of Medicine in Houston, Texas, followed by a fellowship in Hematology/Oncology at Emory University School of Medicine in Atlanta, Georgia.

Takeaways from Dr. Sanda’s Chat on Prostate Cancer

Thank you for attending the live chat with Dr. Martin Sanda on prostate cancer. (Link to: ) Your questions and participation were terrific. Below are additional Q&As that we didn’t have time to get to during the live chat portion.

As you know, prostate cancer is the second most common cancer in men, second only to skin cancers. Emory Healthcare is privileged to partner with you in your health and is ready and able to assist if needed. Please use the resources on this page and this website to contact us if we can help in any way.

Question: What are today’s best prostate cancer diagnosis methodologies?
Answer: Despite a lot of advances in imaging tests such as MRI or higher-resolution ultrasound, there is still a need to biopsy the prostate in order to determine whether or not prostate cancer is present. The biopsy provides important information, not only as to whether there are cancer cells, but if so, how aggressive or how fast-growing those cancer cells appear to be. Bone scans and CT scans are useful to look for spread of prostate cancer elsewhere. Also, new PET (positron emission tomography) scans or other diagnostic studies that image molecules which are taken up by cancerous tissue and not by normal tissue are emerging. But, their role in standard care is not yet sorted out. MRI can provide valuable information about the size and configuration of tumors in the prostate itself and the immediate vicinity, as part of a watchful waiting monitoring plan, or as a guide for treatment planning.

Question: What are the dangers of conventional biopsy?
Answer: The main risk of prostate cancer biopsy is infection, which can be seen in approximately one out of 50 to one out of 100 cases and can require hospitalization for treatment. More commonly, some men may feel faint after a biopsy and should plan on taking the day off or taking it easy if they undergo a prostate biopsy procedure. Rarely, men might experience bleeding from where the needle is inserted into the prostate and this, too, can require hospitalization. Common after prostate biopsy is having blood in the semen or ejaculate; however, this does not pose any danger or risks and will typically resolve in a matter of a few weeks.

Question: Are there new drugs and and prostate cancer treatments on the near horizon?
Answer: Major scientific discoveries have taken place over the past five to 10 years and many more are underway. This has led to a half-dozen new treatments for advanced prostate cancer that have become available in the past several years. A broad range of new treatments are being developed, including more refined types of hormonal therapy, including immune therapies or therapeutic vaccines and also targeted therapies that are aimed at molecular differences between the cancer cell and normal tissue.

Related Resources:

About Dr. Martin Sanda

Dr. Martin SandaMartin G. Sanda, MD, an internationally recognized prostate cancer surgeon and scientist, was appointed chair of the Department of Urology at Emory University School of Medicine and service chief for Emory Healthcare. He also serves as director of the Prostate Cancer Center, which will be established within Emory’s Winship Cancer Institute.

Sanda joins Emory from Harvard Medical School, where he was professor of surgery in urology, and from Beth Israel Deaconess Medical Center, where he served as director of the Prostate Cancer Center. He was also the co-leader of the Prostate Cancer Program at the Dana Farber Cancer Center.

 

Though Common, Prostate Cancer is Often Very Treatable – Join Our Q&A Chat for Details

Prostate Cancer Q&A ChatDid you know that prostate cancer is the second most common cancer experienced by men, after skin cancer? The good news is that, when caught early, it can often be treated with great success.

Millions of men are living today as survivors of prostate cancer. Being armed with good information in advance is a key ingredient in protecting yourself or your loved ones from this disease.

Join Emory Chairman of the Department of Urology, Dr. Martin Sanda, on Tuesday, September 24, for an online web chat to discuss “Prostate Cancer.”

Prostate Cancer Chat Sign Up

A New Interactive Tool to Answer Your Cancer Questions: Introducing the Whiteboard

Cancer Facts & FAQs whiteboardWe’re excited to introduce a new interactive initiative that was launched in partnership between Emory Healthcare and Winship Cancer Institute of Emory University. This platform, called “Whiteboard,” opens up a new way for people to do their own kind of research about cancer. Readers can scroll through a variety of questions on different cancer topics, read and like these questions, or submit their own. Newly submitted questions will be reviewed by our Winship team, including our physicians, investigators, nurses and other support and care team members. Depending on the type of question, we are able to respond quickly (within a business day or two). More complex or specific questions may require further research and collaboration on our part and therefore may take us longer to answer.

The Winship Cancer Institute of Emory University is Georgia’s only National Cancer Institute-designated cancer center, meaning that Winship meets the highest standards of cancer research. Members of the Winship team are constantly working to find new cancer treatments as well as to discover ways to prevent cancer and detect it early. By creating the Whiteboard, our online community has a way to conduct its own cancer research and get trustworthy answers directly from Winship’s experts.

Getting cancer questions answered via the Winship Whiteboard is easy. Simply go to the Whiteboard, click on the notepad on the top right, ask your question, and click submit; the team at Winship will get back to you with an answer. Questions can be submitted related to any cancer topic or type, ranging from general prevention tips and survivorship resources, to questions related to specific types of cancer, such as prostate cancer, breast cancer and lung cancer.

We’ve received some fantastic cancer questions on the Whiteboard so far. Kevin, for example, asked, “My PSA was elevated at my check-up. Do I have prostate cancer?” Justin asked, “What can former smokers do to possibly offset the damage of past smoking and reduce cancer risk?” While Travis asked, “Are there any foods I can eat to help prevent cancer?” All of these cancer questions have been answered by the doctors and researchers from the Winship Cancer Institute on our Whiteboard. Whether you have just one cancer question, or many, you can submit them all on the Whiteboard and get answers from the cancer experts at Winship. Even if you don’t have a question, please take the time to browse and like your favorites!

We welcome your feedback on our new cancer FAQ site in the comments below.

Related Resources:

When do your Moles Require a Trip to the Dermatologist?

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!

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.

Related Resources:

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

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.

Related  Resources

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

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

All About Colon Cancer

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.

Related links

Colon Cancer Prevention Begins with Education and Screenings!

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.

Related Resources: