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The Future of Cancer
Care is Here. 2012 Annual Report
Table of Contents
Medical Director’s Letter . . . . . . . . . 2.
Feature Section: The Future of
Cancer Care Begins with Hope . . 3
Dallas Hope
Baylor T. Boone Pickens Cancer
Hospital
Oncology Evaluation and Treatment
Center
Programs of Focus . . . . . . . . . . . . . . 6
JaNeene Jones, RN, FACHE, Named . New Vice President of Baylor Health .
Care System Oncology Services
Baylor Health Care System Brands
Sammons Cancer Centers across
the Metroplex
Innovative Clinical Trials Center Ribbon
Cutting and Support from Swim
Across America
Baylor Health Care System is a Gold
Standard Employer
Integrative Medicine: Sticking It to
Cancer Treatment Side Effects
Crystal Griffith: Moving on with Life
Combining the Art and Science of Head
and Neck Cancer Care
Outpatient Oncology Clinic: Dental
Oncology
Hope Lodge
Maria James: The Biggest Win
of Her Life
Patient Support . . . . . . . . . . . . . . . 15
Healing with Support
Janie Walker, Head and Neck
Cancer Survivor
Disease Specific Support Groups
Survivors’ Celebrations
Healing Arts Performance Series
FitSteps® for Life
Barrett Lectureship
In Memoriam: Chef Ramah “Katie”
Bickerstaff
Blood and Marrow Transplant Program: How to Save a Life
Young Adult Cancer Survivors’
Dine & Dash
Hematology Patient Advocate Provided by the Leukemia and Lymphoma
Society®
Cancer Genetics Program
Community Events/Outreach
Free Community Screenings
Community Outreach Events
Cancer Registry . . . . . . . . . . . . . . . 25
Department Update
Summary of 2011 Cancer Registry Data
Patient Care Evaluation
Study . . . . . . . . . . . . . . . . . . . . . . 29
Bladder Cancer Patient Study
Bill Dippel: A Slam Dunk
Education . . . . . . . . . . . . . . . . . . . . 35
Fellowship Programs
Cancer Education Abroad
Where Are They Now?
New Medical Staff Additions to Surgical Oncology Department
The Seeger Surgical Breast Oncology
Fellowship 30th Anniversary
Site-tumor Conferences
Oncology Lectureships
Fellows Research
Management of Metaplastic Breast . Cancer: Clinicopathologic Features,
Prognosis and Response to Therapy
Continuing Medical Education
Symposia
Education in Palliative and End-of-Life
Care
Laura Granado: A Full and Healthy Life
Research. . . . . . . . . . . . . . . . . . . . . 44
Hope for Advanced Melanoma: New
Developments in Cancer Vaccines
Research in Breast Surgical Oncology: .
On the Lookout for PracticeChanging Results
The Surgical Oncology Research
Database: One-Stop Shopping for
High Quality Clinical Patient Data
Progress of Research Grants
Growth of Clinical Oncology Research . Coordination Staff
Accrual of Clinical Trials 2012
Contributions at the American Society
of Clinical Oncology Meeting
Publications . . . . . . . . . . . . . . . . . 52
Philanthropy . . . . . . . . . . . . . . . . . 55
T. Boone Pickens’ $10 million
Investment in Baylor
2012 Celebrating Women Luncheon
The Joan Horner Interfaith Prayer
Garden
Boon Family Crusade for Cancer
Research
Contact Information . . . . . . . . . . . . 59
Location Maps. . . . . . . . . . . . . . . . . 60
3410 Worth St.
Dallas, TX 75246
1.800.4BAYLOR
214.820-3535
BaylorHealth.com/DallasCancer
Cancer research studies on the campus of Baylor University
Medical Center at Dallas are conducted through Baylor
Research Institute, Texas Oncology, and US Oncology. Each
reviews, approves, and conducts clinical trials independently.
Their clinical trials are listed together, in this publication, for the
convenience of patients and physicians.
Physicians are members of the medical staff at one of Baylor
Health Care System’s subsidiary, community, or affiliated
medical centers and are neither employees nor agents of those
medical centers, Baylor University Medical Center, or Baylor
Health Care System.
Copyright © 2012, Baylor Health Care System. All rights
reserved. SAMMONS_396_2011 DH
Photographs may include models or actors and may not
represent actual patients.
2 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report Medical Director’s Letter
Abraham Lincoln said, “The best thing about the future is that it comes one day at a time.” One way to interpret this is that
today is yesterday’s future, so in a sense, the future is here. For those with cancer, the future is here. Here in 2012, and here at
Baylor Charles A. Sammons Cancer Center. The number of cancer survivors in the U.S. grows annually and through discovery
of the pathways that distinguish cancer cells from their normal counterparts, new and more specific treatments are becoming
available.
In 2012 we opened the new Baylor T. Boone Pickens Cancer Hospital, adding an inpatient facility designed for the needs of the cancer patient, to
complement Baylor Charles A. Sammons Cancer Center’s outpatient facilities that opened in 2011. We not only opened physical doors, but we also
opened a door to view the journey of three patients through their cancer care with the acclaimed documentary, Dallas Hope.
To keep the flame of the future burning brightly, we welcomed two of our graduating fellows, Drs. Micah Burch and Carolina Escobar to our medical
staff. Dr. James Fleshman joined us after a distinguished tenure at Washington University in St. Louis to become Chief of Surgery at Baylor University
Medical Center. We also welcomed JaNeene Jones, RN, FACHE, who took over as Vice President for Oncology and COO of Baylor T. Boone Pickens
Cancer Hospital.
This year, we launched Baylor Charles A. Sammons Cancer Center network. The cancer programs at six additional Baylor hospitals now carry the
Sammons name. Each of these programs has achieved accreditation from the American College of Surgeons’ Commission on Cancer and participates
in network research, education and quality initiatives. Our goal is to provide outstanding evidence-based and compassionate cancer care throughout
our communities.
We look forward to 2013—we look forward to tomorrow—because although the future is here today, it is also still ahead of us and will continue to bring
us hope.
Alan M. Miller, MD, PhD
Chief of Oncology, Baylor Health Care System
Medical Director, Baylor Charles A. Sammons Cancer Center at Dallas
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 3
The Future of Cancer Care Begins with Hope
Dallas Hope
who let us into their lives are Michelle
If you look up the word “hope” in Webster’s
Berndt, a 30-year-old mother of two;
Dictionary, it is described as the emotional
Cherysse Daniels, a 25-year-old leukemia
state that promotes the belief in a positive
survivor; and Bill Bradford, a 78-year-old
outcome related to events and circum-
retired business executive. Their heartfelt
stances in one’s life. Television viewers
journeys and real-life battles with cancer
across North Texas had a front-row seat
connected viewers with their everyday
to witness our hope at work in the three-
acts of courage, faith and hope.
part series premiere of Dallas Hope. This
unprecedented documentary, which
To celebrate the premiere of this
aired on WFAA Channel 8 in November,
documentary, a special Hollywood-style
highlighted the hope that follows a cancer
red carpet event and screening was held
diagnosis.
on October 30, 2012, at Baylor T. Boone
Pickens Cancer Hospital.
The series followed the lives of three
cancer patients undergoing treatment
at Baylor Charles A. Sammons Cancer
Right: Jennifer
Coleman, Joel
Allison, and Elaine
Hawes enjoying
the Dallas Hope
premiere
Dallas Hope star
Michelle Berndt
talks with Dr. Alan
Miller and Ellen
Miller
Center at Dallas. The stars of Dallas Hope
4 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report Baylor T. Boone Pickens Cancer
“The cancer hospital and cancer center
Hospital Grand Opening
are fully integrated and were built to com-
Baylor T. Boone Pickens Cancer Hospital,
plement each other,” stated Alan Miller,
the region’s first dedicated cancer hospi-
MD, PhD, chief of oncology for Baylor
tal, joins Baylor Sammons Cancer Center
Health Care System and medical director
at Dallas in providing advanced cancer
of Baylor Sammons Cancer Center.
care. The grand opening was held in early
November 2012. The new hospital opened
The hospital offers quality care with staff
in two existing buildings at Baylor Dallas
trained in all aspects of cancer treatment,
that underwent a $125 million renovation.
including an oncology evaluation and
Baylot T. Boone
PIckens Cancer
Hospital
Dallas Hope star
Michelle Berndt
and family celebrate
at the premiere.
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 5
treatment center, a blood and marrow
Baylor University Medical Center at Dallas
transplant unit and a variety of support
opened the Oncology Evaluation and Treat-
services.
ment Center to provide scheduled urgent,
non-emergency medical care for patients
Oncology Evaluation and
currently receiving cancer care at Baylor
Treatment Center
Dallas. The center offers care designed
Above: Tony Martinez, Dallas Hope producer
with John Pippen, MD
Receiving prompt, specialized care for
specifically for cancer patients. Staff are
urgent but non-emergency conditions is
trained and knowledgeable about specific
Left: Dallas Hope star Cherysse Daniels and
Edward Agura, MD
especially important for people receiving
issues, symptoms and side effects related
treatment for cancer. At night and on
to cancer treatment, including excessive
Below: Dallas Hope stars Cherysse Daniels
and Michelle Berndt
weekends, this often means a trip to the
nausea or pain.
emergency room. But, with patients’
already weakened immune systems from
The center is open from 4 p.m. to 7 a.m.,
cancer treatment, being exposed to infec-
Monday through Thursday, and from 4 p.m.
tious diseases in an emergency room can
Friday to 7 a.m. Monday. Appointments are
compromise their condition.
required, which helps reduce waiting times.
