A PUBLICATION OF THE BARBARA ANN KARMANOS CANCER INSTITUTE
APRIL 2016
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Moonshot President Obama Launches New Charge to Cure Cancer
Knocking Down Barriers Study Seeks to Increase Lung Cancer Screening Referrals
Specialized Care Karmanos Offers More Treatment Options for Gynecologic Cancers
KEEP YOUR PLATE FULL Proper nutrition is important for cancer patients
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f you thought receiving a cancer diagnosis means having to give up your favorite foods, think again. “We’re more liberal than restrictive with patients’ diets,” says Kristin Black, a Karmanos Cancer Institute clinical dietitian. “It’s best that patients maintain their weight during cancer treatment. It helps with sustaining energy levels, tolerating treatments and it contributes to better cancer outcomes.” The clinical dietitians at Karmanos work with patients and their multidisciplinary care teams to create individual diet plans that meet patient needs during treatment.
“Dietary plans vary depending on the cancer type, stage and location, as well as any treatment side effects,” Black says. “We generally recommend high-protein, high-calorie foods to help patients maintain muscle mass, energy and weight.” These foods include nuts, nut butters, full fat dairy products, starches, and lean meats such as chicken, fish and pork. “If a patient cannot meet their nutritional needs with whole foods, we have a variety of high calorie, high-protein supplemental drinks we will recommend,” she says. “Hydration is also very important, so we recommend drinking an adequate amount of water as well as other options such as teas and milk.”
Many cancer patients have other health issues, like diabetes, heart disease or obesity. In those instances, the dietitian will prioritize matters depending on the severity of the secondary illness. “In addition to cancer, some patients may have a chronic illness such as diabetes,” Black says. “In this case, we want to avoid very high blood sugars that may cause unintended symptoms such as infection, dehydration and fatigue. However, for a patient with very advanced cancer and unintentional weight loss, the initial and immediate focus is on treating the cancer and maintaining weight in order to optimize their quality of life. “We don’t like to see gradual weight loss during cancer treatment. But once a patient with obesity has stabilized, in some circumstances we can focus on creating a diet that promotes healthy weight loss.” Before making a grocery list, Black recommends talking with your doctor and clinical dietitian about your specific dietary needs. “Nutrition is one of the keys to treating cancer,” she says. “We’re here to listen to your concerns and offer a dietary plan that meets your needs and food preferences.”
CONTACT US For more information about a cancer diagnosis or treatment, call 1-800-KARMANOS (1-800-527-6266) or visit karmanos.org.
WELCOME It’s undoubtedly an exciting time in the field of cancer treatment research and development. Clinical and basic scientists at Karmanos Cancer Institute and across the country are feeling energized, thanks to President Barack Obama’s recently announced Cancer Moonshot Task Force, which allocates $1 billion towards efforts in eliminating cancer. This will serve as an additional impetus to empower scientists at Karmanos, as well as those at other leading cancer centers nationwide, to develop new and innovative cancer therapies. Karmanos had contributed significantly to the extraordinary therapeutic advances made in recent years to patients who need them. Recently, Karmanos once again earned the prestigious designation of comprehensive cancer center from the National Cancer Institute, a designation we’ve held since 1978. Developing new and innovative therapies means everything to the approximately 12,000 new patients we treat on an annual basis. Facing a cancer diagnosis is a life-altering event. What we strive to deliver to every patient is not only the best therapies found anywhere, but a sense of hope for a brighter future. We’ve now expanded greater access to therapies and more hope across the state since joining McLaren Health Care in January 2014. In these pages, you’ll read about some of our newest staff members, all of whom are cancer treatment specialists. You’ll also read other stories about how to stay healthy if you’re diagnosed with cancer and effective ways of being monitored for the disease. Thank you for reading Hope magazine! As always, we’re here for you if you or a loved one is diagnosed with cancer.
Gerold Bepler, M.D., Ph.D.
