C O L L A B O R AT I N G
T O
C O N Q U E R
C A N C E R
IS THERE A
NATURAL CURE FOR CANC E R?
12: I CAN FOCUS ON THE SUN SHINING 16: CLOSING THE GAPS 10: Q&A WITH NEIL BOX, PhD 11: C3 MD RAJEEV VIBHAKAR 18: SUPPORTER FOCUS ON PAUL SANDOVAL
ANSCHUTZ MEDICAL CAMPUS
SPRI NG 2015
C OURT E SY OF KAT Y DAVE NPORT
N3WS C AT H Y B R A D L E Y, P h D , NA M E D A S S O C I AT E D I R E CTO R F O R PR EVE NTION & CONTROL CU Cancer Center and the Colorado School of Public Health have partnered to hire an associate director for cancer prevention and control. Cathy J. Bradley, PhD, comes to CU from Virginia Commonwealth University where she is associate director at VCU’s Massey Cancer Center, chair of the university’s Department of
BRADLEY
YOUNG COLON CANCER PATIENT FINDS HOPE AT CU CANCER CENTER
Healthcare Policy and Research
At 34 years old, with long blonde hair, a fit physique, and an overwhelmingly positive attitude, Katy
and interim chair of the Department of Social
Davenport hardly looks like someone who is fighting cancer. Yet after noticing some blood in her stool,
and Behavioral Health. Bradley is a health economist specializing in
a precautionary colonoscopy discovered a tumor. “When we went in we honestly thought it would be nothing,” Katy says. “It was truly a shock for both
cancer, with more than 100 articles published
me and my husband to find out that I had a tumor, especially because there is no history of colon cancer
in peer-reviewed journals. Much of her recent
in my family.”
work focuses on finding and fixing gaps in
A biopsy confirmed that the tumor was malignant and on New Year’s Eve, Katy was diagnosed with
cancer care affecting underserved and minority
stage three colon cancer. After talking to some friends she quickly turned to the CU Cancer Center for
populations. She also has pioneered research
a second opinion. Christopher Lieu, MD, assistant professor of medical oncology at the CU School of
addressing cancer and its effect on employment.
Medicine, became her oncologist. Her tumor was removed and Katy is optimistic about the six months
Bradley will be a key member of the CU Cancer
of chemotherapy that follow surgery.
Center’s executive leadership team, as well as a
“If I could give advice to not only young cancer patients, but all patients, it would be to try and keep
professor in the Department of Health Systems,
a good attitude and keep finding things to smile about,” she says. “Also be sure to take care of yourself
Management and Policy at Colorado School of
and make sure you do what you need to do.”
Public Health. “Dr. Bradley is an outstanding scholar and I am very pleased she will be leading our faculty
MUTATIONS NEED HELP FROM AGING TISSUE TO CAUSE LEUKEMIA THI NK STOCK
Why are older people at higher risk for developing cancer? Prevailing opinion holds that, over time, your body’s cells accumulate DNA damage and that eventually this damage catches up with the body in a way that
and students in this important area of science,” said David Goff, MD, PhD, dean of the Colorado School of Public Health. “We look forward to her contributions to our school, CU Cancer Center, and CU Anschutz.”
causes cancer. A CU study published in the journal Aging shows that this prevailing opinion is incomplete. In addition to DNA damage, cancer depends on the slow degradation of tissue that surrounds cancer cells, something that naturally comes with aging. “It’s really all about natural selection and survival of the fittest,” says James DeGregori, PhD. “When you’re young, healthy cells are optimized to the surrounding tissue – they’re the ‘fittest.’ At that point, any mutation that affects function makes a cell less fit, so cells with mutations, even cancer-causing mutations, are out-competed by the young, fit, healthy cells. But when the tissue landscape changes with aging, healthy cells may no longer be optimized to their surroundings. In this aged landscape, mutations may actually make certain cells better, allowing them to out-compete the normal cells and form tumors. That’s why older people get cancer.”
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15%
OF HIGH SCHOOLERS TR I E D E -C I GAR ETTE S
WHOSE NUMBERS SHOULD WE USE TO CALCULATE THE COST-EFFECTIVENESS OF TARGETED ANTI-CANCER THERAPIES? Health economics helps insurers, health care systems, and providers make treatment decisions based on the cost of extra “units” of health arising from a specific treatment. By calculating the cost for each year of life or quality-adjusted year of life gained, these groups can decide whether changing treatments or adding in a new treatment beyond the existing standard of care is “worth it.” However, while the resulting incremental cost effectiveness ratio (ICER) is often presented as an absolute measure upon which to base these decisions, an opinion published by CU Cancer Center researchers D. Ross Camidge, MD, PhD, and Adam Atherly, PhD, suggests that the consumers of these data need to be much more aware of the
LONG-TERM HEALTH EFFECTS OF
assumptions underlying these calculations. FLIC KR/MORE BY LE SS
E-CIGARETTES STILL UNKNOWN Although current research is limited, there is growing concern about the long-term health effects of e-cigarettes. “We cannot say for sure if e-cigs have a link to causing cancer but we do know there is much to be clarified about them and their contents,” says Arnold Levinson, PhD. “We don’t know enough about what else besides nicotine is in e-cigarette liquid and vapor. We also don’t know what happens when a major e-cigarette ingredient, glycerin, is warmed enough to vaporize.” The 2013 youth risk survey for Colorado asked high school students to answer questions about their tobacco habits. The survey revealed that approximately 21.8 percent of high school students have smoked one whole cigarette in
“Increasingly physicians are being presented with health economic analyses in mainstream medical
their lifetime and 15.1 percent have tried an
journals as a means of potentially influencing their prescribing. However, it is only when you understand the
e-cigarette.
multiple assumptions behind these calculations that you can see that they are by no means absolute truths,”
“It’s clear that traditional cigarettes are still
Camidge says.
the biggest issue,” says Ashley Brooks-Russell,
“Something that might seem clear-cut from the outside really gets tricky and much less definite when
assistant professor at Colorado School of Public
you pull it apart,” Atherly says. “The cost per unit of health that is used to determine if a drug is or isn’t used
Health. “However e-cigs are not far behind and
seems like an unequivocal fact, but is often highly equivocal.”
their use is continuing to rise.”
“If we don’t address the feasibility of actually delivering these breakthroughs to patients in the real world
FAULTY CHROMOSOME REPAIR
HOW RED WINE CAUSES…AND PREVENTS CANCER
LEADS TO CANCER
Alcohol use is a major risk factor for head and neck cancer. But a
Like a car’s front and back bumpers, your cell’s
CU Cancer Center study shows that the chemical resveratrol found
chromosomes are capped by “telomeres” that
in grape skins and in red wine may prevent cancer as well.
protect this genetic material against deterioration.
“Alcohol bombards your genes. Your body has ways to repair
When telomeres break down, cells die – in many
this damage, but with enough alcohol eventually some damage
cases, that’s a good thing, because immortal cells
isn’t fixed. That’s why excessive alcohol use is a factor in head
cause cancer.
and neck cancer. Now, resveratrol challenges these cells – the
A study published in the journal SCIENCE by
ones with unrepaired DNA damage are killed, so they can’t go
CU Cancer Center members at the University of
on to cause cancer. Alcohol damages cells and resveratrol
Colorado at Boulder and Denver looked inside human
kills damaged cells,” says Robert Sclafani, PhD, professor of
bladder cancer cell lines and patient genetics to show
biochemistry and molecular genetics at the CU School of Medicine.
that improper reactivation of the gene TERT repairs
THIN KSTOCK
they will not be breakthroughs at all,” they write.