6 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report Programs of Focus
JaNeene Jones Named New Vice
President of Baylor Health Care
System Oncology Services
In February 2012, JaNeene Jones, RN,
FACHE, began her new role as vice
president of Baylor Health Care System
oncology services, as well as chief operating officer of Baylor T. Boone Pickens
Cancer Hospital and Baylor Sammons
Cancer Center at Dallas on the Baylor
Dallas campus.
Jones began her career at Baylor more
than 25 years ago as an administrative
fellow and advanced to various leadership
roles with Baylor University Medical Center
at Dallas and the system. Most recently,
she served as BHCS vice president of
transplantation services for four years.
Baylor Health Care System Brands
Sammons Cancer Centers Across
the Metroplex
Seven facilities across Baylor Health Care
System are now branded with the Baylor
Charles A. Sammons Cancer Center name
as part of the system’s push to bring
patients throughout North Texas the quality
clinical care and advanced technology for
which Baylor Charles A. Sammons Cancer
Center at Dallas is known.
JaNeene Jones, RN, FACHE
Baylor Charles A. Sammons Cancer Centers
are coming soon to Baylor Medical Center
at Carrollton and Baylor Medical Center at
McKinney.
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 7
1: Baylor Charles A.
Sammons Cancer
Center at Dallas
1
2: Baylor T. Boone
Pickens Cancer
Hospital
3: Baylor Charles
A. Sammons Cancer
Center at Fort Worth
2
3 4
Baylor Health Care System facilities in
research and education and access to
Fort Worth, Garland, Grapevine, Irving,
clinical trials across the Sammons cancer
Plano, and Waxahachie hold certifications
network, said JaNeene Jones, RN, FACHE,
from the American College of Surgeons’
Baylor Health Care System vice president
Commission on Cancer. This system-wide
of oncology services and chief operating
approach to extend the Sammons Cancer
officer of Baylor Sammons Cancer
Center name was based on the facilities’
Center at Dallas and Baylor T. Boone
achievement of this certification and to
Pickens Cancer Hospital.
show Baylor’s commitment to cancer care,
cancer research and cancer education.
In addition to the now seven Sammons
Cancer Centers, facilities located in
5
“We are very excited about growing
McKinney and Carrollton are expected to
4: Baylor Charles A.
Sammons Cancer
Center at Garland
together to bring quality cancer care to
join the Sammons cancer network in the
the citizens of North Texas and beyond,”
future.
5: Baylor Charles
A. Sammons Cancer
Center at Grapevine
said Alan M. Miller, MD, PhD, chief of
oncology, Baylor Health Care System
and medical director of Baylor Charles A.
6: Baylor Charles A. Sammons Cancer
Center at Irving
6
Like the Baylor Dallas location, these new
7: Baylor Charles A. Sammons Cancer
Center at Plano
cancer programs will have patient navi-
8: Baylor Charles A. Sammons Cancer
Center at Waxahachie
9: Baylor Medical
Center at Carrollton
Sammons Cancer Center.
gators and genetic counselors available
7 8
at each location to help patients through
their diagnosis, treatment and care. Other
benefits of the system-wide approach
10: Baylor Medical
Center at McKinney
include better collaboration on cancer
9 10
8 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report Innovative Clinical Trials Center
Dallas. “The ICTC is dedicated to providing
Ribbon Cutting and Support from
access to treatments only available in a
Swim Across America
few centers around the world, including
Baylor Charles A. Sammons Cancer Center
immunotherapeutic options such as cancer
at Dallas held a ribbon cutting for the
vaccines from Baylor Institute for Immunol-
Innovative Clinical Trials Center (ICTC) on
ogy Research and pharmaceutical agents
June 8, 2012, in honor of Swim Across
selected for specific molecular targets.”
America’s (SAA) commitment to raising
funds benefiting the ICTC. The ICTC offers
Swim Across America (SAA), a national
patients better access to a wide range
organization that holds dozens of commu-
of new research and treatment options.
nity-oriented open-water swims, is commit-
The ICTC expands the already extensive
ted to raising $1 million for cancer research,
program of cancer clinical trials offered at
prevention and treatment at Baylor’s ICTC
Baylor Sammons Cancer Center.
over a four-year period. In June 2012,
more than 300 swimmers and volunteers,
The ICTC consolidates all oncology phase
I clinical trials from Baylor researchers
and their academic and clinical research
partners in one facility located on the 7th
floor of Baylor Sammons Cancer Center.
Qualified patients will receive all testing
and treatments during trials at the center.
“The ICTC will simplify the process for
patients participating in a clinical trial by
providing one location for clinical examinations, infusions, imaging studies, sample
collection for lab work, and follow up,” said
Carlos Becerra, MD, medical director of the
ICTC and an oncologist on the medical
staff at Baylor University Medical Center at
including JaNeene Jones, RN, FACHE,
Above: BHCS
Foundation Director
Amy McNabb, Alan
Miller, MD, and SAA
Dallas committee
member Andrea
Dickson
Right: SAA Dallas
Committee, Alan
Miller, MD, along
with swimming
superstar Quinn,
the therapy dog,
open the Innovative
Clinical Trials
Center
Below: More than
300 swimmers and
volunteers helped
raise $275,000
to support the
Innovative Clinical
Trials Center
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 9
vice president of oncology services for
families. The CEO Roundtable on Cancer,
of traditional medicine practiced in China
Baylor Health Care System, Alan M. Miller,
a nonprofit organization of cancer-fighting
and other Asian countries. According to the
MD, PhD, chief of oncology for Baylor
CEOs, created the CEO Cancer Gold
National Center for Complementary and
Health Care System and medical director
Standard in collaboration with the National
Alternative Medicine, part of the National
of Baylor Sammons Cancer Center, and
Cancer Institute, many of its designated
Institutes of Health, acupuncture aims to
Dr. Becerra participated in the fundraising
cancer centers, and leading health nonprof-
“restore and maintain health through the
swim. Over the last two years, SAA has
it organizations and professionals. Today,
stimulation of specific points on the body.”
raised more than $635,000 that directly
more than 3 million employees and family
Many studies show that acupuncture works
benefits the ICTC phase I clinical trials
members are benefiting from the vision and
by releasing natural chemicals in
program.
leadership of employers who have chosen
the body, such as endorphins, to inhibit pain
to become Gold Standard accredited.
or change the perception of pain.
the local SAA committee and member of
The CEO Cancer Gold Standard calls for
“Acupuncture involves the stimulation of
the 1988 Olympic swim team, SAA chose
companies to evaluate their health benefits
defined anatomical points on the body
to support the ICTC at Baylor Sammons
and corporate culture and take extensive,
using a variety of techniques,” said Carolyn
Cancer Center after an intensive search
concrete actions in five key areas of health
Matthews, MD, medical director of the
for the best of the best in terms of cancer
and wellness to fight cancer in the work-
Integrative Medicine program and gyne-
research in North Texas. The 2011 open-
place. To earn Gold Standard accreditation,
cologic oncologist on the medical staff at
water swim represented the first year of an
a company must establish programs to
Baylor University Medical Center at Dallas.
initial four-year sponsorship of the ICTC.
reduce cancer risk by prohibiting tobacco
“The needles used are extraordinarily thin
“Our goal is to raise in excess of $1 million
use at the workplace, encouraging phy-
and are stimulated manually, electronically
during those four years,” said Watters. “We
sical activity, promoting healthy nutrition,
or with heat to achieve the desired effect
hope and anticipate that this commitment
detecting cancer at its earliest stages when
of pain relief.”
will be extended for many years.”
outcomes may be more favorable, and
According to Daniel Watters, chairman of
Baylor Health Care System is a
providing access to quality care, including
Today, the American Academy of Medical
participation in cancer clinical trials.
Acupuncture (AAMA) reports that 3,500
Gold Standard Employer
Carolyn
Matthews, MD
physicians and almost 12,000 nonphysi-
Baylor Health Care System received CEO
Integrative Medicine: Sticking It to
cians in the United States are practicing
Cancer Gold Standard™ accreditation,
Cancer Treatment Side Effects
acupuncture. An additional 400 to 500 phy-
recognizing its extraordinary commitment
One of the oldest healing practices in the
sicians are being trained annually according
to the health of its employees and their
world, acupuncture has long been part
to AAMA standards in this therapy.
10 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report Crystal Griffith: Moving on with Life
Crystal Griffith was trying to be a supportive friend. She had just
graduated from college and was starting a career and her young adult life.
A younger friend confided that a suspicious spot was found on her breast
as part of her annual gynecologic exam. She asked Griffith to accompany
her to the biopsy.
“I was scared for her and I wanted to help,” says Griffith. “But I also was
thinking, ‘Here I am older than her and I have never had a yearly exam.’
I got a funny feeling about it, but that feeling turned to fear when I felt a
lump myself two weeks later. I would never have had the courage to
go in, but seeing my friend go through it, I knew what I had to do.
I scheduled an appointment with my doctor right away.”
Thankfully, Griffith’s friend’s biopsy results were benign. However, Griffith
was not so lucky. At age 25, she was diagnosed with breast cancer.
