Seek Winter 2008

Taking the Team Approach SURVIVOR’S STORY

THE VALUE OF SECOND OPINIONS

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ie m e r p

e u s is

contents WINTER 2008

features Team Spirit

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The team treatment concept offers advantages for patients and health care providers.

POWERED BY THE SUEN

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4

Some sisterly advice led James Y. Suen, M.D., to a career in medicine.

Lessons Learned

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Volunteer Beth Jackson helped shape the Cancer Institute Auxiliary.

From the Heart

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A young girl makes a heartfelt gesture in memory of her mom.

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On the Case

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John Shaughnessy, Ph.D., shares what it means to be a molecular detective.

in every issue From the Director. . . . . . . . . . . . . . . . . . . . . 3

Welcome to Seek Expansion . . . . . . . . . . . . . . . . . . . . . . . . . . 10

The Cancer Institute expansion includes many patient-friendly features.

Profile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Herman Davenport tells his story of winning the .

battle with prostate cancer.

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

$2 million trust Melanoma study Colon cancer

screening Women’s retreat Support groups

20 “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

Spotlight . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

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FFANY Shoes on Sale Groundbreaking ceremony Gala for Life

On the cover: Herman Davenport is a prostate cancer survivor.

Photo by Johnpaul Jones Looking Beyond Cancer’s Limits

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Editor Susan Van Dusen Art Director Laurie Shell Managing Editor Liz Caldwell

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Writers Liz Caldwell, Jon Parham, David Robinson, Susan Van Dusen Creative Director Keith Runkle Photographer Johnpaul Jones Production Manager Angi McDaniel Database Manager Kelly Pollnow Executive Director Winthrop P. Rockefeller Cancer Institute Peter D. Emanuel, M.D. Chancellor University of Arkansas for Medical Sciences I. Dodd Wilson, M.D. Vice Chancellor of Communications & Marketing Pat Torvestad Associate Vice Chancellor of Communications & Marketing Leslie Taylor 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’s letter

Welcome to Seek!

There are many changes afoot with regard to cancer on the UAMS campus. On Sept. 28, 2007, we broke ground on a 300,000square-foot addition to the Cancer Institute. The new tower will be roughly twice the size of our current space, allowing for increased and improved patient care areas as well as vitally needed new research space.

Also on that day, we changed our name from the Arkansas Cancer Research Center to the Winthrop P. Rockefeller Cancer Institute.

A newspaper article following those events proclaimed a “New Day in the Fight Against Cancer.” Truly, we feel like we are in the midst of new beginnings in our assault on cancer here at UAMS.

At the same time, we are kicking off a new means of sharing information at the Cancer Institute. Seek will be a quarterly publication that replaces our foundation newsletter, but in a much expanded way.

We chose the title Seek because it portrays our mission — to seek out ways that will one day enable us to live in a world without cancer.

The magazine will have a variety of stories to tell about physicians, patients, family members, volunteers, fundraising events, support groups and everything in between. We will inform you about foundation and auxiliary events, as well as research successes happening here at the Cancer Institute.

In addition to pictures from many different events, we also will include pictures of our building process as the new tower to the Cancer Institute is constructed during the next two years. And just as the Cancer Institute is growing and evolving, so too will the magazine evolve. We welcome your comments and suggestions as Seek grows and matures.

It is a new day in our fight against cancer, and with your help we are firmly convicted and determined to succeed.

Peter D. Emanuel, M.D. Executive Director, Winthrop P. Rockefeller Cancer Institute

Winthrop P. Rockefeller Cancer Institute

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Team Spirit By susan van dusen

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Looking Beyond Cancer’s Limits

T A Cancer Diagnosis Can Turn Your Life Upside Down.

It Helps to Have a Team of Professionals Backing You Up.

Think back to life 20 years ago — George H.W. Bush is elected, “Murphy Brown” premiers and Pan Am Flight 103 explodes. Seems like a long time ago. Especially when you consider the impact the past two decades have had on cancer care in America.

“The typical one doctor, one nurse that you had 20 years ago has evolved into much more of a team concept,” said Peter Emanuel, M.D., executive director of the Winthrop P. Rockefeller Cancer Institute at the University of Arkansas for Medical Sciences (UAMS).

