The University of Chicago Medicine
A PUBLICATION FOR PHYSICIANS
A future without seizures New hope for children and adults with severe, uncontrolled epilepsy
Inspired approach to treating stage 4 head and neck cancer without surgery Kidney-pancreas transplants expand options for patients with diabetes
Neuroblastoma team offers world-class expertise, latest therapies
The University of Chicago Medicine and Biological Sciences has been at the forefront of medical care, research and teaching for more than 90 years. Located in historic Hyde Park on the South Side of Chicago, the University of Chicago Medicine and Biological Sciences includes: Patient Care Bernard A. Mitchell Hospital (adult) Comer Children’s Hospital Duchossois Center for Advanced Medicine Numerous outpatient locations throughout the Chicago area
DEAR COLLEAGUES, This is an exciting time for the University of Chicago Medicine as we expand the horizons of health care and our own facilities. In June, we opened the University of Chicago Medicine Comprehensive Cancer Center at Silver Cross Hospital in New Lenox, Ill. The new outpatient diagnostic and treatment center brings University of Chicago Medicine cancer specialists and their advanced and investigational therapies into a community hospital setting. We will follow that expansion with another on our Hyde Park medical campus, where our new hospital opens in February. January. Like Theour 10-story, cancerstate-of-the-art center, the 10-story, facilitystate-of-the-art combines the latest facility technologies combines thewith latest innovative technologies architecture, with innovative an inspiring architecture, setting for an our inspiring physicians setting asfor they our physicians provide complex as theycare provide expertly complex and compassionately. care expertly and compassionately. Throughout this edition of Inspired, the strength of that care is made clear, as are our advances in the treatment of hypertension, epilepsy, head and neck cancer, pediatric neuroblastoma, and other complex and specialty cases. We are truly proud of the expansion taking place in our programs and facilities, and we’re equally excited about our expanding relationships with physicians in our community as well as research colleagues worldwide. We look forward to building on those now and in the future.
Teaching Programs Pritzker School of Medicine Master’s and doctoral degree programs Postdoctoral programs Research Medical and basic science units Among our many honors and acknowledgements: 12 Nobel laureates; ranked 10th of all U.S. medical schools; one of only 41 National Cancer Institutedesignated comprehensive cancer centers; ranked second in nation for National Institutes of Health grant support per researcher. University of Chicago Medicine and Biological Sciences Executive Leadership Kenneth S. Polonsky, MD, Dean of the University of Chicago Biological Sciences Division and the Pritzker School of Medicine, and executive vice president for Medical Affairs for the University of Chicago Sharon O’Keefe, president of the University of Chicago Medical Center Richard Baron, MD, dean for clinical practice and chair of the University of Chicago Medicine Department of Radiology T. Conrad Gilliam, PhD, dean for research and graduate education, Biological Sciences Division Holly J. Humphrey, MD, dean for medical education, Pritzker School of Medicine Inspired is published quarterly by the University of Chicago Medicine.
Kenneth S. Polonsky, MD Dean, Biological Sciences Division and the Pritzker School of Medicine Executive vice president for Medical Affairs for the University of Chicago
Editors: Anna Madrzyk Ginny Lee-Herrmann Email us at: email@example.com Design: Group Chicago Contributing writers: Jamie Bartosch, Tanya Cochran, Megan Doherty, Elizabeth Gardner, Darcy Lewis, Gretchen Rubin, Anita Slomski and Matt Wood
A Brand for the 'Forefront of Kids' Medicine'
The University of Chicago Medicine Comer Children’s Hospital introduces a new, updated logo, strengthening its connection to the University and re-emphasizing its place as the center for children’s specialized health care in Chicago.
Sign up for a CME program at our new hospital. — Back cover
Committed to care and compassion Medical student Laura Blinkhorn pulls weeds outside a senior housing complex during the University of Chicago Medicine’s 10th annual Day of Service and Reflection in May. Blinkhorn, a fourth-year student at the Pritzker School of Medicine, was among more than 200 volunteers during the Urban Health Initiative event, which fosters ties between the medical center and its South Side neighbors. “As a medical student, it’s important to know the community, where our patients come from,” Blinkhorn said.
