Nutritional Know How How a cancer diagnosis changes your dietary needs
Michelle Morgan is a registered dietitian at the Cancer Institute.
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Looking Beyond Cancer’s Limits WINTER 2012 Editor Susan Van Dusen Art Director Mikel Holloway 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.
Chancellor, University of Arkansas for Medical Sciences Dan Rahn, M.D. Director, Winthrop P. Rockefeller Cancer Institute Peter D. Emanuel, M.D. Associate Director of Administration, Winthrop P. Rockefeller Cancer Institute Shirley Gray
WINTHROP P. ROCKEFELLER CANCER INSTITUTE
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Welcome to this issue of Seek! As the winter weather months fall upon us, we look forward with great anticipation to the opening of our new research floors. With completion scheduled for March, we will add more than 30,000 square feet of new research space for cancer investigators. We are proud that this construction initiative is financed by the National Institutes of Health (NIH), through the American Recovery and Reinvestment Act of 2009 (ARRA). This construction is part of the original stimulus package to get the country’s economy back on track. As part of the ARRA initiative, $1 billion dollars went to the NIH to distribute to academic medical centers for construction projects. Our $10.5 million grant was the only project in Arkansas chosen for funding. Since receiving word of this grant back in January 2010, our architects and construction crews have been hard at work creating our new research space, which is vitally needed as we were filled to capacity in our current research laboratories. While a few of the researchers already on our staff will move to these new labs, the bulk of space is being reserved for new recruits, many of whom will start arriving between March and July 2012. I will fill you in about those recruits in the next issue of Seek. Last summer, Arkansas became the first state to open a publicly funded umbilical cord blood bank. Among its many purposes, the bank provides an alternative means for stem cells for patients needing a bone marrow transplant. Read about this initiative on Page 4. We use robotic surgeries for patients with prostate cancer, ovarian cancer and other cancers occurring in the abdomen. Now, a UAMS surgeon has become the first in the state to utilize robotic methods for a patient with throat cancer. Read about Dr. Emre Vural’s groundbreaking surgery on Page 8. Finally, our own Dr. Martin Hauer-Jensen has received a contract of up to $13 million to proceed with advanced development of a promising drug to protect people after they’ve been exposed to radiation. We applaud Dr. Hauer-Jensen’s efforts and share his success on Page 12.
Peter D. Emanuel, M.D. Director, Winthrop P. Rockefeller Cancer Institute
Looking Beyond Cancer’s Limits
contents WINTER 2012
features
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In the Bank
The Cord Blood Bank of Arkansas is the first of its kind in the nation.
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A Gratifying Challenge
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Mission (Almost) Accomplished
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Making Every Bite Count
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Better, Faster, Stronger
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Scientists Without Walls
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Dan Davis, M.D., offers specialized dermatology services with a personalized touch. Radiation research led by Martin Hauer-Jensen, M.D., Ph.D., is a national security priority. For cancer patients, nutrition takes on a whole new meaning.
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New committees streamline the research proposal process. Open lab design offers advantages for cancer researchers.
in every issue Profile ................................................................... 8 UAMS’ first patient for robotic throat cancer surgery embraced the alternative.
16 Cover photo by Johnpaul Jones
l Nutritionoaw Know H s er diagnosi s How a canc dietary need your changes
ered is a regist te Morgan r Institu Michelle at the Cance dietitian
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Medicine Bag....................................................... 14
ARA Scholar Cervical Cancer Prevention Advancing Nanomedicine Natasha Milojkovic, M.D. Breast Cancer Program Accreditation
Spotlight.............................................................. 24 Partners Card Kick-off Party
Gala for Life
Never Lose Spirit
“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
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Michele Fox, M.D., leads Arkansas’ new cord blood bank, located at UAMS.
In t he
Bank Cord Blood Bank of Arkansas is the first of its kind nationally. By NATE HINKEL
“They told us the best course of treatment Valentine’s Day 2008 was more heartwould be an umbilical cord blood transplant,” Brian wrenching than heartfelt for Brian and Jennifer Odle. Odle said. “We had been so up and down for weeks But because of an innovative use of cord blood, wondering if it could be treated, so once we had a similar to a new effort housed at the University of plan of action there was finally a sense of calmness.” Arkansas for Medical Sciences (UAMS), and a strongThe cord blood came from a national cord willed 18-month-old toddler, the family’s memories of blood bank. Amelia’s procedure, which took place in that trying winter soon evolved into a heartwarming San Antonio, was a success, and her cancer has been affair. in remission ever since. It was during a family fishing trip to their retreat Since first being used in a stem cell transplant on the Little Red River that February when the Odles in 1988, umbilical cord blood is playing an noticed that their daughter, Amelia, had an eye that important and evolving role appeared swollen. “We just had a terrible feeling that something This is science and in the treatment of leukemia, many other lifejust wasn’t right,” said Brian Odle. research and execution lymphoma and threatening blood diseases. Their fear became reality it its greatest and “Patients who learn that once a rare tumor equivalent to a bone marrow transplant isn’t the size of her eyeball was found most practical form.” a possible treatment for their in Amelia’s eye socket. She was disease are finding that a cord blood transplant diagnosed with acute myelogenous leukemia (AML), may now be a viable option,” said Peter Emanuel, and the family was M.D., director of the Winthrop P. Rockefeller Cancer told there was a 50 percent chance it could be treated. Institute. “The first cord blood transplant was as After achieving remission with several recent as 1988, and doctors and researchers are still courses of chemotherapy and radiation treatment, learning more about the similarities and differences doctors decided the next step should be a cord from traditional bone marrow transplants.” blood transplant.
