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Progress Fall 1997

Index

Wicha Recognized with Distinguished Professorship

Hope has a New Home - Cancer Center Dedicates New Building

Research Roundup

New Educator Guides Patients and Staff Through Information Maze

Hope Emerges

Prevention PeRiScope - Winning the War on Cancer

Redman Heads Clinical Trials Effort

Cancer and Aging the Focus of President’s Cancer Summit at U-M

Cancer Center Dedication

 

Wicha Recognized with Distinguished Professorship

In conjunction with the dedication celebration, members of the Cancer Center Advisory Committee along with other special friends of the Center announced the establishment of a Distinguished Professorship endowment to be held by the Director of the Cancer Center, Max Wicha, M.D. The endowment will be created from gifts pledged in recognition of Wicha’s leadership in bringing the Cancer Center from its infancy to one of the premier centers in the country. Following Wicha’s tenure as director of the Cancer Center, the professorship will be renamed the “Max S. Wicha Distinguished Professor of Oncology.”

“As we take on the challenges of defeating cancer, we are inspired by the courage and determination of our patients and their families.”

Max S. Wicha, M.D.

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Hope Has a New Home

Cancer Center Dedicates New Building Cancer Center building

A colorful banner with the words, “Seeking, Discovering, Caring, Curing, Helping, Healing” streamed down the new Cancer Center and Geriatrics Center facade on a sunny June 13 to mark the building’s long-awaited dedication ceremony.

A crowd of nearly 1,000 patients, staff, philanthropists, University and state dignitaries, and other community members gathered under the striped tent set atop the Center’s parking structure to hear inspirational remarks by Gov. John Engler and Former Athletic Director and Coach Glenn “Bo” Schembechler.

The ceremony’s other speakers included U-M President Lee C. Bollinger; Vice Provost for Medical Affairs Emeritus George D. Zuidema, M.D.; Cancer Center Director Max S. Wicha, M.D.; and Geriatrics Center Director Jeffrey B. Halter, M.D. The dedication was followed by a community open house, with tours of the new facility’s clinics and research lab demonstrations.

cutting the red tape

“The [physicians and researchers] here will work together as a team, so they can come up with discoveries that will make treatments better and, perhaps in the end, will lead to the ultimate victory -- a victory over cancer.” Bo Schembechler

 

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Research Roundup

Promising prostate cancer vaccine tested
Could a genetically engineered vaccine to fight prostate cancer be on the horizon? A U-M Cancer Center researcher believes a new clinical trial using a combination of gene therapy and hormone therapy will go a long way toward answering that question.

Martin Sanda, M.D., assistant professor of Urology and Oncology, is testing the safety and biological effects of a vaccine for men in whom prostate cancer recurs after radical prostatectomy. The test vaccine is a genetically engineered version of the smallpox vaccine, called “prostvac,” in which a prostate-specific gene has been inserted to arm the immune system against prostate cancer cells. The hope is that the vaccine will encourage the growth of T-lymphocyte cells that will recognize and kill the prostate cancer cells.

The Phase I/II study — expected to enroll approximately 25 men — is one of three nationwide looking at the vaccine, but Sanda says the U-M trial is unique.

“This is a novel approach to develop a new cancer therapy in early disease before it has been evaluated in advanced cancer that’s no longer curable,” Sanda says. He points out that with advances in screening, most new cases are early forms of the disease, so it makes sense to target early treatment.

image of Victorian family

Colorectal cancer studied in at-risk Jewish population
Bert Vogelstein, M.D., and his colleagues at Johns Hopkins University — including co-investigator Stephen B. Gruber, M.D., Ph.D., now at the U-M Comprehensive Cancer Center — recently identified the first known genetic mutation that causes familial colorectal cancer and have developed a simple blood test to identify it. The mutation is present in more than 680,000 of the world’s 11.2 million Ashkenazi Jews, making it the most common cancer-related mutation known.

Familial colorectal cancer accounts for between 15 and 50 percent of the 130,000 cases of colorectal cancer diagnosed in the U.S. each year, but its cause was not known. The researchers discovered that a mutation — first identified in a single Ash-kenazi patient — occurs in a cancer-causing gene known as APC. In subsequent studies, researchers found the mutation occurred in:

  • more than 6 percent of 766 Ashkenazi Jews studied;
  • one-third of Ashkenazi Jews with a family history of disease;
  • one in six Ashkenazi colon cancer patients who developed cancer prior to age 66; and
  • one in eight of those who developed colorectal cancer at any age.

Researchers believe that this APC mutation doubles a person’s risk of developing colorectal cancer. However, according to Gruber, the disease often can be detected with regular screening tests at an early stage when it’s most curable.

Gruber is organizing clinical studies at the U-M Cancer Center to further determine how much risk is associated with the APC mutation and how best to counsel people regarding risk and prevention. He plans to enroll hundreds of people of Jewish descent who fit one or more of the following criteria:

  • have had colorectal cancer;
  • have a family history of colorectal cancer in a parent, brother, sister or child;
  • are interested in genetic testing and/or risk assessment for colorectal cancer.