President & CEO Barbara Ann Karmanos Cancer Institute
April 206 ABOUT KARMANOS
Karmanos Cancer Institute at McLaren Flint Welcomes
NEW SURGICAL ONCOLOGISTS Since joining forces with McLaren Health Care in 2014, Karmanos continues to grow by welcoming new physicians at its centers across Michigan, bringing new hope to the patients it cares for. Recently, Karmanos Cancer Institute at McLaren Flint welcomed two new surgical oncologists to its comprehensive team of cancer specialists: Tolutope Oyasiji, M.D., MRCSI, and Smit Singla, M.D., MRCS Ed., M.Sc.Both physicians are certified through the American Board of Surgery, and have clinical interest in minimally invasive surgical approaches to cancer care and regional therapy, which includes specialized procedures for patients with regional or locally-advanced disease. Dr. Oyasiji completed a fellowship in Complex General Surgical Oncology at Roswell Park Cancer Institute in Buffalo, New York. He received his medical degree from the University of Ibadan in Nigeria, and he completed residencies in general surgery at the Royal College of Surgeons in Ireland and at Yale New Haven Hospital in New Haven, Conn. “Karmanos Cancer Institute at McLaren Flint is a wonderful facility and I’m very excited to provide patients with high-quality, personalized care,” Dr. Oyasiji says. “We provide patients more options to receive the best multidisciplinary care available. Patients benefit by having access to specialized procedures close to home.” Dr. Singla completed a clinical fellowship in Complex General Surgical Oncology at Roswell Park Cancer Institute. He did his surgical residency training at the Hospital of University of Pennsylvania and Temple University Hospital in Philadelphia. He also trained in surgery through The Royal College of Surgeons in Edinburgh, UK. In addition, Dr. Singla has spent time doing a research fellowship in surgical oncology at the University at Pennsylvania and training in Advanced Surgical and Perioperative Care at Cardiff University in Wales. “I offer patients customized treatment plans based on their individual needs,” Dr. Singla says. “Using a team approach, we strive to attain the best cancer outcomes by bringing together multiple disciplines under one roof. In addition, we empower patients with complementary and educational resources to help them become active participants in their health and healing. This enhances recovery and reduces stress.”
The Barbara Ann Karmanos Cancer Institute, a McLaren Health Care subsidiary, is one of only 45 National Cancer Institute-designated comprehensive cancer centers in the United States. Federal designation as a comprehensive cancer center is the pinnacle of translational oncology research. Elizabeth Katz External Marketing & Communications Manager Editor, HOPE Email: hope@karmanos.org
TOLUTOPE OYASIJI, M.D., MRCSI
SMIT SINGLA, M.D., MRCS ED., M.SC.
FOR YOUR OWN COPY OF HOPE, VISIT karmanos.org Copyright 2016 Barbara Ann Karmanos Cancer Institute
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HOPE | APRIL 2016
For more information about a cancer diagnosis or treatment, 1-800-KARMANOS (1-800-527-6266) or visit karmanos.org
THE NEW FRONTIER OF CANCER RESEARCH
Moonshot
PRESIDENT OBAMA LAUNCHES NEW CHARGE TO CURE CANCER
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n January, President Obama announced the creation of the Cancer Moonshot Task Force. Just as America launched an effort in the early 1960s to put a man on the moon, the present goal is equally lofty: beating cancer. A $1 billion federal investment in cancer research funding will greatly aid research at academic-based centers like the Karmanos Cancer Institute, says Karmanos President and CEO Gerold Bepler, M.D., Ph.D.
“This investment is phenomenal and something we’ve desired for years,” Dr. Bepler says. “More scientists will pursue pent-up ideas and receive research-specific grants. Researchers will make new findings to apply toward the ultimate goal—curing cancer.” The Moonshot initiative also promotes collaboration between research centers, philanthropic organizations, and the biotechnology and pharmaceutical industries to help generate new ideas and cancer breakthroughs. “Because cancer is such a complex disease, no single group can tackle it completely,” Dr. Bepler says. “Karmanos already partners with other hospitals on research projects. The Moonshot initiative will further promote these types of partnerships—particularly between research centers and the pharmaceutical industry.” Although it takes time to see the results of research, Dr. Bepler says the Moonshot initiative may significantly impact cancer rates in just a few years. “The ultimate measure of success is the annual number of new cancer diagnoses,” he says. “As early as three years from now, we hope to see those statistics decrease. “Based on our experience, curing cancer is substantially more complex than flying to the moon. But we continue applying new discoveries to cancer prevention and treatment. I believe we’ll make even greater progress in the near future.”