The team to which Emanuel refers is one of the latest developments in cancer care aimed at providing the most individualized and advanced treatment for every patient. The approach is already in practice at the Cancer Institute, where the Breast Team serves as a model just waiting to be replicated in many other areas.

“With the melding together of minds, we are seeing different approaches to different things,” Emanuel said. “It’s so different than the system we’ve been using for decades; I don’t think we fully recognize the total impact of it yet.”

A Personal Perspective If anyone understands the impact of team treatment, it’s Alice Beard. A 22-year employee of the Cancer Institute, Beard was diagnosed with breast cancer in April 2006. She immediately became a patient of not only one doctor, but of the entire Breast Team. “All of these wonderful people are in place, so you really just have to be guided along,” Beard said. The team is led by V. Suzanne Klimberg, M.D., director of the UAMS Breast Cancer Program.

The journey for Beard began with a digital mammogram at the UAMS Breast Center confirming her suspicions about the lump she had already discovered. Robert Fincher, M.D., medical director of breast imaging, performed her biopsy, and pathologist Soheila Korourian, M.D., examined the results.

The Breast Team

Breast cancer survivor Alice Beard understands the value of team treatment.

Winthrop P. Rockefeller Cancer Institute

serves as a model just waiting to be replicated in many other areas.

From there, the Breast Team consulted on Beard’s case and determined that due to the large size of her tumor, she should undergo chemotherapy prior to surgery. The team meets every Wednesday to discuss and make recommendations on patients’ specific needs.

Beard’s medical oncologist, Issam Makhoul, M.D., was a major proponent of shrinking the tumor before operating, said Beard, who underwent chemo from April through October. u seek

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Karen M

ack, R.N .

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Westbrook, M.D., on Nov. 2, 2006.

Today she is cancer free, back at work and enjoying time with her grandchildren.

“I don’t know how to thank my , M.D. cher r care team,” she said. “Cancer is a long n i F t o r Robe dical Direct experience. You’d better just get ready to give a year out of your life. It provides such a peace of mind to have a whole care team supporting you.”

In the Works Because of the Breast Team’s success, Emanuel plans to use it as a model for other cancers treated at the institute. In fact, the building expansion scheduled to open in 2010 is specifically designed with team treatment in mind.

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“One floor of the new building is designed for what we call multidisciplinary clinics. On some days it can be used for clinics with a large patient volume, such as the breast clinic, and on other days it can be converted into separate, smaller clinics,” Emanuel said.

The idea behind the multidisciplinary clinic lies in the fact that the patient can be seen by Looking Beyond Cancer’s Limits

Reaching Out

Not only do patients at the Winthrop P. Rockefeller Cancer Institute benefit from the expertise of its health care professionals, but so do others throughout the state.

Through the use of video conferencing, physicians across Arkansas can interact with members of the institute’s Breast Team during its weekly meetings. The team members work together to offer comprehensive care to every breast cancer patient and include everyone from surgeons and radiologists to pathologists and medical oncologists.

“Physicians who refer patients here can participate in interactive conferences about their treatment, or they can use us as a second opinion panel for patients in their community,” said Maureen Smith, breast clinical research coordinator and a member of the Breast Team. several health care providers in one location without having to travel across the UAMS campus. The health care providers also can confer and exchange ideas more readily.

Maureen Smith, a nurse and breast clinical research coordinator, believes it’s an idea whose time has come. “The more D. we can do to M.

k,

consolidate and expedite care, the more everyone will benefit,” she said.

Smith is part of the Breast Team, which includes surgeons, radiologists, pathologists, medical and radiation oncologists, researchers, scientists, engineers and breast surgery oncology fellows. Social workers and doctorate-level psychologists are brought in as needed.

“The team concept is good, especially at a teaching institution like UAMS,” Smith said. “We have a lot of interaction and flexibility among the staff, and everyone has a level of cross training. Those are great benefits to the patients who put their trust in us to help restore their health.” . , M.D g r e limb ne K n a z V. Su l:

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Two events sealed James Y. Suen’s future: an auto accident and a conversation with his sister.

The renowned surgeon and one of the forces behind the Winthrop P. Rockefeller Cancer Institute’s expansion said his path into medicine was as much about happenstance as anything.

encouraged him to consider a medical career.

