Clinical trial spotlight: lung cancer

Radiation therapy uses high-energy x-rays to kill tumor cells. Drugs used in chemotherapy work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Which radiation therapy regimen is more effective when given together with chemotherapy to treat patients with limited-stage small cell lung cancer?

Bogart

Bogart

Jeffrey Bogart, MD, professor and chair of radiation oncology, is trying to answer that question. He is the national study chair of a clinical trial sponsored by the National Cancer Institute that compares survival times between two different chest radiation therapy regimens.

About 15 percent of lung cancers are small cell lung cancers. At the time of diagnosis, about a third of people with small cell lung cancer are classified as limited stage because the tumors have not spread beyond their lungs.

Chemotherapy and radiotherapy may both be effective in treating small cell lung cancer. The National Cancer Institute reports that combination therapy — such as being offered in this study — has been shown to improve long-term survival in some patients.

Learn about this and other clinical trials taking place at Upstate at www.upstate.edu/hospital/clinical_trials/ Click on “active clinical trials” in the left column. Choose the “cancer” category and then press “search.”

 

 

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Raising spirits, awareness and money for cancer

This year’s National Cancer Survivors Day celebration drew 460 cancer survivors and their guests to a lunch buffet, music and door prizes. The event, sponsored by Upstate, featured a safari theme.

This year’s National Cancer Survivors Day celebration drew 460 cancer survivors and their guests to a lunch buffet, music and door prizes. The event, sponsored by Upstate, featured a safari theme. Photo by Zanette Howe.

The Central New York community made the Upstate Cancer Center possible, with many donations coming directly from grateful patients and family members. The Foundation for Upstate Medical University was the hub for the philanthropy which drew the support of thousands of people. The four-year fundraising effort brought in $17.4 million for the center.

Toni Gary, a development director at the foundation, says more than 325 individual children and school groups made donations. Student and community groups sponsored efforts that included a fishing fundraiser that brought in $450 in May and a basketball fundraiser in April that brought in $4,200. The Phoenix High School Lady Firebirds varsity pitcher, Megan Brown, raised $2,000 over 20 games by securing pledges for strikeouts. A Liverpool Middle School teachers’ basketball game held in March raised $1,600. A wrestling tournament in January at Skaneateles High School raised $1,300.

A $32,000 gift from the Alive! Foundation will help support the new therapeutic music program in the Upstate Cancer Center. The money was raised through the foundation’s Ride for Alive!, an annual cycling event that takes place in July in Skaneateles.

“We are committed to helping cancer survivors live well,” says Julia Wamp, co-founder of Alive! Foundation. Wamp, a cancer survivor, and her husband Michael established the foundation in 2012 to educate and empower survivors to live healthier, happier lives.

A Fulton teacher, Danielle Delfanian has raised more than $5,000 since 2011 by making duct tape rose pens, wallets, hair clips and bracelets through her organization, Roses for Breast Cancer.

Paige’s Butterfly Run attracted more than 2,500 participants this June for its 5K race, 3K fun run/walk and Caterpillar Crawl for kids in downtown Syracuse. The event has raised more than $2 million over the past 18 years to benefit pediatric research and cancer care. The money is also used to provide patients and families with “comfort kits,” gift cards for food and gas to those traveling far and other amenities to help meet the needs of a life that has suddenly been turned upside down.

The kickball tournament took place in May. Photo by Doug Rosenthal.

The kickball tournament took place in May. Photo by Doug Rosenthal.

More than 175 players on 17 teams played in the Kick Cancer Kickball Tournament in May. They raised more than $2,400 this year, bringing the three-year total amount of money they have donated to the Upstate Cancer Center to more than $6,000. Doug Rosenthal, who works in Information Management & Technology at Upstate, helps to organize the event, which takes place at the Syracuse Kickball Park in Liverpool.

