Cancer Update April 2010

Issue No. 21 / April 2010

In this issue Darcy Burbage receives top nursing society award

Medical Genetics program points to the future of medicine

New partnerships speed discovery research

New colorectal cancer program spotlights world-class cancer care

Trial of new lung cancer screening could advance early detection Brother and sister recognized for their fundraising efforts

cancer update Helen F. Graham Cancer Center leadership reduces cancer in Delaware Through research, evidence-based practice and community outreach, Christiana Care’s Helen F. Graham Cancer Center plays a leading role in Delaware’s rapidly declining cancer incidence and mortality rates.

Formerly first in the nation for cancer incidence and mortality, Delaware now ranks number eight in cancer incidence and 11th in cancer mortality. Rates for cancer mortality in Delaware are dropping faster than anywhere else in the country, at twice the national rate.

Reducing cancer health disparities National Cancer Institute Web site features Helen F. Graham Cancer Center

(L-R) Nicholas J. Petrelli, M.D., William Bowser, Esq., chair of the Advisory Council of the Delaware Cancer Consortium, and Stephen Grubbs, M.D., before a March meeting of the consortium. Not present in the photo is James Spellman, M.D., from Beebe Hospital, Tunnel Cancer Center.

Disparities in incidence and mortality rates between white and African American Delawareans are disappearing, thanks in part to joint programs such as Screening for Life. No disparity in colorectal screening existed between African Americans and Caucasians in 2008. And cancer incidence rates among African Americans are dropping three times faster than among whites. (continued on next page)

Rates for cancer mortality in Delaware are dropping faster than anywhere else in the country, at

twice the national rate.

(continued from previous page)

Helen F. Graham Cancer Center leadership reduces cancer in Delaware At the Helen F. Graham Cancer Center:

62%

of cancer patients in Delaware receive their care.

Undergirding the Graham Center’s work is participation as one of only 16 sites in the National Cancer Institute’s (NCI) Community Cancer Centers Program.

Because community hospitals treat 85 percent of cancer patients, the program enhances community-based cancer care by: • Increasing the number of patients (particularly minorities) in clinical trials.

• Collecting, storing and sharing tissue and blood samples for cancer research.

• Developing a national database of medical records through NCI’s Cancer Biomedical Informatics Grid (caBIG).

The Center for Translational Cancer Research, a collaboration with the University of Delaware and Nemours/A.I. duPont Hospital for Children, engages in vital biomarker and stem cell research. Founded in 2003, the Tissue Procurement Center (TPC) has more than a thousand specimens and a corresponding patient database on NCI’s caBIG. Because of the TPC, the Graham Center received a $4.6 million grant to participate in the NCI Cancer Genome Atlas Project.

Genetic counseling and gene testing

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• Following a multidisciplinary team approach to cancer care.

research studies on preventing and treating cancer.

• Decreasing cancer health disparities.

The Graham Center runs genetic counseling and gene testing programs throughout the state—offering, as needed, prophylactic surgery, chemoprevention and increased surveillance to people with gene alterations.

Research

Multidisciplinary disease site centers

“Ninety percent of the progress in cancer care and research results from clinical trials sponsored by the National Cancer Institute,” says Nicholas J. Petrelli, M.D., Bank of America endowed medical director of the Helen F. Graham Cancer Center. “Our patient accrual rate into clinical trials is nearly seven times the national average— 26 percent, compared to the national rate of 4 percent.”

Giving new meaning to treating the whole person, the Graham Center has established 16 multidisciplinary centers— from disease-focused ones such as the Hepatobiliary-Pancreatic and Head and Neck centers to ones focused on quality of life, such as the Wellness and Survivorship centers. As part of the team, nurse navigators guide patients through the labyrinth of cancer care, helping with everything from scheduling to transportation. The centers coordinate support services—nutrition counseling, social services, psychology and palliative and pastoral care—and promote positive communication both among physicians and between physicians and their patients and families.

$4.6

million grant to participate in the NCI Cancer Genome Atlas Project.

16

multidisciplinary centers focusing on treatment and quality of life.

Under the leadership of Principal Investigator Stephen S. Grubbs, M.D., the NCI Community Clinical Oncology Program (CCOP) at Christiana Care is running more than 100 research studies on preventing and treating cancer. “CCOPs produce high-quality clinical research and are the vehicles that elevate community quality cancer care,” says Dr. Grubbs.

