The Forefront - Winter 2020 - University of Chicago Medicine

WINTER 2020

Health, Science & Wellness

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TOGETHER WE ANSWER CANCER

A passion for food and life PAGE 8

Chef Grant Achatz reflects on teamwork in medicine and in his profession

PAGE 3

Do your feet get bigger as you age?

ALSO IN THIS ISSUE PAGE 12

When a parent with young children has cancer PAGE 14

What’s new in CAR T-cell therapy

Winter 2020

The Forefront

IN THIS ISSUE ON THE COVER

8 Cover photo

by Taylor Glascock

An interview with Chicago chef Grant Achatz, 12 years after his successful treatment for advanced tongue cancer.

LIKE FATHER LIKE SON Michael Hill and his son, Dennis, received cochlear implants — nine years apart — from the same UChicago Medicine surgeon.

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TOGETHER WE ANSWER CANCER UChicagoMedicine.org/AnswerCancer #AnswerCancer

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Grant Achatz’s UChicago Medicine physician team

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NO STOMACH, NO CANCER

MORE COMFORTABLE MAMMOGRAMS

To eliminate his risk for a hereditary form of cancer, Jon Grossman had his stomach removed.

New technology is improving breast cancer screening and care.

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OUR TOP DOCS

84 UChicago Medicine cancer experts named to Chicago magazine’s latest list of top cancer doctors.

The Forefront magazine features stories about life-changing care and breakthroughs in medical research at the University of Chicago Medicine and Biological Sciences.

Kenneth S. Polonsky, MD Dean of the University of Chicago Biological Sciences Division and the Pritzker School of Medicine and Executive Vice President for Medical Affairs Sharon O’Keefe President of the University of Chicago Medical Center

VISIT OUR WEBSITE FOR MORE INFORMATION: Adult and children’s care UChicagoMedicine.org Science, health and wellness news

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Christou, Kate Dohner, Jane Kollmer, Natalie This publication does not provide medical advice or

Contributing photographers

treatment suggestions. If you have medical problems

Taylor Glascock, Robert Kozloff, Jean Lachat,

or concerns, contact a physician, who will determine

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your treatment. Do not delay seeking medical advice because of something you read here. For urgent needs, call 911 right away.

CROHN’S AND COLITIS CARE THAT’S LEADING THE WORLD AND

David Rubin, MD, is an international leader in digestive diseases clinical research.

CHANGING LIVES. At UChicago Medicine, patients with Crohn’s disease and colitis are getting the most advanced treatments available and enjoying a better quality of life. Dr. David Rubin and his world-renowned team are at the forefront of digestive health, leading clinical research to identify better treatments for inflammatory bowel disease and prevent cancer.

Visit UChicagoMedicine.org/IBD or call 1-888-824-0200

OBESITY FUELS BREAST CANCER

Obesity packs a double whammy for breast cancer patients. The most aggressive form occurs at a dramatically higher rate in overweight or obese women. Furthermore, obesity reprograms cells that normally destroy tumors into cells that actually promote breast cancer, according to research at the University of Chicago. Roughly one-third of all adults in the United States are obese. “Current treatment of breast cancer patients ignores the ongoing obesity epidemic,” said researcher Marsha Rosner, PhD. “We need to promote weight loss as a cancer prevention measure, help breast cancer patients lose weight and identify new drugs for obese cancer patients.” Rosner and Lev Becker, PhD, both of the Ben May Department for Cancer Research, recently published these findings in the Journal of Experimental Medicine.

HIGH BLOOD PRESSURE AFFECTS DEMENTIA RISK

Controlling blood pressure can lower your risk of developing dementia. Alzheimer’s disease and dementia affect nearly 10% of adults in the U.S. These conditions are often detected too late for successful treatment. Controlling blood pressure is a promising new avenue for preventing dementia, according to Shyam Prabhakaran, MD, MS, chair of neurology at the University of Chicago Medicine.

Prabhakaran’s editorial in a recent Journal of the American Medical Association accompanied two new studies analyzing the connection between blood pressure and dementia. “We know now that controlling blood pressure to a goal of 120/80 in midlife benefits brain health as well as heart health,” he wrote. “Almost anybody could identify high blood pressure and begin treatment for it, well before changes related to dementia begin in the brain.”

Science news, straight to your inbox Science Life is a new biweekly newsletter with the latest science and research stories from The Forefront, our home for news from UChicago Medicine and the Biological Sciences Division.

Sign up at UChicagoMedicine.org/science-life

EXPANDING EFFORTS TO ELIMINATE HIV

More HIV testing will be available in the Chicago area, thanks to a $4.5 million grant awarded to the University of Chicago Medicine. About one in seven people who have the virus are unaware they are infected. In Chicago, an estimated one out of every 100 people has HIV, according to David Pitrak, MD, chief of infectious diseases and global health, who heads the Expanded HIV Testing and Linkage to Care program. The hospital will increase the number of tests it administers on the South and West sides of Chicago, and will begin offering tests in suburban Cook County. “We’re the major provider of HIV care and preventative services on the South Side, which is a disproportionately affected area,” Pitrak said. “Our goal is to eliminate HIV.”

READ MORE AT

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CPR TRAINING KIOSK

Hands-only CPR is easy to learn and saves lives. UChicago Medicine, in partnership with the American Heart Association, has installed an interactive kiosk to teach members of the public how to assist a person suffering from cardiac arrest. The kiosk evaluates users for proper CPR technique and provides feedback. “It is our hope that this kiosk will train a whole new army of lifesavers here in Chicago,” said Lisa Hinton, American Heart Association Metro Chicago executive director. The kiosk is located in the 7th-floor Sky Lobby of the Center for Care and Discovery.