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How to Donate Now that the Cord Blood Bank of Arkansas is up and running, the next critical step is to grow the bank’s reserves and become part of the national network. The first step in doing that is getting Arkansans to understand how easy it is to donate cord blood following the birth of a healthy child. “It doesn’t matter where you give birth in the state,” said Michele Fox, M.D., medical director of the Cord Blood Bank of Arkansas and director of cell therapy and transfusion medicine at UAMS. “Donating is completely painless and simple. Before giving birth, new parents can request an easy-tofollow kit that they give to their doctor at the time of birth.” And from there the donated cells will quickly be delivered to UAMS for storage. The bank accepts cord blood donations for public use, private use or research.
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With public banking, cord blood is stored so that it can be transplanted into any patient who is considered a match. Public cord blood banks cover the cost of processing, testing and storing donated cord blood. Private banking allows donors to store the cord blood for their family’s use should the need arise. There is a fee for the initial collection plus an annual storage fee. Research banking allows the Cord Blood Bank of Arkansas to use the cord blood to further research studies. Research laboratories and technology companies conduct studies to help improve the transplant process for future patients, and to discover new ways to use the cells to help repair damaged tissues. Fox emphasized the need to reach minority groups with the cord blood donation effort to ensure those communities have the same opportunities to
Looking Beyond Cancer’s Limits
Up and Running While those transplants are not yet being performed at the Cancer Institute, UAMS is on the front edge nationally with this summer’s grand opening of the Cord Blood Bank of Arkansas at UAMS. “We feel very strongly about this cause and what UAMS is doing to make this available to other families in the same position as we were,” Brian Odle said. “This is science and research and execution in its greatest and most practical form.” Michele Fox, M.D., director of cell therapy and transfusion medicine at UAMS and medical director of the Cord Blood Bank, has led an effort to make Arkansas the first statewide-coverage cord blood bank in the nation to open with a mandate for public, private and research banking. Cord blood cells that are harvested after the birth of healthy children have the potential to drastically change the lives of hundreds of millions of Americans through their use in bone marrow transplants and have tremendous promise for regenerating diseased or injured tissues.
Grand Potential
Umbilical cord blood is one of three sources that can be used in transplants, with the other two being traditional bone marrow and peripheral, or “circulating,” blood. While researchers are still discovering the full potential of cord blood, it has already aided in finding treatment for anemia, leukemia, lymphoma, lupus, multiple sclerosis, rheumatoid arthritis, sickle cell disease, spinal cord injury and Crohn’s disease. Further research is being done to find treatment for corneal degeneration, heart disease, stroke, Parkinson’s and Alzheimer’s, according to the National Marrow Donor Program (NMDP). “We feel that while we already know the amazing benefits cord blood cells have shown us, it’s still in its infancy as far as what the full potential could be,” Emanuel said. Once the Cord Blood Bank of Arkansas reaches the 100 donations needed to become a member in the NMDP, it will link Arkansas’ bank into its database, allowing UAMS to match donations with potential transplant patients worldwide.
reap the benefits for their families. “With further research and the operation of the efficient national cord blood banking system, more than 100 million Americans and 2 billion people worldwide could potentially be treated or cured of diseases,” Fox said. “The next critical step is to let Arkansans know how easy it is to make a difference by donating cord blood following the birth of a healthy child.”
For more information on the potential of cord blood and how you can donate in Arkansas, visit www.cordbloodbankarkansas.org.
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Better
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UAMS’ first patient for robotic throat cancer surgery embraced the alternative. By DAVID ROBINSON
Throat cancer survivor Pat Longinotti (right) has a clean bill of health six months following his surgery by Emre Vural, M.D.