Dr. Petrelli credits the centers with increasing patient visits to the Graham Center from (continued on page 3)

“ Ninety percent of the progress in cancer care and research results from clinical trials sponsored by the National Cancer Institute.”

— Nicholas J. Petrelli, M.D. Bank of America endowed medical director of the Helen F. Graham Cancer Center

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about 60,000 in 2003 to more than 134,000 in 2009. That means more than 60 percent of all cancer patients in Delaware receive their care at the Graham Center, according to the Delaware Cancer Registry.

In 2009, the Helen F. Graham Cancer Center had 134,000 patient visits, which is more than double the 60,000 patient visits recorded in 2003.

134,000 135,000

Community outreach Without engaging participants in their own health care, the most cutting-edge research and innovative practices will not change the health of communities.

Christiana Care is highly successful in educating communities about the importance of prevention and early intervention.

In churches and community centers, at festivals and health fairs— as they test blood pressure and cholesterol levels and give flu shots, members of the Graham Center Outreach team talk with people and build relationships with such community groups as the African American Warriors Against Prostate Cancer, who then take the message to their communities.

Solving the relentless problem of health disparities has commanded the attention and dollars of major health care foundations and government agencies for two decades. Yet, the disparities remain virtually unchanged—except in Delaware. Christiana Care’s Helen F. Graham Cancer Center is leading the way in cancer prevention, treatment and research. z

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Darcy Burbage receives top nursing society award Darcy Burbage, RN, MSN, AOCN, CBCN, clinical nurse specialist at the Christiana Care Breast Center at the Helen F. Graham Cancer Center, is the 2010 recipient of the Pearl Moore Making a Difference Award from the Oncology Nursing Society (ONS).

ONS is a national professional organization of 37,000 registered nurses and other health care professionals committed to excellence in oncology nursing. The award is named for Pearl Moore, a charter member of ONS who served as CEO for more than 25 years.

The award recognizes Burbage’s significant contributions to the oncology nursing profession at the local and regional levels. She is recognized for her many performance improvement projects that have enhanced the quality of care of patients with breast

cancer, and for being a wellrespected leader and mentor.

“To have been selected to Darcy Burbage, RN, MSN, receive this award named AOCN, CBCN after a pioneer in the field of oncology nursing is an honor,” says Burbage. “It is a testament to the many talented nurses, physicians, managers and support staff who have mentored me throughout my career, as well as to the patients who allowed me into their lives.” z Cancer Update 3

Bruce Boman, M.D., right, works in the Center for Translational Cancer Research with post-doctoral fellow Lynn M. Opdenaker.

Medical Genetics program points to the future of medicine Building on scientific advances, Christiana Care’s new Medical Genetics program is transforming the diagnosis, treatment and prevention of many diseases.

The program encompasses pediatrics, maternal-fetal medicine, cardiology and cancer, leading us to the cutting edge of research and treatment. One goal is to develop an infrastructure to diagnose inherited disorders while tailoring treatments based on a patient’s unique genetic profile. The program provides full clinical genetic services in Delaware.

Until now, adults in need of genetic testing traveled to Philadelphia or Baltimore.

“The future of medicine is genetics,” says Bruce Boman, M.D., Ph.D., director of Cancer Genetics and Stem Cell Biology at the Helen F. Graham Cancer Center.

“Many diseases have genetic components.”

All cancers result from genetic changes in cells. In about 5 to 10 percent, including breast, ovarian, colorectal, pancreatic and prostate cancers, as well as melanoma, the

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genetic changes are inherited from one or both parents.

“When we know about a person’s risk factors, we can tailor prevention strategies to help lessen the likelihood that cancer will develop,” says Zohra Ali-Khan Catts, MS, CGC, director of Cancer Genetic Counseling. “We can screen to catch cancer early, when it is most curable.”

Zohra Ali-Khan Catts, MS, CGC

Researchers are discovering genetic links to many more conditions and will learn much more through a collaboration between the Center for Heart & Vascular Health and the Helen F. Graham Cancer Center. “We will have a combined database, which offers unparalleled opportunities for research,” says William Weintraub, M.D., FACC, John H. Ammon Chair of Cardiology and director of the Christiana Center for Outcomes Research. z

William Weintraub, M.D., FACC

New partnerships to speed discovery research UD health sciences dean shares her vision The Helen F. Graham Cancer Center at Christiana Care plays a key role in the Delaware Health Sciences Alliance by being focused not only on finding innovative treatments for cancer, but also on getting them to patients sooner.

