C3: Collaborating to Conquer Cancer
Published 3 times a year by the University of Colorado Cancer Center, C3 highlights the cancer research and care underway at this elite federally designated comprehensive cancer center. Spring 2011 edition.
COLLABORATING TO CONQUER CANCER A Newsletter for the University of Colorado Cancer Center | Anschutz Medical Campus SPRING 2011 Motherhood Mystery Reaching Rural Areas with the Best Cancer Care A Conversation Hang Yin, PhD Cocktails for a Cure Raises $145k for Young Women's Breast Cancer Research CENTER NEWS Mascaux Vasiliou Hendrick Anchordoquy Richer Anderson University of Colorado Cancer Center, Kaiser Permanente Colorado join forces in cancer research Yearly mammograms from age 40 save 71% more lives A new study questions the controversial 2009 US Preventive Service Task Force recommendations for breast cancer screening, with data that shows starting at a younger age and screening more frequently will result in more lives saved. The University of Colorado Cancer Center has added a ninth member to its consortium: Kaiser Permanente Colorado's Institute for Health Research. The CU Cancer Center, Colorado's only federally designated comprehensive cancer center, is the hub of cancer research in Colorado. Researchers from University of Colorado Denver, University of Colorado Boulder and Colorado State University are members, as are cancer care physicians at University of Colorado Hospital, The Children's Hospital, Denver Health, Denver VA and National Jewish Health. Adding the Institute to the cancer center consortium, which is funded with a multiyear comprehensive cancer grant from the National Cancer Institute, brings a large group of cancer health outcomes researchers and cancer health services providers into the mix. Investigators with Kaiser Permanente's Institute for Health Research are conducting cutting-edge cancer research in patientcentered communications, health services and comparative effectiveness research. They have a large, NCI-funded cancer health communications center that does research into improving how we talk to patients about cancer. Kaiser Permanente is also helping to lead an NCI-supported consortium of managed care organizations conducting research on how cancer is prevented and managed in health care systems. Colon cancer is the third most common cancer in Americans, with a one in 20 chance of developing it, according to the American Cancer Society. This enzyme biomarker could help physicians identify more colon cancers and do so at earlier stages when the cancer is more successfully treated. The research was led by Vasilis Vasiliou, PhD, professor of molecular toxicology at the University of Colorado School of Pharmacy, and published in the Jan. 7 online issue of Biochemical and Biophysical Research Communications. Vasiliou's team studied colon cancers from 40 patients and found a form of this enzyme known as ALDH1B1 present in every colon cancer cell in 39 out of the 40 cases. The enzyme, which is normally found only in stem cells, was detected at extraordinarily high levels. R. Edward Hendrick, PhD, clinical professor of radiology at the University of Colorado School of Medicine, and Mark Helvie, MD, director of breast imaging at the University of Michigan Comprehensive Cancer Center found that if women begin yearly mammograms at age 40, it reduces breast cancer deaths by 40 percent. When screening begins at 50 and occurs every other year, it reduces breast cancer deaths 23 percent. The difference: 71 percent more lives saved with yearly screening beginning at 40. They found that women ages 40-49 who are screened annually will have a false-positive mammogram once every 10 years. They will get asked back for more tests once every 12 years and will undergo a false-positive biopsy once every 149 years. "The USPSTF overemphasized potential harms of screening mammography, while ignoring the proven statistically significant benefit of annual screening mammography starting at age 40." says Hendrick. "In addition, the panel ignored more recent data from screening programs in Sweden and Canada showing that 40 percent of breast cancer deaths are averted in women who get regular screening mammography. Our modeling results agree completely with these screening program results in terms of the large number of women lives saved by regular screening mammography." 18 investigators funded with $480k in pilot grants The CU Cancer Center awarded $480,000 in pilot and seed grant funding to Colorado cancer researchers. The funding comes from four programs: The center's National Cancer Institute Cancer Center Support Grant, its American Cancer Society Institutional Research Grant, private donations and its Breast Cancer Specialized Program of Research Excellence developing program, funded with donations from Safeway Foundation. Each project was selected for funding after a competitive review by a committee of peer researchers. These grants will help researchers kick-start new research projects. Often pilot- and seed grant-funded projects go on to receive large federal and private grants based on data collected during the pilot-funded research. Awardees are: Jingshi Shen, Chad G. Petersen, Isabel Schlaepfer, Monique Spillman, Gerrit Bouma, Laurie Carr, Shi-Long Lu, Rebecca Schweppe, Kimberly Jordan, Ndiya Ogba, Joshua Klopper, Caroline Kulesza, Thomas Anschodoquy, Xuedong Liu, S. Gail Eckhardt, Steven Anderson, Jennifer Richer and Bolin Liu. Mascaux wins National Lung Cancer Partnership grant for screening work A University of Colorado Cancer Center researcher believes she could find a simple, non-invasive test that would diagnose lung cancer in its very earliest stages or even while it's still pre-cancerous. Celine Mascaux, MD, PhD, a post-doctoral fellow the CU Cancer Center, has identified several molecular changes in patients with the earliest stages of lung cancer. She also has found that these markers differ between smokers and non-smokers as well as between men and women. Most importantly, she has found biomarkers that indicate the presence of lesions at low risk of turning cancerous from those that were at high risk or were already invasive cancer. 