Seek Fall 2009

Keeping

Cancer at Bay

Tom Kelly, Ph.D., studies ways to prevent the spread of breast cancer. Page 6.

seek FALL 2009

Editor Susan Van Dusen Art Director Laurie Shell Photographer Johnpaul Jones

Seek is published quarterly for the Winthrop P. Rockefeller Cancer Institute by the Office of Communications & Marketing at the University of Arkansas for Medical Sciences, 4301 W. Markham St. #890, Little Rock, AR 72205-7199; phone (501) 686-5686; Fax (501) 686-6020.

Director, Winthrop P. Rockefeller Cancer Institute Peter D. Emanuel, M.D. Associate Director of Administration, Winthrop P. Rockefeller Cancer Institute Shirley Gray Executive Director, Winthrop P. Rockefeller Cancer Institute Foundation Rachelle Sanders Database Manager Kelly Pollnow

WINTHROP P. ROCKEFELLER CANCER INSTITUTE

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As we head toward next summer’s opening of the first phase of the Cancer Institute’s expansion, we also are working tirelessly to expand our research and clinical programs.

Even the most beautiful buildings in the world are just that — buildings. It’s the people and programs within those buildings that change the lives of others.

In recent months, we have made great strides in addressing the needs of Arkansans facing one of our deadliest diseases — lung cancer. Mostly attributable to tobacco use, lung cancer took the lives of more Arkansans in 2008 than breast cancer, prostate cancer and colorectal cancer combined.

We have now assembled a multidisciplinary team to combat this killer. Read about the team and one of its members, Konstantinos Arnaoutakis, M.D., in this issue of Seek.

Also in this issue, read about how breast cancer has struck three generations of the James family. Even though we are unlocking some of the genetic mysteries that cause breast cancer, this family illustrates that we have much more to do in discovering the inherited risks for breast cancer. Their story also reminds us of the importance of mammograms, regular checkups and self exams.

After Claire and Ken MacNeill lost their daughter to breast cancer, they found a desire to immerse themselves in the Hot Springs Village Walk for Cancer Research. Having completed the walk for the past two years, I can say that the entire Village is involved in this fundraising effort, from the older adults to the cancer survivors to the school-age children who do car washes and bake sales toward the effort. Each and every dollar they raise for cancer research comes from the heart. A big thank you to everyone in Hot Springs Village!

Finally, I’d like to say a word about our annual Gala for Life. Not even the downturn in the economy could quash the spirit or generosity of Arkansans. We had a perfectly wonderful and successful Gala this year, grossing nearly $800,000. I thank all of you for your spirit of giving!

Peter D. Emanuel, M.D. Director, Winthrop P. Rockefeller Cancer Institute Looking Beyond Cancer’s Limits

contents FALL 2009

features

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4

A Tough Cell

Thomas Kelly, Ph.D., is looking for a way to stop breast cancer cells in their tracks.

Need to Know

Experts share insight at the Symposium on Lymphoma and Leukemia.

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Meeting the Challenge

22

It Takes a Village

Konstantinos Arnaoutakis, M.D, sees a brighter future ahead for lung cancer patients.

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Claire and Ken MacNeill have turned tragedy into hope.

in every issue Profile ............................................................... 4 Breast cancer is a reality for three generations of the James family.

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Medicine Bag................................................... 14

Head and Neck Oncology Clinic expands Celebrating survivors Cancer Biomedical Informatics Grid HPV research

Expansion........................................................ 16 New pharmacy is a huge step ahead.

Spotlight.................................................................24 Gala for Life

Partners Card kick off

RockStar Lounge

Cover photo by Johnpaul Jones

“It was luck of the draw that I was fortunate enough to be born a Rockefeller. But with that comes the additional obligation, or I should say opportunity, to do some good.”

Winthrop P. Rockefeller 1948-2006 Winthrop P. Rockefeller Cancer Institute

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Family History

This North Little Rock family knows well what cancer can do.

But they’re determined not to

let it cloud each day.

By Jon Parham

Rita James (center) with her daughters, Jennifer (right) and Karen (left).

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Looking Beyond Cancer’s Limits

profile

When Rita James was diagnosed with breast cancer in 1991, it stirred painful memories.

Her mother died of breast cancer in 1969 at age 47. That’s just two years older than Rita was at the time of her diagnosis.

Those memories reawakened when one of her two daughters was diagnosed in 2009. As the James family soon realized, family history can be one of the best indicators of breast cancer occurrence.

Waging War James’ cancer battle began Jan. 16, 1991, the same day fighting began in the Gulf War against Iraq.

“I remember waking up that day wondering if we were at war, but I was already at war against my cancer,” she said of the day she was diagnosed.

A mastectomy followed.