According to Sclafani, the resveratrol in red wine (and other
telomeres long after natural degradation should have
chemopreventive chemicals found in grape seed extract) isn’t a magic
led to cell death. The study also shows that interrupt-
bullet that can completely undo the cancer-causing effects of alcohol,
ing cancer’s ability to reactivate TERT in a way that
but by killing the most dangerous cells it may decrease the probability that
leads to telomere repair could interrupt the growth
alcohol use will cause cancer.
of many cancer types.
3 C3: SPRING 2015
T H INKST OC K
IS THERE A
NATURAL CURE FOR CANC E R?
BY GARTH SUNDEM
I
Acai juice, milk thistle, green tea, resveratrol, brown rice, grape seed extract, bitter melon and more
n April, 1971, ping pong player Glenn Cowan missed the U.S. team bus after a practice in Nagoya, Japan. A Chinese player waved him onto their waiting bus and the rest is history: In what has become known as Ping Pong Diplomacy, a delegation of America’s best players toured China, where they were treated like royalty and roundly thumped in exhibition matches against unseeded Chinese athletes. After the visit, relations between the countries thawed. Nixon visited the following year. And in the late 1970s, restrictions on emigration from China were eased and Chinese relocation to the United States skyrocketed. Unfortunately, when Chinese women moved to the United States, their chance of developing breast cancer moved as well. Women in the United States have more than five times the breast cancer risk of women in China – 101 cases per every 100,000 people compared with only 18.7 per 100,000 in China. And here is the important part: when a woman of Chinese descent moves to the United States and adopts a Western lifestyle, she adopts a Western risk of breast cancer as well. It’s not genetics. Something in the difference between life in China and life in the U.S. affects breast cancer risk. The question is, what is it? Is it something in the Chinese diet? A feature of traditional Chinese medicine? Is it air quality or social structure or the angle of the sun in China that protects Chinese women from breast cancer? More broadly, if something “natural” protects these Chinese women, could the same thing protect you against cancer…or even cure the disease?
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T H INKST OC K
G O O G L E SAYS Y E S All it takes is a quick Google search to discover that the answer is a resounding yes… and that Western medicine has been hiding the truth for years. “Wasabi has powerful anti-cancer properties but can be difficult to fit into your diet,” says Dr. Oz. “Miracle cannabis oil may treat cancer,” writes SF Weekly. “Beat cancer with 35 percent hydrogen peroxide,” writes Natural News. “Carla received a death sentence in 1958, yet 54 years later she is in vibrant health, thanks to the Gerson Diet!” says the Gerson Diet website. “Frankincense oil shown to kill cancer and boost immunity,” writes someone called Dr. Eric Z, in an article that has been shared on Facebook more than 11,000 times. “I was very excited back in the 1980s about the idea that we could find particularly potent ingredients or compounds in natural products that we could give to people as drugs and thereby reduce cancer risk. It hasn’t worked. And we have scores of failures,” says Tim Byers, MD, MPH, associate director for cancer prevention and control at University of Colorado Cancer Center. Byers recently chaired a major symposium at the annual meeting of the American Association for Cancer Research that he describes as “a post mortem on the first generation of chemo-prevention studies.” Despite the internet’s hopeful claims, not one “natural” product has been definitively shown to treat cancer or decrease cancer risk. But Byers doesn’t see past failures as a reason to give up the search. Here are four ways researchers here and elsewhere are searching for natural products that could treat or prevent cancer:
ACAI IS A FRUIT RICH IN BIOFLAVINOIDS SHOWN TO INDUCE APOPTOSIS IN PRECLINICAL STUDIES OF PROSTATE CANCER, LEUKEMIA, AND ESOPHAGEAL CANCER.
1 . G I V E A NATU R AL P R O D U CT TO CAN C E R PATI E NTS AN D S E E I F I T WO R K S Here’s an idea: what about giving a natural product to a group of cancer patients and seeing if it works? Believe it or not, this has been done in very controlled circumstances at the CU Cancer Center. See, in many slow-growing cases of prostate cancer, the best course of care is to watch and wait. And while watching and waiting, the reasoning went, it certainly couldn’t hurt to drink commercially available acai juice. “Acai is a fruit rich in bioflavinoids shown to induce apoptosis in preclinical studies of prostate cancer, leukemia, and esophageal cancer,” write CU Cancer Center researchers Elizabeth Kessler, MD, Elaine Lam, MD, and colleagues. In other words, it worked in a dish and because it is not likely to do any harm, why not give it a try? The researchers are planning a couple more experiments this spring. In early results, of the 21 patients treated on a clinical trial, all of whom had rising PSA (a measure of growing prostate cancer) prior to entering the study, 18 patients saw the rate at which their PSA was increasing slow down. One patient who entered the trial with a PSA of 12.57 had a PSA of 2.15 after 36 weeks of acai juice. In the world of cancer research, these early results are promising but still require additional validation before acai juice can be recommended broadly.
2. GIVE A NATU RAL PRODUCT TO A H UGE POPU LATION AN D S E E H OW M ANY LATE R D EVE LO P CAN C E R In an ideal world, here’s how a cancer prevention trial would work: You would ask 100,000 people to drink acai juice and ask 100,000 people to drink an equal quantity of water, and you would note how many people in each group got cancer. Twenty years later, if the acai group had 2,300 cases of cancer while the water group had 2,400, you might have evidence that acai prevents cancer. Unfortunately, that’s what it takes: It may require treating 100,000 people to prevent what would otherwise have been 100 additional cases of cancer. And if there is any chance at all that acai juice has even the mildest of side-effects, it wouldn’t be ethical to treat this massive number to prevent these few cases. Does the risk outweigh the reward?
5 C3: SPRING 2015
C ASE Y C ASS T H INKST OC K
Tim Byers, MD, MPH, associate director for cancer prevention and control at University of Colorado Cancer Center, finds value in searching for natural products that could treat or prevent cancer.
“YOU JUST CAN’T
“A great example is anti-inflammatory drugs and colon cancer risk. We did a trial and it was big enough to show beneficial effects on colon polyp development, but we also saw increases in heart attacks. Do you want to trade having fewer colon polyps for more heart attacks? Not me,” says Byers. Many possible cancer preventions come with risk, and with human patients, the math doesn’t justify the chance. For this reason, the most successful cancer prevention trials have been trials of things that don’t actually go in your body, namely education. Or they are for things we already know are good for you, for example exercise, weight loss or a healthy diet.
DISENTANGLE
3 . AS K TH E C O M P UTE R S
GENETICS FROM
Imagine you have 100,000 women in the United States and 100,000 women in China. What are the lifestyle differences between these women? Which lifestyle differences affect cancer risk? This is a question not even a supercomputer can answer. “You just can’t disentangle genetics from all the cultural factors. So far our weak, feeble attempts to pull out any single agent haven’t been successful. Is it the green tea? Or differences in obesity or physical activity? Or any one of thousands of other confounding factors?” Byers asks. Instead, researchers are on the lookout for what are called “natural experiments” in which something specific and random happens to change a population’s behaviors. If a potato blight struck Idaho, forcing Americans to snack on fried grasshoppers instead of chips, and our rate of colorectal cancers declined immediately and dramatically, the natural experiment might tell us something about the health benefits of chips compared with grasshoppers. Or take natural experiments in cancer screening: Chance factors tied to health insurance access means that some people are screened and others are not, and cancer mortality tends to be lower in the screened populations (due in part to early detection). These natural experiments can accidentally create situations in which research is possible. But to date, no convincing natural experiments have been uncovered to test the effectiveness of prevention or treatment with natural products; there has been no accidental shortage in green tea or ability for one community to eat bitter melon while a neighboring community cannot.