BAD AIR AND MENTAL HEALTH

Living in polluted areas, especially in childhood, is linked to mental illnesses such as depression and bipolar disorders, according to a study at the University of Chicago. Researchers examined a database of 151 million people and studied neuropsychiatric diseases alongside air pollution measurements.

U.S. counties with the worst air quality had a 27% increase in bipolar disorder and 6% increase in major depression when compared to those with the best air quality. The team also found a strong association between polluted soil and an increased risk of personality disorder.

Similar research in Denmark found early childhood exposures correlated even more strongly with major depression, schizophrenia and personality disorders.

Computational biologist Atif Khan, PhD, and Andrey Rzhetsky, PhD, an expert on human genetics and data science, led the study, which was reported in PLOS Biology.

AS K TH E EXPE R T Kelly Hynes, MD

How do your feet change as you get older?

Have you gone up a shoe size? Do you have more foot pain?

Most age-related foot discomfort is normal. University of Chicago Medicine orthopaedic foot and ankle surgeon Kelly Hynes, MD, explains what’s going on with middle-aged feet and what you can do to stave off problems and pain.

WHAT HAPPENS WHEN MY FEET AGE?

The muscles and tendons in our feet lose their elasticity over time. This is because tissue becomes less tight, resulting in increased width and sagging of the arches.

Contrary to popular belief, feet do not get longer as we get older. It might seem like you need a bigger shoe, but it’s because the feet have widened and fit more comfortably in a bigger-size shoe.

DOES LOSS OF ELASTICITY CAUSE INJURIES?

It varies, depending on how much you’ve used your feet in your life. But when tissues in your feet collapse even a little, it can result in arthritis and pain. If you have discomfort, your foot may need more support, which usually means adjusting your footwear.

CAN I STILL WEAR FLIP-FLOPS AND HIGH HEELS?

I wouldn’t say everybody has to give up their favorite sandals and heels. But if you notice pain or if your foot doesn’t feel stable, it’s time to look for shoes that are more supportive.

WHAT KIND OF FOOTWEAR DO YOU RECOMMEND?

Look for a more solid sole and slightly stiffer arch support. Buy shoes that are comfortable. For many foot conditions, you want a shoe that doesn’t bend in half easily.

Look at the thickness of the sole. If it’s only a few millimeters, then it probably won’t give you enough support.

CAN MIDDLE-AGED PEOPLE PREVENT FOOT PROBLEMS?

In theory, if you always wear reasonable shoes — especially

when you’re active or on your feet a lot — that should help. Always make sure your feet are comfortable in the shoes you’re wearing. A lot of foot problems happen because the calf muscles are very tight, which sends more force through the foot and ankle joints. A few minutes of calf-stretching in the morning and before bed make a difference. Still, some people are just more prone to foot problems than others.

COMPREHENSIVE ORTHOPEDIC CAR E RE TO FIND OUR IS WH CLOSER TO WHERE YOU LIVE, O RT H O PAE DIC E XPER TS WORK AND SHOP 94

RIVER FOREST 290 ELMHURST

SOUTH LOOP

COMMON FOOT PROBLEMS AS WE AGE?

Plantar fasciitis is number one. That’s pain underneath the heel, especially first thing in the morning. Achilles tendinitis is a similar wear-and-tear condition that causes pain at the back of the heel. The other thing that’s really common is adult acquired flat foot.

The tendons that are meant to hold up the arch become wearker over time, causing a foot that wasn’t flat to become flat. Arthritis commonly affects the middle of the foot, when the arch starts to sag and collapse, and the big toe.

WHEN IS FOOT SURGERY NECESSARY?

Occasionally we need to do surgery if arthritis in the foot hasn’t improved after stretching, shoe changes and maybe injections. If adult acquired flat foot gets very bad, where the foot’s position has changed quite a lot and the therapy and orthotics haven’t worked, then sometimes we operate on that problem. And for big toe arthritis, about 50% of the time people will at some point have surgery.

Comer Children’s Hospital Duchossois Center for Advanced Medicine

HYDE PARK

WHAT ARE SOME OF THE MOST 55

294 355

90

ORLAND PARK

94

CRESTWOOD

TINLEY PARK

57

CALUMET CITY 65

80

FLOSSMOOR CROWN POINT

Hyde Park – Chicago Calumet City Hyde Park – Chicago Duchossois Center for 1600 Torrence Ave. Advanced Medicine Center for Duchossois 5758 S. Maryland Ave. Orland Park Advanced Medicine 14290 S. La Grange Roa ComerComer Children’s Children’s Hospital Hospital – Chicago Comer Children’s – 5721 S. Maryland Ave. – Chicago Elmhurst South Loop 4th Floor 360 W. Butterfield Road

Tinley Park

South Loop – Chicago 1101 S. Canal St.

River Forest 7411 W. Lake St.

Tinley Park 6701 159th St. Flossmoor

Crown Point, IN 11456 S. Broadway

Crestwood

Crestwood Calumet City 4742 Cal Sag Road

Orland Park

Flossmoor 19550 Governors Highway River Forest

Call 1-888-824-0200 to make an appointmen at a location near you.

UChicagoMedicine.org/ortho

First sounds The audiologist clicked a link on her computer screen, and 10-month-old Dennis Hill perked up. His eyes began to dart around the room.

“Denny?” his mom said.

“Can you hear me?” his dad said, as a smile spread across Dennis’ face.

The toddler’s new cochlear implant had just been turned on and he was hearing his parents’ voices for the first time. Minutes later, he was smiling and babbling, possibly hearing his own voice for the first time, too.

improving both the sound quality and speech and language outcomes.”

