Imagine - Winter 2018 - University of Chicago Medicine

WINTER 2018

COVER STORY

Cancer advances

How immunotherapy and other breakthrough treatments are helping cancer patients survive and thrive MODEL OF STRENGTH

Shanette Caywood inspires women living with advanced breast cancer ALSO IN THIS ISSUE PAGE 1

Cold-weather joint pain and what to do about it PAGE 5

Managing inflammatory bowel disease (IBD) in kids

Imagine

WINTER 2018 IN THIS ISSUE

ON THE COVER

8

TARGETING LDL Bringing down “bad” cholesterol to reduce

3

heart risk.

4

STAR TURN With her Crohn’s disease in remission, actress Dara Cameron is back in the spotlight.

FIRST VISIT Our specialists provide sensitive gynecologic care for adolescent girls.

11

READ ONLINE RESOLUTION Rx Giving up on your New Year’s resolutions already? You’re not alone. Our experts can help.

BACK IN PLAY Shanette Caywood on the lakefront trail.

The sales executive has run several 5Ks

College hockey player

since being diagnosed with advanced

returns to the ice after

breast cancer. Cover photo by Jean Lachat

complex surgery for a rare brain condition.

6

Breakthroughs in

Find these stories and more on THE FOREFRONT, our new science, health and wellness website at uchicagomedicine.org.

immunotherapy and targeted treatments are revolutionizing cancer care for patients.

Imagine 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 WEBSITES FOR MORE INFORMATION: Adult care uchospitals.edu Children’s care uchicagokidshospital.org

Vice President, Chief Communications and Marketing Officer: William “Skip” Hidlay Editor: Anna Madrzyk Associate Editor: Gretchen Rubin Design: SBDWorks, Inc. Contributing writers Kat Carlton, Thea Grendahl Christou, John

Science, health and wellness blog

Easton, Ashley Heher, Heather Linder, Angela

uchicagomedicine.org

Terri Tye, Lorna Wong, Matt Wood

Main number 1-773-702-1000

Wells O’Connor, Gretchen Rubin, Anita Slomski, Contributing photographers David Christopher, Rob Hart, Robert Kozloff,

Appointments

Jean Lachat, Joe Sterbenc

1-888-824-0200

Read Imagine online at uchospitals.edu/Imagine

Email us at imagineeditor@uchospitals.edu Facebook.com/UChicagoMed Twitter.com/UChicagoMed This publication does not provide medical advice or treatment suggestions. If you have medical problems or concerns, contact a physician, who will determine your treatment. Do not delay seeking medical advice because of something you read here. For urgent needs, call 911 right away.

IT’S COLD OUTSIDE Do your joints hurt?

Stiffness, aches and pains are often associated with changes in weather, especially the falling temperatures of winter.

UChicago Medicine rheumatologist Anisha Dua, MD, MPH, explains the whys and hows of weather-related joint pain and what you can do to reduce your risk.

WHY DOES THE COLD CAUSE PAIN AND STIFFNESS?

There is no one explanation for why dropping temperatures affect your joints.

One theory relates to drops in barometric pressure, which causes tendons, muscles and the surrounding tissues to expand.

Because of the confined space within the body, this can cause pain, especially in joints affected by arthritis.

ARE SOME PEOPLE MORE SUSCEPTIBLE THAN OTHERS?

Everyone’s body reacts to fluctuating barometric pressure, but people with arthritis and those with chronic pain are more vulnerable to feeling discomfort.

Also, bad weather can affect people’s moods; if you are sad or depressed, the perception of pain can be magnified.

WHEN SHOULD I CONSULT A DOCTOR?

If you experience any unusual or new symptoms with your joints — such as persistent swelling, redness, difficulty putting pressure on, or using, the joint — it’s a good idea to consult your physician.

Anisha Dua, MD, MPH

If you have consistent or severe pain that becomes disabling, seek medical care right away.

REDUCE YOUR RISK FOR JOINT PAIN

» Ease the shock of cold weather on your

body by dressing in layers to stay warm.

» Build up muscle and bone strength through

exercise. This reduces pressure on your joints, so they are less prone to injury.

» Maintain a healthy weight to decrease

stress on your joints, especially your knees.

» Avoid unnecessary strain on your joints

during daily activities.

» Apply heating pads to painful areas.

Heat helps relax your muscles.

» Get up, walk around and be active

indoors and outdoors. Stretch before going outside to loosen stiff joints.

Staying active in the winter keeps your muscles and joints healthy.

» Get a good night’s sleep, eat healthy

and keep a positive outlook.