Upstate had a presence at breast cancer walks and runs, including the American Cancer Society’s Making Strides Against Breast Cancer; the Carol M. Baldwain Breast Cancer Research Fund’s A Run for Their Life; and the Susan G. Komen Race for the Cure. A new grant from Komen will help underserved women secure their mammograms.

The 12th annual Father Daughter Valentine Ball, held this year at the Empire Room of the New York State fairgrounds, raised $30,832 to benefit pediatric cancer services at Upstate.

Upstate students and employees snacking at Deb’s Grill collected $1,185.25 in spare change to benefit the cancer center.

Learn about the Foundation for Upstate by calling 315-464-4416

Read Upstate’s Cancer Care magazine

 

 

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Dentist explains how to prevent dry mouth after radiation for cancer treatment

SmithPatrick6Tooth decay can be a side effect of radiation for cancer treatment, because of a condition called dry mouth.

Dentist Patrick Smith, assistant professor of surgery and residency program director of the dental services and clinic at Upstate, explains.

What is going on?

“Radiation of the head and neck, in particular, and some chemotherapy drugs can lead to xerostomia, or dry mouth, which is any condition in which the patient notes that their mouth is less moist than it used to be. They are just not producing saliva like they once did.

“Why is that bad? Because any plaque or calculus (hardened plaque also called tartar) that exists on the teeth will only accelerate potential decay. In addition to helping wash away food particles, saliva actually helps with digestion and neutralizes acids produced by bacteria. So when saliva is reduced, it can lead to problems.”

How can decay be prevented?

“Fluoride treatments, routine brushing, and accelerated dental checkups — maybe every fourth months instead of every six.”

Can dry mouth be treated?

“There are medications that can be prescribed for severe cases, to stimulate saliva production, and you might want to try a prescription or over-the-counter rinse or moisturizer.

“It may also help to sip water or suck ice chips throughout the day. And, avoid products – including caffeine, alcohol, tobacco and sugary foods – which make the situation worse.”

Does dry mouth go away once the cancer is gone?

“Radiation really dries out the salivary glands, and that’s a long-term process. It is not something that you are going to recover from quickly. In fact, some patients never recover, which is why dentists need to see patients with new cancer diagnoses early.

“When someone is diagnosed with cancer, it’s very important that they visit their dentist before they start treatment to determine if they have any particular areas of concern. Do they have a potential for abscess development? Do they have decay in their teeth?

“If you don’t have a dentist, ask your oncology team for a referral. Here at Upstate we have the dental service, and we work closely with our oncology associates.”

Symptoms of dry mouth

  • dryness in mouth, throat
  • saliva that seems thick or stringy
  • bad breath
  • difficulty chewing, speaking, swallowing
  • altered sense of taste
  • burning sensation in the mouth
  • problems wearing dentures
  • more frequent tooth decay
  • gum irritation, gum disease
  • mouth sores or cracked lips
  • dry, rough tongue

Sources: National Institute of Dental and Craniofacial Research, Mayo Clinic

Read Upstate’s Cancer Care magazine

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Revitalizing through reading as you recover from illness, injury

Book suggestions from Mary Laverty, a librarian in the Family Resource Center of the Upstate Golisano Children’s Hospital.

Sometimes you need a story that makes you laugh

PetePreschool

“Pete the Cat and His Four Groovy Buttons,” (2013) by James Dean and Eric Litwin. Pete the Cat is wearing his favorite shirt, the one with the four totally groovy buttons. When one falls off, does Pete cry? Goodness no! He just keeps on singing his song.

fortunatelyYouth

“Fortunately the Milk,” (2013) by Neil Gaiman, illustrated by Skottie Young. A little boy and his little sister awake one morning, milkless. Their mother is away on business, their father is buried in the paper, and their Toastios are dry. When father goes for milk, something goes wrong, and he doesn’t return. When he does, finally, he has a story to tell. There is time travel, treachery, adventure, and, fortunately, the milk he procured is rescued at every turn.

kidsAdult

“Kids These Days,” (2014) by Drew Perry. The author paints a landscape of weird and beautiful Florida and its inhabitants, all original, hilarious, and utterly believable. At the center of the story is a portrait of a father-to-be who is paralyzed by the idea of taking responsibility for another human life when he can’t seem to manage his own.