“I told my friend she had saved my life,” says Griffith. After surgery, 16
rounds of chemotherapy and 35 rounds of radiation therapy, she is once
again moving on with her life. “I had to take a year off of my life to do all
this,” she says. “But now I have accepted it and am feeling more
confident.”
Crystal Griffith
poses at the 2012
Saks Fifth Avenue
Key to the Cure
Fashion Show
Left: Crystal
marches in the
2011 Sole Sisters™
relay
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 11
“Acupuncture is a time-honored treatment
“Head and neck cancer is a big challenge,”
for many of the symptoms experienced
said John C. O’Brien, Jr., MD, a surgeon
by cancer patients,’ said Dr. Matthews.
on the medical staff at Baylor Dallas.
“The wonderful thing about acupuncture
“Nowhere else is the art and science of
is that is has very few side effects and it
surgery challenged as much as it is in the
won’t interfere or interact with a patient’s
head and neck area. The preservation of
medications. Most who try this are open to
form, function and quality of life is difficult.
new approaches or have not had as much
We prioritize the cancer ablation (removal),
relief as they would like with what they
preservation of function and cosmetic
have already tried to control treatment side
results—in that order.”
effects. Most acupuncture patients feel
quite good at the end of treatment.”
Most often, treatment includes surgery,
radiation therapy and/or chemotherapy,
Combining the Art and Science of
all of which can cause long-lasting side
Head and Neck Cancer Care
effects. While surgery is commonly per-
In the past 20 years, the incidence and
formed before radiation or chemotherapy,
death rates from oral and head and neck
newer types of chemotherapy drugs have
cancers have been declining in all popula-
been developed that allow certain patients
tions, according to the National Cancer
to avoid surgery altogether.
Institute. While these cancers are usually
Head and
neck cancer
consultation
with patient
treatable, especially if caught early,
“There have been a lot of clinical trials that
therapies can cause lasting side effects
have looked at ways to treat patients and
including disfigurement, loss of smell or
avoid performing surgery,” said Lance
taste and dry mouth. Physicians on the
Oxford, MD, an otolaryngologist on the
medical staff and clinical professionals at
medical staff at Baylor Dallas. “This is one
Baylor University Medical Center at Dallas
of the biggest advances in head and neck
work as a coordinated team to diagnose
cancer in 20 years. For example, certain
and develop a treatment plan for each
patients can be treated first with chemo-
patient diagnosed with an oral or head
therapy and radiation therapy in an effort
and neck cancer and help reduce these
to keep their vocal chords intact and avoid
life-altering side effects.
a laryngectomy or removal of part of or the
12 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report entire larynx, which can affect breathing,
This type of cancer that affects every part
swallowing and speaking.”
of a patient’s life requires teamwork and
expertise. Baylor Charles A. Sammons
Any needed reconstruction procedures
Cancer Center strives to meet the chal-
are discussed during the initial treatment
lenges of patient cases and looks at their
planning process. If possible, these surger-
individual situations to develop an appropri-
ies are performed at the same time. New
ate treatment plan. Dedicated physicians
technology available at Baylor University
and medical staff, along with emotional
Left: Consultation with a dental clinic
patient
Medical Center at Dallas enables physi-
and spiritual support, work in tandem to
Below: Oncology Outpatient Dental Clinic
cians and reconstructive surgeons on the
provide this multidisciplinary approach to
medical staff to discuss and visualize a
advanced cancer care.
treatment plan that is tailored for each
patient. This new 3-D technology allows
Oncology Outpatient Dental Clinic
head and neck surgeons to meet with
Chemotherapy, radiation treatments and
plastic surgeons to measure the area that
transplants affect many different parts of
needs to be resected. During the same
the body, including the mouth, teeth and
procedure, the plastic surgeons can also
gums. The Oncology Outpatient Dental
perform necessary reconstruction, which
Clinic at Baylor Sammons Cancer
provides many patients a better recovery.
Center provides preventive and proactive
“Often, the reconstructive surgery can be
oral health care before and after cancer
performed right away so the patient leaves
treatment or organ transplantation. Organ
the hospital essentially whole again,”
transplant recipients have a higher risk of
added Jason Potter, MD, a plastic sur-
oral cancer and should undergo regular
geon on the medical staff at Baylor Dallas.
screenings to detect cell abnormalities or
“These issues are a significant concern
irregularities.
with head, neck and oral cancer patients,
and I think we can reassure them that not
“It is important to see a dental oncology
only are they getting advanced treatment
professional before beginning cancer treat-
for their cancer, but we are doing every-
ment,” said Jane Cotter, RDH, MS, dental
thing possible to get their life back to
hygienist. “There is much the dental clinic
where they were before.”
staff can do to prevent significant oral pain
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 13
and infection by seeing a patient before,
and transplant patients and will coordinate
services such as quitting resources, nico-
to the area soon, located on the campus
during and after treatment.”
with the patient’s primary physician to take
tine replacement therapies and prescribed
of Baylor University Medical Center at
an active stance in preserving their dental
nicotine replacement therapies.
Dallas.
Hope Lodge
Hope Lodge offers cancer patients and
The dental oncology clinic and lab services
health.
are designed to reduce the incidence
of oral complications associated with
In addition to dental oncology services,
Patients and their caregivers who travel
their caregivers a free, temporary place
such treatments. The dentists and dental
tobacco cessation counseling is offered
out of town for treatment will have a place
to stay when their best hope for effective
hygienists on the medical staff of the
to patients, their family members and
to call home away from home in Dallas.
treatment may be in another city. Accord-
Oncology Outpatient Dental Clinic under-
the public. Ms. Cotter also is a certified
The American Cancer Society announced
ing to the American Cancer Society, Hope
stand the special oral needs of cancer
tobacco treatment specialist and offers
that a Hope Lodge location will be coming
Lodge provides a nurturing, home-like
environment where guests can retreat to
private rooms or connect with others.
Currently, there are 31 Hope Lodge locations throughout the United States.
Sample interior family room at Hope Lodge,
soon to be built on the campus of Baylor
University Medical Center at Dallas
14 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report Maria James: The Biggest Win of Her Life
Maria James coaches girls basketball. She survived cancer twice. After
9 years of being cancer-free, she was treated again at Baylor for a
different type of breast cancer. She’s now been cancer-free for more
than 3 years. It’s the biggest win of her life.
We’ve been pioneering cancer research and treatments for 35 years and
thousands of patients. That adds up to one huge commitment to erase
cancer.
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 15
Janie Walker
Patient Support
Cancer education and support are two
Center offers many different types of
myself or who had already weathered
essential components in the treatment
support groups, ranging from educational
the storm and were leading somewhat
process. Named in honor of former patient
to disease-specific, through the Virginia R.
normal lives again. There is some-
Virginia R. Cvetko, the Cvetko Patient
Cvetko Patient Education Center.
thing very special about meeting with
people who understand all that you are
Education and Support Center provides
many disease-specific education and
In March 2011, Janie Walker was taken by
experiencing. Throat cancer treatment
support programs to help patients and
surprise when she was diagnosed at age
damages one of the most essential
their caregivers understand and navigate
58 with nasopharyngeal cancer, a form
areas of the body, since humans use
the physical, emotional and spiritual chal-
of head and neck cancer. While going
their throats to eat, drink and survive.
lenges of fighting cancer.
through 8 weeks of chemotherapy and 35
Therefore, I would say that this group
radiation treatments, Janie’s physicians
is one of the most necessary support
Healing with Support
recommended she join a cancer support
elements available. I can’t say enough
Disease-Specific Support Groups
During the cancer journey, support is
group. Below, Janie shares her
about how important it was for me to
• Amyloid Support North Texas:
important for patients and their caregiv-
experience.
see these folks in their different stages
Quarterly
• Bladder/Kidney Cancer Support
Group: Monthly
• Breast Cancer Support Group:
Monthly
• Carcinoid Cancer Texas Survivors:
Monthly
• Colon Cancer Support Group:
Monthly
• Graft-Versus-Host Disease Support
Group: Quarterly
• Gynecological Cancer Support
Group: Every other Monday
of recovery. They made me realize there
ers to connect. Baylor Sammons Cancer
• Lung Cancer Education Support
Group: Monthly
• North Texas Myeloma Support
Group: Monthly
• Ovarian Cancer Support Group:
Every other Monday
• Oral and Head and Neck Cancer
Support Group: Monthly
• Prostate Cancer Education and
Support Group: Monthly
• Waldenstrom’s Macroglobulinemia
Support Group: Bimonthly
• Young Adult Cancer Survivors:
Bimonthly
Janie Walker, Head and Neck
was hope for me to someday recover
Cancer Survivor
and showed me that my life could fol-
I first heard about the SPOHNC (Sup-
low their example of restoration. When
port for People with Oral and Head and
you are in the midst of the worst part,
Neck Cancer) group when I began my
you can’t imagine that you will ever be
chemo and radiation treatments. My
able to be normal again. Of course, as
doctors strongly urged me to attend,
we always say in the group, the defini-
because they were aware of how much
tion of normal is forever changed, but
I would need the support and help of
you adapt to a “new” normal.
