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04: ALL THE TIME IN THE WORLD 12: Q&A WITH CHARLOTTE MCRAE 13: C3 MD SARAH TEVIS, MD 14: A BETTER WAY 17: IS YOUR IMMUNE SYSTEM TRYING TO KILL YOU?
S P R I N G 2 019
NORM PACE, PHD CAVE EXPLORER, “FATHER OF MICROBIAL ECOLOGY,” STAGE IV MELANOMA SURVIVOR
UNIVERSITY OF COLORADO ANSCHUTZ MEDICAL CAMPUS
N WS His heart is not in the right place Daniel De Leon may seem like a typical 25-year-old. He loves to go out with his friends, is a full-time student at CU Denver, and works out a few days a week. But Daniel’s story is anything but typical. Not only was he diagnosed with testicular cancer at age 23, but when a lung tumor resisted treatment, Daniel needed total lung removal surgery. “I felt a bit of a lump but didn’t think much of it,” says Daniel. “But then it started to grow and I was losing weight. That is when I started thinking it may be cancer.” Three days after diagnosis he went in for surgery to remove the tumor, and though Daniel received additional treatments, his cancer continued to grow. That’s when Daniel’s oncologist referred him to CU Cancer Center, where Elizabeth Kessler, MD, took over his care. “The only way to get rid of the tumor was surgery,” explains Kessler. “What was tricky in Daniel’s case is that the location of the tumor was in such a place
D A N I EL W O R K I N G O U T AT TH E C U A N S C H U TZ H EALTH AND W ELLNESS C EN TER W I TH O N E O F H I S D O C TO R S , M I C H A EL W EYANT, MD “It was super interesting to watch the growth,” says Daniel. “As the lung
where we couldn’t just take a portion of the lung. We ended up having to
got bigger I also felt better. I didn’t need as much time to recover and I wasn’t
remove his left lung.”
out of breath all the time.”
After his surgery Daniel was left with just one lung but was finally cancer free. And that one lung had a surprise in store. X-rays after surgery showed that Daniel’s lung was expanding in size and capacity. As his lung grew,
Daniel continues to go to the Anschutz Health and Wellness Center a few days a week and even runs into members of his care team there. “After treatment my lifestyle changed,” says Daniel. “My mental and
other organs shifted – now Daniel’s heart is a few inches to the left of
physical state improved, and I became more aware of how important it is to
where it normally would be.
take care of my health.”
“The body compensates,” explains Kessler. “Everything shifts a little after surgery.”
Now cancer free, Daniel is excited (and expectedly anxious) about what comes after graduation in May.
The Rise of Early Onset Colorectal Cancer More and more young people are being diagnosed with colorectal cancer, up
microbiome due to antibiotic exposure are just some of the theories behind the
approximately 40 percent in the last 25 years. This is in stark contrast with a
rise of colorectal cancer in young people.
decrease of 40 percent in populations typically affected by the disease. “The reasons why this is happening are not clear. There are plenty of theories
According to a recent survey from the Colorectal Cancer Alliance: • 82% of young cancer survivors were initially misdiagnosed
floating around that might explain the increase, but nothing is definitive,” says
• 73% were diagnosed at a later stage
Dennis Ahnen, MD, gastroenterologist and CU Cancer Center member.
• 50% felt their symptoms were ignored
A rise in obesity among children and young adults, a decrease in childhood physical activity, increased consumption of processed meat, and changes in the
• 62% did not have a family history • 67% saw at least two doctors before being diagnosed
With The Right Care, Patients Now Living A Median 6.8 Years After Stage IV ALK+ Lung Cancer Diagnosis According to the National Cancer Institute, patients diagnosed with stage IV
Get more CU Cancer Center news on our blog: www.coloradocancerblogs.org Subscribe for updates on the latest research, news, and events
non-small cell lung cancer (NSCLC) between the years 1995 and 2001 had 2% chance of being alive 5 years later. Now a CU Cancer Center study tells a much more optimistic story. For stage IV NSCLC patients whose tumors test positive for rearrangements of the gene ALK (ALK+ NSCLC), treated at UCHealth University of Colorado Hospital between 2009 and 2017, median overall survival was 6.8 years. This means that in this population, instead of only 2 percent of patients being alive 5 years after diagnosis, 50 percent of patients were alive 6.8 years after diagnosis. “What this shows is that with the development of good targeted therapies for ALK-positive lung cancer, even patients with stage IV disease can do well for many, many years,” says Jose Pacheco, MD, investigator at CU Cancer Center and the study’s first author. “I think the study suggests that for some types of NSCLC, it may become much more of a chronic condition rather than a terminal disease.”
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PROMISING outreach
The state of cancer in Color ado According to the U.S. Centers for Disease Control, Colorado has the fifth lowest overall rate of cancer in the United States, behind only District of Columbia, Arizona, New Mexico, and Nevada. And the American Cancer Society recently reported that the U.S. cancer death rate has dropped 27 percent over 25 years. In Colorado, the decline in
Thousands of Color adans contributing to cancer research at CU Cancer Center When it comes to cancer research, the more data, the better. That is the premise behind the Oncology Research Information Exchange Network (ORIEN), an innovative data-sharing initiative that brings together 19 accomplished cancer centers to accelerate the progress of cancer research and improve clinical care. The University of Colorado Cancer Center joined the collaboration in 2015 and has since enrolled over 5,000 participants in a research protocol that stores tissue samples along with clinical and epidemiological data with the hope of discovering the best new and existing treatments for genetic subsets of cancer. “We are grateful to the men and women enrolled in this protocol,” says Virginia Borges, MD, the principal investigator for the ORIEN Total Cancer Care® (TCC) research protocol at the CU Cancer Center. “We are stronger when we work together. The more data we collect the better our chances
the cancer death rate is even steeper: 31 percent reduction over the same period. Does this mean that cancer in Colorado is a concern of the past? Not so fast, says Myles Cockburn, PhD, co-leader of the CU Cancer Center Prevention and Control Program. “Ask someone who has cancer whether cancer remains a problem,” he says. “The point is that while it’s good to see cancer rates going down, much suffering remains. As well as focusing on how to truly make cancer a disease of the past, we need to better understand how to help the increasing number of people living with cancer.”
MYLES CO CKBURN, PHD
While smoking cessation, early detection and improved treatments have decreased the danger of some cancers, cancer remains the second leading cause of death in the United States, behind only cardiovascular disease, and while Colorado’s overall cancer rate is low, rates of some cancers meet or exceed national averages. For example, due in part to altitude and climate, Colorado has the nation’s highest per-capita rate of skin cancer. “It’s not like we don’t know how to improve,” says Cockburn. “There are still far too many people smoking, not staying out of the sun, not being vaccinated, not being screened.” According to Cockburn, “The overall state of cancer in Colorado is good relative to other places in the U.S. but nowhere near as good as we want it to be. While we have taken great steps toward decreasing the suffering associated with cancer, there is still much more to do.”
of understanding how cancer works and how we patients in the long run because we can determine more quickly whether a particular treatment is likely to be effective.”
