Posts Tagged ‘Winship Cancer Insitute’

Multiple Myeloma Symptoms & Treatment – Real Patient Story

Meet Emory's real Multiple myeloma patient and learn about Multiple myeloma symptoms and treatment optionsMultiple myeloma begins in the bone marrow with plasma cells going haywire. This article shares a multiple myeloma patient story, as well as discusses symptoms and treatment options.
Seven years ago, Tamara Mobley was so busy, active, and energetic that if she were a cartoon, she’d be a blur. The dedicated mother of two young boys, a loving wife and a full-time employee in a good job, she didn’t get much downtime.

“I think I was just busy, like any other typical mom,” Mobley says. “You know, just doing things to take care of the house, my family and doing my best to be a valued employee. That was my life before, just ripping and running.”

Then Mobley, who was 33, got tired. Not just garden-variety, too-little-sleep, I’ve-been-doing-too-much sort of tired. But bone tired, from the moment she woke up each morning. Then, there was the severe back pain. And then, the passing out. She was getting sick and it was happening fast. For a young, vibrant, working wife and mother that was terrifying.

A trip to the emergency room led to a rapid diagnosis of multiple myeloma — a cancer of the blood — and a recommendation from her doctor to seek treatment at Emory and Winship.
Mobley was so ill that she got to Emory University Hospital in an ambulance. And that’s when all the ripping and running slowed way, way down — at least for a while.

Multiple Myeloma Symptoms

As cancer goes, multiple myeloma is a bit of a misfit.

For one thing, it’s rare. The American Cancer Society estimates that about 30,000 new cases of myeloma will be diagnosed this year, trailing far behind the most common cancers — breast and lung — each of which will derail more than 220,000 lives. That’s stiff competition for research funding and awareness.

For another, it’s mysterious. Multiple myeloma begins in the bone marrow with plasma cells going haywire. But experts aren’t entirely sure how the process starts or what the key risk factors are. The disease is most common in people over 65, men are slightly more vulnerable and that African Americans are more than twice as likely as white Americans to get it. But we don’t know why.
The most notable differ
ence between multiple myeloma and pretty much all other types of cancer is that the life expectancy for myeloma patients has doubled in the past decade. All thanks to treatments developed and tested at Emory’s Winship Cancer Institute.

Multiple Myeloma Treatment

Last November, the US Food and Drug Administration (FDA) approved the fourth new myeloma drug to be green-lighted within one year —three of those within one monthv—and all four were tested in clinical trials at Winship.

“There’s no other story like that in cancer,” says Sagar Lonial, Winship’s chief medical officer and chair of the Department of Hematology and Medical Oncology in the School of Medicine.
Since his arrival at Emory and Winship in 1997, Lonial has built the multiple myeloma program into one of the best and most sought-after in the country. A team of experts who specialize in the disease leads this program. As Georgia’s only National Cancer Institute–designated cancer center and one of just 69 in the US, Winship offers patients the chance to be treated in the same building where research is taking place. There are three floors dedicated to basic science and three to clinical care.

“That marriage of research and patient care is powerful,” Lonial says. “Our scientists see cancer patients every day.”

One of those is Mobley, who has been in treatment at Winship since that devastating ambulance ride in 2009. Once her condition was stabilized, she began the standard protocol. It consists of a three-pronged attack:

  • Chemotherapy to blast away the cancerous cells
  • Stem cell harvesting and transplantation to regenerate healthy bone marrow cells
  • Regimen of medications calibrated to keep the cancer at bay and send it into remission for a long time.

It’s that last phase that has put Winship’s approach ahead of other myeloma treatment centers. Instead of a one-by-one, trial-and-error approach to drug therapy, Lonial has advocated a full court press. It allowed to hit the residual cancer with a simultaneous three-drug combination.

Mobley was put on an aggressive course of therapy made up of

  • Lenolidamide (Revlimid), an immune modulator
  • Bortezomib (Velcade), a proteasome inhibitor
  • Dexamethasone, a corticosteroid

“That concept of combination therapy is one that our center is focused on and one that benefited her early on,” Lonial says.

According to myeloma researcher Lawrence Boise, Georgia Cancer Coalition Distinguished Cancer Scholar and coleader of the Cancer Cell Biology Program at Winship, scientists are finding that there are many reasons for this. But the most compelling is that it works. “Dr. Lonial doesn’t leave any bullets in the chamber,” Boise says. “In all the trials, all the data, all the comparisons show that three drugs are better than two.”

When Lonial joined Emory’s hematology and oncology department nearly two decades ago, other researchers might have seen a department struggling with turnover and inadequate resources. With the encouragement of a mentor—Kenneth Anderson, probably the best-known myeloma specialist in the world—Lonial saw an opportunity to build a program, from the ground up.

