UVM Cancer Center: Innovations (Fall 2022)

Greetings from the UVM Cancer Center! Over the last year, the Cancer Center has made strategic investments in research, education, community outreach, and clinical care with the goal of aligning our current program with the National Cancer Institute best practice. Across the board, we are investing in faculty, staff, and programs to reduce the burden of cancer for residents of Vermont and northern New York. Initiatives include:

RESEARCH: Strengthen Clinical and Fundamental Research

We are supporting UVM faculty to obtain cancer-focused peer-reviewed extramural funding and have established new collaborations across the UVM campus to foster inter-disciplinary research opportunities. Over this year, we have helped in the recruitment of six physician investigators and a fundamental researcher focused on DNA damage and repair. Excitingly, we have helped to create nine additional positions, most in laboratory sciences, in collaboration with the College of Nursing and Health Sciences, the College of Arts and Sciences, the College of Agriculture and Life Sciences, and various departments within the Larner College of Medicine. These recruitments are underway and will greatly enrich each of the three Cancer Center research programs: Cancer Control and Population Health Sciences, Host Factors and Tumor Progression, and Molecular Mechanisms of Malignancy.

EDUCATION: Coordinate Cancer Education and Training

We are building infrastructure to better coordinate cancer education, training, and mentoring with the addition of new staff, establishment of a summer cancer research program for graduate, medical, and undergraduate students, and the creation of the Clinician Investigator Development Award which provides protected time for clinicians to engage in scholarly activity.

COMMUNITY OUTREACH: Expand Community Outreach Efforts

Over the past year, we have launched our Community Advisory Board so that we can both inform our community partners about what we are doing here in the Cancer Center and receive input from these stakeholders to ensure that we are meeting the needs of the community. We have also begun a detailed analysis of cancer incidence and mortality within our catchment area of Ver mont and northern New York to ensure that our research can best address the cancer burden overall and cancer disparities, particularly for patients in rural areas. As an example, we are collaborating with the Vermont Department of Health, Vermonters Taking Action Against Cancer (VTAAC), and the Dart mouth Cancer Center on a lung cancer screening public education campaign.

CLINICAL CARE: Support Cutting-Edge Clinical Care and Novel Clinical Trials

It is vitally important that we provide the most innovative, state-of-the-art clinical care. This includes supporting both National Cancer Institute and industry- and investigator-initiated clinical trials that can provide direct benefit for patients. In collaboration with the UVM Medical Center, we recruited a director for and are moving forward with implementation of a CAR T-Cell (chimeric antigen receptor T-cell) program that offers new hope for patients with refractory leukemia, lymphoma, and myeloma. In collaboration with the Osher Foundation and philanthropic sources, we are expanding opportunities for patients and cancer survivors to have access to integrative approaches like acupuncture, yoga, and meditation.

RANDALL F. HOLCOMBE, M.D., M.B.A. J. WALTER JUCKETT CHAIR IN CANCER RESEARCH

PROFESSOR OF MEDICINE, LARNER COLLEGE OF MEDICINE DIRECTOR, UNIVERSITY OF VERMONT CANCER CENTER CHIEF, DIVISION OF HEMATOLOGY & ONCOLOGY

Philanthropy

Center by the Numbers

Outreach

University of Vermont Cancer Center 149 Beaumont Avenue Burlington, VT 05405

CONTRIBUTORS

Kate Strotmeyer, Managing Editor Jeff Wakefield, Copywriter Ann Howard, Designer

CONTACT INFORMATION

UVM Cancer Center cancer@uvmcc.med.uvm.edu 802-656-3099

@UVMCancerCenter www.vermontcancer.org

PHILANTHROPY SPOTLIGHT

pain,

and

Examples include

mindfulness, and other similar

Foundation, University of Vermont Medical

Victoria Buffum Fund will expand patient access to

addition to benefiting patients with cancer, these

clinical applications of the emerging field

Osher Center of Integrative Health established

$5.5 MILLION

will help create the Osher Center for Integrative

at the University of Vermont. The vision of the Osher Center

Integrative Health is to be a leader in advancing integrative health

education, clinical care, research, and policy and to serve as a nexus and catalyst of integrative health activities in Vermont. Integrative oncology services are central to the new center’s mission.

