Posts Tagged ‘cancer research’

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

June 10th, 2013 By Winship Cancer Institute

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.

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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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Winship Central to New Study Evaluating Bone Marrow vs. Blood Stem Cell Transplant

December 3rd, 2012 By Winship Cancer Institute

Patients with leukemia or blood-related cancers are typically treated with one of two techniques, either a bone marrow transplant, or a blood stem cell transplants. Currently, there are many studies are currently being conducted to determine which option is right for each patient type.

Past studies have shown that when blood stem cell (as opposed to bone marrow) transplants are used between HumanLeukocyte Antigen (HLA)-identical siblings, or siblings whose tissue is immunologically compatible,  the engraftment process is accelerated. Engraftment is when the donated cells, in this case, blood stem cells, begin to grow and produce their own new blood cells. However, with this benefit, there can be some risk. Studies have also shown that when blood stem cell transplants are used, the risk of acute and chronic graft-versus-host-diseaese (GVHD) is increased when compared to GVHD rates experienced by patients who receive bone marrow transplants. Other studies have demonstrated that patients with high-risk leukemia experience a decreased rate of relapse and improved survival rates from of blood stem cell transplant. Because these two treatment options have varying benefits and risks depending on unique patient circumstances, ongoing research is being conducted to better understand those potential benefits and  risks.

Edmund K. Waller, MD, Winship Cancer Institute

Edmund K. Waller, MD
Director of Bone Marrow & Stem Cell Transplant
Winship Cancer Institute

Edmund K. Waller, MD, Director of the Bone Marrow and Stem Cell Transplantation Center at Winship Cancer Institute, was a key author and researcher in a study published on October 18, 2012, in the New England Journal of Medicine that could influence whether leukemia and blood-related cancer patients receive transplants from blood stem cells or bone marrow.

The study reported on the first randomized trial comparing bone marrow with peripheral blood stem cells (PBSC) for unrelated-donor transplantation. The trial involved 48 centers enrolling 551 patients as part of the Bone Marrow and Clinical Trials Network (BMT CTN). Dr. Waller helped design the study, and his lab at Winship analyzed the cells in each type of graft as the central core lab for the trial.

The study found no significant difference in the overall survival rate at two years, and no difference in relapse rates or in acute graft-versus-host-disease (GVHD). It did, however, find a significantly higher rate of chronic GVHD among patients receiving blood stem cell transplants.

Because GVHD can be a difficult and sometimes life-threatening complication from transplants, this finding could result in patients and their physicians choosing different treatments. At the very least, this finding will generate serious discussion among leaders in the transplant field about whether bone marrow or PBSC transplantation is a better treatment option.

Chronic GVHD starts more than three months after a transplant and can severely diminish a patient’s quality of life over his or her lifetime. Dr. Waller says the study leads him to believe that since the survival rates are the same, bone marrow should be the standard for the majority of unrelated-donor transplants. Exceptions to this would be patients with life-threatening infections and patients at high risk for graft rejection.

Winship played a key role in this study and, according to Waller, is part of on-going BMT CTN studies that will help shape transplant protocols and outcomes.

“This is an outstanding example of Winship investigators leading in the resolution of major questions in cancer care,” said Fadlo R. Khuri, MD, Deputy Director of the Winship Cancer Institute, and Chair of the Department of Hematology and Medical Oncology at Emory University. “Dr. Waller and his colleagues have helped define a major question, namely, whether patients who receive grafts from unrelated donors should receive peripheral stem cells or cells from the bone marrow harvest of others. This is paradigm shifting work, and Dr. Waller and his colleagues are to be congratulated for their foresight and persistence in answering this important question.”

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Questions on Validity of PSA Test as Prostate Cancer Screening Tool?

October 10th, 2011 By Viraj Master, MD

Prostate Cancer PSA ScreeningViraj Master, MD Prostate cancer is the second leading cause of cancer death among American men.  Nearly 250,000 men will be diagnosed with prostate cancer this year.  More than 32,000 men will die from prostate cancer this year.  In Georgia, 7,360 men will be diagnosed and 1,080 will die.  With statistics like that, we want every advantage possible in our fight with this disease.

Since the early 1990s, the Prostate Specific Antigen (PSA) test has been the primary screening tool used to detect prostate cancer. The PSA is a simple blood test, non-invasive and easy to administer and process.  The US Preventive Services Task Force has recently recommended, however, that the PSA test no longer be offered to men as a screening tool.

This task force is a federally funded independent panel of experts in prevention and evidence-based medicine.  It is comprised of primary care providers such as internists, family practitioners and pediatricians, but not oncologists or urologists.  Their job is to evaluate the benefits of preventive services like screening and make recommendations about which services should be routinely incorporated into primary medical care.