ALL THE CULTURAL FACTORS. SO FAR OUR WEAK, FEEBLE ATTEMPTS TO PULL OUT ANY SINGLE AGENT HAVEN’T BEEN SUCCESSFUL.” —DR. TIM BYERS
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Instead of restricting the use of natural products to watch-and-wait situations, or dreaming of the day we can run a 100,000-person prevention trial, or waiting for a natural experiment to divide a population into unintentional treatment and nontreatment groups, researchers at the CU Cancer Center and elsewhere are flipping the workflow of natural cure research: Instead of working from populations backward to find the product that might fight cancer, researchers at CU are starting with promising natural products and picking apart the chemistry just like a laboratory would treat any man-made pharmaceutical. If there is a natural cure for cancer, it may come from the laboratory of Rajesh Agarwal, PhD, professor at the Skaggs School of Pharmacy and Pharmaceutical Sciences, and co-leader Cancer Prevention & Control Program at the CU Cancer Center. Agarwal has built a career dissecting the molecules inside natural products such as milk thistle, grape seed extract and bitter melon. “The whole idea here is whether there are modalities people use in their life, for different reasons, that could be useful in slowing the growth of cancer,” Agarwal says. “If we try to do a study without knowing the mechanism of how a product works, you can spend many millions of dollars and you don’t know what you’re going to get out of it. We ask if these things are good in preclinical studies in test tubes and experimental animals, then go from there.” For example, Agarwal writes papers with titles like, “Grape seed extract targets mitochondrial electron transport chain complex III and induces oxidative and metabolic stress leading to cytoprotective autophagy and apoptotic death in human head and neck cancer cells” and “Silibinin inhibits aberrant lipid metabolism, proliferation and emergence of androgen-independence in prostate cancer cells via primarily targeting the sterol response element binding protein 1.” Don’t worry. You won’t be tested on comprehension. What these papers show is Agarwal’s appreciation that it will be impossible to prove that natural products treat cancer until we can show how they treat cancer. What does grape seed extract do? It messes up the mitochondria of head and neck cancer cells. What does the chemical silibinin, derived from milk thistle, do? It keeps prostate cancers from burning fat and also from losing their dependence on androgen. Proving these mechanisms eventually helps to make the case for clinical trials in humans to actually test these treatments. Dr. Agarwal is currently building the case for clinical trials for grape seed extract to treat the watch-and-wait situations of prostate cancer with rising PSA and also colorectal cancer in which polyps have been surgically removed. The science is solid. Time will tell if these chemicals that work so well in the lab also work in human cancer patients.
T H INKST OC K
4 . P I C K A PA RT TH E B I O LO GY
IT WI LL B E
IMPOSSIBLE T O P R O V E T H AT N AT U R A L P R O D U C T S T R E AT C A N C E R U NTI L WE CAN
SHOW HOW T H E Y T R E AT C A N C E R
G R E E N T E A F O R B R EAST CAN C E R? “The evidence regarding the potential benefits of tea consumption in relation to cancer is inconclusive at present,” writes the National Cancer Institute. But deep in the laboratories of the CU Cancer Center, a pair of researchers is unearthing a very different and quite compelling story. If you’ve stuck with this admittedly difficult science article so far, stick with it a bit further. Here’s the story: Estrogen receptor-positive (ER+) breast cancer is commonly treated with the drug tamoxifen, which restricts the cancer cell’s access to the estrogen it needs to grow and survive. But 30 percent of ER+ breast cancers do not respond to tamoxifen. Why?
7 C3: SPRING 2015
T H INKST OC K
CHOCOLATE IS A DRUG. COFFEE IS A DRUG. WHY NOT RESVERATROL, BROWN RICE, OR BITTER MELON? THERE’S NO SOLID SCIENCE SAYING YES, BUT THERE’S ALSO NO ABSOLUTE EVIDENCE SAYING NO.
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Hany Abdel-Hafiz, PhD, and Kathryn Horwitz, PhD, have part of the answer – an important difference between ER+ breast cancer cells that respond to tamoxifen and those that don’t. It’s not a genetic mutation; there’s no known difference in the genomes of resistant and sensitive cells. The answer is in something called the epigenome. The epigenome doesn’t change a cell’s genes, but it helps to decide which genes are turned on or off. If genes are blueprints, the epigenome is the general contractor that chooses how to use them. There are epigenetic changes that make ER+ breast cancers resistant to tamoxifen. Importantly, changes in the epigenome are reversible. “If epigenetic changes create tamoxifen resistance, then it is reasonable to suggest that reversing the epigenetic changes will restore tamoxifen sensitivity,” says Abdel-Hafiz. Is there a switch? Could we flip breast tumors from estrogen-independent to estrogen-dependent and resensitize them to tamoxifen? We can in the lab. It takes about two cups of warm but not boiling green tea. Abdel-Hafiz has isolated the active ingredient from a green tea extract and shown that in a tamoxifen-resistant ER+ breast cancer cell line, it resensitizes the cells to tamoxifen. In other words, a compound in green tea – comparable to drinking two cups – transforms breast cancer cells from treatment resistant to treatment sensitive ones. “In Egypt, where I am from, people drink a great deal of dark tea. But it is prepared by five-to-ten minutes of boiling. This degrades the active ingredient,” says Abdel-Hafiz. “The Chinese and Japanese, possibly from centuries of folk knowledge, understand this. They know to prepare green tea in hot but not boiling water to maximize its health benefits. That is the way I prepared a green tea extract in the lab.” Is 80-degree Celsius green tea the secret to the long-sought difference in breast cancer rates between the United States and China? “There’s a long list of things that reduce risk in lab models of cancer that don’t appear to work in humans,” Byers says. “And there’s an even longer list of cancer drugs that seemed promising in the lab that didn’t pan out in people.” But there are also reasons why many of these natural (and other) drugs haven’t proven effective. “We discover that we have used the wrong product in the wrong population with the wrong cancer and have evaluated the wrong measure of success,” says Agarwal. He points out that after the CU Cancer Center wrote about his work with bitter melon juice last year, he has had more than 500 phone calls and emails from patients using or interested in using bitter melon with their cancers, “many of whom report their tumors are shrinking,” Agarwal says. Chocolate is a drug. Coffee is a drug. Why not acai juice, milk thistle, green tea, resveratrol (from red wine), brown rice, grape seed extract, or bitter melon? There’s no solid science saying yes, but there’s also no absolute evidence saying no. And in the absence of answers, there is certainly hope that a natural product could prevent or treat cancer. “For sure in my lifetime a natural substance will be proven to be a treatment or prevention for cancer,” Agarwal says. For now, choosing to dose yourself with bitter melon or another natural product rather than following a doctor’s recommended course of cancer therapy is much more likely to be a death sentence than a cure. But in many cases, there is no harm in adding natural products in addition to your doctor’s prescribed course of therapy (consult your physician). At the CU Cancer Center we will do more than hope – here, we continue to apply the best modern research techniques to analyze and test what are sometimes ancient medicines. The jury is still out on a natural treatment or prevention for cancer. And until there is a verdict, we will continue to gather evidence.