91 Percent Response R ate For Venetoclax Against Newly Diagnosed AML In Older Adults
CU C ance r C en t e r
can treat it more effectively. This sharing helps
Traditionally, older adults diagnosed with acute myeloid leukemia (AML) would be expected to live less than a year. Now, CU Cancer Center clinical trial results show 91 percent response rate to the combination of venetoclax with azacitidine in older adults newly diagnosed with AML. Based on these results, the U.S. Food and Drug Administration (USFDA) granted accelerated approval for venetoclax to treat patients who are aged 75 years and older or are ineligible for intensive chemotherapy due to coexisting medical conditions. “Two patients on this study have been off all therapy for nearly three years, and others who
DANIEL POLLYEA, MD remain on therapy seem to be on the same trajectory, suggesting this regimen may be curative in some settings,” says Daniel A. Pollyea, MD, MS, investigator at CU Cancer Center and clinical V IRG INI A BORGES, MD
director of Leukemia Services at the CU School of Medicine. “We see this new regimen as a paradigm shift in the way we will treat this disease in this population, moving forward.”
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Ben Walburn: All the Time in the World BY GARTH SUNDEM
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PH OTO C RE DI T: R OB L I NNE N BE R GE R
I met Ben Walburn at 4:00am on a slushy spring morning four years ago in a Boulder parking lot outside the house of a mutual friend, Adam.
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It was still dark and clouds spit little wet icicles as Ben and I huddled by our cars in the glow of headlamps, blowing steam off insulated coffee cups while trying to raise Adam via text. The plan was to exploit Adam’s birthday as an excuse for a weekend rock-climbing trip somewhere dryer and warmer – was it Escalante or maybe it was Penitente? Finally, Adam texted back: His young kids had gotten sick overnight and he had to bail. Without Adam, the trip fell apart. Ben and I made vague plans to climb together at some point, but it never seemed to come together. He was in his early 40s, I was in my late 30s, and we were both busy. Besides, it wasn’t pressing – we had all the time in the world to make it happen. In 2017, I heard through the grapevine that Ben was diagnosed with sarcoma – a relatively rare kind of cancer that forms in soft tissue – and I got in touch to point him toward the University of Colorado Cancer Center sarcoma program, one of the few centers in the country specializing in exactly Ben’s kind of cancer. He pushed his insurance to transfer care to Anschutz and I ran into him a couple times after that, once at a climbing gym in Louisville, where it took me a minute to recognize him, bald from chemotherapy and radiation treatments; once on a sunny afternoon when he popped around a corner onto a belay ledge in Eldorado Canyon State Park; and then again in Eldo this past February at a cliff called Rincon, where Ben was climbing with an old buddy who had flown in from the east coast and his best friend from many years in Colorado. Ben was there to say goodbye – to his friends and to this place that he loved. Because by that point it was obvious that Ben Walburn was going to die. When Ben showed up at Anschutz, his sarcoma was already advanced. Entangled with the organs through his midsection, surgery was not an option. With treatments, he hoped to shrink the tumor enough that it could be removed, but in a scan after chemoradiation, Ben and his doctors saw that instead of shrinking, the cancer had spread to his liver, his lungs, his bones. That February day at Rincon, I happened to be climbing with our mutual friend, Adam. As Adam and I arrived at Rincon, Ben’s group was already shoving ropes back into bags and we bantered awkwardly, nobody saying the obvious: Ben looked gaunt, fragile. How much longer did he have? Still, when we talked about the climbing route I planned to try, something Ben had done years ago, he remembered it perfectly and pantomimed the crux moves, standing on top of a boulder. “From the left-hand crescent, kick your foot out right to the good edge and toe-in! Press the left rail and stand up to the righthand razor blade!” he said, demonstrating with his arms and legs. I imagined how he must have looked to hikers on the trail far below, like Daniel from Karate Kid practicing wax-on and wax-off in the bow of Mr. Myagi’s rowboat. Before he left, Ben mentioned that he had a special piece of rock-climbing gear that he’d used on the route – a #1 Black Diamond Offset Stopper that fit snugly into a crack at about 2/3 height. “You place it right and that thing’s an anchor!” Ben cackled. He said that if I would stop by his house, he’d like to give the piece to me. We heard him coughing in the boulder field on the way down. His friends carried the gear. “Isn’t life grand?” Adam said, as the sunset lit the sandstone cliff on fire. A few days later, I knocked on Ben’s door in Lafayette. As per the etiquette in these situations, we sat in his kitchen drinking beer and telling tall tales. Like Ben’s first trip to Yosemite, when he couldn’t even get a tent site in Camp 4 and had to bail for Joshua Tree, coming back to Yosemite with just enough time for a hail Mary attempt at the route he’d spent two years training for, The Nose on El Capitan. He’d had to take whatever partner he could find, he told me, which turned out to be a Polish teenager named Robert who’d been overstaying his camping limit by hiding from the rangers in the woods with a backpack and a bicycle.
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P HOTO CRE DI T: CRAI G HOF F M AN
BEN SIGNS OFF ON A CLIMB CALLED “THE WISDOM” IN ELDORADO CANYON STATE PARK
“I’m looking at the Nose, looking at this kid, and my options were one: Robert,” Ben chuckled. “We get to the top and it was great, nobody else up there, just casually in the afternoon sitting by that El Cap tree up there. The cloudscape was amazing, the view of the Valley. I proved something to myself. It felt good.” He shook his head, took another pull on his beer. Eventually, as we both knew we would, we got around to his cancer. Ben talked about finally having to put down his beloved dog, Salsa, and about how he’d taken Salsa to a special place in Eldo, where they had shared so many days. “When Salsa died, I was like, now I’m gonna do some trips, do some long routes,” Ben said. “May of 2017, or maybe end of April, I had just come back from my first time in Spain. I come back with a bronchial infection that lasted a long time and finally went to the doctor. He said it wasn’t pneumonia and that it would go away, but it turned out I had super high blood pressure. We followed up and I posted another high blood pressure, like 186 over 114. And I was feeling uncomfortable, started getting lower back pain, dull and droning. We decided to go in looking to rule things out with ultrasound… and that’s when we found the mass.” Ben took a deep breath then got up and went into his back room, saying that he wanted to get the piece of gear he’d told me about. While he was rummaging around, I leaned against a doorjamb and looked across the sea of prescription bottles on his kitchen counter. Ben never married or had kids, so he could do things like that, just leave prescriptions out on the counter. I didn’t recognize most of the drugs and assumed they were painkillers and other potions for symptom management, because I knew by then that Ben and his doctors had decided against further treatment. When Ben came back, he handed me the piece of gear, a wired chunk of metal about the size and shape of a thumbnail. I thanked him and said I’d give it back after I was able to climb the route. Ben said not to worry about it – I could keep it. I was skeptical about his plan: should I really stop to shove the piece of gear into the crack like he suggested or save my energy by trying to move fast through that section? “Take it up with you,” Ben said. “It’s nice to have it, for peace of mind, just in case.” He leaned back, running a hand across his midsection. “I can feel the tumors across here,” he said. “Sometimes it just feels like a big meal. Sometimes I can feel the lumps.” He saw me looking at one of the prescription bottles and incorrectly assumed I knew what it was. “Yeah,” he said. “My doctor said I’m one of the first in Colorado. One of the first to, you know, use Medical Aid in Dying.” The prescription I was looking at was for a drug that could end Ben’s life.