Still, since her mother’s cancer returned after treatment, she wanted to consider all options — leading her to the Cancer Institute and Laura Hutchins, M.D., director of the UAMS Division of Hematology/ Oncology.

“I knew when I came here she’d be aggressive in her treatment, and that’s what I wanted,” James said.

She began a six-month chemotherapy treatment.

Hutchins sat with her through the first dose.

Through the treatments, James kept working as a math curriculum specialist with the Winthrop P. Rockefeller Cancer Institute

Little Rock School District. She did not let the disease slow her.

Daughter Karen said her mother remained positive through the ordeal. “Mom taught us to appreciate every day and not to sweat the small stuff,” she said.

Winning the Battle In 1996, she had her fiveyear checkup. It was a milestone, particularly since her mother did not survive five years after her diagnosis.

“

I remember waking up that day wondering if we were at war, but I was already at war against my cancer.”

But it wasn’t long after that when Rita felt another lump. The cancer had returned, meaning a round of radiation therapy.

Cancer left the James family alone for 13 years. Then in May 2009, an abnormality showed up in a mammogram of Rita’s daughter, Jennifer, 40.

Knowing the family history, both Jennifer and Karen began having regular mammograms and checkups early. Jennifer was not surprised to find the abnormal area was malignant.

“I was scared just knowing what mom had been through,” said Jennifer, who had a mastectomy in July. “But I don’t

think of breast cancer as a death sentence anymore. I found mine before I could even feel anything.”

Her prognosis is good.

Forging On Because of their strong family history, Rita and her daughters decided to be tested for genetic defects that can indicate an increased risk for breast cancer. About a third of patients with a family history of cancer will have such a genetic mutation.

Rita’s test showed a defect in one gene segment. Her daughters had a 50-50 chance of inheriting the defect that could mean an increased risk of cancer.

But it was Karen, not Jennifer, who had the genetic anomaly.

“I think the testing is important, but to me the results showed that family history can be just as important as genetics,” Jennifer said.

Karen took the results in stride, continuing regular checkups and self-exams. “It’s just something to stay on top of,” she said.

The women are adamant about the importance of mammograms, regular checkups and self-exams.

“I’m amazed at people who have a lump and don’t do anything,” Rita said.

“Or who won’t get a mammogram because they say it hurts too much,” added Jennifer. seek

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Looking Beyond Cancer’s Limits

A Tough Cell

Stopping the spread of breast cancer cells is this scientist’s goal.

By Susan Van Dusen

Tom Kelly, Ph.D., earned the U.S. Department of Defense’s Synergistic Idea Award for his study of breast cancer metastasis.

Winthrop P. Rockefeller Cancer Institute

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Thomas Kelly Jr., Ph.D., decided at a young age not to be an engineer.

“It was too much math,” he said.

Engineering also was his dad’s career, and while some people might naturally follow in their parents’ footsteps, Kelly decided to make his mark elsewhere.

After all, as he nonchalantly noted, “My father is famous.”

Dubbed the “Father of the Lunar Module,” the late Thomas Kelly Sr. was lead design engineer of the first manned spacecraft to land on the moon, a feat whose 40th anniversary was celebrated earlier this year.

Not only did he design the lunar module and help develop the process that allowed it to land and return to orbit, he also got the money to make it all possible.

“He was an inspiration to me because, not only did he do something really unbelievable, he also was one of the lead authors of the proposal to NASA that funded the project and provided thousands of people with jobs,” said Kelly, associate professor in the UAMS Department of Pathology.

Writing grant proposals is a regular part of a scientist’s career, and Kelly is no exception.

In fact, he had success in 2008 when he was awarded the U.S. Department of Defense’s Synergistic Idea Award for his research focusing on the

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role of fibroblast activation protein-alpha (FAP) in breast cancer metastasis. Out of 134 proposals submitted for the international award, Kelly’s project was one of only 14 selected for funding.

He credits his grant writing success to some early tutoring from his dad.

“I got another Department of Defense grant earlier in my career, and he helped me with my basic grant writing skills. It was something we bonded over,” Kelly said.

The Department of Defense Breast Cancer Research Program was created in 1991 as a result of advocacy efforts by the National Breast Cancer Coalition. Since that time, the program has granted about $2 billion for innovative research projects, such as Kelly’s, across the country.

Stopping the spread

Kelly’s 2008 award includes a two-year grant of $361,203 and operates as a collaborative effort between Kelly’s group at the UAMS Winthrop P. Rockefeller Cancer Institute and the research group led by Patrick McKee, M.D., at the University of Oklahoma Health Science Center in Oklahoma City.

The scientists’ goal is to gain a better understanding of how to control the aggressive behavior of breast cancer cells.