2 | C3: SPRING 2011 | WWW.COLORADOCANCERCENTER.ORG University of Colorado team identifies new colon cancer marker A CU Cancer Center research team has identified an enzyme that could be used to diagnose colon cancer earlier. It is possible that this enzyme also could be a key to stopping the cancer. Get more CU Cancer Center news on our blog Subscribe to our blog to get Target: Cancer, a weekly post from a CU Cancer Center leader about what's up in cancer research and treatment, and the latest news from CU Cancer Center. Go to www.coloradocancerblogs.org/subscribe today! CONVERSATION Hang Yin, PhD Dr. Hang (Hubert) Yin is an assistant professor of chemistry and biochemistry and a member of the Colorado Initiative in Molecular Biotechnology at the University of Colorado Boulder. He is also a member of the University of Colorado Cancer Center Developmental Therapeutics Program. His research focuses on building new tools to probe inaccessible proteins that play a role in cancer development--specifically, lymphomas and leukemia. C3: When you were awarded a Stand Up to Cancer (SU2C) research grant of $ 750,000, emerging from a field of more than 400 applicants, the chair of the grant review committee asked applicants to step out of their "comfort zone" potentially to revolutionize cancer research. How have you stepped out of your comfort zone? Yin: We plan to develop novel biotechnological tools to probe and study the integral membrane protein Latent Membrane Protein-1, which plays an important role in cancer development. Conventional thought has it that it is difficult, if not impossible, to develop specific probes for these proteins as they are buried deep in cell membranes. Structure-based drug designs cannot work against certain membrane proteins because scientists don't know how those proteins function, so they cannot target them. We believe we can move beyond that conventional thinking, or comfort zone, to unlock these important drug targets using a combination of screening and structure-based design technologies. We hope to come up with highly specific and selective peptide probes that can actually target these proteins through structures that were previously regarded as impenetrable. It's like trying to awaken a person in a deep sleep at the bottom of the ocean by poking him with a submarine. Despite a daunting challenge like this, the preliminary studies suggest that we may succeed. C3: Your project focuses on the Epstein-Barr virus (EBV). How can this common virus be useful in uncommon research? Yin: Although EVB affects more than 90 percent of humans and its infections are mostly benign, it can come into play in various types of lymphomas. We know EBV hijacks certain white blood cells and makes them cancerous, but we don't really know how it happens because we don't have a tool to probe the protein that regulates that virus's activities. When my colleague and peer Cancer Center member, Dr. Jennifer Martin, approached me to study this problem, we realized that this could provide an ideal model system to which we can use computationally designed probes. I had to say that this was a pretty wild idea as, to the best of our knowledge, no previous work has been done to target a complex integral membrane protein using externally derived agents. C3: How does your work combine protein engineering with chemistry and biochemistry? Yin: My lab currently has about 20 researchers with various backgrounds ranging from computational simulations, peptide and protein biochemistry, organic synthesis, molecular biology, to cell biology. For the LMP-1 project, we have been using an array of different techniques, including computational simulation, spectroscopies and organic synthesis to study cancer biology. With these powerful tools in hand, we can address daunting questions that were inaccessible previously. However, the integration process is by no means painless. Something intriguing and rational to a biochemist may seem absurd to a computer scientist and vice versa. However, the CU Cancer Center and Colorado Initiative in Molecular Biotechnology have done an excellent job to facilitate such collaborations as the leaders do have the vision and strong faith in multidisciplinary research. C3: You completed your doctorate at Yale and a post-doc fellowship at the University of Pennsylvania School of Medicine. What brought you to Colorado? Yin: I grew up in Beijing, which is a pretty overwhelming place. When I first came to visit Colorado, I fell in love with this peaceful land immediately. Then I had a chance to join the Colorado Initiative in Molecular Biotechnology and the Department of Chemistry and Biochemistry at CU. CIMB is a place with such exciting research and entrepreneurial tradition, and the Cancer Center offers a plethora of productive collaborations. The possibility for cutting-edge research is only limited by your imagination. A Conversation With Hang Yin, PhD: Assistant Professor of Chemistry and Biochemistry and a member of the Colorado Initiative in Molecular Biotechnology at the University of Colorado Boulder COLLABORATION Motherhood Mystery Cancer Center studies reveal link between pregnancy and breast cancer Story by Michele Conklin, Photos by Glenn Asakawa 4 | C3: SPRING 2011 | WWW.COLORADOCANCERCENTER.ORG