Dennis’ parents have decided to raise him bilingual, a decision Suskind called “bold and admirable.” While he will be able to hear and speak as a result of his cochlear implant, he will also be fluent in American Sign Language (ASL). Both Michael and Jenna are bilingual.

Being part of both the hearing and deaf worlds is a sensitive topic in the deaf community. Some believe a deaf person should proudly own the identity and embrace deaf culture and language. Giving a cochlear implant to a deaf or hearingimpaired child becomes an inflection point, changing the trajectory ahead.

It was an emotional moment for his parents, Michael Hill, 23, and Jenna Jones, 24, who live near Rockford. Both parents are deaf, “ASL will always be Dennis’ first language. and each has a cochlear implant — an We’ve been signing with him since electronic device that’s implanted in the ear birth,” Jenna said. “The deaf and uses a microphone and transmitters to community really does have provide sound. amazing and intelligent people.

Dana Suskind, MD, an otolaryngologist at the University of Chicago Medicine Comer Children’s Hospital, performed Michael’s cochlear implant surgery nine years ago.

He was 14, and the surgery changed his life.

The parents decided to bring Dennis, who was born with hearing loss, to Suskind for the same surgery.

Michael and Jenna sign with Dennis. Both parents are deaf.

“The surgery itself hasn’t changed in nine years,” Suskind said. “It’s the external software components that have advanced,

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Parents Michael Hill and Jenna Jones with baby Dennis

I am so blessed to have wonderful friends who do and don’t have cochlear implants or hearing aids, and we all accept who we are.

I look forward to Dennis meeting more people in the deaf community and finding his own path.”

Dennis’ parents based their decision on personal experience.

Jenna got her cochlear implant when she was 18 months old. Because she could hear all her life, Jenna can speak and hear more clearly than Michael, making it easier for her to do things like talk on the phone.

Michael used hearing aids before getting his cochlear implant as a teenager. He struggled to adjust. “I hated it at first,” he said. “I didn’t want to wear it. I can’t explain it, but the sound was different than it was when I wore hearing aids. It takes a lot of getting used to. But once I did, it was life-changing.

Pediatric audiologist Michelle Gozdecki adjusts the external piece of Dennis Hill’s cochlear implant — a microphoneequipped device that’s held in place by a magnet.

Now I wish I’d gotten it a long time ago.

I’m sure Dennis will be able to hear and talk a lot better than I can.”

Suskind emphasized that early language exposure in any language, spoken or signed, is paramount to a child’s development.

“The earlier you expose kids to rich language development, the better it is,” said Suskind, author of “30 Million Words: Building a Child’s Brain” and founder of the TMW Center for Early Learning + Public Health at the University of Chicago.

Children born deaf to parents who are fluent in sign language have the benefit of being exposed from day one to a vibrant and stimulating early language environment.

Those who receive cochlear implants and access to sound from the device become bilingual and part of both worlds.

What is a cochlear implant?

A cochlear implant is a surgically implanted device that allows children and adults with severe degrees of hearing loss to access sound. It consists of two pieces: a surgically implanted device that goes inside the ear and an external piece that sits on the head behind the ear.

In the months and years to come, Dennis will still need regular checkups to make sure the implant is working at the proper level, pediatric audiologist Michelle Gozdecki said.

Dennis’ parents were willing to make the 2½-hour drive each way to have the surgery performed by Suskind, an expert in hearing loss who directs the University of Chicago Medicine’s Pediatric Hearing Loss and Cochlear Implant Program.

“She did such a great job for me, and for a friend of mine, that I knew she would do a great job for my son,” Michael said.

Watch baby Dennis hear for the first time: UChicagoMedicine.org/ FirstSounds

Unlike a hearing aid, which amplifies sound, a cochlear implant bypasses damaged portions of the ear and stimulates the auditory nerve. It doesn’t replicate normal hearing, but the auditory signals allow recipients to develop the ability to understand speech and other important environmental sounds.

The implant includes a microphone, a speech processor, a transmitter and receiver/stimulator and an electrode array. The microphone picks up sounds, the speech processer selects and arranges those sounds, and a transmitter converts the sounds into electrical impulses. The electrode array collects impulses and sends them to different regions of the auditory nerve.

Before surgery, a thorough examination is done to determine whether a cochlear implant is the right option for a child or adult. The cochlear implant surgery typically takes two to three hours and is often an outpatient procedure. The implant is turned on a few weeks later.

Visit UChicagoMedicine.org/cochlear-implant for more information.

OUR TEAM Dana Suskind, MD, (pictured left with baby Dennis) leads our expert and dedicated cochlear implant team. Our highly trained specialists include surgeons, audiologists, speech pathologists, child life specialists, a social worker, a geneticist, a developmental pediatrician and a psychologist.

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Thriving without a stomach

FOR SOMEONE WITH THE CDH1 GENE MUTATION, THE LIFETIME RISK OF DEVELOPING STOMACH CANCER IS 67% TO 70% FOR MEN AND 56% TO 83% FOR WOMEN BY AGE 80.

Cancer.Net

Jon Grossman’s mother, Alice, was diagnosed with stage 4 stomach cancer in 2015. She passed away three years later.

“During her illness, my mom was selfless, brave and inspiring,” Grossman said.

“She also saved my life.”

While undergoing treatment, Alice had genetic testing to determine if the cancer was hereditary. The results showed a mutation in the CDH1 gene, which raises the risk for a type of stomach cancer called hereditary diffuse gastric cancer.

“My results came back in February 2018, just a month after my mom died,” said Grossman who was just 35 when he learned he had inherited the mutation. “The recommended course of action was to have a total gastrectomy — removal of my stomach — to eliminate the risk.”

Grossman chose the University of Chicago Medicine Gastrointestinal Cancer Risk and Prevention team for his care.