WHERE TO FIND US Comprehensive rheumatology services are available on our main campus in Hyde Park and at the following UChicago Medicine locations:

Adults

Children

Chicago-Streeterville

Elmhurst

150 E. Huron NEW

Joliet

Rheumatology at Joliet 903 129th Infantry Drive Suite 600

Comer Children’s at Edward

Merrillville, Ind.

UChicago Pediatric Specialists | A B O V E | Rheumatologists Asha Muthalaly, MD, left, Maria Sosenko, MD, and

Saba Ahmed, MD, at the new UChicago Medicine rheumatology practice in Joliet.

For an appointment, call 773-834-0066.

U C M C O N N E C T 1 - 8 8 8 - 8 2 4 - 0 2 0 0 | UCHOSPITALS.EDU | UCHICAGOKIDSHOSPITAL.ORG » 1

95

UChicago Medicine and Comer Children’s physicians on Chicago magazine’s 2018 Top Doctors list

Imagine that!

SNIFFING OUT DEMENTIA RISK

NOT TOO LATE TO VACCINATE

Men infected once with human papillomavirus (HPV), the most common sexually transmitted infection, might still benefit from vaccination. A new analysis shows that HPV infection does not provide protective immunity, in contrast to many other viruses. Instead, men with genital HPV are up to 20 times more likely to be re-infected with the same HPV type within one year.

HPV, a major cause of genital warts and cancers of the genitals, mouth and throat, affects about 40 percent of women and 45 percent of men in the U.S. “Vaccinating boys before HPV exposure is a highly effective way to reduce the burden of HPV infection, but vaccinating men who have already been infected could also be effective,” said Sylvia Ranjeva, a University of Chicago graduate student who led the study published in the Proceedings of the National Academy of Sciences.

A smell test could help identify people at risk for dementia. University of Chicago Medicine researchers found that adults who could not identify at least four of five common scents were more than twice as likely than people with a normal sense of smell to develop dementia.

Nearly 3,000 adults who participated in the study were asked to identify five common odors: peppermint, fish, orange, rose and leather.

A multidisciplinary team found a robust connection between smell dysfunction and a subsequent diagnosis of dementia. “Sense of smell is closely connected with brain function and health,” said Jayant M. Pinto, MD, lead author of the study published in the Journal of the American Geriatrics Society. “We’re hoping to find people who are at risk of dementia early on in the disease and develop new treatments.”

READ MORE AT

uchicagomedicine.org

NIXING CODEINE FOR KIDS

A warning against giving codeine to children has not eliminated the risky practice. Codeine was a common treatment for pain following tonsil and adenoid surgeries before 2013, when federal regulators warned that the practice could be fatal in children due to unpredictable variability in how their bodies process the drug. Researchers from the University of Chicago, Harvard University and the University of Michigan found that one in 20 children were still prescribed codeine two years after the “black box warning,” the FDA’s strongest danger signal. Non-opioid medications like acetaminophen and ibuprofen are the recommended first-line drugs for children.

UChicago health policy expert Rena Conti, PhD, studies the effect of FDA warnings and was a co-author of the study published online in the journal Pediatrics.

YEARS AT THE FOREFRONT And we are still making the grade.

For almost a century, the University of Chicago Medicine has been at the forefront of health care, including patient safety.

We are proud to have earned a Grade “A” rating from the hospital watchdog, the Leapfrog Group, in every survey since it started measuring patient safety. Join us in celebrating 90 years at the forefront at uchicagomedicine.org.

2 » THE UNIVERSITY OF CHICAGO MEDICINE IMAGINE MAGAZINE | W I N T E R 2 0 1 8

FREE VASCULAR SCREENINGS IN ORLAND PARK Since 2014, the University of Chicago Medicine has partnered with the Heart Health Foundation to offer Dare to C.A.R.E., a free heart and vascular disease education and screening program.

C.A.R.E. stands for: Carotid artery disease Causes at least 300,000 strokes per year.

Abdominal aortic aneurysms 90 percent of ruptured aneurysms are fatal, but patients whose aneurysms are detected early have a 95 percent survival rate.

Renal artery stenosis If untreated, 15 to 20 percent of patients will need dialysis.

Extremity artery disease Affects more than 10 million Americans, especially those older than 50.

Participants receive a 20-minute, noninvasive ultrasound of the neck, abdomen and legs. Screenings are offered at the University of Chicago Medicine in Orland Park, 14290 S. La Grange Road.

To be eligible for a free screening, patients must be age 60 or older, or over age 50 with certain heart and vascular risk factors such as smoking, diabetes, high blood pressure and high cholesterol. Patients over 40 with diabetes are also eligible.

For more information or to make an appointment, please call 773-834-5599.

