for, comforting and supporting a loved one in hard times
10
At Winship, family caregivers are essential members of the health care team. They are vital in helping loved ones navigate their way through cancer treatment and recovery.
20
Becoming Her Own Hero: Surviving two types of cancer taught Loriana to be her own advocate
24
Winship and the American Cancer Society are partnering to reduce cancer burden and risk
28
New Medical School Dean Says Winship’s Reputation Matches Reality: An Interview with Sandra L. Wong, MD, MS
30
On the road to creating personalized anti-cancer vaccines
On the cover: The Caregivers: Advocating for, comforting and supporting loved ones in hard times
Illustration by Mario Wagner
Can a culture of innovative thinking help us address the most pressing challenges in health care?
Gail Grimmett finds healing in philanthropy and service 36 34
From the Executive Director 2
Pioneering Perspective 4
ZACHARY L. BERCU, MD, RPVI, FSIR Can A Culture of Innovative Thinking Help Us Address the Most Pressing Challenges in Health Care?
Trailblazers 6
Cover Story
The Caregivers: 10
Advocating for, comforting and supporting loved ones in hard times
Features
Becoming Her Own Hero: Surviving two types of cancer taught Loriana to be her own advocate 20
Winship & ACS Partner to Reduce Cancer Burden and Risk 24
New Medical School Dean Says Reputation of Winship Matches Reality: An Interview with Sandra L. Wong, MD, MS 28
On the Road to Creating Personalized Anti-Cancer Vaccines 30
Around Winship
Philanthropy: Gail Grimmett Continues Her Late Husband’s Legacy and Finds Healing in Philanthropy and Service 34
Inspiring Hope:
Q&A with head and neck surgeon Nicole C. Schmitt, MD, FACS 36
Emory University is an equal opportunity/equal access/affirmative action employer fully committed to achieving a diverse workforce and complies with all federal and Georgia state laws, regulations and executive orders regarding nondiscrimination and affirmative action. Emory University does not discriminate on the basis of race, age, color, religion, national origin or ancestry, sex, gender, disability, veteran status, genetic information, sexual orientation, or gender identity or expression.
Website: winshipcancer.emory.edu. To view past magazine issues, go to winshipcancer.emory.edu/magazine
Editorial
Editor: John-Manuel Andriote
Art Director: Marco Alarcón
Lead Photographers: Jenni Girtman, Jack Kearse
Contributors: Andrea Clement, Susannah Conroy, Javier De Jesus, Jenny Owen
ELCOME TO THE FALL 2024 ISSUE OF WINSHIP MAGAZINE
As we near the coming of a new year, we feel a renewed excitement for the opportunities we have at Winship for our science to bring hope to our patients and their loved ones. In this issue, we look inside the hearts and homes of women and men caring for their loved ones who are facing cancer— and inside Winship’s research labs where life-changing medicines begin.
Equally exciting is the promise of personalized anti-cancer vaccines offered by mRNA and other new vaccine technologies being studied at Winship.
In our interview with the new dean of the Emory University School of Medicine, surgical oncologist and cancer researcher Sandra L. Wong, MD, MS, shares her impressions of Winship— before and since coming to Emory.
“As we near the coming of a new year, we feel a renewed excitement for the opportunities we have at Winship for our science to bring hope to our patients and their loved ones.”
Interventional radiologist Zachary L. Bercu, MD, RPVI, FSIR, asks in his “Pioneering Perspective” editorial whether a culture of innovative thinking will help us address health care's most pressing challenges. Then we hear from four Winship researchers whose innovative thinking is helping to change the game for people living with cancer.
Our cover story, “The Caregivers,” offers intimate snapshots of six Winship patients and the family members who stepped up to advocate and care for them during their challenges with cancer. At Winship, we consider caregivers to be essential members of the health care team. In our patient profile, we feature Loriana Hernandez-Aldama, whose experience with not one, but two types of cancer taught her the importance of being her own best advocate.
We are excited to share the news about Winship’s new research partnership with the American Cancer Society to identify interventions that can reduce the burden and risk of cancer—and increase the likelihood that cancer will be diagnosed at an early stage.
Gail Grimmett reflects on her years of supporting Winship since her late husband, Darrell, was treated for multiple myeloma. She has been a top fundraiser for the Winship 5K since it began in 2011, the year she and Darrell first came to Winship. Most recently, she made a planned gift that will establish a distinguished professorship in multiple myeloma research.
Our “Inspiring Hope” feature in this issue is Nicole C. Schmitt, MD, FACS, co-director for translational research in Winship’s Head and Neck Cancer Program. This Q&A illustrates why her patients rave about her ability to help them feel safe and comfortable.
Finally, we offer a selection of photos from the 14th annual Winship 5K, held on Saturday, September 28. We are grateful for the record number of participants and the more than $1 million they raised for cancer research and care at Winship.
Thanks to all for your interest and support on behalf of our clinicians, researchers and, most of all, our patients.
With deep appreciation,
Suresh S. Ramalingam, MD, FACP, FASCO
More than 3,500 people registered to run and walk in the 2024 Winship 5K Run/Walk on Saturday, September 28, with another 498 participating online. Together they helped raise more than $1 million for cancer research and care at Winship. Now in its 14th year, the Winship 5K has raised more than $10 million to date.
PIONEERING PERSPECTIVE
ECan a Culture of Innovative Thinking Help Us Address the Most Pressing Challenges in Health Care?
BY ZACHARY L. BERCU, MD, RPVI, FSIR
ven in this incredible era of technological advancement and civilizational marvel, we continue to face considerable challenges that weigh heavily on the shoulders of health care teams focused on improving lives and human health.
Barriers seem to be ever present in the United States, and across the globe: inequitable access to health care, antibiotic resistance, complex mul timodal diseases, polypharmacy (the use of multiple medications to treat multiple conditions at the same time), patient frustrations with everyday experiences, a sense of “commoditization” of health care practice, loss of auton omy for those who practice, tight ening of reimbursement, health care worker burnout, loss of focus on the patient, and a per ceptive divergence of patient and health care worker interests.
How do we take the weight of the world and convert our challenges into opportunities? How do we open our minds to the most innovative solutions that not only address today’s challenges but also build infrastructure and opportunities for tomorrow?
I am grateful to be in a technologically advanced specialty, interventional radiology (IR), where we tend to be early adopters of innovation. IR is a field not bound by organ system or pathology, but rather by the constellation of characteristics involving procedural, clinical and imaging expertise. Arguably, interventional radiologists may be cued toward innovation, even if they do not recognize that process is occurring.
Interventional oncology (IO) is the focus of IR on cancer care. It involves endovascular (in a blood vessel) and
percutaneous (direct-to-tumor) approaches to minimally invasive image-guided therapies. Novel therapies are also exploring approaches using the biliary system, the genitourinary system and the gastrointestinal tract.
As our imaging/visualization improves with new fluoroscopy, ultrasound, computed tomography (CT), magnetic resonance imaging (MRI) and camera-based/ direct visualization techniques, we begin to open the door to more advanced therapies. You might say the global positioning satellite (GPS) system is being developed, and what comes next may be akin to the self-driving vehicle. Already, on the research and early clinical side, we are seeing explosive growth in endovascular and percutaneous image-guided robotics; novel visualization tools; generative AI tools to improve systems efficiencies, labor-intensive tasks and patient triage; and wearables that provide critical realtime information about patients. Many of these technologies fall into the space of biomedical engineering and/or digital health.
To unlock the greatest likelihood of our achieving the most cutting-edge and life-changing therapies, health care must enact a culture of innovative thinking. This culture does not require every individual to have an in-depth knowledge of engineering overnight. Instead, it calls upon us to feel empowered to address our challenges head-on and understand that there is an effective iterative, lean, design-thinking process available to solve even the most stubborn problems. The “low-hanging fruit” is where challenges are most
common, prescient and painful. These areas warrant immediate attention. For frontline health care workers, articulating the challenge creates the opportunity for those with an engineering background to pivot and focus. Without that clinical needs-driven approach, solutions are created for which there may not be significant problems. The most effective way to identify where time and effort should be spent is to start with the pain points; the next step is developing the team to embark on the process.
“
How do we open our minds to the most innovative solutions that not only address today’s challenges but also build infrastructure and opportunities for tomorrow?”
A critical aspect of this process is the commercialization piece, the intellectual property and the regulatory pathway. I explain to residents and students that this is important, not because these innovations will necessarily lead to companies with big exits or wealth for innovators and entrepreneurs. It is critical because creating value in the solution is essential to ensuring it has sustainability and becomes a reality.
The power of innovation in human health is
becoming apparent to many. Most of the “big tech” companies are pivoting toward health care. Health care represents the single largest industry vertical in AI, and they are taking notice.
Regardless of what stakeholders may come into this space, they will succeed only if they remain focused on the mission. They will need the experiences—the eyes, the ears, the frustrations, the hopes, the dreams, the setbacks and the opportunities of those closest to the frontlines. It will need to be hyper-focused on the patient, so it is not just “technology for technology’s sake.” And it will take our greatest challenges and convert them into opportunities that will forever change all our experiences. w
Zachary L. Bercu, MD, RPVI, FSIR, is the clinical site director for interventional radiology at Emory University Hospital Midtown, assistant program director for the Interventional Radiology Residency and Fellowship Program and associate professor in the Department of Radiology and Imaging Sciences at Emory University School of Medicine.
Technicians prepare the interventional radiology lab for a patient at Winship Cancer Institute at Emory Midtown.
TRAILBLAZERS
JESSICA WELLS, PHD, FAAN, is the assistant director of Winship’s Community Outreach and Engagement and an associate professor in the Nell Hodgson Woodruff School of Nursing at Emory University. Her research focuses on cancer control and prevention, particularly among those at risk for HIV. She recently completed a K01 Career Development Award in which she examined individual, interpersonal and neighborhood factors of adherence to follow-up after an abnormal anal Pap test in women living with HIV.
Q: Please tell us about your work aimed at cancer prevention among those at risk for HIV, such as increasing HPV vaccination in HIV community clinics?
A: Due to highly effective antiretroviral therapies, people living with HIV (PLWH) are now aging into a life expectancy of the general population. HIV is a chronic and manageable condition, but PLWH are now experiencing and impacted by non-AIDS related comorbidities, such as HPV-related cancers. Yet, evidence-based cancer screening and prevention strategies are not targeted or tailored for this high-risk population. Given that PLWH have the highest burden for anal cancer, promotion of HPV vaccination as a means of primary cancer prevention is of critical importance. My work partners with HIV community clinics to integrate a high-quality HPV vaccination recommendation and administration of the vaccine within clinical care.