Other partners in the Alliance are the University of Delaware (UD), Nemours/A.I. duPont Hospital for Children and Thomas Jefferson University. Leading the Alliance is UD’s new dean of the College of Health Sciences, Kathleen Matt, Ph.D. “One shared objective is to create more opportunities for interdisciplinary and translational cancer care,” Dr. Matt says. “One of my biggest goals is to draw upon our collective vision and expertise to shorten the pipeline between discovery and delivery, so that new knowledge can have an effect on people’s lives right now.”

A springboard for collaboration is the Center for Translational Cancer Research (CTCR) at the Helen F. Graham Cancer Center. The CTCR was the site of the first local coordinated effort to unite clinicians with researchers at UD’s Department of Biological Sciences to translate laboratory science more quickly into improved clinical tools for screening, preventing and treating cancer. Christiana Care’s Tissue Procurement Center provides human tissues for a variety of translational investigations.

“By bringing groups from various disciplines at the university to work together with clinicians at the

Kathleen S. Matt, Ph.D., DHSA executive director and dean, UD College of Health Sciences

Helen F. Graham Cancer Center, we can begin to develop integrated solutions to complex problems that surround the diagnosis, prevention and treatment of cancer, cancer recovery and quality of life,” Dr. Matt says.

Starting with transformational education programs that integrate various health professions for collaborative research, symposia and clinical opportunities, Dr. Matt’s vision of a continuum of cancer care extends well beyond her college framework, through the Alliance and to the community.

Comprehensive cancer care is the hallmark of the Helen F. Graham Cancer Center, with 16 distinct multidisciplinary disease centers, or MDCs. Dr. Matt’s own research interests as a neuroendocrinologist have prompted exploration of joint studies with Clinical Nurse Specialist Cindy Waddington, RN, MSN, AOCN, and the team at the Mind, Body and Spirit Wellness MDC into the physiological effects and benefits of holistic, or complementary, cancer treatments. z

“ Relationships we develop with our patients are unique and rewarding.

We may be their ‘bright spot’ on a dark and scary journey, but I am constantly in awe of their grace and kindness in the face of illness.”

—Laurie Konopka Patient physician access coordinator for the Oncology Pain and Symptom Management Practice

Cancer Update 5

New colorectal cancer program spotlights world-class cancer care The Helen F. Graham Cancer Center at Christiana Care is launching a new Colorectal Cancer program with an impressive list of colorectal cancer care services.

Project Leader Bruce Boman, M.D., Ph.D., Center for Translational Cancer Research (CTCR) director of Cancer Genetics and Stem Cell Biology, sees broader opportunities for translational and clinical research.

“The Colorectal “The Colorectal Cancer Cancer program program is an example of catalyzes the CTCR’s Christiana Care taking a ability to conduct leadership role to do more colon cancer stemto address this disease,” says cell research aimed Nicholas J. Petrelli, M.D., at finding curative Bank of America endowed treatments, while medical director of the Helen Bruce Boman, M.D., Ph.D. potentially doubling F. Graham Cancer Center. the number of active research proto“We offer a wealth of expertise cols through new collaborations and in colorectal cancer screening, increased accruals.” prevention, treatment and research.”

Dr. Boman is the institutional The new program will spur growth principal investigator for the and public awareness of the cornerAPTIUM GI Consortium, an elite stones of cancer care at the Helen F. group of institutions collaborating to Graham Cancer Center, with clinical/ accelerate research in gastrointestinal surgical expertise in colorectal cancer cancers. He also is the protocol chair prevention, diagnosis and treatment; for the upcoming NSABP national a tumor registry for research on colon cancer prevention trial. The hereditary cancers; a cancer genetics trial seeks to determine if Crestor®, program and high-risk family a cholesterol-lowering statin, can registry; and tissue procurement for prevent new colon tumors from translational research and the Cancer forming in patients who have had Genome Atlas Project. A unique colon cancer surgery. feature is the Rectal/Anal Cancer Multidisciplinary Center, offering the Key to the design and development of the Colorectal Cancer program latest research, treatment and management options for colorectal cancer. are the scientists in the CTCR, cancer genetics and high-risk family The new program also strengthens cancer registry, the Christiana Care our leadership role and widens Section of Colorectal Surgery, the opportunities for accruals to national Department of Pathology, the chemotherapy and radiation oncology Department of Medicine section clinical trials, including those of Gastroenterology & Medical sponsored by the National Surgical Oncology, the Department of Adjuvant Breast and Bowel Project Radiation Oncology, and Community (NSABP). Dr. Petrelli chairs the Outreach and Education. z NSABP’s Colorectal Committee.