“The primary goal of the study is to understand the risk of colorectal cancer in the Jewish community and learn how we can effectively intervene,” says Gruber, an assistant professor of Internal Medicine and Epidemiology in the division of Molecular Medicine and Genetics.

Those interested in learning more about these clinical studies should call the Cancer AnswerLine™ nurses at 1-800-865-1125.

 

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New Educator Guides Patients and Staff Through Information Maze

Educating patients is not a new role for Shon Dwyer. She’s been committed to meeting this critical need throughout her career as a nurse and administrator at the University of Michigan Medical Center.

But now it’s official. As the Cancer Center’s new health educator, Dwyer devotes her time to helping patients and staff navigate the maze of cancer-related information.

“As a nurse, I really loved the part of my job that focused on patient education,” says Dwyer, who has bachelor’s in nursing and a master’s in business administration from U-M. “Patients and families who are informed strengthen the health care partnership and feel more in control.”

She currently spends much of her day in the Cancer Center’s new Patient Education Resource Center (PERC) — created through a gift to the Center. There she gathers, reviews and organizes health information ranging from books, newsletters and pamphlets to videos, CD ROMs and internet web sites.

Dwyer relies heavily on volunteers for staffing during busy clinic hours. “Many of our volunteers are cancer survivors themselves, so there’s an instant bond with patients and a deeper level of understanding.” However, she stresses that volunteers, who commit four hours a week for a year, are there to help patients navigate the resources — not give medical advice.

Dwyer has been inspired by a new model of health education advocated by the Center’s Director of Cancer Prevention and Control, Victor J. Strecher, Ph.D., M.P.H. The concept of tailoring health messages to an individual’s needs has been shown to be much more effective than providing mass-produced materials. Although the PERC now relies on many standardized materials, Dwyer expects that to change in the next few years.

Beyond her duties with the PERC, Dwyer plans to involve all clinicians in the development of new resources. “We need to develop innovative ways of educating patients on the spectrum of prevention, treatment and survivorship issues. Our patients should feel connected when they leave here,” explains Dwyer. “My hope is that patients will take advantage of our resources when they’re here, know how and where to find information after they leave and feel comfortable about calling us anytime for help.”

She also wants to encourage innovation in the way health care providers educate. “Our clinicians are the most knowledgeable when it comes to the content of patient education, but they often need help to give the message at the right time and at the patient’s level.”

Dwyer gives the example of a patient undergoing chemotherapy who is given everything he would ever need to know about chemotherapy on his first day of treatment.

“Even if this patient wasn’t sick, he couldn’t possibly process that much information,” she says. She advocates a step-wise teaching approach — ask patients what their needs are, combine that with critical information from the caregivers’ perspective and then go at an individualized pace.

The value of this new role at the Cancer Center has yet to be measured with surveys or studies, but Dwyer already has marked a successful milestone. “My first day on the job, a patient hugged me.”

We’d love to meet you!
Visit us on Cancer Center Level B1-Room 361.
Call us at (313) 647-8626.
The PERC is open 9 a.m. to 7:30 p.m.,
Monday through Friday.

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National Cancer Survivors’ Day Celebration and Town Hall meeting

Hope Emerges

“There is no such thing as false hope,” proclaimed Ellen Stovall, keynote speaker at the National Cancer Survivors’ Day Celebration and Town Hall meeting held this past June. Stovall called this the “universal truth” she discovered since being diagnosed with Hodgkin’s disease in 1971. A member of the President’s National Cancer Advisory Board and executive director of the National Coalition for Cancer Survivorship, Stovall credits her survival to excellent medical care and her feelings of hopefulness.

She also discovered two great “cancer lies” — cancer is a death sentence, and a personality exists that can predict a cancer diagnosis. She encouraged the audience of more than 500 cancer survivors, family members, friends and health care professionals to stop blaming themselves and their institutions and get on with the things they can change. “Eliminate tobacco, live well and when the time comes, die well,” said Stovall.

Stovall agreed with author Arthur Frank, who defines cancer as a “dangerous opportunity.” She explained that “a cancer diagnosis compels and permits one to think about life in a new way. It forces one to stop and ask why we live as we do and what the future may look like. A cancer diagnosis can give one the opportunity to choose the life we lead for however long it will be.”

During the past 25 years, Stovall has seen the emergence of a new breed of cancer survivors who are living life with a new-found awareness and expertise. “These are survivors who are dispelling the myths and changing the language -- from victim to victor, from patient to survivor,” she said. Stovall believes that most survivors feel more secure, self-assured and thus more empowered when they understand their options and resources available.

She hoped the community dialogue begun at the Town Hall meeting would lead to a better understanding of “our shared commitments, our shared frustrations, our shared disappointments and especially our shared hopes.”