CONTACT US
For more information about a cancer diagnosis or treatment, call 1-800-KARMANOS (1-800-527-6266) or visit karmanos.org.
HPV VACCINES PREVENT CANCER In tandem with the newly-created Cancer Moonshot Task Force, the Karmanos Cancer Institute has joined 68 other National Cancer Institute-designated Cancer Centers in calling for increased human papillomavirus (HPV) vaccination rates. HPV is known to cause almost all cervical cancers in women and about 25 to 35 percent of all head and neck cancers, with the majority of those cases found in men. “There are three FDA-approved vaccines that are up to 95 percent effective in preventing HPV-related illnesses,” says Shelly Seward M.D., member of the Gynecologic Oncology Multidisciplinary Team at Karmanos. “The vaccine is most effective when given to boys and girls between ages 9 and 13. Despite the vaccine’s safety profile, only 30 percent of girls and 17 percent of boys in Michigan complete the three-dose vaccination series.” Because HPV is transmitted sexually, many parents aren’t comfortable discussing the vaccine with their child’s medical provider. “Karmanos is teaming with other state health departments and alliances to create a broad-based education program for future health care providers,” Dr. Seward says. “We’ll focus on effective and efficient strategies for conveying the vaccine’s benefits to patients and parents. When given accurate information, why wouldn’t a parent choose to prevent cancer in their child?”
Karmanos Cancer Institute
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FIGHTING HARD-TO-TREAT CANCERS
KNOCKING DOWN
BARRIERS
STUDY SEEKS TO INCREASE LUNG CANCER SCREENING REFERRALS
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ood news for longtime tobacco users with Medicaid/ Medicare: coverage is now available for lung cancer screening and tobacco dependence treatment programs. Studies show screenings can reduce lung cancer mortality by 20 percent. Unfortunately, not enough patients are aware of these screening and treatment program services. Lung cancer remains the leading cause of cancer death in the U.S in both men and women.
To ensure that qualifying patients receive appropriate screening, the Karmanos Cancer Institute in Detroit and Karmanos Cancer Institute at McLaren Macomb, Ted B. Wahby Cancer Center in Mount Clemens are partnering in a Michigan Department of Health and Human Services project that examines the barriers doctors face in making referrals. The project is called the “Health Systems Change for Tobacco Dependence Treatment and Lung Cancer Screening Project”. “The ways physicians and hospital systems incorporate tobacco dependence treatment and lung cancer screening guidelines into their practices differ widely,” says Michele Cote, Ph.D., MPH, associate center director for Education at Karmanos and associate professor in the Department of Oncology at Wayne State University School of Medicine. “We want to ensure that all patients who visit a medical clinic for any service are vetted consistently to see if they need or qualify for a referral. It’s about building awareness so lung cancer screenings become as common as mammograms.” Screening guidelines for some cancers, like colorectal, are age-based. But other factors like current smoking status and smoking history make the lung cancer or tobacco dependence treatment referral process more complex. “It takes a little more time and questioning to determine if a patient needs a lung cancer screening or tobacco dependence treatment program referral,” Dr. Cote says. “We’re surveying about a dozen physicians within McLaren Macomb to see how they’re making referrals and identifying obstacles that might hinder referrals. We want to eliminate these barriers so we can provide optimal care to all Karmanos and McLaren patients.” People most likely to benefit from lung cancer screening are ages 55-80, are current smokers or former smokers who quit not more than 15 years ago, and people who have a history of smoking a pack of cigarettes a day for 30 years.