“She said, ‘If you were a doctor, you could help people,”’ Suen said. “I told her I was too nervous and not smart enough, but she convinced me I could make it.”

After becoming a surgeon with a specialty in head and

Powered by the

Changing Course

As a second-year math major at the University of Texas, Suen (pronounced Sun) was nervous and uncertain.

He decided that a math degree wasn’t in his future, and a medical degree wasn’t on his radar, either.

Not long after deciding to change his major, Suen happened upon a one-car accident. Worried that the smoldering vehicle was about to explode, he pulled three unconscious people to safety and applied pressure to their bleeding wounds. Although he had done the right thing, he felt like anything but a hero.

“That event scared me so much, I was just shaking,” Suen said. “I wished I could have been more calm and more helpful.

I began to think about how I could help people.”

At home in Arkansas a few weeks later, he confided in his sister, a nurse, who 8

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full-time again after stepping down last year as director of the Cancer Institute.

A Distinguished Career

In a career filled with honors, Suen said the 1996 creation of the $1 million James Y. Suen, M.D., Chair in OtolaryngologyHead and Neck Surgery was the

Suen

neck cancers, Suen provided the foundation for UAMS’ Department of Otolaryngology – Head and Neck Surgery and has served continuously as its chairman for 33 years.

His memories of those first years are rich.

Suen was the only otolaryngology staff member, and his office was a converted restroom in the clinic area. His secretary — Mrs. Moon — was his only employee. He still chuckles when he mentions the juxtaposition of their names and recalls the dreary conditions of his former clinic at the old State Hospital Infirmary.

As the only surgeon in his specialty, Suen saw patients at UAMS, Arkansas Children’s Hospital and the Veteran’s Administration Hospital, working 16-hour-plus days.

The department today has 12 clinical staff, plus five doctorate-level researchers, and Suen, who is seeing patients

by David Robinson

most rewarding for him and his department.

The endowment’s major benefactor was John A. Phillips of Rogers, a patient and friend of Suen’s. The balance came from other friends, colleagues and patients.

Suen served six years as the Cancer Institute’s director, and he counts his work on its expansion as one of his most gratifying experiences.

“There is such a big need for the expansion, and I had been pushing for it for a long time,” said Suen. “The new Cancer Institute will provide everything we need to take care of patients in the best possible way.”

At 67, Suen remains passionate about helping people through surgery, research and teaching.

“I feel like I’m in the prime of my In his spare time, life,” he said.

Suen is an amateur magician.

Etc.

Looking Beyond Cancer’s Limits

As a Young Man, James Suen Didn’t Think He was Cut Out for Medicine. Thousands of Cancer Patients are Thankful He was Wrong.

Winthrop P. Rockefeller Cancer Institute

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It Takes a

Village

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Planning the 300,000square-foot addition to the Winthrop P. Rockefeller Cancer Institute involved more than architects and doctors.

While faculty and staff worked closely with architects since 2005 to design the 12-floor addition, the planners also reached out to patients and family members. They wanted to ensure a facility that was welcoming, efficient and comfortable for the tens of thousands of patients walking through its doors every year.

The Cancer Institute enlisted Cromwell Architects Engineers of Little Rock and FKP Architects, a nationally recognized architectural firm whose portfolio includes work at M.D. Anderson Cancer Center in Houston. Years of planning have gone into every room and every floor of the building set to open in 2010.

A Healthy Environment

Planners looked to improve efficiency at the same time as providing more space.

On clinic floors, several services will be consolidated. In many cases, patients will stay in one place while doctors and staff come visit them — rather than the other way around.

“If our patients can have a smooth, positive experience in 10

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An artist’s rendering of the new Cancer Institute lobby.

to Design a Cancer Institute Expansion

by JON Parham

a clean environment, they will associate it with safety, which will help with their healing process,” said Brian Dinsmore, the Cancer Institute’s clinical operations director.

The design of the rooms will promote collaboration among the patient’s care team, making it easier for consultations, Dinsmore said.

The planners looked for ways to support the families, too.

The first floor will include a lobby with a two-story ceiling, housing a large waiting area and services such as a food court (featuring healthy foods), gift shop, relaxation room and business center with high-speed Internet and fax access.