Ask the Expert E VA N S T E I N , M D

When it comes?to “bad” or LDL cholesterol, lower is better. Evan Stein, MD, is a world-renowned lipidologist — a physician who specializes in managing fats in the blood. He sees patients at the University of Chicago Medicine’s new lipid clinic on the Hyde Park campus and at 150 E. Huron St., Chicago.

WHAT BRINGS PATIENTS TO THE LIPID CLINIC?

My focus is on patients who have coronary heart disease and, despite medication, still need additional cholesterol reduction, especially for LDL — often called the “bad” cholesterol. I also treat people who can’t tolerate statins to lower their cholesterol and patients at high risk for heart attacks, such as diabetics, smokers and those with high blood pressure.

WHAT OTHER CONDITIONS DO YOU TREAT?

We see patients who have inherited high cholesterol, known as familial hypercholesterolemia or FH. This is a genetic disorder that causes a defect in the way LDL cholesterol is cleared from the blood and leads to early heart disease. FH is inherited as a dominant gene, and patients’ parents, siblings and children should be screened as they each have a 50/50 chance of having the same defect. Once diagnosed, it important for patients — even children — to start cholesterol-lowering treatment.

Lowering LDL cholesterol is by far the most proven, and generally easiest, way to reduce risk of heart disease.”

EVAN STEIN, MD

WHO NEEDS TO BE AWARE OF THEIR CHOLESTEROL LEVEL?

Statistically, African Americans have some of the highest rates of heart disease, and studies have shown they are an undertreated population for prevention of heart disease and strokes. However, everyone needs to keep an eye on his or her cholesterol. Lowering LDL cholesterol is by far the most proven, and generally easiest, way to reduce risk of heart disease. Studies with existing and new LDL cholesterollowering medications now convincingly demonstrate that “lower is better” and “lowest is best.”

To make an appointment with Dr. Stein, call 1-888-824-0200.

U C M C O N N E C T 1 - 8 8 8 - 8 2 4 - 0 2 0 0 | UCHOSPITALS.EDU | UCHICAGOKIDSHOSPITAL.ORG » 3

CROHN’S DISEASE IN REMISSION

IT’S A WONDERFUL LIFE

While performing on stage, Chicago actress Dara Cameron, 33, can make audiences laugh or cry, feel joy or sorrow. She needs to give it her all every time. “And that’s hard to do when you have a chronic illness,” she said.

But with help from the digestive diseases team at UChicago Medicine, Cameron has now been in remission from Crohn’s disease — a type of inflammatory bowel disease (IBD) — for more than three years and is thriving in her stage career.

DREAMS INTERRUPTED

Cameron was diagnosed with Crohn’s in 2001 at age 16. Medication helped, but abdominal pain and nausea regularly caused her to miss school and, to her great disappointment, many play practices.

A theater arts major in college, Cameron met and fell in love with fellow student — and now husband — actor, composer and lyricist Michael Mahler. “Michael really earned his stripes during our college years,” she said, describing how he accompanied her to the emergency room whenever she suffered a severe flare-up.

During her first professional job, as an understudy in a children’s play for a Chicago theater in 2006, Cameron needed emergency surgery for a perforation in her small intestine. “And I was unceremoniously fired from my first gig,” she said.

Fortunately, she was able to restart her acting career. And despite feeling “okay, not great,” she sang and acted on stages in New York and across Chicago and the suburbs.

But, in 2013, just as she was to open as a lead for a comedy in Chicago, she became seriously ill. UChicago Medicine gastroenterologist David Rubin, MD, a world-renowned IBD expert, diagnosed a

| A B O V E | Dara Cameron and her husband, Michael Mahler, during a dress rehearsal for the

2017 production of “It’s a Wonderful Life: Live in Chicago.” Dara and Michael are expecting their first child in March 2018.

DREAMS REALIZED

Crohn’s is a disease that can change the quality of your life at any time. But I have a team in place at UChicago Medicine that will take care of me. At the end of the day, it’s reassuring.”

DARA CAMERON

stricture in her intestine — a narrowing that could lead to a complete blockage — and recommended surgery.

Cameron pleaded with Rubin to allow her to delay the procedure.

Rubin prescribed a special diet as a shortterm solution. He also promised her that after the surgery, he would help her better manage her condition to prevent further recurrences.

4 » THE UNIVERSITY OF CHICAGO MEDICINE IMAGINE MAGAZINE | W I N T E R 2 0 1 8

Cameron opened the show to great reviews and completed the successful play’s full run.

In early 2014, UChicago Medicine IBD surgeon Roger Hurst, MD, removed two portions of her small intestine. Since then, Rubin’s team has been monitoring her for signs of recurrence — before any symptoms come back.

“One of the greatest advances we’ve made in managing Crohn’s disease is our ability to prevent it after surgery,” Rubin said.