The bottom floor of Winship houses the Clinical Trials Unit, the key to the multiple myeloma program’s growth and success. Within a few years, Lonial had recruited top scientists and clinicians, including Boise, and was testing new classes of drugs in Phase I clinical trials. They proved to be game changers.

Multiple myeloma is a cancer of the blood that develops when normal, antibody-producing plasma cells become malignant and their growth spirals out of control. They build up in the bone marrow until they crowd out healthy blood cells. They can form lesions and tumors in multiple bones, hence the condition’s name.

But the cancerous cells also secrete protein and, like normal cells, they’re engineered to do this in a particular way—the protein assembled and folded just so. When that assembly goes awry, as it does in myeloma cells, the malformed proteins are broken down by proteasomes—protein complexes whose job it is to get rid of problem proteins by degrading them—and that opens up the pipeline for more myeloma cell production.

About ten years ago, scientists discovered that if you interfere with the proteasome’s work—allowing the abnormal proteins to accumulate—the cancerous cells, which in a sense are trying to function normally, will self-destruct. Rapidly.

“Proteasome is part of quality control, so if you inhibit that, and all these mid-folded proteins build up, that causes stress, and the cell kills itself,” Boise explains.

Winship conducted trials of a promising proteasome inhibitor, bortezomib (Velcade), in 2002. One of the first patients to receive it went into remission quickly. “If there was a moment when the light went on, it was then. I remember running upstairs to the director’s office with the graph of this patient’s counts,” Lonial says. “That treatment is now the standard of care.”

Learn more about Tamara’s story here.

Treating Pancreatic Cancer

pancreatic cancer imagePancreatic cancer is a very aggressive disease that is prone to metastasizing or spreading. Unfortunately, it has been rising in incidence in the United States with approximately 50,000 new cases per year. Treatment for pancreatic cancer varies depending on the individual patient, but when determining surgical treatment options we consider these questions: Has the tumor spread? Is it removable? And is the patient in good enough shape to have surgery?

If surgery is an option, the approach for pancreatic cancer is dictated by where the tumor is located, and the surgeon may remove parts or, in rare circumstances, the entire pancreas. Most tumors are diagnosed in the head of the pancreas, and these can be removed with a pancreaticoduodenectomy, also known as the Whipple procedure. The Whipple procedure, an aggressive operation that typically takes between three to six hours to complete, involves removing a third of the pancreas and part of the intestines called the duodenum. However, if the tumor is on the other side of the pancreas then it can be removed with something called a distal pancreatectomy, which involves less reconstruction than the Whipple procedure.

In addition to the standard surgical options, we also utilize technologically advanced, minimally invasive surgical approaches using laparoscopy and robotic surgery. Laparoscopic surgery involves placing medical instruments in the belly through tubes, which results in smaller incisions. This approach can get patients out of the hospital a little faster because of less blood loss and fewer complications than standard surgery. We are also using cutting-edge robotic surgery for pancreatic cancer. This technology can be used in the Whipple procedure and the distal pancreatectomy, and the robot provides the surgeon with incredible dexterity. While traditional laparoscopic instruments do rotate and open and close, the robot has wrists and 3D visualization. This allows the surgeon to see things with good depth perception instead of looking at a flat screen, which can be especially helpful for complex surgeries in confined areas. The surgical robot is a valuable, minimally invasive tool for selective circumstances, although it is not necessary for all pancreatic procedures.

About Dr. Kooby

koobyDavid A. Kooby, MD, FACS, is a board certified surgical oncologist specializing in laparoscopic and open surgical treatment of pancreas, bile ducts, stomach, and colon cancers. Dr. Kooby is a pioneer in minimally invasive and robotic pancreatic surgery, and serves as Professor of Surgical Oncology in the Department of Surgery at Emory University School of Medicine. Dr. Kooby also is the Director of Surgical Oncology at Winship at Emory Saint Joseph’s Hospital and the Director of Minimally Invasive GI Surgical Oncology at Emory University School of Medicine. Dr. Kooby will be co-directing the International Hepato-Pancreato-Biliary Association State of the Art Conference

 

RELATED RESOURCES:
Pancreatic cancer at Winship
Steve Jobs, pancreatic cancer & the Whipple Procedure 
Intro to Pancreatic Cancer Part I: Stats, Types, & Risk Factors
An Intro to Pancreatic Cancer Part II: Prevention, Diagnosis & Treatment
5 Early-Distress Warnings of Digestive Cancer

Pancreatic Cancer: Incidence and Outlook

Pancreatic cancer increases with age and most people are between 60 to 80 years old when diagnosed. Early pancreatic cancer often does not cause symptoms. Pancreatic cancer can affect anyone. People with a family history of pancreatic cancer in first degree relatives have an increased risk.