COLLABORATION Megan Walbridge was too busy chasing after her 15-month-old toddler to give much thought to the lump under her arm. A quick call to her general practitioner to set up an appointment, then she was back at it--teaching Samuel baby sign language, helping him negotiate stairs, playing hide-and-go-seek and splashing in the sprinklers. "THE LAST THING ON MY MIND WAS BREAST CANCER," SHE SAYS. "I HAVE ABSOLUTELY NO FAMILY HISTORY, I WAS YOUNG AND STILL BREASTFEEDING AND I HAD REALLY TAKEN CARE OF MY HEALTH. I DIDN'T THINK I HAD TO WORRY ABOUT BREAST CANCER UNTIL I WAS 50 OR EVEN OLDER." Her doctors agreed. Most likely a breast infection, they said; let's keep an eye on it. The changes came fast. Within days a "cord" had developed that ran from the lump to her nipple. Her breast started swelling. Within three weeks, her breast had tripled in size, grown hot and hard, and had the texture of an orange peel. At 33, Walbridge was diagnosed with breast cancer. As if the diagnosis were not shocking enough, Walbridge soon learned that the greatest joy in her life--becoming a mother--had actually increased her chances of getting the disease. Pregnancy and breastfeeding have long been thought to reduce a woman's chance of getting breast cancer. But a research team at the University of Colorado Cancer Center is working to raise awareness that pregnancy actually increases the risk of breast cancer in women for up to 10 years or more after each pregnancy. This risk eventually goes away for women who have babies before they are 30, but it never quite disappears for the vast numbers of women who choose to have children in their 30s or 40s. About 25,000 women under the age of 45 will be diagnosed with breast cancer in the United States this year. Up to half of those women will have breast cancer associated with a pregnancy within the past six years. "We're talking about a vital component of American society," says Virginia Borges, MD, an oncologist at the CU Cancer Center who specializes in this area. "These are women with babies and young children at home. If we lose them, we lose a wife, a mother and a worker." Megan Walbridge discovered she had inflammatory breast cancer 15 months after her son Samuel was born. CREATING THE RIGHT ENVIRONMENT Borges has partnered with Pepper Schedin, PhD, researcher and professor of medical oncology at the University of Colorado School of Medicine, to better understand pregnancy-associated breast cancer (PABC). Schedin was the first to identify that the process involved in returning breasts to their normal state after pregnancy or breastfeeding creates an environment ripe for cancer promotion. During this process, called involution, the body uses wound healing mechanisms to kill milk-producing cells, similar to how the body removes damaged tissue after a cut. "Wound healing is a good process, but tumor cells happen to love wound-like environments," Schedin says. "This environment is not only more likely to grow tumors but also to cause metastases." Pregnancy-associated breast cancer can grow and spread more rapidly than breast cancer in women who have not had children. Some studies show that, on average, a woman diagnosed with breast cancer within two years of giving birth has a 40 percent 5-year survival rate, compared with a 70 percent rate in a woman who has not had a child prior to diagnosis. "None of this is to say women shouldn't get pregnant," says Borges, an associate professor of medical oncology at the CU School of Medicine, and mother of two young sons. "Having children is a good thing. The point we would like to make is that care providers need to have this on their radar screens, and women need to be self advocates." WWW.COLORADOCANCERCENTER.ORG | C3: SPRING 2011 | 5 COLLABORATION Pepper Schedin, PhD, and Virginia Borges, MD, MMSc, have partnered to better understand pregnancy-associated breast cancer. Borges and Schedin are as warm as their first names, Ginger and Pepper, suggest. Their passion for helping young women with breast cancer led them five years ago to open the Young Women's Breast Cancer Translational Program at the CU Cancer Center. The team there specializes in the diagnosis, treatment and research of breast cancer in women under the age of 40 with a special emphasis in pregnancy associated breast cancer. Today, the program treats about 100 young women annually. I've lived a very healthy lifestyle all my life, eating organic food and hormone-free meats and dairy. I assumed I was doing everything right, so why worry." Megan underwent six rounds of chemotherapy treatment over the following 18 weeks. "They hit me with the toughest drugs they had," she says. Her last round of chemotherapy was on Dec. 2, 2011, and she had a bilateral mastectomy on Dec. 30. Six weeks of daily radiation followed. "We were in battle mode for seven months, just trying to survive and raise our son. Now it feels a little strange, kind of surreal to have it over," she says. DIFFICULT DIAGNOSIS On the day Megan Walbridge was diagnosed with Stage 3 inflammatory breast cancer, her surgeon, Rebecca Wiebe, MD, of Exempla Lutheran Medical Center, referred her to the CU program. Walbridge was seen the following day and started chemotherapy the next morning. Walbridge started treatment just 24 days after first feeling the lump under her arm. Although the journey seemed agonizingly slow and frustrating to her, many women are not diagnosed for months or even longer. This is because the chance of breast cancer in these women is so slim that it can be easily overlooked. Indeed, even prominent organizations including the American Cancer Society and the National Cancer Institute do not yet list pregnancy as a risk factor for breast cancer. "I feel very