Q: What are you most excited about in your research?
A: We have the tools to prevent HPV-related cancers, but work is needed to assure PLWH have equitable access to the HPV vaccine to help achieve as normal a life expectancy and quality of life as the general population. I’m most excited about the potential of my research to address a significant gap that targets a high-risk group and can reduce the clinical burden from vaccine-preventable HPV-related cancers.
Meet four of Winship's outstanding research scientists whose day-to-day work is changing the game in important ways for people with cancer.
DOUGLAS WALKER, PHD, is a member of Winship’s Cancer Prevention and Control Research Program and an associate professor in the Gangarosa Department of Environmental Health at the Rollins School of Public Health at Emory University and adjunct assistant professor at Utrecht University. He is an environmental engineer and analytical chemist with training in metabolomics and developing EWAS (exposome-wide association study) methodologies for environmental health and precision medicine research.
Q. Please describe the methods you are developing for measuring biomarkers of complex exposures of emerging concern—including microplastics, e-waste and polyfluorinated chemicals?
A: While my research primarily focuses on blood, lung and breast cancer outcomes, these methods have been used to study a wide range of diseases and have increased our knowledge of how environmental exposures may contribute to increased risk of these diseases. We are also using these methods to develop new approaches to measure complex, emerging exposures of concern, including microplastics, per- and polyfluorinated compounds (PFAS, commonly referred to as “forever chemicals”) and exposures from electronics waste (e-waste). While these exposures are widespread, their assessment in human populations has been limited due to the difficulty in measuring the large number of chemicals in these classes. My hope is our research can greatly improve our understanding of these complex exposures in humans and potential associations with health risks.
Q. What are you most excited about in your research?
A: The relationship between exposures and human health is complex, and the methods we have developed and applied in our laboratory will be one of the key approaches to begin unravelling this complexity. What most excites me about our research is that we have the potential to detect and identify the exposures that may impact human health, increase disease risk and lead to environmental disparities. Identification of these exposures will lead to interventions that reduce or eliminate them and contribute to improving public health. I also hope that by developing approaches that allow us to monitor for new or emerging exposures, we are able to prevent additional harmful pollution in a proactive manner, rather than focusing on mitigating these exposures after they have become widespread pollutants.
TRAILBLAZERS
ANDREA B. MOFFITT, PHD, is a member of Winship’s Cell and Molecular Biology Research Program and holds a joint appointment as assistant professor in the Department of Hematology and Medical Oncology and the Department of Human Genetics at Emory University School of Medicine. Moffitt aims to develop genomic tools for measuring treatment response, predicting clinical outcome and investigating the nature of residual cells in acute myeloid leukemia (AML) and other hematological malignancies.
Q: Please tell us about the genomic tools you are working to develop for measuring treatment response and predicting clinical outcome in acute myeloid leukemia and other cancers?
A: As a patient with cancer is treated and monitored, the levels and patterns of DNA from cancer cells detectable at the primary site of the cancer and in the blood can serve as a marker for a successful surgery, resistance to therapy or an impending relapse. Routine blood samples offer the opportunity to monitor patients by examining cancer cells or cell-free DNA in the blood.
My laboratory is developing genomic tools that can detect residual cancer cells remaining after a successful treatment. Strategies that we developed allow us to detect a single cancer cell among a million healthy cells, which is about a thousand times more sensitive than standard methods. Preliminary studies suggest that this test may be able to predict which patients with leukemia will experience relapse.
Q: What are you most excited about in your research?
A: We are now able to detect leukemic cells when they are at levels that doctors have never been able to see before. This opens the possibility of treating a patient whose leukemia is likely to relapse earlier than ever before. I am excited to integrate our work into clinical trials at Emory to help improve the timing and course of treatment for patients with leukemia, with promise for improving the lives of patients. I am also excited to train the next generation of scientists to tackle these challenging problems in cancer using genomic and bioinformatic approaches.
Meet four of Winship's outstanding research scientists whose day-to-day work is changing the game in important ways for people with cancer.
LISA SUDMEIER, MD, PHD, is a radiation oncologist treating patients with brain and spinal tumors at Emory University Hospital and an assistant professor in the Department of Radiation Oncology at Emory University School of Medicine. Sudmeier’s research focuses on improving treatment for brain metastases and primary brain tumors, with a particular emphasis on immunotherapies. She aims to understand how the brain’s unique immune microenvironment interacts with the immune cells infiltrating tumors within the brain, and how different cancer treatments affect these cells. She is a member of Winship's Cancer Immunology Research Program.
Q: Please tell us how and why immunotherapies offer potentially significant treatments for brain metastases?
A: Up to 25% of patients who die from cancer are affected by brain metastases, which are also a source of significant neurologic morbidity. Immune checkpoint blockade (ICB), a type of immunotherapy that activates a patient's immune system to attack their cancer, has improved outcomes in multiple types of cancer, and some clinical data has shown that ICB can be effective in the brain. This is consistent with our results showing that the cells which are activated by ICB (PD-1+ CD8+ T cells) are present within brain metastases.
But many patients with brain metastases don't respond to ICB or only respond for a short time. We need to better understand what determines whether or not brain metastases will respond to ICB, how to increase the likelihood of an effective anti-tumor immune response in the brain and how to optimize multimodality therapy that involves surgery, radiation therapy, ICB and other systemic agents.
Q: What are you most excited about in your research?
A: We have recently focused on deciphering how the surrounding brain environment may be shaping the tumor immune landscape. Different neurotransmitters released by neurons in the brain may influence the tumor's microenvironment within the brain. Concentrations of these neurotransmitters, which are affected by many different commonly prescribed medications, could be an important factor regulating the tumor's ability to evade immune-mediated destruction. Another exciting project in the lab focuses on the crosstalk between T-cells and innate immune cells such as neutrophils. T-cells are the targets of ICB, but many other immune cells interact with T-cells to regulate their function and may have untapped therapeutic potential. w
The Caregivers: Advocating for, comforting and supporting a loved one in hard times
by Pam Auchmutey
“There are only four kinds of people in the world,” the late former First Lady Rosalynn Carter once said. “Those who have been caregivers, those who are currently caregivers, those who will be caregivers and those who will need caregivers.”
Caregiving is something Carter knew well as a daughter, wife, in-law and national mental health policy leader and advocate. Her father died of cancer when she was 13; her husband, former President Jimmy Carter, is a cancer survivor treated at Winship Cancer Institute of Emory University; and President Carter’s parents and three siblings all died of cancer.
At Winship, family caregivers are essential members of the health care team. They are vital in helping loved ones navigate their way through cancer treatment and recovery. They may be spouses, partners, parents, siblings or adult children. Close friends, neighbors and coworkers also may help as needed.
“Cancer is everybody, “ says Robin Sievers, whose husband is a cancer survivor treated at Winship. “While your loved one physically has the disease, everyone around them is affected by it emotionally.”
“ Cancer is an oppressive black cloud on an otherwise beautiful day. You can either focus on the possibility it might rain, or you can rejoice that it hasn’t.”
– Robin Sievers
Self-care is key part of caregiving
Matt and Liz Ames would agree. Five years ago, Liz began treatment at Winship for an aggressive type of appendix cancer and is now cancer-free. During her treatment, the couple weathered many long and anxiety-ridden days. As Liz’s caregiver, Matt assumed multiple roles: patient advocate, appointment scheduler, driver, insurance wrangler, chief morale officer, nurse, household manager and Facebook correspondent (to provide updates on Liz)—all while working part time as a lawyer and parenting two young boys.
Doing it all could be exhausting and overwhelming. To cope, Matt became adept at using spare bits of time to take care of his mind and body. He practiced his faith, went for a quick run, connected with a new friend and rediscovered his music CDs. He also wrote about his caregiving experiences, which became fodder for his book “Through the Impossible: Lessons in Caregiving from a Husband Who’s Been There.”
Supporting the patient and caregivers with wraparound care
To fill that void, Winship provides wellness and support services for patients and caregivers, during and after treatment. Services include psychiatric oncology, spiritual health and support groups. Also, oncology social workers provide counseling for individuals and families.
“ No matter how dark or frightening the moments, Liz and I never let go of the belief that somehow, some way, we were going to find our way through.”
– Matt Ames
Matt did what the National Cancer Institute, the American Cancer Society, Winship Cancer Institute and other health agencies, clinicians and researchers recommend that caregivers do: practice self-care so you can take better care of your loved one.
But Matt still faced an unexpected hurdle after Liz’s cancer treatment ended. Although his family had come through a crisis, his stress, anxiety and uncertainty remained as he and Liz adjusted to their new normal.
“When you are a caregiver, your whole identity is wrapped up in getting a loved one through their cancer treatment,” says Caroline Peacock, DMin, PCSW, MDiv, director of spiritual health at Winship. “When treatment ends and their loved one finally comes home, the caregiver can experience a kind of disorientation. Also, the community they’ve come to know—doctors, nurses and others—are no longer there to rely on and talk with.”
When Peacock rounds at Winship’s Clifton campus, she visits with patients and their caregivers. “We offer support based on their values and the things that bring meaning to their life, whether it’s through prayer, meditation, nature and the outdoors or community activities,” she says.
She also encourages them to “talk about the hard parts” that go along with cancer treatment and recovery. “People tend to emphasize the positive by saying things like, ‘Oh, you’re going to pull through this,’” says Peacock. “They don’t feel they have a space to talk about how hard going through cancer can be. We are that space for them, where they can share whatever burden is on their heart.”
Peacock’s colleague, Wendy Baer, MD, leads a team of licensed social workers and medical experts in psychiatry who help families manage emotions, behaviors and relationships during cancer treatment. She and others counsel patients and caregivers, together and individually. “We create a neutral space for the patient and caregiver to share what’s on their mind and what they’re struggling with,” says Baer, director of psychiatric oncology at Winship. “Sometimes, patients don’t realize what an emotional journey cancer can be for their caregivers.” Baer urges caregivers “to think about what you’re good at.” Such strengths may be managing appointments or picking up medications, listening and providing encouragement, doing household chores or taking care of children and pets. “It’s
Caroline Peacock, DMin, PCSW, MDiv
Wendy Baer, MD
important for caregivers and patients to know that one person can’t do everything,” says Baer.