the friends I would make there. I started attending meetings, and of course,
I am one who will be eternally grate-
the further I got into this horribly
ful for the help and support I received
debilitating treatment, the more I found
through this support group and for the
I needed their strength and advice. I
lifelong friends I’ve made during such a
quickly made friends with many who
difficult time, when I needed them most.
were either currently in treatment like
16 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report Survivors’ Celebrations
• Breast cancer: Leslie Mouton, anchor
Several annual celebrations to honor can-
at KSAT 12, the ABC affiliate in San
cer survivors of prostate, ovarian, breast,
Antonio, Texas, is a breast cancer survi-
and lung cancers were hosted by the
vor, and she shared her cancer journey
Cvetko Center. Survivors and their guests
with viewers every step of the way. She
enjoyed a luncheon, community resources/
made the ultimate statement in support
information and a keynote speaker:
of cancer patients by anchoring one
Above: Dr. Kartik Konduri speaking at the
Lung Cancer Survivor Celebration and
Luncheon
newscast without her wig. Mouton did it
• Prostate cancer: Author and prostate
to show people the reality of cancer, to
cancer survivor Bob Hill presented at
inspire other women losing their hair,
this celebration with the topic, “The Club
and hopefully to ease the fear of being
No Man Wants to Join.” Hill is the author
bald. At this year’s celebration, Mouton
of Dead Men Don’t Have Sex: A Guy’s
presented “All About Attitude” to
Guide to Surviving Prostate Cancer. The
survivors.
book is based on his personal journal,
which he began within two hours of
• Lung cancer: Kartik Konduri, MD, an
diagnosis, and chronicles his entire pros-
oncologist on the medical staff at Baylor
tate cancer experience through surgery,
University Medical Center at Dallas,
recovery and rehabilitation.
presented at this first-ever lung cancer
survivor celebration and luncheon. His
• Ovarian cancer: “Beyond Survival: How
topic was “Lung Cancer 2012: Where
Cancer Can Deepen Our Capacity for
Are We and Where Do We Go from
Joy, Meaning, and Connection” was
Here”?
presented by Martin Lumpkin, PhD,
at this celebration. Dr. Lumpkin is an
Healing Arts Performance Series
award-winning psychologist who spe-
Grammy Award–winning harpist Merry
cializes in helping those who struggle
Miller was the first musician to kick off the
with various stress-related conditions.
new Healing Arts Performance Series at
Baylor University Medical Center at Dallas
in September 2012. The Healing Arts
Committee seeks to offer Baylor staff,
Left: Ovarian cancer survivor and presenter,
Ginger Wilhelmi with Martin Lumpkin, PhD,
keynote speaker at the Ovarian Cancer
Survivor Celebration and Luncheon
Grammy Awardwinning harpist
Merry Miller
performs at the
inaugural event
for the Healing
Arts Performance
Series
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 17
Below: A therapist
and cancer patient
during her exercise
routine at the
Dallas FitSteps
program
patients and their families quality perform-
for the holidays, Albert’s performance was
Journal of Oncology Practice, show that
ing art as an opportunity to briefly unwind
entitled “Traditions of the Season.”
within 1 month, patients experience statis-
and relax. The free, quarterly events show-
tically significant improvement in physical
case professional artists who have a
The main purpose of the Healing Arts
health, mental health, vitality, social func-
passion for creating healing sounds and
Performance Series is to raise awareness
tion, and bodily pain, all of which can be
movement.
of the role of the healing arts in support
sustained long-term.
of modern medicine. Since its inception
“If there is ever a time people need the
five years ago, the Healing Environment
At the Baylor Dallas FitSteps program,
peace and tranquility, joy and pleasure of
Fund’s goal is to continue to bring beauty
trainers see patients at all stages of the
music and the arts, I think it’s when they
into a sometimes scary setting.
cancer continuum. “An increasing number
are spending time in a medical facility,”
Below: Donnie
Ray Albert
of patients are exercising during radiation
said Pam Carnevale, manager of the
FitSteps for Life
treatment and chemotherapy as well as
Virginia R. Cvetko Patient Education and
Exercise is beneficial not only for the
before and after bone marrow and stem cell
Support Center. “The Healing Arts Per-
physical body, but also for the mind and
transplants,” said Kathy Kresnik, FitSteps
formance Series is intended to promote a
spirit of the cancer patients who partici-
clinical exercise specialist. “The convenient
restful atmosphere and bring comfort to
pate in the FitSteps for Life® program at
location facilitates patient participation and
patients and their caregivers.”
Baylor Sammons Cancer Center at Dallas.
gives a welcome destination for inpatient
Research demonstrates that exercise
members and their spouses or caregivers.”
®
Miller, an internationally renowned harpist,
improves cancer survival up to 50 percent.
has released more than a dozen albums,
Exercise immediately benefits patients
Members can participate in both exercise
including the bestselling Tranquility and
going through the most emotionally, phy-
classes and an individualized program
Serenity, and she has performed on
sically and financially challenging times in
of aerobic exercise, stretching, muscle
NBC’s Today Show, ABC’s Good Morning
their lives—so much so that the American
strengthening and balance exercises
America and Fox News.
Society of Clinical Oncology now recom-
focusing on core strength. The Hank
mends that exercise be incorporated into
Dickerson Wellness Center located in the
In December, renowned bass-baritone
routine cancer treatment. Barbara Haas,
Oncology Outpatient Clinic is equipped
Donnie Ray Albert was the featured
MD, professor at the University of Texas
with treadmills and elliptical machines for
performer. As a trained operatic singer
at Tyler and Cancer Foundation for Life
cardiovascular activity, stability balls to
from Southern Methodist University, Albert
board member and research director,
improve balance and core strength and
has performed on Broadway and with the
collected 5 years of data on FitSteps
resistance bands and light dumbbells for
Washington National Opera. Just in time
participants. The data, published in the
muscle strengthening and toning. Basic
®
18 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report At the Barrett Lectureship (left to right): Pam Carnevale, Cvetko
Center Manager, Dr. Allen Stringer, Medical Director of the Cvetko
Center, Ed Cvetko, Bill Barrett (seated), Dr. Deforia Lane, and Mary
Barrett
movements are taught by a clinical exercise
Dr. Lane distinguished herself in her ability
specialist and can be easily continued at
to empathize with seriously ill patients
home with minimum equipment, while still
because of her personal struggle with
providing maximum benefits. Since relocat-
cancer.
ing to the new outpatient cancer center in
2011, there have been more than 4,000
Her work has been recognized in national
visits by patients to the FitSteps® program.
publications such as Reader’s Digest, as
well as other forums, including National
Any cancer patient or survivor may partici-
Public Radio, CNN, CBS This Morning and
pate free of charge. All members must
Wall Street Journal TV. Dr. Lane’s lecture,
have a physician referral to get started;
“Music Therapy and Medicine: A Dynamic
they are then scheduled for a one-on-one
Partnership” explained how music therapy
evaluation and personal training session to
is not just a new-age treatment, but has its
design a fitness routine to meet their cur-
roots in ancient cultures that incorporated
rent needs. Staff trained in exercise science
music into healing rituals.
supervise members and continue to work
with them, adjusting their exercise routine
The annual Charlotte Johnson Barrett
as their abilities change.
Lectureship was established to address
psychosocial issues and concerns of can-
Barrett Lectureship
cer survivors and their families. Charlotte
The Charlotte Barrett Lectureship was
Barrett was a cancer patient who helped
given by Deforia Lane, PhD, MT-BC, in
establish the first patient support group at
the Hunt Auditorium at Baylor Sammons
Baylor Sammons Cancer Center at Dallas.
Cancer Center at Dallas on December 5,
After her death in 1982, her family and
2012. Dr. Lane is the resident director of
friends generously established an endow-
music therapy at University Hospitals
ment to support annual programs and
Seidman Cancer Center in Cleveland,
seminars relating to cancer patient educa-
Ohio. She has designed and implement-
tion and support.
ed music therapy programs for diverse
patient populations, from the mentally
handicapped to those with cancer.
Left: Dr. Deforia
Lane
Above: Chef
Katie’s legendary
fish tacos
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 19
Chef Katie Bickerstaff, teaching and serving
up recipes for cancer patients in the
demonstration kitchen in the Virginia R.