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BETTER OUTCOMES BEGIN WITH EMPATHY Shame. It’s one of the reasons why some former smokers referred for lung cancer screening never follow through. But we need to re-think the stigma surrounding this disease, says Becky Loomis, R.N., BSN, thoracic coordinator/nurse navigator at Karmanos Cancer Institute at McLaren Greater Lansing. “Many people with lung cancer feel as though they brought the disease on themselves because they smoked,” she says. “No one should ever feel guilty for having cancer. People need to check their biases and have compassion for these patients. Non-smokers can also develop the disease.” To raise awareness of lung cancer and bring empathy to patients with the disease, McLaren Greater Lansing held a “Lung Cancer Awareness Event” in November 2015. The event included physician presentations, educational materials and information about lung cancer screenings, and stories from lung cancer survivors. Karmanos at McLaren Greater Lansing will hold another lung cancer awareness event this November. “Lung cancer screening is very important,” Loomis says. “It’s possible to detect the disease at an early stage. And current or heavy smokers who receive a CT lung cancer screening have a 20 percent lower mortality rate compared to patients who received only a chest X-ray. Early detection leads to more opportunities for treatment and better cancer outcomes.”
UNIQUE ONCOLOGY SERVICES
FACTS ABOUT
SARCOMA
A KARMANOS SPECIALIST ADDRESSES THIS RARE DISEASE
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rthopedic Oncologist Melissa Zimel, M.D. is uniquely qualified among Karmanos Cancer Institute physicians to speak about sarcoma. She is the center’s first surgical specialist in removing these rare tumors, which can occur in soft tissue or bones. She works out of Karmanos’ Detroit location as well as Karmanos Cancer Institute at McLaren Macomb, Ted B. Wahby Cancer Center in Mount Clemens.
An X-ray can pinpoint the location of a sarcoma. A doctor may also order a CT scan or MRI for further analysis. A biopsy can determine if the tumor is cancerous or benign. Treatment therapies for sarcoma include radiation, chemotherapy and surgery.
“There are only about 200 orthopedic oncologists in the country,” says Dr. Zimel, who joined Karmanos in January. “It’s great to be part of such a fantastic group of physicians who practice multidisciplinary care—it’s the most effective way to deliver comprehensive cancer treatments. Patients can have their needs met at Karmanos rather than search elsewhere for a cancer expert.”
In addition to removing bone and soft tissue tumors, a large part of Dr. Zimel’s work involves bone reconstruction, since patients with bone cancer are at risk of a fracture.
Dr. Zimel’s expertise is uncommon in part because sarcoma accounts for about one percent of all cancers diagnosed, according to the National Cancer Institute. Soft Tissue Sarcoma can occur in muscles, fat, blood vessels, tendons, fibrous tissues and tissues around joints. The most common type of bone sarcoma (or bone cancer) in adults is chondrosarcoma, which is found in cartilage. Scientists don’t know what causes most sarcoma cases, although some types are known to be genetically inherited.
MELISSA ZIMEL, M.D.
“For example, we might insert a rod in a patient’s leg to prevent a bone from breaking,” Dr. Zimel says. “So instead of relying on crutches, the patient can continue walking and remain as mobile as possible. One of the most rewarding things about my job is having such a large impact on patient quality of life.”
“Sarcoma can occur anywhere in the body,” Dr. Zimel says. “Generally, a soft tissue sarcoma has no symptoms. It starts as a small lump, but can grow fairly large. Patients usually notice the lump when it causes pain by pressing against nerves and muscles. Symptoms of bone cancer include sudden pain, tenderness or swelling around a joint, or an unexplained bone fracture.”