They are testing the theory that the protein known as FAP actually facilitates breast cancer growth and metastases by cleaving proteins into fragments that encourage the formation of blood vessels that nourish the expansion of cancer. Metastasis refers to the transference of cancerous cells from their original site to another location in the body and is the most deadly feature of breast cancer.

Out of 134 proposals submitted for the international award, Kelly’s project was one of only 14 selected for funding.

The research teams at UAMS and the University of Oklahoma are exploring the possibility that FAP actually protects breast cancer cells that are traveling in the body by mediating the rapid coating of the tumor cells with fibrin, the blood protein that is a major component of blood clots. “The fibrin coating may help the tumor cells survive and escape to allow the spread of cancer in other parts of the body,” Kelly said.

Kelly hopes that his research may someday lead to a clinical trial to prevent tumor

Looking Beyond Cancer’s Limits

progression, although such a trial is several years in the making.

“Our hope is that we can use a drug to stop FAP from helping the tumor cells cut through the breast tissue and enter the blood. By doing that, we may be able to contain the tumor in one location,” he said. “Then if the cells did escape, they might be more susceptible to dying before another tumor is able to form.”

exploring new ideas

Kelly’s interest in FAP also is leading him to explore its immune suppression capabilities.

Along with Jerry Ware, Ph.D., professor in the UAMS Department of Physiology and Biophysics, Kelly is examining the possibility that FAP-like molecules may serve to inactivate the immune-stimulating proteins called chemokines that serve as chemical messengers to control the activities of the immune system.

Ware received a similar Department of Defense grant — the Idea Award — in 2008 to continue his longtime research into the role of blood platelets in the growth and spread of tumors.

“Part of your body’s innate immune system is a component called natural killer cells that find and kill tumor cells. They do this by responding to signal molecules that are released in the area of the tumor,” Kelly said.

If FAP-like molecules cleave the chemokine, causing it to become inactive, the natural killer

Winthrop P. Rockefeller Cancer Institute

cells may not receive the signal to act.

“The chemokine is like a traffic policeman telling the natural killer cells it’s time to move. When it is inactivated, it doesn’t attract the natural killer cells as much. We’re exploring the idea that having FAP in that environment can turn off the chemokine’s signal to kill the tumor cell and give the tumor a better chance of survival,” Kelly said.

team effort

In his 17 years at UAMS, Kelly has seen the breast cancer program grow into the collaborative effort it is today.

By incorporating input from physicians, researchers, nurses, fellows, social workers and others, the program serves the physical, emotional and psychological needs of the whole patient.

A group of clinicians and basic scientists within that larger context meets regularly to discuss their combined efforts. Kelly describes their meetings as a cross talk between those trying to cure patients and those creating new tools to accomplish that goal.

“I’ve been involved in a lot of collaborations, but our Breast Cancer Focus Group is one of the most interesting and fun,” Kelly said. “It helps us all gain a better understanding of the disease.”

Like Mother, Like Son

Most mothers and sons

share common traits. Maybe they have the same eye color or musical talent.

But few share what UAMS

researcher Thomas Kelly Jr. and his mom, Joan, have in common: a Ph.D. earned the very same year.

“My mother and I each

got a Ph.D. in 1988, which is sort of fun,” said Kelly, who is the second oldest of six siblings.

While Kelly’s Ph.D. is in

cell biology and anatomy from the University of North Carolina at Chapel Hill, his mother’s is in English literature from the State University of New York in Stony Brook.

“Every summer when we

visit her in New York state, I let her assign me a book to read. I’ve read a lot of English teacher books,” he said.

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N

eed to Know

By Nate Hinkel



Experts at

UAMS’ annual

symposium

share the latest developments in treating

and diagnosing leukemia and lymphoma.

Every four minutes, someone in the world is diagnosed with a blood disorder.

And every 10 minutes, someone dies from one.

It’s because of these daunting statistics that researchers and doctors, including several experts at the UAMS Winthrop P. Rockefeller Cancer Institute, use countless resources to find innovative ways of diagnosing and treating hematological disorders.

As a result of those efforts, new discoveries are constantly being made. However, with these advances comes the challenge of keeping front-line health care providers up to date on the latest developments.

Anne-Marie Maddox, M.D., director of research in the UAMS Division of Hematology/ Oncology, noticed this need and started the Cancer Institute’s annual Symposium on Lymphoma and Leukemia.

“There are a lot of changes that occur in the treatment and diagnosis of hematological disorders,” Maddox said. “In order to update physicians, nurses and other health professionals on these constantly evolving changes we’ve started holding this symposium every year.”

The latest symposium, held Sept. 18 at the Cancer Institute, was the third annual event. The all-day affair drew more than 300 physicians, nurses and even a handful of pharmacists from across the state.