“I routinely tell patients that surgery is the fastest way to get well and stay well.

We literally ‘reset’ the disease.”

Cameron’s stage career has taken off. She credits her care team at UChicago Medicine with keeping her healthy, happy and in remission. “And they helped me make my dreams come true,” she said.

More children are being diagnosed with inflammatory bowel disease (IBD), especially Crohn’s disease.

TREATING KIDS WITH IBD

Although IBD is a lifelong disease, children with the disorder are able to live a normal life once the inflammation is controlled with medication.

As the immune system goes awry in IBD, it injures the lining of the digestive tract, causing uncontrolled inflammation and ulcers. Children may develop symptoms as young as 18 months old. These include:

“Kids go to school and do fine academically, they play sports and travel with their families, and they can eat most of the foods they want, including pizza and chicken nuggets,” Gokhale said.

» persistent severe abdominal pain » nausea » fatigue

Treatment typically includes a short course of steroids to rapidly reduce inflammation, followed by anti-inflammatory drugs and immunosuppressants to keep inflammation at bay. New medications in the pipeline are even more effective at preventing flare-ups. These medications work by microscopically healing the lining of the intestines.

» low-grade fever » diarrhea, which may be bloody.

But not all children have these symptoms.

Others may not grow properly or have delayed puberty.

Ranjana Gokhale, MD, pediatric gastroenterologist at the University of Chicago Medicine Comer Children’s Hospital, is an expert on IBD in children.

If she suspects a child has IBD, Gokhale orders blood and stool tests to look for anemia and signs of inflammation. To confirm the diagnosis, she may perform an endoscopy or colonoscopy to look inside the child’s digestive tract and biopsy a small piece of tissue.

UChicago Medicine treats a large number of children and adults with IBD and, as a research institution, participates in numerous clinical trials that provide patients with access to new and innovative medications. This includes medications that aren’t yet commercially available to children.

Tackling Crohn’s Disease and Ulcerative Colitis: Diet and Nutrition

FREE SEMINAR FOR PATIENTS AND FAMILIES

Digestive Diseases Center

February 21, 2018 7 to 9 p.m.

Homewood Suites Orland Park 16245 S. La Grange Road

Children younger than 18 are the fastest-growing population of IBD patients in the U.S. An estimated 80,000 children are living with IBD. Source: Crohn’s & Colitis Foundation

Some kids also need a special diet supplemented with essential nutrients to help them regain weight and catch up on their growth.

WHAT PARENTS CAN DO

Help prevent flare-ups by making sure children take their medications on time every day. It’s especially important for teenagers, who tend to be less compliant.

The Comer Children’s IBD team will also assist parents in getting support at a child’s school through a 504 plan, which accommodates children with disabilities.

“Children with IBD need close medical monitoring, and they shouldn’t be penalized for missing school for frequent clinic visits,” Gokhale said.

Research breakthroughs, update on therapies and the role of diet and nutrition in IBD. Seminar will include a special focus on IBD in kids and teens.

Presented by David Rubin, MD; Russell Cohen, MD; Sushila Dalal, MD; Ranjana Gokhale, MD; and Dejan Micic, MD. To register, call 1-888-824-0200 or visit uchospitals.edu/IBDEventFeb2018.

For information on other events, email ibdcenter@uchicago.edu.

U C M C O N N E C T 1 - 8 8 8 - 8 2 4 - 0 2 0 0 | UCHOSPITALS.EDU | UCHICAGOKIDSHOSPITAL.ORG » 5

Melanoma IMMUNOTHERAPY

Innovative cancer treatments Groundbreaking research Helping patients thrive after diagnosis We’re at the forefront of fighting cancer with the latest treatments, including immunotherapy and targeted therapies.

Some of these advances are built on discoveries made at the University of Chicago Medicine. As national leaders in cancer clinical trials, we bring new treatments to our patients quickly, often before they are available elsewhere.

Even when cancer can’t be cured, it often can be controlled as a chronic disease for many years. We strive to help patients not only to live after a cancer diagnosis, but to live well.

Cancer treatment hasn’t slowed Anwar Hakim down.

And he wants to keep it that way.

As an architect for an international firm, Hakim works on projects all over the world. Since starting immunotherapy for metastatic melanoma in May 2016, he has traveled to sites in Europe, Asia and the Middle East. “I stay positive and keep active,” he said.

In late 2015, Hakim went to his primary care doctor complaining of fatigue, shortness of breath and abdominal discomfort. Tests revealed tumors in his small bowel, the lower lobe of his left lung and an adrenal gland.

He could feel a mass in his upper right thigh.