Cvetko Patient Education Center
In Memoriam
Blood and Marrow Transplant
hopefully eradicate the cancer cells in her
Chef Ramah “Katie” Bickerstaff, our friend
Program: How to Save a Life
system. “I didn’t understand what a stem
and coworker, passed away on June 8,
In late 2007, Candice Stinnett was 21, a
cell transplant was,” she said. “I was
2012. She began her career with Baylor
mother to a young son, and had recently
scared and thought it was something
in 2007 as executive chef at Baylor
begun a job she loved as an emergency
involving surgery. My physician explained
Waxahachie. Katie most recently served
dispatcher. When she felt a lump on
it all so well to me. He described the
as the executive chef of Café Charles at
the side of her neck that didn’t hurt but
cancer like a fire pit. The chemo was water
Baylor Sammons Cancer Center at Dallas.
wouldn’t go away, she didn’t think much of
putting the fire out, but there could still be
it. When she did get it examined, doctors
some embers smoldering. You don’t just
Katie was a beloved leader and teacher.
initially thought it was an infected lymph
want to sprinkle a little water on it. You
Her passion for cooking was evident to all
node and gave her antibiotics. However,
want to put all the fire out. That is what the
who met her. She loved to conduct cook-
when January 2008 rolled around and
transplant would do. It would give me new
ing demonstration classes for patients at
nothing changed, they ordered a biopsy.
cells to be healthy.”
the Diabetes Health and Wellness Institute
The result: non-Hodgkin’s lymphoma.
and at the Virginia R. Cvetko Patient Edu-
“Honestly, when they said that, I didn’t
Although Stinnett has three sisters, none
cation and Support Center. While leading
know what it was,” she said. “I didn’t
of them was an appropriate match for
her team at Café Charles, she developed
know it was cancer. I didn’t want it to be
the peripheral blood stem cell transplant.
a healthy, inviting menu, with fish taco
anything serious, much less cancer. I went
A possible donor was found through Be
Fridays as one of her signature specials.
home and looked it up and just could not
the Match® Registry but was only a 70%
Katie was truly caring and a thoughtful
believe this was happening.”
match and lived out of the country. Her
mentor to her team.
next best option was an autologous transUnfortunately, it was happening. Stinnett
plant, in which Stinnett’s own peripheral
was immediately fitted for a port to deliver
blood stem cells are collected, cleaned,
her chemotherapy medications. She
and then reintroduced into her system.
received six rounds of chemotherapy treat-
After more chemotherapy to shrink exist-
ments, once every 3 weeks. In June 2008,
ing cancer cells and medication to boost
scans revealed the cancer was gone.
production of existing healthy cells, the
transplant took place in June 2009.
But by January of the next year, it had
returned. This time, doctors recommended
During pretransplant procedures and
a peripheral blood stem cell transplant to
after the transplant itself, Stinnett and her
20 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report husband, John, stayed at Baylor University
disease as small as possible. On October
Medical Center at Dallas’ Twice Blessed
7, 2010, she received her donor’s stem
House, an affordable housing option
cells and was able to return home on
for transplant patients and their family
October 23. This time, she said, after
members who live at least 50 miles away.
initially not feeling great, she started to feel
Because she had a high risk for infection,
better and stronger day after day. “Once I
family members and church friends helped
started to feel better and got home, I didn’t
care for their son. Just 6 weeks after the
want the focus to be on cancer anymore,”
procedure, Stinnett returned to work as a
she said. “I just wanted to be there for my
dispatcher.
family and live a normal life.”
Although recovering at home and back
to work, Stinnett still felt tired all the time.
She chalked that up to a stressful job and
an active young son. Unfortunately, at her
1-year checkup in July 2010, the nonHodgkin’s lymphoma reared its ugly head
again. “I was incredibly devastated when
I was told the cancer was back again,”
she said. “When I wasn’t sleeping, I was
planning my own funeral. A few weeks
later, I learned a donor was found and
matched me almost perfectly. I was finally
able to smile again, and my future wasn’t
a blur anymore. Someone signed up to
save my life!”
The procedure to test and prepare the
donor took approximately 6 weeks. During
that time, Stinnett was given medication
and more chemotherapy to keep her
Above: Baylor’s Twice Blessed House
Right: Candace and Jonathan napping in the
BMT inpatient unit
Below: A radiant Candace Stinnett with son,
Jonathan, and husband, John
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 21
Leading up to her peripheral blood stem
invitation to go visit and stay with them is
to move away from the typical support
October 2012 and offices in the Cvetko
cell transplant, Stinnett said she explained
always open.”
group setting and cater to the interests of
Center, on the second floor of the cancer
young adults. Past activities have included
center. Garner is working with Cvetko
to her son, Jonathan, how the donor’s
blood would help her get healthy. While
Young Adult Cancer Survivors
speed networking and a poetry jam, held
Center staff to provide a comprehensive
the only information they had about the
Dine & Dash
at various locations throughout Dallas.
continuum of care, helping patients with
donor was that he was a man in his early
In an effort to better meet the needs of
30s from the United States, Jonathan
young adult cancer survivors, the Young
“The immediate bonds we all share as
Society’s community resources, blood
decided to name him “Brighton.” “He told
Adult Cancer Survivors’ Coalition was
young adult cancer survivors bring me
cancer support groups, patient educa-
me he picked that name because he is
formed in 2012 through the Virginia R.
a great amount of peace and continue
tional programs, and continuing education
bright like the sun and shines on our day
Cvetko Patient Education Center. Young
to help in my emotional healing,” said
opportunities applicable to hematology
for me,’ said Stinnett. “Thanks to this
adults between the ages of 15 and 40 years
Candice Stinnett, a survivor of non-
for clinical staff. Garner will also be visiting
donor, I have a different outlook on life.
have had no improvement in survival rates
Hodgkin’s lymphoma. “For a long time I
Baylor Health Care System facilities
I don’t let little things bother me, and we
in two decades. As a result, the National
would receive treatment alongside older
around the Metroplex.
dance every single day. I want to experi-
Cancer Institute led a national effort to
patients and felt alone. At Dine & Dash, we
ence life with the windblown hair and
increase support for this population.
all have had cancer and are all of similar
Cancer Genetics Program
ages. We know each other’s struggles and
One of the most significant breakthroughs
Between 2005 and 2010, 2,057 young
stories, leaving me feeling truly connected
in cancer research is the ability to identify
In December 2010, 14 months after
adults with cancer were treated throughout
to others during my cancer journey.”
genes that may contribute to the develop-
Stinnett’s transplant, she received a phone
Baylor Health Care System, according to
call that her donor had released all of
cancer registry data. This number makes
Hematology Patient Advocate
Sammons Cancer Center at Dallas offers
his information for the recipient. “After
Baylor a leading health care provider for
Provided by the Leukemia and
the Cancer Genetics Program to help
staring at the phone for about 15 minutes
this age group. The mission of the coalition
Lymphoma Society
determine if an individual is at risk for one
trying to think of something to say, I just
is to improve the quality of life for young
To better serve hematology patients in
of the genetic mutations that can lead to
went ahead and dialed his number,’ she
adults with cancer. This goal is being
North Texas, the Leukemia and Lymphoma
cancer.
said. “He answered and I said, ‘Hi, this is
accomplished through education, research
Society® applied for and received a grant
Candice. You saved my life last year.’ He
and psychosocial support.
from Baylor Charles A. Sammons Cancer
In 2012, the genetic services at Baylor
Center for an in-house hematology patient
Dallas and across the Baylor Health Care
springboard beneath my feet.”
immediately knew who I was, laughed,
access to the Leukemia and Lymphoma
ment of certain types of cancer. Baylor
®
and we chatted for 45 minutes like we
A special highlight of the coalition is Dine
advocate. This advocate will better serve
System expanded significantly. Genetic
were lifelong friends. His name is Jared
& Dash, a bimonthly support meeting
hematology patients and their families by
counseling services are now provided by
and he lives in California and is married
offered for young adult survivors and
providing on-site service. Melissa Garner,
two board-certified genetic counselors
with two girls and a boy on the way. The
caregivers. Dine & Dash was designed
LPC, MPS-ATR, started in this position in
who work closely with physicians on the
22 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report medical staff from a variety of medical dis-
Community Events/Outreach
ciplines. More than 500 new patients were
Baylor Sammons Cancer Center at Dallas
seen for genetic counseling compared with
hosts several cancer awareness events
335 new patients in 2011.
and screenings and participates in many
Laura Panos,
(right), genetics
counselor, explains
the complexities of
genetics testing
health fairs throughout the community.
Genetic services, which were initially
This year, 45 community education/out-
limited to individuals at risk of hereditary
reach events were held throughout Dallas
forms of breast cancer, have been expand-
and surrounding areas that were attended
ed to include individuals at risk of any
by a total of 2,469 participants. The follow-
benign or malignant tumor. More than 75
ing highlighted events are just a sample of
patients were seen for a predisposition to
the outreach activities conducted in 2012.
a nonbreast malignancy or tumor, including those at risk to develop colon cancer,
Free Community Screenings
uterine cancer, ovarian cancer, thyroid
• Baylor Sammons Cancer Center hosted
cancer, kidney cancer, melanoma, and
a head and neck cancer screening on
other predispositions.
April 28 in collaboration with the Baylor
College of Dentistry. Of the 100 patients
Counseling services for oncology-related
screened, 23 received abnormal results
indications are provided at Baylor Dallas,
and were encouraged to follow up with
Baylor Regional Medical Center at Plano
their primary care physician.
and Baylor All Saints Medical Center at
Fort Worth. Recently, genetic counseling
• Every month, self-referral skin cancer
services were expanded to include coun-
screenings are offered in the Oncology
seling for any adult genetic condition.
Outpatient Clinic at Baylor Sammons
This expansion includes a cardiovascular
Cancer Center at Dallas. In 2012, a total
genetics clinic at THE HEART HOSPITAL
of 240 patients were screened. Out of
Baylor Plano’s Center for Advanced
this total number, 104 received abnormal
Cardiovascular Care, which has already
results and were encouraged to seek
seen several families for inherited cardio-
follow-up care with their primary care
vascular diseases since its inception in
physician.
October 2012.