DEC DINGCANCER
IT’S NOT JUST GENES, B UT H OW YO U U S E T H E M Think of your genes as the instruments in an orchestra. One gene is the cello, another is the THINKST OC K
flute, and another the French horn. Now imagine the orchestra of your genes in a recording studio. “Epigenetics” is the name of the sound engineer who turns up and down these instruments to decide the balance of the recording. Unfortunately, the result of faulty epigenetics goes beyond cacophony and into cancer. There are a handful of existing drugs that work to rebalance your body’s epigenetics. For example, the class of drugs known as HDAC inhibitors seeks to turn up the “volume” of the gene p53, which works to suppress cancer.
THINKSTOCK
Epigenetics controls gene balance
9 C3: SPRING 2015
C ASE Y C ASS
A CONVERSATION WITH NEIL BOX, PhD Assistant Professor, Department of Dermatology, University of Colorado School of Medicine, Charles C. Gates Center for Regenerative Medicine and Stem Cell Biology
BY GA RT H S U N D E M
Neil Box grew up in Queensland, Australia where he saw the effects of sun exposure
of our research projects. Also, with reduced funding
firsthand. Now, in addition to teaching and his research into the biology of how skin
from the National Institutes of Health, we’re definitely
reacts with UV radiation, Dr. Box is helping to raise awareness in Colorado about sun
looking for ways to reach people who would like to
protection and sun-safe behaviors. We caught up with Dr. Box between important
help us continue our research.
grant submissions to talk about his work. C3: In your opinion, what is more important – C3: How did you get interested in
C3: In addition to research, teaching and
research to find new treatments for mela-
melanoma research?
writing grants to fund your work, you
noma and other skin cancers or outreach
Box: Queensland is the melanoma capital of the
also co-founded the Colorado Melanoma
programs that improve awareness and
universe. There’s a big hole in the ozone over
Foundation (CoMelFound.org) in July 2013.
screening?
Australia and we spend a lot of time at the beach.
Has it been challenging to be a communica-
Box: Both, of course. Here’s an anecdote:
I had three relatives diagnosed with early-stage
tor as well as a scientist?
I happened to be at a meeting where I saw political
melanoma, but even beyond melanoma, you
Box: As scientists, we are always talking about our
candidates from the last election. One of them said,
can see the effects of sun exposure. In Australia,
work, at conferences, in papers, in talks to various
“Oh, you’re at the CU Cancer Center. What a hidden
people’s skin looks a lot older, and I remember as a
groups locally, nationally and internationally. Now
gem!” And it struck me as kind of a shame. Why are
kid seeing these old men who had been treated for
with a website, a blog, and social media such as
we hidden? Shouldn’t we be obvious in our com-
non-melanoma skin cancers, with parts of ears or
Facebook and Twitter, it’s a new set of skills, but
munity? As an academic institution, we should be
noses removed.
really we’re engaging in scientific communication all
making our knowledge as available as we can. The
the time. And it all works together. Our goal is to help
question is, how can we best serve our community
C3: Colorado is at altitude and we’re proud
fewer people die from melanoma or be affected by
to make an impact on disease rates?
of our outdoors. Do you see parallels in sun
other skin cancers. The more we can connect with
risk or sun protection here?
people online, the more people we can reach with
C3: Melanoma is the most aggressive form
Box: Colorado is a high UV exposure state, but
our messages about sun protection and screen-
of skin cancer, with 5-year survival rates for
people don’t realize it. In Queensland there was an
ing. We are also trying to engage our community
Stage III disease at right about 50 percent.
awareness of sun-related issues. There’s a real need
in supporting our melanoma research program, for
How do you help people balance the risk of
for that here. There will be about 1,400 new cases
example, by identifying melanoma survivors who
the disease against the desire to go outside
of melanoma diagnosed in Colorado this year and a
could become mentors for new melanoma patients
and enjoy the sun?
little less than 200 people will die from the disease.
and by encouraging people to participate in some
Box: Melanoma isn’t one of the cancers that tends
THIN KSTOCK
to run in families. More often than not, it happens in isolation; your family doesn’t have experience with the disease. People just know it’s dangerous. They read about it and get scared pretty quickly. We need education – people need to know what a diagnosis means and what they need to do to put up a fight. What we’re trying to do at the Colorado Melanoma Foundation and the CU Cancer Center is create basic community awareness of the effect of the sun. As you improve the community’s knowledge, people do more to cover up, more to be sun safe, and more to get the screening, diagnosis and treatment they need. As awareness goes up, safety improves. What we have to do is improve awareness.
Melanoma isn’t one of the cancers that tends to run in families. What we’re trying to do is create basic community awareness of the effect of the sun.
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CLINICAL
CARE C U C ANC E R C E NT E R
MD Collaborating across campuses and cancers RAJ E E V V I B HAK AR S E E S B R EAKTH R O U G H S O N T H E H O R I ZO N I N H OW WE TR EAT P E D IATR I C B R AI N T U M O R S BY E R I K A MATI C H Research wasn’t part of the plan. Rajeev Vibhakar,
“Several of the kids in the oncology unit had
MD, PhD, MPH, director of the Children’s Hospital
brain tumors and I realized we didn’t know that
Colorado Program, left his native Tanzania for
much about them,” he says. “We didn’t really
Macalester College in St. Paul, Minnesota with the
understand what these brain tumors were doing.
intention of becoming a small-town pediatrician.
I decided that’s what I want to study because that’s
He finished his undergraduate work, moved on to
where I can make a difference.”
medical school at New York Medical College… and something changed. Between his first and second years of med school, Vibhakar went to work in a biochemistry lab that was exploring how certain proteins bind to DNA. He was hooked.
Vibhakar explains that cancers in children are
ABOUT RAJEEV VIBHAKAR, MD, PHD, MPH Investigator, University of Colorado
completely different than adult cancers – the treat-
Cancer Center
ments are different, the drugs are often different
Director of Pediatric Neuro-Oncology
and the biology of the tumors is very different.
Program, Children’s Hospital Colorado
In 2009, after his residency and fellowship were complete, Vibhakar made the move to University
Assistant Professor of Pediatrics, University of Colorado School of Medicine
“The process was so fascinating I asked my
of Colorado School of Medicine’s Department of
university if they would take me into their MD/PhD
Pediatrics. He is the director of pediatric neuro-
program and let me do research,” says Vibhakar.
oncology at Children’s Hospital Colorado, studying
“I wanted to learn how things work and probably
genetic mechanisms that turn brain cells into
One of the genes Ford studies is important in
more importantly how much we don’t know about
cancer and how genetic differences can help
regulating the way stem cells in the brain work.
the human body, but I really didn’t know where
diagnose and treat children with brain tumors.
Another project with a biologist at CU Boulder
I was going with it.” A 4:00 a.m. emergency room visit from a 14 year-old girl during Vibhakar’s fourth year of medical school helped determine where he would go with his research and clinical career. She had bruises on her legs and attributed them to being kicked around during a soccer game the day before. “She wanted help with pain control because she
“We’re still only curing 40 to 50 percent of children with brain tumors. There is a long way to go.” —rajeev vibhakar “I came here because of the ability to col-
looks at new chemical compounds to target tumor cells. And yet another with the Department of Pharmacology hopes to discover better drug targets in pediatric brain tumors. Vibhakar wants therapies and outcomes in brain cancer to improve the way they have in leukemia. “We’re still only curing 40 to 50 percent of
laborate with people,” says Vibhakar. “Dr. Nick
children with brain tumors,” he says. “We really are
had a dance recital and she wanted to feel better,”
Foreman, the leading pediatric neuro-oncologist,
between a rock and a hard place. Even the children
says Vibhakar. “We looked at her and we said that
developed a tumor bank in 1997. We have a lot
that we do cure, often times we leave them with
is not from being kicked, that is something much
samples and genetic data to study. That’s what
significant side effects. There is a long way to go.”
more serious.”
attracted me initially.”