“The Symposium on Leukemia and Lymphoma has 

really come into its own. Our speakers were all international authorities in their field of expertise, producing a really high quality event,” said Cancer Institute Director Peter Emanuel, M.D., whose expertise lies in treating both pediatric and adult forms of leukemia.

His bench-to-bedside research approach for a rare pediatric leukemia is a model for research into many other cancers.

“

It’s just another way UAMS helps serve the state’s medical community.”

“If the clinical staff doesn’t have a good understanding of new developments in treatment and diagnosis, then the benefits of those may not always get passed on to patients,” said Elias Anaissie, M.D, director of the Myeloma Institute for Research and Therapy’s Supportive Care Program. “This is a significant symposium to have, and it’s just another way UAMS helps serve the state’s medical community.”

Aside from UAMS experts Maddox, Anaissie and Robert Lorsbach, M.D., Ph.D., director of hematopathology, four additional world-renowned experts representing some of the country’s most respected cancer centers also were invited to speak at this year’s event.

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“It’s extremely significant that other experts are able to come and share research and innovations and bring some perspective from outside of Arkansas to the table,” Lorsbach said. “This has grown into a very valuable tool for clinical workers in Arkansas who deal with these disorders on a daily basis.”

Up on the Mantle

Exploring a different topic each year of the symposium, Maddox this year lectured on a rare form of lymphoma that makes up just 6 percent of all non-Hodgkin lymphomas.

Mantle cell lymphoma (MCL) is found in only about 3,500 new patients each year, according to the Leukemia & Lymphoma Society. It occurs mostly in older adults, with the average age of diagnosis in the mid-60s.

“Mantle cell lymphoma has a very poor prognosis, but there have been some advancements in treatment recently,” Maddox said. “It’s extremely important to identify and diagnose prognostic factors to help treat this disease.”

Currently, MCL is treated like other B-cell lymphomas with multi-drug therapies, often with as many as five different combined agents and sometimes including stem-cell transplants.

Maddox said there are several ongoing clinical studies right now focusing on these new treatments.

Support Network Anaissie was recruited to the world-renowned UAMS Myeloma Institute for Research and Therapy in 1996 because of his expertise in managing health complications associated with the treatment of cancer.

Anaissie created one of the bedrocks of the Myeloma Institute: the Supportive Care Program. Its eight physicians, called hospitalists, and 10 specially trained advanced practice nurses (APNs) provide the intensive care that patients need throughout their monthslong treatments by UAMS’ myeloma specialists, who are led by Bart Barlogie, M.D., Ph.D., director of the Myeloma Institute.

There are several ongoing clinical studies right now focusing on these new treatments.

Anaissie’s clinical and research interest is in infections and other complications that affect immunosuppressed patients. He and his team have found several innovations that allow them to deliver more patient-specific supportive care.

At this year’s symposium, Anaissie presented “Treatment of Infections in Immunocompromised Hosts,” which explained specific complications and infections and the means Looking Beyond Cancer’s Limits

his team has developed to predict those patients who are most at risk for developing them.

“The unique Supportive Care Program allows myeloma patients to be treated as outpatients by providing them 24-hour access to our team,” Anaissie said. “We have as many as 200 patients receiving treatment at any given time, and we are there to help them through the many physical and emotional complications related to their disease and treatment.”

Says WHO

Lorsbach’s expertise lies in pediatric and adult hematopathology, which is the branch of pathology dealing with diseases of the blood.

His research interests are in

the clinical and translational characterization of leukemias and lymphomas.

Lorsbach’s lecture at this year’s symposium focused on the World Health Organization’s new classifications of acute leukemias.

If left untreated, acute leukemia typically results in patient mortality in as little as days to weeks. So it’s paramount to have a precise and reproducible classification of acute leukemias in order for clinicians to make an accurate diagnosis.

“The two most commonly used classifications are the more traditional French-AmericanBritish (FAB) system and the more modern World Health Organization (WHO) system,”

Lorsbach said. “The WHO system was introduced in 2001 with a newer version introduced in 2008.”

The FAB system, Lorsbach said, was comprehensive but provided little prognostic impact, while the 2001 WHO system built on that foundation.

The 2008 WHO system provides further refinement and has a more extensive reliance on molecular abnormalities and cytogenetic, or the branch of biology that deals with heredity and cellular components.

“In order for the full implementation of the 2008 system, we will need to include greater molecular testing,” Lorsbach said.

Expert Opinions Four guest speakers were invited to lecture on their areas of expertise at the 2009 Symposium on Lymphoma and Leukemia.

H. Joachim Deeg, M.D.

Professor of medicine Fred Hutchinson Cancer Research Center University of Washington School of Medicine

“Myelodysplasia: Progress and Treatment”

Julie Vose, M.D.