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confines of the throat. There’s a good reason UAMS’ head and neck cancer surgeons are also fellowship The clinical stage 4 tumor, which was less trained in reconstructive surgery. than 2 centimeters, was removed as precisely as if Cancers of the head and neck are often found in a traditional open surgery. in the most difficult places to reach, resulting in “In addition to avoiding an open surgery, Mr. risky, disfiguring operations that require hours of Longinotti won’t need chemotherapy, and that reconstruction and months of healing. was our ultimate goal,” said Vural, who also is That could have been the case for Pat director of the Transoral Robotic Surgery Program Longinotti of Bryant, whose throat cancer was at UAMS. “This is a major change for head and discovered at the base of his tongue in early 2011. neck cancer surgery and a tremendous benefit A traditional surgery would have meant sawing the for patients.” entire lower jaw in half to reach the cancer, risking Longinotti returned to work a week after damage to his salivary glands surgery. In contrast to patients and the position of his bite, who have the traditional and long-term problems with I had total confidence surgery and can’t chew or chewing and swallowing. swallow for months, Longinotti in Dr. Vural; “Even if everything goes was eating steak just two weeks well, patients are left with a big the guy is great.” after his procedure. scar; they need many weeks to “The robot is the way to recover, and it’s painful,” said go if you want a fast recovery time,” he said. “I’ve Emre Vural, M.D., a head and neck cancer surgeon been going 90 to nothing since about the 10th day in the UAMS College of Medicine’s Department of after surgery.” Otolaryngology-Head and Neck Surgery. The robot can be used to remove tumors up to For Longinotti, 55, Vural proposed a much 4 centimeters in diameter. Because UAMS sees the less invasive alternative: a robotic surgery that most serious cancer cases — with tumors larger than would allow the tumor to be removed by working 4 centimeters — Vural said only about 15-20 percent from inside the mouth. Vural was recently certified for the procedure on the da Vinci Surgical of UAMS throat cancer patients would benefit. But as word gets out about the alternative robotic surgery, System robot. If Longinotti followed Vural’s Vural said he expects UAMS to see a steady increase recommendation, he would be the first patient at in patients eligible for the robotic surgery. UAMS and in Arkansas to have a transoral robotic throat cancer surgery. Longinotti said his entire experience at UAMS Longinotti, a residential remodeling was extraordinary under the circumstances. contractor, said he didn’t hesitate to say yes to the “I’m very pleased with the whole hospital; robotic procedure. Dr. Vural, the nurses, everyone,” he said. “I tell “I had total confidence in Dr. Vural; the guy everyone, if I get an ingrown toenail, I’m going is great,” said Longinotti, who also has multiple nowhere but UAMS. I believe in that place.” sclerosis. “He shoots straight with me, doesn’t treat me like a number, and I appreciate that. It was clear to me that he knew what he was doing.” The robotic surgery, performed in just 26 In addition to head and neck surgery, UAMS’ minutes, went exactly as planned. With Vural surgical robot is used by cancer specialists in sitting at the robot’s console a few feet from the urologic, gynecologic, colon and rectal cancers, patient, he used his fingers to manipulate the and for some cardiothoracic procedures. robot’s surgical instruments inside the cramped
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Dan Davis, M.D., knows the importance of good communication with his patients.
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Gratifying Challenge
dan Davis offers more than just specialized surgery to patients. By Kristen Hansen
In a day and time where the easiest local anesthesia, Mohs surgery is a way to remove means of contacting someone is to tweet them all cancerous tissue while leaving healthy skin or post on their Facebook page, Dan Davis, tissue unharmed. M.D., believes that developing a real working First, all of the visible skin cancer and an relationship with his patients is one of the most additional thin layer of tissue from the tumor important aspects of his career. area are surgically removed. This tissue is used to "I talk to my patients on the phone create a map of the surgical site. "I take a small constantly," said Davis. He is well aware that some section of skin and examine it under a microscope patients travel hundreds of miles to be treated by one layer at a time, versus cutting through several him. "A lot of my patients drive or fly for hours to layers of potentially healthy skin." The skin tissue get treatment here and then turn around and go is thoroughly checked under the microscope for right back," he said. "So calling them on the phone evidence of remaining cancer cells. is not a big deal." If cancer cells are detected in a section of Davis received his medical degree from the the tumor area, the map is used to return to that University of Colorado. For him, it wasn't a matter specific section and another thin layer of tissue of if he finished his degree, is removed for microscopic but when and where. "I had testing. "This process continues a pediatrician who was kind When I was 5, until the cancer is completely of a role model to me," Davis I decided medicine gone,” Davis said. "No healthy said. "When I was 5, I decided medicine is what I wanted to is what I wanted to do.” skin is wasted." Performing Mohs surgery do and it never changed at all." Davis completed his is impressive in itself, but dermatology residency at the University of Davis hopes for even better services in the future. Texas at Houston, followed by a fellowship "We've come a long way and built up a lot as far in dermatopathology at the University of as numbers," he said. But to build up services for Texas Medical Branch. He did four years of patients at UAMS is a personal goal of his. "I'd like faculty practice at the University of Alabama at to be a little more well-rounded and versatile for Birmingham, then matriculated to the University our patients." of Iowa for consecutive procedural dermatology American Cancer Society data estimates that and research fellowships. nearly 12,000 people in the U.S. will die from "UAMS just worked," Davis said of his skin cancer in 2011. Light skin, blazing sun and decision to move to Little Rock. Davis' wife, a public uneducated on prevention are associated Donna Pellowski, M.D., is a physician in the UAMS with a higher risk of skin cancer. Unfortunately, College of Medicine’s Department of Dermatology these few things are also associated with the as well and he said they were both seeking jobs South. at a university setting. “My family is in Colorado "Being here in Arkansas we get amazing skin and her family lives in the midwest. We wanted cancers," Davis said. "The factors associated with something central, and we found it here." skin cancer are so prevalent here. One special service that Davis offers his skin "It's a horrifying challenge — but to be able to cancer patients is the precise and effective Mohs cure those, it's the most gratifying." micrographic surgery. A method that uses only
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MISSION ALMOST
ACCOMPLISHED
Martin Hauer-Jensen’s radiation research is a national security priority. By David Robinson
Martin Hauer-Jensen, M.D., Ph.D., holds a vial of the drug SOM230 now under development.