Sometimes you need a story that lets you cry

daisyPreschool

“A Ball for Daisy,” (2011) by Chris Raschka. A wordless story about love and loss. Any child who has ever had a beloved toy break will relate to Daisy’s anguish when her favorite ball is destroyed by another dog.

keplersYouth

“Kepler’s Dream,” (2013) by Juliet Bell. A young girl makes her fractured family whole again with the help of a very special book. When eleven-year-old Ella’s mother has to be hospitalized to undergo cancer treatment, Ella spends the summer at “Broken Family Camp” with her grandmother, whom she’s never met. The situation is hardly ideal for either of them. Ella is afraid her mother may die, but her grandmother seems to care more about her library full of books than she does about her very own daughter. Then a rare and beloved book, “Kepler’s Dream of the Moon,” is stolen from her grandmother’s library. A dynamic story of family and forgiveness.

ThiefAdult

“The Book Thief,” (2007) by Markus Zusak. This remarkable story is about the ability of books to feed the soul. The setting is 1939 Nazi Germany. Liesel Meminger is a foster child living outside of Munich who scratches out a meager existence for herself by stealing when she encounters something she can’t resist: books.

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Battling cancer and saving kids at the Waters Center

Pediatric oncologist William Waters MD (left, with bowtie) with colleagues. ND. Ten years ago, Upstate’s Center for Children’s Cancer and Blood Disorders was named in his honor.

William Waters MD (upper left, with bow tie) and colleagues, circa 1964. Ten years ago, Upstate’s Center for Children’s Cancer and Blood Disorders was named in his memory.

Richard Sills MD was a high school student in 1964, the year that Upstate’s hospitals opened. At that time, he laments, “almost nobody survived childhood cancer.”

The medical specialty of pediatric hematology-oncology was new in those days and William Waters MD, a 1942 graduate of the College of Medicine, was one of the first practitioners in the Syracuse area. Sadly, he died in 1966, at age 47.

Frank Oski MD, chairman of pediatrics, 1972 to 1985

Frank Oski MD, chairman of pediatrics, 1972 to 1985

Ten years later, Sills began a fellowship in pediatric hematology-oncology at Upstate, working under the direction of then-chairman Frank Oski MD, another pioneer in the field. Sills describes Oski as “an incredible teacher and role model for everyone who trained under him.”

In 2007, Sills returned to Upstate to direct the William Waters Center for Children’s Cancer and Blood Disorders. The center serves a 21-county region and, last year, treated 454 children with cancer and blood disorders and had 617 patients enrolled in the survivor wellness program.

Thankfully, 70 percent of children with cancer today will survive their disease.

What has changed in the last 50 years to improve the survival rates so dramatically?

According to Sills, it’s the result of multiple improvements in medical care — the use of more effective, more intensive chemotherapy regiments as well as tremendous improvements in general medical care. Sometimes Sills and his staff use doses of chemotherapy five times greater than would have been used in the 1960s.

Richard Sills MD, chief of pediatric hematology-oncology

Richard Sills MD, chief of pediatric hematology-oncology

“A cancer diagnosis is completely different than what people think,” explains Sills. “Today, it’s an astounding success story.”

“Over the last 25 years, we’ve taken away much of the pain of procedures and reduced the nausea from chemo-therapy,” he continues. “Kids are not afraid to come to the hospital.”

The Waters Center is housed in both the Upstate Golisano Children’s Hospital and in the new Upstate Cancer Center. How do these facilities affect care?

“It’s much more patient- and family-friendly today. The environment is warm and happy for children, comfortable for families.”