Above and below: Sole Sisters™ torch relay
Above right: Health/fitness, nutrition and
cancer education materials were available
Right: Corner Bakery Café generously
provided lunches for the participants
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 23
Above: The cancer center glowed red during
the Light It Up Red for Lymphoma weekend
Left and below: Olympic gold medalist,
Shannon Miller, speaking during the Sole
Sisters™ annual celebration
Community Outreach Events
medalist and ovarian cancer survivor,
• The Mary Kay Expo was held during
served as keynote speaker in a special
July and August 2012. The W. H. &
program held in the Tom Hunt Auditorium
Peggy Smith Baylor Sammons Breast
at Baylor Sammons Cancer Center at
Center at Dallas provided breast cancer
Dallas. Miller shared her experiences as
and gynecological cancer education
a cancer survivor along with her time
materials to several hundred Mary Kay
spent as a member of the “Magnificent
sales professionals at the expo, held at
Seven” U.S. women’s gymnastics team,
the Dallas Convention Center.
who took home the gold medal at the
1996 summer Olympic games. Event
• In honor of National Blood Cancer
participants enjoyed door prizes, a
Awareness Month, Baylor Sammons
complimentary lunch provided by Corner
Cancer Center at Dallas participated
Bakery Café, and information tables with
in the Light It Up Red for Lymphoma
health/fitness, nutrition and cancer edu-
national campaign. Started by the
cation materials.
Lymphoma Research Foundation, the
cancer center glowed red during the
• Saks Fifth Avenue Galleria Dallas and
weekend of September 21 to 23 to shine
Baylor Sammons Cancer Center put
a light on blood cancer awareness and
out a call for the most sinful fashion
support those battling this disease.
purchases hiding in the back of closets
through the Pink Passion®: Closet
• Ovarian and breast cancer survivors
Confessions contest. Participants had
along with supporters grabbed their
to pin a picture of their fashion crime
walking shoes for Sole Sisters™ on
on Pinterest for a chance to win a shoe
October 6. This annual event promotes
shopping spree worth $750 courtesy of
good health/fitness practices and early
Saks. Along with their “closet confes-
detection of breast and ovarian cancers.
sion,” contestants also shared their
A half-mile torch relay walk inside Baylor
reason for supporting Breast Cancer
Tom Landry Fitness Center Park honor-
Awareness Month. The winner of the
ing survivors kicked off in the morning.
contest was chosen via in-store voting
Afterward, Shannon Miller, Olympic gold
during the Saks Fifth Avenue Key to the
24 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report Cure Fashion Show on October 20,
insurance and environment. The Great
featuring breast and ovarian cancer
American Smoke Out is a national
survivors wearing the latest trends of
campaign to encourage smokers to quit
the season.
for one day with the hope that they will
remain tobacco-free for life.
• In collaboration with TNT: Tobacco-free
North Texas, the American Cancer
Society’s Great American Smoke
Out™ was held on November 15 in
Truett Hospital, located on the campus
of Baylor University Medical Center at
At the Great
American Smoke
Out (left to right):
Phyllis Yount,
Pam Carnevale,
Alan Wright, and
Jennifer Williams
Dallas. This year’s focus was on the
financial toll tobacco use can have on
Far Left: Margie Urbina and Jennifer Williams
a person’s physical health, medical
Left: Breast cancer survivor, Pam Brickett, at the fashion show
Below: Breast and ovarian cancer survivors (left to right):
Mary Morgan, Ragina Ireland, Donna Guyette, Paris Jasso, Bobbie
Sewall, Glynda Tabraham, and Pam Brickett
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 25
Cancer Registry
Summary of 2011
Department Update
The registry developed a remote registrar
from Spokane, Washington; and Briana
Cancer Registry Data
In 2012, the Baylor Dallas Cancer Registry
program, recruiting three certified tumor
McCants, CTR, from Bessmer, Alabama.
This report includes the tumor registry
grew with the addition of three registrars.
registrars who live outside the Dallas–Fort
The addition of these experienced regis-
data on patients who were first diagnosed
New processes were added to the program,
Worth area: Susanna Arias, CTR, from Fort
trars brings the cancer registry staff to
or initially treated at Baylor University
as well as new information technologies.
Lauderdale, Florida; Bonnie Stewart, CTR,
Total Analytic Cases: 2010 vs. 2011
2011 Total Analytic Cases: Baylor Sammons and Percentage of Region 3
(Continued on page 28)
Medical Center in the year 2011. These are
called analytical cases, and in 2011 there
were 2911 cases (in 2010 there were 2910
cases). We care for 10% of the cases in
our region of Texas Public Health Region
3 (19 counties, 175 facilities) and slightly
less than 3% of the cases in Texas. These
numbers are stable since 2009.
Several charts are provided comparing our
rank of case volume to National Cancer
Data Base cancer centers in the U.S. and to
Texas hospitals; comparing case numbers
by major categories in 2010 and 2011; and
finally, looking at 2011 Baylor Sammons
cases as a percentage of Region 3 cases.
To summarize, our total case volume was
unchanged between the two analytical
years 2010 and 2011. There were substantial increases in Gyn and GU case volumes,
compared to decreases in GI and lung.
Despite these slight changes, our cases
as a percentage of Region 3 remain fairly
consistent from as low as 5% to as high
as 38%.
Primary Site
All Sites
Oral Cavity
2011
2010
2911 2910
Primary Site
All Sites Combined Oral Cavity and Pharynx
Baylor Sammons
Percentage of Region 3
2911
10%
66
10%
66
60
Digestive System
580
631
Esophagus
25
Respiratory System
235
271
Stomach
42
10%
133
7%
99
13%
149
28%
Bone
9
13
Connective/
Soft Tissue
Melanoma
Colon
Rectum
9%
28
26
Liver and Intrahepatic Bile Duct
69
76
Pancreas
89
14%
Breast
566 586
Larynx
12
5%
Female Genital
308
275
69
5%
566
13%
28
8%
172
27%
76
19%
228
5%
Testis
13
7%
Urinary Bladder
69
7%
Melanoma of the Skin
Male Genital
242
157
Breast
Urinary System
200
181
Cervix Uteri
Brain and CNS
164
154
Corpus and Uterus, NOS
Thyroid
92
96
Blood and Bone
Marrow
Hodgkin’s Disease
Prostate
146
150
14
13
Non-Hodgkin’s
Ovary
Kidney and Renal Pelvis
126
12%
Brain and Other CNS
164
38%
Lymphoma
71
90
Unknown Primary
53
49
Thyroid
92
Other/Ill-Defined
12 24
13%
Hodgkin’s Lymphoma
14
8%
Non-Hodgkin’s Lymphoma
71
6%
Multiple Myeloma
42
11%
88
11%
Leukemia
26 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report Baylor University Medical Center Dallas Analytic Cases Diagnosed 2011
Gender
Primary Site
Total Analytic Cases
Male
All Sites2911
1206
Oral Cavity
Lip
Tongue
Oropharynx
Hypopharynx
Other
Digestive System
Esophagus
Stomach
Colon
Rectum
Anus/Anal Canal
Liver
Pancreas
Other
66
1
25
2
3
35
580
25
42
133
99
7
149
89
36
Respiratory System235
Nasal/Sinus
2
Larynx
12
Lung/Bronchus
218
Other
3
Bone
9
General Stage
Female
In Situ
Localized
Regional
Distant N/A
Unknown
1706
133
1208
691
518
169
193
4521
1
0
18
7
1
1
1
2
24
11
016446
0
0
0
0
0
1
0
0
0
8
16
1
0
0
0
0
2
0
0
0
0
0
2
1
0
0
0
8
24
3
0
0
319261 8196217
1105
44
21
4
1
10
10
1
0
3
29
13
0
11
15
8
5
3
53
80
2
33
69
28
0
1
51
48
5
36
46
8
0
4
34 0 1 4 101
100
49
0
85
34
16
0
14
43
46
0
16
24
36
0
13
19
17
0
4
15
12
0
5
123
112
2
0
10
2
109
109
2
1
54
33973
99
021
1
0
1
0
0
0
1
0
4
7
0
0
1
39
67
91
0
20
0
0
1
1
0
1
0
5
3 100
Connective/Soft Tissue28
10
18 015111
0
1
43
32 742186
02
40
29
6
39
17
6
0
1
3
3
1
3
1
0
0
1
Skin
Melanoma
Other
Breast
75
69
6
566
4
562 833311232306
Benign includes: Gastrointestinal stromal tumors, benign meningiomas, benign brain, and other cns benign.
Other/Ill-Defined includes: ill-defined sites and hematopoietic diseases not included in the leukemia/lymphoma/myeloma category.