“We help patients who are at increased risk for gastrointestinal cancer to understand their risks, potentially do genetic testing and provide their care in a very personalized way,” said gastroenterologist Sonia Kupfer, MD, who started the program in 2015.

Jon Grossman

Kupfer says it’s important to manage individuals who have the CDH1 mutation using a multidisciplinary team approach.

In addition to meeting with Kupfer, patients at UChicago Medicine see a genetic counselor, a surgeon, a gastroenterologist who specializes in nutrition and a dietitian.

After being healthy his whole life, Grossman said it felt surreal to think about voluntarily subjecting himself to major surgery and lifelong lifestyle modifications. “My medical team was incredible at reassuring me and helping me weigh the pros and cons,” he said.

“It made me so much more confident in my choice to have the gastrectomy.”

In June 2018, surgical oncologist Kevin Roggin, MD, performed Grossman’s total gastrectomy using a robot-assisted approach.

After removing the entire stomach, Roggin

reconnected the end of Grossman’s esophagus to the beginning of his small intestine, so he could continue to eat and swallow.

The stomach accommodates large meals, starts digestion and delivers food into the beginning of the intestine, a small amount at a time. It produces a protein needed to absorb vitamin B12 and regulates the release of insulin to promote sugar absorption.

Without a stomach, undigested food travels rapidly into the small intestine.

“Changing to small meals that are low in simple sugars is the key to eating without a stomach,” said Carol Semrad, MD, who heads the adult nutrition support team at UChicago Medicine. “A knowledgeable registered dietitian is essential for diet education and management following a gastrectomy.”

LIVE AT T H E F O R E F R O N T

Watch patient Jon Grossman and his physicians, Sonia Kupfer, MD, and Kevin Roggin, MD, talk about genetic factors in stomach cancer.

UChicagoMedicine.org/StomachCancerLive

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Who is at risk for a gastrointestinal cancer?

Grossman adjusted to a daily rhythm of eating between five and 10 times a day.

At first, he struggled with figuring out what foods and how much to eat. “Now, I tend to focus on foods that are easy to digest, calorie dense and low in added sugars.

My go-to is a protein smoothie with peanut butter and hemp seed.”

If you have first-degree relatives (parents, siblings, children) or other family members who have had a gastrointestinal cancer, your risk of developing cancer may be increased. The risk is even higher if a firstdegree relative is diagnosed with the cancer at a young age (before 60).

He found support and information from other gastrectromy patients through a CDH1 mutation Facebook group.

Recently, he created a blog at CDH1gene.com to share his story and what he’s learned about living without a stomach.

Our genetic counselors and physicians use personal and family history as well as genetic testing to evaluate cancer risk.

“I’ve found it’s therapeutic for me to get these things off my chest,” Grossman said.

“But more importantly, I hope the blog is benefiting others who are going through what I went through — deciding if and when to have the surgery and how to cope afterward both mentally and physically.”

The Gastrointestinal Cancer Risk and Prevention Clinic at the University of Chicago Medicine offers personalized risk assessment for individuals and families who may be at increased risk for colorectal, stomach, pancreatic or other cancers of the digestive system.

Once risk is determined, we offer: » Cancer prevention counseling and strategies » Surgical procedures » Colorectal cancer screening and surveillance, including colonoscopy » Pancreatic cancer screening for high-risk patients » Cancer prevention for patients with inflammatory bowel disease Read more at UChicagoMedicine.org/GI-cancer-risk

Cancer survivorship classes focus on nutrition The University of Chicago Medicine Ingalls Memorial Hospital is offering cancer survivorship classes that teach nutrition and cooking for a healthy lifestyle during and after treatment.

“While a cancer diagnosis affects everyone differently, adequate nutrition during treatment and recovery are essential to promote a positive outcome and an enhanced quality of life,” said registered dietitiannutritionist Cheryl Bacon, who leads the classes along with Ingalls dietetic interns.

The class teaches participants to add healthier foods to their diets. Instructors give a presentation about a food’s properties, followed by a cooking demonstration.

Some class topics include quick meal planning, how to interpret organic and non-GMO food labels, dietary supplement considerations and debunking nutrition myths related to cancer.

Side effects from cancer treatment can make eating a challenge. The seminars also cover modifications for meal preparation to ensure patients get the nutrition they need.

While the focus of the classes is on nutrition and cancer, Bacon said the information shared is beneficial for anyone looking to make healthier meal choices.

The hour-long classes are held at UChicago Medicine Ingalls Memorial in Flossmoor, 19550 Governors Highway.

Classes start at 6 p.m.

Upcoming dates: • January 21, 2020 • March 17, 2020 • May 5, 2020 To register for an upcoming cancer survivorship workshop or for more information, call 708-915-5723.

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Triumph over cancer,

In 2007, chef and restaurateur Grant Achatz was 33 and a rising star.

Alinea, his imaginative and multisensory restaurant in Lincoln Park, was receiving rave reviews within two years of its opening, including being named best restaurant in America by Gourmet magazine.

He was lauded as a pioneer in molecular gastronomy.

Then, Achatz learned that a painful spot on his tongue was stage 4 cancer.

The diagnosis threatened his sense of taste, his livelihood and his life.

“I was determined to find the best possible treatment,” he said.

“But I never expected to find it in my own backyard.”

He and his close friend and business partner Nick Kokonas consulted several cancer centers across the country.

“We did a rigorous investigation of treatments,” Achatz said. “But at every turn, I was met with what I thought was a very antiquated approach.

The treatments didn’t seem creative or thoughtful.”

At each of the hospitals, doctors recommended invasive surgery for the cancerous tumor.

The procedure involved removal and reconstruction of 70% of his tongue.