“With our communication today will come understanding, with our understanding fear diminishes, in the absence of fear hope emerges and in the presence of hope, anything is possible.”
26-year cancer survivor Ellen Stovall

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Prevention PeRiScope

by Victor Strecher, Ph.D., M.P.H. and John J. Brusk

firing cannon

Winning the War on Cancer
Dr. John Bailar from the University of Chicago recently received intense media attention by claiming the “war against cancer is far from over.” From 1970 to 1994, Dr. Bailar points out, death rates from cancer in the United States have actually increased six percent. He believes that any progress observed from a decreasing number of cancer deaths largely reflects prevention efforts and an increase in early detection (such as breast and cervical cancer screening). Holding this view, he maintains that resource allocation should be realigned toward prevention, even if that “may well mean curtailing efforts focused on therapy.”

It is true that cancer death rates have not gone down as much as hoped. There are many cancers that are not easily treated. Yet there are reasons to be optimistic. Death rates from cancer among children have gone down dramatically. One need only walk down the halls of C.S. Mott Children’s Hospital to understand the impact of these advances. On a larger scale, during the past few decades scientists have learned a great deal about cancer’s origins and development.

Yes this research is costly, and no it hasn’t produced the results hoped for in the early 1970s. Advances in cancer knowledge have come at a cost, but this knowledge is critical if the next steps are to be taken toward more effective treatments. And there are signs of progress: from 1991 to 1995, the National Cancer Institute estimates that deaths from cancer began to decline.

Some of this decline is undoubtedly due to prevention efforts made in the United States. For example, reductions in smoking rates have been dramatic and are likely to have a very strong impact on cancer rates. Early detection efforts — particularly in breast cancer (through mammography and clinical breast examination) and cervical cancer (through PAP testing) — are also beginning to pay off in the form of lower death rates.

However, a balanced arsenal of treatment and prevention efforts is needed. In order for early detection to be of any value, effective treatments must be made available. Many women, for example, fail to get a mammogram for fear of finding breast cancer. Yet it’s known that such early detection saves lives. As cancer treatments continue to improve, it is likely that more individuals will be interested in receiving screening.

We must also be better at applying what is known about cancer treatment to all Americans. In 1988, the General Accounting Office examined treatment patterns for several diseases. They reported that a considerable group of patients, including 94 percent of those with colon cancer, did not receive what the National Cancer Institute considers state-of-the-art treatments. Clearly, progress against cancer cannot be properly evaluated when many individuals are not receiving the best care available.

Research in cancer prevention has given us powerful weapons to fight cancer. As a result of such efforts, we understand more about the causes of cancer, the identification of environmental and genetic risks related to cancer, the development of cancer-preventing drugs, and how to best affect health behaviors through effective education. Nonetheless, treatment efforts should be considered just as necessary.

While cancer death rates have been slow to decline, many cancer patients are living longer because they received the appropriate treatment. Research should continue to be devoted to improving these treatments and the quality of life led by cancer survivors.

We have not yet won the war on cancer. There is no doubt that much of our effort to defeat cancer should be spent on prevention. However, prevention and treatment of cancer are most successful when they are used together. Their natural dependence on each other makes it clear that to defeat cancer, prevention and treatment must fight hand in hand.

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Redman Heads Clinical Trials Effort

Navajo Indians use them for healing rituals. Tibetan monks useBruce G. Redman, D.O., has been appointed associate professor of internal medicine and director of the clinical trials program at the U-M Cancer Center. A leading expert in prostate cancer, renal cell carcinoma and melanoma, Redman previously served as director of the genitourinary oncology program at the Barbara Ann Karmanos Cancer Institute in Detroit.

“Dr. Redman is an outstanding clinician and clinical investigator, who will add significantly to our efforts in developing immunotherapies for cancer patients,” says U-M Cancer Center director Max S. Wicha, M.D. “We are truly delighted to have Dr. Redman join the Cancer Center team.”

“I joined the University of Michigan Cancer Center because of the cutting-edge research under way here, and I look forward to continuing to build the U-M’s clinical program,” says Redman, who received his medical degree at the Chicago College of Osteopathic Medicine and completed his oncology fellowship at Wayne State University in Detroit.

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Cancer and Aging the Focus of President’s Cancer Summit at U-M

With mortality rates from cancer declining due to advances in research, more people are living longer. Older Americans and their care givers now must confront cancer in new ways. That issue was the focus of the latest summit meeting of the President’s Cancer Panel, held July 31 at the U-M. The meeting — “Cancer and the Aging Population” — was sponsored by the National Cancer Institute and is one of four public meetings this year examining the concerns of special populations.

U-M physicians, along with a host of cancer and geriatrics experts from around the country, spoke about a range of issues — access to health care; prevention and detection; health and behavior; molecular and biological questions; survivorship; and supportive care.

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“The [physicians and researchers] here will work together as a team, so they can come up with discoveries that will make treatments better and, perhaps in the end, will lead to the ultimate victory -- a victory over cancer.” Bo Schembechler

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Editor

Max S. Wicha, M.D.
Director, U-M Cancer Center

Maria White
Director, Marketing Communications

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Speak with a Cancer nurse: 1-800-865-1125
Please Note:

This publication is now a part of the Cancer Center's News Archive. It is listed here for historical purposes only.