Congratulations are in Order!

Every year Billboard releases its prestigious list of Women In Music: The Most Powerful Executives in the Industry, and every year several of our board members are included for being “ground-breakers and game changers.” This year our board members Jody Gerson, Julie Swidler, Jennifer Breithaupt and Sharon Dastur as well as our New York Honors Gala honoree Marsha Vlasik were all listed. We are so honored to work with these incredibly hard-working women to continue our vital leukemia, cancer and AIDS research.

To read the full list, please visit billboard.com.

Guest Blog Post: Important Advice if You’re Considering Mastectomy

Ingrid Meszoely, M.D. is Associate Professor of Surgical Oncology and Clinical Director, Vanderbilt Breast Center at Vanderbilt-Ingram Cancer Center.

Following the completion of several large studies in the late 1980s and early 1990s involving thousands of women, it was clearly determined that the number of years a woman lived following breast cancer surgery was exactly the same whether she underwent mastectomy (removing the whole breast) or lumpectomy (just removing the part  of the breast with the cancer). This was a big breakthrough for breast cancer treatment with the realization that more surgery doesn’t result in better outcomes.  Initially this resulted in a trend of women choosing lumpectomy over mastectomy in order to preserve their breasts.

However in recent years, as Dr. Kummerow and many other researchers have found, there is a nationwide trend in choosing mastectomy over lumpectomy despite there being no clear survival advantage.  In addition, many women choose to undergo mastectomy of the non -affected breast despite the fact that the risk of developing cancer in this breast is very low and that it does not have any effect on survival from their current breast cancer.

As a breast cancer surgeon, I see this same phenomenon in my own practice.  The choice of mastectomy on one or both sides is often driven by multiple factors including the fear of cancer coming back or a new cancer on the other side and the wish to do everything one can to prevent this.  This often provides some sense of control and peace of mind in the setting of an overwhelming diagnosis.

When a woman is diagnosed with early breast cancer and given the choice of mastectomy or lumpectomy because she is a candidate for either procedure, the options should be considered carefully.

It should be clearly recognized that mastectomy does not provide 100 percent protection from cancers coming back. Cancers often come back at other sites outside of the breast before they return in the area of the removed breast tissue.  Because mammograms or other imaging studies are not routinely used after mastectomy, the finding of recurrences along the chest depends on continued routine self -exam and clinical exam by their doctor when the tumor is large enough to feel as opposed to being detected on mammogram when it is very small.

Mastectomy is also associated with increased complications compared to lumpectomy and these are often related to the reconstruction, which can be discouraging.  It is even more devastating when there are complications related to the unaffected breast when women choose mastectomies on both sides.

Lymph node surgery often is performed in the setting of mastectomy.  If just a single lymph node is found to be involved with breast cancer, removal of additional lymph nodes is recommended which can result in added complications. However if a lumpectomy is chosen, generally 3 or more lymph nodes need to be involved with cancer before more lymph nodes are removed.

When a woman presents with newly diagnosed early breast cancer and is put in the position of making a decision between lumpectomy and mastectomy, a thoughtful discussion should be initiated with her treating physicians.  Ultimately, the decision is very personal and she should choose the procedure that suits her lifestyle and provides her with the greatest sense of wellbeing.

 

The Power of Philanthropy: Reducing the Burden of Breast Cancer

The longstanding history between the T.J. Martell Foundation and Vanderbilt-Ingram Cancer Center underscores the power of philanthropy in reducing the burden of cancer. While we celebrate the many advances that result from these powerful partnerships, we know that continued support will position us to make new discoveries that change the course of cancer for patients and families throughout the world.

Increases in cancer cure and survivorship over the past 30 years showcase the impact of discovery on cancer care. In 1971, one in 69 people was a cancer survivor, and a total of three million survivors lived in the United States. In 2012, one in 23 people is a cancer survivor, accounting for a national total of 13.7 million survivors. The collective efforts of all who fight cancer are responsible for these life-saving victories.

While these snapshots of progress are encouraging, malignant disease will continue to be common—and in need of directed treatment—for many years to come. Currently, between 35 percent and 40 percent of oncology treatment is genetically directed. While this represents an enormous increase over the last several decades, this figure also shows the potential and need for continued research and therapeutic discovery. This year alone, 1.6 million Americans will receive a new cancer diagnosis. The pace of discovery impacts the type of care each of these individuals will receive.