Contributing photographers: David Christopher, Dianna Douglas, Dan Dry, Jean Lachat and Bruce Powell Address: The University of Chicago Medicine 5841 S. Maryland Ave. Chicago, IL 60637 The University of Chicago Medicine Comer Children’s Hospital 5721 S. Maryland Ave. Chicago, IL 60637 Physician Referral Line: 1-800-824-2282 Appointments: 1-888-824-0200 Follow the University of Chicago Medicine on Twitter at twitter.com/UChicagoMed or visit our Facebook page at facebook.com/UChicagoMed. You can read more about our news and research at uchospitals.edu/news and at sciencelife.uchospitals.edu. This publication does not provide medical advice or treatment suggestions. If you have medical problems or concerns, contact a physician who will determine your treatment. Do not delay seeking medical advice because of something you read here. For urgent needs, call 911 right away. Read Inspired online at uchospitals.edu/inspired.
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Hypertension center earns ‘comprehensive’ designation
Collaborative care for complex aortic disease
The American Society of Hypertension (ASH), the nation’s largest organization of hypertension specialists, has designated the University of Chicago Medicine as a Comprehensive Hypertension Center, the first in the country. This George Bakris, MD designation is the highest level of formal recognition for academic medical centers that demonstrate expertise in treating patients with complex hypertension and its comorbidities. The University of Chicago Medicine Comprehensive Hypertension Center is directed by George Bakris, MD, a nephrologist and board-certified ASH hypertension specialist. “The Comprehensive Hypertension Center designation distinguishes the University as a center of excellence for hypertensive diseases,” said Bakris, who also is the immediate past president of ASH. The center offers individualized care through inpatient and outpatient consultation to patients who have hypertension in addition to other health conditions, including early kidney disease, diabetes and high risk for heart attack or stroke. The center also is a national leader in hypertension research. Bakris is the national co-principal investigator of the Symplicity HTN-3 trial on refractory hypertension and principal investigator of the AMETHYST trial dealing with potassium management in people with kidney disease and hypertension. He is also on the steering committee of two other international kidney outcome trials.
T he University of Chicago Medicine aortic diseases program provides
multispecialty, state-of-the-art care for patients with complex aortic problems. “We feel we offer something very unique in the whole Midwest,” said vascular surgeon Ross Milner, MD, who co-directs the program with cardiac surgeon Mark Russo, MD, MSc. The team includes experts from several specialties — vascular and cardiac surgery, general and interventional radiology, anesthesia, imaging and nursing — working collaboratively to treat patients with aortic disease. The team offers leading-edge care, including minimally invasive and hybrid surgery, for aneurysms, dissections, congenital aortic diseases such as Marfan syndrome and other conditions. In February, the University of Chicago Medicine was the first hospital in Chicago to perform a transcatheter aortic valve replacement (TAVR) outside of a clinical trial setting. “This nonsurgical treatment clearly has been shown to provide improved survival and better quality of life for patients who are poor candidates for surgery and for whom no options previously existed,” Russo said. uchospitals.edu/specialties/ aortic
By the Numbers
pediatric cochlear implant surgery performed in spring 2012
Cordero Rice, 1, hears for the first time. The toddler, deaf since birth, was the recipient of the University of Chicago Medicine’s 100th pediatric cochlear implant surgery, performed by surgeon Dana L. Suskind, MD, left, and her team.
young physicians chosen for prestigious Bucksbaum Institute fellowships on enhancing the doctor-patient relationship
Monica Peek, MD, MPH, internal medicine specialist and a fellow of the new Bucksbaum Institute for Clinical Excellence, is studying whether removing racial and cultural obstacles in doctor-patient interactions will reduce health disparities among African Americans with diabetes and other chronic diseases.
Average number of clinical trials conducted at the University of Chicago Medicine each year
+ Educational Opportunities Register for CME events at cme.uchicago.edu.
Controversies in the Management of Complex GI Cancer Patients
All day, September 7 Ritz-Carlton Chicago 160 E. Pearson St., Chicago
University of Chicago Medicine Comprehensive Cancer Center at Silver Cross Hospital Inaugural Symposium
7:30 a.m. to 3:30 p.m., September 15 1850 Silver Cross Blvd., New Lenox, Ill.
Orthopedic surgeon specializes Chicago Breast Reconstruction in minimally invasive surgery Symposium All day, September 28 for sports injuries Ritz-Carlton Chicago 160 E. Pearson St., Chicago
Comprehensive Cancer Center at Silver Cross opens The new University of Chicago Medicine Comprehensive Cancer Center at Silver Cross Hospital brings University of Chicago cancer specialists and their advanced treatment programs to a convenient community setting. The $21.6 million, 20,000-square-foot outpatient cancer treatment center — a joint venture between the University of Chicago Medicine and Silver Cross — opened June 25 in New Lenox, Ill.
The University of Chicago Medicine Comprehensive Cancer Center at Silver Cross Hospital offers leading-edge treatments not typically available in a community hospital setting.