UVM Medical Center Auxiliary supports integrative oncology research

A $100,000 AWARD from the University of Vermont Medical Center

Auxiliary will support the Breast Cancer and Integrative Oncology Program by providing funds for research into improvements in outcomes for patients with breast and other cancers who receive integrative therapies.

Victoria Buffum Fund to provide no cost acupuncture to hematology and oncology inpatients

A NEW GRANT from the Victoria Buffum Fund will enable hematology and oncology inpatients at the UVM Medical Center to have access to free inpatient acupuncture. The use of acupuncture in cancer patients has been found to reduce pain and decrease use of analgesics. In addition to providing acupuncture service at no cost to patients, the new grant will also fund research into benefits of acupuncture for patients with cancer.

LUNG CANCER

UNLIKE SCREENINGS FOR breast, prostate, and other cancers, which have a long history and are routine procedures, examining non-symptomatic patients for signs of lung cancer is relatively new. Lung cancer screening for at-risk patients became a standard recommendation covered by insurance only in 2013, after research showed it saved lives, and is still much less utilized than screening for other cancers.

The discrepancy comes at a high price. Absent a regular screening protocol, lung cancer is often detected late, after it has spread, and is the number one cause of cancer death in Vermont and the country. Lung cancer kills more Vermonters, and more Americans, than breast, prostate, and colorectal cancers combined.

Dartmouth Cancer Center and the University of Vermont Cancer Center in partnership with Vermont’s state cancer coalition, Vermonters Taking Action Against Cancer, launched a community education program to make lung cancer screening for eligible patients—those over 50 who have smoked a pack of cigarettes a day for 20 or more years, including those who quit no more than 15 years ago—much more prevalent in Vermont. The project was funded by the National Cancer Institute.

Lung cancer screening is much needed in Vermont. Only 14.5% of eligible Vermonters are currently screened, according to the Journal of the National Cancer Institute.

“Vermont is above the national average of 5%,” said Beth Zigmund, M.D., UVM Cancer Center member and director of lung cancer screening at the UVM Medical Center. “But that number is still low; we miss well over half of Vermont’s eligible population.”

Vermonters with lung cancer currently have, on average, a five-year survival rate of 26%, close to the national average of 24%, according to the American Lung Association (ALA).

However, for those whose cancer has metastasized widely—a group that includes nearly half of all those screened in Vermont—five-year survival is just 6%. The number grows to 60% for Vermonters whose cancer is detected when localized at the original site, only about one quarter of those screened, according to the ALA.

“If they’re detected early, local tumors can be removed surgically, and that can be curative for many lung cancer patients,” said Randall Holcombe, M.D., M.B.A., director of the UVM Cancer Center. “By the time you have symptoms, like pain or coughing blood, the cancer may have spread, and the outlook is much less positive.”

The campaign included a variety of strategies, including public relations, marketing, social media, public education, and provider trainings. Learn more at:

PROBING OXYGEN’S MYSTERIES

OXYGEN: NO OTHER element feels as vital to human existence. It’s the key ingredient in the air we breathe. Deprive us of it for just four minutes, and we’re dead. Oxygen is critical for the chemical reactions our cells need to survive. The conversion of oxygen to water via oxidation-reduction reactions, or redox—the transfer of electrons from one substance to another—in our cells, is central to basic functions, including metabolism and respiration. Specialized catalysts that function during metabolism and respiration turn oxygen into oxidants, chemical substances that react with other cellular molecules, including proteins.

But there’s an oxygen paradox: While it’s essential to living organisms, it also causes damage that leads to illness and death.

Oxidants change the structure of our proteins in precise ways through oxidation reactions, allowing the proteins to function optimally. However, some protein oxidations occur at the wrong locations or in the wrong proteins, which can lead to metabolic diseases, cancer, chronic inflammation, and permanent scarring of organ tissue, known as fibrosis. Fibrotic tissue is more susceptible to further damage and disease, leading ultimately to tumor metastasis, aggressive cancer, organ failure, and death. Once fibrosis develops in an organ, such as the lungs, the organ tends to become therapyresistant and fail.