As we look to the future, to our ability to contribute to prevention, to develop new therapies and to use existing therapies in new ways, we are mindful of the enduring support we receive from our philanthropic partners. Without the strategic investments made by the T.J. Martell Foundation, Vanderbilt-Ingram’s ability to advance our understanding of cancer and impact patients’ lives would be distinctly different.

Dr. Jennifer Pietenpol of the Vanderbilt-Ingram Cancer Center

A major focus of research in the laboratory of Jennifer A. Pietenpol, Ph.D., is to define molecular changes that are frequent in breast cancer cells and to use bench-based discoveries to advance patient care.  Treatment of patients with triple negative breast cancer (TNBC) has been challenging due to the heterogeneity of the disease and the absence of well-defined molecular drivers amenable to targeted therapies. Thus, identification of predictive biomarkers is critical to select patients for more precise therapies against TNBC.  For the past several years, Dr. Pietenpol’s group has been integrating their expertise in molecular genetics, with bioinformatic analyses of high dimensional genomic data sets, to molecularly sub-classify difficult-to-treat TNBC.   They have  been identifying and validating molecular ‘drivers’ involved in different types of TNBC as well as using the information gained to benefit patients and to generate the next set of hypotheses that  they are testing at the bench.

Dr. Vandana Abramson of the Vanderbilt-Ingram Cancer Center

The laboratory will continue to investigate novel therapeutic approaches based on the genetic and biological underpinnings of TNBC.  They are very grateful for the T.J. Martell Foundation support and, in particular the recent support through the Martina McBride Cancer Research Fund as it has enabled a highly productive collaboration with Dr. Vandana Abramson, a leading medical oncologist specializing in breast cancer at Vanderbilt-Ingram.  The cross-disciplinary collaboration is allowing for more rapid advancement of pre-clinical data from the bench to the clinic and thus, alignment of patients to molecularly targeted therapy.

PALB2 Gene Mutation Affects Breast Cancer Risk

Having a family history of breast cancer nearly doubles a woman’s risk of developing the disease and genetic factors are known to play a major role in the origin of breast cancer.

The BRCA1 and BRCA2 genes were identified as major breast cancer susceptibility genes nearly 30 years ago and it is estimated that these gene mutations explain about 50 percent of familial breast cancer cases.  BRCA1 and BRCA2 mutation tests have been widely used in high risk women (e.g., women with a strong family history of breast cancer) for risk assessment and management which may include prophylactic surgical and drug therapy intervention.

However, a significant fraction of familial breast cancer cases remain unexplained. A recent study identified the PALB2 gene as another major breast cancer predisposition gene. The PALB2 (Partner and localizer of BRCA2) gene produces a protein that is crucial for key BRCA2 functions. Mutation carriers of this gene were found to have a 35 percent risk of developing breast cancer by the age of 70, triple the risk seen in the general population.  For breast cancer diagnosed before age 40, having PALB2 mutations was related to an 8 to 9-fold increased risk.  It is estimated the PALB2 mutations explain about 2 to 3 percent of familial breast cancer risk. This study expanded our knowledge of genetic contributions to the familial profile of breast cancer.

Currently, the benefit and risk of deploying preemptive measures like surgery or drug therapy based on PALB2 mutation status is unknown. While the utility of applying PALB2 mutation information for risk management of high risk populations needs to be further investigated, individuals with known mutations of this gene are encouraged to seek genetic counseling because PALB2 mutations are also known to increase the risk of pancreatic cancer and may increase the risk of ovarian cancers. Mutations in PALB2 are very rare in the general population. Thus, screening for PALB2 in the general population appears to be unnecessary.

Xiao Ou Shu, M.D., Ph.D., MPH
Ingram Professor of Cancer Research
Vanderbilt-Ingram Cancer Center

HPV-Positive Head and Neck Cancer Patients May be Safely Treated with Lower Radiation Dose

A new study suggests that lowering the dose of radiation therapy for some head and neck cancer patients may improve outcomes and cause fewer long-term side effects.

The research was presented by lead author Anthony Cmelak, M.D., professor of Radiation Oncology at Vanderbilt-Ingram Cancer Center (VICC), during the 50th annual meeting of the American Society of Clinical Oncology (ASCO), held recently in Chicago.