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He asked if I knew what it was like to die of cancer, or of liver failure, which is what he was looking at, and I told him that despite writing about the disease for the past eight years, I didn’t really know that much – I wrote more about science than about people – but that from what I’d heard, liver failure wasn’t the worst: You didn’t fight for breath; you felt relatively good until going downhill quickly; you knew who you were at the end. I asked what the chances were that he would use the prescription. “I don’t know the percentage,” Ben said, thinking as he looked out the window, where the sun was shining and every so often a car drove by deeper into the cul de sac. “Probable,” he said, finally. “I don’t know the circumstances. If I’m asleep or unconscious or in pain, what’s the point? I’ll probably take it. Chances are probably pretty good.” He smiled at the piece of gear in my hands. “Anyway, it’s nice to have it, for peace of mind, just in case.”
There’s a lot of opportunity with this. I’ve learned, I’ve continued to grow, I’ve changed who I feel I am as a person. At some point, it became obvious that Ben was all talked out and I said something about needing to go because I had to pick up dog food on the way home and cook dinner before my kids got home from practice. Isn’t life grand, I thought as I ate lasagna with my wife and two kids, our two fat Labradors under the table. Later that night, Ben texted to ask if I might want to write about him and his experience and I told him I’d be honored. Then I started thinking about it: could I really write about Medical Aid in Dying? Should I? Planning to ease into the story, I texted Ben back to see if he had time to chat a few days later, to which he replied, “The weather is calling for 44° partly sunny/cloudy and little wind…?” This was, of course, his way of suggesting that we go climbing. It didn’t happen. Believe it or not, the Colorado weather forecast was incorrect, and with clouds obscuring the Flatirons, we pushed climbing off to another day. Instead, we met in downtown Louisville for coffee, where Ben engaged our waitress in a “purely hypothetical” discussion about what harmless but illegal things she would do if “purely hypothetically” she found out she only had a month to live. Ben joked that he had put together a multi-sport getaway plan for robbing a bank that included running, biking, climbing, and tubing along the Boulder Creek Trail. “I read the statistics and the only real success stories were finding it early and cutting it out. Well, we didn’t find it early,” he said, when we were alone. “Right there I’m not in a good bracket. It was pretty much then and there that I made my peace. I mean, even then you gotta try, you still hope, you can’t just give up, but I embraced the possibility of death and set out to do some things with this gift. There’s a lot of opportunity with this. I’ve learned, I’ve continued to grow, I’ve changed who I feel I am as a person. I’ve had the opportunity to heal relationships in my life, helped other people come to different understandings about me. It gives me a sense of motivation – and there’s no more need for validation.” Ben said that what he’d really like to do is, “Go in the back of Eldo somewhere, back where I took Salsa, to drink the Koolaid,” but he’d decided against it because consuming the life-ending medication anywhere but at home is against the rules of the M.A.I.D. program and Ben didn’t want his death to make it any harder for people to use the program in the future. “Or there’s this spot off Baseline, the Dry Creek Dog Park, where all you see is the rolling field of tall grass, a rolling texture for as far as you can see, and then just boom the Flatirons rising out of it.” Before we left the coffee shop, Ben and I made vague plans to climb together. But it never quite came together. By the time you read this, Ben Walburn will almost certainly have passed. Now, in early May, I don’t know if he will use a prescription to end his life. I also don’t know that it matters. What I do know is that we don’t have all the time in the world. We never really did. I used my daughter’s Dremel tool to engrave Ben’s initials in the piece of gear he gave me. I may not use it on that route up at Rincon, but it will be nice to have it, just in case. And if you find a Black Diamond #1 offset stopper cut with a “BW” stuck in a crack somewhere up in Eldo, take it with you. If you place it right, that thing’s an anchor. And as you do, think of Ben Walburn, gaunt and smiling on top of a boulder, miming moves as the sun sinks into the Divide.
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P HOTO CRE DI T: CRAI G HOF F M AN
BEN, WITH ADAM BELAYING, LOGS AIRTIME WHILE FALLING OFF THE CRUX OF “THE WISDOM”
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DING CANCER
Perspectives of Ben’s Providers When I spoke with Ben, he gave his permission for me to speak with his doctors and to write about their experience as providers working with a patient using Colorado’s Medical Aid in Dying program. Despite voters’ approval of the Colorado End-of-Life Options Act in 2016, I was surprised to learn that in early 2019, both of Ben’s main doctors at CU Cancer Center had yet to help a patient pass through the program. Ben was their first. I was also surprised to learn how truly difficult it was for these doctors, personally and professionally, and how much the process forced them to reflect on their wishes for their own end-of-life experiences. Here, in their own words, is what they had to say. VICTOR VILLALOBOS, MD Director, CU Cancer Center Sarcoma Program “I really like Ben a lot. He’s an incredible guy, incredibly thoughtful, and I think he’s been thinking about MAID for quite some time. He totally understands the approach – he wants to live as much good time as possible. He wants to be able to do what he wants to do. Our treatment approach has been to limit toxicity so that he can do what he likes to do for as long as he can do it and that is rock climbing. In a certain way, this isn’t new to oncology – we often sacrifice time being alive to time being comfortable. It’s new in the fact that the patient has a drug cocktail made up to die, with the intent to die quickly, but not new in trading more life for better life. Still, it was a strange feeling, writing that prescription. Most of what we do is try to help people and be safe about it. It’s a weird feeling writing a prescription for a dosage that is toxic. Looking at the doses, it’s like, wow. This process was difficult for all of us. It made me think about what I wanted for my own life. I find it very peaceful to me, to have that thought that if I had a bad diagnosis, and had implications of suffering, the idea that you would have medication available to ease that transition. Some patients don’t use that option, but even having the option is soothing.”