UVM Cancer Center member, Yvonne JanssenHeininger, Ph.D., is an expert in the fields of pulmonary fibrosis and redox medicine.

“The mission of my research is to find a way to stop a disease that is otherwise untreatable,” said JanssenHeininger, professor of pathology and laboratory medicine. “In my lab, we focus on specific biochemical processes that we believe contribute to fibrosis, and we have discovered exciting new tools for looking at oxida tion targets. We are designing precise small molecules to prevent incorrect protein oxidations from happening or reverse them, changing the course of disease.”

With fellow Cancer Center member Albert van der Vliet, Ph.D., Janssen-Heininger co-founded the internationally recognized Redox Biology and Pathology Program at UVM. She recently received a Lung Cancer Discovery Award from the American Lung Association (ALA) to study protein oxidation in the development of lung cancer with the aim of creating a new druggable target for chemotherapy-resistant tumors.

IN 2022, DR. JANSSEN-HEININGER, PH.D., WAS NAMED A UNIVERSITY DISTINGUISHED PROFESSOR, THE HIGHEST ACADEMIC HONOR THAT UVM CAN BESTOW UPON A MEMBER OF THE FACULTY.

EXCERPT FROM VERMONT MEDICINE BY JANET ESSMAN FRANZ

CELLULAR, MOLECULAR AND BIOLOGICAL SCIENCES DOCTORAL CANDIDATE MAURICE NEWTON (LEFT) WORKS IN THE LAB WITH YVONNE JANSSEN-HEININGER, PH.D.

INAUGURAL JUCKETT SCHOLARS LAUNCH CANCER CARE DELIVERY STUDIES

THE NEW CLINICIAN Investigator Development Initiative (CIDI) is designed to encourage productivity and career development for clinician investigators at the UVM Cancer Center.

“Clinical research is valuable and possible when investigators are given protected time, mentorship, and resources to dive into scholarly activity,” said Randall Holcombe, M.D., M.B.A., director of the UVM Cancer Center.

Two awardees, Kara Landry, M.D. and Alissa Thomas, M.D. will each receive approximately $250,000 over two years with an eye towards creating new standards for cancer care delivery.

Kara Landry, M.D.

MENTOR: RANDALL HOLCOMBE, M.D., M.B.A.

With a clinical and research interest in genetic factors that play a key role in developing cancer, Kara Landry, M.D. is investigating how to best care for patients with hereditary cancer syndromes.

“Right now, the burden of coordinating care often falls on our patients, especially those living in rural areas where access to care may be more limited,” said Landry.

“Since early detection and screenings are important for this group, we can improve how we help them navigate sub-specialists and shared decision making.”

This winter, Dr. Landry will begin enrolling high-risk patients in a program that will become the medical home base for the cohort. This shift in approach aims to show improvements in adherence to screening, prevention, and other early detection strategies, a reduction in patient distress, and improved patient experiences.

Alissa Thomas, M.D.

MENTOR: JIM WALLACE, M.D.

Brain metastases require a multidisciplinary team summoning the expertise of surgeons, radiation oncologists, palliative care doctors, and other sub specialists to the care of a single patient.

Shifting from a sequential model where patients see a string of individual clinicians towards a concurrent and multidisciplinary care approach will require precise

coordination on the front end but has the potential to improve the overall quality of care and be much less work for both the patient and physicians in the long run.

“A collaborative consultation, where the patient is in the room with their care team that includes providers from all of the relevant disciplines, has the potential to enhance individualized decision making and make a real impact in the disease and our approaches to treatment,” said Thomas, the division chief for neuro-oncology at the UVM Cancer Center.

The study will enroll 40 patients over the course of the year to measure patient-physician communication and understanding around prognosis.

WITH FUNDING FROM THE J. WALTER JUCKETT FOUNDATION, ALISSA THOMAS, M.D. (LEFT) AND KARA LANDRY, M.D. LAUNCH CLINICAL RESEARCH STUDIES.

IRENE’S STORY

STEVE FARRAR LOVED to paint portraits as an illustration major at Syracuse University in the early 1980s. But after graduating and launching a career in graphic design, Farrar drifted away from his passion for painting people and faces. He’d just as soon not have had the experience that brought it back: his wife Irene’s breast cancer diagnosis in 2012.