The girl was diagnosed with leukemia later that
Here he has taken collaboration to a new level.
Yet he is optimistic breakthroughs are on the horizon.
morning. Vibhakar took care of her for the next six
In addition to studying pediatric brain cancer,
months and developed a relationship with the girl
Vibhakar is doing research with CU Cancer Center
the next 15 years, we really will have a significant
and her family. That relationship helped him decide
members studying leukemia – the proteins involved
change in not only how we treat kids but how
to specialize in pediatric cancer. Similar experiences
in that disease also are important in understanding
we can impact their survival and how well they
caring for kids during a pediatric residency at the
brain tumors. Vibhakar also collaborates with CU
survive,” he says.
University of Iowa cemented the decision.
breast cancer researcher, Dr. Heide Ford.
“I truly believe that within my career, within
11 C3: SPRING 2015
T H INKST OC K
I CAN FOCUS ON THE
Sun Shining
How wellness coach Denise McGuire, PhD, turned to mindfulness in her own cancer journey.
N
ormally, in this space, in this magazine, we tell stories of triumphant patients living with cancer, or we catch up with clinical trials that give people back their lives, or we share the inspiration of those in remission from cancer against all odds. And yet, as we all know, cancer kills people. It takes spouses and parents and children and beloved members of our families and our friends and people that we work with and people that we have never even heard of. On March 15, 2015, cancer took the life of Denise McGuire, PhD. She was generously sharing her journey through radiation and chemotherapy and a stem cell transplant. She was confident the transplant would work but her cancer had other plans. It only seems right to share her thoughts, insights and legacy because that’s what cancer will never steal from Denise. In fact, she said she was honored to share her story and the tools helping her navigate cancer, sometimes moment by moment. BY E R I K A MATI C H
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Mindfulness is always about practice – noticing where my thoughts are going and then redirecting them.
THI NK STOCK
C OURT E SY OF GE T INT H E ZONE . NE T
Her story starts with the connection between mind and body. Imagine getting pulled over for speeding. Your heart starts racing and your palms start sweating. Does that mean you suddenly developed atrial fibrillation and hyperhidrosis, or excessive sweating? No. It’s a perfectly normal, temporary reaction to a hefty fine and a DENI SE McGUI RE couple points on your driver’s license. The reaction is also an example of the connection between our minds and our bodies. For people with cancer, the connection can help them endure an experience that is devastating both physically and emotionally. For more than 25 years, McGuire, a licensed psychologist and mental fitness coach, had helped people learn ways their mind could help their body. She worked with a diverse group: athletes, executives, people with cancer and other conditions, and folks looking to lose weight or even simply live a healthier, better life. McGuire’s journey with cancer started in September 2014, although she didn’t know it yet. She was experiencing some nausea and vomiting. But Extreme Weight Loss: Destination Boot Camp at the University of Colorado Anschutz Health and Wellness Center at the Anschutz Medical Campus was approaching, a pilot program for the CU Anschutz Health and Wellness Center to give people the tools to lose weight and keep it off. McGuire was set to work with participants on the mental part of weight loss. She wondered if she was feeling the stress of starting boot camp. “I was also gearing up for a trip to Italy,” said McGuire. “I was mostly feeling OK during the trip. I thought maybe I was overdoing the gelato.” When McGuire returned, she made an appointment with her primary care physician and after meeting with specialists found herself in the unenviable position of being diagnosed with diffuse large b-cell lymphoma, an aggressive cancer that affects white blood cells responsible for producing antibodies. It was November 8, 2014. Now she would have to use the techniques she had taught others to endure her own grueling treatment. “I started with an aggressive treatment plan, six rounds of chemotherapy. I underwent three different regimens. I was hospitalized for a two week cycle,” said McGuire. “I find relying on the things I teach other people in similar circumstances, like mindfulness and breathing, is a natural application in what I’m going through.” In addition to her work at the CU Anschutz Health and Wellness Center, McGuire also worked at University of Colorado Hospital’s (UCH) Center for Integrative Medicine. McGuire had seen how a positive outlook and emotional support helped others with cancer deal with the disease. “Mindfulness is always about practice – noticing where my thoughts are going and then redirecting them. I concentrate on
— DENISE McGUIRE
my breath, close my eyes and bring myself back to now,” said McGuire. “Instead of focusing on pain, I can focus on the sun shining or not feeling nauseated or a visit from a great friend.” Lisa Corbin, MD, medical director of UCH’s Center for Integrative Medicine, is a long-time friend and colleague of McGuire. Corbin agrees mindfulness can be beneficial. And challenging. Sometimes, Corbin says, it’s what makes sense for that person at that second. “When you have cancer, there are so many things that are being done to you,” said Corbin. “I’ve seen people work with Denise and other psychologists and it’s so beneficial in so many ways. It helps them find their untapped potential and work on the things they can control like sleep, stress, nutrition and exercise.”
13 C3: SPRING 2015
T H INKST OC K
To honor Denise I am asking for each one of you to think of one thing you are grateful for today.
COURTESY OF DENISE MCGUIRE
— HOLLY WYATT, MD
“Dr. Denise” coaches patients from Extreme Weight Loss: Destination Boot Camp. They credit McGuire with changing their lives by giving them the tools to save themselves.
Corbin adds that when people think of integrative medicine, they think it’s going to be about herbs and acupuncture. “We encourage people to slow down and we remind them there is power in learning the things they can do for themselves. Some feel so out of control and we help them unlock the potential in controlling what they can.” McGuire’s initial treatment for the lymphoma was designed to beat back the cancer, but in her case, it didn’t go as planned. About 80 percent of the time, people with diffuse large b-cell lymphoma go through chemotherapy and go into remission. Not so with Denise. Her cancer was unusual. She needed to start from scratch. Her immune system would be wiped out by chemo and radiation so it could be built back up with a cord blood stem cell transplant under the direction of Jonathan Gutman, MD, the director of allogeneic stem cell transplantation at CU Cancer Center. Gutman saw McGuire’s skills help her through the difficult battle. “It’s enormously important to do all you can to help yourself. Denise created a support system and helped herself in a remarkably strong way,” Gutman says. “As a therapist, I’m usually on the giving end. I have to remind myself it’s OK to let people take care of me,” said McGuire.