The cancer center offers state-of-the-art chemotherapy and radiation therapy and access to innovative clinical trials. Technology includes the TrueBeam next-generation linear accelerator, which delivers targeted radiation therapy to provide the safest and most precise treatments. TM
Other services include cancer screenings, patient support groups and a resource center. University of Chicago Medicine physicians will provide gynecologic oncology services at Silver Cross Hospital in conjunction with the center. ucmcancer-sch.org
Mark your calendar Advances in Treating Oral Cancers
Chicago, fall 2012
Advances in Kids’ Medicine
Chicago, fall 2012 and spring 2013 University of Chicago Medicine physicians are available to present in-office CME courses in greater Chicagoland and Northwest Indiana.
at the forefront of cancer care and discovery
For information, please contact Carrie Sota, firstname.lastname@example.org.
More than 350 cancer clinical trials
210 University of Chicago laboratory and clinical scientists studying cancer
The University of Chicago Medicine Physician Relations Program
92 presentations by University of
Chicago Medicine physicians at the recent American Society of Clinical Oncology (ASCO) conference
Please contact us by phone or email with any request. We are here to serve you. Physician Relations Program 1-773-234-2036
1of 41 National Cancer Institute-
Carol Marshall, Director 1-773-702-9205 email@example.com
designated Comprehensive Cancer Centers
Carrie Sota, Assistant Director Serving Northwest Indiana 1-773-892-2120 firstname.lastname@example.org
One floor of the 1.2-millionsquare-foot new hospital opening in early 2013 devoted to cancer care
Anthony Turner, Associate Serving the South and Southwest Suburbs 1-773-729-0822 email@example.com Demetria Avant, Associate Serving the Western Suburbs 1-773-717-0458 firstname.lastname@example.org
1of 11 National Cancer Institute Breast Cancer Specialized Programs of Research Excellence (SPOREs) in the United States
Dionne Meekins-Michaud, Associate Serving all regions for Pediatrics 1-773-717-0457 email@example.com
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RESEARCH NEWS The buzz on beehive extract An over-the-counter natural remedy derived from beehives arrests the growth of prostate cancer cells and tumors in mice, according to a new study. The active ingredient in honeybee hive propolis shuts down tumor cells’ system for detecting sources of nutrition, University of Chicago Medicine researchers found. “So it doesn’t kill the cancer, but it basically will indefinitely indefinitelystop stop prostate prostatecancer cancer proliferation,” proliferation,”said said genomics genomicsresearcher Richard researcher Baker Richard Jones, PhD, Bakersenior Jones,author PhD, senior of the study authorinofCancer the study Prevention in Cancer Research. Prevention Research. The innovative The innovative protein-onomics protein-onomics technique technique the team developed the team developed may be used may to be study used to study the mechanisms the mechanisms of other of promising other promising natural natural remediesremedies that previously that previously would have would been have been too expensive too expensive to test.to test.
Nicolle Rager, National Science Foundation
‘Top-down’ treatment for Crohn’s A large-scale study of medical claims data shows that introducing sophisticated biologic therapies early improves Crohn’s disease outcomes. Traditional treatment focuses on a “step-up” strategy, starting with such simpler and cheaper medications as 5-ASAs and corticosteroids and ramping up to targeted biologic therapies. But patients treated with a “top-down” approach that reverses that order were less likely to need steroids, lose response to their biologic therapy and require surgery. “We’re essentially reversing the management strategy in Crohn’s disease,” said David T. Rubin, MD, co-director of the University of Chicago Medicine’s Inflammatory Bowel Disease Center. New target for cancer therapy Manipulation of two biochemical signals that regulate the numbers of mitochondria in cells could shrink human lung cancers transplanted into mice, researchers from two Chicago medical centers reported in FASEB. “We found that human lung cancer cell lines have an imbalance of signals that tilts them toward mitochondrial fission. Lung tumors from patients here at the University of Chicago displayed these same mitochondrial
abnormalities (excess DRP-1, deficient mitofusin-2), an important sign that this observation may be clinically relevant,” said Stephen L. Archer, MD, lead author from the University of Chicago Medicine. Boosting Boostingthe the fusion signal or blocking the fission signal through various methods, including gene therapy, caused tumors to shrink drastically. “We believe this provides a promising new approach to cancer treatment,” Archer said. Take 115 tablets… Providing tablet computers to medical residents increases their efficiency, reduces delays in patient care and enhances continuity of care, according to a report from the University of Chicago Medicine in the Archives of Internal Medicine. In November 2010, the medical center was the first in the country to provide residents with tablet computers on a large scale, supplying iPads to all 115 internal medicine residents. Surveyed in 2011, more than three out of four residents said the portable computers freed them up them to spend up to spend more time moreon time direct on direct patient care. patient Thecare. study Thealso showed study also residents showed using residents tablets using submitted tablets submitted 5 percent 5 percent more orders morebefore orders7before a.m. rounds, 7 a.m. rounds, and 8 percent and 8 percent more orders more orders before hand-offs. before hand-offs. More food, fewer pills An unusual clinical trial at the University of Chicago Medicine is studying whether a drug for advanced prostate cancer might be just as safe and effective, but more convenient and less expensive, if taken at a much lower dose with food. GI absorption of Zytiga (abiraterone acetate) is more affected by food than any other marketed drug labeled to be taken on an empty stomach. Five times as much of the drug is taken up with a low-fat meal; up to 10 times as much with a high-fat meal. “Taking one pill with a meal, rather than four pills on an empty stomach, is much more convenient for patients, so it may improve compliance,” said Russell Szmulewitz, MD, director of the study. The The recommen results could affect future dosage recommendations, potentially saving patients thousands of dollars a month. Read more at uchospitals.edu/news.