Patient-focused Care

The unique plan and design was developed in direct response to the needs of the UAMS patients, said Diane Osan, a principal architect with FKP. For example, in some other cancer centers where FKP has worked, facility planners called for private chemotherapy infusion rooms.

That wasn’t the case at the Cancer Institute.

“As we worked with the families and nurses in Arkansas, we found that they valued socialization in this intense environment — even during infusion — because it allowed

patients to bond and share with other patients,” Osan said.

That input led to lower partitions and other design elements letting patients and family members have different levels of privacy, including the ability to visit with other people during treatment.

The infusion chairs will have access to natural light, increasing the comfort level for patients.

Looking Beyond Cancer’s Limits

Years of planning have gone into every room and every floor.

A healing garden will further improve the patient experience.

The environmentally friendly design of architect Hrand Duvalian of Cromwell Architects Engineers of Little Rock also promotes energy efficiency. The windows are designed to block heat gain in the building from solar radiation while letting in as much light as possible.

Winthrop P. Rockefeller Cancer Institute

Sensors on light fixtures will allow “daylight harvesting” as they automatically adjust lighting levels to maximize use of sunlight, saving money on utility costs while making the facility more comfortable.

“UAMS is showing true leadership and forward thinking in health care planning by providing healthy food choices for guests; by

Etc.

offering amenities like a healing garden and lots of natural light; and by pursuing Patient visits certification as a increased by ‘green’building that 45,000 during the is environmentally past seven years. responsible, energy efficient and a healthy place to work,” Osan said.

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Changing Lanes

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Many Arkansans will recall the havoc wreaked by the icy winter of 2000. Herman Davenport of Little Rock could deal with the power outages and slippery streets, but when the second storm of the season delayed the results of his prostate cancer biopsy, he struggled to keep his cool.

“I will never forget it,” Davenport said. “We were blanketed with ice and snow, and I had to wait several weeks. That was agonizing.”

Davenport, now 60, had decided in 1996 to get an annual prostate exam, primarily because he noticed that his wife, Bobette, was diligent about her own preventive health care, and he felt he owed it to her to do the same.

His PSA (prostate-specific antigen) score rose each year. In 2000, his doctor referred him to a local urologist, who performed a biopsy, and after Davenport’s excruciating wait, told him he had prostate cancer.

That wasn’t the end of the bad news.

Davenport and his wife met with his urologist who told them that the removal of his prostate would likely save his life, but the side effects would be severe. Davenport could expect to be incontinent and impotent, and he could become paralyzed in his left leg, he was told.

“It was really a heavy session; we were just trying to absorb the weight of his words,” Davenport said.

He went back for a second visit, and the urologist was emphatic. “He said, ‘You will have these side effects. We are concerned about saving your life, and we don’t do surgeries that minimize these side effects.’”

The urologist also encouraged him to seek a second opinion, which led Davenport to Graham Greene, M.D., a fellowship-trained surgeon who came to the UAMS Winthrop P. Rockefeller Cancer Institute in 1997 and established a urologic oncology section.

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“The diagnosis didn’t change, but the differences in the two consultations were amazing to me,” Davenport said. “Dr. Greene said there are no guarantees; he was clear about that. But what I got was optimism and hope. That meant a lot to me.”

Like the first urologist, Greene recommended a radical prostatectomy. He also assured Davenport and his wife that, given Davenport’s age, good health and early detection, the condition was treatable.

And, while he could expect some incontinence and impotence, the conditions would be temporary, said Greene, who has developed nerve-sparing surgical techniques at UAMS related to sexual function.

“What I got was optimism and hope. That meant a lot to me.”

“Dr. Greene was right in terms of side effects,” Davenport said. He had surgery on April 4, 2001, and rebounded quickly, so much so that he was able to help his daughter move to Little Rock from Emory University in Atlanta the following month.

The predicted incontinence was gone in three or four months, and the sexual side effects were nearly gone in about two months, Davenport said.

Today, Davenport, a former Levi Strauss executive, enjoys traveling with his wife and running his community development consulting business.

There’s no need for additional treatment, although he does have regular checkups at UAMS.

“Life is pretty much back to normal,” he said.