The diagnosis was metastatic melanoma — a shock because Hakim had no sign of the aggressive cancer on his skin.

When a first round of treatment at another hospital failed to slow the cancer, Hakim turned to UChicago Medicine for a second opinion. Medical oncologist Jason Luke, MD, suggested a Phase 1 clinical study of a combination immunotherapy for advanced melanoma based on research done at UChicago.

“Dr. Luke told me about the treatment, the clinical trial and the possible side effects,” Hakim said. “And then he said, ‘Something positive could happen here.’ My decision was made easy. Of course, I went all in.”

UChicago Medicine had just opened the trial, which aimed to boost the effectiveness of Keytruda — an immunotherapy — by adding a medication that helps the immune system attack the tumor with maximum power. Hakim was only the 12th patient in the country to enroll in the study.

“Six years ago, we didn’t have much to offer patients with advanced melanoma,” Luke said. “Now we are seeing unbelievable responses to immunotherapy. And we are bringing what we design in the laboratory to enhance these therapies to our patients at a rapid pace.”

For Hakim, the treatment worked quickly.

Within nine weeks of starting therapy, his tumors had shrunk dramatically. A year and a half later, the tumors are not growing.

Because Hakim experienced few side effects, he’s been able to maintain a full schedule of work and travel.

“My wife and two daughters — who were very scared and upset when I was first diagnosed — are thrilled,” Hakim said. “This has taken an amazing path for me. I can’t thank my medical team and the entire staff at UChicago Medicine enough. They’re incredible.”

| L E F T | Anwar Hakim is an associate director and technical designer at the architecture firm Skidmore, Owings & Merrill LLP in Chicago.

Immunotherapy harnesses the power of the immune system to fight cancer and, in many cases, has led to complete remissions.

UChicago Medicine researchers are finding ways to improve immunotherapies to help even more patients. The science behind Anwar Hakim’s treatment — immunotherapy combined with an enzyme inhibitor to boost its effectiveness — came to a large degree from labs at UChicago Medicine. The new combination is now being used not only for melanoma but also for other cancers.

CAR T-cell therapy is a new type of cancer immunotherapy that supercharges a patient’s own blood cells to attack cancer. uchicagomedicine.org/ defeat-cancer

U C M C O N N E C T 1 - 8 8 8 - 8 2 4 - 0 2 0 0 | UCHOSPITALS.EDU | UCHICAGOKIDSHOSPITAL.ORG » 7

Targeted cancer therapy uses drugs or other substances to more accurately find and attack the parts of cancer cells that allow them to grow abnormally and spread. Targeted therapies give doctors more ways to tailor cancer treatment to specific tumors. In some cases, targeted drugs are used in combination with surgery, radiation and/or chemotherapy.

Breast Cancer TARGETED THERAPY A stage 4 cancer diagnosis devastated Shanette Caywood.

Today, she is a model of strength.

A month before she turned 34, Caywood was diagnosed with metastatic breast cancer that had spread to her liver and spine.

“You feel like your world is ending,” she said. “The only thing I could think about was my kids — who was going to be there for them?”

That was five years ago. Caywood recently

turned 39, and her cancer — while not curable — is stable.

her liver and spine, and hormone therapy for a small tumor in her other breast.

She was drawn to the University of Chicago Medicine’s focus on research and the opportunity to participate in clinical trials. Breast cancer specialist Rita Nanda, MD, worked with Caywood to develop a treatment plan that would give her the quality of life she wanted.

Despite her fatigue and at times feeling like she was “moving in slow motion,” the Chicago resident continued to work during treatment. She took up running along the lakefront and has completed several 5K races.

“From the first day I met Dr. Nanda, she has always given me hope,” said Caywood, a sales executive and mother of two. “I always felt like I was a part of the decision-making.”

Caywood’s type of cancer — HER2-positive — is a more aggressive form. Initially, she received targeted therapy as part of a clinical trial. Because she has done well and her disease has remained stable for so long, she was able to undergo a mastectomy, radiation and reconstruction. She is now receiving targeted therapy to manage metastases in

“I had to challenge myself to do something I hadn’t done before and show my body and cancer that I was in control,” she said.

Vowing to “live life larger,” Caywood has become a speaker and counselor, working to inspire other young women facing a stage 4 diagnosis. She also began modeling in local fashion shows and was featured in the national Ulta Beauty campaign for breast cancer research.

“That was huge for me, just being able to be that face, showing beauty through something you thought would break you.”

| B E L OW | Shanette Caywood, who was featured in the national Ulta Beauty campaign for breast cancer research.

8 » THE UNIVERSITY OF CHICAGO MEDICINE IMAGINE MAGAZINE | W I N T E R 2 0 1 8

A B O V E | Ivy Elkins during her family’s dream trip to Iceland in August.