Caregivers should also practice a rule taken from airline safety: Put on your own oxygen mask first before you put it on someone else. “You have to take care of yourself first before you can take care of someone else,” Baer says. “Research shows that when caregivers do better, patients do better.”
Matt Ames knows what it’s like to put on that oxygen mask. At the beginning of his book are four lines from “My Blood,” a song by the duo Twenty One Pilots. The lyrics are apropos for any caregiver:
You’re facing down
A dark hall
I’ll grab my light
And go with you. w
Staying Vigilant
Amanda Vanterpool doesn’t shy away from homework. She has done her share as a professional in medical research, pharmaceutical quality control and assurance and financial management. In 2023, she started her own business as a wealth and health advocate, a career move resulting from a recurrence of her mother’s breast cancer.
“This whole journey with my mom opened my eyes to the benefits of having good health and life insurance so that no one winds up in the same position my family did because of my mom’s illness,” says Amanda.
In 2016, her mother was diagnosed with stage 0-1 breast cancer at Winship Cancer Institute at Emory Saint Joseph’s Hospital. “She caught it very early,” says Amanda. “She had a lumpectomy, followed by chemo and radiation. We thought we dodged a bullet. She had less than a year of treatment, so that was great.”
But four years later her mother began having fevers and fainting spells and didn’t know why. For two months, she was in and out of the emergency room, and no one in the family could accompany her because of the COVID-19 pandemic. A scan showed a fracture in her spine that was likely metastasized breast cancer.
“I didn’t know that could happen,” says Amanda, who dove into the National Cancer Institute website and scientific articles to learn more. “Getting more information helped calm me down.”
A biopsy confirmed everyone’s fears, and her mother began treatment for stage 4 breast cancer at Winship’s Clifton campus. At the time, she was very weak, had difficulty getting out of bed and used a walker. She tried two different medications and enrolled in a clinical trial in late 2022 to test a new hormonal drug. Then, in November 2023, she began taking a new chemotherapy drug that targets metastatic HER2-low breast cancer.
“My mother gained her strength back quickly after her infusion treatment began,” says Amanda. “She’s active and able to drive again. Her cancer antigens are almost nonexistent in her blood tests. She has chemo every three weeks, but it’s so much easier.”
“Cancer has been all-consuming for the past few years,” she adds. “My mom is figuring out what to do next. Travel? Write a book? She’s trying to find herself in this cancer journey.”
Amanda is transitioning as well. Instead of being at every doctor’s appointment and asking questions, she has time to focus more on herself and other family, including her husband, newly married sister and brother, who all provided caregiving support in various ways.
If there’s one piece of advice Amanda has for other caregivers, it’s this: Keep the person with cancer up—a lesson she learned from a Winship doctor.
“It’s very hard for someone with cancer to rebound,” she explains. “We focused on staying vigilant with my mom. If a medication wasn’t working or she wasn’t feeling well, we got it addressed very quickly. It’s important to raise the flag and ask questions so you can pivot. It’s very hard to come back from getting run down when you have cancer.”
Amanda Vanterpool
Strength in Numbers
Word travels about the quality of patient care at Winship Cancer Institute of Emory University.
In 2018, Jerome Webb was driving down I-75 to Florida when his trip took an unexpected but necessary turn. His aunt called to tell him that his mother was ill at her home in Middle Georgia.
“I was just five minutes away from the exit when she called,” says Jerome. “When I got there, I found out she had breast cancer. She had kept it from everybody.”
His mother’s health condition was serious. She had a heart problem, needed blood transfusions and her cancer was advanced. Her doctors at the hospital in Warner Robins recommended hospice care. On her last doctor’s visit there, a nurse practitioner recommended that Jerome take his mother to see Jane Lowe Meisel, MD, a physician with Winship’s Glenn Family Breast Center, a Discovery and Developmental Therapeutics researcher at Winship and associate professor in the Department of Hematology and Medical Oncology at Emory University School of Medicine.
“The nurse practitioner said Dr. Meisel might be able to treat my mother with medication,” Jerome recalls. “That’s how we got my mother to Emory.”
Meisel recommended two different drugs for her treatment. When neither one proved effective, she switched her patient to chemotherapy. Jerome’s mother also had a heart valve replacement at Emory. But during the past year, she slowed down considerably after being diagnosed with Alzheimer’s disease. For a
time, she lived with Jerome’s sister in an Atlanta-area townhouse. She then lived with Jerome and his wife in their Stone Mountain ranch house, where it was easier for her to get around. Dorothy unfortunately passed away in August.
Jerome is retired and the oldest of six children. Because his siblings still work, he oversaw his mother’s care, from taking her to doctor appointments to handling insurance paperwork. Other family members routinely helped. His mother’s youngest sister, who lives in Middle Georgia, came for two to three weeks at a time. When she was not there, Jerome took over. His wife, daughters, sister-in-law and cousins also stepped in when needed.
“We’ve been blessed. Our family has always been close,” says Jerome. He adds that it was still a challenge, not because of dealing with his mother, but trying to get the in-home services she needed to keep her comfortable.
Jerome understood that taking time to care for himself was just as important.
“Knock on wood, my health is pretty good for my age,” says Jerome, 67. “I’ve always tried to eat right and stay active. My family knew that if we didn’t take care of ourselves, we couldn't take care of my mother. We worked together to make sure one person didn’t get overwhelmed. But it could still be overwhelming because of what it was.”
The Angels Among Us
Cancer has shadowed much of Lillian Hamilton’s life. Her mother died of brain cancer when Lillian was 17. Years later, Lillian commuted between Atlanta and her native New Jersey to
PHOTO OF
AND WEBBS: JENNI GIRTMAN; PHOTO OF LILLIAN HAMILTON AND MICHAEL REEDER: COURTESY OF LILLIAN HAMILTON
Left to right: Marvin Vance, Mary Vance, Gwendolyn Webb and Jerome Webb, holding a photo of Dorothy Vance, for whom they were caregivers.
Lillian Hamilton and Michael Reeder
care for her father, who lived with pancreatic cancer for 10 years.
On December 16, 2016, Lillian’s sister was diagnosed with breast cancer and eventually passed away. Four years later, on the same date, Lillian learned she herself had breast cancer.
Today, Lillian is cancer-free thanks to the care she received at Winship Cancer Institute of Emory University—and the love and support of her fiancé, Michael Reeder. The couple, who live in Kennesaw, got engaged during Lillian’s recovery. They had known each other for 10 years before they dated.
“One day, Lillian’s sister called me out of the blue to ask why I didn’t date her sister,” says Michael. “Lillian and I have been together ever since.”
After the sister learned she had breast cancer, she asked the couple to be her caregivers during chemotherapy. “I had no experience dealing with cancer, but I was glad she wanted both of us to help,” says Michael.
He rose even further to the task when Lillian learned of her diagnosis at an Atlanta-area community hospital. They opted to get a second opinion and soon made an appointment with Kevin Kalinsky, MD, MS, director of the Glenn Family Breast Center at Winship Cancer Institute. When the couple mentioned they had gotten an opinion from the New Jersey oncologist who had treated Lillian’s father, Kalinsky immediately phoned him to consult.
“When someone is diagnosed with cancer, the patient is in shock, and the caregiver is in shock too,” Michael says. “You’ve got to put that aside and think it through. You’ve got to take the initiative. If a second opinion is warranted, get a second opinion. Our priority was to get healthy at any cost and not to wait.”
Lillian’s treatment plan included a single mastectomy and radiation. Reconstructive surgery was an option for later after her body healed.
Her outpatient surgery was set for late January 2021—during the COVID-19 pandemic and just as Michael’s employer was preparing for a three-day external audit. Lillian suggested postponing her surgery so that Michael could assist with the audit, and she could have another week of normal life.
“No, we can’t wait,” Michael insisted. “You need to do this.”
Lillian’s surgery was expected to take 90 minutes. It lasted four to five hours so her surgeon could remove several lymph nodes. Lillian’s cancer was now stage-3 and required chemotherapy. “Going home the day of her surgery was terrifying,” Michael recalls.
The first days and weeks at home were tough. Lillian and Michael were confined to one room because of COVID. Neighbors brought plenty of food, but Lillian didn’t feel like eating, mostly
because of nausea caused by her pain medication. So, Michael stocked up on bland foods like soup, rice and eggs and learned how to cook.
When Lillian felt strong enough to ride to the drive-thru at Chick-fil-A, she made a discovery. None of her clothes fit and she felt off balance because of her mastectomy. The couple improvised and made a breast form out of some cloth. “I had symmetry!” Lillian says.
The makeshift form sparked a business idea. Lillian partnered with Shaun Francis, a work colleague who had been treated for brain trauma at Emory, to establish Natura3, a web-based breast form alternative company. Natura3 forms are made of bamboo cotton that women can shape and size themselves. The forms provide a soft alternative to silicone breast forms.
“I could wear mine during radiation,” says Lillian. “I didn’t feel lopsided anymore, and I could wear my regular clothes, which helped me feel normal.”
The couple ventured out more as Lillian became stronger. Michael took her to the park, where she sat by a lake, and to Target, where she rode in an electric cart to shop. Whenever Lillian had an appointment at Winship, he packed a day bag with a blanket, water canteen, earbuds, a battery phone charger and a notebook full of information he’d written down during many previous appointments.
At times, treatment could be frustrating when unexpected complications arose, such as trips to the ER for rehydration from nausea or experiencing the first bout of chemo brain—the forgetfulness that chemotherapy can cause. During COVID, when the couple suggested creating an urgent care space specially for patients with cancer to better protect them from COVID, Winship did just that. “They listened to us and to other patients,” Michael says.
The hardest part of Lillian’s recovery is now far behind her. During her recovery, she and Michael completed a web-based cancer survivorship program to learn better coping skills and strengthen their mental outlook.
“Right now, I talk to a few people who are going through cancer,” Lillian says. “It’s helpful for them to talk with someone who’s been through it. Sometimes, all you need to do is text them a heart emoji to let them know you’re thinking of them.”
The couple is grateful for the many kindnesses shown them by strangers, family, friends and Winship specialists and staff.
“I’m convinced there are angels on this planet,” says Michael. “We’re thankful to be back to living life again.”
Keeping Dark Clouds Away
Robin Sievers has some ground rules for dealing with cancer: Be honest about how you’re feeling on good days and bad. Cry when you need to. And never go online.