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 27
Gender
Primary Site
Total Analytic Cases
Female Genital
Cervix Uteri
Corpus Uteri
Ovary
Vulva
Other
308
28
172
76
20
12
Male
0
0
0
0
0
0
Urinary System200
Bladder
69
Kidney/Renal
126
Other
5
136
56
78
2
Brain and CNS
Brain (Benign)
Brain (Malignant)
Other (Meninges, Spinal Cord, Nerves)
164
15
45
104
68
5
26
37
142
92
50
In Situ
309
28
172
77
20
12
Male Genital2422420
Prostate
228
228
0
Testis
13
13
0
Other
1
1
0
General Stage
Female
Endocrine
Thyroid
Other Localized
3
1
0
0
2
0
167
16
121
15
11
4
108
30
77
1
0
0
0
0
30
0
27
3
4696
23
69
23
27
0
0
0
49
49
0
Blood and Bone Marrow
Leukemia
Multiple Myeloma
Other
146
88
42
16
89
50
29
10
57
38
13
6
0
0
0
0
Lymphatic System
Hodgkin’s Disease
Non-Hodgkin’s Lymphoma
85
14
71
48
10
38
37
4
33
023
0
6
0
17
Unknown Primary
Other/Ill-Defined
Distant 75
7
34
20
7
7
57
1
15
40
0
1
N/A
0
0
0
0
0
0
Unknown
7
3
2
2
0
0
0181 49 804
0
172
46
6
0
4
0
8
3
2
0
0
0
1
0
0
0
0
6429
13
27
48
0
3
2
96
10
19
67
Regional
3
0
3
0
3029
6
6
23
22
1
1
5
0
4
1
33
33
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
4
0
115
15
0
100
14
0
14
0
749 4
6
0
4
1
49
0
141
86
39
16
02
0
2
0
0
0
0
529
0
3
5
26
028
0
5
0
23
5323
30000
1
0
52
12
57
0
3
5 004
28 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report (Continued from page 25)
will be automatically downloaded into the
a total of seven full-time certified tumor
suspense of the database for abstracting.
registrars, including the cancer registry
This will not only save time, but also
manager and supervisor.
increase efficiency in the cancer registry.
Patient Age by Gender
Male
Female
500
450
400
In 2012, the ePath® application of Artificial
The staff attends monthly webinars, which
Intelligence in Medicine was approved for
include presentations from the North
installation. The application will save each
American Association of Central Cancer
250
cancer registrar time due to the automa-
Registries. All Registry staff attended the
200
tion of casefinding review of 100% of
Texas Tumor Registrars Association
150
pathology reports. This automation will
(TxTRA) 40th Annual Educational Confer-
100
“read” each pathology report and choose
ence in Hurst, Texas, as well as the
only those cases applicable to the cancer
Baylor-sponsored annual Cancer Registry
registry. Upon electronic review by a reg-
symposium The Value of Quality Data,
istrar, each case that requires abstracting
which featured presentations on GI cancers.
350
300
50
0
0–9
10–19
20–29
30–39
40–49
50–59
60–69
Male
BUMC
National
Texas
Breast
Prostate
Prostate
Breast
25%
Prostate
Lung
Lung
20%
Colorectal
Colorectal
Uterus
Melanoma
Melanoma
15%
Brain and Other CNS
Bladder
Non-Hodgkin’s Lymphoma
10%
Liver
Non-Hodgkin’s Lymphoma
Kidney
5%
Kidney
Kidney
Bladder
Thyroid
Thyroid
Leukemia
Pancreas
Uterus
Pancreas
Ovary
Leukemia
Pancreas
Corpus Uteri
Thyroid
Female
30%
Breast
Lung
90–99
35%
Colorectal
Leukemia
80–89
Patient Stage by Gender
2011 Top 12 Sites
70–79
0%
Stage 0
Stage I
Stage II
Stage III
Stage IV
Unknown
N/A
Left: Laith I.
Abushahin, MD
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 29
Center: Thomas E.
Hutson, DO
Patient Care Evaluation Study
Right: Winston S.
Webster, MD
invasive disease, and metastatic cancer.
In these cases, therapy aims to prolong
Invasive Bladder Cancer:
Most invasive bladder cancers are high-
Nonmuscle invasive tumors comprise ap-
survival and improve quality of life.
The Baylor Experience
grade tumors. These tumors originate in
proximately 65% to 70% of new bladder
Advances in the use of cisplatin-based
By Laith I. Abushahin, MD, Thomas E.
the bladder mucosa, progressively invade
cancer cases. This category of bladder
combination chemotherapy have led to
Hutson, DO, and Winston S. Webster, MD
the lamina propria, and then move into
cancer includes Ta (papillary), T1 (submu-
improved survival. Despite this progress,
the muscularis propria, perivesical fat, and
cosal invasive), and Tis (carcinoma in situ).
metastatic disease is associated with a
Bladder cancer is the fourth most com-
contiguous pelvic structures, with increas-
Treatment is directed at reducing recur-
limited life expectancy, and cures are rare.
mon malignancy diagnosed in men in the
ing incidence of lymph node involvement
rences and preventing progression. The
United States, with an estimated 73,510
with progression. The depth of invasion
initial intervention generally is a complete
Locally advanced and metastatic disease
new cases and 14,880 deaths in 2012.
by the primary tumor is the most impor-
transurethral resection of all visible bladder
have been the primary focus of research
More than 90% of these new cases in
tant prognostic variable for progression
tumors (TURBT). This is often followed
due to the high mortality and morbidity
the U.S. will be urothelial or transitional
and overall survival for localized disease,
by adjuvant intravesical therapy. Muscle-
of urothelial cancer of the bladder (UCB).
cell carcinomas. Bladder cancer is rarely
especially with degree of muscle invasion.
invasive tumors represent around 30%
Despite adequate local control after
diagnosed before the age of 40, and the
Stage II is the first stage the tumor invades
of cases on presentation. This group
cystectomy, the overall survival (OS) for
median age of diagnosis is 65, which can
the muscle. In stage III, the tumor extends
encompasses several different entities
muscle-invasive UCB is suboptimal; 5-year
alter treatment plans due to the presence
just beyond the muscle layer and can
including stage II (T2), stage III (T3, T4a),
OS rates are 52% to 77% for pathologic
of comorbidities. Patients with bladder
extend into the prostatic stroma, uterus,
and stage IV (T4b or lymph node–positive
T2 disease; 40% to 64% for T3 disease;
cancer typically present with painless
and/or vagina. In stage IV, the tumor
disease) and is an area of great interest in
and 26% to 44% for T4 or node-positive
hematuria; however, the initial presentation
invades even further, into the pelvic or
bladder cancer research. The main reason
disease.2 Most patients who succumb
can be irritative voiding symptoms such as
abdominal wall.3 Lymph node involvement
this group is of such interest is to deter-
to bladder cancer ultimately die due to
increased frequency, urgency, and dysuria.
has been reported as an important prog-
mine if bladder preservation is possible
distant disease rather than locoregional
In men over the age of 40, the presence of
nostic marker as well in several studies.
without compromising survival. Radical
recurrent disease. Historically, the recom-
otherwise unexplained hematuria indicates
The TNM staging system now classifies
cystectomy is the standard treatment of
mended treatment for muscle-invasive
urothelial cancer until proven otherwise by
any lymph node involvement, as well as
choice in the U.S. for this stage, although
disease (≥T2) was radical cystectomy
a urologic evaluation of the entire urinary
metastatic disease, as stage IV.3
bladder-sparing approaches have gained
with lymph node dissection. Based on
favor in recent years. Another issue is to
successes seen in the treatment of other
1
2
2–6
tract. Cystoscopy is the gold standard
7
2
for the initial evaluation of patients with
Historically, the clinical spectrum of
determine if the lesion can be managed
epithelial neoplasms, chemotherapy was
potential bladder cancer. Patients with
bladder carcinoma was divided into
locally or if the patient is at high risk for
combined with surgery to improve the
visible tumors have the tumors either
three categories that differ in prognosis,
distant spread requiring systemic therapy.
likelihood of cure. The use of neoadjuvant
biopsied or resected to determine the his-
management, and therapeutic intentions:
Lastly, the third group encompasses
chemotherapy offers potential advantages
tology, as well as the depth of invasion.
nonmuscle-invasive disease, muscle-
patients with distant metastatic disease.
over adjuvant therapy, including early
30 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report treatment of systemic micrometastases,
for muscle-invasive bladder cancer.
thus may justify the administration of
much to be learned on the best approach
potential downstaging of primary and re-
Postoperative adjuvant chemotherapy
chemotherapy for patients at high risk of
to treat muscle-invasive UCB.
gional disease, and an in vivo assessment
is another systemic treatment option for
relapse.
of chemosensitivity. Giving chemotherapy
patients with muscle-invasive bladder
in the neoadjuvant setting also avoids
cancer. Use of adjuvant chemotherapy
Bladder preservation may be accom-
incurable and requires systemic therapy.
potential delay in systemic treatment due
allows for immediate surgical interven-
plished with muscle-invasive UCB, in
Currently the first-line therapy is a com-
to postoperative complications, as 58% of
tion, providing debulking and relief of local
appropriately selected patients, without
bination of cisplatin and gemcitabine or a
patients may have postsurgical complica-
symptoms. Another advantage of adjuvant
compromising outcomes using a trimodal-
multidrug combination regimen including
tions after radical cystectomy. Several
chemotherapy is that its use can be based
ity approach. This approach is character-
cisplatin, such as MVAC chemotherapy.
studies support the role of neoadjuvant
on complete pathologic staging of the
ized by maximal transurethral resection
Regimens containing taxanes are being
chemotherapy for T2 and T3 UCB lesions.
tumor, which more accurately assesses a
(TUR) followed by concurrent chemother-
explored for use in front-line therapy. There
Grossman et al reported that patients who
patient’s risk, as clinical staging is often
apy and radiation therapy. In appropriately
is no standard second-line therapy for
received methotrexate, vinblastine, Adria-
inaccurate. Data regarding adjuvant che-
selected patients, bladder preservation
patients with metastatic bladder cancer.