Lung Cancer TARGETED THERAPY

Four years ago, Ivy Elkins thought she had only a few months to live.

Last summer, she climbed to the top of a waterfall in Iceland.

By the time Elkins learned she had lung cancer in 2013, it had already spread to her bones and her brain.

“My prognosis seemed dismal,” Elkins said.

“Would I reach my 50th birthday? Celebrate my 20th wedding anniversary? Take vacations with my husband and two sons again?

I didn’t know the answer to these questions.”

A new, targeted treatment at UChicago Medicine gave her optimism and hope.

“Our understanding of lung cancer genetics has opened new opportunities to personalize therapy for each patient,” oncologist Jyoti Patel, MD, said.

A biopsy of tumor cells revealed that Elkins had non-small cell lung cancer (NSCLC) as a result of a mutation in a gene called EGFR (epidermal growth factor receptor). The mutation, which is more common in women and people like Elkins who have never smoked, allows cancer cells to grow quickly.

At the time of Elkins’ diagnosis, the FDA had just approved a targeted treatment that attaches to abnormal EGFR molecules and blocks the cancer-causing signals.

Within a week of taking the medication, Elkins’ condition improved. “The tumor in my lung shrank, all the brain lesions were gone and bone in my cervical spine began to heal,” she said. The side effects were minimal and manageable.

But eventually — in Elkins’ case, it was three years later — the targeted drug stops working because another mutation develops in the EGFR gene.

Patel identified the new mutation even before symptoms appeared. Fortunately, there was a new FDA-approved targeted medication for the second mutation, too.

Now, a little more than a year after starting this new treatment, the tumor on Elkins’ lung has shrunk in half.

“All along, at all the critical junctures, Dr. Patel has absolutely made the best decisions for my health,” Elkins said.

And Elkins makes the best of the turns in her life by giving back. The northwest suburban woman is a high-profile advocate for lung cancer research, representing patients at national and international conferences, and is actively involved in the organization LUNGevity. “I plan to be around a long time,” she said. “And I plan to make every day count.”

U C M C O N N E C T 1 - 8 8 8 - 8 2 4 - 0 2 0 0 | UCHOSPITALS.EDU | UCHICAGOKIDSHOSPITAL.ORG » 9

Mesothelioma HIPEC Jessica Blackford-Cleeton’s cancer was aggressive.

So was her treatment.

Blackford-Cleeton built a rewarding career advising fire departments and other agencies on public education efforts. She and her husband were thinking about starting a family. Then, in 2015, she received a frightening diagnosis: peritoneal mesothelioma, a rare cancer that develops in the lining of the abdomen.

Blackford-Cleeton, then 32, turned to the University of Chicago Medicine, which has a comprehensive program devoted to mesothelioma diagnosis, treatment and research.

Oncologist Hedy Lee Kindler, MD — a nationally recognized expert on mesothelioma — guided BlackfordCleeton’s care. “Dr. Kindler was the first doctor I spoke to who had extensive knowledge of the disease,” BlackfordCleeton said. “She also answered my questions and really helped with my anxiety about being newly diagnosed.”

Kindler recommended a state-of-the-art procedure that combines surgery with a powerful dose of heated chemotherapy pumped directly into the abdomen. HIPEC (hyperthermic, or heated, intraperitoneal chemoperfusion) targets and kills cancer cells that remain after surgery. Cancer surgeon Kiran Turaga, MD, MPH, an expert in the complex procedure, removed all visible tumors in Jessica’s abdomen, which was

| A B O V E | Jessica Blackford-Cleeton, with her husband, Brandon Cleeton, and baby Avery.

then bathed in heated chemotherapy for 90 minutes.

UChicago Medicine is one of the few hospitals that offer HIPEC for both adults and children with cancer in the abdominal cavity, including ovarian, colorectal and appendix cancer, and some types of sarcoma.

Worried about how the extensive surgery

HIPEC (hyperthermic, or heated, intraperitonial chemoperfusion) is a targeted surgical technique for the treatment of some abdominal cancers.

During the procedure, heated chemotherapy is applied directly to the abdominal cavity after the surgical removal of visible tumors. Heat causes the blood vessels to expand, enabling high-dose chemotherapy to penetrate deeper and more effectively. HIPEC has fewer side effects than traditional chemotherapy because the drug targets specific areas rather than circulating throughout the whole body.

10 » THE UNIVERSITY OF CHICAGO MEDICINE IMAGINE MAGAZINE | W I N T E R 2 0 1 8

might affect her ability to have children, Blackford-Cleeton asked Turaga to try to save one of her ovaries. He did, and one year after surgery Jessica was cleared to begin in vitro fertilization. In August 2017, Jessica and her husband, who live in central Illinois, were thrilled to welcome their son, Avery.

