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Annual Report - 2007-2008 - Cancer Care Cycle

Annual Report - Winter 2009

Momentum in Prevention 

New Division Head Expands Prevention Efforts
Profile: Epidemiologist Aims to Lower Risk of Recurrence in Breast Cancer Patients
Profile: Nurse Practitioner Helps Out-of-the-Ordinary, High-Risk patients
Profile: How M. D. Anderson's Tobacco Treatment Program Gives a Patient Hope
New Journal Focuses on Cancer Prevention Research

New Division Head Expands Prevention Efforts 

Ernest Hawk, M.D., left his post at the National Cancer Institute in December 2007 to join M. D. Anderson as its vice president for cancer prevention and head of the Division of Cancer Prevention and Population Sciences. Trained as a medical oncologist with a specialization in cancers of the gastrointestinal tract, cancer prevention is Hawk’s life work. “Many underestimate the value of taking proactive measures to address cancer prevention,” Hawk says. “Taking part in prevention studies is one way people can take steps to improve their health while generating research results that may increase cancer prevention options for family members and future generations.”

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Epidemiologist Aims to Lower Risk of Recurrence in Breast Cancer Patients

By Robin Davidson

Abenaa Brewster, M.D.

While volunteering at a children’s hospital during her junior year at Stanford University, Abenaa Brewster, M.D., witnessed firsthand the care and compassion required by oncologists. Right then, she made the decision to become an oncologist, and she’s never looked back.

While I enjoy epidemiological research and have a fabulous collaborative research team, I derive just as much pleasure from my clinical activities and seeing patients in the Nellie B. Connally Breast Center,” says Brewster, assistant professor in the Department of Clinical Cancer Prevention.

She recently led a team of researchers who studied 2,838 women from the M. D. Anderson Tumor Registry who were originally diagnosed with stage I-III breast cancers and treated with adjuvant systemic therapy, such as chemotherapy and/or tamoxifen.

“Understandably, one of the most common questions posed by breast cancer survivors is ‘What are the chances of it coming back?’ Now we can tell some women within a certain percentage their future risk of recurrence, and clinicians may be able to make more informed decisions regarding prescription of extended adjuvant endocrine therapy for a period of years,” she says.

The study also indicated a need for the continued development of risk-reduction strategies for pre-menopausal breast cancer survivors because of the need for more effective therapies in this younger age group.

“The magnitude of risk of recurrence should indicate a need for us to consider extended endocrine treatment for eligible women to further lower their risks,” Brewster says.

“My research in molecular epidemiology is focused on using hospital- and population-based cancer studies to identify epidemiological and biological factors that are associated with breast cancer risk and survival. These novel studies are providing important insights into how a patient’s lifestyle and genetic make-up determine her risk of having a poorer chance of survival after a diagnosis of breast cancer and will serve to more effectively personalize cancer care.”

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Nurse Practitioner Helps Out-of-the-Ordinary, High-Risk Patients

By Robin Davidson

Robin Coyne

Every day spent working in M. D. Anderson’s Cancer Prevention Center reaffirms Robin Coyne’s commitment to prevention.

“Prevention and education are so important,” says Coyne, an advanced nurse practitioner. “Encouraging patients to adopt a healthy lifestyle and helping them reduce their risks is very fulfilling.”

First and foremost a clinician, Coyne diagnoses and counsels cancer patients, conducts regular surveillance for survivors to help prevent recurrences and works with well patients to prevent cancer altogether.

Each Tuesday, she participates in a multidisciplinary group called the Breast Clinical Management Conference. Together, they address difficult cases via a team approach, making decisions on how to monitor and treat breast cases that may be considered out of the ordinary.

“The patients’ conditions aren’t benign, but they may not have cancer either. They may just have some abnormal or atypical results that need to be followed closely and cause them to be at high risk for breast cancer. We have a team of breast experts — surgeons, radiologists, pathologists and cancer prevention specialists — watching over their care.”

Coyne has developed a database of the hundreds of women presented at the Breast Clinical Management Conference to help identify trends and characteristics of high-risk patients to determine long-term care and prognosis.

One day of her workweek is spent seeing patients in the Undiagnosed Breast Clinic.

“Naturally, these women are anxious. Either they found an unexplained lump or have received abnormal results,” she says. “I am glad to be their resource, hopefully allaying some of their fears. Educating patients and providing reassurance and compassion are important aspects of overall care.

“I’ve worked at M. D. Anderson for 10 years. To see the technology and the resource advances that have taken place in cancer prevention and early detection is so motivating. We’ve made great progress in oncology care. There’s a lot of hope to offer to patients.”

Ritsuko Komaki, M.D., professor in the Department of Radiation Oncology, served as 2007-2008 president of the American Radium Society and received the Marie Sklodowska-Curie Distinguished Award from the Society in Tribute to Maria Sklodowska-Curie.

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How M. D. Anderson’s Tobacco Treatment Program Gives a Patient Hope

By Katrina Burton

Charles Zelbst

When Charles Zelbst was diagnosed with bladder cancer in April 2005, his doctor at M. D. Anderson told him he should quit smoking.

“Every rational adult knows that smoking is bad for you,” Zelbst says. “But quitting is not an easy thing to do. After 42 years of being an avid smoker, I know that you don’t control the smoking, it controls you.”

He began smoking at the innocent age of 10 and was a habitual smoker by 13. He admits his first taste of cigarettes was due mainly to peer pressure, trying to impress a girl. What he didn’t know at the time was that cigarettes are addictive and would have a lasting effect on his health. As the cravings for the nicotine grew, his habit had him smoking at least four packs of cigarettes a day.

At the time of his cancer diagnosis, Zelbst had already tried a variety of cessation methods, from hypnosis to acupuncture, even a 21-day, no-smoking camp, but nothing seemed to rid him of the cravings. It was M. D. Anderson’s Tobacco Treatment Program that finally gave him hope he could kick the habit.

The Tobacco Treatment Program, funded by M. D. Anderson’s portion of the State of Texas Tobacco Settlement Funds, offers tobacco-cessation services, including in-person behavioral counseling and several tobacco-cessation medication treatments, at no cost to eligible M. D. Anderson patients.

Zelbst, whose cancer is in remission, joined the Tobacco Treatment Program in August 2008 and credits it with giving him some confidence that he will actually quit smoking for good.

“The program was the first quit-program that reduced my cravings,” he says. “Coupled with the medication and counseling, the program is really working for me, and I believe it will work for others.”

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New Journal Focuses on Cancer Prevention Research

Scott Lippman, M.D., chair of M. D. Anderson’s Department of Thoracic/Head and Neck Medical Oncology, was appointed founding editor-in-chief of Cancer Prevention Research, the newest journal of the American Association for Cancer Research. This monthly journal launched in print in June 2008 and is dedicated to cancer prevention, from preclinical research to clinical trials. “Cancer Prevention Research encompasses the full range of prevention research and opinion in one resource,” Lippman says. “The journal also serves as a forum for commentaries on key public policy issues affecting cancer prevention while highlighting the central role of cancer prevention and early detection in public health.”

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© 2014 The University of Texas MD Anderson Cancer Center