CONTACT US For more information about a cancer diagnosis or treatment, call 1-800-KARMANOS (1-800-527-6266) or visit karmanos.org. Karmanos Cancer Institute
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COMPREHENSIVE CANCER SERVICES
SPECIALIZED
CARE
KARMANOS OFFERS MORE TREATMENT OPTIONS FOR GYNECOLOGIC CANCERS Gynecologic cancers are by definition specialized cancers. Symptoms of gynecologic cancers can be challenging to define and detect and physician scientists, such as those at Karmanos Cancer Institute, are working hard to create more effective ways to fight these cancers. “If you have a specialized cancer, you want specialized care,” said Shelly Seward, M.D., member of the Gynecologic Oncology Multidisciplinary Team at Karmanos and Wayne State University School of Medicine (WSU SOM). “At Karmanos, we provide not only excellent standard of care treatment, but access to new and innovative therapies from the very beginning of a cancer diagnosis.” Case in point: Women treated for gynecologic cancers have access to clinical trials at all disease stages at Karmanos, with cutting-edge treatments that can be combined with therapeutic agents so that all lines of defense against a cancer are utilized. Dr. Seward provides both surgical and medical treatment for gynecologic malignancies. She is also part of the Phase I Clinical Trials Team at Karmanos that can enroll women, based on their type of cancer, on early clinical trials that offer cancer therapies not found at other hospitals or treatment centers in metro Detroit. Those therapies include genetically targeted agents and immunotherapy trials. Another benefit to coming to Karmanos is access to oncologists who conduct the type of research that uncovers ways that gynecologic cancers can be more easily diagnosed and more effectively treated. “There’s a lot we don’t know about the field of gynecologic oncology,” said Ira Winer, MD., Ph.D., fellow member of the Gynecologic Oncology Multidisciplinary Team at Karmanos and medical and surgical oncologist. “We are working at Karmanos to close the gap in diagnosis, treatment and surveillance of cancer to optimize the care of our patients.” In addition to his clinical practice, Dr. Winer is involved in basic and translational research in ovarian and endometrial cancers. Conducting research is a defining characteristic of a National Cancer Institute-designated comprehensive cancer center, a distinction Karmanos has earned since 1978. “Having access to an NCI-designated comprehensive cancer center like Karmanos offers patients significant advantages,” Dr. Winer said. “There are more treatment options and clinical resources for patients. The care we provide is all-encompassing.”
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HOPE | APRIL 2016
Shelly Seward, M.D. Credentials: Medical degree, Eastern Virginia Medical School. Residency, The Ohio State University. Fellowship, Wayne State University/Karmanos Cancer Institute Member, American Medical Association; board certified by the American Board of Obstetrics and Gynecology in Obstetrics and Gynecology, as well as in the Gynecologic Oncology Subspecialty. Dr. Seward sees patients at Karmanos’ Detroit and Farmington Hills locations.
Ira Winer, M.D., Ph.D. Credentials: Medical degree, and Ph.D. in Cell and Molecular Biology, University of Michigan Member, American Medical Association; board certified by the American Board of Obstetrics and Gynecology Dr. Winer sees patients at Karmanos’ Detroit and Clarkston locations.
Please call 1-800-KARMANOS (1-800-527-6266) to make an appointment with Drs. Seward or Winer GYNECOLOGIC ONCOLOGY TREATMENT SPECIALTIES AT KARMANOS: • Primary and recurrent ovarian cancer • Fallopian tube cancer • Peritoneal cancers (which affect the lining of the abdominal cavity) • Uterine/endometrial cancers • Cervical cancer • Vaginal and vulvar cancers • Gestational trophoblast disease/neoplasia (a group of conditions in which tumors grow inside a woman's uterus)
SURGICAL PROCEDURES OFFERED FOR GYNECOLOGIC CANCERS:
• Minimally-invasive robotic surgery for uterine tumors and ovarian disease. • Single-incision surgery for ovary removal. • Extensive, upper abdominal and pelvic tumor removal for advanced-stage gynecologic tumors. • Surgery for recurrent gynecologic malignancies. • Surgical procedures for the placement of ports and internal chemotherapy administration
SUPPORTING KARMANOS CANCER INSTITUTE
ACCELERATING
Cancer Research
Karmanos Cancer Institute is revolutionizing the way doctors treat cancer. With a steadfast commitment to innovative research, Karmanos is able to offer patients access to innovative treatments and clinical trials that are not available anywhere else. The research being performed at Karmanos is leading to better cures and better outcomes for patients. Credit for the ongoing advancements in cancer care at Karmanos belongs not only to its many skilled researchers and physician scientists, but also in large part to its philanthropic donors for their generous support. One instrumental partner in the effort to advance cancer care is General Motors, which has been an incredible supporter of the Institute for many years. General Motors first sponsored the Annual Dinner, Karmanos' premiere fundraising event in Detroit in 2011, and GM has extended its event support each succeeding year. Throughout the years, GM’s significant financial support has allowed Karmanos to renovate their treatment facilities, offering patients a more comfortable and soothing environment while receiving care. In addition, GM has recognized the value of the critical research being performed at Karmanos, and its importance in accelerating the advancement of treatment options. GM has invested significant funding to further develop research programs that have a major impact on the future of cancer care. In gratitude for GM’s continued devotion to advancing cancer research, Karmanos named a floor at its main campus in Detroit the “General Motors Research Floor” last year.