She set those rules after she and her husband, Keith, learned he had stage 4 metastatic cancer in early 2021. At the time, Keith was undergoing radiation treatment at a community hospital for squamous cell carcinoma, a type of skin cancer he had removed from his forehead six months earlier. Then a lump had appeared in his neck, and an MRI showed it was cancerous.
“We fell into each other’s arms and cried,” Robin recalls. “It was such a shock. But you can’t pretend your whole life hasn’t changed. We prayed for God to knit together the best medical care we could find. We promised each other that we would never Google it (Keith’s cancer), and we would listen to his doctors.”
They definitely paid attention when the community hospital doctor who read Keith’s MRI scans told them, “You need to be at Emory.”
The Sievers soon made an initial appointment at Winship Cancer Institute’s Clifton campus. “It was like drinking from a fire hose,” Robin says. “We met with every care manager, every doctor, every specialist, one after the next.” The team recommended surgery, followed by proton radiation therapy. They also discussed possible challenges for Keith after surgery, such as difficulty swallowing or closing his eyes, weakness on his right side— and not being able to play golf in the North Georgia community where the couple live.
“That’s not going to happen. It’s just not,” Robin told Keith.
In the journal she kept, she described the mindset they adopted: “Cancer is an oppressive black cloud on an otherwise beautiful day,” she wrote. “You can either focus on the possibility it might rain, or you can rejoice that it hasn’t.”
To further cope, she cooked meals made from organic ingredients and made high-protein drinks for Keith. “Whether those things helped, I have no idea,” says Robin. “But they helped me. It was something I could do.”
On the day of Keith’s surgery, Robin could not stay with him because of hospital restrictions for COVID-19. Later, she drove him the 150 miles to and from Atlanta for proton therapy, a daily regimen that lasted eight weeks. During his treatments, she taught herself to knit and formed a sorority of sorts with other family caregivers waiting like her. “Not only did it help them, but it helped me,” says Robin, the group veteran.
In late 2021, a routine scan revealed a tumor in Keith’s lung. He chose to take an immunotherapy drug being tested in a clinical trial, which required more round trips to and from Atlanta every two weeks. The trek was worth it. At the end of five months, Keith’s lung tumor was gone.
Since his initial diagnosis, the Sievers have embraced helping others dealing with cancer. They’ve taken meals to neighbors and friends and talked with strangers seeking their advice. Keith volunteers with the Cancer Hope Network, which provides one-on-one peer support to adult patients with cancer and their loved ones. He continues to play golf and recently won a two-day tournament.
The couple knows they are fortunate and that not everyone survives cancer. “Winship saved Keith’s life and mine too,” says Robin. “I can’t imagine life without him.”
Valuing Academic Medicine
Before working on the business side of health care, Monte Masten, MD, practiced obstetrics and gynecology for 13 years. He delivered babies, performed C-sections and other surgeries and cared for women with reproductive health conditions, including ovarian cancer.
“I certainly know the good and bad side of that,” says Monte, who lives in Roswell, GA, with his wife, Marsha, who is a nurse.
In April 2023, when Marsha wasn’t feeling well, Monte insisted on going to the ER to determine if she was having a flareup of diverticulitis. They were leaving soon on a trip to Geneva, Switzerland, and he didn’t think she should get on a plane until they knew the cause of her severe stomach pain.
Robin and Keith Sievers
PHOTO OF ROBIN AND KEITH SIEVERS: JENNI GIRTMAN
A CT scan showed Marsha had two large masses in her abdomen. The news hit “like a punch to the gut,” says Monte, who cried upon hearing the results. “So, we went home. We were shell-shocked.”
To learn more, Monte reached out to an OB/GYN professor and surgeon in St. Louis, with whom he had trained. After looking at the CT scan and report, the professor said it looked like Marsha had ovarian cancer that had spread to her liver. He recommended the couple contact his colleague, Susan Modesitt, MD, who had recently joined Winship Cancer Institute of Emory University. Marsha soon had an appointment to see Modesitt at Winship’s Emory Midtown location.
“I know it’s hard for a lot of people to get access to really good care,” says Monte. “I’ve seen how tough this battle can be. To be able to see Dr. Modesitt so quickly made a lot of difference. We were very fortunate to have world-class care at Emory.”
After getting the results of a liver biopsy, Marsha began chemotherapy. Each session lasted seven hours. Monte and Mary, his stepdaughter who is a nurse, took turns changing the iced mittens and socks on Marsha’s hands and feet every 15 minutes to minimize the risk of nerve damage that aggressive chemotherapy can cause.
“It’s tough sitting in a chair getting chemo, and it’s tough being the caregiver,” Monte says, “but we managed.”
More difficult days lay ahead. In August 2023, Marsha had an eight-hour surgery to remove a lymph node with cancerous cells next to her aorta and a total hysterectomy to remove any suspicious tissue. Once home, Monte helped her recover.
The first four weeks were the toughest as Marsha experienced abdominal pain, weakness and difficulty eating and drinking. She
slowly regained her strength and independence, aided by a stirrup device Monte learned about on Amazon to help patients get out of bed. Her upbeat nature helped, despite having a history of cancer on her side of the family.
“Marsha is very stoic,” says her husband. “I’ve rarely seen her break down. She’s told me, ‘Someone else is controlling my fate. All I can do to fight this is do what I can and stay positive.’”
After recovering from surgery, Marsha completed more chemotherapy, which ended in October 2023. She’s now taking a PARP inhibitor, an oral drug that prevents cancer cells from reproducing by targeting the harmful variant of the BRCA2 gene. Some days, she feels the drug’s side effects of fatigue and nausea. Other days, she feels fine.
Despite the side effects, Monte appreciates how treatment advances like PARP inhibitors can help patients like Marsha.
“The reason you fight cancer each day is because you never know what kind of medications we’ll have five years from now because of breakthroughs in research being done today,” he says. “PARP inhibitors weren’t available five years ago. The mRNA technology used to develop COVID vaccines looks really promising for developing a therapeutic vaccine for cancer. That’s the thing you live for each day because there may be something extraordinary around the corner.”
Monte offers important advice for patients and caregivers seeking treatment for a life-threatening condition: seek care at an academic medical center. “We’re blessed to have Emory in Atlanta,” he says. “Winship has world-class researchers, physicians, surgeons and nurses. Find the best care possible, get a second opinion and learn as much as possible.”
After Marsha’s final chemotherapy treatment, she and Monte visited Winship’s Clifton campus for a scheduled checkup. In the stairwell below their feet, the word “hope,” stood out in giant letters on the landing. The couple paused to take a picture.
“That’s what you’ve got to hold onto,” says Monte, “to keep fighting, one day at a time.”
Monte and Marsha Masten
Matt and Liz Ames find their way back from the wild
For family members, caregiving is deeply personal and daunting when a loved one is diagnosed with cancer. Suddenly, home and work life shift radically as cancer treatment and recovery become the priority day to day.
Just ask Atlantans Matt and Liz Ames, who liken her cancer diagnosis to being hit by lightning.
In spring 2019, Liz decided to have a small stomach hernia repaired that occurred shortly after childbirth three years earlier. The hernia was causing more discomfort, her stomach bulged noticeably and her energy level had dipped—a noticeable
symptom for a 38-year-old wife, mother, corporate attorney and competitive runner. The couple agreed something was off.
Liz went to see a gastroenterologist and her gynecologist, who did a sonogram that showed a buildup of fluid in her abdomen. No one could pinpoint the cause, so Liz insisted her hernia surgeon schedule an MRI to rule out anything serious. Her scan on July 2, 2019, showed she had appendiceal adenocarcinoma— appendix cancer.
Liz’s cancer was rare. Of the approximately 1,500 cases diagnosed annually in the U.S., most are low-grade. In these cases, cancerous mucin (a fluid comprised of mucus cells) spreads slowly from the appendix to other tissues and is easier to treat successfully. In Liz’s case, a biopsy showed her cancer was highgrade—more aggressive and more difficult to treat.
The news sent the family into what Matt calls “survival mode.” Liz went on disability leave. Matt cut back his law firm hours to be with Liz and, aided by extended family, keep life on track for sons Eli and Isaac, then 6 and 3. The couple did their homework to find the best expert to treat Liz’s rare form of cancer. Their diligence led them to Charles Staley, MD, a surgical oncologist specializing in stomach, esophageal, appendiceal, colorectal and peritoneal surface cancers at Winship Cancer Institute of Emory University as well as Winship’s chief of surgical oncology and a professor of surgery at Emory University School of Medicine. “We had our man,” Matt would later write in his book “Through the Impossible: Lessons in Caregiving from a Husband Who’s Been There” (see sidebar).
Liz’s treatment began with six rounds of chemotherapy with a drug then being tested in a clinical trial, followed by surgery.
Matt and Liz Ames
She stayed in the hospital for 19 days and, after a long recovery at home, completed more chemotherapy in isolation because of the COVID-19 pandemic.
Finally, in mid-spring 2020, she completed her last chemo treatment. Friends gathered outside her home to celebrate from a safe distance, while others shared celebratory videos on Facebook. But a new reality soon set in. After months of being cared for by Winship experts, Liz and Matt were on their own.
“We went from survival mode to being released back into the wild,” says Matt. “For someone with Liz’s type of disease, she still has way too many doctors’ appointments. She still goes in for bloodwork and scans. We still hold our breath and wonder what the next few years of our lives will look like. We weren’t prepared for that emotional fallout.”
The couple found ways to cope. They talked often about how they were feeling and leaned on each other to restabilize. They savored the small beauties in daily life that often go unrecognized. When Matt had 15 minutes to spare, he used the time to exercise and clear his mind. When Liz needed some rest, he took their boys on a quick outing to give her some quiet time. At Liz’s urging, Matt looked for a caregiver support group but couldn’t find one that felt right. He reached out to his rabbi, who connected him with a younger man going through a family crisis. The two men connected over dinner and became good friends.
Today, the Ames family is thriving. On weekends, the parents cheer their boys, now 11 and 8, on the athletic field. Liz has a new full-time position with Delta Air Lines and is helping raise funds for a new rooftop garden at the 17-story Winship Cancer Institute at Emory Midtown. She and Matt often speak with families and groups seeking advice about cancer treatment and caregiving.
Every day above ground is a good day
Matt Ames still remembers the smiling, cheerful woman who used to deliver the mail in his law office. Their daily exchange began as follows:
Matt: “Grace! How you doin’ today?”