CLAY SMITH, MD Program Director, Blood Cancer & BMT Program, CU School of Medicine “Ten years ago, you could tell people with a very high likelihood that their life would not go on for a long period of time. The challenge we run into this last decade is we’re living in this age in which there is an explosion of new therapies – we’re drinking from a firehose of new treatments. And so, at least in blood cancer (less so with a sarcoma like Ben’s), it may be next month or three months or six months from now that an effective therapy could come along. It’s a wonderful time, but it makes it much more difficult to think about when to say enough is enough. It’s a conversation we’ve been having forever. But with MAID there is an active participation by the medical system in shortening a person’s life and even though I philosophically think this should be available to people, I actually decided I would not participate. What if I’m wrong and they don’t have just six months to live? Morally and ethically, I feel like it’s a person’s right, and could even consider it myself in certain circumstances, but emotionally, I don’t think I could actively write that script’ and watch someone go home knowing... On an intellectual, rational perspective, I know my thinking on this is irrational, but I don’t know how to get around that. My mind says one thing and my heart says another. What I do know is that these are the kinds of things we should be talking about all the time – the real-life stuff.”
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MARTIN MCCARTER, MD Surgical Oncologist, UCHealth University of Colorado Hospital “Talking with colleagues, not a whole lot have experience with MAID. When the bill was passed everyone was on high alert expecting people to come out of the woodwork, and it didn’t happen. It’s on both ends – on the doctor’s side, it’s a hard conversation to have, and none of us are experienced or trained in that. And patients, in some way, are afraid to bring the topic up, I think. I talk with my residents: It’s almost like it’s un-American to do nothing. Everybody is wired to do something if it can be done, explore every last option, fight to the end. It’s a battle; it’s a war; that’s the language we use. It’s human nature not to want to die. But when you’re faced with those decisions, things change. Your perspective changes a great deal. Still, it’s a rare person who can be like Ben and say enough is enough.”
JEANIE YOUNGWERTH, MD Director, Palliative Care Consult Service at CU School of Medicine “When we talk about goals of care, we learn a patient’s story. We talk to them about their values, who they were before illness, who they feel they are now. When someone enquires about aid in dying, we don’t go straight into the law, we go into tell me more about wanting to learn more about this, what’s going on with you and your illness, and how is your life being affected? It’s an inquiry, a process of learning more. Ultimately, it’s about suffering, but suffering comes in so many ways and so many layers. It’s really interesting: Some things we have in our heads about what we want for ourselves, sometimes people who are actually in those positions, their minds change. Hopefully, I’ll react in the way I think I will, but I don’t think any of us can know until confronted with the reality of our own mortality. Dying well means different things to different people. Our role is to figure out what that means for each person.”
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A CONVERSATION WITH CHARLOTTE MCRAE Participant in the University of Cancer Center Center’s
B Y E R I K A M AT I C H
T RE VR ME RC H ANT
Research Summer Fellowship Program
The University of Colorado Cancer Center’s Research Summer Fellowship program
understanding and foster the possibility
began in 1987 as a way to spark curiosity in the next generation of cancer scientists
of health for more people.
and physicians. This summer, Charlotte McRae is visiting from the University of Alabama Honors College in Tuscaloosa, AL. Here C3 speaks with this promising young researcher about her future goals and the experience that inspires her fight against cancer.
C3: What creates your interest in the field of medical research?
my emotions could not. In his last actions, my
Charlotte: My father was a renaissance
edge research, helping advance solutions for
man. Cultures electrified him and after
others, and I feel called to continue his legacy.
majoring in Ancient Greek and the Classics at Princeton, he expressed his love for culture through a little red library in our house. He designed it himself – a room held together by bricks of books and mortars of innumerable countries’ art. My dad would spend his downtime reading in that den, and I would join him. When he was diagnosed with stage four glioblastoma, his brain, once brilliantly full of life and knowledge, slowly regressed under a struggling mass of cells. When my dad was close to passing, the roles between us completely switched. I naturally became his caretaker and helped him retain his quality of life as much as I could. He could barely recognize faces or speak complete sentences, yet he would still call for me and knew how I loved to care for him. When I
father left a legacy as a contributor to cutting-
C3: Why did you apply to the CU Cancer Research Summer Fellowship? Charlotte: Currently, I am studying neuroscience on the pre-med track at the University of Alabama, where I have learned an immense amount of science, but haven’t yet had the chance to apply my studies in an intense research setting. Gaining scientific knowledge is important, yet knowledge only becomes useful when applied. I feel this fellowship at the University of Colorado Cancer Center will give me first-hand experiences that I could not obtain in a classroom. Through this fellowship, I will have the opportunity to develop skills
C3: What do you most look forward to in Colorado? Charlotte: Even though I’m a hard worker and often spend the bulk of my time studying, nature, culture, and art are staples for my soul. I’m looking forward to enjoying these aspects of life in the beautiful state of Colorado while furthering my passion for science.
C3: What do you most look forward to in your career? Charlotte: I know as a doctor I will have instances where nothing goes as planned, but that is the mystery of life. I look forward to the everyday practice of medicine, but I will also embrace my role as a facilitator of life’s unpredictable course, both when it is heart-warming and, more importantly, when it is heart-wrenching. I am eager to use my skills as a doctor to transform these lessons I have learned into the motivation and ability to cure and heal.
that I can use in my career to create
diligently watched the hospice doctor and her grace in supporting my father and our family, I knew I would spend my life exploring medical science.
C3: What excites you about research? Charlotte: When my father was beyond the help of physicians, he worked with C/O CHARLO TTE M CRAE
researchers at Duke Oncology Center to use his cells to create a novel vaccine for immunotherapy. I was enamored with the research and would travel with my father to the lab in order to learn more about the immunotherapy. The logic of medicine brought me a sense of understanding when
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C H A R L O TTE W I TH H ER FATH ER
CLINICAL
CARE T RE VR ME RC H ANT
MD Instant Gratification BREAST SURGEON, SARAH TEVIS, MD, HELPS PATIENTS BALANCE CANCER CARE WITH REAL LIFE B Y E R I K A M AT I C H
Instant gratification is the desire to experience fulfillment without delay. It’s not always a good thing. Unless you’re Sarah Tevis, MD, a surgical oncologist and mentored member of the University of Colorado Cancer Center. For Tevis, instant gratification means curing cancer in the operating room. “As surgeons we like fixing a problem,” says Tevis. “That’s what drew me to surgery. You can treat cancer very definitively.” Tevis told her parents from a young age she would be a physician, but, “I didn’t have a sense of what kind of doctor I wanted to be until I was in high school and my dad developed lung cancer,” she says. “I was old enough to be involved in his care and I got a good sense of how a team takes care of cancer patients.” Then came college, and then medical school at the University of Wisconsin School of Medicine and Public Health. Tevis was halfway through her residency there when she decided to specialize in breast cancer surgery. Her time on the breast service allowed Tevis to meet patients and learn about the research that guides treatment recommendations. She also learned to help patients make treatment decisions based on their life priorities. “I did the breast rotation my third clinical year and really enjoyed the patient population,” Tevis says. “We have great evidence for treating patients with breast cancer and they have a lot of
issues to manage like young kids, time off work, and transportation. I like to help them with everything.” And by “everything” Tevis means not only cancer surgery, but the multitude of issues that surround cancer care, not the least of which are the demands of a continuing life, including jobs and families. Often, the realities of life surrounding cancer mean that not every patient has the same priorities. “I have patients coming to my clinic and I’m thinking about their breast cancer,” says Tevis. “But they are thinking about their 8-year-old autistic son, so their focus is on completing treatment with the least amount of doctor visits or surgery.” In fact, Tevis’s goal to offer compassionate care that takes into account the real lives of patients outside of cancer has led her to make these issues the focus of her research, measuring the impact of cancer on patients’ psychosocial well-being, sexual health, and even cosmetic outcomes. “Patient concerns are very subjective, but we can’t ignore these important aspects of the cancer experience,” stresses Tevis. “Those concerns influence patient decision making and a patient’s ability to go through with all their treatment and achieve the best outcome.” Because cancer can so deeply affect so many aspects of a patient’s life, it can be challenging to identify all the needed supportive resources.
