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Patient Care Highlights

Annual Report - Winter 2010

 

Smoother pathway to survivorship

With the successful launch of four pilot clinics, M. D. Anderson is expanding its survivorship program. To date, survivors of cancers of the genitourinary system (bladder, prostate, testicular and penile), gynecologic system (cervical, endometrial, ovarian and other rarer gynecologic cancers), thyroid and breast are being transitioned to clinics that offer continued surveillance for recurrence, while monitoring and addressing late effects related to their cancers. In the community, M. D. Anderson also partnered with the Harris County Hospital District’s Lyndon Baines Johnson General Hospital to open its Survivorship Clinic for breast cancer patients.

What’s it really worth?

When it comes to spending millions, analyzing the value of purchases is important. That’s why M. D. Anderson’s Perioperative Value Analysis Team assesses equipment and technology for the operating rooms before they are purchased. The group recently hit a home run for all surgeons with the purchase of 60 ElectroSurgical Units, used to control bleeding during surgery. The units replaced 10-year-old equipment that was nearing its life expectancy. Through the value analysis process, the purchase will result in savings of more than $1.8 million for the institution over seven years.

Jeffrey Weinberg, M.D., associate professor, Department of Neurosurgery; team co-chair

Paul Gidley, M.D., associate professor, Department of Head and Neck Surgery; team co-chair

Lisa McMillian, manager, Department of Perioperative Materials Management

Age doesn’t have to be a factor

The door is now open for older patients with acute myeloid leukemia or myelodysplastic syndrome to receive potentially curative blood stem cell transplants from a matched donor. According to an extensive analysis of every such transplant conducted in North America between 1995 and 2005 for these two diseases, patients older than 65 do just as well as younger patients with transplants that are preceded by an M. D. Anderson-derived, milder chemotherapy regimen.

Sergio Giralt, M.D., professor, Department of Stem Cell Transplantation and Cellular Therapy

Reported in December 2008 at the 50th annual meeting of the American Society of Hematology.

Less toxicity for lung cancer patients

Patients treated for locally advanced non-small cell lung cancer who receive chemotherapy and proton beam therapy have fewer instances of bone marrow, lung and esophageal toxicities than patients who receive the standard treatment of intensity-modulated radiation and concurrent chemotherapy. The reduction in toxicity decreases the debilitating side effects of standard treatment that often lead to infection, bleeding, fatigue, difficulty in breathing, pain on swallowing and even death. In collaboration with Massachusetts General Hospital, M. D. Anderson is enrolling patients in a National Cancer Institute-approved randomized clinical trial to confirm these initial findings.

Ritsuko Komaki, M.D., professor, Department of Radiation Oncology

Reported in November 2008 at the Chicago Multidisciplinary Symposium in Thoracic Oncology.

Collaboration focuses on pediatric eye tumors

To fight retinoblastoma, a rare childhood cancer of the eye, doctors and researchers from four Texas Medical Center institutions — the Children’s Cancer Hospital at M. D. Anderson, Texas Children’s Cancer Center at Texas Children’s Hospital, The Methodist Hospital Research Institute and Baylor College of Medicine — have joined forces. Opened in March 2009, the Retinoblastoma Center of Houston is the first of its kind in the southwest United States and the only one in the nation using gene therapy in clinical trials. Patients also have access to proton therapy and genetic testing.

Dan Gombos, M.D., associate professor, Department of Head and Neck Surgery; clinical co-director, Retinoblastoma Center of Houston

Cynthia Herzog, M.D., professor, Division of Pediatrics; coordinating committee member, Retinoblastoma Center of Houston

Peter Zage, M.D., Ph.D., assistant professor, Division of Pediatrics; research co-director, Retinoblastoma Center of Houston

Transforming breast cancer screening

Researchers may have discovered a better method for monitoring women who have a very high risk of breast cancer. Magnetic resonance imaging (MRI) alternated with mammography every six months has been found to detect breast cancer not identified by mammography alone. One important unanswered question is whether an alternating MRI and mammography screening program will save lives — a topic for further study.

Huong Le-Petross, M.D., associate professor, Department of Diagnostic Radiology

Reported in December 2008 at the 31st Annual Meeting of the CRTC-AACR San Antonio Breast Cancer Symposium.

Addressing pre-surgery stress

In the first study to examine the benefits of pre-surgical stress management for men with prostate cancer, researchers found that men who participated in the brief stress management sessions prior to and immediately after surgery experienced less short-term mood disturbance the week before and the morning of surgery. They also had better long-term quality of life up to one year after surgery, compared to patients who received standard care or supportive attention.

Lorenzo Cohen, Ph.D., professor, departments of Behavioral Science and General Oncology; director, Integrative Medicine Program.

Reported in the July 1, 2009, edition of the Journal of Clinical Oncology.

Tiny tools bring lymphedema relief

For breast cancer patients who experience the common and debilitating condition known as lymphedema, there’s new hope. An M. D. Anderson study found that women who underwent a super-microsurgical technique, lymphaticovenular bypass, experienced reduced fluid in their swollen arms by up to 3%. In the minimally invasive surgery, surgeons use tiny microsurgical tools to make a few small incisions in the patient’s arm and redirect lymphatic fluid to microscopic vessels, promoting drainage and alleviating lymphedema. M. D. Anderson is among just a few institutions in the country to offer this technically complex surgery.

David Chang, M.D., professor, Department of Plastic Surgery; director, Plastic Surgery Center

Reported in March 2009 at the 88th Annual Meeting of the American Association of Plastic Surgeons.

Umbilical cord stem cells may link to better outcomes

In a first-of-its-kind randomized clinical trial, M. D. Anderson researchers are addressing the critical challenge associated with “standard” cord blood stem cell transplants for adult patients. Generally, the low doses of stem cells found in cord blood lead to longer recovery times. By exposing umbilical cord cells to growth factors in the lab and expanding the number of stem cells, patients recover faster and are less vulnerable to bleeding, infection and transplant failure.

Marcos de Lima, M.D., associate professor, Department of Stem Cell Transplantation and Cellular Therapy

Elizabeth Shpall, M.D., professor, Department of Stem Cell Transplantation and Cellular Therapy

Reported in December 2008 at the 50th annual meeting of the American Society of Hematology.

New findings for high-risk breast cancer patients

Women diagnosed with breast cancer are known to be at increased risk of developing the disease in the opposite breast, yet not all have the same degree of risk over their lifetime. In a study of women who had the disease in one breast yet chose to remove both, M. D. Anderson researchers discovered clinical features that identified strong predictors to help patients decide if they should undergo a prophylactic mastectomy. These included high risk for breast cancer based on the metrics in the Gail risk assessment tool, certain types of breast cancer, or finding multiple tumors in the affected breast.

Kelly Hunt, M.D., professor, Department of Surgical Oncology

Reported in the March 2009 issue of Cancer.


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