Screening, or early detection, for prostate cancer is a complicated issue.  Unlike the colonoscopy, which provides clear evidence of early detection and has been determined to have saved lives in multiple studies, the PSA test has been contradictory, with some studies showing a benefit, while others did not.  There are many reasons, including the fact that most forms of prostate cancer are relatively slow-growing cancers.  Generally, a man with prostate cancer may live for many years without ever having the cancer discovered.  In fact, many men with prostate cancer will not die from it, but with it.  In addition, high or increasing levels of PSA can indicate an increased risk for prostate cancer, but can also indicate an infection or an enlarged prostate.  So, the USPSTF determined that because of these uncertainties, the risk of over treatment is greater than the benefit, and their recommendation states that PSA tests should no longer be offered as a screening tool.

The biggest issue in prostate cancer that confronts patients, their families and their healthcare providers is to delink screening with treatment.  Not all forms of prostate cancer require active therapeutic interventions, but some do.

While the PSA test is imperfect, it is – at this time – the best tool we have at our disposal for early detection of prostate cancer.  The Winship Cancer Institute of Emory University aligns with the American Urological Association, the American Cancer Society, American College of Physicians and the American College of Preventive Medicine and recommends informed decision-making.  Our recommendation is that men at average risk should receive information, including a PSA test if they want it, at an appropriate middle age, although African American men or men with a family history of prostate cancer should receive information at an earlier age, such as 40, or 45 years.

So, what do we mean when we say “informed decision-making”?  This means that doctors should discuss the potential benefits and harms of PSA screening with their patients and consider their patients’ preferences, overall health, and family history when making decisions regarding screening with a PSA test.

Unfortunately, there is no easy answer.  Each patient comes to us with his own distinctive characteristics, and those characteristics must be taken into consideration when deciding whether to have the PSA test.

About Dr. Viraj Master
Dr. Master specializes in the treatment of adrenal cancer, bladder cancer, kidney cancer, prostate cancer, testicular cancer. He is also an expert in laparoscopic surgery. Dr. Master received his Medical Degree in the University of Chicago in Chicago, Illinois, in 1997. He completed his Internship at University of California, San Francisco in 1999, where he also completed his Fellowship in 2003.

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Can Lung Cancer Mortality Be Reduced by 20%? Answer May Be ‘Yes’

June 30th, 2011 By Walter J. Curran Jr., MD

Walter J. Curran Jr., MD

Walter J. Curran Jr., MD, Executive Director, Winship Cancer Institute

The report in the New England Journal of Medicine (NEJM) this week that low-dose CT scanning of smokers reduced deaths from lung cancer is a major step forward in the cancer research world – and really, in the world at large, considering the high human and financial toll that this disease imposes.

Lung cancer remains the nation’s number one cancer killer, claiming more lives than the next three most common cancer killers — prostate, breast and colorectal cancers – combined. In the U.S. alone, over 157,000  people died from the disease in 2010. That’s more than 3,000 people per week.

One reason for this devastating toll is that no reliable screening test has existed to detect the disease in its early stages. Most cases are diagnosed only after symptoms appear. If   lung cancer could be diagnosed before symptoms appear, the cure rate should be much higher.

The article in the NEJM shows there is reason for hope. A study conducted at 33 cancer centers nationwide, including Winship, enrolled more than 53,000 people at high risk of developing lung cancer between August, 2002 and April, 2004. They were randomly assigned to receive either low-dose CT scanning or a chest X-ray as a means to detect lung cancer. Data were collected on the participants through 2009. The findings were significant. Deaths from lung cancer were reduced by 20 percent in the group who underwent the low-dose CT scans.

If we could reduce lung cancer mortality in the U.S. by 20 percent, we’d be saving 30,000 lives a year.

Even so, the findings published in NEJM may not result in an immediate change in CT scan screening guidelines for lung cancer. Screening guidelines of any kind require additional study and evaluation. Further analyses of this trial will also be required.

We have made tremendous strides in the treatment of lung cancer, but we also know that the real breakthroughs will happen when we are able to prevent its development or establish the earliest possible diagnosis. The dialogue on how best to implement low-dose CT scan screening for lung cancer should begin now.