tenderizer on the damaged tissue.” Martin Hauer-Jensen, M.D., Ph.D., was exploring ways to prevent radiation injuries The potentially life-saving SOM230 inhibits long before most people worried about a Sept. the secretions from the pancreas, giving the 11-type terrorist attack or a nuclear meltdown like intestine a chance to heal after radiation exposure. that in Japan. Assuming it receives FDA approval, it would be a The inspiration 25 years ago to study the national security breakthrough as one of a very intestinal damage often caused by radiation cancer small number of drugs that protects people after therapy has Hauer-Jensen now within reach of a they’ve already been exposed to radiation. scientist’s Holy Grail: A drug that will save lives SOM230 originally was developed by the when taken after radiation exposure. drug company Novartis to treat certain hormone Hauer-Jensen’s medical career began as a disorders. FDA approval to use SOM230 for surgical oncologist in his native Norway, and he radiological emergencies also would be good news has spent the last 21 years at UAMS as both a for cancer patients, especially those who receive surgeon and researcher. He transitioned fully to targeted radiation treatments for cancers in the radiation research in 2008, joining the UAMS College of Pharmacy as associate dean for research pelvic floor. In certain prostate and gynecologic cancers, it may be difficult to avoid radiation and director of the Division of Radiation Health. damage to the intestine. In just two years, the program grew from one person — HauerMy whole career “SOM230 is a radiation Jensen — to 23 people. External mitigator, and it will also be used has been leading to mitigate or prevent the adverse research funding quickly reached more than $4 million a year. effects of radiation in cancer to this point.” On top of that, the ink is now therapy,” Hauer-Jensen said. barely dry on the largest contract The drug received serious study beginning awarded to a College of Pharmacy researcher in its in 2005 from a consortium of researchers led by 60-year history. Awarded by the federal Biomedical Hauer-Jensen. Advanced Research and Development Authority “After the fourth year, the results were so (BARDA) to Hauer-Jensen in September, the good we determined that we should consider it for four-year contract amounts to $4.5 million over human use,” he said. the next two years, and it will rise to nearly $13 million assuming two 12-month options are exercised. BARDA is in the Office of the Assistant ‘To the people’ Secretary for Preparedness and Response in the Hauer-Jensen is the only scientist in Arkansas U.S. Department of Health and Human Services. ever to receive a National Cancer Institute (NCI) The contract enables Hauer-Jensen, the MERIT Award, which provides up to 10 years principal investigator, to proceed with advanced of research funding. Such prestige is difficult to development of the promising radiation drug match, but the BARDA contract puts him on the called SOM230. cusp of a life-saving drug, he said. “My whole career has been leading to this ‘Like meat tenderizer’ point; finally we have a compound that we’ve Hauer-Jensen’s research has focused on the taken from the early stages of development to intestine, which is second only to bone marrow in near FDA approval,” he said. “I’m hopeful that this sensitivity to radiation. The intestine and bones is something that we can bring to the people.” are most susceptible because of their rapidly proliferating cells. Treatments exist for irradiated bone marrow but not for the intestine. “The amount of damage to the intestine Hauer-Jensen also is collaborating with the determines whether you live or die after exposure Armed Forces Radiobiology Research Institute to radiation,” he said. “When you irradiate the on a promising drug that could be taken before intestine, it falls apart because the proteolytic dangerous radiation exposures. enzymes secreted by the pancreas work like meat
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Winthrop P. Rockefeller Cancer Institute
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Early Protection
Parents of children ages 11 to 18 in three Arkansas counties have an advantage in the fight against cervical cancer. The virus that causes cervical cancer, known as HPV (human papillomavirus), is the most commonly sexually transmitted infection found in both men and women. The three-shot Gardasil HPV vaccine series protects against cervical cancer as well as 90 percent of precancerous cervical lesions, vulvar,
vaginal and anal carcinomas. The Cervical Cancer Education Prevention Program provides education and free Gardasil vaccinations to girls and boys in Pulaski, Jefferson and Chicot counties. The program is a partnership between UAMS and the Arkansas Department of Health. To find out more about this program and if your child qualifies, contact Sharmin Moody, program manager, at (501) 526-6335, or visit www.healthygirlsboys.com.