He’d lose his ability to taste. If he chose not to have the surgery, doctors told him, the advanced cancer could take his life within six months.

REASON FOR OPTIMISM

Back home, Kokonas urged his friend to go to the University of Chicago Medicine for yet another consultation. Achatz refused.

He was emotionally and psychologically tired of having heard the same grim news over and over.

Kokonas didn’t give up.

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Michelin star chef Grant Achatz

and in the culinary world “I literally went over to Grant’s house, beat on the door and said, ‘I’m going to kick it in, so you might as well come with me,’” Kokonas said. “And then when we sat down with the team at UChicago Medicine, what we heard was completely different.”

The head and neck cancer team of medical oncologist Everett Vokes, MD, radiation oncologist Daniel Haraf, MD, and surgeon Elizabeth Blair, MD, proposed an alternative strategy to the young chef.

“We offered Grant the opportunity to participate in a clinical trial,” Vokes said.

“Treatment would start with chemotherapy to tame the tumor — taking the inflammation and the size down — followed by chemotherapy and radiation. If needed, the radical surgery could come later.”

Achatz signed on immediately.

“Everything I had been told up to this point was flipped upside down,” he said. “The surgery became ‘only if necessary.’ And there was talk of new technologies and creative medicine.”

He finally had a reason to be optimistic.

A UNIFIED GOAL

Achatz underwent eight weeks of chemotherapy followed by six weeks of radiation and chemotherapy. The treatments were grueling but effective in first shrinking the tumor and then destroying it.

To ensure there was no microscopic disease left, Blair then performed surgery to remove the lymph nodes in his neck.

Achatz lost his ability to taste during treatment and for several months afterward.

But he remained committed to his work, continuing to put in long hours at Alinea.

“We all had this unified goal of being the best restaurant in America,” he said. “It felt like I had to show up every day and prove to the staff that we were going to continue on the path of being the best. Otherwise, I would have let them down.”

Watch Grant Achatz talk about surviving cancer and the importance of teamwork in medicine and in his profession.

UChicagoMedicine.org/ChefAchatz

During this time, he learned some valuable lessons about the importance of teamwork.

“As the effects of cancer treatment took hold, I realized I couldn’t do it all myself,” he said. “Rather than making every decision in Alinea’s kitchen, I began to trust more in my staff. I learned you have to work as a team to succeed.”

Achatz appreciated that his doctors functioned the same way.

“My illness required a lot of creative people working together to solve the problem,” he said. “My three doctors — each in their own specialty — offered me a very individualized, yet team approach. I felt confident in them and in myself that I made the right decision.”

Beard Foundation named him the best chef in America. Alinea has won many more national and international accolades, including a Michelin three-star rating — the only restaurant in Chicago with the honor.

Achatz and Kokonas continue to reimagine fine dining and drinking through such concepts as the Aviary, Next and the St. Clair Supper Club.

The motto of their restaurant group is constant evolution. “We break down normal protocols and reformulate them in a way that’s more meaningful and more powerful,” Achatz said.

“My doctors at UChicago Medicine did the same thing. It felt comforting and it resonated with me.”

PUSHING BOUNDARIES IN DINING AND IN MEDICINE

Just a few months after the medical team told Achatz he was cancer free, the James

On the next page, learn more

about the head and neck cancer specialists who treated Grant Achatz.

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The chef ’s medical team

These three physicians are among

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UChicago

Medicine cancer experts named to Chicago magazine’s 2019 list of top cancer doctors —

| A B O V E | Daniel Haraf, MD, left, Everett Vokes, MD, and Elizabeth Blair, MD

the most of any Chicago-area health system. A total of 396 physicians made the list.

Medical oncologist Everett Vokes, MD, is an expert in head and neck cancer. His clinical and translational research has focused on the interaction of chemotherapy and radiation. This work has shown that intense treatment combining these two therapies can bring locally advanced head and neck cancer into remission and improve patient survival without extensive surgery.

Radiation oncologist Daniel Haraf, MD, worked with Vokes to pioneer the use of chemotherapy together with intensity-modulated radiation therapy (IMRT) for head and neck cancers. IMRT, a highly precise form of three-dimensional radiotherapy, uses computers to accurately plan and deliver radiation with the fewest possible side effects for patients.

See all the UChicago Medicine cancer physicians on the “Top Cancer Docs” list: UChicagoMedicine.org/TopCancerDocs

Ear, nose and throat surgeon Elizabeth Blair, MD, specializes in the diagnosis and surgical treatment of cancers in the head and neck. She performs biopsies for staging tumors and surgery, which may be the sole treatment for early cancer. Surgery also may be used as part of multidisciplinary care for advanced tumors.

SECOND OPINIONS FOR CANCER CARE Seeking a second opinion from a cancer expert can ease your mind and help you make informed decisions about treatment.

The University of Chicago Medicine Comprehensive Cancer Center can offer solutions not widely available at other hospitals.

Our specialists are dedicated to helping you understand your options so you can select the best care plan for your needs.

Visit our experts in person To request an appointment, call 1-855-702-8222.

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Get an online second opinion and access our cancer experts without leaving home. The remote service is convenient and confidential. Once we receive your medical records, we strive to turn around a second opinion within 72 hours.

UChicagoMedicine.org/CancerSecondOpinion

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GALA DRIVES NOVEL DISCOVERY On November 9, the University of Chicago Cancer Research Foundation (UCCRF) Women’s Board held the 53rd annual Breakthrough Ball, its signature event, which raises funds for cancer research at the University of Chicago Medicine Comprehensive Cancer Center.

The event, held at the Four Seasons Hotel Chicago, draws approximately 500 civic and philanthropic leaders committed to advancing cancer prevention, care and treatment.