Walter J. Curran Jr., MD
Executive Director, Winship Cancer Institute of Emory University
Associate Vice President, Cancer, Woodruff Health Sciences Center
Chair of Radiation Oncology

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Cancer Patient Rescues Dog and Is Rescued in Return

April 26th, 2011 By Emory Cancer Care

Carol Witcher & Floyd Henry

Carol Witcher, breast cancer patient & her dog Floyd

Carol Witcher rescued her dog when he was seven months old, but never imagined that he would rescue her in return. Over two years ago, her dog, Floyd Henry displayed some curious behavior that made Carol worry that something may be seriously wrong.

“When he sniffed me, he kind of turned back and really pushed into my right breast, real hard,” Carol recalls. “He started sniffing, sniffing, sniffing.” Carol adds, “He pushed real hard for one shot…Then he looked at me straight in the face, and began to paw my right breast. And I thought, ‘This is not good.’” After four days of continuous sniffing, nudging and pawing from her 8-year-old boxer, Carol made plans to see a doctor at the Winship Cancer Institute of Emory University.

It turned out that Carol did in fact have breast cancer that would require treatment with chemotherapy, surgery and then radiation. According to breast surgical oncologist at Winship, Dr. Sheryl Gabram, “Her type of cancer presented as an indistinct  asymmetry in her breast…I absolutely believe the dog saved Miss Witcher’s life.”

Dr. Gabram and Charlene Bayer PhD, a chemist at Georgia Institute of Technology, are no strangers to this type of phenomena. They have been  investigating  cancer patients’ breath in a pilot study involving 20 volunteers with normal mammograms compared to 20 newly diagnosed breast cancer patients. They have found that cancer causes the body to release certain organic compounds and the patterns of these compounds can be detected with mass spectrometry, a device that separates out compounds for analysis. It is possible that dogs can smell these compounds but people cannot. Ultimately, Drs. Gabram and Bayer hope that this simple breath test could lead to a means to alert physicians in the office that a patient may have an underlying breast cancer. And in Carol Witcher’s case, quite possibly it did.

As Gabram notes, in the study that Miss Witcher was involved in prior to her treatment, “Our model predicted  more than 75 percent of the time correctly which patients did have breast cancer and which ones did not.” This study will be published in early June in the American Surgeon.

ABC News recently covered Carol’s story and discussed previous situations in which the combination of a person’s breath and a dog’s sense of smell led to accurate cancer diagnoses. According to the ABC News story, “In January, a study published in the British journal Gut said that a specially-trained 8-year-old black Labrador retriever named Marine had detected colorectal cancer 91 percent of the time when sniffing patients’ breath, and 97 percent of the time when sniffing stool.” They add that “Dogs have also reportedly sniffed out skin, bladder, lung and ovarian cancers.”
While they might not be able to pinpoint or vocalize what are wrong, canines have demonstrated that they are able to determine that something is wrong.

We will keep you posted on the latest developments in the breath diagnostic work of the team at the Winship Cancer Institute of Emory University, Georgia’s only NCI-designated cancer center, and the Georgia Institute of Technology.  In the meantime, you can learn more about Carol’s story by checking out the ABC News video here.

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Why a Pap Smear Might Not Catch All Cervical Cancers

March 21st, 2011 By Morgan Griffith

Most women are familiar with the Pap smear, also known as the pap test. Most of us are also aware that the main goal of the Pap smear is to identify cancerous or abnormal cells that may turn into cancer after collecting them from the lining of the cervix. However, based on findings recently published in the International Journal of Cancer, Pap smears may not be the most reliable way to pinpoint cancer types that can often be harder to detect.

According to Kevin Ault, MD, an associate professor of obstetrics and gynecology at Emory’s School of Medicine and Winship Cancer Institute, the Pap smear is not always effective in the diagnosis of adenocarcinoma. Ault came to this conclusion after conducting a post-hoc analysis of Gardasil vaccine trials. Adenocarcinoma is a type of cervical cancer that begins significantly far up the cervical canal, an area that often is not sampled when a Pap smear is conducted.

Andenocarcinoma is the second most common type of cervical cancer, accounting for about 20 percent of all cervical cancer cases. While the overall incidence rate of cervical cancer is on the decline, Ault reports the proportion of andenocarcinoma cervical cancer is rising.

As the 8th most common type of cancer in American women, more than 12,000 new cases of invasive cervical cancer are diagnosed each year. Scientists believe that pre-invasive cervical cancer may develop over a period of months or years after the cervix is infected with the sexually transmitted HPV.

A leading expert and pioneer in the field of human papilloma virus (HPV), Ault suggests women might seek an HPV and Pap test at the same time. Why? A positive HPV test may be an indicator for early stages of adenocarcinoma cervical cancer that can’t be determined via a standard Pap test.