New Physician Joins Hematology/ Oncology Team
NatasHa Milojkovic, M.D., has joined the UAMS
Division of Hematology/Oncology and sees patients in the Cancer Institute’s Medical Oncology Clinic.
Milojkovic is fellowship trained and previously served as hematology/oncology attending physician at the AR/OK Cancer Center in Fort Smith. She received her medical degree from the University of Belgrade School of Medicine and completed her internal medicine residency at the University of Pittsburgh Medical Center Shadyside hospital.
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Breast Cancer Program Gets Accreditation
The UAMS Breast Cancer Program, led by V. Suzanne Klimberg, M.D., has received a three-year accreditation from the American College of Surgeons’ National Accreditation Program for Breast Centers (NAPBC). The NAPBC is a non-governmental, not-for-profit organization that identifies and recognizes breast centers providing quality care in the United States. Breast centers accredited through the NAPBC have been evaluated by a governing, multidisciplinary board as meeting or exceeding the necessary requirements of quality breast care. Klimberg is chief of the Division of Breast Surgical Oncology at UAMS and a professor in the Departments of Surgery and Pathology in the UAMS College of Medicine.
Honoree Patti Upton (center) with Vladmir Zharov, Ph.D., (left) and James Y. Suen, M.D.
Advancing Nanomedicine A $250,000 contribution by AT&T Arkansas in honor of outgoing board member Patti Upton gave a boost to the nanomedicine research program in the Cancer Institute. The contribution was presented by AT&T Arkansas president Ed Drilling in a ceremony attended by Gov. Mike Beebe. Upton is president and CEO of the Heber Springs-based company Aromatique and served on the AT&T board of directors from 1993 to April 2011. Nanomedicine, the medical application of nanotechnology, involves the creation and use of materials and devices at the level of molecules and atoms, about one-billionth the size of a meter. Vladimir Zharov, Ph.D., is director of the Phillips Classic Laser and Nanomedicine Laboratory, senior scientist in the Cancer Institute, and a professor in the College of Medicine. Winthrop P. Rockefeller Cancer Institute
Peter A. Crooks, Ph.D., (center) with Daohong Zhou, M.D., (left) and Ranil Wickramasinghe, Ph.D.
Research Scholar Peter A. Crooks, Ph.D., chairman of the Department of Pharmaceutical Sciences in the UAMS College of Pharmacy, was named by the Arkansas Research Alliance (ARA) as 2011 ARA Scholar. The award includes a three-year grant worth $500,000 for Crooks and his team of more than a halfdozen doctoral-level researchers to discover and develop new cancer treatment drugs, agents to improve patient outcomes after radiation therapy and medication to treat acute and chronic pain. Crooks and his team will complement ongoing research in the UAMS Winthrop P. Rockefeller Cancer Institute and in the UAMS College of Pharmacy’s Division of Radiation Health. Formed from funds appropriated by the state Legislature and authorized by the Arkansas Science and Technology Authority in 2007, the ARA strengthens economic development in the state by championing university-based research and innovation in defined strategic focus areas.
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Making Every Bite Count For cancer patients, nutrition takes on a whole new meaning. By SUSAN VAN DUSEN
Dietitian Michelle Morgan counsels cancer patients about their unique nutritional needs.
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We all grew up hearing it: eating six small meals each day and setting an “Eat your fruits and vegetables. alarm as a reminder of when to eat. She also They’re good for you.” And that recommends trying ginger tea or ginger ale to help sentiment is certainly true to this with nausea. day. But for people who have been Consuming small amounts of food is fine, diagnosed with cancer, nutrition takes she said, as long as it is packed with calories on a whole new meaning. and protein. The value of protein is that it helps “Nutrition for a healthy person maintain muscle mass, an essential component to is completely different than nutrition speeding recovery. for a person who has been diagnosed with “Sometimes all people want to eat is fruit. I cancer,” said Michelle Morgan, registered tell them that they have to add something to it dietitian at the UAMS Winthrop P. Rockefeller that will ensure they get enough protein, such as Cancer Institute. “Just throw everything you yogurt, cottage cheese, nuts or peanut butter,” she know out the window.” said. First, Morgan said, cancer patients should To get started, Morgan recommends that put top priority on food safety. While most people patients make a list of their favorite foods and have high immunity to the everyday germs and then pick out the ones that are highest in protein. bacteria that come their way, Then, patients can keep the list We’re not as cancer patients are the opposite. handy as a reminder of their And lower immunity means that best protein-packed options. concerned about illness can spread more quickly Those who simply can’t stomach eliminating foods as food or who need an extra and easily. In the past, cancer patients dose of protein can use protein we are about how were placed on very strict, lowor dried milk in their we handle the food.” powder bacterial diet. Today, the priority regular glass of whole milk. is not as much on the type of Oral supplements also offer food, but on the way it is handled and prepared. an “insurance policy” for those who need more “We’re not as concerned about eliminating time until they get back on a regular diet. foods as we are about how we handle the food,” said Morgan, who holds a certification in oncology Unique Challenges nutrition from the American Dietetic Association. Some specific types of cancer offer unique For example, people with low immunity should challenges in terms of nutrition. For example, always thoroughly wash their hands and cutting people experiencing gastrointestional cancers boards when preparing food. They also should should avoid fiber and high fat foods in favor of avoid putting raw meat next to fresh fruits and fine, smooth food, preferably that has been put vegetables in their supermarket buggy through a blender. or refrigerator. Head and neck cancer patients, on the other “Germs can spread, even through the hand, often cannot swallow and are placed on packaging,” she said. a feeding tube. “It’s really important that we Symptom management is another major monitor head and neck cancer patients to make concern for cancer patients and is an area where sure they aren’t losing too much weight,” consultation with a dietitian can help. Morgan said. Depending on the type of cancer a patient has To help with that effort, Morgan is and the treatment they undergo, their symptoms spearheading a pilot project in the Cancer will differ. While not all chemotherapy patients Institute’s Otolaryngology – Head and Neck experience the same side effects, many report loss Cancer Clinic where patients are screened about of appetite, nausea, vomiting, and constipation their nutritional needs and referred to Morgan if or diarrhea. a need is found. The hope is that the program will To combat these side effects, Morgan suggests grow to include patients in other clinics as well.