The study focused on patients with newly-diagnosed oropharyngeal cancers related to the human papilloma virus (HPV). More than two-thirds of new head and neck cancer patients have HPV-positive tumors and the number of these patients is on the rise. Cmelak’s prior cooperative group study found that patients with HPV-positive oropharyngeal cancer have significantly longer survival rates than patients whose tumors are HPV negative.

For the new study, 80 HPV-positive patients with stage III, or IVa,b squamous cell cancer of the oropharynx received induction chemotherapy, including paclitaxel, cisplatin and cetuximab.

After chemotherapy, 62 of the patients showed no sign of cancer and were assigned to receive a 25 percent lower dose of intensity-modulated radiation therapy – an advanced technology that targets the radiation beam more accurately to treat the tumor without harming surrounding tissue. The rest of the patients received a standard IMRT dose. The drug cetuximab was also given to both groups of patients along with the IMRT treatment.

Two years after treatment, the survival for the low-dose IMRT patients was 93 percent.  Those who did not have complete resolution of cancer following induction and went on to get full-dose radiation had an 87 percent two-year survival. Eighty percent of the low-dose patients and 65 percent of standard IMRT patients also showed no evidence of tumor recurrence.  Ninety-six percent of those who had minimal or no smoking history had no evidence of tumor recurrence after two years following treatment, and long-term side effects were minimal.

The investigators concluded that patients with HPV-positive cancer who had excellent responses to induction chemotherapy followed by a reduced dose IMRT and cetuximab experienced high rates of tumor control and very low side effects particularly for those with a minimal smoking history.

Treating tumors in the delicate head and neck region often causes side effects that can be troublesome and long-lasting, including difficulty swallowing, speech impairment, dry mouth, problems with taste and thyroid issues, so any therapy option that reduces these side effects can have an impact on patient quality of life.

“Treatment for head and neck cancer can be quite grueling, so it’s very encouraging to see we can safely dial back treatment for patients with less aggressive disease and an overall good prognosis, particularly for young patients who have many years to deal with long-term side effects,” said Cmelak.

He noted that lower-dose IMRT is not recommended for patients with HPV-negative cancer or larger tumors.

The authors note that further studies of reduced-dose IMRT in HPV-positive patients are warranted.

Other investigators include Jill Gilbert, M.D., VICC; Shuli Li, Ph.D., Dana Farber Cancer Institute, Boston, Massachusetts; Shanthi Marur, M.D., William Westra, M.D., Christine Chung, M.D., The Johns Hopkins University School of Medicine, Baltimore, Maryland;  Weiqiang Zhao, M.D., Ph.D., Maura Gillison, M.D., Ph.D., The Ohio State University, Columbus, Ohio; Julie Bauman, M.D., Robert Ferris, M.D., University of Pittsburgh Cancer Institute; Lynne Wagner, Ph.D., Feinberg School of Medicine, Northwestern University, Chicago, Illinois; David Trevarthen, M.D., Colorado Cancer Research Program, Denver;  A. Demetrios Colevas, M.D., Stanford University, California; Balkrishna Jahagirdar, M.D., HealthPartners and Regions Cancer Care Center, St. Paul, Minnesota;  Barbara Burtness, M.D., Fox Chase Cancer Center, Philadelphia, Pennsylvania.

Funding was provided by The National Cancer Institute, a division of the National Institutes of Health (CDR0000665170).

 

Excerpt: Colon Cancer Screening Saves Lives

Widespread screening for colorectal cancer has helped prevent an estimated half-million cases of the disease since the mid- 1970s, a new study suggests.

At a time when screening for many kinds of cancer is being questioned, the findings underscore the importance of screening for colorectal cancer in saving lives, said the senior author of the study, Dr. James Yu, an assistant professor of therapeutic radiology at Yale School of Medicine.

Colonoscopies, beginning at age 50, are considered the gold standard in colon cancer screening, although other techniques, like fecal occult blood testing, can detect some cancers.

 To read the full article in The New York Times, please click here.

Monday, April 7th is World Health Day

Dr. Margaret Cuomo is the author of “A World Without Cancer: The Making of a New Cure and the Real Promise of Prevention.”

World Health Day, April 7th, is a great opportunity to focus our attention on what should be an American priority: cancer prevention.