Chief, Section of Hematology/Oncology University of Nebraska Medical Center

“T-Cell Lymphoma” Marcos de Lima, M.D.

Jorge E. Cortes, M.D.

Associate professor, Department of Stem Cell Transplantation and Cellular Therapy M.D. Anderson Cancer Center University of Texas

“Treatment and Monitoring of CML”

“Innovations in Bone Marrow Transplantation”

Deputy chairman, Department of Leukemia M.D. Anderson Cancer Center University of Texas

Winthrop P. Rockefeller Cancer Institute

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Clinic

Expansion William Greenfield, M.D.

Award-winning Research

A UAMS research project concerning immune responses to human papillomavirus (HPV) was recently awarded first place at the American College of Obstetricians and Gynecologists Annual Clinical Meeting.

William Greenfield, M.D., assistant professor in the UAMS Department of Obstetrics and Gynecology, received the award for research conducted in collaboration with Mayumi Nakagawa, M.D., Ph.D., associate professor of pathology.

While the immune system of most women can suppress or eliminate HPV on its own, the virus persists in other women, potentially leading to cervical cancer.

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The research was conducted from January 2007-July 2008 and included 65 patients in the final analysis. Study participants were women who had previously received an abnormal Pap smear result and were at UAMS for a follow-up exam.

Their findings concluded that the patients who showed improvement in their follow-up Pap smear also had a significant immune response to the E6 protein of HPV16. These findings provide the possibility that the E6 protein may be an effective area to target a therapeutic vaccine, as opposed to the preventive vaccine Gardasil that targets young women before they are exposed to HPV.

The Head and Neck

Oncology Clinic recently expanded its staff with the addition of Mauricio Moreno, M.D. Moreno’s clinical interests include head and neck surgery, thyroid and parathyroid surgery, head and neck microvascular reconstruction, and vascular anomalies. His research interests are functional rehabilitation after major reconstruction and alternative treatments for recurrent thyroid cancer.

Moreno comes to UAMS from the University of Texas M.D. Anderson Cancer Center in Houston where he completed fellowships in head and neck surgical oncology and microvascular reconstructive surgery, followed by a fellowship in head and neck surgical endocrinology.

Looking Beyond Cancer’s Limits

Celebrating

Survivors

caBIG Achievement

Accepting the award for UAMS where (left to right) Gail Douglas; Laura Hutchins, M.D.; Cheryl Lane; and Umit Topaloglu, Ph.D.

The Winthrop P. Rockefeller Cancer Institute was

recognized as a world leader in the development and use of caBIG technologies at the caBIG Annual Meeting July 20-22 in Washington, D.C.

Developed by the National Cancer Institute

(NCI) of the National Institutes of Health, caBIG (Cancer Biomedical Informatics Grid) is a network connecting cancer and biomedical researchers.

For the seventh year, survivors of ovarian and other gynecological cancers were celebrated during a day-long retreat Sept. 26 at the Winthrop P. Rockefeller Cancer Institute.

Shout About the Disease that Whispers promotes complementary and conventional approaches in the care of women with gynecological cancers. The retreat is hosted by the Just Among Women support group.

Alexander Burnett, M.D., director of the UAMS Division of Gynecologic Oncology, presented the keynote address, and certified genetic counselor Jill Kelsay offered the lunch presentation.

Participants also took part in breakout groups promoting wellness and healing.

As one of only seven cancer centers

honored at the meeting, the Cancer Institute received the NCI’s Delivering Results Award designated for a project that addresses specific research questions using caBIG applications, caGrid and data available for sharing.

In addition to the award, the UAMS contingent

presented a 90-minute presentation on their successful deployment of multiple caBIG tools for clinical research, and Laura Hutchins, M.D., director of the Division of Hematology/Oncology, participated in a teleconference to researchers and IT professionals in India.

Winthrop P. Rockefeller Cancer Institute

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Elbow Cancer

Institute

pharmacy

gets needeD space and room to grow.

Pharmacists Michael Parr and Randy Towell (with a little help from some “friends�) examine the new pharmacy area under construction in the Cancer Institute expansion.

By Jon Parham

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The pharmacy that serves the Cancer Institute is usually a hive of activity.

Staffed with five or six pharmacists and technicians, the 1,500-square-foot space is crammed with medication preparation areas. There’s a clean area for medications that require special precautions and an area for handling new drugs being studied.

Add to that an area for order entry and pick-up, a storage room and an office/ break room to make for very close quarters.

Fortunately, all that is about to change.

When the Cancer Institute’s new tower is completed in 2010, the new pharmacy will be one of the first areas to open.