“A long period passed when I wasn’t doing any paintings,” he said. “But with Irene getting cancer, that changed a lot in our lives. For me it meant, I’ve got to get back into this; I need to start doing a painting.”

The project he tackled made up for lost time: a breathtaking 8-foot by 4-foot closeup of Irene when she was in the throes of chemotherapy (pictured below).

The painting project, along with other steps the couple took, offers clues for how patients and caregivers can survive the emotional trauma of a cancer diagnosis, said Kathy McBeth, a psychologist and cancer survivor at the UVM Cancer Center who specializes in working with cancer patients and their loved ones.

See and Be Seen

The photo session of Irene that Steve conducted—to capture the image he would paint—might have seemed arduous for someone in the thick of cancer treatment. “He took lots of photos and directed me on how to sit and where to look,” Irene said. But the experience was relaxing, she said.

That statement hints at something profound, says McBeth: how important it is for cancer patients to

be seen as they are without disguising their feelings. Steve’s experience was also emotionally meaningful, as anyone who experiences the painting can see, McBeth says. Even though the wife was the one who was going through treatment, the husband was also feeling hurt and sad for her. His own heart was a little bit on the gray side.

‘Not Going to Control Us’

For Steve and Irene, the painting was one way to avoid feeling helpless and take action. Another was the deep commitment to fitness the couple embraced in the form of Dragon Boat racing. When Irene began the program weeks after finishing radiation therapy, she could barely lift the paddle. Today, she is one of Dragonheart Vermont’s top competitors.

Steve celebrated Irene’s commitment to exercise and health in a second portrait (pictured on the cover). One afternoon in the spring of 2020 during a family photo session with Irene and the couple’s two daughters, Steve asked her to make a “strong pose,” she said.

The muscleman posture she struck became a bookend to the first painting—and a fitting symbol for the journey the couple took together.

“There are no magic words, there’s no magic bullet” for getting through cancer, McBeth said.

“What’s most important is to be honest with your feel ings and let that shine, let that come forward, because that’s what matters.”

STAGE 2 PORTRAIT OF IRENE

BY STEVE FARRAR, OIL ON PANEL

“ FOR CARE-GIVERS, EXPRESSING THOSE FEELINGS IS VITAL FOR EMOTIONAL HEALTH ”

– KATHY MCBETH, PSYCH-MA

University of Vermont Cancer Center 89 Beaumont Ave. Burlington, VT 05405 www.vermontcancer.org

WOMEN’S HEALTH AND CANCER CONFERENCE 25TH ANNIVERSARY

WHEN PATTI O’BRIEN, M.D., organized the first Women’s Health and Cancer Conference, in the fall of 1997, the UVM Cancer Center event was among the only meetings in the world devoted to the information needs of patients, who were often kept in the dark about their treatment at that time.

O’Brien was motivated to create the conference in part because of her own experience. After her breast cancer diagnosis, she began attending a support group. Members gave strong emotional support to one another, but had so many questions about cancer and its treatment that O’Brien began delivering what felt like mini-lectures to the group.

“That was when I realized the need for the conference,” she said.

The event was popular from its inception, drawing 600 people its first year. After two virtual years, once again over 600 people registered for this year’s free, hybrid conference. The conference was supported by the Victoria Buffum Fund and Eleanor B. Daniels Fund at the UVM Cancer Center.

$1 million Endowment Creates the Patti O’Brien, M.D. Women’s Health and Cancer Fund

This year, in recognition of her contribution, the Courtney and Victoria Buffum Family Foundation established the Patti O’Brien, M.D. Women’s Health and Cancer Fund to support the conference every year through a $1 million endowment.

In making this grant, the Foundation board of directors wanted to honor Vicki Buffum’s intent to help women and cancer patients get support in every way possible.

“We’re thrilled to be able to support this key event,” said board member Tom Gauntlett. “And we’re forever grateful to Patti O’Brien for having the foresight 25 years ago to see how great the need was. That the conference is so robust today is testament to her hard work and that of many others who have contributed to its success over the years.”

learn more about the many ways you can support the UVM Cancer Center.

ANDY DUBACK