Grace: “Good morning, Matthew. And you know what? Every day above ground is a good day.”
And then one morning, someone else brought the mail. Grace was gone. Years later, Matt learned that Grace had a troubled home life. And yet, she smiled and expressed gratitude every day.
“Grace’s take on the world left quite an impression on me,” Matt writes in his book “Through the Impossible: Lessons in Caregiving from a Husband Who’s Been There” (Ibis Books, 2023). The book chronicles his experiences caring for his wife, Liz, during her arduous but successful treatment for appendix cancer at Winship Cancer Institute of Emory University. It’s an honest and upbeat how-to for anyone needing advice on how to care for a loved one—and yourself—during a medical crisis.
When Liz first learned she had cancer, Matt created a private Facebook group to inform family and friends about her progress. After her treatment ended, Matt kept on writing as a journaling exercise. Eventually, a book took shape—with Liz’s blessing. Matt writes candidly about learning caregiving through trial and error. His greatest lesson: learning to let go of his old self and moving on, one day at a time. “No matter how dark or frightening the moments,” Matt says, “Liz and I never let go of the belief that somehow, some way, we were going to find our way through.” w
One of the hardest challenges, Matt found, was dealing with the emotional highs and lows after Liz’s cancer treatment ended. They had survived a crisis. Now what?
Writing the book helped him reflect on what he learned as a caregiver, how it strengthened his love for family and friends, how it deepened his gratitude and faith and how others can do the same.
Liz is the book’s biggest fan. She writes in the foreword: “Life can be messy and unpredictable. No matter your struggle—be it cancer, depression or some other major trauma or setback—the takeaways from this book apply to all of them. If you can apply any piece of Matt’s advice to your day-to-day life, I promise your world will be a little brighter.”
Becoming Her Own Hero: Surviving two types of cancer taught Loriana to be
her own advocate
by John-Manuel Andriote
Georgia-born Loriana Hernandez-Aldama was living in Texas, enjoying a successful career as a TV news anchor, when she says two doctors in Austin dismissed her fatigue. They told her she was just tired and overworked, “a new mom trying to have it all.” Loriana was in the midst of a fertility treatment aimed at having another baby. In fact, it was her fertility doctor who told her, “You have acute myelogenous leukemia.”
Tapping contacts she had established through her medical reporting, Loriana was able to be treated for the leukemia at Johns Hopkins in Baltimore. She recalls being told, “Get on a plane. Say goodbye to your son. You don’t have time to waste. You’re dying.”
Loriana says this is how she learned to appreciate the difference between a community cancer center as compared with a National Cancer Institute-designated Comprehensive Cancer Center like Hopkins and Winship Cancer Institute of Emory University: “one of them saying, ‘you’re just tired’ and another one saying, ‘you’re dying.’”
That difference, and the seriousness of her diagnosis, led Loriana to make the hard choice to leave her son for what turned into a year in order “to be here today.”
Ten months into her treatment, chemo wasn’t working. Her doctors held off on trying to do a stem cell transplant
because, as a Latina, Loriana confronted the fact that there are very few compatible donors because of a low number of Latinos and other people of color in the bone marrow donor registry and in clinical trials. Again, she was told, “We don’t know if you’re going to live.”
Loriana had little choice but to move forward with the stem cell transplant. Afterward, during the COVID-19 pandemic, Loriana also developed breast cancer—like her sister. In fact, cancer was all too familiar in her family: besides her sister, her mom had throat cancer, and her dad has a blood disorder.
Rebuilding the “pit crew” in a new city
For his part, David A. Frank, MD, PhD, Winship’s director of the Division of Hematology and professor of hematology and medical oncology at Emory University School of Medicine, says, “I have spent a good part of my career, both at Harvard and at Emory, teaching medical students, interns, residents and fellows. I always tell them that whenever you are in a room with a patient, regardless of whatever else is happening in your life, the only thing you should be focused on is what this person is saying to you and what you can be doing to help them.”
Loriana and her husband’s television careers meant moves every couple of years. The challenge of building what she calls “a whole new pit crew” after each move added to the stress of living with cancer. “Having to build that team is intimidating, and you have to have trust,” she says. “For me, it was very scary to leave the doctors that saved my life.”
After her husband’s career brought the family back to the Atlanta area, Loriana told her husband that she planned to connect with Winship Cancer Institute of Emory University “because it’s an NCI-designated Comprehensive Cancer Center, and they have some of the best doctors in the world.”
Three years later, Loriana says, “Once I got established here and built the whole team, I feel so good being here at Emory, and I feel that I’m safe and protected, and I’m in the best hands that I could ever be in.”
In particular, she says, “I have been blessed to find Dr. [David] Frank, one of the most patient-centric, amazing doctors who actually leans in, listens and looks at the whole patient—which is what we need all doctors to do, all oncologists. He knows how to talk to each patient in the way that they need to be spoken to and how they understand. And so, I do feel very safe having him as my fearless leader in my leukemia world.”
Loriana calls her Winship breast oncologist her “pit crew leader.” She says that Kevin Kalinsky, MD, MS, director of the Glenn Family Breast Center at Winship and professor in the Department of Hematology and Medical Oncology at Emory University School of Medicine, has guided her in navigating the various specialties she has needed at Winship—whether it’s a neurologist to address the burning sensation in her feet, an infectious disease doctor to deal with her compromised immunity or a cardio-oncologist to consult about her blood pressure. Loriana says Kalinsky “looks beyond” just the breast cancer. “He steps back and looks at the whole patient. Just talking to him, he really asks, ‘How is your life? What is going on? Is everything good in your life? Are you having transportation issues? Child care issues?’”
Her high regard for Kalinsky is mutual. “She is an incredible advocate for herself and her family,” he says of Loriana . “She comes to clinic prepared and asks thoughtful questions.” He points out that Loriana’s experience at Winship “highlights the benefits of being cared for at a comprehensive cancer center and the associated multidisciplinary care based on patient-oriented research.”
Surviving, but living with PTSD
Loriana calls the mental health aspects of her cancer experience “cancer’s invisible side effect.” After her treatment and transplant, she says she experienced “cancer-related PTSD.” Being separated from her son while undergoing treatment far from home, together with the risks and uncertainties of the
Kevin Kalinsky, MD, MS
David A. Frank, MD, PhD
PHOTO COURTESY OF LORIANA HERNANDEZ-ALDAMA
Loriana with her husband and son
transplant and being told multiple times that she might not live fused into a perfect storm for post-traumatic stress disorder.
Even after surviving cancer, challenges remain—including mental health. Loriana says, “If people start to see that t here is a connection between my being mentally well and staying on treatment and in treatment, it’s a win-win for everybody. Compliance goes up. We go to our appointments when we feel better. When we’re depressed, we’re not going to come to our appointments. When we’re depressed, maybe anxiety goes up and more problems come together.”
In her experience, Loriana has found that not every institution providing cancer care offers mental health care as part of its survivorship programming. At Winship, she says, “I am so blessed. I have a psychiatrist here named Dr. [Wendy] Baer, and she has really helped me navigate part of this journey, because the level of PTSD that I live with really controls my life in so many ways.”
Wendy Baer, MD, serves as Winship’s director of psychiatric oncology and is an associate professor, holding joint appointments in the Department of Psychiatry and Behavioral Sciences and the Department of Hematology and Medical Oncology at Emory University School of Medicine. Baer says, “We know that when somebody’s suffering from clinical depression or an anxiety disorder, or in their actions with regard to addiction and a substance use disorder, those medical problems interfere in people’s ability to take care of themselves and follow recommendations for best practices to manage cancer and treatment” (See sidebar for more of Baer’s
recommendations for addressing mental health in survivorship).
“Survivorship is tough,” says Loriana. “In survivorship, you’re constantly on your toes, looking over your shoulder, fearing a shoe’s going to drop.” She has to catch herself, pull herself back into the mindset of gratitude, so depression doesn’t take over.
One way Loriana keeps herself out of what she calls a “dark rabbit hole” is by using her voice to advocate on her own behalf and for others who aren’t as comfortable asking for explanations or taking an active role in their care. “I’m a former news anchor and network medical reporter,” she says. “If I can use my voice and share my depression and trauma, be transparent and vulnerable, and help another life, then I feel like I have a moral obligation to do it, because I said, ‘If I live, I will serve.’ I’ve just been serving ever since. It feels like it’s all I can do to deal with the depression.”
Loriana hates the phrase “the new normal” in survivorship. “But I’ve had to shift what brought me joy.” She is working on a book she is calling “Finding Joy Between the Fence Posts.” “You have to find joy as a cancer survivor and patient in the straightaways because there’s always going to be little things that pop up in survivorship that alter your life.”
Summing up the ways she is managing the aftereffects of having had cancer, Loriana says she stays very active, works out and tries to be her own hero. She says, “I know that the more fit you are going into a fight, whatever it may be, the better positioned you are to prevail and do well.” w
Tips for successful survivorship
Psychiatrist Wendy Baer, MD, Winship’s director of psychiatric oncology, says, “We know that you’re a survivor from the day you’re diagnosed. But many people tend to think about survivorship from the time they finish chemotherapy, immunotherapy or radiation, perhaps after they’ve healed from surgery, and they don’t have plans to go back to the cancer center for three to six months for scans.”
Baer says that common mental health concerns that can come up in survivorship include fatigue and fear of recurrence—wondering if the cancer will come back. She says that while some people will benefit from seeing a therapist for talk therapy, others may need to treat their anxiety with a prescription medication.
Baer offers three recommendations for dealing with the anxiety that can crop up in survivorship:
Train the brain to be in the present— and not necessarily at the activity level you may have been at a year or five years ago. Baer says, “We want to be careful in the present time not to judge ourselves or compare ourselves too harshly to who we were months or years ago. We want to be kind and gentle with ourselves for who we are today, and it may mean adjusting your mindset about who you are in the present time.”
Make peace with what has happened. Baer says, "Finding some acceptance of what has happened medically allows you then to move forward and not get stuck in the past or stuck in your grief."
Take medications as prescribed, get follow-up screenings, exercise and eat an anti-inflammatory, cancer-fighting, healthy diet. “All of that can be affected if your mind or your mood are not in a healthy place,” Baer says, “which raise the risk of not having the outcomes that you want to have with regard to managing your cancer.”