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“There’s been an outpouring. Many people have stepped forward to offer support and help – kids I went to kindergarten with, people I haven’t seen in 20 years. It’s definitely a huge surprise.” The support McGuire received – or Dr. Denise as clients and colleagues affectionately called her – is the result of the support she gave. Colleagues say the mark she leaves behind is indelible. Participants from Extreme Weight Loss: Destination Boot Camp say Dr. Denise changed their lives, gave them the tools to save themselves. Those she worked with believe McGuire will always be part of the wellness programs she created and taught and the people who benefitted from them. Dr. Denise passed away March 15, 2015. She was described as comfortable and well cared for to her last breath. “Now is a time to feel your feelings and remember her calming presence and her smile,” writes Holly Wyatt, MD, medical director of Extreme Weight Loss: Destination Boot Camp. “Denise was big on gratitude so to honor her I am asking for each one of you to think of one thing you are grateful for today. It can be a big thing or a little thing she always said it doesn’t matter. I think that is what would make her smile right now, and I know she will be smiling with us for the years ahead.” Denise’s friend, Lisa Corbin, visited her in the inpatient oncology unit in the days after her stem cell transplant. She was taken aback at what she encountered. “For the first time since her diagnosis, she actually looked like she had cancer. The treatment had taken a toll,” Lisa said. ”We talked about how she was feeling and then she asked me about something that had been going on in my life. She made it a point to remember the details about others even with what she was going through.” Celebrated poet Maya Angelou once said, “People will forget what you said and people will forget what you did, but people will never forget how you made them feel.” The heartbreaking thing about cancer is that it doesn’t care how wonderful Denise McGuire made people feel. It doesn’t care who you are or what you’ve done. Sometimes it doesn’t care that you have the best treatment in the world, strong odds, and the mental and emotional skills to fight like crazy. But Dr. Denise cared. Cancer can’t erase that. And no one who loved her will ever forget.
ST RY INSIDE
Mindfulness in Cancer Care You’re about to give a speech and you feel sick to your stomach. The thought of eating something sweet, sour or
Mindfulness is defined as relaxed moment to moment awareness without judgment. Some may refer to it as meditation. Some hail it as the mind-body connection. No matter what you call it – mindfulness is about improved quality of life for people with, or without, cancer. All you have to do is notice your thoughts and let them go. It sounds simple enough but it’s a practice that’s not always easy. “At first, incorporating activity is easier for some people.” says Sayrd Annon, LCSW, oncology social worker at University of Colorado Hospital’s (UCH) Breast Center. “When you do yoga the focus is on breath through movement. You should not be thinking about what you’re making for dinner during the downward dog.” Cancer patients at University of Colorado Hospital gather once a month for an hour to learn a variety of mindbody techniques including meditation, breathing and guided imagery. The benefits include more effective stress management and improved management of symptoms associated with cancer therapies. The mindfulness group is a safe place for cancer survivors to learn tools that will improve quality of life for the newly diagnosed, those in cancer treatment, and those finding a new normal following treatment. “Their minds are caught up in mental chatter,” says Annon. “They have fears of recurrence, whether their treatment will work, whether they did something to contribute to their cancer.” Annon goes on to say that the group is just one way to help patients and caregivers deal with a cancer diagnosis and the crazy life challenges it brings – including everything from fighting the
illness to juggling finances, friendships and things like meals and transportation. Take a breath. Notice what you feel. And then let it go. What’s really important about the whole process is to make sure you don’t judge what you think or feel – just acknowledge it. Annon says you will start to feel a little better when you exercise that relaxation response and your body will benefit immediately. Here’s how it works: The parasympathetic nervous system helps maintain equilibrium and relaxation, decreases heart rate and lowers blood pressure. When you breathe and focus, your body feels less stress. Annon maintains we can train ourselves to respond more productively to stress if we just notice what is happening and move forward. Many of us are much more familiar with the sympathetic nervous system that mobilizes us for the fight or flight response – increased heart rate, high blood pressure and more stress.
Annon references a book called “Why Zebras Don’t Get Ulcers.” The zebra sees a threat and fights it or takes off. And then it’s over. The zebra doesn’t over-analyze the decision to fight the predator or wonder whether it should have taken off. It doesn’t obsess about the encounter. As a result, unlike humans, a zebra is not chronically stressed out, stomach churning, because it zigged when it could have zagged. In addition to the improved mood, stress reduction and easing of symptoms associated with cancer and other medical conditions, there are more reasons to make the mind-body connection. Annon says it’s accessible, affordable and empowering. She also says it’s helpful for all stages of cancer treatment. “The mind is so powerful and we can be our own worst enemies. The practice of mindfulness means reworking our minds and developing new habits.” —By Erika Matich
THINKSTOCK
savory makes your mouth water. These examples illustrate the idea that what we think can influence how we feel.
15 C3: SPRING 2015
CLOSING THE GAPS IN CANCER CARE
C U PROGRA MS F OR P REVENTION, EAR LY DIAGNOSIS AND EFFIC IE N T T RE ATMEN T SEEK T O LOW ER CANCER R ATES IN AT-R ISK POPU LAT IO N S Imagine this: You are uninsured but know that something is wrong with your health. You are afraid to go see a doctor due to medical bills and ultimately decide to wait…until it is too late and you are admitted to the emergency room. Once there, doctors discover that you have late stage cancer. “Poverty is a big reason why cancer is still the number one killer in Colorado,” explains Tim Byers, MD, MPH, associate director for cancer prevention and control at the University of Colorado Cancer Center. “It creates a barrier against prevention, early diagnosis, and timely treatment.” Here at the CU Cancer Center we’re working hard to change this. Through programs such as the Tobacco Cessation, Colorado Colorectal Screening Program, and Patient Navigator Training Collaboration we are helping to promote cancer preventative behaviors, catch cancer earlier, and ensure that all patients get the best care. But changing the course of cancer for the 13-15 percent of Coloradoans living in poverty (according to the U.S. Census Bureau) requires more than making sure impoverished Coloradoans get excellent treatment. It’s also about helping to decrease the chance they get cancer in the first place. See, it’s not just that impoverished Coloradoans are more likely to die from their disease; it’s that they’re more likely to get the disease.
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The most recent Colorado Cancer and Poverty Report found that people living with lower incomes were more likely to use tobacco products, be obese, and have inactive lifestyles, all of which increase the risk of developing cancer. Byers, who collaborated with researchers and physicians across Colorado to write the report, feels that people living in poverty are aware of the negative health effects of these lifestyle choices but have other, more urgent, worries. “I feel confident saying that most people are aware that smoking causes cancer,” says Byers. “What is happening is that these people are trying to deal with immediate concerns such as feeding their family. If you’re worried about putting food on the table today, you might not be as worried about the health consequences of smoking, 12 or 20 years in the future.” All this adds up to increased cancer risk in people living in poverty.
PROM OTIN G PR E V E N TI ON : TOBAC C O C ESS ATI ON In 2011, Arnold Levinson, PhD, University of Colorado Cancer Center investigator and associate professor in the Colorado School of Public Health, headed a pilot program to help low-income parents quit smoking.
T H INKST OC K
BY TAYLOR BAKEM EYER
“Low-income life puts people under constant stress,” says Levinson. “And stress is a strong predictor of difficulty quitting smoking.” The program explored the use of trained, community-based “guides” to help parents of children in the Denver Head Start program obtain effective smoking cessation treatments, including the Colorado QuitLine and nicotine patches or gum. “It was my theory that people trying to do something to improve the lives of their children may be readier and more able to quit smoking,” Levinson says. In addition to treatments, trained guides also provided emotional support to parents trying to quit. “By locating guides where parents go twice a day, smokers who want help quitting don’t have to go anyplace special. We find them where they live on a daily basis. This community intercept model isn’t new in public health – what’s new is putting guides there rather than a clinical treatment program,” he explains. Now Levinson hopes to use this pilot program to study the effectiveness of community-based guides to help low-income people quit smoking, with the goal of expanding the program to reach more people and prevent more cases of smokingrelated cancers.