THE ANNUAL DINNER Karmanos Cancer Institute’s 34th Annual Dinner is on Saturday, April 16, at the Michigan Motion Picture Studios in Pontiac. For more information, contact (313) 576-8108 or smileyk@karmanos.org.
“We are so proud to have a well-known and respected supporter like GM, as well as our many other generous donors in the community, because it draws attention to our cancer-fighting mission,” says Gerold Bepler, M.D., Ph.D., president and CEO of Karmanos. “We view ourselves as ambassadors of groundbreaking cancer care, just as GM views itself as an ambassador of innovative automotive technology. We’re a great fit for each other.” For the sixth consecutive year, a GM executive will chair the Institute’s Annual Dinner. Paula and Steve Kiefer, vice president, Global Purchasing and Supply Chain for General Motors, are chairing the 2016 event on Saturday, April 16 with proceeds benefitting cancer research. These funds will bolster research projects like population science studies, personalized medicine and advanced cancer imaging technology. “With GM’s help, we have been able to not only make amazing advancements in cancer treatments, but renovate many of our treatment facilities as well,” said Nick Karmanos, vice president of Institutional Relations. “Donors like GM understand the value of our work and help us pave the way to a future free of cancer.”
PAULA AND STEVE KIEFER, KARMANOS ANNUAL DINNER CHAIRS Karmanos Cancer Institute
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Non Profit Organization U.S. Postage PAID Detroit, MI Permit No. 1579 Mail Code: NCO6MC 4100 JOHN R DETROIT, MI 48201
Questions or comments: info@karmanos.org Connect with Karmanos
Find a physician at Karmanos Go to the karmanos.org home page and in the Get Started section at the middle of the page, select ‘Find a Specialist’. From here you can perform a search by entering a physician name or keyword in the keyword information field, or search by cancer type, zip code, or proximity search.
At the Barbara Ann Karmanos Cancer Institute, we have more than 100 oncologists who work out of 14 locations throughout Michigan and treat the 200-some different kinds of cancer. Our website karmanos.org makes it easy to find a specific physician based on name, cancer type, keyword, your zip code or the proximity to your location. You can also do an advanced search, which allows you to search by the above criteria, as well as by multidisciplinary team and language spoken.
Don’t have internet access? No problem! Just call 1-800-KARMANOS (1-800-527-6266) and our Patient Concierge Service will help you find the doctor you need!
BARBARA ANN KARMANOS CANCER TREATMENT LOCATIONS 3140 West Campus Drive Bay City, MI 48706 43097 Woodward Ave., Suite 100 Bloomfield Hills, 48302 5680 Bow Pointe Dr. Clarkston, MI 48346 4100 John R Detroit, MI 48201 31995 Northwestern Hwy Farmington Hills, MI 48334
4100 Beecher Road, Suite A – Radiation Oncology, Suite B – Medical Oncology Flint, MI 48532 918 N. Center Avenue Gaylord, MI 49735 2901 Stabler Lansing, MI 48910
1080 Harrington Blvd. Mt. Clemens, MI 48043 1221 South Drive Mt. Pleasant, MI 48858 416 Connable Avenue Petoskey, MI 49770 Radiation Oncology
1540 Lake Lansing Road, Suite 103 Lansing, MI 48912
560 West Mitchell St., Suite 185 Petoskey, MI 49770 Medical Oncology
1295 Barry Drive, Suite B Lapeer, MI 48446
621 Court Street, Suite 105 West Branch, MI 48661