The children’s hospital has individual patient rooms with sleeper chairs for family members, a family resource center, a classroom and play rooms. The new cancer center is nature-themed and has a playroom and specially designed areas for infants, children and teenagers.

“When I was first practicing, kids screamed when they had to go to the hospital,” says Sills. “Now, they cry when they have to leave because they’re  having fun and don’t want to go home.”

Zach Ellingson on the cover of the new Cancer Care magazine.

Zach Ellingson on the cover of the new Cancer Care magazine.

To “meet” one of the patients of Upstate’s Waters Center, read Cancer Care magazine’s story on  Zach, who was diagnosed with cancer four years ago, at age 8.

 

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Surgeon specializes in treating diabetics

palmashawPeople who have diabetes are at increased risk of lower leg amputation. The disease may diminish blood flow and sensation in their feet, and it may impair vision, so any wound is not readily apparent. Then because their immune system is compromised, their bodies struggle to fight any infection.

“If they don’t have good blood supply to their foot, you can give all of the antibiotics that you want, but the antibiotics go in the blood, and the blood can’t get to the foot. So therefore you have an untreated infection, and the patient can quickly lose the limb,” says Palma Shaw, MD, a vascular surgeon at Upstate University Hospital who specializes in limb salvage.

Tools at her disposal: improving blood flow through minimally invasive surgery, or through delicate open surgery in which veins are rerouted. If a wound has been festering for a month or more, she may have to surgically remove the wound or use an enzyme-based medication to stimulate healing.

More advanced options include hyperbaric oxygen and cell therapy.

Hopefully it never comes to that. Shaw urges people with diabetes to make regular visits to a podiatrist. She says monitoring foot health is as important as tracking sugar levels, blood pressure and kidney function.

Hear Dr. Shaw’s interview on this topic on HealthLink on Air

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Answers to questions about living with cancer

hafeez51silhQ: “I’m not depressed but I just want to be left alone, so what can I do about friends who keep trying to include me in their social plans?”

A: “The first thing would be to tell them,” advises Aliya Hafeez, MD, an assistant professor of psychiatry and behavioral sciences and a breast cancer survivor.

“You will have two types of friends. One who will feel so uncomfortable with your diagnosis that they will avoid you. Do not take this personally as this is about them not you. However, you do have the right to tell them how it makes you feel.

“The second group will include those who will go out of their way to make certain you are OK and will invite you to everything and anything they can think of. Again they may be doing this to alleviate their own anxiety.

“It is OK to tell your friends exactly what you need. Make certain that you are getting a good share of love and support as that is crucial when going through the cancer experience.”

Reach Dr. Hafeez through Upstate Connect at 315-464-8668.

Listen to an interview with her on HealthLink on Air radio.

Read Upstate’s Cancer Care magazine.

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Ridlon wildflower painting hangs in hospital lobby

Artist Jim Ridlon with his work, "Goldenrod and Wild Asters." Photo by Rich Whelsky.

Artist Jim Ridlon with his work, “Goldenrod and Wild Asters.” Photo by Rich Whelsky.

Wildflowers adorn the lobby of Upstate University Hospital downtown, in a painting called “Goldenrod and Wild Asters.”

The painting is the largest from artist Jim Ridlon’s garden series. It consists of 30 9-by-12-inch painting he made over a year at fields between Cazenovia, the village where he resides, and New Woodstock, where he has a studio.

“I would go to the same spot at different times of the day to capture the color shifts and moods of the day,” he explains. “I can paint realistically. What I wanted was more of a feeling for what happened in that garden, from early morning to early evening.”

Drawn by the vibrant yellow of the goldenrod and contrasting purple of the wild asters, Ridlon later cut the small paintings and turned them into a giant collage.

As a child, Ridlon says he always enjoyed art; he was dyslexic and struggled with reading and writing. Today he is retired from the art faculty of Syracuse University, where he taught for 35 years. He played football for SU in the 1950s and then played professionally for eight years, for the San Francisco 49ers and the Dallas Cowboys.