driven to tell my story because young women are not educated about this," Walbridge says. "I honestly believed I didn't have to worry about breast cancer since I don't have a family history and LONG-TERM RISK While being pregnant raises the risk of breast cancer for all women, the risk is lower for younger women. Having a baby before age 30 increases the risk of breast cancer by 10 percent (and the risk to all women under 30 is extremely low already). That increased risk disappears over time and pregnancy eventually helps protect these women from breast cancer later in life. The trend in the United States of women having babies when they are older increases the likelihood of more cases of pregnancy-associated breast cancer. The risk increases 30 percent if the mother is over the age of 35, and that increased risk never fully goes away. 6 | C3: SPRING 2011 | WWW.COLORADOCANCERCENTER.ORG COLLABORATION "The probability of an individual woman getting breast cancer associated with her pregnancy is very low," Schedin explains. "But it's a low probability in a very big number of women. The sheer fact that five million women (per year in the US) are giving birth creates a societal problem." Schedin has become nationally renowned for the team's work on pregnancy-associated breast cancer. Her hypothesis that cancer is aided by the involution process is being tested by labs around the world and, so far, seems to be holding up. Last year, the team published a paper about the wound-healing effect in the American Journal of Pathology. In this study, they showed for the first time in humans that the natural processes of immune suppression and tissue inflammation during involution breeds cells that are friendly to cancer. They are now looking at whether anti-inflammatories such as fish oil, aspirin or ibuprofen can help the body's immune system fight this cancer-promoting effect. In a pre-clinical study that is pending publication, the team found that giving ibuprofen to mice for two weeks during the involution process reduced the incidence of breast cancer, tumor size and metastases to the same levels as in mice that had never been pregnant. PREGNANCY-ASSOCIATED BREAST CANCER: WHAT WE KNOW NOW � More than 12,000 women will be diagnosed with pregnancyassociated breast cancer this year in the United States � 1,000 women will die this year from pregnancy-associated breast cancer � Pregnancy increases a woman's risk of breast cancer, particularly in mothers over the age of 30, for up to 10 years or more after giving birth � If you're a woman who has given birth, you should: -- Understand that pregnancy is a risk factor for breast cancer -- Be aware of any changes in your breasts and contact your physician quickly, particularly if these changes occur after pregnancy or weaning -- Get a breast exam as part of your six-week post-partum visit -- Follow the American Cancer Society guidelines for mammography screenings: Annually beginning at age 40; women with a family history should begin screenings 10 years younger than the earliest age anyone in the family was diagnosed. (It is not recommended that women get screening mammograms earlier, as the technology is not proven effective at detecting cancer in these women.) HELPING YOUNG WOMEN The Young Women's Breast Cancer Translational Program at the University of Colorado Cancer Center was founded in 2005 by Virginia Borges, MD, and Pepper Schedin, PhD. It specializes in the treatment and prevention of breast cancer in women under the age of 40, with a special focus on pregnancy-associated breast cancer. The program provides comprehensive breast cancer treatment and survival support to more than 100 women each year. Services include breast imaging, minimally invasive diagnostic techniques, surgery, chemotherapy and radiation therapy. The program features a nurse navigator who helps patients manage consultations and treatments. The program offers an extensive array of clinical trials to patients at all stages of diagnosis and treatment, including the latest therapies for pregnant women to optimize the mother's outcome without endangering the developing baby. The Diane O'Connor Thompson Breast Center at University of Colorado Hospital, where the clinical program treats young women, also provides counsel and support for women through treatment and into survival. This clinic includes social workers trained in the unique challenges of young women's breast cancer, including support and resources for significant others and children. The program also instigates and participates in both basic and clinical research into the causes, treatment and prevention of breast cancer in young women as well as pregnancy-associated breast cancer. To learn more or provide support, please call 720-848-1030. "WE ONLY UNDERSTAND INVOLUTION AT A RUDIMENTARY LEVEL," SCHEDIN SAYS. "THIS WORK HIGHLIGHTS THAT WOUND HEALING IS A BAD PLAYER AND THAT WE MIGHT BE ABLE TO REDUCE THE CANCER-PROMOTING EFFECT OF THE POSTPARTUM PERIOD." Although a promising step, Borges and Schedin know they have years of work ahead of them to understand if the same effect can be achieved in women. They point to earlier studies of beta carotene and Vitamin E in lung cancer that were first thought to be cancer-fighting and were eventually shown to be cancer-promoting in some cases. "With cancer, we've been wrong many times before," Borges cautions. "What we can say absolutely is that pregnancy increases a woman's risk of breast cancer and that women and their physicians need to be aware of that increased risk and take any changes in the breast seriously." WWW.COLORADOCANCERCENTER.ORG | C3: SPRING 2011 | 7 CLINICAL CARE Reaching Rural Areas with the Best Cancer Care By Mary Lemma Twice a month