Since it began in 1966, the ball has raised funds to support the work of groundbreaking cancer researchers — from Nobel Prize-winner Charles Huggins, MD, whose research established the role of hormones in cancer, to Janet Rowley, MD, whose work identified the genetic basis of leukemia, to Ralph Weichselbaum, MD, and Everett Vokes, MD, who pioneered a new standard of care for head and neck cancer.

This year’s event was made possible thanks to the efforts of the UCCRF Women’s Board and generous support from sponsors and attendees. Palladium-level sponsors — who each contributed $100,000 or more — included Debra and Ira Cohen, Dancing with Chicago Celebrities, Elizabeth and Michael Luttig, and Joan and Paul Rubschlager.

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Jacelyn and Michael Walsh with their daughters, Ellery, 12, and Emersyn, 8

Parenting during cancer treatment: One mom’s story Jacelyn Walsh hadn’t seen her 12- and 8-year-old daughters for weeks. It was flu season, so they weren’t allowed to visit her in the hospital. Now Easter was almost here, and Walsh realized she’d have to watch her girls open their baskets via FaceTime.

Walsh, 41, of Chicago, had been at the University of Chicago Medicine for a month, recovering from a high fever following CAR T-cell therapy for acute lymphoblastic leukemia (ALL).

“I begged the doctors to let me go home for Easter,” said Walsh.

“They put some conditions and restrictions on me, but they ultimately let me leave.”

She also went to her daughter’s First Communion a few weeks later.

Because of her weak immune system, she had to wear a mask, sit a short distance from the other parishioners and hold the reception in a private room with just a few people.

Parenting young children while battling cancer means missed moments, physical restrictions and disrupted routines and plans.

The stress and emotions can take a toll on the entire family.

12 » THE UNIVERSITY OF CHICAGO MEDICINE

“It’s a balancing act, and it’s very, very challenging in so many ways,” said Walsh, who has been in remission since April 2019.

During Walsh’s six-year battle with ALL, which included three relapses, the hardest times were her long or unexpected hospital stays. It meant missing events and leaving the kids with babysitters or grandparents, sometimes on short notice, when her husband, Michael, joined her at the hospital.

“They’ve had to learn that mom isn’t always going to be at their things. Either because I have a doctor’s appointment or my immune system isn’t strong enough to be in a school or in a crowd.

And I’ve had to learn to be OK with that,” she said.

The girls sometimes saw their mom cry or be scared, so they’d bring her little gifts or crawl into bed and cuddle with her.

“Having children during cancer is a blessing, because it gives you something to fight for,” Walsh said. “I want to be here for them. I want to watch them grow up. So I’m going to do whatever it takes.”

Talking to them about cancer is another obstacle. Walsh did it in an age-appropriate and honest way. To explain her CAR T-cell therapy, for example, she described it as a “cell boot camp” where her blood cells would go away, learn some new things and then come back ready to fight. She used videos to explain things,

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Jacelyn’s leading-edge treatment CAR T-cell therapy is an emerging form of cancer immunotherapy that involves supercharging a patient’s T cells to recognize and attack cancer cells.

| A B O V E | Parenting children while undergoing cancer treatment was challenging, Jacelyn Walsh said, but her girls learned some important life lessons.

including a UChicago Medicine video that explains the therapy in easy-to-understand terms.

“Everyone approaches it differently, but I think it’s best to answer questions completely but with as limited information as possible until more questions are asked,” Walsh said. “We don’t want to give them information they don’t need or understand. If they don’t have anxieties about things, we don’t want to create them.”

Explaining things was easy when the kids were little. It got harder as they got older. After a classmate’s parent died of cancer, the couple had an honest talk with their daughter about the possibility of death but also the many possible positive outcomes.

CAR T-cell therapy involves extracting a cancer patient’s white blood cells and reprogramming the T cells — the roving warriors of the immune system — with an antibody-like protein called chimeric antigen receptor, or CAR. The modified cells are returned to the patient’s body, a process that takes less than 10 minutes. These re-engineered T cells bypass healthy cells and latch on to and kill the diseased cells — basically using a patient’s own immune system to fight cancer.

Jacelyn Walsh received the treatment at the University of Chicago Medicine as part of a clinical trial of CAR T-cell therapy for acute lymphoblastic (lymphocytic) leukemia (ALL). For adults with ALL, researchers have been seeing responses greater than 90%.

If there’s a silver lining to being a parent with cancer, Walsh said, it’s that the kids are learning by example.

“If I lose my hair, if I have to wear a mask, I have to be confident in that. I think it’s a great lesson for my daughters, too. You may not be what other people expect you to be, or you may not look the way other people look, and that’s OK. These are life lessons I wish I didn’t have to teach my kids, and I didn’t have to learn myself. But ultimately, as a family, we are stronger because of it,” she said.

They’ve also learned the importance of a strong support group from their school, family, therapists and friends.

Now cancer-free, Walsh mentors other parents with cancer oneon-one through Imerman Angels (imermanangels.org), a local support group. She and her husband are also active in the Leukemia and Lymphoma Society (lls.org).

“Through it all, she’s been an incredible mom,” said her UChicago Medicine oncologist, Wendy Stock, MD. “It just speaks to her resilience and her family’s resilience.”

Watch a video to learn more about CAR T-cell therapy and how it works.

UChicagoMedicine.org/defeat-cancer

Advances in CAR T-cell therapy PAGE 14 Wendy Stock, MD

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SPECIAL SECTION

TOGETHER WE ANSWER CANCER

What’s new

Since commercial approval two years ago to treat some blood cancers, CAR T-cell therapy continues to show so much promise that University of Chicago Medicine researchers have expanded their studies to see how the breakthrough treatment can be used to fight other forms of the disease.