FEATURE WINSHIP
WINSHIP & ACS PARTNER TO REDUCE CANCER BURDEN AND RISK
by John-Manuel Andriote
A unique new research partnership between Winship Cancer Institute of Emory University and the American Cancer Society (ACS) will help identify interventions that can reduce the burden and risk of cancer and increase the likelihood that cancer will be diagnosed at an early stage.
“ We expect this research to translate into interventions and dissemination of evidence-based practices that can ultimately contribute to achieving our mission,” says Suresh S. Ramalingam, MD, FACP, FASCO, Winship’s executive director and the Roberto C. Goizueta Distinguished Chair for Cancer Research at Emory University School of Medicine.
Supported by a $6 million, three-year grant from the Robert W. Woodruff Foundation, the partnership will focus on building a cloud-based data storage and analytical system that will allow Winship and ACS scientists to analyze and seek practical uses for the massive amount of data and biological samples that ACS has gathered in its three-part Cancer Prevention Study cohorts over the past seven-plus decades.
“
It doesn't make sense for us to build a parallel data science team when world experts are right there in the same city with our own scientists.”
—Karen E. Knudsen, MBA, PhD, former CEO of the American Cancer Society
“
Bringing these two groups together and leveraging those resources, which are precious resources, including samples and data, could really accelerate addressing some of the key questions our research teams are focused on.”
—Suresh S. Ramalingam, MD, FACP, FASCO, executive director of Winship Cancer Institute
The partnership formalizes years of informal collaboration between Atlanta-based Winship and ACS. Ramalingam expects the partnership “to be very much a highly functional day-to-day working partnership between ACS and Winship.”
ACS's outgoing CEO Karen E. Knudsen, PhD, says the partnership “makes complete sense” since both organizations are based in Atlanta, and it reduces duplication of effort. “It doesn’t make sense for us to build a parallel data science team when world experts are right there in the same city with our own scientists.”
A collaboration between Winship and ACS will support each organization’s mission and will benefit all who will be spared a later-stage cancer diagnosis because of the prevention interventions that will ultimately result. “Cohort studies are mission-critical for understanding cancer risk,” Knudsen says. “It’s honestly one of the only ways to truly get at it.”
What each partner brings
“We have some of the world’s largest population studies focused on cancer,” says Alpa V. Patel, PhD, FACSM, ACS’s senior vice president of population science. “We’ve engaged more than 2.5 million participants across the country in these studies over 70-plus years. But they’re fundamentally underutilized because we are a small team here.”
Knudsen says the Cancer Prevention Study has collected more than 400,000 samples from its current 1.5 million participants—including blood, saliva, stool, tumor tissue if someone developed a cancer, and information from each individual, including their medical history, family history, exposures, occupation and habits. With such a vast amount of information, Knudsen says, “there’s not a way possible for someone to manually curate all of that data and identify what cancer risk looks like.”
The partnership with Winship will enhance ACS’s ability to analyze the data and samples from its Cancer Prevention Study cohorts. In turn it will provide Winship researchers with the kind of information they need to discern connections between and among data findings, and ultimately to “translate” what they find into real-world interventions and best practices for preventing and treating cancer.
While the ACS is very good at collecting data and specimens,
and storing specimens, William L. Dahut, MD, ACS’s chief scientific officer, says ACS needs scientific partners to understand the biology and provide a deeper understanding of what’s going on beyond the statistics. The partnership is “about having a scientific partner who has the capabilities, which really increase our capabilities to understand what's going on with patients.”
Dahut says the cohort studies have been aimed at understanding the factors driving cancer diagnosis and outcomes, leading to ways either to prevent or detect cancer earlier on. The new levels of analysis will allow scientists to “go deep” in geographic areas or groups of people and examine the risks associated with environmental factors, obesity or other aspects known to be driving cancer. He says it also will help to “understand it in a way that ultimately can give us the tools that we can use to change the trajectory, whether it’s finding it early or preventing it or changing the outcome.”
Kimberly Kerstann, PhD, Winship's former chief administrative officer and associate director for research administration, says the partnership “opens up the ability for Winship investigators to access the wealth of data that the ACS has available to contribute to new and innovative research ideas.” Likewise, she says ACS benefits by their world-renowned experts having “greater connectivity” to basic and translational scientists at Emory who may be able to use the data and biospecimens ACS has collected “to advance some key research initiatives and pursue new research ideas that the ACS may have not had the infrastructure to pursue.”
She points out that cancer centers like Winship often do studies with people after they have cancer. “The ACS cohorts started collecting data before study participants had cancer and have longitudinal data that can help understand environmental factors that they were exposed to.” She adds that there’s also the potential to utilize genetic data. “The ACS cohorts can provide
Alpa V. Patel, PhD, FACSM
William L. Dahut, MD
Kimberly Kerstann, PhD
Because data and informatics are central to the Winship–ACS partnership, Winship Magazine asked Madhusmita Behera, PhD, Winship’s chief informatics and data officer, why they are important in cancer care and research.
WM: How does the data that ACS will share with Winship get analyzed or “digested” in a way that is then useful in evaluating interventions and creating interventions?
MB: We’re talking about large amounts of data collected over several decades as part of the ACS cohort studies that are being used for this partnership. This particular partnership allows ACS researchers and Winship researchers to work collaboratively using this massive dataset, which also includes the biological samples for more than 400,000 patients that were collected in these cohorts. The data will be made available for research through a cloud-based platform that was developed as part of the infrastructure to support this initiative.
WM: What role does artificial intelligence play in analyzing the data?
MB: It’s interesting that you should ask about AI because we have launched widespread AI efforts across the organization under the AI.Humanity Initiative. My new role as Emory University’s chief research informatics officer, as well as my role at Winship, provides me the unique opportunity to engage in many organizational initiatives, including the partnership with ACS. Part of the data aggregation efforts with ACS also includes digital pathology data, which allows the pathology slides to be digitized and made available to researchers for research investigation, such as applying AI tools and deep learning techniques for analysis of those images. These techniques could also be applied to the genomics data generated and collected as part of this effort.
WM: Does the physical proximity of Winship and the American Cancer Society, both in Atlanta, facilitate relationships between the two organizations?
MB: You are absolutely right. This really allows the world-class researchers from both organizations to closely partner with each other. And in fact, we had our first retreat for this partnership back in March, earlier this year. That was a wonderful opportunity and provided the forum for our researchers from both organizations to interact and collaborate, and some great ideas were exchanged.
WM: Why is the gathering and analysis of data so central to ending cancer as we know it?
MB: Gathering and analyzing data is crucial in the progress against cancer for a number of reasons. It allows researchers to identify patterns and trends in cancer incidence, progression and response to treatment. Most importantly, the systematic collection and analysis of data are fundamental to advancing our understanding of cancer, developing innovative treatments and ultimately leading to better outcomes for patients.
control populations that we as a cancer center may not have had access to before.”
Ramalingam says, “the synergy here is the key point.” He explains, “Bringing these two groups together and leveraging those resources, which are precious resources, including samples and data, could really accelerate addressing some of the key questions our research teams are focused on.”
First things first—building the infrastructure
The first order of business for the new partnership has been to address the need for a platform for storing, accessing and analyzing the ACS cohort data. “It’s not as exciting,” says Patel, “but we need to make sure that we have a platform that can be accessed by Emory investigators with as much ease as internal investigators at ACS, so there was some investment in that data platform and making it accessible to Winship investigators.”
Patel says that next was building a deeper partnership with Winship to provide ACS with a similar level of “insider access” with Winship resources as Winship's own researchers will have with ACS’s resources.
She says the third important step is making sure that once the infrastructure is built connecting the two institutions, there is funding available “that will support kick-starting some really fun science.”
The infrastructure in question is a cloud-based platform that will be available to the investigators for research in a secure and regulatory-compliant manner. “This data infrastructure also includes bioinformatics and advanced analytic pipelines in the platform,” says Madhusmita Behera, PhD, Winship’s chief informatics and data officer and chief research informatics officer for Emory University. “A researcher, informatician or statistician can go into the platform, access the data directly to build the subject cohorts they
PhD
Madhusmita Behera,
want to ask questions about, or the set of participants data they want to study, including clinical data linked with genomics or digital pathology data, and they can analyze the data within the platform. The platform has been designed to be self-serving for users.”
Artificial intelligence (AI) technology and tools are central to the database—and its ability to analyze the vast amounts of data available from the ACS cohorts (See sidebar accompanying this article). “There’s not a way possible for someone to manually curate all of that data and identify what cancer risk looks like,” says Knudsen.
The AI-supported platform will make ACS data available more quickly and effectively than it ever has been before. “The key for this partnership is accelerating something that we know can tell us more about cancer risk through cohorts,” Knudsen says. “And the partnership allows us to work faster together to get answers that people deserve and need.”
Timothy L. Lash, DSc, MPH
Timothy L. Lash, DSc, MPH, Winship’s associate director of population sciences and chair of the Department of Epidemiology at the Rollins School of Public Health, says that “any time you can find ways to reduce barriers to research, it gives opportunities to accelerate the knowledge base.” For this reason, he thinks that “creating this digital portal will give opportunities for new research studies to Emory investigators that lead to new ideas, ultimately new evidence and ultimately new interventions.”
Through the partnership, ACS will provide 10 pilot grants of $100,000 each to support collaborative research between a Winship researcher and an ACS investigator to use the cohort data. It will also fund five postdoctoral fellows who will be jointly mentored by the ACS and Winship. Patel says the “longer-term hope” is that the pilot grants will lead to larger NIH and other grant applications to further build upon the collaboration between scientists in the two institutions.
Putting data to work—now and in the future
Ramalingam says that, “when leveraged appropriately,” data can answer critical questions facing the cancer field. “This can yield new insights on things that we can be, and should be, doing to prevent cancer, to reduce the risk of cancer,” he says. He explains that this requires making sure the data are structured and available to the research community, asking the right questions and “having the right team in place to pull the data that's necessary to answer critical questions.”
Behera says that with so much data available through the partnership “the sky is the limit” in terms of what can potentially be done with it, including opportunities to leverage AI tools to answer key questions.
Understanding how prevalent particular targets and mutations are in the population of people with a particular cancer is one example, Kerstann says. It could help in investigating molecular targets yet to be identified that are present in individuals with cancer, possibly leading to druggable targets that could then become viable treatment options. She says that understanding potential targets that predispose someone to cancer may let us better detect and even prevent cancer. Likewise, “the cohort data could provide information on why some people’s cancer progresses or not—and lead to our being able to suppress these pathways.”