for almost three years, Madeleine Kane, MD, has been catching a 6:30 a.m. flight from Centennial Airport near Denver to care for cancer patients at the San Luis Valley Regional Medical Center in Alamosa, about 220 miles southwest of the state capital. There she sees 15 to 20 patients, then dictates progress notes and writes chemotherapy orders before flying back to Denver almost ten hours later. Kane, professor of medical oncology at the University of Colorado School of Medicine, staffs two full-day medical oncology clinics a week at the University of Colorado Hospital Anschutz Cancer Pavilion. Every Thursday, she sees oncology patients at the Denver VA Medical Center, and every other Monday she sees HIV/AIDS-related cancer patients at the Infectious Diseases Clinic at UCH. She also travels to San Juan Cancer Center in Montrose to see cancer patients every couple of months, which she has been doing for nine years. Since 1985, the CU Cancer Center has provided consultations and direct patient care at partner sites across Colorado. Today, those sites include hospitals in Grand Junction, Alamosa, Glenwood Springs, Montrose and Vail/Edwards. The center employs a full-time coordinator to help with patient referrals to the center's main facility in Aurora for therapies those rural and mountain hospitals can't provide. For Kane, the rewards of rural outreach far outweigh a seemingly daunting schedule. "The most rewarding aspect of the work I do is probably the ability to educate patients and engage them in being part of a team in managing their cancer. This reduces their fear and anxiety," she says. Outreach to cancer patients in rural and mountain areas is critical because patients there don't have easy access to cancer care compared with patients in urban and suburban areas. At the university, Kane focuses on head and neck, GI and thyroid cancers, but rural outreach entails treating the full spectrum of cancers and blood disorders. Kane has been called "the optimistic oncologist," but that is not to say she wears rose-colored glasses. "I try to offer hope but am realistic," she says. "There are very few situations where the cancer isn't treatable even if it's not curable." Kane stresses there is more than one option for patients, and as the principal investigator on as many as 10 cancer clinical trials at a time, and co-investigator on 40 or more, she's a big proponent of bringing clinical research to rural sites. She oversees the Cancer Center's clinical trials program. "We think of our clinical trials as standard-ofcare options, and we're fortunate because the clinical research staff is very motivated and educated," she says. The San Luis Valley Regional Medical Center now can offer a level of care it was unable to provide as recently as 2008, when one oncology nurse did everything. Today the hospital has a dedicated cancer scheduler, a full-time patient navigator and an oncology clinic manager help patients connect with funding and support, which is vitally important in an area that is not well off, Kane explains. A stronger support system enabled one of Kane's patients, Maria Fernandez of Sanford (see profile on opposite page), to begin her chemotherapy in distant Salida, then complete it at the oncology infusion center in nearby Alamosa's San Luis Valley Regional Medical Center. Maria had been diagnosed with stage IV lymphoma, but "with lymphoma, that is not as bad a prognosis with the availability of newer drugs," Kane says. Her patient underwent intense chemotherapy and has been in remission since November. "I feel very privileged to go to outreach clinics and take the expertise of the CU Cancer Center to people in rural areas where this isn't available," Kane says. "People are gracious and grateful...it's really very rewarding." To learn more about care outside Denver, visit regionalnetwork.coloradocancercenter.org. Madeleine Kane, MD Specialty: Medical oncology and clinical trials Research interests: New therapies for cancer CLINICAL CARE MARIA FERNANDEZ Diagnosis: Lymphoma Physician: Dr. Madeleine Kane By Mary Lemma Feeling "Really, Really Good" and Resuming Routine Maria Fernandez thought her neck was just getting thick from weight gain, but her husband, Herman, sensed otherwise and insisted she see her health care provider to be sure the lymph nodes weren't involved. "My husband didn't want to dilly-dally," Maria recalls. "I think he was afraid that I just wouldn't get to it." But she did. Maria's doctor referred her to a specialist in Pueblo, who diagnosed her with lymphoma in April 2010. Lymphoma begins in the cells of the immune system and is classified as Hodgkin's's or non-Hodgkin's's. About 475,000 people in the United States are living with lymphoma or are in remission. Maria's lymphoma was non-Hodgkin's, the most common, and the specialist removed a lymph node "the size of a golf ball," Maria recalls. The doctor then referred Maria to Dr. Madeleine Kane, an oncologist at the University of Colorado Cancer Center (see profile on opposite page). Maria and her husband, a ranch hand in Alamosa, live in Sanford, a town of 800 about 20 miles south of Alamosa in Conejos County. Maria's first treatment was at a clinic in Salida, about 80 miles away, but an oncology care coordinator was able to "choreograph," as Maria puts it, the financial resources so she could see Dr. Kane at nearby San Luis Valley Regional Medical Center. Outreach in rural areas enables patients like Maria, who was born in Alamosa and has lived in the area for her 63 years, to get treatment close to home. "I was really apprehensive," Maria recalls, "and my instinct was to have a paper full of questions" from her family--two sons and daughters-in-law, and three grandchildren. "I was