Looking Beyond Cancer’s Limits

profile

A Second Opinion Turns This Cancer Survivor’s Dire Diagnosis Into Renewed Hope

Winthrop P. Rockefeller Cancer Institute

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MedicineBag C A N C ER I N S T I T U T E N E W S

Melanoma Advancements Laura Hutchins, M.D., is one of the investigators leading a study of Allovectin-7, an investigational product for advanced melanoma. Hutchins is a professor, director William R. “Bill” and the late Cacilia Howard

of the UAMS Division of Hematology/Oncology and director of clinical research for the Cancer Institute.

A Lasting Legacy William R. “Bill” and Cacilia

If Allovectin-7 is found to be safe

Howard of El Dorado established a $2 million

and effective in clinical trials, it may offer

charitable remainder trust to benefit the UAMS

patients a new option for fighting advanced

Winthrop P. Rockefeller Cancer Institute. The trust is designated for breast cancer research.

melanoma. The ongoing study is designed

to determine whether more patients with

many other families,” Bill Howard said. “We hope

advanced melanoma respond favorably to Allovectin-7 alone than to standard chemotherapy.

Melanoma is more likely to occur in those having fair skin, a large number of moles, a history of sun tanning or sunburns, or close

“Cancer has touched our family, as it has so

that this gift will assist the scientists who work each day to find better treatments and hopefully someday a cure for breast cancer.”

The trust will benefit research conducted

by the team of scientists led by V. Suzanne Klimberg, M.D., chief of the Division of Breast Surgical Oncology at UAMS and director of the Breast Cancer Program at the Cancer Institute.

relatives with the disease.

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Looking Beyond Cancer’s Limits

Supporting Network

with gynecological cancers. The retreat is hosted

Women who have been diagnosed with

ovarian and other gynecological cancers and their

by the Just Among Women support group.

care partners recently gathered at the Cancer

Participants had the opportunity to attend

Institute to learn about advances in treatment of

keynote and luncheon presentations, breakout

the disease.

sessions, a question-and-answer session with a

“Shout About the Disease that Whispers”

gynecologic oncology advanced practice nurse,

is held annually to promote complementary and

and a discussion of nutrition during and after

conventional approaches in the care of women

cancer treatment.

Information Wanted

Clinic-based

the Cancer Institute

patient education can

and the UAMS College

improve colon cancer

of Public Health.

screening rates, according to

The study found that

a study recently completed

patients who watched a

by UAMS researchers and 19

video about the risk of

other Arkansas health

colon cancer and the

care providers.

screening procedure were more

likely to request a screening

The research project

was funded by the National

than patients who did not view

Cancer Institute and the UAMS

the video.

Department of Family and

Preventive Medicine through its

M.D., Garnett professor

Arkansas Research Collaborative

and chairman of the UAMS

for Quality Improvement (ARC-

Department of Family and

QI). ARC-QI collaborated on the

Preventive Medicine, led

project with investigators from

the study.

Winthrop P. Rockefeller Cancer Institute

Geoffrey Goldsmith,

A new study conducted at the Cancer Institute finds that many cancer patients prefer to receive health information rather than emotional aid from support groups.

“There’s a good deal of research about what kinds of groups are helpful for cancer patients, but less information about what they themselves are looking for,” said Allen Sherman, Ph.D., director of the Behavioral Medicine Program and lead author of the study of 425 patients.

Most study participants wanted practical medical information about cancer delivered immediately after diagnosis or during treatment.

About twice as many chose medical information (38 percent) over emotional support (20 percent), and 30 percent wanted a focus on wellness and health promotion.

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Lessons Learned by liz caldwell

Thirty Years Ago, Beth Jackson was Inspired by Caring Volunteers. Today, She’s the One Inspiring Others.

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B

Beth Jackson knows the power of volunteering.

When her mother was being treated for ovarian cancer in 1976, both women were on the receiving end of the care and concern of volunteers.

The Winthrop P. Rockefeller Cancer Institute was not yet built, so Jackson took her mother to Houston for treatment at M.D. Anderson Cancer Center.

“I saw what the volunteers did and the impact they had on the patients’ lives,” said the Little Rock woman, who traveled back and forth to Houston for six years until her mother passed away in 1982.

It wasn’t long before Jackson was on the giving end as a volunteer for patients and families at UAMS’ new Cancer Institute.