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“A lot of the patients that I see now are transitioning from inpatient to outpatient or they are referred by their physician. We hope that it will soon become a regular process for more patients to receive nutrition consultations while they are here for their regular medical appointments,” Morgan said.
Career Choice Morgan’s interest in nutrition started at an early age. With both a brother and a sister diagnosed with phenylketonuria (PKU), she was intensely aware of their dietary restrictions and how it affected their lifestyle and health. PKU is a rare genetic condition in which the body is unable properly to break down an amino acid called phenylalanine, which is present in significant amounts in such common foods as milk, eggs and artificial sweeteners. People diagnosed with PKU must adhere to a lifelong diet that is extremely low in phenylalanine. “Watching my family deal with the challenges of PKU made me aware that I could have a career helping people handle some of the same types of situations,” she said. Morgan began her nutrition career with
an internship at UAMS while simultaneously earning her Master of Science in Clinical Nutrition degree from the UAMS College of Health Related Professions. After her internship ended, a position at UAMS came open, and she applied. “When I accepted the position, there hadn’t been anyone specifically assigned to provide nutrition consultations to blood stem cell transplant patients,” she said. “The nutritional needs that I saw in some of those patients were significant.” Morgan continued in that position for about 10 years, working primarily with multiple myeloma patients. UAMS has performed more than 10,000 blood stem cell transplants for multiple myeloma patients, more than any other outpatient facility in the world. In April 2011, she transitioned from working exclusively with myeloma patients to working with the whole Cancer Institute population. That includes one-on-one consultations and developing classes on topics of interest to a variety of patients. “I’m interested in offering classes on a regular basis so patients can benefit from the expertise of a clinical nutritionist and also learn from each other’s experiences,” she said.
Supportive Care Thousands of patients travel hundreds of miles each year to the Winthrop P. Rockefeller Cancer Institute at the University of Arkansas for Medical Sciences (UAMS) to receive researchdriven cancer treatment. Many of these patients are on limited incomes, and the expense of travel — in addition to medical treatment — can be an overwhelming burden. To assist these patients and make the most of their visits to the Cancer Institute, a process is under way to develop a comprehensive, integrated patient support program to be housed in the new Ford Patient Support Pavilion. The program will allow patients to receive consultations from a pharmacist, nutritionist and social worker at the time of their regularly scheduled medical appointment, reducing the need to return for specific consultations or to seek these services in their own community, where they often are not available.
Winthrop P. Rockefeller Cancer Institute
The services also would allow all patients, including those with limited literacy, the opportunity to speak to trained professionals about topics such as drug interactions, treatmentrelated illnesses and mental health issues, rather than relying on printed materials or online searches that can prove inaccurate.
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Better, Faster,
StRonger New committees streamline the research proposal process. By JON PARHAM
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Looking Beyond Cancer’s Limits
“Better, faster research leads to better patient care.” That’s how Laura Hutchins, M.D., a clinical researcher, director of clinical research for the Winthrop P. Rockefeller Cancer Institute and director of the UAMS Division of Hematology/ Oncology sees it. Now, thanks to that commitment, the Cancer Institute is seeing more clinical trials moving from inspiration to initiation. A restructured review process for studies is allowing better coordination among scientists, physicians and research support services. Improving the process makes it easier for new discoveries to develop into potential cancer treatments. About a dozen Disease Oriented Committees (DOCs) were organized in 2010 to bring clinicians, translational and basic scientists together with statisticians, regulatory staff and others involved in the research process. The committees, based on tumor or organ type, meet regularly to review research proposals. The panels can include medical oncologists, surgeons, radiologists, pathologists and others interested in a particular type of research. “The committees create focus groups centered on a specific disease site,” said Dorothy Graves, Ph.D., a research professor in the Division of Hematology/Oncology and the DOCs administrator. “By getting all of the interested parties in the same room, we’re better able to advance research and ensure Cancer Institute resources are maximized to bring the best possible research-driven care to our patients.” Hutchins said the process better integrates the research interests of physician-scientists who see patients in the clinics with the work of basic scientists working in the labs. From the outset, the main measuring sticks for the success of the DOCs process was the number of open clinical trials (nearly 200 compared to about 140 before the new process) and increased patient participation (up 33 percent in the first nine months following DOCs creation versus the nine months prior). The committees working with the Research Support Center also completely erased a backlog of some 17 trials waiting to complete the review process.