“Everything is a new normal, but my new normal is good,” she said.

Watch a step-by-step animation of how HIPEC works. uchicagomedicine.org/hipec

5 reasons to visit an adolescent gynecologist

This may surprise many families, but most teenage girls should see a gynecologist for the first time between the ages of 13 and 15, according to the American College of Obstetricians and Gynecologists.

The first visit gives her a chance to talk with the gynecologist, become familiar with the specialty and learn about her body.

Amber Truehart, MD, a specialist in pediatric and adolescent gynecology, explains why it’s important to bring your daughter to the gynecologist in her early teens.

1

| A B O V E | Amber Truehart, MD, sees patients at UChicago Medicine in Hyde Park

and Orland Park.

2 2 3 3

Teenagers aren’t always comfortable asking adults about periods, sex and birth control — and they deserve better information than hallway gossip from their friends. Developing a trusting relationship with a physician early on will help girls feel comfortable asking tough questions.

4 4

Adolescent gynecologists have Adolescent gynecologists have special training and are experienced in special training and are experienced talking to girls at various stages in talking to girls at various stages of their adolescence. of their adolescence.

A pelvic exam in an emergency A pelvic exam an emergency situation with ainphysician she’s never situation a physician never met beforewith is not the ideal she’s way to met beforeaisgirl nottothe ideal way care. to introduce gynecologic introduce girl to gynecologic care.can Early visitsa with a caring physician Early visits with a caring physician help build trust and confidence before can help is build trust and confidence an exam needed. before an exam is needed.

Many young girls are misinformed Many young girlsand are sexually misinformed about pregnancy about pregnancy and sexually transmitted infections. Your daughter should learn about sexually transmitted Your transmitted infections. infections (STIs)

and pregnancy prevention before becoming sexually active.

5

A gynecologist can help your daughter deal with such issues as menstrual pain, heavy bleeding, irregular periods and vaginal discharge. The physician will order a basic blood workup if necessary.

Some myth busting may be needed when it comes to how hormones can regulate menstrual cycles. A teen from a family where the women are used to heavy periods, for example, might not realize that she doesn’t have to have a period that lasts for nine days.

Sensitive care for girls and young women Our pediatric and adolescent

LOCATIONS

gynecologists offer preventative

Hyde Park Comer Children’s Hospital

care for girls and young women up to age 22, as well as treatment for a wide range of

We take special care to address the physical and emotional needs of girls and young women, teach them about their bodies and support them in making healthy choices.”

JULIE CHOR, MD, MPH

gynecologic conditions.

Julie Chor, MD, MPH

Duchossois Center for Advanced Medicine Orland Park 14290 S. La Grange Road

Melissa Gilliam, MD, MPH

For an appointment,

Amber Truehart, MD

call 773-702-6118.

U C M C O N N E C T 1 - 8 8 8 - 8 2 4 - 0 2 0 0 | UCHOSPITALS.EDU | UCHICAGOKIDSHOSPITAL.ORG » 11

A new approach to emergency care UChicago Medicine opened the newest and most advanced adult emergency department in the city on December 29.

The $39 million facility increases our capacity to see patients needing urgent treatment for acute illnesses and injuries. It’s designed with features that will help us provide faster care and more privacy.

“Our commitment to patient care and the community is embodied in this new Emergency Department,” said Sharon O’Keefe, president of the University of Chicago Medical Center. “To this point, our front-line staff spent about 300 hours on a design that not only improves medical care but also the patient experience.”

The new ED marks an important step toward offering adult trauma services, which are expected to begin in May 2018, pending regulatory approval.

INSIDE THE NEW ED Patients see an ED physician earlier in the process. A physician assesses the severity of a patient’s illness or injury in the Rapid Assessment Unit.

Then the patient is moved either to the Specialty ED or to the Rapid ED for treatment and discharge.

Increased access to urgent treatment. The new ED has three Rapid Assessment bays, 16 Rapid ED rooms and 26 Specialty ED rooms.

Resuscitation bays help deliver lifesaving care. Resuscitation bays are being used to treat stroke and heart attack patients. Once the hospital is approved to provide adult trauma services, these bays also will be used to treat patients for vehicle crash injuries, major falls, serious head injuries, gunshot wounds and other trauma.

Dedicated radiology services.

The ED has its own state-of-the-art CT scanner, which produces four times more images and creates a faster, quieter and more comfortable patient experience.

Multidisciplinary care for patients with liver tumors The UChicago Medicine Liver Tumor Clinic brings together medical and surgical liver experts along with cancer specialists to offer personalized care for patients with primary liver cancer, bile duct cancer and benign tumors of the liver.