Scientific evidence tells us that over 50 percent of all cancers are preventable by applying what we know right now. Attention to diet, exercise, avoiding alcohol, protecting our skin from the sun, managing stress and, of course, ending smoking all contribute to significantly reduce cancer risk. These are the “broad strokes” of cancer prevention. The devil is in the details, and people need to know which foods, what kind of exercise, how to manage stress, etc. There are highly-effective strategies to prevent cancer, but we need to learn them. We should be teaching our children about the kinds of foods that reduce cancer risk and encouraging them to stay physically active to prevent cancer and other diseases. Anti-smoking education should focus on the young as well as adults, emphasizing that “It’s not cool to smoke, because there’s nothing cool about cancer.”

Learning that whole grains, legumes, fruits and vegetables can help prevent many cancers, including cancers of the prostate, breast, mouth, throat, esophagus, lung, colon, kidney, pancreas, thyroid, gallbladder, and probably other cancer types is a powerful lesson that can have a significant impact on children’s lives. In many cases, children who have been taught about cancer-preventing strategies can become the role models and teachers for their parents.

Our fruits, vegetables and grains should be free of harmful pesticides that promote cancer. Our cattle, poultry and fish should not be exposed to antibiotics or hormones that will be harmful to their human consumers. Our personal care products, such as shampoo and deodorant and toothpaste; cosmetics, such as lipstick, mascara and eyeliner; and our household cleaning products should be free of chemicals that disrupt our hormones, and increase our cancer risk.

The scientific and medical community, including the World Health Organization and the American Association of Obstetricians and Gynecologists and the American Reproductive Society, are speaking out against the harmful chemicals in our environment.

In a joint Committee Opinion issued by the American College of Obstetricians and Gynecologists (The College) and the American Society for Reproductive Medicine in September 2013, obstetricians and gynecologists were urged to advocate for government policy changes to identify and reduce exposure to toxic environmental agents.

Among the reproductive and health problems associated with exposure to these toxic chemicals, these powerful medical groups listed childhood cancers, miscarriage and stillbirth impaired fetal growth and low birth weight, preterm birth, birth defects, cognitive/intellectual impairment and thyroid problems.

In 2010, the President’s Cancer Panel issued a scathing report entitled, Reducing Environmental Cancer Risk: What We Can Do Now,” in which it stated: “The true burden of environmentally induced cancer has been grossly underestimated.”

It takes a village to support cancer prevention. Government and the industries producing our food, personal care products and cosmetics, household and industrial cleaning products, fertilizers and pesticides should be partners in the effort to ensure that our food is pure and healthful, and that the products used on our bodies and our farms, in our homes, schools and businesses aren’t cancer-causing. Less Cancer, a not-for-profit organization founded by Bill Couzens, seeks to educate individuals and raise awareness that results in the protection of human health, the environment, and our economy. Less Cancer’s work on health and the environment spans a wide range of issues, including specific contaminants, pollution sources and also healthy lifestyle choices, such as diet, exercise, and smoking cessation. While we work to protect all communities, our approach is particularly relevant to at-risk populations, such as children, low-income communities, and workers. Less Cancer’s ultimate goal is to reduce incidences of diagnosed cancer in all people. As a Less Cancer board member, I am honored to be a part of this vital mission.

A World Without Cancer, the book I wrote in 2012, is my personal journey with cancer as a doctor, a diagnostic radiologist and experiencing cancer’s horrific effects on my patients, friends, and family. The good news is that cancer is not an inevitability for us. Whether we are adults or children, members of the media or medical community, government, industry or cancer advocacy group, we can all contribute to a healthier environment, a stronger, more vibrant society, and ultimately, to a world without cancer. If we fully dedicate ourselves to the prevention of cancer, this impossible dream will become a reality.

Margaret I. Cuomo, M.D., is a board-certified radiologist and served as an attending physician in diagnostic radiology at North Shore University Hospital in Manhasset, N.Y. for many years. Specializing in body imaging, involving CT, Ultrasound, MRI and interventional procedures, much of her practice was dedicated to the diagnosis of cancer and AIDS. She is the daughter of former New York Governor Mario Cuomo and Mrs. Matilda Cuomo and sister to Governor Andrew Cuomo and ABC’s Chris Cuomo. She resides in New York. Cuomo’s book, A World Without Cancer, was published October 2012 by Rodale.

Today is National Cancer Prevention Day!

Everyday Ways to Prevent Cancer

By Leslie Vandever

February is National and World Cancer Month—observations meant to increase public awareness of cancer, cancer prevention, and cancer research. And Tuesday, Feb. 4 is National Cancer Prevention Day.