SARAH TEVIS, MD
“We have so many things we have to talk to them about,” she says, “including different types of surgery, the potential for chemotherapy, if they are going to need radiation, and what kinds of medication they will need longer term.” In addition to her surgical schedule and research on supportive services, Tevis is a leading expert in the treatment of a rare type of lymphoma called Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), which, in rare cases, forms around a textured implant and can travel to other parts of the body. “I’ve seen patients with different presentations of the disease,” says Tevis, who recently published treatment guidelines for the condition. “I’ve operated on patients with the disease and so it’s nice to offer that option to women in this region with this type of lymphoma.” As a surgeon, Tevis can cure breast cancer in some of her patients. And for her, that’s the most gratifying kind of instant gratification.
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A Better Way NORM PACE, PHD: CAVE EXPLORER, “FATHER OF MICROBIAL ECOLOGY,” STAGE IV MELANOMA SURVIVOR BY TAYLOR ABARCA
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THIS PHOTO AND COVER PHOTO BY GLENN ASAKAWA, UNIVE RSIT Y OF C OLORADO
Cancer doesn’t discriminate. Cancer doesn’t care if you have a PhD. It doesn’t care that you have held faculty positions at top universities. It couldn’t care less that you are a distinguished professor of molecular, cellular, and developmental biology at the University of Colorado Boulder. It also doesn’t care about your upcoming trip to Washington, DC to be awarded the 2019 National Academy of Sciences (NAS) Award in Early Earth and Life Sciences Stanley Miller Medal. It doesn’t care that you’re widely known as the “father of microbial ecology.” Norman (Norm) R. Pace, PhD, knows first-hand that cancer is not particular. A shocking late stage melanoma diagnosis in 2017 was, in his words, a “chilling” discovery that nearly took his life.
An unwelcome surprise
“The morning of my diagnosis I got out of the shower and had a seizure, which caused me to fall and whack my head,” recalls Norm, 76. “I was able to raise hell and get the attention of my granddaughter who was visiting. If she wouldn’t have been there, I would have died.” Norm lives alone in Boulder, Colorado. It was pure coincidence that his granddaughter was there that day. “We drove to the hospital where I went through all the usual testing – MRI, blood work, the whole deal,” he explains. “When I saw the scans, I wasn’t particularly hopeful. There were slugs of tumors all over my body and brain. It was chilling to hear the diagnosis.” The diagnosis was stage IV melanoma. Often, melanoma makes an appearance as an abnormal mole or even a black spot under a nail. In Norm’s case, there were no spots on his body, and it wasn’t until the cancer nearly killed him that he even knew it existed. “It was shocking to hear that I had melanoma,” he says. “If you looked at me you would have never thought I had it.” Two days later Norm had surgery to remove two masses, one 3.5-centimeter and the other 1.5-centimeter, from his brain. Unfortunately, there were more, but additional tumors were too deeply interwoven in his brain to be removed.
Second opinions save lives
After his surgery, Norm, with the encouragement of his colleagues, decided to pursue a second opinion before continuing with his treatment. He was referred to the University of Colorado Cancer Center at the Anschutz Medical Campus, where Karl Lewis, MD, associate professor in the Division of Medical Oncology, took over his care. “When Norm arrived, he was very sick, recovering from his recent craniotomy and still with active brain metastases,” says Lewis, who is also the associate director of the Melanoma Research Clinics at the University
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of Colorado Anschutz Medical Campus. “Fortunately, we have effective medications that can result in significant long-term control of the melanoma.” Norm was put on a treatment regimen of pembrolizumab, commonly known as Keytruda. Keytruda, an immunotherapy, works by making cancer cells visible to the immune system so that they can be eliminated by the body’s killer T-cells. “Keytruda saved me,” says Norm. “I could physically see the tumors in my body changing. They turned hard and red
More than cancer
PHOTO BY GLENN ASAKAWA, UNIVERSIT Y OF C OLORADO
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before they shrank away. It reminded me of parasites that move around the body.” For the past two years, Norm has been travelling to CU Cancer Center once every three weeks for treatment. He also had two gamma knife surgeries – a kind of precisely targeted radiation – to remove the remaining tumors in his brain. “The whole experience at Anschutz has been very impressive,” says Norm. “I am absolutely delighted. Treatment has been far more successful than I ever thought it would be.”
In April, Norm traveled to Washington, DC to accept the National Academy of Sciences (NAS) Award in Early Earth and Life Sciences Stanley Miller Medal, something he thought he would not have the opportunity to do. The prestigious award is given out once every five years to experts in the field of research on Earth’s early development as a planet. According to the NAS, Norm earned the award for “pioneering work into the diversity of life on Earth.” During his career as a distinguished professor emeritus of molecular, cellular and developmental biology at CU Boulder, Norm developed gene sequencing tools that allow scientists to identify virtually all microorganisms on the planet. “When I started studying microorganisms there wasn’t a great way to identify them because they don’t grow in labs like they do in their natural environments,” he explains. “I thought to myself ‘there has to be a better way.’” With the knowledge of his friend Carl Woese, PhD, (famous for defining Archaea as a new domain of life), Norm developed this better way. Norm learned that by sequencing and comparing the genes in rRNA of an unknown organism to the genes in the rRNA of an identified organism, he could learn a lot about the relationship between the two. This led to a paradigm shift in the study of microbiology, paving the way for scientists all over the world to identify new microorganisms by sequencing their genes rather than trying to culture them in a lab, something that had never been done before. Basically, Norm’s work revolutionized the way scientists categorize life on Earth. Not only did Norm throw open the gates of genetic microbiology, he also has helped mapped the world beneath our feet. Before his cancer diagnosis, Norm spent his free time in the darkness and vastness of unexplored caves. In the 1970s he led an expedition that mapped the longest cave system in Colorado – the Groaning Cave located in the White River National Forest.