“Patients with liver cancer are not dealing with just one thing or with cancer in an otherwise healthy organ,” said Anjana Pillai, MD, medical director of the new clinic.

“They are battling two competing diseases — end-stage liver disease and the cancer itself.”

Liver cancer typically affects individuals who already have advanced liver disease or cirrhosis, usually as a result of hepatitis B or C, alcoholic liver disease or fatty liver disease.

Incidences of advanced liver disease and liver cancer have risen in the past few decades.

When patients visit the Liver Tumor Clinic, they see several specialists during one appointment. “Depending on the stage of the cancer and overall liver function, they may be given several options for care,” Pillai said.

12 » THE UNIVERSITY OF CHICAGO MEDICINE IMAGINE MAGAZINE | W I N T E R 2 0 1 8

UCHICAGO MEDICINE LIVER TUMOR CLINIC Hyde Park Duchossois Center for Advanced Medicine Learn more at uchicagomedicine.org/ liver-tumor-clinic.

For an appointment, call 1-888-824-0200.

ACCEPTING A

CHALLENGE Family supports training of diabetes educators Diagnosed with type 1 diabetes at 13 months, Maggie McNally, now 13 years old, knows the ins and outs of managing her condition. That’s not to say it’s easy. Type 1 is an insulin-dependent form of diabetes that has no cure. The eighth-grader must continually monitor her carbohydrate intake, blood sugar level and insulin dosing. It’s a complex equation that requires frequent revisions to achieve a healthy average blood sugar level.

When Maggie was little, her parents, Alison and Drew McNally, managed her diabetes. With a toddler who couldn’t express the feelings of “going low” — a potentially dangerous state when blood sugar plummets — or when her blood sugar was too high, they had to be vigilant. They also needed ready access to a care team.

At the University of Chicago Medicine Kovler Diabetes Center, the care team includes certified diabetes educators who, working with physicians, help patients confidently self-manage their condition. Certified diabetes educator Amy Hess Fischl advised Maggie’s parents on bringing into balance the many factors involved in their daughter’s diabetes management.

The challenge of managing diabetes is hour to hour. The diabetes educator is your day-to-day point person.”

ALISON McNALLY

Today, Hess Fischl helps the young teen fine-tune dosages programmed into her insulin pump and buoys her confidence through the ups and downs of dealing with the condition.

“Even when I have bad numbers, Amy is not disappointed,” Maggie said. “She just makes it better and makes me feel good.”

| A B O V E | Alison McNally and her daughter, Maggie, at home

in Winnetka.

Maggie’s 4-year-old cousin, Teddy McNally, was diagnosed with type 1 diabetes when he was a baby and is also a Kovler Diabetes Center patient. For Teddy’s parents, Jodi and Gray McNally, Hess Fischl also has been an essential part of their journey.

“Diabetes educators have a proven impact in helping people achieve better glucose control and reduce their risks of complications,” said Louis Philipson, MD, PhD, the James C. Tyree Professor in Diabetes Research and Care, director of the Kovler Diabetes Center, and the McNallys’ physician.

“Yet, with diabetes sharply on the rise, there are too few of them to meet the demand for services. We need to support more highly skilled health professionals in becoming certified diabetes educators.”

Recognizing this need, the McNallys — Alison and Drew, Jodi and Gray, and their extended family — have given generously to establish the McNally Family Certified Diabetes Educator Program at Kovler Diabetes Center.

The program provides a new platform for preparing diabetes educators for certification.

“With this new pipeline of diabetes educators coming through the program, Kovler Diabetes Center will be even more prepared to help people with all types of diabetes better manage their disease and health,” Philipson said.

Gray McNally sees the McNally Family Program as a way to address the shortage of people like Hess Fischl and “give the newly diagnosed immediate help in navigating the complex, new world they find themselves in.”

NONPROFIT ORGANIZATION U.S. POSTAGE PAID CAROL STREAM, IL PERMIT NO. 2003

The University of Chicago Medicine 5841 S. Maryland Avenue, MC 1110 Chicago, IL 60637

If you receive an extra copy of this publication, please share it with a neighbor or friend.

If you prefer to be removed from our mailing list, please call 855-622-6116.

welcome to THE FOREFRONT THE FOREFRONT is your one-stop digital destination to learn more about UChicago Medicine’s groundbreaking research, discoveries and advances in clinical care.

Our new science, health and wellness news and information website features engaging stories, videos and multimedia content spotlighting UChicago Medicine physicians, scientists, nurses and staff, and our patients and their families.

Come explore THE FOREFRONT with us

uchicagomedicine.org