In recognition of September being Blood Caner Awareness Month, Dr. Sagar Lonial, Winship’s Chief Medical Officer shares a video about his Winship phase III clinical trial study on elotuzumab in treating myeloma patients.
Many cancers have benefited from FDA approvals for monoclonal antibodies (mAbs). Multiple myeloma, a second common blood cancer, had limited outcome improvements with mAbs until Dr. Lonial’s recent work. Dr. Lonial’s research was presented at the 2015 American Society of Clinical Oncology (ASCO) Annual Meeting and was published in the New England Journal of Medicine earlier this year.
Recently, a clinical study initiated by Winship Cancer Institute of Emory University, found that providing prostate cancer patients with a video-based education tool significantly improved their understanding of key terms necessary to making decisions about their treatment.
In 2013, Master, Jani and Goodman released an Emory study that showed that prostate cancer patients (treated at Grady Hospital in Atlanta) experienced a severe lack of understanding of prostate key terms. The original study showed only 15 percent of the patients understood the meaning of “incontinence”; less than a third understood “urinary function” and “bowel habits”; and fewer than 50 percent understood the word “impotence.”
In response to their findings, the three principle investigators jumped to find a solution to the problem. The latest study explored using a video-based tool to educate prostate cancer patients on key terminology. The physicians predicted that with a better understanding of terms linked to disease, patients would be able to participate in shared and informed decision-making throughout the prostate cancer treatment process.
About the Prostate Cancer Video Trial:
56 male patients were recruited from two low-income safety net clinics and received a key term comprehension test before and after viewing the educational video.
The video software (viewed by participants on iPads) featured narrated animations depicting 26 terms that doctors and medical staff frequently use in talking with prostate cancer patients.
Participants who viewed the educational video demonstrated statistically significant improvements in comprehension of prostate terminology. For instance, before viewing the application, 14 percent of the men understood “incontinence”; afterward, 50 percent of them demonstrated understanding of the term.
“This shows that video tools can help patients understand these critical prostate health terms in a meaningful way. The ultimate goal is to give patients a vocabulary toolkit to further enable them to make shared and informed decisions about their treatment options,” says Viraj Master. “Our next goal is to improve the tool further, and study this tool at different centers.”
Additional Information about the Prostate Cancer Trial:
The research for this study was made possible by a Winship Cancer Institute multi-investigator pilot grant and the contributions of faculty and students from Winship, the Rollins School of Public Health and the Emory School of Medicine.
This study was led by three Winship at Emory investigators: Viraj Master, MD, PhD, FACS, Winship urologist and director of clinical research in the Department of Urology at Emory University; Ashesh Jani, MD, professor of radiation oncology in the Emory School of Medicine; and Michael Goodman, MD, MPH, associate professor of epidemiology with the Rollins School of Public Health.
None of this has been possible without patients putting their trust in our physicians, nurses, scientists, and many others, to deliver optimal care while asking critical questions about novel drugs and approaches. When I think about the impact of our Phase I unit on patients and their families, I recall a recent conversation with a seasoned oncologist here at Emory. He said, “Donald, if I saw anyone in the chairs here at a store, I wouldn’t know they had cancer.” A simple statement, but one that conveys a number of key messages about how our phase I trials have evolved over five years. Drugs we now have at hand, as a whole, are much safer and better tolerated than conventional chemotherapy. We also have access to more agents with much better activity against cancer, leading to more treatment options.
With improved treatment comes a sense of satisfaction. However, we cannot over-emphasize the critical effect patients have on us as health care providers, researchers, and human beings. As a clinician-researcher, the greatest motivating factor I have is seeing patients do well on trials and coming to visits to talk about trips, family gatherings, important personal events, and the role that treatment on a trial had in helping them live their lives.
For this, we say thank you to our patients and their families for their trust and the courage they show on a daily basis. You keep up your fight, and we will keep up ours.
About Dr. Harvey
R. Donald Harvey, PharmD, FCCP BCOP is director of the Winship Cancer Institute’s Phase I Clinical Trials section, and Associate Professor of Hematology and Medical Oncology at the Emory University School of Medicine. He is a Fellow of the American College of Clinical Pharmacy and a board certified oncology pharmacist. Widely published in peer-reviewed journals, Dr. Harvey’s research interests include the clinical application of pharmacokinetic, pharmacodynamic, and pharmacogenomic data to patient care.
Tamara Mobley, 38 and married with 8 and 12 year old sons, has been battling multiple myeloma for five years now under the care of Dr. Sagar Lonial at the Winship Cancer Institute of Emory University. She went on a clinical trial at Winship in order to get the most advanced drug for treating this blood cancer. Because of that trial, the drug is now FDA-approved and is helping Tamara maintain her active life.
Clinical trials are responsible for most advances in medical treatment, but they can’t take place without volunteer participants like Tamara. Unfortunately, there are still many misconceptions about clinical trials that keep people from participating.
For instance, some believe joining a clinical trial is a last resort in the treatment process, which was not the case for Tamara and many other Winship patients. For Tamara, enrolling in a clinical trial was a good option once her standard cancer drugs stopped working.