totally impressed with Dr. Kane because she answered almost all my questions before I even asked." Maria's first chemotherapy treatment produced an allergic reaction, "but Dr. Kane took care of it right away." Maria has been in remission since November, and Dr. Kane is optimistic about her prognosis. Maria has an appreciation of receiving good care because she's been on the giving end. After working as an aide at Alamosa Hospital, Maria went back to school at what was then Alamosa Vocational School to become a licensed practical nurse in 1987. For the next 17 years, she worked at a nursing home in Alamosa until retiring in 2005. "I really liked working with the elderly and hearing their stories of how it was for them when they were young and how things had changed," she says. Now that she's cancer free and feeling "really, really good," Maria is getting caught up on the household work she was too fatigued to keep up with when she was ill. She walks every day for 15 to 30 minutes and has returned to a creative activity she has enjoyed for 20 years: making beaded jewelry. Maria won't sell it, though, preferring to make gifts for family and friends. When she was first diagnosed, Maria had many offers of chicken soup from her community, a town where people can be as close-knit or as private as they wish. "I got a lot of support," she says, "but my husband wanted to make the soup. He was the most supportive of all." About Non-Hodgkin's Lymphoma Doctors seldom know why one person develops non-Hodgkin's lymphoma and another does not. But research shows that certain risk factors increase the chance that a person will develop this disease. In general, the risk factors for non-Hodgkin's lymphoma include the following: Weakened immune system: The risk of developing lymphoma may be increased by having a weakened immune system (such as from an inherited condition or certain drugs used after an organ transplant). Certain infections: Having certain types of infections, such as HIV and Epstein-Barr virus, increases the risk of developing lymphoma. However, lymphoma is not contagious. Age: Although non-Hodgkin's lymphoma can occur in young people, the chance of developing this disease goes up with age. Most people with non-Hodgkin's lymphoma are older than 60. Having one or more risk factors does not mean that a person will develop non-Hodgkin's lymphoma. Most people who have risk factors never develop cancer. Source: www.cancer.gov WWW.COLORADOCANCERCENTER.ORG | C3: SPRING 2011 | 9 COMMUNITY RAHOOL AND KUNTAL VORA Area Supported: Head and Neck Cancer Research By Lynn Clark BROTHERS LIVE DAD'S LEGACY: "DON'T TALK, TAKE ACTION." Naren Vora thought golf was a dumb game. But if he could experience the good his sons, Rahool and Kuntal, have done with a golf tournament, he might change his mind. By June, the Naren A. Vora Memorial Golf Tournament will have raised more than $50,000 for head and neck cancer research at the University of Colorado Cancer Center in just three years. The Vora brothers are not satisfied with that number and have just made a pledge to raise $100,000 for the center's burgeoning research program in memory of their father, a man whose mantra throughout their lives was "Don't talk, take action." Naren immigrated from India in 1967 to attend the University of Northern Colorado. He earned a master's degree in education, and in 1977 started a photography and video services company. "He became successful to the point he wanted to be," Rahool says. "He wanted to provide well for his family but have freedom. He was a kind, gentle spirit." Naren was diagnosed with head and neck cancer in 2005. He came to the CU Cancer Center in 2007 to be treated by radiation oncologist David Raben, MD. "Once we met with Dr. Raben, my dad, my brother and I came to the consensus that he was someone my dad should have seen at the beginning of the process," Rahool says. "We wound up losing our dad in September 2007. We believe that, had he been treated at the Cancer Center from the beginning, he would probably still be alive." Head and neck cancer--tumors that originate in the mouth or throat--is a devastating disease, leaving many of its victims disfigured and unable to taste. While diagnosis is declining in older men who are heavy drinkers and smokers, it is rising in men ages 30 to 45 due to infection with carcinogenic versions of the human papilloma virus. About 25,800 Americans will be diagnosed with the disease this year and about 5,300 will die from it, according to the American Cancer Society. on donations for prizes and paying operational costs out of their own pockets for the first two years. Now they're partnering with AMC Cancer Fund, the Cancer Center's grassroots fundraising partner, to put on the tournament. Proceeds from the first year went to a different organization. But Raben came to the tournament and spoke to attendees about what he and his collaborators at CU hoped to accomplish. That day, the Voras decided to make the CU Cancer Center the event's beneficiary. "Our initial commitment was $10,000, and we more than fulfilled that so we made a larger commitment," Rahool says. "We've tried to fashion something in the spirit of our dad. He wasn't a golfer, but we knew he'd want us to take action. We have done that, taking a personal tragedy and turning it into something positive." He says he hopes their fundraising efforts will help CU researchers develop treatments that can enhance quality of life, "but certainly the brass ring is a cure. It seems like one of those nebulous ideas, but when you're around the folks at the CU Cancer Center, it feels like it's within reach." Kuntal says it's hard not to feel a sense of pride every time he walks into the research buildings