C AT CHI NG I T E AR LY: C O L O R ADO CO L OR E CTAL S CR E E NI NG PR OGR AM Do you remember the person from the opening example? With the cancer spread, this person has a roughly 15 percent chance of living 5 years. If the health system had caught the cancer earlier, before it spread, the number could have been 90 percent. Catching cancer early is the goal of the CU Cancer Center’s Colorado Colorectal Screening Program (CCSP), which gives uninsured people with incomes at or below 250 percent of the Federal Poverty Level access to colonoscopies to screen for colorectal cancer. Colonoscopy not only detects cancer at an early stage, but can also detect precancerous growths that can be removed, preventing the cancer from developing. Shockingly the CDC has found that if everyone aged fifty and older met the current screening guidelines at least 60 percent of deaths from the disease could be avoided. “Our goal is to increase CRC screening rates in Colorado. The program does this not just by providing screening exams, but by raising awareness of the need for screening, supporting patient navigation for screening, and assisting our partner clinics across Colorado to reduce barriers to screening,” says Sheryl Ogden, RN, BSN, program manager of CCSP. As of May 2014 it had completed more than 16,000 screenings. And since its beginning in 2006, more than 130 program participants have been diagnosed with colon cancer – that’s 130 who caught cancer early and have a much better chance of successfully fighting the disease.
TOP QUALITY C ARE : PATIEN T N AVIGATO R TRAIN IN G C OLLABORATI V E In addition to the financial burden of screening and treatment, cultural barriers can keep patients from receiving the care they need. For example, many patients say they are uneasy talking to physicians, have had bad experiences with health care in the past, or may not speak the same language as their provider. It’s hard to trust your life to a system that you perceive as having different beliefs, values, and resources than you do. At the CU Cancer Center, the Patient Navigator Training Collaborative (PNTC) trains people to help others in their communities navigate the health care system. “You don’t necessarily have to be a nurse or social worker to be a part of the program,” says Patricia Valverde, PhD, MPH, co-director of PNTC. “Many in our classes are just passionate people who want to help others.” Valverde helped bring patient navigation to the Anschutz campus back in 2006 when it was being tested in a clinical trial at Denver Health. Since then the program, along with many others like it, have expanded immensely not just in cancer care but also in many other diseases. In cancer, there are two main types of navigators: those that help patients with screening and diagnosis, and those that help navigate treatment. “For example, after a test shows something is wrong, screening and diagnostic navigators may call patients to help ensure they follow through with treatment,” Valverde explains. “Many times they find patients do not want to go due to fear of not having the financial resources, fear of dying, or even just the concern of not being able to find transportation to appointments.” “Once a patient is diagnosed with cancer, the navigator works with him or her throughout their treatment,” says Valverde. “They also help the patient not feel overwhelmed and can connect them to all kinds of resources, whether it’s financial assistance, transportation, or even food.” In the end, the navigators become so much more than liaisons between patients and their physicians. Many become very close with the people they help. “I’d imagine that over years one navigator can touch hundreds of people,” says Valverde. “The support that is given means so much to the patient and ensures they receive timely treatment.” Cancer care isn’t just about delivering the best medicines – it’s about not needing to deliver these medicines in the first place. Of course no program or combination of programs can prevent cancer completely or ensure an early diagnosis in every case. But here at the CU Cancer Center, we know the cracks in prevention, early diagnosis and efficient treatment that let dangerous cancers sneak through. And we are working every day to close these gaps in cancer care.
17 C3: SPRING 2015
S U P P O R T E R
F CUS ROBE RT O PARADA
Paul’s Story S E NATOR’S LEGACY H E LPS TO TRAI N TH E N EXT GE N E RATION OF PANCR EATIC CANCE R R E S EARCH E R S BY TAY L O R B A K E M EY E R Colorado Senator. Tamale maker. Education
PAUL’S STORY: TREATMENT
Activist. Denver icon. Paul Sandoval is known by
Together the Sandoval’s decided that, of all the
many names in Colorado.
options nationally, the CU Cancer Center was
Throughout his professional career Senator
where Paul would receive the best treatment.
Sandoval was able to rise above party lines, give
Staying local also allowed Paul to be around the
advice to both seasoned and up-and-coming
people he loved in the state that he had spent
politicians, and was deeply involved with Colorado’s
his life serving. Colin Weekes, MD, was Paul’s
education system. In his personal life, Paul was a
oncologist.
loving father, husband, and friend to many. He was
“What struck me the most about him is that
known to have “amazing instincts” in politics and
when we first met he introduced himself as a
business. He ran his small family restaurant and
tamale maker,” says Weekes. “He was a very
tamale factory where he would make tamales from
humble and respectful person from the start.”
a passed-down family recipe.
Sandoval was put on a clinical trial right away
In 2012 Sandoval lost his battle to pancreatic
to combat the disease. Although the ultimate goal
cancer. His untimely death at 67 touched thou-
was to extend his life, Paul made it clear that he
sands across the state and nation. Now his wife
had other intentions.
Paula, along with friends and other members of
“His perspective on the clinical trial was that
Senator Paul Sandoval in his element, painted by Roberto Parada. Before politics, he ran a small family restaurant and tamale factory. “The goal of the fund is to award one $20,000
the Sandoval family are helping to fund gradu-
he thought it may help him, but really he was
or two $10,000 scholarships each academic year
ate students at the University of Colorado Cancer
more concerned about it helping other people,”
to graduate students focused on pancreatic cancer
Center working to better understand the disease
says Weekes.
research at the University of Colorado Anschutz
and discover better treatments.
At first Sandoval seemed to respond well to
Medical Campus and the University of Colorado
treatments. However, tragically, it did not last and
Cancer Center,” explains Allison Krebs, director of
PAUL’S STORY: DIAGNOSIS
his condition continued to deteriorate. Eventually he
development for the CU Cancer Center.
Like many pancreatic cancer patients, Paul didn’t
was told he could no longer be on the clinical trial.
have any symptoms until the disease had pro-
“I remember the day we told him we had to take
The first recipient of the Sandoval Scholarship, Melanie Blevins, was selected in 2014. The scholar-
gressed beyond the point where he could benefit
him off the trial very clearly,” Weekes explains. “He
ship will help Blevins continue her study of the
from life-saving treatments.
and Paula were both at peace with it and wanted
Six1/Eya transcriptional complex, a known cause
to go spend time with their friends and family.”
of another cancer, namely breast cancer.
“The first thing we noticed was his weight loss and lack of appetite,” says his wife, Paula Sandoval. “He became incredibly weak and we
On April 24, 2012, Paul passed away peacefully in his home surrounded by loved ones.
knew something was not right.”
“Since receiving this scholarship, I have begun to take the knowledge we have obtained in our breast cancer model and apply it to pancreatic
Paul went in for testing numerous times but
PAUL’S STORY: HIS LEGACY
cancer, hoping that the advances we make will not
it seemed no one had an answer for his sudden
“After Paul’s passing we wanted to redirect our
only be beneficial for breast cancer, but pancreatic
health deterioration. It wasn’t until friends, including
existing scholarships to make more of them a
cancers as well,” Blevins says.
CU President Bruce Benson, recommended he
personal legacy for Paul,” says Paula. “That is why
go to the University of Colorado Cancer Center
we created the Paul Sandoval Pancreatic Cancer
being honored throughout Denver. A new campus
that he got the truth: Paul had stage three
Research Fund at the University of Colorado
within Denver Public Schools being built near
pancreatic cancer.