“The difference will be like night and day. It is unbelievable,” said assistant pharmacy director Randy Towell, Pharm.D.

The existing pharmacy will fit almost four times over into the future 5,400-squarefoot pharmacy now under construction on the fifth floor of the Cancer Institute expansion.

Additional space — both to accommodate the pharmacy that has outgrown its current home and to allow for future growth — is the most noticeable improvement in the new facility.

But it’s not the only upgrade.

“There are a number of innovative features in the new pharmacy that will better allow us to serve our patients, physicians and researchers,” said Michael Parr, Pharm.D., UAMS pharmacy director.

The new pharmacy incorporates the latest thinking and technology for preparing medications for patients, delivering them and even handling the drugs being used in cancer research or clinical trials. With the added space, it ensures the pharmacy will follow the newest regulations for safely handling hazardous medications, which in the future could include live viruses.

Moving Up

Currently, the pharmacy is located near the infusion rooms where cancer patients receive their chemotherapy treatments. Pharmacists “spike” or attach an IV line to about 150 chemotherapy bags each day, Parr said.

That number has grown in recent years, as have other measures of the pharmacy’s workload. Parr estimated averages of 10,000 orders processed and 9,500 IV bags prepared monthly.

In the Cancer Institute expansion, a larger infusion section will be on the fourth

floor, just below the pharmacy.

Other treatment and research areas will be spread throughout the facility.

While a courier or tube system is used to deliver medication orders now, that will not work for IV bags. There are not enough couriers for the workload and the spiked IV bags could easily leak if jostled by the pneumatic tube system, similar to those used at a bank’s drive-thru.

“If an IV bag leaked in a tube, you would have to disinfect the entire system,” Parr said. “So we’re installing a small elevator or dumbwaiter to transport IVs and other medications that cannot be placed in the tube system.”

A small satellite pharmacy will be on the infusion floor near the dumbwaiter and tube system. Medications and other orders submitted to the pharmacy can be received there.

Keeping it Clean

Additional space will accommodate more of the isolation hoods that restrict air flow and allow pharmacists to prepare IVs in a clean, sterile environment. There will be eight IV hoods when the new pharmacy opens with room to add another four in the future.

The additional hoods will

Elbow

speed up the response time when compared to the current pharmacy with its three hoods.

The hoods in the new area are divided across separate clean rooms for chemotherapy (with four hoods) and nonchemotherapy (two hoods).

Each clean room will include an ante room to disinfect supplies prior to taking them into the clean rooms. Each also will have a dressing room where pharmacy staff can don necessary protective clothing.

Two smaller clean rooms with one hood in each will be available for use with viral medications, which involve using live viruses as delivery methods for cancer-fighting agents. No current drugs involve viruses, but research continues on such medications and these rooms could host further research of drugs in clinical trials.

Towell noted that not all of the new pharmacy space will be used initially. It will be needed, however. The pharmacy was designed to reach operational capacity in 10 years, allowing it space to grow as patient volume and workload increases.

Since other areas in the Cancer Institute are ahead of projected growth, having the room to grow is a blessing, he said.

The Cancer Institute’s new tower is the primarily glass building seen here in the center of the UAMS campus.

Research Considerations Currently, the administration of new drugs involved in research or clinical trials is handled in a shared space in the pharmacy.

In the new pharmacy, investigational drug administration will have its own office. There all of the records on drugs that could one day become new cancer treatments will be maintained.

Finally, the pharmacy will offer pharmacists and technicians a work environment unlike anything they know now. For starters, the order entry room at the entrance to the pharmacy has a floor to ceiling window. Having a window at all is a rarity in a pharmacy, Parr said.

Keeping with the overall design’s focus on natural lighting, the pharmacy offices also have windows. A staff break room features a small balcony with a great view of downtown Little Rock.

‘In the Dry’

By the end of the year, the Cancer Institute expansion will be “in the dry,” which in construction parlance means the facility will be completely enclosed.

This also means the heating and air system will be online.

Many of the surfaces, such as granite pieces that adorn the elevator lobbies and wood countertops are being installed throughout the building, though many are covered for protection until construction is complete.

Preparations are being made for “cut-throughs” to join the new building with the existing Cancer Institute.

Those will be made sometime after the building is enclosed.

Dwyer Drive, which winds around the Cancer Institute, has been reworked during construction. It serves as the entry point for supplies and equipment headed to the loading docks for both the Cancer Institute and UAMS Medical Center.

As it passes by the fourth floor of the Cancer Institute expansion, a driveway was included to accommodate ambulances. This allows any medical emergencies that may arise in the infusion area to quickly be taken to the UAMS Medical Center emergency room.

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A new UAMS specialist discovers rewards in treating the deadliest cancer.

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Konstantinos Arnaoutakis, M.D., is part of the new lung cancer team.