In 2017, the Food and Drug Administration approved the use of CAR T-cell therapy for adults with diffuse large B-cell lymphoma and for children and young adults with acute lymphoblastic leukemia (ALL).

UChicago Medicine became the first site in Chicago and Illinois to be certified to offer both treatments, which use a patient’s own genetically re-engineered T cells to find and destroy cancer cells. As of September 2019, the academic health system has treated 100 patients with CAR-T. UChicago Medicine — which offers the most CAR-T trials in the Midwest — is now conducting 15 studies for the blood diseases multiple myeloma, acute lymphoblastic leukemia, mantle cell lymphoma, follicular lymphoma and chronic lymphocytic leukemia. Trials for solid tumors like lung, cervical, and head and neck cancers are in the early stages.

in CAR T-cell therapy “These trials are not widely available, and some of them are the first worldwide,” said Michael Bishop, MD, director of UChicago Medicine’s cellular therapy program.“They’re only being done at select institutions, and we have been asked to do many of them.”

Bishop and his team have seen encouraging results.

We are offering truly leading-edge therapies that nobody else is offering. We hope we are going to improve patients’ lives and outcomes.”

MICHAEL BISHOP, MD

“We’re seeing responses greater than 90% in adult lymphoblastic leukemia, and the multiple myeloma success rate is greater than 50% and even higher in some studies,” he said.

In diffuse large B-cell lymphoma, the success rate is 30% to 40% for long-term complete

| R I G H T | Michael Bishop, MD, in UChicago Medicine’s new Advanced Cellular Therapeutics Facility.

LIVE AT T H E F O R E F R O N T

Watch oncologists Michael Bishop, MD, and Sonali Smith, MD, talk about advances in immunotherapy.

UChicagoMedicine.org/ ImmunotherapyLive

14 » THE UNIVERSITY OF CHICAGO MEDICINE

The Forefront | W I N T E R 2 0 2 0

remissions. “We’re seeing great successes, but we’ve got to improve,” he added. “We’re now trying to understand why certain people respond and why others don’t.”

While CAR-T has been a transformational innovation in cancer treatment, its success in treating all cancers has been limited.

For example, the therapy has not been very effective on soft tumors such as ovarian cancer, which are difficult for the reprogrammed T cells to find, Bishop said.

In areas where CAR-T has shown promise, progress has been moving quickly.

UChicago Medicine is poised to become one of the first hospitals in the country to offer ready-made “off-the-shelf ” CAR-T cells to patients. UChicago Medicine’s Advanced Cellular Therapeutics Facility is a state-of-the-art laboratory that can process and manufacture cells for therapeutic purposes, including CAR T-cell therapy.

Soon, rather than having a patient’s own blood cells removed and sent to a lab for genetic engineering, which can take weeks, in-stock CAR-infused T cells will come from a young, healthy donor. This would speed up delivery of the “living drug” to UChicago Medicine patients.

NEWS HONORS

GEORGE BAKRIS, MD, director of the Comprehensive Hypertension Center at UChicago Medicine, received the Irvine Page-Alva Bradley Lifetime Achievement Award from the American Heart Association to acknowledge his lifetime of outstanding achievements in the field of hypertension.

LUCY GODLEY, MD, PHD, an expert in the care and treatment of patients with diseases of the bone marrow, won the Outstanding Mission-Focused Health Care Professional award from the Leukemia & Lymphoma Society.

UChicago Medicine physicians VINEET ARORA, MD, MAPP, and ERNST LENGYEL, MD, PHD, were elected to the National Academy of Medicine, considered one of the highest honors in health and medicine. Members are selected based on outstanding professional achievement and commitment to service. Arora is an academic hospitalist and medical educator. Lengyel, a gynecologic oncologist, is chair of the Department of Obstetrics and Gynecology.

PHYSICIAN SPOTLIGHT Pediatrician ANNA VOLERMAN, MD, has been selected to participate in the Robert Wood Johnson Foundation’s Clinical Scholars leadership program.

Volerman will focus on developing a model to integrate community health workers in schools to support a culture of health.

Pediatric gastroenterology MARC ELIAS, MD

Gynecologic oncology KATHERINE KURNIT, MD, MPH

Cardiology ROHAN KALATHIYA, MD ANN NGUYEN, MD GIANLUCA TORREGROSSA, MD

Emergency medicine physician AASIM PADELA, MD, received the 2019 Muslim Achievers Award from the Council of Islamic Organizations of Greater Chicago for his outstanding contributions to the study of medical ethics.

Hematologist-oncologist OLATOYOSI ODENIKE, MD, has been elected to serve on the Medical Oncology Board of the American Board of Internal Medicine.

TIMOTHY SENTONGO, MD, director of the Pediatric Nutrition Support Service, and CECELIA POMPEIIWOLFE, RD, lead pediatrics dietitian, received the American Society for Parenteral and Enteral Nutrition award for Clinical Nutrition Support Team of Distinction.

The College of Healthcare Information Management Executives has awarded UChicago Medicine and Ingalls Memorial with a Healthcare’s Most Wired Special Recognition award. The award was given for UChicago Medicine IT’s deployment of technologies and strategies to help analyze data and achieve meaningful clinical and efficiency outcomes, in addition to experimenting with advanced technologies, like telehealth, to expand access to care.

NEW PHYSICIANS

AMITA SINGH, MD

LEADERSHIP ELLINGTON JONES is the new executive director of digestive diseases for UChicago Medicine.

joins UChicago Medicine as executive director of nursing informatics.

BENJAMIN LAUGHTON

is the new director of the Comprehensive Cancer Center’s Office of Community Engagement and Cancer Health Equity.