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ST RY INSIDE
Melanoma in Colorado Colorado has the United States’ highest per-capita rate of skin cancer, driven in part by high elevation and an outdoor lifestyle. How much more intense is Coloradoans’ sun exposure? Well, about 300 days of sunshine each year makes it easy for a population that trends younger than other states to hike in the summer and ski in the winter. Then there’s the level of intensity of UV rays from the sun, which is measured in something called the “Index Scale.” The Index Scale, which ranges from 1-11+, takes into account things like how much atmosphere is present in a location, seasons, cloud cover, and more. The lower the number on the Index Scale, the safer it is to be outside. Colorado’s UV Index Scale rating is hit by a double whammy – higher elevation with more sunny days – resulting in a summer score that is generally between 7 and 10, which is considered “high” to “extreme.” To protect yourself from UV rays that can cause melanoma and other skin cancers, always be sure to practice sun safe behavior. This includes seeking shade, wearing large hats, covering up exposed skin with light clothing, and wearing (and reapplying) sunscreen. Experts also recommend a yearly skin check with a dermatologist to ensure that any skin cancers that develop are caught early.
“For me, caving is the perfect way to escape from the evils of this world,” says Norm, who stepped into his first cave at just 14 years old. Since then, Norm has explored more than 100 caves, often times as the first human to set foot inside. In 1987, he received the Lew Bicking Award, which, according to the National Speleological Society, “has been established to recognize a dedication to the thorough exploration and mapping of a cave or a group of caves.” It is one of the highest honors that can be awarded to cavers. In 2016, Norm went on his final cave expedition, which he fondly refers to as “Geezers go to Groaning.”
“A lot of the original people that were with me when I first explored the caves were there, as well as many students,” he says. “I couldn’t keep up with the students, but it was a fun day.” So, what does a man who literally founded a field of science, helped identify hundreds of previously unknown microorganisms, won numerous prestigious awards, explored hundreds of miles of caves, and was diagnosed with advanced stage melanoma do with this “extra” time that luck and science have provided? “Like anyone else, I don’t know how long I am going to be here,” Norm says. “For now, I am simply grateful for each day I have. Who knows what is coming next?”
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IS YOUR IMMUNE SYSTEM TRYING TO KILL YOU? Prevention and Control
BY GARTH SUNDEM
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WHAT DO FORMER PRESIDENT JIMMY CARTER AND POISON DRUMMER RIKKI ROCKETT HAVE IN COMMON? Hint: It’s not their taste in music. Carter’s White House included a constant backdrop of classical music, while Rockett’s multi-platinum 1986 album “Look at What the Cat Dragged In” was described by Revolver Magazine as, “Under-thought and relentlessly fun.” No, the commonality is that both were treated with anti-cancer drugs called immunotherapies that harness the power of the immune system to attack cancer. For Carter, immunotherapy treated melanoma that had spread to his brain and liver, and for Rockett, it was throat cancer. But the immune system is a fickle ally in the fight against cancer. Just as we are learning to use the immune system to attack tumors, research is showing that a dysregulated immune system may also be a powerful co-conspirator in the cause of many cancers. Blame it on inflammation. Here’s how the immune system is supposed to work: When you step on a Lego while stumbling toward the coffee maker at 6:00am, white blood cells, antibodies and other immune cells rally to the puncture wound on the bottom of your foot to fight possible infection and start the healing process. These new arrivals make the area around the Lego wound swell, while blood vessels that dilate to welcome nutrients and enzymes to the site can make the area hot to the touch. Similar happens with bacterial, viral, or fungal infection: Your immune system recognizes the problem and mobilizes inflammation to deal with it. Then, once the immune system has successfully squelched infection, inflammation ends. Or at least it should. “When acute inflammation happens, there are two phases – a pro-inflammatory event should be followed by an anti-inflammatory event. When the amount and timing is dysregulated, it creates chronic, sustained inflammation, which can contribute to tumor initiation, progression, and metastasis,” says Mayumi Fujita, PhD, CU Cancer Center investigator and professor in the CU School of Medicine Department of Dermatology. Think of it like your backyard barbecue. You light the barbecue to grill your food and when your food is cooked, you turn it off. But a barbecue that constantly smolders would eventually eat through the structure of the grill. That’s the difference between acute and chronic inflammation – the first cooks infections, while the second can lead to conditions that cook you.
How Chronic Inflammation Causes Cancer There are at least three ways that chronic inflammation causes cancer. Let’s look at them from most to least obvious. First and most obviously, inflammation can cause DNA damage. It’s a bit like pouring hydrogen peroxide on a wound – immune system cells involved in inflammation release a chemical called reactive oxygen species (ROS), which sizzles infection, but also “stings” surrounding, healthy tissue, in this case in a way that can break apart linkages in your DNA. And what is cancer but a healthy cell with broken DNA? Like smoking and sunburn, chronic inflammation assaults cells in ways that multiply the chance of picking up a cancer-causing genetic mutation. Then chronic inflammation fertilizes these dangerous cells. Think about it: The role of inflammation is not only to stop infection, but also to start wound healing. Unfortunately, the immune system’s cocktail that stimulates healing through the growth of blood vessels that deliver oxygen and nutrients, can also spur the growth of cancer.
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Chronic Inflammation and the Tissue Ecosystem A third way that chronic inflammation causes cancer has less to do with creating and nurturing cancer cells, and more to do with damaging the ecosystem surrounding these cells – researchers call this the “tumor microenvironment.” It’s like your lawn: If your lawn is healthy, grass will out-compete dandelions. But dandelions capitalize on disturbed earth and when the soil is damaged, suddenly dandelions are able to out-compete your grass (or, it seems, especially my grass…). “It’s survival of the fittest for the populations of cells inside your body. Healthy cells are optimized for healthy tissues, but introducing chronic inflammation adjusts the tissue landscape so that all of a sudden, cancer cells can find themselves the most fit,” says James DeGregori, PhD, CU Cancer Center Deputy Director.
Maybe in addition to designing new drugs to target cancer cells, we should be designing interventions to support the health of tissues that surround cancers... Here’s an interesting piece: Chronic inflammation is a feature of aging. “What if it’s not just picking up a cancercausing mutation, but age-associated changes to the tissue microenvironment that helps to create higher rates of cancer in older adults?” DeGregori asks. In fact, DeGregori’s work shows that instead of making “super cells,” many of the genetic mutations found in a range of cancers instead actually make these cancer cells less fit to survive in healthy tissues. And he also shows that cells pick up potentially cancer-causing mutations all the time, but that in a healthy tissue ecosystem, these dangerous cells lose the
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battle of natural selection against healthy cells, keeping the body cancer-free. DeGregori’s work has at least two very important implications: Maybe in addition to designing new drugs to target cancer cells, we should be designing interventions to support the health of tissues that surround cancers; and perhaps by protecting the tissue ecosystem – by fighting chronic inflammation among other things – we could prevent the disease in the first place.