Pancreatic cancer specialist, Dr. David Kooby from Winship Cancer Institute of Emory University talks about why the disease is so prevalent and why it is so difficult to treat.

Learn more about Winship Cancer Institute of Emory University.

Risk Factors and Symptoms of Pancreatic Cancer

The pancreas is a flat, banana-shaped organ that is located behind the stomach. Functionally, it can be regarded as two separate organs based on the chemicals each produces. The exocrine pancreas makes up the largest part of the gland and is responsible for creating enzymes that help break down foods we eat so that they can be used by the body. The endocrine pancreas is composed of groupings of cells that make up a much smaller part of the gland. These cell clusters, called islets, are responsible for producing hormones, such as insulin, that help regulate the amount of sugar in the blood.

What are the risk factors and symptoms of pancreatic cancer? Winship surgical oncologist, Dr. David Kooby answers those questions.

Learn more about Winship Cancer Institute of Emory University.

Reclassifying Brain Tumors with Precision

8-24 cancerGroundbreaking study will change the way brain tumor patients are diagnosed.

Winship cancer researcher and neuropathologist Dan Brat is the first author of a groundbreaking study that will change the way patients with diffuse gliomas, a form of brain tumor, will be diagnosed and treated in the future.

Brat and 306 other researchers from 44 institutions studied a group of six related brain tumors that has been surrounded by diagnostic confusion for decades. They used a large number of advanced molecular platforms capable of examining the genetic make-up of brain tumors (e.g. mutations, gene deletions, and other genetic changes) and were able to determine that there are three well-defined types of tumors based on this analysis, rather than six as previously thought.

Brat explains, “The use of the biomarkers in the diagnosis of these forms of brain tumors will lead to a much more consistent manner of diagnosis and patient management. It will also allow us to investigate these tumors as unified groups in a way that should advance our understanding.”

Brat will join an international group of neuropathologists in Heidelberg, Germany, meeting this summer to revise the World Health Organization classification of brain tumors based on new molecular findings. This is a major step in starting to classify and treat brain tumors more precisely based on their genetic makeup.

RELATED RESOURCES:
Brain Tumor Treatment at Winship
Battling this brain tumor takes a combination of powerful tools Emory News Center 7/31/14
Progesterone could become tool versus brain cancer Emory News Center 6/18/14
New York Times story: http://nyti.ms/1GgdQ66

Eric Berry credits Emory nurse as the “real MVP” of his treatment

KCTV5

When Eric Berry first learned he had a type of blood cancer known as Hodgkin lymphoma, the Kansas City Chiefs football player returned to his home and family in Georgia and sought treatment at Winship Cancer Institute. Berry became a patient of Dr. Christopher R. Flowers, a Winship hematologist specializing in lymphoma and director of the Emory Lymphoma Program, and started regular chemotherapy treatments at Winship that lasted for several months. During that time, nurse Stephanie Jones took care of Berry and got to know both him and his family. It turned out that nurse Stephanie made quite a lasting impression on Berry. At the end of July, he returned to Kansas City to resume practices with his team and during his first press conference, he gave a shout-out to Jones and credited her as being the “real MVP” of his treatment. Jones says she’s proud of the honor and admiring of Berry’s determination to beat the cancer. Winship is fortunate to have a dedicated oncology nursing staff that demonstrates patient- and family-centered commitment, care and collaboration. All Winship nurses are specially trained to administer complicated chemotherapy regimens and implement steps for symptom management. As Stephanie shows, our Winship compassion is what is remembered.

See Eric Berry and Stephanie’s story on KCTV-TV Kansas City.

Learn more about Winship Cancer Institute of Emory University.

Winship Trial Reduces Mortality Rate for APL Patients

Winship's APL team (left to right): Martha Arellano, Kaitlin Sitchenko, Anand P. Jillella, Vamsi Kota, Ann Shen, Emily Bennett.

Winship’s APL team (left to right): Martha Arellano, Kaitlin Sitchenko, Anand P. Jillella, Vamsi Kota, Ann Shen, Emily Bennett.

Winship oncologist Anand Jillella, MD is spearheading a clinical trial for patients with Acute Promyelocytic Leukemia (APL) that could change the mortality rate for this disease on a major scale.

Often called the heart attack of leukemias, APL is a highly aggressive disease that is curable if treated early. A third of patients, however, do not survive the first month of treatment. By observing and analyzing the problem, Jillella and his team of physicians, nurses, and research staff came up with a collaborative approach that decreases mortality from 30 percent to about five percent. This new trial is open to patients all across the country.

Jillella has found that some physicians who treat patients with APL may not be familiar with the potential complications that can develop during treatment. He took a very detailed treatment algorithm and boiled it down to a three-step process that can be easily shared. “As soon as we get a call from a community physician, we send the simplified algorithm via smart phone,” says Jillella. “We come up with a treatment plan based on what the patient is experiencing and follow up with them regularly to get them through that difficult first month.”