“We know that the progress against cancer is going to be made primarily by preventing cancer or by detecting it early,” Ramalingam says. “Treating advanced stage cancer is important, and we’re making good inroads there and playing an important part. But we need to be preventing it, however possible. That’s why I think this partnership is strategically very important for Winship as we look at reducing the burden of cancer not only in our catchment area, in the state of Georgia, but beyond it.”
Since the effort to “end cancer as we know it” requires a marathon rather than a sprint, it’s essential that the ACS data, the platform being constructed to support it and the Winship-ACS partnership behind it are buttressed by resources that will ensure its continuation.
ACS’s Dahut says, “We’re already having conversations about what we want to do with the current data, how we really cement this relationship in a way that it lasts for generations.” Instead of a collaboration that ends after the initial Woodruff Foundation grant, he says, “We see this as really a way to build the premier population science, nonprofit cancer center collaboration in the world.” He adds, “And we couldn’t be prouder to be part of it.” w
FEATURE WINSHIP
New Medical School Dean Says Reputation of Winship Matches Reality: Sandra L. Wong, MD, MS
BY JOHN-MANUEL ANDRIOTE
Sandra L. Wong, MD, MS, an accomplished surgical oncologist and researcher, joined Emory University School of Medicine as dean in March 2024. She also serves as the chief academic officer for Emory Healthcare. Wong most recently served as chair in the Department of Surgery at the Dartmouth Hitchcock Medical Center, the flagship campus of the Dartmouth Health system in Lebanon, New Hampshire.
Wong is a widely recognized health services researcher in academic surgery, with an extensive record of research funding and peer-reviewed journal publications. She has been a leader in prominent professional organizations, including the Society of Surgical Oncology, the Society of University Surgeons and the Society of Surgical Chairs.
WINSHIP MAGAZINE: What was it about Emory University School of Medicine that interested you in taking the job as dean of the medical school?
I have to say I was really excited to consider being a part of a team that is very integrated and aligned, considering how the components of Emory University, Woodruff Health Sciences Center, the School of Medicine and Emory Healthcare work together to make great things happen. Given my background as a surgical oncologist, having an NCI-designated Comprehensive Cancer Center with Winship’s reputation was what I was looking for and the kind of team I wanted to be a part of.
WM: Are you currently seeing patients as a surgical oncologist?
Well, not quite yet, but that's definitely in the game plans. I love taking care of patients. It is a tremendous gift. My expertise is in soft tissue tumors and skin cancers, so hopefully I can contribute to those clinics and see patients in that setting.
WM: In your recent interview with Ravi I. Thadhani, MD, MPH, Emory University’s executive vice president for health affairs, you said that this is a time of great opportunity and great challenge for academic medicine. Could you describe what you see as some of the opportunity, as well as some of the challenge?
I actually think the challenge is the opportunity because thinking about the greater mission and view of the mission, it really is about making sure that we train the next generation of clinicians, clinician-investigators and clinician leaders. And right now the health care field is a challenging landscape. We work in high-pressure environments and need to continually develop and take care of our workforce.
We also know that we face the direct challenges of the pressures of taking care of patients, the productivity pressures, the desire for folks to have more bandwidth to teach and do research. And all of those things together make for a pretty busy job.
In our people, I see this great desire to meet our missions, to really be able to provide the best patient care, to be top educators and to continue to push the boundaries of innovation and discovery. The challenge is how do we do all of that? I think we're good for it. I think we have all the right people. We need to put the pieces together and make sure that we continue to grow in the same direction.
WM: As dean of the medical school, how do you see the medical school and Winship aligning?
The alignment is such a natural one. Maybe the question you're asking is really about how do we make that happen? So many of our research programs are about how we discover so that we can conquer cancer. And then on the back end is how we deliver cancer care better—how we take those discoveries into the clinic at a faster pace and with greater fidelity. So many people who I interact with really want to see that relationship be stronger, and I see that relationship as key and critical.
WM: What are your impressions so far of Winship?
Everything that I believed about Winship has held up. Winship has an outstanding national reputation and is well recognized for being an outstanding cancer center. Winship is a matrixed organization that really allows for outstanding patient care, care of a greater population and continued advances in science and in clinical care.
Now that I’m here and meeting people, interacting with our faculty, interacting with our staff, it's such a joy to actually see that my prior perception matches the reality. It takes a team to fight cancer and make sure we provide hope for our patients.
WM: What do you see in the near- and long-term future for cancer care, and how will Emory University School of Medicine be part of that and contribute to that?
I know this gets said a lot in terms of how we will be able to personalize cancer care instead of a “one-size-fits-none” model. We're learning more and more about cancer and how to get a better understanding of each individual's cancer to better target and tailor therapies.
We have a lot of untapped potential in terms of digital health and other technologies. I also think it’s about understanding what our patients really want. Balancing quality of life, quantity of life and how we take care of the entire patient.
WM: What sorts of partnership opportunities do you foresee for Winship to create among the medical school, the nursing school and the public health school, to build synergy among Emory's various components?
That is exactly our opportunity, to really pull all of the key stakeholders together to advance the cancer care of patients and to advance our discoveries around cancer. I think it’s all there. There’s probably not a single person at Winship that I’ve talked to who isn’t so excited about that opportunity and really thinking about how much better we can do if we work together better.
WM: You’re a surgical oncologist. What led you to choose that specialty?
We take care of patients one at a time—cancer has always been compelling to me because we work for the sometimes elusive cure for patients. Sometimes that’s possible and sometimes it’s not, but there is always a patient in front of you who needs to get taken care of. The patients are an inspiration to me. Also, being an oncologist really spoke to me in terms of how much I really value teams in medicine. And that was a hook for me—the best cancer care takes great teamwork. w
FEATURE WINSHIP
WON THE ROAD TO CREATING PERSONALIZED ANTI-CANCER VACCINES
BY KIRA GOLDENBERG
hen First Lady Jill Biden visited Emory University in September 2023, it was to talk about the university’s key role in a federal push to unlock the potential of mRNA in the field of cancer treatment. “It’s incredible to see how the pieces of this project come together,” she told an assembled group.
Messenger RNA (mRNA)—the molecules used in most COVID vaccines—tells DNA how to make specific proteins that push the immune system to create antibodies targeting the proteins, peptides, polysaccharides, lipids or nucleic acids that can trigger an immune response.
Biden had just come from touring the lab of Philip Santangelo, PhD, a member of Winship’s Cancer Immunology Research Program and professor in the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech School of Engineering and Emory University School of Medicine.
Santangelo’s team is now more than a year into work they hope will ultimately pave the way for personalized cancer vaccines that can help patients’ immune systems attack tumors. That work broadly involves using synthetic mRNA to spur the creation of specific immune-system antibodies so the body itself can help identify and eradicate cancer. The Santangelo lab is expert in creating synthetic mRNA.
Santangelo is the principal investigator whose team, based at Emory, Yale and the University of Georgia, received the first grant—$24.8 million—from the federal government’s recently created Advanced Research Projects Agency for Health (ARPA-H). Its
name evoking the Advanced Research Project Agency (ARPA) created in 1958 to fund America’s space race—the original moonshot— ARPA-H was created to support innovative research projects aimed at fueling the Biden administration’s relaunched “cancer moonshot” and changing cancer as we know it.
“They’re finding ways to train our immune systems to fight cancer and other diseases,” the first lady said of the lab’s research. Then, mentioning her stepson Beau Biden, lost to brain cancer in 2015, she addressed lab members directly: “Your work can change lives.”
The dream scenario is having the ability to sequence a patient’s tumor, identify mutations that are evading a body’s immune response and rapidly build custom vaccines. It’s theoretically possible—even easy—but the science is still under development.
Philip Santangelo, PhD
Creating mRNA vaccines
In mRNA-based COVID vaccines, the mRNA instructs the body to make the protein that the coronavirus uses to infiltrate cells, causing it to build up a supply of antibodies ready to defend against it. It’s a delicate vaccine to ship and store because mRNA easily falls apart under less-than-ideal circumstances.
In cancer treatment, mRNA works a little differently. While viruses and other antigens are invaders from outside the body, cancer cells are bodily mutations gone wild. Every cancer in every person is unique. This means, theoretically, that every mRNA-based cancer vaccine would have individualized instructions and packaging directly targeting each recipient’s tumor biology.
“Cancer RNA vaccines are trying to induce the immune system to become activated and expand in response to proteins that are abnormally expressed or mutated in specific cancers,” says Edmund K. (“Ned”). Waller, MD, PhD, FACP, the Rein Saral, MD, Professor in Cancer Medicine at Winship. Waller is the director of the Bone Marrow and Stem Cell Transplant Program and also holds appointments at Emory University School of Medicine and as director of the Center for Regenerative Engineering and Medicine at Emory, Georgia Tech and the University of Georgia.
The dream scenario is having the ability to sequence a patient’s tumor, identify mutations that are evading a body’s immune response and rapidly build custom vaccines. It’s theoretically doable—even easy—but the science is still under development.
“Leveraging the human immune system to treat cancer has become the standard of care for many cancers,” says Winship’s Executive Director Suresh S. Ramalingam, MD, FACP, FASCO, the Roberto C. Goizueta Distinguished Chair for Cancer Research at Emory University School of Medicine. “However, the benefits of present immunotherapies are limited to a relatively small subset of patients.” His own research looks at personalized medicine approaches to treating metastatic cancers.
Ramalingam is optimistic about Santangelo’s research. “The recent ARPA-H award to the Santangelo lab will help develop novel mRNA vaccines to treat cancer,” he says.
Making the dream come true
For the dream to become a reality, there are many steps from bench to clinical trials to FDA approval—not least because the agency would need to approve a drug that, theoretically, looks different every time it’s deployed.
Santangelo and colleagues are currently combing through countless combinations of tumor types and mRNA in animal models to move forward in clinical trials with a few that have the most potential to help the most people. For some cancers, for example, scientists already know which proteins mRNA needs to make to trigger the correct immune response in a large number of cases. Top candidates under consideration include head and neck cancer, melanoma, colon cancer and lung cancer. “We’re going to start with something less personalized so that we can get ourselves in the door and everyone’s comfortable with the approach,” Santangelo says.
Edmund K. (“Ned”) Waller, MD, PhD, FACP
Suresh S. Ramalingam, MD, FACP, FASCO
The Emory team is collaborating with a group at Yale specializing in dendritic cells, which build the proteins based on mRNA instructions, and the lab is working to build partnerships with Winship clinicians to test drugs in the lab using patient blood draws. “The goal of my work is not to cure mice of cancer,” Santangelo says, referring to research that precedes clinical trials in humans. “The goal is to get this into people and to improve people’s lives. I want one thing that solves one problem by the time I retire.”