< Meet Our Faculty >
Mitchell C. Posner, MD, is chief of general surgery and surgical oncology and medical director of clinical cancer programs at the University of Chicago Medicine. He is an internationally recognized expert on upper gastrointestinal cancers, including pancreatic, esophageal, stomach and liver cancer. Posner is chairman of the Gastrointestinal Committee of the American College of Surgeons Oncology Group, the only national, surgically focused cooperative dedicated to oncology clinical trials. What are your goals as director of clinical cancer programs at the University of Chicago Medicine? Providing easy access to what is rated as the No. 1 cancer center in Chicago and one of the leading cancer centers in the country, communicating with referring physicians in a more standardized fashion and offering an ideal patient experience. How quickly will a new patient of the GI cancer program be seen? We strive to see patients within a week of their initial call, and I think we’re very good at that. Our new goal is to schedule a visit within three days. We have a dedicated intake team that coordinates appropriate appointments with medical oncology, surgical oncology, gastroenterology and radiation oncology. They are experienced, knowledgeable and able to navigate patients in a very seamless way through a complex process. Are there any promising treatments for pancreatic cancer? Clearly we’ve moved the needle. The ability to deliver chemotherapy regimens that have more activity than regimens we used even a couple of years ago is significant. Most importantly, it’s well known that surgeons and hospitals with high volumes have better outcomes. From a surgical perspective, since surgery is still the only curative treatment, our ability to do these procedures with lower morbidity and very low mortality is compelling for both patients and care providers. What inspires you about the University of Chicago Medicine? Great people in a great setting that has the perfect balance of research, clinical excellence and the training of the next generation of both academic and clinical leaders. That’s our mission. That’s what inspires me.
Stopping Nathanâ€™s seizures Epilepsy program provides definitive diagnoses, multidisciplinary care for children and adults
Michael Kohrman, MD, and Nathan Kalina
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ive-year-old Nathan Kalina is a “miracle child,” says his mother, Megan. Diagnosed with myoclonic-astatic epilepsy (Doose syndrome) at age 3, Nathan suffered dozens of seizures a day, of four different varieties. A multipledrug regimen kept his seizures only partially controlled while burdening the preschooler with side effects, including insomnia and attention deficits. At a friend’s suggestion, the Naperville, Ill., family contacted Michael Kohrman, MD, director of the Pediatric Epilepsy Center at the University of Chicago Medicine Comer Children’s Hospital. Kohrman recommended implantation of a vagus nerve stimulator and had Nathan evaluated for surgery. Pediatric neurosurgeon Leila Khorasani, MD, implanted the VNS at the beginning of April 2011, and by the end of the month Nathan was seizure free. The VNS delivers tiny electrical impulses to the brain via the vagus nerve every 5 minutes. In addition, the Kalinas also have a special magnet to induce extra electrical impulses to stop a seizure. Nathan still takes antiseizure drugs, but the Kalinas are cautiously starting to wean him off some of them. “He’s completely recovered and suffered no long-term damage,” Megan says. “His milestones have caught up, he’s growing like a weed, and we can breathe again.” Kohrman has been able to help many children who have tried two or more drugs and haven’t achieved seizure control. He estimates that 5,000 children in the Chicago area could benefit from surgical treatment for their seizures, but only about 100 per year receive such treatment. “Ultimately our goal is no seizures and no side effects,” Kohrman said. The University of Chicago Medicine offers advanced, seamless epilepsy care for patients of all ages. The pediatric and adult epilepsy programs are accredited as Level 4 epilepsy centers — the highest rating available — from the National Association of Epilepsy Centers. Our multispecialty team excels at providing