Cancer Center.”
Dick’s Sporting Goods Park will be named the
“When we heard the word ‘cancer’ the first
The Paul Sandoval Pancreatic Cancer Research
question that came to our minds was ‘how long
Scholarship fund was established by Paula
does he have?’” Paula says.
Sandoval in 2012.
Paul was given three months to live at the time of diagnosis.
In addition to the scholarship, Paul Sandoval is
“Paul Sandoval Campus.” A lecture hall in North High School also shares his name. “I think it is so important to honor Coloradoans that have changed the state,” says Paula. “We are extremely thrilled to honor the legacy of Paul.”
Learn more about giving to the Paul Sandoval Pancreatic Cancer Research Scholarship fund at cufund.org/PaulSandoval
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C O M M U N I T Y
N E W S
ENDOWED CHAIR ESTABLISHED IN YOUNG WOMEN’S BREAST CANCER RESEARCH This March marked the establishment of the Robert F. and Patricia Young Connor Endowed Chair in Young Women’s Breast Cancer Research in the Division of Oncology at the University of Colorado Anschutz Medical Campus, made possible with generous commitments totaling $1.5 million from Patricia Anne Connor and the John J. Connor & Irene A. Connor Family Foundation. With their support, we are able to provide valuable resources for one of the world’s foremost experts in young women’s breast cancer and to improve outcomes for countless patients and families. Associate Professor Virginia “Ginger” Borges, MD, has been appointed the first Robert F. and Patricia Young Connor Chair. The establishment of the Connor Endowed Chair would not have been possible without the generosity and vision of the Connor family, or the collaboration of Dean Richard Krugman,
CU CANCER C E NT E R
Dr. David Schwartz, Dr. Dan Theodorescu, Dr. Wells Messersmith and Dr. William Robinson.
KNOCK OUT CANCER GALA The “Let’s Knock out Cancer” gala on January 24 at Hyatt Regency Convention Center drew a sell-out crowd of more than 1,000 people and grossed a little more than $1 million in donations to support the work of the University of Colorado Cancer Center, said Erin Henninger, senior director of the University of Colorado Hospital Foundation. Local musical legend The Fray provided the entertainment, while cancer survivor Jon Wilmot gave the audience a moving personal narrative of his battle with the disease. A nonsmoker, Wilmot was diagnosed with stage IV lung cancer. Through his own determination, the support of his family, and a Cancer Center clinical trial of drugs that target the mutation that drives his cancer, Wilmot is living an active, productive life.
RUNNING IN UNDIES RAISES $51K FOR COLORADO COLORECTAL SCREENING PROGRAM The Denver Undy 5000 5K run/walk raised more than $51,000 for the Colorado Colorectal Screening Program (CCSP), a program at the University of Colorado Cancer Center that provides underserved
UPCOMING EVENTS
Coloradans colonoscopies at no cost, in partnership with community clinics and community
• August 8: Dinner in White
gastroenterologists.
This year’s location is a mystery! It will be announced the day of the event. • November: Men’s Event at Elway’s Date to be determined. For more details about these events, visit http://events.coloradocancercenter.org.
The Undy 5000 was held June 28, 2014, with over 1000 participants. The event took place at City Park in Denver. The team from University of Colorado Cancer Center was led by Kim Gall, human resource manager at the CU Cancer Center. “The Undy is one of my favorite events,” says Gall. “You get to run around in your ‘undies’ and support an amazing program that helps so many people.” The race stands out from many other 5K events because participants run in specially designed boxer-style shorts, providing a fun way to bring attention to a serious disease. This is a family-oriented event open to all ages. In addition to the 5K, there was a 1-mile family fun run and a silent auction.
CORRECTION
“This supplement to current grant funding helps us provide screening to the medically underserved
In the Winter 2014 edition of C3: Collaborating to
of Colorado and assist with treatment for those diagnosed with colorectal cancer,” says Sheryl Ogden,
Conquer Cancer, we reported incorrectly about a
RN, BSN and program manager of the Colorado Colorectal Screening Program. “The Undy 5000 is truly
philanthropic gift from Mr. and Mrs. Morton and
a wonderful event.”
Sandra Saffer to University of Colorado Cancer Center. Although the Saffers are friends and donors to the CU Cancer Center, this particular article was in error. We deeply apologize for this mistake and have created internal practices and policies to prevent future errors of this nature.
19 C3: SPRING 2015
UNIVERSITY OF COLORADO DENVER
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R ET U R N S E RV I C E R E Q U E ST E D
C3: Collaborating to Conquer Cancer Published twice a year by University of Colorado Denver for friends, members and the community of the University of Colorado Cancer Center. (No research money has been used for this publication.) Editor: Garth Sundem | 303-724-6441 | garth.sundem@ucdenver.edu Contributing Writers: Taylor Bakemeyer, Erika Matich Photos: Casey Cass The CU Cancer Center Consortium Members UNIVERSITIES
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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
ORIEN Puts Big Data in CU Cancer Science
M E S S A G E
I
n cancer research, there’s only so much we can learn from
Degette (D-Colo) and Rep. Fred Upton, Chair of the House
one tumor. Is a change in the tumor’s genes the cause
Committee on Energy and Commerce (R-Mich), I spoke at the
of the cancer or is it just random chance? Will a treatment
Capitol as part of the 21st Century Cures Roundtable, a panel
that happens to work against one tumor work against others
on the future of biomedical innovation in the United States. The
or is it just luck? That’s why the University of Colorado Cancer
climate in Washington can be contentious, but one thing that
Center is excited to announce its new membership in the
everyone seems to agree on is the importance of remaining the
prestigious Oncology Research Information Exchange Network
world leader in biomedical science research. Our knowledge and
(ORIEN), a unique research partnership expected to exponentially increase the number of patients involved in precision oncology research studies. ORIEN personifies “big data” – extensive databases with cancer patient information (medical history, cancer tissue, DNA) that can be used for basic research and clinical trials. Patients
FROM THE DIRECTOR DAN THEODORESCU, MD, PhD
participating in ORIEN will have a greater opportunity to be matched to clinical trials of targeted “smart” drugs. It means that the results of one patient treated at the CU Cancer Center will be compared to the results of patients treated
“The goal of the ORIEN partnership is to speed the pace of discovery, allowing the CU Cancer Center and other ORIEN institutions to discover, test, prove and offer more precision medicines more quickly than ever before.”
at other leading cancer centers around the country so that instead of learning from one patient, one treatment, one tumor,
infrastructure allows the United States to look inside cancers and
we have the opportunity to learn from many. The goal of the
to experiment with sophisticated models of the disease in ways
ORIEN partnership is to speed the pace of discovery, allowing
that are the envy of the world. Now our challenge is to continue
the CU Cancer Center and other ORIEN institutions to discover,
a strong climate of funding as this infrastructure delivers new
test, prove and offer more precision medicines more quickly than
treatments and new hope to cancer patients.
ever before. Our membership comes at a time when the CU Cancer
As I said in Washington, patients are the heart and soul of personalized medicine. We really rely on them. We are eternally
Center is earning national recognition as a leader in precision
grateful for their participation. The CU Cancer Center has been,
medicine – the ability to match treatments to the unique features
and with your help will continue to be, one of the world leaders
of a patient’s condition. Last fall, at the invitation of Rep. Diana
in delivering on the promise of personalized medicine.
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