Ridlon submitted his artwork for consideration to be included in the Upstate Cancer Center. The selection committee decided it would instead be perfect for the main wall in the hospital lobby. The painting’s white border matches the white of the wall, so that the painting appears to be floating.

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Which surgery provides best long-term outcome for kidney cancer?

Gennady Bratslavsky, MD, leads the Department of Urology.

Gennady Bratslavsky, MD, leads the department of urology.

Used to be, when surgery was recommended for kidney cancer, surgeons would remove an entire kidney. Now research shows patients fare better 10 years after surgery if the operation removes just the tumors.

It makes for a trickier operation, but the kidney-sparing surgery gives patients a decreased risk of developing chronic kidney disease, according to an Upstate study published recently in the journal, Urologic Oncology.

Urology resident Michael Daugherty, MD, and his mentor, Gennady Bratslavsky, MD, analyzed a national database, concentrating on people between the ages of 20 and 44 who underwent surgery for small, localized kidney tumors. “We looked at these younger patients because we wanted to see what effects the surgery itself would have on the patient and their long-term outcomes. With the younger patients, they were assumed to have less underlying diseases, less chance of having hypertension or heart disease or things that would possibly cause them to have an earlier death.”

They compared cancer-specific survival and overall survival between those who had their kidney removed and those who just had the tumors removed. They found no difference in cancer-specific survival, “which means the surgical removal got rid of the cancer in both ways equally,” he says. In overall survival, however, “those treated with the entire removal of the kidney did worse at 10 years. Those that had the nephron-sparing surgery did better in the long term.”

Not all kidney cancers are treated with surgery. Many factors including the type of cells involved help doctors decide what to recommend. “These cancers may be very different in their sizes, their behaviors and their prognoses,” says Bratslavsky, who leads the department of urology at Upstate.

Some kidney cancers are hereditary, passed from parents to children through a defective gene. Some are not. Some are discovered incidentally, when a patient has a medical image for another reason, and a tumor is revealed on a kidney. Many are discovered only after a patient notices blood in his or her urine.

“Unfortunately when patients present with symptoms, the disease may be much more advanced,” says Bratslavsky.

iStock_000017857727MediumUpstate physicians offer methods of destroying tumors without traditional surgery, and newer treatments that tap into the body’s own immune system to destroy cancer cells. “Active surveillance” is another important option when tumors that are slow growing or for patients for whom surgery would be too risky. Most of the surgeries for kidney cancer at Upstate are done laparoscopically, through tiny incisions, using robotic assistance.

No matter which type of cancer is diagnosed, Bratslavsky says, “it’s very important that patients with kidney tumors are managed in a setting where they can be provided with a multidisciplinary approach, such as at Upstate.” Radiologists, pathologists, medical oncologists, urologists and others come together in one room to discuss a particular patient’s options. This is where the question is asked, and answered: Which treatment, which surgery offers the patient the best outcome?

Read the study abstract in the journal, Urologic Oncology

Listen to the HealthLink on Air radio interview

Read Upstate’s Cancer Care publication

 

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Numbers help tell the story of the Upstate Cancer Center

Print

17.4 million dollars were raised through the Foundation for Upstate — drawn from 18,449 gifts and pledges — to help build the $74 million Upstate Cancer Center.

preview140 villages, towns or cities in New York have residents who receive cancer care at Upstate University Hospital.

1 sky light in the healing garden lets natural light into the first floor of the George E. and Caryl Lee Johnson Radiation Oncology Center.

48 steps take you to the top of the Jim and Juli Boeheim Stairway of Hope from the cancer center lobby.

146 cassions secure the foundation, the deepest of which is 57.35 feet below the first floor.

Hear a radio interview about the new Upstate Cancer Center

Read the new Cancer Care publication

Sign up for a free subscription by sending your name and address to magazine@upstate.edu

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