Looking Beyond Cancer’s Limits

Meeting the

Challenge

By David Robinson

His first-time patients are usually terrified, said Konstantinos Arnaoutakis, M.D.

Having been diagnosed with lung cancer, they’ve read or heard enough to believe they’ve just received a death sentence.

That’s possible, given lung cancer’s 85 percent five-year overall mortality rate, but Arnaoutakis, a hematologist/oncologist who specializes in lung There is a and upper digestive tract cancers, says his new need and a patients usually don’t challenge here have all the information they need. They often in Arkansas, know, for example, but also hope.” don’t about the promising new drugs that can help them live longer and improve their quality of life — and possibly cure them.

“There is a future and a hope in the moleculartargeted drugs that we already have,” he said. “The other exciting thing is that research in lung cancer is slowly catching up with breast cancer in terms of individualized and personalized oncology.”

As a member of UAMS’ new team of lung cancer specialists, Arnaoutakis joins Matthew Steliga, M.D., a thoracic surgeon with a focus on lung and esophageal cancer who recently joined UAMS, and Klaus Hollmig, M.D., another hematologist/oncologist dedicated to treating lung cancer patients. The team is led by Thaddeus Bartter, M.D., who joined UAMS earlier this year and specializes in locating and diagnosing lung cancer using minimally invasive approaches.

Before joining UAMS, Arnaoutakis was chief hematology and medical oncology fellow at St. Elizabeth’s Medical Center in Boston, a teaching affiliate of Tufts University School of Medicine.

The UAMS group is the most comprehensive

“

Winthrop P. Rockefeller Cancer Institute

lung cancer team in Arkansas, which has among the nation’s highest lung cancer death rates.

“There is a need and a challenge here in Arkansas, but also hope,” Arnaoutakis said.

With its new team in place, UAMS will increase its participation in national clinical drug trials and beef up its own lung cancer research.

“It’s very important for Arkansans to be able to stay in the state for their cancer treatment,” he said. “It has huge psychological implications when they can stay close to their family while receiving treatment.”

The promise of new and better treatments is tempered by the reality that an estimated 2,160 Arkansans will die of lung cancer this year, according to the American Cancer Society.

Only about 15-25 percent of non-small cell lung cancer is caught early enough to be surgically removed, and only 50-70 percent of those patients will be alive five years later.

Arnaoutakis said he doesn’t let such daunting statistics quell his constructive, positive approach.

Once I started working in the field, I realized very quickly that this was something that I really enjoyed because I focus on the positive things I can do for patients,” he said. “And for patients that I cannot cure, I feel that treatment helps them in terms of quality of life.”

Arnaoutakis also is prepared when his patients don’t do well.

“As a physician, it’s a huge privilege to help patients through the difficult process of coping with a terminal illness,” he said.

“It’s not easy, but Arnaoutakis’ research is focused on novel targeted therapies it’s something for non-small cell lung cancer, that I feel is an important service which is less aggressive than small cell lung cancer. to people.”

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It Takes a

Village Everything happens for a reason; it’s what you do as a result that counts.

That’s the mantra Ken and Claire MacNeill of Hot Springs Village adopted after experiencing one of life’s most difficult challenges. And the UAMS Winthrop P. Rockefeller Cancer Institute and its patients are benefiting from the couple’s positive attitude.

“The ability to take a tragic situation and find a way to apply that toward helping someone else can be very therapeutic,” said Claire MacNeill, a 30-year nursing veteran who retired along with her husband, Ken, to Hot Springs Village from Rhode Island in 2002.

“Our daughter’s battle with breast cancer has been a motivating factor to give back, and it feels good to do it.”

Texas Turnaround

In 2004, Claire got a phone call from her daughter, Kerrie, who lived in the Dallas area and had just celebrated her 44th birthday.

“She said, ‘Mom, I have a lump,’” Claire said.

“I told her to get to the doctor right away. That’s the last thing you want to hear when you get a call from your daughter.”

She was diagnosed with breast cancer and underwent a lumpectomy, the results of which were not good. The results of the biopsy indicated the cancer had spread to several lymph nodes and a full mastectomy was soon ordered.

“She was very upset at having to deal with this while being the single mother of two teenagers and a 6 year old,” said Claire, who 22

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Village Walk courtesy of Bill Hammond

By Nate Hinkel

along with Ken spent time in Texas taking care of the children. “She underwent chemo and radiation and just tried to keep marching on.”

Sadly, Kerrie died within nine months of her diagnosis.

Organizing a Village

In the aftermath, the MacNeills couldn’t shake the feeling that they still had something to give.