patients with a definitive diagnosis and uses sophisticated evaluation techniques to optimize both surgery and drug treatments. Adult and pediatric epilepsy care is offered on the main University of Chicago Medicine campus in Hyde Park. In addition, pediatric epilepsy experts see patients at offices in Elmhurst, Ill., Hinsdale, Ill., Naperville, Ill., Palos Heights, Ill., and Merrillville, Ind. While Nathan’s response to VNS is atypically good, Kohrman says the University of Chicago Medicine has better than average success rates with this procedure and others because of its expertise in identifying patients likely to benefit from a given treatment strategy. The vast majority of the program’s surgical patients see their seizure activity drop at least 60 to 75 percent, said David M. Frim, MD, PhD, chief of neurosurgery. Frim, who treats children and adults, says the University of Chicago Medicine epilepsy program’s strengths include: Teamwork. “We are a truly integrated program, between adult and pediatric epileptologists, neurosurgeons, neuroradiologists, neurophysiologists, and nurse specialists. The best part of the program is the interdisciplinary conference where we are all there to think about the best way to treat each individual patient,” Frim said. The team keeps in close communication with referring physicians. Experience. “We see so many epilepsy patients that our system is continuously running, and we don’t have big breaks.” This provides the opportunity for these experts to learn from the outcomes of a larger group of patients. Resources. Dedicated inpatient units, including an adult neuro-ICU, a specialized adult neuro unit with six beds wired for advanced monitoring, a distinct area of the pediatric ICU specifically equipped for epilepsy monitoring and eight beds in the pediatric epilepsy center’s long-term monitoring unit staffed by specially trained nurses. uchicagokidshospital.org/specialties/epilepsy
Sharon O’Keefe, left, and Susan Axelrod
The The quest quest for for aa cure cure Susan Susan Axelrod Axelrod co-founded co-founded Citizens Citizens United United for for Research Research inin Epilepsy Epilepsy (CURE) (CURE) inin 1998 1998 out out of of frustration frustration after after not not being being able able to to find find successful successful therapy therapy for for her her daughter daughter Lauren’s Lauren’s seizures. seizures. The The Axelrods Axelrods (Susan's (Susan's husband, husband, David, David, isis an an advisor advisor to to President President Barack Barack Obama) Obama) tried tried countless countless drugs, drugs, special special diets diets and and surgery, surgery, with with no no effect. effect. Lauren, Lauren, now now inin her her 30s, 30s, suffered suffered brain brain damage. damage. But But she she has has been been seizure seizure free free since since 2000, 2000, thanks thanks to to aa single single drug drug that that proved proved effective effective for for her. her. Since Since its its inception, inception, CURE CURE has has raised raised more more than than $18 million for epilepsy research and $18 million for epilepsy research and awareness. awareness. University of Chicago Medical Center University of Chicago Centerto the President Sharon O’KeefeMedical was named President Sharon O’Keefeboard was in named the national organization’s May. “Itohave national May. “I have seen howorganization’s epilepsy can board disruptinthe lives and plans seen how epilepsy canfamilies,” disrupt the and plans of patients and their saidlives O’Keefe, the of patients their families,” O’Keefe, mother of aand child with epilepsy.said “I also havethe seen mother of a child withtoward epilepsy. “I also have seen remarkable progress understanding this remarkable progress towardresearch. understanding disease through innovative I look this disease innovative research.speed I lookup the forwardthrough to this new role in helping forward to this new role in helping speed upand, the pace of progress in understanding, treating pace of progress we hope, curing in thisunderstanding, disorder.” treating and, we curing thisvisit disorder.” For hope, more information, cureepilepsy.org.
Mapping the brain EEG monitoring, MRI scans and even PET scans can prove inadequate for identifying the exact location of an epileptic focus. But the University of Chicago Medicine is a leader in the nation in its ability to analyze data from multiple imaging scans and other testing to produce a highly detailed, three-dimensional image of the brain and its electrical activity. These images help the multispecialty epilepsy team determine whether the patient is a candidate for potentially curative epilepsy surgery. The images also can precisely guide surgeons to the abnormal area of the brain that is causing the seizures or allow more targeted investigations that improve the accuracy of the seizure surgery, allowing it to be less invasive. “We can concentrate on finding the safest and least traumatic way to remove the seizurecausing area,” said David M. Frim, MD, PhD, chief of neurosurgery, “because we’re so sure that we are operating on the correct tissue.”