Are Cancers Caused by Chronic Inflammation Really a Big Problem? In short, yes. According to the National Institutes of Health, about 1 in 5 cancers are linked to chronic inflammation. For example, the more years you live with the chronic inflammatory condition ulcerative colitis, the higher your risk of developing colon cancer, with 2 percent risk after 10 years, 8 percent risk after 20 years, and 18 percent risk after 30 years (lifetime risk in the general population is about 4.2 percent). Similar is true of autoimmune conditions like pancreatitis and hepatitis, which increase the risk of pancreatic and liver cancer, respectively. In addition to autoimmune conditions, cancer risk climbs with other conditions that create chronic inflammation, like infections and environmental exposures. For example, infection with the bacteria h. pylori leads to chronic inflammation implicated in stomach cancer. And in addition to damaging DNA, smoking and asbestos exposure both cause chronic irritation and thus inflammation in tissues of the lung, increasing the risk of lung cancer and mesothelioma. Really, it seems as if anything that causes chronic inflammation also increases cancer risk, including many of the lifestyle choices we make every day. “We focus on two components: diet and activity level,” says Regina Brown, CU Cancer Center Member and Medical Director of Oncology at UCHealth Lone Tree Medical Center. Some of the influence of diet and activity on cancer risk works through obesity. Basically, obesity can cause low levels of chronic inflammation, which increases cancer risk just like any of the earlier causes of chronic inflammation (plus, fat tissue is higher in estrogen and insulin-related growth factors, which may influence some cancers). Additionally, diet and activity level may influence chronic inflammation directly, whether or not these lifestyle choices contribute to obesity. “When we test diets that are higher in fiber, like a rice and bean diet, in 4-weeks time we are able to see inflammatory markers go down in stool, urine, and blood. And things like
eating diets high in red meat have been shown to affect the mucosal lining of the GI tract,” says Brown. “Also, there is a lot of research focusing on sedentary lives, especially in increasing the risk of early-onset colorectal cancer. For example, a study published in February showed that colorectal cancer risk increased with the number of hours of TV people watch a day.” The study Brown refers to looked at the data of 89,278 female nurses who contributed health and lifestyle info to a giant database. In these women, there were 118 cases of early-onset colorectal cancer. Who were these unlucky women? Well, more than one hour of TV watching per day was associated with 12 percent increased risk, and more than two hours per day was associated with almost 70 percent increased risk. Does this necessarily mean that watching TV causes colorectal cancer? No. But, it does imply that some mix of lifestyle issues might be to blame.
“It might seem a little simplistic, but from our work and the work of others it also seems real: Inflammation is bad; it revs up our immune system and it causes disruption. And anything we can do to decrease chronic inflammation may be good,” Brown says. Is your immune system predisposed to gnaw at your own tissues? Do you have a nagging infection that keeps your immune system revved up? Are environmental exposures to things like smoking or asbestos creating constant immune activation? Or are you eating and sitting your way to obesity and/or tissue irritation? If so, chronic inflammation could be increasing your cancer risk. And the secret to staying cancerfree may be soothing your immune system so that your tissue ecosystem continues to favor healthy cells over their cancerous cousins.
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D O N O R
S T O R Y
Patten-Davis Foundation GIFT TO ACCELERATE PANCREATIC CANCER RESEARCH
C ANC E R C E NT E R
BY De vin Lynn
D AVI D C O H EN ( L EF T) , JO A N ( J O N I ) B EL L , D R . A L EXI S L EA L , A N D TERCE ( TYSO N) DI NES Since 2015, over 450 benefactors have generously given to the University of
of the Patten-Davis Foundation, the CU Cancer Center is nationally ranked and
Colorado Cancer Center. Chief among them is the Patten-Davis Foundation
continues to improve patient outcomes.
— a longstanding philanthropic partner to CU. In the past two decades, the
patients. The Patten-Davis Foundation is integral to our success, and I’m
diabetes and cancer research.
excited about the research made possible by their generosity,” said CU Cancer
The foundation was established by Amy Davis, a philanthropist and forward-thinking citizen dedicated to causes in Colorado and Wyoming. After
Center Director Richard Schulick, MD, MBA. The most recent endowments, the Gina Guy Endowed Funds in Pancreatic
the death of her father in 1992, she created the Courtenay C. and Lucy Patten
Cancer Research, include a professorship awarded to Alexis Leal, MD,
Davis Foundation. For the next several decades, Amy dedicated herself to
assistant professor of medical oncology. Leal joined CU Anschutz in 2017 to
philanthropy – volunteering and contributing to causes throughout the Rocky
continue her leading research in gastrointestinal malignancies. Her focus in the
Mountain region. It was the Patten-Davis Foundation that allowed her to make
laboratory and clinic is on gastrointestinal cancers including colorectal cancer,
such a meaningful impact on Colorado, and focused her time and energy on
esophageal, gastric and pancreatic cancers, and more. “This endowment
health care, open spaces and education.
allows me to dedicate more time to my research to pursue the therapies of
“We believe in continuing Amy Davis and the Davis family’s proud legacy of giving back to the community,” said David Cohen, Patten-Davis Foundation
tomorrow,” said Leal. Research efforts in gastrointestinal cancers are focused on providing
trustee. “By giving to the CU Anschutz Medical Campus, we are making an
targeted therapies, so patients receive the right treatment the first time. Leal’s
impact on countless lives.”
hope is that her research will reduce the suffering associated with cancer
In 2019, the Patten-Davis Foundation completed the funding of their sixth endowment at the CU Anschutz Medical Campus. The endowed funds created
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“Philanthropy accelerates our ability to bring novel treatment options to
Patten-Davis Foundation has made substantial philanthropic investments in
treatments and allow patients to live extraordinary lives. “If my research is successful, I’ll have more options for my patients battling
by the Patten-Davis Foundation encourage faculty to pursue high-risk, high-
gastrointestinal cancers,” said Leal. “These new therapies will be more
reward research that holds promise for transforming patient care. With the help
effective, giving patients and their families hope during a difficult time.”