Winthrop P. Rockefeller Cancer Institute
Priorities, Coordination, Collaboration
Before creation of the DOCs, a smaller group looked at clinical study proposals across the organization. Now, not only do the committees focus on studies related to their specific organ or disease location, they include representatives from the support services on which the studies often rely: the UAMS Tissue Procurement Facility, radiology, biostatistics and research administration. “Bringing all of the research resources together not only allows for better coordination with other investigators, it makes more efficient use of support services,” Hutchins said. “The committees also provide a go-to resource for scientists considering a clinical study.” Cindy Witkowski, R.N., who serves as a gatekeeper for clinical trials by forwarding the proposals to the proper committee for review, said one of the first tasks of each committee is to consider its feasibility. “They make sure there are no competing studies and that there is a sufficient patient population available to make it a productive study,” she said. Each committee understands the availability of resources available for each disease site. Studies can be prioritized or turned down if they are not good matches for UAMS. The committees can be a sounding board for research ideas, offering suggestions for improving the proposal. “The quarterly meetings offer a casual, collegial forum for talking about research,” Graves said, noting that clinical researchers and laboratorybased scientists previously did not interact as much. The committees promote collaboration that can boost research studies. “We had a laboratory researcher in one committee who was interested in a clinical trial but had never conducted one before, so with the DOCs, he was able to draw on the expertise and resources of clinical researchers on the panel,” she said. Research funding is becoming even more competitive, Graves said, and is now more focused on interdisciplinary studies — which draw from multiple specialties — or translational research, where basic laboratory discoveries can be turned into new medical treatments. “It was something we needed to do to move forward as a research institution,” Graves said. “It is something that helps us as an institution and helps our patients.”
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Scientists W I T H O U T
WALLs Open lab design offers advantages for cancer research. By DAVID ROBINSON
Open research labs at the Cancer Institute promote collaboration between scientists.
UAMS’ Winthrop P. Rockefeller Cancer Institute includes some spectacular design features, but one of its most impressive will elude public view. Scheduled to open in early 2011, the building’s ninth and 11th floors will be devoted to cancer research and, some say, an informal social experiment for the scientists who work there. Unlike traditional labs, most of the 33,660 square feet of new space will be open, without walls separating each laboratory. Cancer Institute Director Peter Emanuel, M.D., announced plans for the open labs last year at the grand opening ceremony for the institute’s 12-story expansion tower. UAMS’ adoption of the open-lab concept
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was approached with a degree of caution after the idea was broached by Cynthia Walston of FKP Architects in Houston. “UAMS needed a little encouragement,” said Walston, who leads the science and technology group at FKP and has led the design of more than 2 million square feet of research space. “This is very different for UAMS. The other labs around the campus are what we call cellular labs, each assigned to a specific investigator.” A building committee appointed by UAMS’ James Y. Suen, M.D., former director and Cancer Institute co-founder, visited four such research laboratories around the United States before making a final decision. Suen also is chair of the Department of Otolaryngology – Head and Neck
Looking Beyond Cancer’s Limits
meeting. “I believe it’s a good decision; it’s the right decision.” Kieber-Emmons said all the National Cancer Institute-designated cancer centers the committee visited are making every effort to advance research collaboration, whether externally or internally. “I thought open space would be a good thing for us because of who we are and what we’re trying to encourage,” said Kieber-Emmons, a professor of pathology in the UAMS College of Medicine whose own research involves work on a breast cancer vaccine to prevent recurrence of the disease. “We are an emerging cancer institute. You have to facilitate and promote interaction, and the best way to do that is to allow more contact to occur between investigators.” The advantages to researchers include flexibility and adaptability. A mobile bench system will replace traditional fixed cabinetry so that researchers can reconfigure their labs themselves, avoiding future constructions costs. Open labs also mean space can be assigned according to a researcher’s needs. “Administratively it’s a great idea because we can use space more effectively and more efficiently,” said Kieber-Emmons, who first worked in an open lab in 1986. “It’s cost effective; it encourages sharing of equipment, and it provides actually more space to investigators, not less.” The new labs’ first occupants will be Rick Edmonson, Ph.D., who is leading the development of personalized medicine through the UAMS Proteomics Core; Mayumi Nakagawa, M.D., Ph.D., who is conducting research of a therapeutic vaccine