In 1986, Jackson got a call from her friend, Jo Ellen Ford, who wanted to talk about starting an auxiliary to serve the Cancer Institute, which was in the planning stages. Jackson met with Ford and other friends.

She emphasized to them that volunteers serve both the patients and caregivers.

“My input was based on my experience at M.D. Anderson and the impact volunteers

Cooks Tour 2008

had on our lives. I think our volunteers today serve a vital purpose,” Jackson said.

Making a Difference

Over the years, Jackson has served as president of the Cancer Institute’s auxiliary and chairman of two of its main fundraisers — Partners Card and Cooks Tour.

“If there’s a job over there to do, they just give it to me,” she said.

The auxiliary has raised more than $1 million to help support the UAMS Family Home, the Auxiliary’s Cancer Support Center and to fund grants that benefit patients at the Cancer Institute and other cancer-related organizations. A third source of auxiliary funds is the Cancer Institute Gift Shop.

About $385,000 has gone to support the UAMS Family Home, a facility that provides affordable lodging in a homelike setting for cancer patients receiving treatment at the Cancer Institute, as well as for parents of premature infants being cared for at UAMS Medical Center’s neonatal intensive care.

Cooks Tour, begun in 1991, has been a big source of those funds. Last year it brought in $72,000. This year, Cooks Tour

is April 20 in the Deauville neighborhood of Chenal Valley in west Little Rock. The event will feature several homes open for tours and samples of delicacies by area chefs.

“I’m a big supporter of Cooks Tour,” Jackson said of the event initially begun to raise awareness of the Cancer Institute before it evolved into a fundraiser.

The event also is a time to honor a leader at the Cancer Institute. Each year, one or more honorees are recognized at the Patrons Cocktail Buffet, held the same weekend as Cooks Tour.

This year’s cocktail buffet is April 18 at the Governor’s Mansion and will honor former UAMS Chancellor Harry Ward and the current chancellor, I. Dodd Wilson.

“The reason I volunteer is because the money from the auxiliary goes directly to patient services,” Jackson said.

Those services include everything from coffee for the patient waiting rooms to the purchase of a digital mammogram machine.

“It’s all about making patients and family members who are here feel comfortable and cared for,” she said.

Patrons Cocktail Buffet

Cooks Tour

7-10 p.m. April 18 at the Governor’s Mansion Tickets: $100 per person

1-4 p.m. April 20 in the Deauville neighborhood of Chenal Valley Tickets: $20 in advance or $25 at the door

Tickets will be available starting in mid-March. For information, call (501) 686-8286.

Winthrop P. Rockefeller Cancer Institute

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From the

under the microscope

Heart

by Susan Van Dusen

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M

Cally Cochran’s lemonade stand raised $90 for cancer research. Cally is pictured in the framed photo with her mother, Anne.

Winthrop P. Rockefeller Cancer Institute

Most young girls use their lemonade stand earnings to buy a special treat or fill their piggy bank.

Cally Cochran isn’t like most young girls.

Many of Cally’s friends have had a family member diagnosed with cancer, and she is no exception. When Cally was just a baby, her mother, Anne Riley Cochran, died of the disease at age 34.

Now 11, Cally decided that it would be nice to help others who are living with cancer. To do just that, she and some friends mixed up some lemonade, made a sign (15 cents for a small cup, 25 cents for a large) and staked out a spot in her front yard. The customers arrived, and in three days they had earned $90.

“When I delivered the money to the Cancer Institute, they asked who I would name it for. I told them my mom,” she said. Cally decided to designate her gift to the building expansion project so that it could be matched dollar for dollar by the state of Arkansas.

“I think I’ll do it again,” Cally said of her fundraising project. “I was surprised we made so much money. It really made me happy.” seek

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Looking Beyond Cancer’s Limits

On The Case M o l e c u l a r D e t e ct i v e D u s t s f o r M y e l o m a ’ s F i n g e r p r i nt s by jon parham

John Shaughnessy, Ph.D., does not fit the classic view of a medical researcher: hunched over a microscope, pouring over disease samples on slides until he has a “Eureka!” moment of discovery.