Innovative treatment for advanced head and neck cancer Multispecialty team successfully treats stage 4 cancer without radical surgery
iping the sweat off his face after a 10-mile run in 2009, Craig Martin discovered the lump under his left jaw. An ENT issued a grim diagnosis: the 46-year-old arborist from Libertyville, Ill., had stage 4 tonsil cancer. After extensive research, Martin chose the University of Chicago Medicine for its vast experience treating advanced head and neck cancers and excellent survival rates. “There are many subtleties in treating the various types of head and neck cancers,” said Daniel J. Haraf, MD, medical director of radiation oncology. The head and neck cancer team — medical and radiation oncologists, and head and neck surgeons — focuses exclusively on these difficult malignancies. Kerstin Stenson, MD, and The multidisDaniel J. Haraf, MD ciplinary team pioneered integrated chemoradiotherapy that effectively treats 80 percent of stage 4 head and neck cancers without ablative surgery. “Our highly coordinated multispecialty care focuses on organ preservation. Surgery is used for salvage in the uncommon scenario of treatment failure,” said Everett E. Vokes, MD, physician-in-chief at the University of Chicago Medicine. Martin’s treatment consisted of weekly chemotherapy for 15 weeks and 50 Glenn Bovard treatments of intensity-modulated radiation therapy (IMRT). Haraf was one of the first physicians in Chicago to offer IMRT, which shapes the radiation field to INSPIRED
Craig Martin of Libertyville, Ill., is back to serious running after treatment for advanced tonsil cancer at the University of Chicago Medicine.
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the contour of tumors. “With IMRT, we can better target tumors with higher doses of radiation while sparing critical structures and normal tissue in the area, such as salivary glands or the spinal cord,” he said. For oral cavity tumors or small, early-stage lesions, surgery is often preferable to radiation. “For the newly diagnosed patient, we have every tool to remove the cancer while preserving the function of their organs. Endoscopic laser surgery, new reconstructive techniques and robotic surgery allow us to remove tumors through the mouth instead of opening up the neck,” said Kerstin Stenson, MD, who directs the medical center’s head and neck surgery program. The surgical team also treats patients whose recurrent cancers may have been deemed unresectable by other surgeons and those with complex wounds resulting from chemoradiation, such as osteoradionecrosis. “Patients who typically haven’t been given much hope are referred here,” Stenson said. “Our team is able to give hope for cancer control, pain and wound management and restoration of function.” One of those options is a second round of full-dose radiation therapy — a treatment few cancer centers offer. Haraf is considered one of the world’s leading authorities on reirradiation. Martin, whose cancer went into remission last fall, is back to serious running and biking. “I have no limitations, and I feel great today,” Martin said. “But even when I was at my sickest, the team at the University of Chicago made me feel strong mentally because of their confidence that my treatment would work.” uchospitals.edu/specialties/cancer/head-neck
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World-class care for a rare childhood cancer
Neuroblastoma specialists offer expertise, access to new therapies Neuroblastoma is the most common cancer in infants, but it’s still so rare that even many pediatric oncologists see few cases. Approximately 700 children are diagnosed with the disease in the United States each year. The neuroblastoma program at the University of Chicago Medicine Comer Children’s Hospital draws families from across the country and offers a full range of treatment options, including new therapies not widely available elsewhere. “Sometimes standard treatment approaches don’t work,” said pediatric oncologist Susan L. Cohn, MD. “An experienced medical team is needed to ensure that each child receives the proper
treatment. It is also critical to recognize when the therapy is too toxic or not effective so that alternative treatment strategies can be initiated.” Cohn, director of clinical sciences in the Department of Pediatrics at the University of Chicago Medicine, is recognized as one of the nation’s top authorities on neuroblastoma. She is among a handful of physicians in the country conducting Phase 1 clinical trials of promising new drug therapies for children with aggressive, difficult-to-treat forms of the disease. Cohn works with a multidisciplinary team that includes surgeons, radiation therapists, pathologists, radiologists and
clinical and basic science researchers. Luke and Breanna Leander made the trip from Cambridge, Ill., near the Iowa border to seek Cohn’s expertise to treat their daughter Maggie. Their baby, who had been diagnosed when she was only 10 days old, had a low-risk form of the disease. But the cantaloupe-size tumor in the baby’s belly was causing her breathing to become labored and rapid. Maggie spent four weeks in the hospital getting inpatient chemotherapy. Today she is a healthy 2-year-old. Cohn’s research focuses on tumor genetics and the development of targeted therapies. “The goal now is to better understand the biologic factors that induce aggressive tumor growth and develop treatments that will block these growth-promoting molecules,” she said. University of Chicago Medicine Comer Children’s Hospital physicians have leadership roles in the Children’s Oncology Group (COG), the New Approaches to Neuroblastoma Therapy (NANT) consortium and the Advances in Neuroblastoma Research Association. Cohn also is co-chair of the International Neuroblastoma Risk Group (INRG) Task Force, which since 2005 has compiled data on neuroblastoma patients from around the world. These data have led to new informaSusan L. Cohn, MD tion about prognostic factors and tumor behavior. A recent COG clinical trial has demonstrated that survival for patients with high-risk neuroblastoma can be improved by 20 percent with the addition of immunotherapy. “However, less than 40 percent of high-risk patients are cured with current treatment approaches,” Cohn said. “We must continue to conduct research to ensure that we find a cure for all children with neuroblastoma.” uchicagokidshospital.org/specialties/cancer/ neuroblastoma