World-class vaccine research done here
While Santangelo’s lab has been in the spotlight for its mRNA cancer vaccine research, it’s not the only group at Winship studying immunotherapeutic—“precision medicine”—approaches to treating cancers. Researchers across the institute recognize that one-upping cancerous cells’ skill at evading immune response has the potential to increase remission rates without the potentially harsh side effects in current standard-of-care treatments like surgery and chemotherapy. Waller, for example, works on expanding the efficacy of small-molecule drug immunotherapy via immune cell infusions. “Modulating the immune system to activate it in response to tumor-associated antigens has induced durable remissions,” Waller says. “The fraction of patients with solid tumors who benefit from those approaches still is only one in three or less, so more work needs to be done to make cancer immunotherapy a curative option for more patients.” He adds, “There is a moral responsibility for oncologists to help advance that agenda.”
Waller and colleagues, including Periasamy Selvaraj, PhD, professor in the Department of Pathology and Laboratory Medicine at Emory University School of Medicine and a member of the Cancer Immunology Research Program at Winship, in a 2023 paper in Frontiers in Immunology, reviewed recent innovations in the area. They concluded that new techniques and drug combinations will increase effectiveness. Selvaraj’s own work focuses on personalized immunotherapy cancer vaccines that stimulate immune responses
by using tumor membrane vesicles (TMVs) derived from a patient’s tumor tissue rather than mRNA.
Other labs are doing research that augments the Santangelo lab’s efforts. For example, Rafi Ahmed, PhD, co-leader of Winship’s Cancer Immunology Research Program and professor in the Department of Microbiology and Immunology at Emory University School of Medicine, is focused on optimizing the mRNA platform being used in vaccine discovery. “Our lab has a lot of expertise in defining the properties of T-cells that exist during chronic infection and cancer,” Ahmed says of these immune cells manufactured in bone marrow. “We know which T cell to target and which will respond to the therapeutic vaccination,” allowing the team to design optimally effective mRNA, he says.
As director of the Emory Vaccine Center—the largest, most comprehensive vaccine research center in the world—Ahmed oversees work that includes a core focus on immune system-focused cancer vaccine development. In fact, he has been innovating in the space for decades. He was senior author of a 2008 paper in The Journal of Experimental Medicine demonstrating that it’s possible to augment therapeutic vaccines—aimed at treatment rather than prevention, like annual flu or COVID shots—with an immune cell exhaustion brake that keeps cells fighting for longer. “We were among the first,” Ahmed says, “to show in a preclinical model that, in the setting of a chronic infection that mimics the same features you get in cancer, combination therapy with PD-1 (programmed cell death) and a therapeutic vaccine will result in increased T-cell responses and a better reduction.”
Emory hopes to eventually capitalize on much of this immunotherapeutic research by creating an in-house pathway from lab to approved product. Earlier this year, the university created a Center for New Medicines, helmed by two leading Winship researchers: Haian Fu, PhD, who co-leads Winship’s Discovery and Developmental Therapeutics Research Program and is professor and chair of the Department of Pharmacology and Chemical Biology at Emory
Periasamy Selvaraj, PhD
Rafi Ahmed, PhD
University School of Medicine; and Dennis Liotta, PhD, a member of Winship’s Discovery and Developmental Therapeutics Research Program, Samuel Candler Dobbs Professor in Emory University’s Department of Chemistry, chair of the advisory committee for Drug Innovation Ventures at Emory, and one of the premier discoverers of novel therapeutics in the United States.
Though the Center for New Medicines’ initial focus is on more traditional small-molecule drug development, there are plans to incorporate mRNA vaccines. “There was a need to provide some infrastructure to facilitate the development of new drugs,” Liotta explains. “When you go from discovery to development, that means you’re starting to think about what the FDA is going to want in order to get the compound into the clinic and eventually to be approved.” Though related work has been happening at Drug Innovation Ventures at Emory, that entity has not done any vaccine-related work.
Building up this sort of pipeline means acquiring a host of expertise outside of focused lab research, like knowledge of the business side of drug development and a close familiarity with the FDA approval process. But the potential payback is huge for the university—and for patients with aggressive, intractable cancers, hoping for miracle cures.
“Emory is one of very few academic centers that can develop life-changing drugs with global impact,” Fu says. “Targeting cancer with an mRNA vaccine is not just a dream anymore.” w
“ Emory is one of very few academic centers that can develop lifechanging drugs with global impact. Targeting cancer with an mRNA vaccine is not just a dream anymore.”
–Haian Fu, PhD
Dennis Liotta, PhD
Haian Fu, PhD
Winship | Philanthropy
GAIL GRIMMETT CONTINUES HER LATE HUSBAND’S LEGACY–and Finds Healing in Philanthropy and Service
BY JENNIFER CARLILE
When Gail Grimmett believes in something, she supports it 100%.
“I think it’s important to put my money where my mouth is, and that’s why I support Winship Cancer Institute of Emory University,” she says. Grimmett recently made a planned gift that will establish a distinguished professorship in multiple myeloma research, the type of blood cancer her late husband, Darrell, had.
Although Darrell ultimately passed away, Gail credits Winship and the team led by Sagar Lonial, MD, FACP, Winship’s chief medical officer and professor and chair of the Department of Hematology and Medical Oncology in Emory University School of Medicine, for giving him a longer, better life. “I absolutely believe my husband lived an extra three years because of the clinical trials he participated in at Winship,” Gail says.
The Grimmetts were introduced to Winship in 2011, the year Darrell was diagnosed and the inaugural year of the Winship 5K Race. “It was going to be just the two of us running,” she says. As the senior vice president for sustainability and corporate innovation for Delta Air Lines, Gail invited a small group of coworkers to support them in the race. “The next thing I knew,” she recalls, “my email had gone viral, and we started getting donations from people I didn’t even know. Darrell called them the million points of light, and they were with us from the very beginning of his diagnosis.”
Lonial remembers the upswell of support from Delta as well. “Everyone wanted to be on her team to support Darrell,” he says, “and Gail made sure the funds they raised were directed to myeloma research and treatment.”
Gail Grimmett
PHOTO
Sagar Lonial, MD, FACP
“Efficacy, management of side effects, late effects or even just a higher percentage of patients that are in remission longer—these are the goals,” he says. “And many people with cancer do benefit from participating in clinical trials.” Lonial says Darrell Grimmett volunteered to take part in any trial that might reasonably help him. “And he always said, ‘if it doesn’t help me, it may help somebody down the
Though vital, clinical trials are just one component of the Winship Way, which centers cancer care around the needs of people with cancer and their families. This approach spoke volumes to the Grimmetts throughout Darrell’s 11-year course of treatment. “Winship’s commitment not just to treatment, but to quality of life—and to helping the whole family—is amazing,” Gail says. “Dr. Lonial and his team weren’t just clinical with us. They showed us compassion and understanding. You’re not going to experience that anywhere else, I can assure you.”
Gifts of Service
Gail’s support for Winship also extends to service. She chairs the Winship Advisory Board and wants to increase the board’s fundraising capacity by leveraging board members’ experiences and connections. “We have powerful stories to tell, either about ourselves or a family member,” she says. “I
feel that it’s the board’s responsibility to get out into the community and talk about the number of lives that Winship touches.”
While Gail's board leadership is a tremendous boon to Winship, it also helps Gail. "It allows me to stay engaged with an organization that was a major part of my life for 11 years,” she says. “It’s healing for me.” Her philanthropic giving serves a related, but separate purpose. “The gift I made to name a care community atrium at Winship at Emory Midtown after Darrell continues his legacy and keeps his name associated with the continuing fight against cancer,” she says. “In my mind, he and I made that gift together.”
Gail’s history of giving complements Winship’s mission to provide clinical care, conduct research and educate clinicians and researchers. “Gail has been a tremendous partner and advocate for Winship, and her remarkable support has fostered cutting-edge research and top-notch patient care,” says Suresh S. Ramalingam, MD, FACP, FASCO, Winship’s executive director and the Roberto C. Goizueta Distinguished Chair for Cancer Research at Emory University School of Medicine. “This generous gift will support research and education with the ultimate goal of bringing hope and healing to people with cancer.” w
Join Gail Grimmett and support Winship Cancer Institute of Emory University in a way that speaks to you.
Make a gift to the Winship Discovery Fund, and support research and development in areas with the highest potential for beneficial cancer treatments.
You can also support multiple myeloma research through the Winship Multiple Myeloma Fund.
Establish your own legacy by contacting the Emory Office of Planned Giving today.
INSPIRING HOPE
- Q&A with head and neck surgeon Nicole C. Schmitt, MD, FACS
WINSHIP MAGAZINE: Why did you choose to work at Winship?
Nicole C. Schmitt: Winship is an extraordinarily collaborative place, where everyone is working together to help the patients and advance the science like no other place I’ve been.
WM: Could you describe the considerations you must weigh in designing optimal combinations of chemotherapy and immunotherapy for head and neck cancer? Are these combinations essentially tailored to the individual patient?
NS: Our work has expanded to include a lot of novel treatment combinations, with the goal of helping the immune system fight harder while decreasing toxicity. As we learn more about the immune systems of individual patients, we are getting much better at understanding who will respond to different types of combination therapies, which is really exciting.
WM: One review by a patient says that you made them feel comfortable “even during bad news.” Do you have a “recipe” for making your patients feel safe and comfortable?
NS: I prefer to tell patients everything, with empathy but also complete transparency. Once they feel comfortable and empowered by a strong understanding of their individual situation, I like to sprinkle in a little humor and try to make them smile. This reminds them (and me) that life continues to offer joy even after a cancer diagnosis.
WM: How do you inspire hope in your patients?
NS: I like to emphasize how many of our patients have done really well and how much support we will provide as a treatment team. It is important that patients and families feel that they are not alone.
WM: How do you sustain your own hope as you treat your patients?
NS: My patients sustain me. They are the most resilient people on earth. Watching them survive their cancers and return to their work, families and hobbies makes me believe that anything is possible. w
Nicole C. Schmitt, MD, FACS, is co-director for translational research in Winship’s Head and Neck Cancer Program and associate professor in the Department of Otolaryngology at Emory University School of Medicine.
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