Think of him more as a molecular detective. The study of cancer, such as multiple myeloma, which affects the blood’s plasma, has moved beyond the microscope. He’s looking at the genes that cause cancer, and they are much too small to be seen by a microscope.

“That concept of a scientist sitting behind a microscope is so archaic to modern molecular biology,” said Shaughnessy, director of the Lambert Laboratory of Myeloma Genetics at the Winthrop P. Rockefeller Cancer Institute’s Myeloma Institute for Research and Therapy.

Each tumor may look the same on the surface, but they differ at the genetic level, he said.

Shaughnessy and his research team are tracking the genetic fingerprints of multiple Winthrop P. Rockefeller Cancer Institute

myeloma. He equated the genetic code to a series of switches that are flipped in a certain sequence to cause normal cells to turn cancerous.

Figure out how those switches are flipped on or off, he said, and you can design treatments that prevent it from happening in a specific patient.

“Targeted therapy is the catchphrase now,” Shaughnessy said. “When you can define the genetics, you can design the drugs to target it.”

Making Progress

In 2006, Shaughnessy’s team reported that their genetic analysis work had identified seven subtypes of myeloma.

Each subtype had a bearing on the patient’s prognosis. Some myeloma patients seemed to have a more deadly version of the disease, based on the genetic subtype, with some seeming to have a higher risk of a bad outcome.

“At 24 months, about 90 percent of low-risk patients will be alive, whereas about

50 percent of the high-risk patients have succumbed to the disease,” said Fenghuang Zhan, M.D., Ph.D., a colleague of Shaughnessy’s, in an interview with the American Association of Cancer Research.

Of the seven genetic disease subtypes identified, four were associated with better patient outcomes following

The key also may demonstrate the maliciousness of myeloma. high-dose chemotherapy and a blood stem cell transplantation.

After following 532 myeloma patients for seven years after stem cell transplants, the investigators combined the data with the information on the genetic subtypes, creating a genetic profile to chart the severity of the disease.

In March 2007, the researchers announced that they had found that activity of as few as 17 genes could mean the u seek

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difference between a high or low risk for a poor prognosis. The 13 percent of patients deemed to have high-risk myeloma had a median survival of only 24 months, whereas 65 percent of the remainder were alive at six years, according to the study.

Investigating samples taken at diagnosis and relapse, the researchers also found that a group of patients switched from low risk at diagnosis to high risk at relapse. Shaughnessy said the findings suggest the acquisition over time of genetic features that cause the shift and explain the poor outcome of patients in the high-risk category.

The key also may demonstrate the maliciousness of myeloma. It could be that certain types of low-risk myeloma may have the genetics for high-risk myeloma but masked, Shaughnessy said.

When the low-risk myeloma is treated, it clears the way for the high-risk version.

Shaughnessy’s work continues as his team uses gene expression profiling to determine the activity of every gene in a cancer cell. The genetic patterns are unique for these cells, he said, and the mechanism for a cell to become malignant is a multi-step process. Like any good detective, researchers are now tracing the steps of the suspect, trying to understand how it operates.

“We think we’re much closer to understanding the central pathogenic events that lead to multiple myeloma,” Shaughnessy said. “We are 22

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poised with drugs that will be more effective against those that have been drug resistant.”

He credited much of his team’s success to myeloma patients willing to participate

in the various studies. “What we have been able to do would not have been possible without them. They trust us to do the very best that we can,” Shaughnessy said.

From the Ground Up If John Shaughnessy, Ph.D., was not in the lab piecing together the blueprint of cancer genes, he might have been on a job site following blueprints to build houses.

It may sound like a leap from molecular biologist to building contractor, but maybe not as much as you might think. While a college student, Shaughnessy worked in construction and developed an interest in the work.

Following blueprints to build a house from the ground up appealed to him.

He also sees an analogy in it for his work now.

“Life follows a blueprint,” Shaughnessy said. “If you

had a blueprint to build a house and used it to make duplicates of the house — then spilled coffee on the blueprint and smeared it — when you built subsequent duplicates there would be some kind of deficiency. That’s essentially what happens with cancer.

“A cell becomes defective in some way, making it

malignant. So then every duplicate it makes as it reproduces has the same defect and soon it becomes a tumor.”

Etc.