RELATED RESOURCES:
Getting the Best Cancer Treatments into Outlying Communities
Clinical Trials: Leading the Way to Better Health Care

Cancer Survivor Exercises for Health

Winship at the Y was established to provide cancer survivors with better access to specialized exercise programs. This program, which is unlike any other in the country, is open to any cancer survivor, not just patients at the Winship Cancer Institute.  In addition to physical benefits, exercise may provide a psychological and emotional benefit during and after cancer treatment. Breast cancer survivor, Janel Green, who was treated at Winship Cancer Institute of Emory University, talks about how the special exercise program has helped her regain her health.

RELATED RESOURCES:
Winship Cancer Institute of Emory University
Bringing Survivorship Tools Closer to Home

New Director of Community Oncology at Emory Saint Joseph’s Hospital

szasboEmory Saint Joseph’s Hospital welcomes Stephen Szabo, MD as the new Director of Community Oncology at the hospital’s Winship Cancer Institute. The new program combines the best aspects of community and academic oncology by providing seamless patient care within one medical system.

“This is a powerful model of care,” says Szabo. “Our patients have the advantage of receiving state-of-the-art treatment right in their own community with the resources of a nationally recognized University system. This program provides great depth of care to our patients ranging from a compassionate team of nurses, nurse practitioners and social workers to the technical expertise of very specialized physicians.”

The community oncology program at Emory Saint Joseph’s treats patients with a variety of cancers with a team of medical oncologists, radiation oncologists and array of surgical specialists. The oncology program offers infusion services, radiation oncology, Gamma Knife and interventional radiology services.

Winship is the only National Cancer Institute-designated cancer center in the state of Georgia. “Our patients have access to the latest clinical trials and research in cancer care, and they benefit directly from the basic science research being conducted at the University. This truly is unique for a community oncology program,” Szabo says.

Szabo received his bachelor’s degree in chemical engineering from Cornell University and his medical degree from Cornell University Medical College. He completed his internal medicine residency at the University of Michigan Medical Center, and his fellowship in hematology and oncology at Emory University, Winship Cancer Center. Szabo has been practicing hematology and oncology for the past 15 years.

winship expansion banner

What is High Dose Rate Brachytherapy?

One of the most technically advanced and convenient options for cancer treatment is called high dose rate brachytherapy (HDR). It is a precise type of radiation therapy that is commonly used to treat localized gynecologic, lung, breast and prostate cancers that have not spread to lymph nodes. As opposed to low dose rate (LDR) brachytherapy, where tiny radioactive “seeds” are permanently placed inside or near a tumor, HDR brachytherapy involves temporarily placing high intensity sources of radiation inside the body with a catheter, for example, and then removing them once treatment is complete.

With short treatment and recovery times, HDR brachytherapy can help patients get back to their lives with minimal disruption. At Winship Cancer Institute of Emory University, the therapy is usually performed on an outpatient basis and carried out in two short sessions over one to two weeks. This results in an extremely precise radiation dose and minimal toxicity to the patient. Patients considering HDR brachytherapy may wonder if they will be radioactive following treatment. The answer is no. The radiation flows like the light that shines from a flashlight; it is not present once the treatment session is completed and the device used to deliver the radiation is removed.

HDR brachytherapy is performed at Winship locations by knowledgeable radiation oncologists with special expertise and certification in brachytherapy. The Department of Radiation Oncology at Winship is the only program in Georgia with advanced credentialing recognized by the National Cancer Institute for both LDR and HDR brachytherapy administration and expert usage.

Watch the short video below to learn more about how HDR brachytherapy is used to treat prostate cancer.

Find a Doctor

HDR Brachytherapy is performed at Winship locations by the following physicians:

For more information regarding HDR brachytherapy treatment at Winship Cancer Institute, please visit Emory Radiation Oncology.

In addition to regular treatments, a voluntary research study is being conducted to help men with recurring prostate cancer by using advanced imaging technology called FACBC to guide radiotherapy and determine the best possible course of treatment. Read more>>

About Dr. Rossi

Peter Rossi, MDPeter Rossi, MD, is a board certified radiation oncologist and the Medical Director of Radiation Oncology at Winship at Emory St. Joseph’s Hospital. Dr. Rossi specializes in the treatment of prostate cancer, cervical cancer and ovarian cancer, and his expertise is in the use of external radiation therapy and brachytherapy for treating prostate and gynecologic tumors. Dr. Rossi is on the Quality Assurance Committee of the American Brachytherapy Society. He lectures, proctors and mentors physicians on the use of HDR brachytherapy for the treatment of prostate cancer at Winship and internationally.

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