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High-Impact Donation Helps the Fight Against Breast Cancer

March 4th, 2011 By Emory Cancer Care

Winship Cancer Institute of Emory UniversityIf you’ve been following our cancer blog, you’ve probably seen some of our efforts to keep breast cancer awareness going not just in October, which is Breast Cancer Awareness Month, but year round. The Winship Cancer Insitute of Emory University just received a truly generous gift that will make that fight, and the fight against breast cancer on the whole, a whole lot easier.

The Wilbur and Hilda Glenn Family Foundation has generously committed $5 million to the Winship Cancer Institute. The commitment will name the Glenn Family Breast Program at Winship, establishing a fund to support patient care, research, education and community outreach.

More than 200,000 women in the U.S. will be newly diagnosed with breast cancer this year, and one in eight women will be diagnosed with breast cancer in her lifetime. The gift bestowed upon Winship from the Glenn Foundation will allow the cancer treatment team at the Winship Cancer Institute to further advance results in the research and treatment of breast cancer.

Some of the initiatives in place to achieve this expansion of breast cancer research and treatment include:

  • A Strengthened Effort in Breast Cancer Biobanking: expand and strengthen breast cancer tumor banking efforts at the Winship Cancer Institute and leverage collaborations with the Avon Comprehensive Breast Center at Grady and Emory University Midtown Hospital.  This will make Winship’s breast cancer tissue bank among the most robust in the nation and will ensure full integration of patient outcomes.
  • High Risk Breast Cancer Care:  Building on its strength in assessing women at high risk for breast cancer or disease recurrence and its history of collaboration with other cancer centers, Winship will expand its multi-disciplinary approach to screen and care for more women.
  • Seed Grants:  Building on the success of the established Glenn Scholars program, these seed grants will support young investigators in their research in four critical areas: new therapeutics, early detection, health disparities and imaging.
  • Clinical Trials:  The Glenn Foundation grant will contribute to new clinical trials, including novel treatment trials such as those targeting women with high-risk breast cancer, such as triple negative disease and those women who currently lack access to quality breast health care and treatment.
  • Survivorship:  The gift will strengthen Winship’s survivorship program to include an online database to match patients and caregivers with trained peer partners who offer support and guidance throughout treatment.
  • Community Access:  Winship will build a stronger coordinated community outreach program to enhance access to cancer screening and early detection services throughout and beyond metro Atlanta.

We thank the Glenn Foundation for the very generous gift and look forward to seeing lots of great developments in the research and treatment of breast cancer from the Winship Cancer Institute.

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New Blood Test Aids in Early Cancer Detection

January 6th, 2011 By Suresh Ramalingam, MD

Winship at Emory’s Dr. Suresh Ramalingam explains the test and what it means for cancer detection and treatment.

Suresh Ramalingam, MDYou may have heard in news headlines this week about the ability to detect a single cancer cell among billions of healthy cells. This may be possible via a new blood test (under development) that may someday help detect cancer earlier.

For tumors located in organs such as the lung, prostate, colon and breast, access to tumor tissue is only possible with a biopsy. This requires an invasive procedure, which in certain situations involves surgical intervention. It has been known for sometime that tumors shed their cancer cells that can be found in the circulating blood stream. However, the tumor cells are a significant minority in number compared to normal blood cells. Identifying the tumor cells among billions of normal cells has been a major challenge. Currently, it is possible with sophisticated techniques to identify such cells and count them. The number of circulating tumor cells has been linked to survival outcomes in some studies. Now researchers are trying to not only count, but collect these tumor cells and then conduct molecular testing.

Such an advance would have tremendous implications for cancer research and treatment. First of all, it may not be necessary to obtain tumor biopsies if adequate number of cells can be identified in the peripheral blood. It will be possible then, to administer this test during the course of a patient’s treatment to learn how a tumor is changing, because they do change as treatment progresses. It would also be possible to diagnose cancer early as part of screening strategies for patients at risk for developing certain cancers.

So how does this test work and what does it do? The test uses a microchip resembling a lab slide covered in 78,000 tiny posts. Those posts are coated with antibodies that attract and bind to tumor cells like glue. A patient’s blood sample, about a teaspoon full, is forced across the chip. The cancer cells stick, and a stain makes them glow so researchers can capture them for study.

For patients, care-givers and researchers this is very exciting news. However, this technology is just entering the early stages of testing and will have to go through several studies before it can be applied in routine practice. A number of important research questions will still have to be answered regarding the utility of circulating tumor cells, even if the test proves to be successful.

It is important to emphasize that while the new technology is exciting, it is possibly years away from practical application. If you have questions on this new blood test, please leave them in the comments below.

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