organs, Becker encourages early referral for transplant evaluation. “Most patients who come to us are already on dialysis but can and should get listed (in the national organ recipient database) before starting, if possible,” she said. “Once their creatinine clearance is less than 20, they can start gathering time on the list. We now know there is a clear survival benefit to pre-emptive transplant.” Interdisciplinary, team-based care is the hallmark of the transplant program at the
“It was vital to be at an institution on the leading edge where they develop the next innovations in transplants.” MaryLou Krippner of Lisle, Ill., who received a kidney transplant at the University of Chicago Medicine in August 2011
MaryLou Krippner and Yolanda T. Becker, MD
At the forefront of transplant care Kidney and kidney-pancreas program delivers leading-edge, personalized care
atients with severe kidney failure eventually find themselves with limited options: peritoneal dialysis, hemodialysis, or kidney or kidney-pancreas transplant. Of these transplant options, kidneyonly transplant may be what comes to mind first, especially for patients with type 2 diabetes or who may obtain a living kidney donor match. But Yolanda T. Becker, MD, director of the University of Chicago Medicine kidney and pancreas transplant program, encourages colleagues to cast a wide net when considering the patients, typically younger and with type 1 diabetes, who might benefit from a kidney-pancreas transplant. “Our kidney-pancreas program is growing, as referring physicians realize its enormous benefits,” she said. “It’s true that patients will still need medication after transplant, though they INSPIRED
will be able to discontinue insulin. Transplant also helps slow complications of diabetes, including neuropathy and retinopathy.” The University of Chicago Medicine was one of the first medical centers to offer kidney-pancreas transplants, which typically are covered by Medicare and major insurance providers. “The kidney-pancreas transplant program is one of the centerpieces of our multi-organ transplant program, where the University of Chicago Medicine is and remains a leader,” said J. Michael Millis, MD, chief of transplant surgery. “That’s important because patients — especially those with diabetes — may need to consider many options, including kidney-pancreas and even heart-liverkidney.” Given the potential wait for donor
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University of Chicago Medicine. Each patient is assigned to a personal transplant coordinator throughout the initial evaluation and the typical years-long wait for a donor organ. “We create a personalized schedule for updating each patient’s testing and visits so when the organ becomes available, we can move immediately,” said Katrina Harmon, RN, MSN, CCTC, pre-transplant nurse coordinator. This individualized approach continues after transplant. “We tailor the patients’ care to their needs and preferences,” Harmon said. MaryLou Krippner of Lisle, Ill., received a kidney transplant in August 2011 after a five-year wait. “The posttransplant team has been very accommodating about working with me to get my labs done locally in the suburbs as soon as possible,” she said. Once the initial recovery period is over, many patients experience a profound improvement in quality of life. Tim Kramer, a kidney-pancreas transplant recipient from Lakewood, Ohio, had been waiting for donor organs for three years and was on dialysis for five months. The 38-year-old social worker has type 1 diabetes. Since receiving his transplant, Kramer has run a 10K and a half-marathon. “Running again has been the best gift of all,” he said. uchospitals.edu/specialties/transplant/kidney.html
Eyeing the future
Seenu M. Hariprasad, MD
Grateful patients donate to support research to help solve the challenge of age-related vision loss
After two failed eye surgeries, Richard Hill of South Bend, Ind., was getting desperate as the vision in his right eye continued to deteriorate from retinal detachment. That changed the moment he met Seenu M. Hariprasad, MD, a vitreoretinal specialist and director of clinical research in ophthalmology and
visual science at the University of Chicago Medicine. “He touched my arm, looked at me and said, ‘I can fix this,’” Hill recalled. Hariprasad, named one of the top ophthalmologists in the country by Becker’s Healthcare, is known for his innovative approaches to surgery,
News from the University of Chicago Medicine and Biological Sciences
Inspired …to discover,
to teach and
to give back Richard L. Schilsky, MD, professor of medicine and hematology/oncology section chief, was named a Fellow of the American Society of Clinical Oncology (ASCO) for his volunteer service, dedication and efforts on behalf of the specialty of oncology and patients. Peter Angelos, MD, PhD, the Linda Kohler Anderson Professor of Surgery, chief of endocrine surgery and associate director of the MacLean Center for Clinical Medical Ethics, holds the nation’s first endowed chair in surgical ethics.