Even today, with the incredible scientific and medical advances that have taken place over the last hundred years, cancer remains one of the most frightening—and deadly—diseases we face. Fortunately, we’ve gotten much better at treating and even curing some types of cancer, some of the time. Unfortunately, a definitive cure for all cancers remains beyond our reach.

What is cancer?

Simply, “cancer” is the word for a group of diseases in which the cells—the body’s basic unit of life—develop abnormally and do not die when they should because of a mutation in their DNA. Instead, out of control, these “malignant” cells divide and spread (metastasize) to other parts of the body through the bloodstream or lymph system.

Sometimes mutated cells may form a mass of tissue called a tumor. It’s considered “benign” if it doesn’t spread to other parts of the body, can be removed, and doesn’t come back.

There are more than 100 different types of cancer. In many cases, what starts, or triggers, cells to mutate abnormally and spread is unknown. But scientists have been able to pinpoint some possible triggers for some forms of malignant cancer—and by avoiding or controlling those triggers, you can reduce your odds of contracting the disease.

What steps can you take toward cancer prevention?

  •  Don’t use tobacco. If you do, stop. Smoking has been linked to cancers of the lung, bladder and kidneys. Chewing tobacco has been linked to cancer of the oral cavity and pancreas.
  • Eat healthy. Choose a diet rich in plant-based foods like vegetables, fruit, beans, legumes and whole grains. Limit fat, particularly fat from animal sources. Avoid sugar. Foods that are higher in fat and sugar (and calories) contribute to obesity, which can cause cancer.
  • Avoid becoming overweight or obese. Maintaining a healthy weight for your age, height and build might help to prevent cancer. Obesity has been linked to cancer of the breast, prostate, lung, colon and kidney.
  • Exercise. Regular exercise helps to maintain overall health, helps to control your weight and might protect against breast and colon cancer.
  • Protect yourself from the sun. Many types of skin cancer are linked to the harmful ultraviolet rays in the sun. Use sunscreen liberally and wear tightly woven, loose-fitting clothes in bright or dark colors to protect exposed skin. Try to stay out of the sun between 10 a.m. and 4 p.m. And avoid tanning beds and sunlamps—they’re just as damaging as natural sunlight.
  • Cancer screening. Mammograms, PAP smears, breast and skin exams, and colorectal screening can catch precancerous conditions early. By finding abnormal cells and treating or removing them, some cancers can be prevented. They include cervical cancer, breast cancer and some skin cancers.
  • Chemoprevention.  The vaccine against the human papilloma virus (HPV) and the hepatitis B vaccine can prevent certain types of cancer. There are also medications can treat some pre-cancerous conditions and keep them from developing into a malignant form.

Other steps you can take include limiting the amount of alcohol you drink, and avoiding risky behavior. HPV and HIV infections, which can make you more susceptible to liver, cervical and other cancers, can be prevented by never sharing needles and practicing safe sex: limiting the number of sexual partners you have, and using condoms. Finally, visit your doctor at least once a year for preventive screening and an overall health checkup.

For more information about cancer and other health issues, click here.

Leslie Vandever is a professional journalist and freelance writer. Under the pen-name “Wren,” she also writes a blog about living well with rheumatoid arthritis called RheumaBlog (www.rheumablog.wordpress.com). In her spare time, Vandever enjoys cooking, reading and working on the Great American Novel.

References:

  •  What is Cancer? (2013, Feb. 8) National Cancer Institute. National Institutes of Health. Retrieved on January 26, 2014 from http://www.cancer.gov/

In honor of National Cancer Prevention Day, please consider making a donation to the T.J. Martell Foundation by clicking here. The Foundation funds cutting-edge research that will lead to clinical trials and drug discoveries that will help save lives!

 

We Want YOUR BUSINESS To Get Involved!

We would like to thank Edwards Photography Studios for supporting our organization in the month of January. You can help with a simple “CLICK.” Go to their Facebook page, and click “LIKE.” For each new like in the month of January, they will donate $2 to our foundation. Please SHARE our Facebook posts and invite your friends to do the same!

Does your company have a fan page on Facebook? We’d love for you to get involved with a campaign like this which raises money for life-saving research AND gains exposure for your business, a win-win for everyone involved! Ready to make us your charity of the month? Please email Kate Fitzpatrick, our social media manager, kfitzpatrick@tjmartell.org for details.