for those infected with HPV (human papillomavirus); and Vladimir Zharov, Ph.D., who is internationally recognized for his research using Surgery and is a professor in the nanomedicine. UAMS College of Medicine. Walston notes that not all UAMS researcher Thomas I thought open of the spaces will be wall-less. Kieber-Emmons, Ph.D., was Some spaces are required to space would be a on the committee and an be enclosed for containment, early proponent of the opengood thing for us such as to protect tissue lab concept. Based on his because of who we cultures. Fume hoods also will experience working in open be in enclosed alcoves, and the labs before coming to UAMS, are and what we’re principal investigators will have Kieber-Emmons said the concept offers more advantages trying to encourage.” offices. “In an open space the than disadvantages. When he researchers are more likely to talk, to ask returned from visiting other cancer institutes questions, and a lot of times they’ll advance their with modern open-lab designs, he spoke to a large research because they end up collaborating,” group of UAMS’ researchers. Walston said. “I made it known how I felt,” he said of that
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Winthrop P. Rockefeller Cancer Institute
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Partners Card Kickoff Who: Cancer Institute Auxiliary members and Partners Card committee members, including chairman Diana Smithson What: Kickoff party the 2011 Partners Card When: Aug. 30, 2011 Where: IberiaBank Gerritt Whittaker and Peyton Woodyard
Beth and Emily Ingram
Lou Anne Herget, Sherri McClain and Dinah Sullivan
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Why: One of the Cancer Institute Auxiliary’s most successful fundraisers, Partners Card offers shoppers the chance to purchase a $50 card and in turn receive a 20 percent discount at 160 shops in central and northwest Arkansas. This is the eighth year for the Cancer Institute to offer Partners Card in central Arkansas and the sixth year in the northwest part of the state. During that time, the fundraiser has raised more than $400,000 in central Arkansas and $88,000 in northwest Arkansas.
Robin Dean, Stacy Sells and Diana Smithson
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spotlight
Never Lose Spirit Kickoff Who: Project creator Stacy Sells; underwriters Vincent M. Insalaco and Judy Kohn Tenenbaum; artist James Hayes; Arkansas’ First Lady Ginger Beebe; and guests What: Kickoff for the Never Lose Spirit project When: Oct. 3, 2011 Where: Winthrop P.
James and Meg Hayes, Vincent M. Insalaco and Judy Kohn Tenenbaum
Rockefeller Cancer Institute
Why: Never Lose Spirit glass sculptures by artist James Hayes may be purchased in the Cancer Institute and UAMS hospital gift shops and online at www. neverlosespirit.org. All proceeds from the sale of the sculptures benefit support services for UAMS cancer patients. The project was developed by cancer survivor and volunteer Stacy Sells.
Arkansas’ First Lady Ginger Beebe and Peter Emanuel, M.D.
Stacy Sells with a Never Lose Spirit glass sculpture
Natalie Hunter and Win Rockefeller Jr.
Winthrop P. Rockefeller Cancer Institute
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Gala for Life Who: More than 900 Cancer Institute supporters, including Christy and William Clark, co-chairs, and Jonnie and Kent Westbrook, M.D., honorary chairs What: In its 16th year, Gala for Life is the Cancer Institute Foundation’s premier fundraising event. Musical entertainment was provided by Kool and the Gang. Raye Rogers, Pat Walker and John Shock, M.D.
When: Sept. 16, 2011 Where: Statehouse Convention Center in Little Rock Why: This year’s Gala for Life included a presentation of the Pat and Willard Walker Tribute Award to long-time Cancer Institute supporters Frank Hickingbotham and Herren and Susan Hickingbotham. The event raised more than $650,000.
Guests dance to the music of Kool and the Gang.
Herren and Susan Hickingbotham and Frank Hickingbotham
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Kent Westbrook, M.D., and Jonnie Westbrook
Looking Beyond Cancer’s Limits
spotlight
Carrie and Mike Eggart
Lindsay Luke, Amy Marker, Paul Johnston and Chrissy Gaul
Doug and Catherine Tapp with Nancy and Jim Montgomery
Cheryl and Elvin Shuffield
Pat Walker with Kool and the Gang
Winthrop P. Rockefeller Cancer Institute
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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
Four Corners
Board members bring expertise from across Arkansas and beyond. Raye Rogers
Batesville Founding and Life Member, Cancer Institute Foundation Fund Board
Herren Hickingbotham
Little Rock Principal, Hickingbotham Investments Member, Cancer Institute Foundation Fund Board
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I was honored to continue my father’s legacy of service on the Cancer Institute Foundation Fund board. I’m proud to support the institute and activities like the annual Gala for Life, a fun event that raises awareness and support for the important work that the Cancer Institute does.”
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When former UAMS Chancellor Harry Ward asked me to serve on the founding board, they were still in the early stages of planning for the cancer center. It is phenomenal what has happened through the years as the Winthrop P. Rockefeller Cancer Institute has grown and evolved. It has been a privilege for me to serve on the board and an honor to have been selected as a life member.”