Jeffrey B. Matthews, MD, the Dallas B. Phemister Professor of Surgery and chair of surgery, has been elected president of the Society for Surgery of the Alimentary Tract (SSAT). Anne R. McCall, MD, has been named medical director for radiation oncology at the University of Chicago Medicine Comprehensive Cancer Center at Silver Cross Hospital. McCall, assistant professor of radiation and cellular oncology, has a background in both academic and community hospital settings.
including a sutureless microincisional vitrectomy technique that reduces both operative time and postoperative pain. “It’s no secret we deal with patients who have complex issues,” says Hariprasad, who specializes in diabetic eye diseases, intraocular infections and age-related macular degeneration. Hariprasad also is director of a highly specialized fellowship program in diseases and surgery of the retina, macula and vitreous. To date, grateful patients have donated $56,000 to help train future retina specialists. “By the year 2020, the number of patients who go blind each year will double due to age-related diseases; there are not enough vitreoretinal specialists to treat them,” he says. “People who donate to us are really training the future of this field.” Hill, an attorney with a passion for boating, is once again able to function without limitations. “I have a great deal of respect and admiration for Dr. Hariprasad, not only for his surgical proficiency and skill in training fellows, but also for the caring approach he extends to his patients,” Hill said. “I’m looking forward to a great sailing season on Lake Michigan. I really missed that last year.” For more information or to support the research of Seenu M. Hariprasad, MD, please contact Alicia Kearns at firstname.lastname@example.org.
David T. Rubin, MD, professor of medicine and co-director of the Inflammatory Bowel Disease Center, received the Rosenthal Award for Patient Support and Care, a national leadership award from the Crohn’s & Colitis Foundation of America. Michael Maitland, MD, PhD, assistant professor of medicine, received the Leon I. Goldberg Young Investigator Award from the American Society for Clinical Pharmacology and Therapeutics. Maitland is assistant director for clinical education in the Center for Personalized Therapeutics. Donations from Jim and Karen Frank and others will endow the Janet Davison Rowley, MD, Professorship in Cancer Research at the University of Chicago Medicine, a named professorship honoring one of the University’s most distinguished scientists and alumni. Jim Frank is a University of Chicago Medical Center trustee.
Jill C. Glick, MD, professor of pediatrics and medical director of Child Protective Services, and Mark Myren, PA-C for the cardiac surgery service, are 2012 recipients of Social Work Humanitarian Awards honoring non-social workers who best reflect the values and ethics of the profession and the University of Chicago Medicine. Michelle M. Le Beau, PhD, director of the University of Chicago Medicine Comprehensive Cancer Center, was elected to the board of directors for the American Association for Cancer Research. Le Beau is the Arthur and Marian Edelstein Professor of Medicine. Olufunmilayo I. Olopade, MD, the Walter L. Palmer Distinguished Service Professor of Medicine and Human Genetics and director of the Cancer Risk Clinic, was appointed by President Barack Obama to the National Cancer Advisory Board.
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Save the Date: November 10, 2012 Symposium: Connecting to the New University of Chicago Medicine The Forefront of Medicine and Your Clinical Practice Celebrate the opening of our new hospital and learn about the technological breakthroughs being used to diagnose and treat cancer, GI disorders, cardiovascular disease and neurological disorders, and risk assessment and personalized treatment based on the genetics of disease. Tour the new state-of-the-art hospital and learn how it will advance University of Chicago Medicine programs. Find out more about the new Bucksbaum Institute for Clinical Excellence, a unique initiative focused on improving doctor-patient interaction. 8 a.m. to 4 p.m. November 10 Our new hospital at the University of Chicago Medicine 5700 S. Maryland Ave., Chicago, IL For more information and to register online, visit cme.uchospitals.edu.
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Inspired magazine is published three times a year by the University of Chicago Medicine. The publication is designed to keep referring phys...