In the video below, Fox 5 Atlanta talked to Tamara and Dr. Lonial about the decision to participate in a clinical trial.
A common symptom of a new cancer diagnosis is pure and utter bewilderment. The American healthcare system can be a confusing maze involving dozens of options and decisions. Helping someone understand what comes next is an important part of my job as an oncologist and is necessary to assure a patient’s overall wellbeing.
Here are five actions to consider taking after receiving a cancer diagnosis.
Get a second opinion. Before starting any cancer treatment, get at least one additional physician or team of physicians to review your case and give an opinion on both the diagnosis and possible treatment options. In fact, you may be required to get a second opinion by your insurance company. Don’t worry about offending your doctor. Getting a second opinion is a very common practice.
Look for a clinical trial. Tens of thousands of people benefit each year from volunteering to participate in a clinical trial. Clinical trials can provide you with access to treatments not otherwise available, including new drugs and therapies for many types of cancer. Winship Cancer Institute is proud to offer patients access to hundreds of cancer clinical trials.
Fox 5 News health reporter Beth Galvin features the first “patient” in a Brain Tumor trial that combined surgery with a new experimental agent. Petey, a dog, is a part of a research trial aimed at translating new brain cancer therapies to humans by assessing results in dogs with similar diseases.
Winship Cancer Institute of Emory University neurosurgeon, Costas Hadjipanayis, MD, PhD, developed the experimental agent in his Brain Tumor Nanotechology Laboratory. Petey’s tumor was partially removed in surgery at the University of Georgia (UGA) College of Veterinary Medicine, and the new, investigational drug was infused directly into the tumor area. Now, 15 months later, his tumor has shrunk and Petey is seizure-free and doing well. Watch the full story here:
What if there were a way for 32,000 of the 160,000 lives lost each year related to cigarette smoking to be saved? There may just be. Findings from a recent study show the risk of dying from lung cancer could be reduced by 20 percent by use of a low-dose helical computed tomography (CT) scan. In other words, this type of CT screening could save over 30,000 lives a year.
Lung cancer is the leading cause of cancer-related deaths, and as such, cancer research and treatment experts are constantly looking for ways to reduce the pervasive nature of the disease. The National Cancer Institute (NCI) launched the multi-center National Lung Screening Trial (NLST) in 2002. The trial compared two ways of detecting lung cancer using low dose helical (spiral) CT vs a standard chest X-Ray. Part of this research study was actually led at Emory by radiologist and researcher Dr. Kay Vydareny.
The trial aimed to determine the effects of low-dose helical CT scans vs chest X-Rays on lung cancer death rates in high-risk populations. Both chest X-rays and helical CT scans have been used as a means to find lung cancer early, but the effects of these screening techniques on lung cancer mortality rates had not been determined.
Over a 20-month period, more than 53,000 current or former heavy smokers ages 55 to 74 joined NLST at 33 study sites across the United States. In November 2010, the initial findings from NLST were released. The conclusion? Clinical trial participants who received low-dose helical CT scans had a 20 percent lower risk of dying from lung cancer than participants who received standard chest X-rays.
While the benefits of low-dose helical CT scans in the reduction of lung cancer deaths are obvious, not every diagnostic option comes completely risk free. The CT scans can occasionally detect suspicious abnormalities that do not turn out to be lung cancer – known as false positives. Many of these abnormalities are scars from smoking, areas of inflammation or other noncancerous conditions that may require additional testing to determine that they are not harmful. These tests have been known to cause undue anxiety for patients and may sometimes lead to biopsies or surgeries.
“It is certainly an individual’s choice whether they want to be screened for lung cancer with a CT scan if they have no symptoms. However, it is important to make certain that such individuals have complete information and be well-informed before having such a scan. If a patient has symptoms, such as a persistent cough, weight loss, persistent hoarseness or trouble breathing, he or she should see a physician as soon as possible. Often these symptoms are due to something other than lung cancer, but more tests should be performed to make certain,” says Vydareny.
What should a person at high-risk for lung cancer do? The answer that all physicians agree on is to stop smoking right now, the sooner the better. Or even better … don’t start smoking ever, further reducing the chances of getting cancer or suffering from a stroke or heart attack as well.
“All physicians hope that there will be a test that can screen for early lung cancer and that the dismal prognosis of those with lung cancer will improve. Perhaps it will be screening with CT scans. Perhaps it will be a blood test,” says Vydareny. “That day hopefully will come, but it has not yet arrived. But if you are or have been a heavy smoker, your first step should be to consult your primary care physician to discuss all possible screening options.”
Winship Cancer Institute of Emory University, Georgia’s only National Cancer Institute-designated cancer center, serves as the coordinating center for cancer research and care throughout Emory University and Emory Healthcare. Seeing more than 14,000 patients each year, Winship at Emory offers patients with access to progressive resources, technology and cancer treatment options. To benefit from these investigational advancements in cancer treatment, it is important to seek care from an academic medical center like Winship at Emory, first. Through discoveries made possible by a dedicated team of many of the nation’s best physicians and researchers, Winship at Emory works hard toward a future when science triumphs over cancer.
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