GINA CURRY

JONATHAN GRINSTEIN, MD

Director of Mechanical Circulatory Support

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We’re adding more locations in the city and the suburbs to bring our primary care physicians and specialists closer to where you live, work and shop.

Now open BEVERLY

11250 S. Western Ave.

» Internal medicine » Gastrointestinal care SOUTH HOLLAND

401 E. 162nd St. Suite 207

» Internal medicine

Opening early 2020

New alliance bolsters rehab care The University of Chicago Medicine and Shirley Ryan AbilityLab have joined forces to bring the services and expertise of a premier rehabilitation hospital to patients of the academic health system.

Shirley Ryan AbilityLab took on the clinical management of inpatient rehabilitation services at UChicago Medicine Ingalls Memorial in Harvey on Nov. 1. Over the next year, the alliance is expected to expand to inpatient and outpatient rehabilitation services in all clinical facilities at UChicago Medicine’s Hyde Park campus and later to Ingalls’ outpatient facilities in the south suburbs.

A dedicated team from Shirley Ryan AbilityLab — including physiatrists (physical medicine and rehabilitation physicians) — will manage the programs.

Current therapists and staff will continue to be employed by Ingalls Memorial or, as the alliance expands, UChicago Medicine.

“This collaboration will allow the two organizations to work together and transfer knowledge and best practices in rehabilitation medicine, which will enhance the services we offer throughout our health system,” said Audre Bagnall, chief strategy officer and executive vice president for business development at UChicago Medicine.

RIVER EAST

355 E. Grand Ave.

» Primary care » Women’s care

The arrangement is the latest alliance for the two leading health providers, which have a long history of successfully working with other organizations to expand care into more communities.

» Specialty care HOMEWOOD

17805 S. Halsted St.

» Urgent care » Primary care » Lab and X-ray

16 » THE UNIVERSITY OF CHICAGO MEDICINE

We share the same commitment to providing high-quality care.”

AUDRE BAGNALL UChicago Medicine chief strategy officer and executive vice president for business development

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“Central to our mission is expanding our reach — locally, nationally and globally — so that patients have access to the best in rehabilitation care, with the greatest outcomes,” said Christine DeLeo, vice president for strategic alliances, Shirley Ryan AbilityLab. Shirley Ryan AbilityLab has been ranked the “No. 1 Rehabilitation Hospital in America” by U.S. News & World Report every year since 1991. Anchored by its new flagship research hospital in Chicago’s Streeterville neighborhood, the organization operates nearly 40 sites of care around Illinois and beyond.

| B E L OW | Patient Joslyn Smith, who was injured in an accident, works with physical therapist Meg Clark at UChicago Medicine Ingalls Memorial in Harvey.

GIFT FROM THE

HEART

Donation establishes new center to test cardiology treatments and technologies Richard Parrillo knows the University of Chicago Medicine better than most. He has been seeing his physician, Mark Siegler, MD, for three decades, has been treated for three types of cancer and receives ongoing treatment for a heart condition.

But it isn’t just the excellent care that keeps him coming back.

“I feel a certain kinship with UChicago Medicine,” Parrillo said.

“The doctors who’ve treated me are the best of the best. They are not only nationally known physician-scientists, they are also good friends.”

Parrillo counts many current and former faculty members among his friends at UChicago Medicine, including Siegler, Nishant Agrawal, MD, chief of the Section of Otolaryngology-Head and Neck Surgery and director of head and neck surgical oncology, and Nir Uriel, MD, former director of heart failure, transplant and mechanical circulatory support.

S. Polonsky, MD, dean and executive vice president for medical affairs at the University of Chicago.

Today, Parrillo is two years cancer-free and continues to recommend UChicago Medicine to friends and family.

“I’ve received great care, so I’ve recommended UChicago Medicine to others, and they’ve also received the best medical treatments available,” Parrillo said.

In addition to his most recent gift, Parrillo previously established the Richard Parrillo Family Professorship in Healthcare Ethics in the Department of Medicine, which is currently held by Marshall Chin, MD, MPH, an expert in improving care for patients with chronic diseases.

Parrillo grew up in Oak Park and now divides his time between Chicago, Florida and Wisconsin. Despite his busy travel schedule, he keeps returning to UChicago Medicine.

The doctors who’ve treated

To show his gratitude and to help the millions of Americans living with cardiovascular disease, Parrillo made me are the best of the best.”

“UChicago Medicine has some of the a $5 million gift to establish the RICHARD PARRILLO best doctors in the country, and in Richard P. Parrillo Family Center for some cases, the world,” Parrillo said.

Clinical and Translational Cardiology at UChicago Medicine. The center Parrillo looks forward to seeing how his investment will will help to accelerate the pace of progress in cardiology care by help improve cardiovascular care for patients and drive bringing the most promising new technologies and drugs to be faster progress. tested at UChicago Medicine via clinical trials.

“The Parrillo Center will enable us to create the core infrastructure necessary to design and implement innovative clinical trials, allowing our patients to be among the first to benefit from leading-edge cardiology treatments,” said Kenneth

“Philanthropic support for medical research is very important,” he said. “It not only allows for more rapid testing of different treatments and technologies, it also helps to attract the most talented experts who will develop tomorrow’s innovations.”

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A national leader in patient safety.

16 times in a row.

The University of Chicago Medicine received its 16th consecutive A from the Leapfrog Group, a prestigious industry watchdog. We thank our physicians, nurses and caregivers for helping us achieve this distinction by providing patients with the highest level of care every day. It’s their dedication that keeps us at the forefront of patient safety.

UChicago Medicine remains the only hospital in Chicago to achieve this perfect record. And only 36 hospitals in the country — out of more than 2,600 surveyed — can make that claim.

UChicagoMedicine.org