The Colorectal Cancer program―the only one in Delaware and one of just a few in the region―offers patients the latest treatments and research benefits, and brings together cancer care experts at Christiana Care and area organizations.

“We offer a wealth of expertise in colorectal cancer screening, prevention, treatment and research.”

—Nicholas J. Petrelli, M.D. Bank of America endowed medical director of the Helen F. Graham Cancer Center

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Trial of new lung cancer screening could advance early detection Thomas Bauer, M.D.

Researchers at the Helen F. Graham Cancer Center taking part in a phase II and phase III clinical trial could help launch a potentially key diagnostic test for early stage lung cancer.

Christiana Care is recruiting lung cancer patients to the trial who are diagnosed but have not received any therapy to participate in the test, which uses a molecular marker that binds to cancer cells and fluoresces red under ultraviolet light.

“This trial has the potential to develop a useful alternative to invasive needle biopsy or bronchoscopy, which are currently used to establish the diagnosis of lung cancer,” says Thomas Bauer, M.D., principal investigator. “If accurate, this method could be used to diagnosis other cancers, too.”

Dr. Bauer, chief of Thoracic Surgery, has led several lung and esophageal cancer studies. For more information or referrals, call 302-623-4450. z

“This trial has the potential to develop a useful alternative to invasive needle biopsy or bronchoscopy, which are currently used to establish the diagnosis of lung cancer.”

—Thomas Bauer, M.D., chief of Thoracic Surgery, Helen F. Graham Cancer Center

Brother and sister recognized for fundraising on behalf of the Helen F. Graham Cancer Center Kids Kickin’ Cancer’s Alicia and Brandon Lewandowski won the 2009 Youth in Philanthropy Award from the Association of Fundraising Professionals. Their organization―founded in honor of their dad, who died of cancer at 37―has raised more than $84,000 for the Helen F. Graham Cancer Center through an annual 5K run/walk, golf and soccer tournaments, and other fundraising activities. z Brandon and Alicia Lewandowski celebrate with Gov. Jack Markell at the 2009 Philanthropy Day Awards at Deerfield Golf and Tennis Club.

Helen F. Graham Cancer Center expansion wins award The Helen F. Graham Cancer Center expansion won “Project of the Year, 2009” in the health care category from Mid-Atlantic Construction magazine. The award honors the finest examples of design and construction in Virginia, Maryland, Delaware, Pennsylvania and the District of Columbia. z Cancer Update 7

Non-Profit Org. US Postage

PAID Wilmington, DE Permit No. 357

P.O. Box 1668 Wilmington, Delaware 19899 www.christianacare.org

One of only 14 cancer centers in the nation selected for the National Cancer Institute Community Cancer Centers Program.

NCI site features Helen F. Graham Cancer Center Visit the National Cancer Institute’s Cancer Biomedical Informatics Grid (caBIG®) Web site for a video about Christiana Care’s Helen F. Graham Cancer Center. A member of NCI’s Community Cancer Center Program, Christiana Care uses caBIG’s vast information network, designed to promote knowledge and data sharing among the entire cancer community, to accelerate discovery and ultimately improve patient outcomes. z Find the site at http://cabig.cancer.gov/action/casestudies/ChristianaCare

Brenda Rabeno, operations management coordinator for The Cancer Genome Atlas Project and Rajiv Haravu, senior systems analyst in IT and project manager for caBIG applications, deployed the first caBIG application at Christiana Care, caTissue.

The application supports the daily operations of the tissue procurement lab.

8 Christiana Care Health System Christiana Care is a private not-for-profit regional health care system and relies in part on the generosity of individuals, foundations and corporations to fulfill its mission.

Cancer Update is produced by Christiana Care Health System. Entire publication © Christiana Care Health System, 2010. All rights reserved.

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