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D O N O R
N E W S
Pollyea and Pietr as earn endowed chairs in hematology research In academic medicine, endowed chairs are honors created by philanthropic funds to provide stable, long-term positions for highly accomplished scientists. University of Colorado Cancer Center is proud to announce recipients of two newly endowed chairs, namely Daniel Pollyea, MD, recipient of the Robert H. Allen Endowed Chair in Hematology Research, and Eric Pietras, PhD, recipient of the Cleo Meador/George Ryland Scott Endowed Chair in Hematology Research. The positions recognize the researchers’ excellence in pushing forward the field of hematologic oncology and cancer clinical trials. “Dan has been an outstanding partner in testing new therapies aimed at leukemia stem cells, which we expect will lead to a truly new paradigm in the treatment of this and other blood cancers,” says Craig T. Jordan, PhD, Nancy Carroll Allen Chair and Chief of the CU School of Medicine Division of Hematology. “And Eric has accomplished an incredible amount, considering how early he still is in his career. This chair will help to support his transition from early-career scientist into one of the leaders in the field.” The University of Colorado Cancer Center is honored by the trust of
A I M EE L A P ER R I ER E- H U N T ( L EF T) , D R . C H R I S L I EU , DR. ALEXI S LEAL, J ULI E B A N A H A N , L I S EN A X ELL, DR. SWATI PATEL
Blue Hope Bash
donors who make these positions possible, which in turn make possible the
The second annual Blue Hope Bash took place March 8, 2019 at Mile
recruitment, retention and support of world-class researchers working to
High Station, raising funds for colorectal cancer research. The Denver gala
discover, develop and deliver tomorrow’s treatments for cancer.
represents a partnership between colorectal cancer survivor, Kim Kronenberger,
“An Evening of Hope” for Pancreatic Cancer Research CU Cancer Center was honored to co-host with non-profit Wings of Hope for Pancreatic Cancer Research the event “An Evening of Hope,” which raised funds for life-saving pancreatic cancer research at the University of Colorado Cancer Center. “Pancreatic cancer is the most underfunded, under-recognized and least
and the Colorectal Cancer Alliance. More than three years after being treated at UCHealth University of Colorado Hospital, Kronenberger is cancer free and leads an effort in Denver to raise money for colorectal cancer research. “I was feeling so much better,” she says. “I wanted to pay it forward and help the people who may get this disease after me.” Over the past two years, the success of the Denver event has sparked interest in Indianapolis, Chicago, and Boston to host their own Blue Hope Bash. “The only way we will come up with better treatments for colorectal
studied of all deadly cancers,” explains Maureen Shul, founder of the Wings
cancer is through research,” says Christopher Lieu, MD, CU Cancer Center’s
of Hope for Pancreatic Cancer Research. “We are committed to bringing
deputy associate director for clinical research. “The money raised at the
awareness to this disease and increased funding to the ongoing research
Blue Hope Bash will help us learn more about CRC and new treatments like
taking place at the CU Cancer Center.”
immunotherapy.”
CU Cancer Center director, Richard Schulick, MD, MBA, said in a Town Hall meeting that pancreatic cancer will soon overtake colorectal cancer as the number two cancer killer in the United States. “If you look at the five-year survival rate for patients with pancreatic cancer
Save the Date: Serving Cancer Tennis Tournament The “Serving Cancer” tennis tournament to raise money for pancreatic cancer
who are being treated at the best centers, it is only 25 percent to 30 percent,”
research will be held noon-7:30pm, August 24th at the Ken-Caryl Ranch
says Schulick. “Events like ‘An Evening of Hope’ support incredibly important
Community Center in Littleton, CO. Top quality men’s and women’s doubles will
research that can lead to a better molecular understanding of the disease,
be featured along with kid’s activities, family swimming, food trucks, and live
earlier detection, and more effective therapies.”
music. Prizes will be raffled off for those who attend.
Get more CU Cancer Center news on our blog: www.coloradocancerblogs.org Sign up for our bimonthly newsletter, Colorado Cancer News.
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SPRING 2019 www.coloradocancercenter.org
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C3: Collaborating to Conquer Cancer Published twice a year by University of Colorado Anschutz Medical Campus for friends, members, and the community of the University of Colorado Cancer Center. (No research money has been used for this publication.) Editor: Garth Sundem | 303-724-6441 | garth.sundem@ucdenver.edu Contributing Writers: Taylor Abarca, Erika Matich Photos: Craig Hoffman, Glenn Asakawa, Rob Linnenberger The CU Cancer Center Consortium Members UNIVERSITIES
Colorado State University University of Colorado Boulder University of Colorado Anschutz Medical Campus INSTI TUTIONS
UCHealth University of Colorado Hospital Children’s Hospital Colorado Denver Veterans Affairs Medical Center 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.
T H E
M E S S A G E
FROM THE DIRECTOR RICHARD SCHULICK, MD, MBA DIRECTOR, UNIVERSITY OF COLORADO CANCER CENTER CHAIR OF SURGERY, UNIVERSITY OF COLORADO SCHOOL OF MEDICINE
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How Patients, Clinical Trials Will Help us Cure Cancer When I say that cancer research exists because of patients, I
multiplies our clinical trials by nineteen – we can bring new
mean two things. First, of course, the goal of cancer research
drugs to patients faster, design drugs for subtypes of cancer
is to help patients live longer, better lives. But second, cancer
that are more targeted, and the results of our tests are more
research only exists with the help of patients. That’s because it
powerful than what we could accomplish on our own.
eventually comes down to patients to show the effectiveness of
In fact, in March 2019, we enrolled our 5,000th patient
new cancer treatments. It is through the process of clinical trials
in ORIEN, contributing anonymized results and samples of
with real patients and real cancer that we learn which drugs,
patients’ cancers to a centralized database (with the patients’
procedures, devices, and techniques should be added to the
consent). And because new medicines are being developed at
quiver of “approved” therapies that physicians and oncologists
a pace never before seen, “banking” the genetics of a patient’s
outside academic medicine use across the world, every day.
cancer may allow patients to learn about new drugs matched
The more patients included in well-designed clinical
to their cancer type that come out 6 months, a year, or even
trials, the more who get early access to potentially life-saving treatments. And the more patients who choose to participate in clinical trials, the faster we learn about these treatments and the faster the successful ones become available to everyone else. It’s a win-win: more patients benefit from successful trials so that more patients can benefit after them. That’s one reason University of Colorado Cancer Center in partnership with UCHealth is expanding our ability to offer clinical trials around the state of Colorado, making new
many years from now.
“The goal of cancer research is to help patients live longer, better lives… And cancer research only exists with the help of patients.”
treatments accessible to patients in medical centers near
Cancer researchers need patients to show us which
where they live and work. It’s also why CU Cancer Center
experimental agents should become the next life-saving
participates in a program called the Oncology Research
drugs. And many cancer patients need new drugs as soon as
Information Exchange Network, or ORIEN. By sharing the
possible. By working together to expand access to and use of
results of our treatments with 19 leading cancer research
clinical trials, we can continue to discover, test and refine ways
institutions around the country, it’s as if CU Cancer Center
to help cancer patients lead longer, fuller lives.
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