on the Anschutz Medical Campus. "We know regardless of the size of the monetary commitment, big things are going to come out of it," he says. "Dr. Wang once told us that we are sending a message that not only millionaires can make a difference." "Dr. Wang once told us that we are sending a message that not only millionaires can make a difference." The CU Cancer Center's head and neck cancer research and care program is on the leading edge of understanding the disease and rocketing treatment into the 21st century with targeted therapies. In 2008, the center recruited one of the world's foremost basic scientists in head and neck cancer, Xiao-Jing Wang, MD. In 2010, Antonio Jimeno, MD, PhD, launched the nation's first cancer stemcell clinical trials program with an early-phase trial of a drug that targets head and neck cancer. The Voras' fundraising made that work was made possible by a new tissue bank. "The Cancer Center is making good use of the money we've raised," Kuntal says. "They are going down very innovative paths for this disease. We have one of the best-kept secrets right in our own back yard. You look at the collection of talent they've collected, you look at the passion of these doctors, and that in and of itself serves as motivation to support them." Special events are notoriously difficult fundraisers, with operational costs often eating up profit. The Vora tournament started small, with a few dozen friends and family members. The brothers minimized costs, relying heavily 2011 Naren A. Vora Memorial Golf Tournament June 11, Raccoon Creek Golf Course Register at http://www.amc.org/events.html 10 | C3: SPRING 2011 | WWW.COLORADOCANCERCENTER.ORG COMMUNITY NEWS Cocktails for a Cure raises $145k for young women's breast cancer research More than 150 women braved February cold and slush to support breast cancer research at Cocktails for a Cure, raising $145,000 for breast cancer research along the way. Hosted by the AMC Cancer Fund, the University of Colorado Cancer Center's grassroots fundraising partner, Cocktails for a Cure annual women's event was an energetic evening of networking and socializing. Guests enjoyed music by Denver jazz trio Key of 3 in a candlelit venue splashed with pink and lime green while they nibbled on appetizers and cupcakes and sipped on signature cocktails created exclusively for the event. But it wasn't just about the cocktails--over $145,000 was raised to support the Young Women's Breast Cancer Translational Program, led by Dr. Virginia Borges and Dr. Pepper Schedin, at the CU Cancer Center. Co-chairs Kathy Odle Kortz and Stacy Carpenter led a steering committee of fantastic women who, along with honorary chairs Sue Allon, Keri Christiansen, Laura Dear and Bertha Lynn, were instrumental in the event's success. Carpenter's participation was especially significant as she recently completed treatment after being diagnosed with breast cancer in her seventh month of pregnancy with her first child. Carpenter spoke of her October 2009 diagnosis at the event, and about how much the Young Women's Breast Cancer Translational Program meant to her. Her journey inspired an anonymous donor to pledge a match of $50,000 for funds raised at Cocktails for a Cure. 160 go "Behind the Curtain" for Prostate Cancer The University of Colorado Hospital Foundation's inaugural girls-only event, Behind the Curtain, was envisioned by Denver businesswoman and philanthropist Sharon Magness Blake as a way to mobilize women against a disease they don't get--prostate cancer--and men don't nearly do enough to publicize. Last fall, 160 women and two men, UCH president Bruce Schroffel and University of Colorado Cancer Center director Dan Theodorescu, MD, PhD, enjoyed an evening of fun, entertainment and education at Invesco Field at Mile High. The event raised $35,000 for the Anschutz Cancer Pavilion expansion project. The 2011 event will be held on Tues., Sept. 20 at the Seawell Grand Ballroom at the Denver Center for Performing Arts. It will raise funds for University of Colorado Hospital's prostate cancer initiatives, with speaker Elaine Lam, MD, and entertainment from Girls Only. Call 720-848-7802 or visit www.behindthecurtaindenver.com to register. Macy receives $100k Hyundai Hope on Wheels Grant Hyundai Hope on Wheels, a program that supports children's cancer initiatives, presented a $100,000 Hope Grant to CU Cancer Center researcher Margaret Macy, a pediatric cancer physician and researcher at The Children's Hospital. Macy, assistant professor of hematology/oncology at the CU medical school, works with Children's Experimental Therapeutics Program. "This grant will help us offer new and cutting-edge treatments available to the children with cancer who need it the most," Macy said. While more than 80 percent of children with cancer are cured, certain high-risk tumors do not respond well to traditional treatments. Experimental therapeutics offer new treatments through early-phase clinical trials to patients with these high-risk cancers, treatments which are effective up to 40 percent of the time. Macy will use the Hope Grant to help Children's expand the program infrastructure and treat more children with high-risk cancers, particularly those with brain tumors. Children's Experimental Therapeutics Program currently runs 15 early-phase clinical trials in collaboration with the CU Cancer Center. Summer Events Benefit Cancer Center 5/21 6/25 8/1 8/21 Gift of Life and Breath 5K, Anschutz Medical Campus Undy 5000, Denver City Park Denver Golfers Against Cancer Tournament, Raccoon Creek Echelon Grand Fondo/Fort Collins Cycling Festival, Fort Collins VIEW EVENT DETAILS AT COLORADOCANCERCENTER.ORG AND CLICK EVENTS. WWW.COLORADOCANCERCENTER.ORG | C3: SPRING 2011 | 11 SPRING 2011 www.coloradocancercenter.org University of Colorado Denver 13001 East 17th Place, MSF434 Aurora, CO 80045-0511 RETURN SERVICE REQUESTED C3: Collaborating to Conquer Cancer Published three times a year by University of Colorado Denver for friends, members and the community of the University of Colorado Cancer Center. (No research money has been used for this publication.) Editor: Lynn G. Clark / 303-724-3160, Lynn.Clark@ucdenver.edu Contributing Writers: Mary Lemma, Michele Conklin Photos: Lynn Clark, Glenn Asakawa and Eunice Brownlee Design: Ebb+Flow Design The University of Colorado Cancer Center is Colorado's only National Cancer Institute-designated comprehensive cancer center. Headquartered on the University of Colorado Denver Anschutz Medical Campus in Aurora, The CU Cancer Center is a consortium of three universities and five institutions that are dedicated to cancer care, research, education and prevention and control. The CU Cancer Center Consortium Members Universities Colorado State University University of Colorado Boulder University of Colorado Denver Institutions University of Colorado Hospital The Children's Hospital National Jewish Health Denver Health Medical Center Denver Veterans Affairs Medical Center Kaiser Permanente Colorado Visit us on the web: www.coloradocancercenter.org The CU Cancer Center is dedicated to equal opportunity and access in all aspects of employment and patient care. Non-profit organization U.S. POSTAGE PAID Denver, CO Permit No. 831 THE MESSAGE: Dan Theodorescu, MD, PhD A Unique Tapestry of Scientific and Clinical Expertise found only in Colorado In 1985, under the leadership of Paul Bunn Jr. MD, we began developing a statewide consortium cancer center called the University of Colorado Cancer Center. Nearly all cancer centers are designed around one university and one hospital. But early leaders saw that Colorado is different, and unlike coastal cities where scientific and clinical talent are compacted into a small geographic area, our best resources lie around our beautiful state. Today the CU Cancer Center is one of just a few National Cancer Institute-designated comprehensive cancer centers designated as a consortium. As of December 2010, we have nine institutional members, including the newest: Kaiser Permanente Colorado (see related article on page 2). Our consortium also is different from the others, because it includes three major public universities: University of Colorado Denver, University of Colorado Boulder and Colorado State University. Our members take care of patients and offer cancer clinical trials at five hospitals: University of Colorado Hospital, The Children's Hospital, Denver Health, Denver VA Medical Center, and most recently, National Jewish Health, which added a lung cancer clinical program in 2010. They take care of adults, children and even pets with cancer. The CU Cancer Center unifies the Colorado's basic, translational and clinical cancer research effort to benefit all of our state's citizens. Our membership includes nearly every National Institutes of Healthfunded researcher in Colorado. And our members bring about $139 million in research dollars into the state each year--it's a sizeable economic impact. Our consortium makes cancer research in Colorado more collaborative. In other states, where cancer centers may be practically across the street from one another, there may be more competition. But because nearly everyone doing cancer research in Colorado is a member of our center, they tend to work together. We have shared resources--laboratories that focus on a specific kind of experiment or service, which would be out of reach of most individual investigators--on the University of Colorado Anschutz Medical Campus, at CU Boulder, at CSU and at National Jewish Health. We run clinical trials at all of our member hospitals through our Clinical Investigations shared resource, which allows us to be more organized and efficient, and therefore enroll more patients. We're getting better at bringing our researchers together so they know who is working on what. Last spring, we held the first center-wide scientific meeting, and our programs and shared resources also offer meetings and presentations to help members find out about new and ongoing projects. We even created a new leadership position--Senior Associate Director of Translational and Collaborative Research--to improve and accelerate scientific collaborations across the state. Gail Eckhardt, MD, now holds that position. We're also working on a web solution for researchers that will allow them to find collaborators, equipment and research supplies already in the system. As a whole, the CU Cancer Center consortium has served as a model for other organizations. The Colorado School of Public Health, established in 2008, grew out of our model of bringing multiple universities together. The powerful Colorado Clinical and Translational Science Institute, funded by NIH in 2008, is built on our structure of shared resources and a goal of creating an integrated academic home for clinical and translational science. What's more, we have strong partnerships with both of these organizations, which strengthens us all. Each of our consortium members is excellent on its own. The CSU Animal Cancer Center is considered to be the best animal cancer center in the world. National Jewish Health is consistently ranked by US News and World Report as the nation's top respiratory hospital. The CU School of Medicine--academic home to many of our members--is ranked sixth among public medical schools. And yet together, our organizations weave a unique and synergistic tapestry of scientific and clinical expertise that's found nowhere else in the country.