Shortly after returning from Texas, the couple walked in the Village Walk for Cancer Research benefiting the Cancer Institute and decided they Looking Beyond Cancer’s Limits

Ken and Claire MacNeill turned their tragic loss into new hope for cancer patients.

wanted to support the event in memory of Kerrie.

They organized a scaled-back trail walk in 2005 and had about 80 people participate.

“In 2006 we got the walk going strong again with sponsors, T-shirts and all that,” she said. “We had about 280 walkers and about 25 sponsors.”

Ken MacNeill also has played a big part in keeping the walk going.

“It’s been a pleasure helping out, and it’s great to see people pitching in for a great cause,” said Ken, who has served as finance director, sponsor and prizes scout, and chairman of the volunteer committee.

Winthrop P. Rockefeller Cancer Institute

In 2007, the walk grew to about 400 participants and raised nearly $25,000. In 2008, they added live music and raised close to $27,000.

The 2009 event took place Sept. 17, raising another $25,000 for research programs at the Cancer Institute. Claire acted as the advisor to a new organizing committee this year and hopefully, she says, her passion for the event was contagious.

“They’ll proceed into the future on their own now and carry on with the increased success of the event,” she said.

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Gala for Life Who: About 750 Cancer Institute supporters, including Cheryl and Elvin Shuffield, co-chairmen What: 14th Annual Gala for Life

When: Sept. 11, 2009 Where: Statehouse Convention Center in Little Rock Why: The Gala for Life is

the Cancer Institute’s premier fundraising event .The event brought in about $800,000, and proceeds are used for building and operations.

This year’s Gala included presentation of the Pat and Willard Walker Tribute award to Josephine Raye and Doyle Rogers of Batesville. Musical entertainment was provided by Diamond Rio.

Trip Strauss (seated) and Scott Copas

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UAMS Chancellor Dan Rahn, M.D., (second from left) with Doyle and Josephine Raye Rogers and their son Doyle “Rog” Rogers Jr.

Cancer Institute Director Peter Emanuel, M.D.; Carla Emanuel; Steffany Shelton; and Ken Shelton

Linus Raines, Steve Stephens, Lisenne Rockefeller and Brenda Fulkerson

Looking Beyond Cancer’s Limits

spotlight

Diana Smithson and Hillis Schield

Diamond Rio

Gala for Life co-chairmen Elvin and Cheryl Shuffield

Jo Ellen Ford; UAMS Chancellor Dan Rahn, M.D.; Pat Walker

Susan and Herren Hickingbotham with Diamond Rio drummer Brian Prout (center)

Debbie Walker and Craig O’Neill

Winthrop P. Rockefeller Cancer Institute

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Partners Card Kick-Off Who: Cancer Institute Auxiliary members and Partners Card committee members, including chairman Betty Landrum What: Partners Card kick-off When: Sept. 3, 2009 Where: Ferneau restaurant Why: One of the Cancer

Institute Auxiliary’s largest fundraisers, Partners Card offers shoppers the chance to purchase a $50 card and in turn receive a 20 percent discount at almost 200 shops in central and northwest Arkansas. All proceeds from the sale of the cards goes to the auxiliary to fund projects that directly benefit cancer patients.

Partners Card chairman Betty Landrum with Wally Landrum

Elizabeth Jackson and Katharine Adams

Cindy Murphy, Shayla Copas and Carla Emanuel

Lynda Allen and Kenan Keyes

The crowd gathers for a few words from chairman Betty Landrum

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Looking Beyond Cancer’s Limits

spotlight

RockStar Lounge Who: Fans of rock ’n roll music and the Cancer Institute, along with chairman Angela Moody What: RockStar Lounge When: Oct. 1, 2009 Where: Clinton Presidential

Center

Why: Guests were invited to party like rock stars at this first-ever event benefiting the Cancer Institute. Entertainment included live music by the Hollywood Stones, a Rolling Stones tribute band for Los Angeles, and a Rock Band game contest.

Debbie Kyle, Rex Kyle, Greg Hopkins and Angie Hopkins

Rick Fleetwood, Angela Moody and Gary Davis

Jonnie Westbrook, Win Rockefeller, Jr. and Kent Westbrook, M.D.

Marty Gunaca, Ed Moody, Sue Gunaca and Melissa Moody

Winthrop P. Rockefeller Cancer Institute

For more event photos, check out www.cancer. uams.edu/seek. Look for Spotlight article.

Lauren Bridges, Erin Homyer, Vicki Vowell and Angela Thomas

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NONPROFIT ORGANIZATION U.S. POSTAGE

WINTHROP P. ROCKEFELLER CANCER INSTITUTE

PAID

LITTLE ROCK, AR PERMIT NO. 1973

4301 W. Markham St., #623 Little Rock, AR 72205

Health Notes:

Breast Cancer

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