Shaughnessy’s iPod includes music from Bob Dylan, The Cure, Deathcab for Cutie, Elvis Costello and the Dixie Chicks.

Looking Beyond Cancer’s Limits

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FFANY Shoes on Sale

Who: The Fashion Footwear Association of New York (FFANY) and QVC, one of the largest multimedia retailers in the world

Carla and Peter Emanuel, M.D.

Judy Tenenbaum, Joe Moore, CEO of FFANY, V. Suzanne Klimberg, M.D.

Jonnie and Kent Westbrook, M.D.; Carla and Peter Emanuel, M.D.; Ashley and Rodney Thomason

Shoes on display

What: FFANY Shoes on Sale, a fundraiser sponsored

by FFANY and QVC, benefits the Winthrop P. Rockefeller Cancer Institute and six other organizations across the country with a one-night-only sale of thousands of pairs of shoes donated by companies nationwide When: Oct. 17, 2007

Where: A black tie dinner at the Waldorf Astoria in New York City and a televised fundraiser on QVC Why: During the past 13 years, FFANY Shoes on Sale has raised more than $24 million for breast cancer research and education. (left) V. Suzanne Klimberg, M.D.; Ronda Henry-Tillman, M.D.; and Judy Tenenbaum

Winthrop P. Rockefeller Cancer Institute

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Winthrop P. Rockefeller Cancer Institute Who: More than 200 UAMS supporters

and employees, including Arkansas first lady Ginger Beebe; Lisenne Rockefeller, wife of the late Arkansas lieutenant governor Winthrop P. Rockefeller; representatives from the Winthrop Rockefeller Foundation; Peter Emanuel, M.D., executive director of the Cancer Institute; members of the Arkansas Legislature and other public officials

What: A ceremonial groundbreaking was held to celebrate the start of construction on a 12floor, 300,000-square-foot expansion of the Cancer Institute. Also during the ceremony, UAMS Chancellor I. Dodd Wilson announced the renaming of the Arkansas Cancer Research Center for the late Winthrop P. Rockefeller.

Colin Rockefeller, Lisenne Rockefeller, Liza Freeman and Winthrop P. Rockefeller Jr.

When: Sept. 28, 2007 Where: The top level of the UAMS Outpatient Parking Deck, overlooking the site of the expansion Why: The expansion of the Cancer Institute will allow it to treat more patients, host more research and educate more health care professionals.

Peter Emanuel, M.D.; Carla Emanuel; Winthrop P. Rockefeller Jr.; and I. Dodd Wilson, M.D.

Margaret Clark and William Clark

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Mary Lynn Van Wyck, James Y. Suen, M.D., and DeeDee Ricks

Looking Beyond Cancer’s Limits

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Expansion Groundbreaking

Kent Westbrook, M.D., and Marge Schueck

Ginger Beebe

Sherece West, Ph.D., and F.E. Joyce, M.D.

Sen. Bobby Glover, Sen. John Paul Capps and Dick Trammel

Winthrop P. Rockefeller Cancer Institute

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Gala for Life Who: More than 900 supporters of the Winthrop P. Rockefeller Cancer Institute enjoyed dinner and a musical performance by the Rev. Al Green What: The 12th annual Gala for Life honoring

Joe and Jo Ellen Ford for their years of service and dedication to the Cancer Institute

When: Sept. 28, 2007 Where: Statehouse Convention Center in Little Rock Jo Ellen Ford and grandsons

Why: The Gala for Life is the major fundraising event for the Winthrop P. Rockefeller Cancer Institute Foundation Fund Board. The event raised more than $700,000, which was matched dollar for dollar by the state of Arkansas, resulting in $1.4 million benefiting the institute’s expansion and programs.

Gov. Mike Beebe

Al Green, Sherece West, Ph.D., and Kent Westbrook, M.D.

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Al Green and Carla Emanuel

Looking Beyond Cancer’s Limits

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T. Glenn Pait, M.D., and Gov. Mike Beebe

The Ford family

Mary Ann and Reed Greenwood

Winthrop P. Rockefeller Cancer Institute

Mary Lynn Van Wyck and Al Green

Keith Jackson

Rev. Betsy Singleton, U.S. Rep. Vic Snyder, Hugh McDonald and Michelle McDonald

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Health Notes:

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