mycin (doxorubicin), and cisplatin (MVAC)
motherapy are conflicting, as no random-
with TUR, chemotherapy, and radiation is
Due to this lack of available standard
followed by radical cystectomy showed a
ized trials of sufficient sample size have
feasible and produces high rates of com-
therapies, patients are encouraged to
21-month OS advantage over cystectomy
shown a survival benefit.12 Many of the
plete response with acceptable disease
enroll in clinical trials. Otherwise, if a
alone.9 Two Nordic trials found an OS
trials showing a survival benefit were not
control and OS, all while preserving the
patient decides not to pursue a clinical
benefit of neoadjuvant therapy when com-
randomized, which raises the question of
bladder. The patients who are candidates
trial, the available options for patients
bined with radical cystectomy in patients
selection bias. Two trials showed survival
for this trimodality therapy have T2-4a
with metastatic disease depend on what
with pT3-T4 disease when compared to
advantage from therapy with cyclophos-
bladder cancer with clinically node-neg-
was used in first-line therapy and include
cystectomy alone (5-yr OS 56% vs 48%;
phamide, Adriamycin, and cisplatin (CAP),
ative disease. The primary tumors must
fluorouracil, cisplatin, gemcitabine, carbo-
P = 0.049). A clear OS benefit for neo-
MVAC, or methotrexate, vinblastine,
be able to undergo complete or near-
platin, docetaxel, doxorubicin, ifosfamide,
adjuvant therapy (cisplatin, methotrexate,
epirubicin, and cisplatin (MVEC).
complete TUR. It is important that these
paclitaxel, methotrexate, pemetrexed, and
vinblastine; CMV) was found for patients
contrast, a randomized phase III study
patients have adequate renal function with
vinblastine.18–26
with cT2 grade 3-T4N0 muscle-invasive
with 194 patients reported no difference in
no hydronephrosis so cisplatin can be ad-
UCB compared to cystectomy alone at the
OS or disease-free survival15,16 ; however,
ministered.17 Most of the studies involving
Methods
10-year mark (36% vs 30%; P < 0.05) in
the trial closed early due to poor accrual,
this trimodality therapy use cisplatin-based
Baylor Charles A. Sammons Cancer
the International Collaboration of Trialists
enrolling only 32% of the target sample
chemotherapy, but newer agents are be-
Center at Dallas is a large tertiary referral
trial. These results, as well as the results
size. Nevertheless, the results of these and
ing evaluated. Thus, even though these
center. We identified cases of muscle-
of many other trials, indicate that neoad-
other current trials suggest that adjuvant
studies have promising results, there is still
invasive, locally advanced UCB treated at
juvant chemotherapy improves outcomes
chemotherapy may delay recurrence and
8
10
11
13,14
In
Finally, metastatic bladder cancer is
16
Baylor University Medical Center at Dallas
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 31
Figure 1
100%
Cystectomy
and Chemo
90%
Bladder
Preservation
80%
70%
Chemo Only
60%
TURBT and
BCG
50%
40%
30%
Surgery Only
(Cystectomy)
20%
TURBT
10%
0%
Stage II
Stage III
Stage IV
Figure 1. Percentage of Baylor Dallas bladder cancer patients by stage (stage II, III, or IV) and
treatment: resection of the bladder cancer alone (TURBT; blue), cystectomy (bladder removal;
red), TURBT and Bacillus Calmette-Guerin therapy (green), chemotherapy only (purple),
bladder-preservation therapy (turquoise), and cystectomy and chemotherapy (gold).
Treatment. Figure 1 summarizes the basic
In patients with stage III bladder cancer,
treatments received by the cohort. Overall,
two patients (10%) had TURBT alone,
among patients with stage II disease, two
while 18 patients (90%) had cystectomies.
patients (11%) were treated with TURBT:
Patients treated with TURBT did not un-
one with TURBT alone secondary to multi-
dergo cystectomy due to the presence of
ple medical comorbidities and another who
comorbidities prohibiting surgery and che-
underwent TURBT followed by Bacillus
motherapy. Of those patients who under-
Calmette-Guerin immunotherapy, a treat-
went cystectomy, only five patients (25%)
ment placed into the bladder. One patient
had cystectomy alone as their modality
(5%) was initially treated with a bladder-
of treatment, while the rest of the patients
preserving technique but had a disease
(13) underwent some form of chemo-
recurrence and required delayed-salvage
therapy. Of these patients, four (20%) were
cystectomy after an 11-month disease-
given neoadjuvant chemotherapy prior to
free period, while another (5%) had rapid
surgery compared to eight patients (40%)
progression on neoadjuvant chemotherapy
who received adjuvant chemotherapy and
and did not have surgery. The remaining
one patient (5%) who had both neoadju-
15 patients (79%) underwent cystectomy:
vant and adjuvant chemotherapies. In the
nine patients (47%) had cystectomy alone,
cases where chemotherapy was used,
(BUMC) between March 2007 and May
(34.5%) were stage II and 20 patients
while six (32%) had chemotherapy with
gemcitabine and carboplatin was utilized
2012 through our cancer registry. We gath-
(36%) were stage III. The remaining 16
surgery. In this group with surgery and che-
in 38%, carboplatin and paclitaxel in 31%,
ered demographics and clinical character-
patients (29%) were stage IV with lymph
motherapy, five patients had neoadjuvant
gemcitabine and cisplatin in 15% of the
istics as well as treatments received and
node–positive disease.
chemotherapy prior to surgery, and one
cases, and a combination of both MVAC
subsequently evaluated survival of this
patient (5%) had adjuvant chemotherapy
and gemcitabine, carboplatin, and pacli-
population and compared it to the national
The median age of our cohort was 68.5
following surgery. In the cases where che-
taxel was used in 7%.
benchmarks.
years (range, 41–82). The majority of the
motherapy was given, a regimen contain-
patients were Caucasians (87%), while 7%
ing gemcitabine and carboplatin was used
Among regional stage IV patients, all 16
Results
were African American, 4% were Hispanic,
in 50% of the cases, gemcitabine and
patients had some form of cystectomy and
During the specified time period, 55 cases
and 2% represented other ethnicities.
cisplatin in 38% of the cases, and MVAC in
chemotherapy. Of these patients, 50%
of muscle-invasive, locally advanced blad-
Males represented 76% of the patients,
12.5% of the cases.
had surgery up front followed by adjuvant
der cancer were identified in the cancer
and females, 24%.
registry. Of these cases, 19 patients
chemotherapy; 37.5% had neoadjuvant
chemotherapy followed by surgery; and
32 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report Figure 2
BUMC
NCDB
BUMC
NCDB
BUMC
NCDB
100%
12.5% had both neoadjuvant and adju-
Survival. For our cohort of locally ad-
90%
vant chemotherapies. The chemotherapy
vanced, muscle-invasive bladder cancer,
80%
choice was MVAC in 37.5% of the cases,
we excluded patients diagnosed after
70%
gemcitabine and carboplatin in 31%, gem-
November 2010 to evaluate 2-year OS. A
60%
citabine and cisplatin in 19%, and other
total of 37 patients were eligible for this as-
50%
chemotherapies in 11% of the cases.
sessment. Of these 37 patients, 12 (32%)
were stage II, 13 (35%) were stage III, and
No 1st Course
Rx
Other Specified
Therapy*
Surgery and
BCG
40%
Surgery and
Chemo
30%
Surgery Only
20%
When the results of our study were
12 (32%) were stage IV. A comparison was
compared with those of the National
made of bladder cancer cases at BUMC
Cancer Data Base (NCDB), we found that
with averages of national cancer hospitals
at all stages of muscle-invasive bladder
(Figure 3). At BUMC, overall 2-year survival
cancer (stages II-IV), the patients at BUMC
was 83.3% among patients with stage II
received chemotherapy along with surgery
bladder cancer, 61.5% among patients
more often than the national average
with stage III, and 33.3% among patients
(Figure 2). In both cases, the percentage
with stage IV. These results were bet-
of patients getting surgery combined with
ter at all stages in comparison with data
chemotherapy increased with stage, but
from NCDB. The averages in NCDB were
this increase was much more rapid at
54.7%, 45.8%, and 22.7%, respectively, for
BUMC. At BUMC, 42%, 68%, and 100%
stages II, III, and IV bladder cancer. Again,
of the tumor. The integration of chemo-
use. The cooperation between urologists
of the bladder cancer patients at stages
these better numbers may be related to
therapy into the treatment regimen for
and medical oncologists to develop a
II, III, and IV, respectively, received surgery
more aggressive therapies to treat bladder
locally advanced bladder cancer showed
thorough treatment plan is important to
and chemotherapy. This is in comparison
cancer.
an improvement in survival, mainly due to
the well-being of these patients. BUMC
the reduction in the rate of distant recur-
strives to improve patient access to this
to 18%, 27%, and 49% of the bladder
10%
0%
Stage II
Stage III
Stage IV
Figure 2. Percentage of patients with stage II, III, or IV bladder cancer receiving surgery only
(blue), surgery and chemotherapy (red), surgery and Bacillus Calmette-Guerin (green), no
first-course treatment (turquoise), and other specified therapy (chemotherapy only; purple)
from Baylor University Medical Center at Dallas (BUMC) versus the National Cancer Data
Base (NCDB).
cancer patients at stages II, III, and IV, re-
Conclusion
rence. Review of the data from the NCDB
collaborative approach and develop an
spectively, who received surgery and che-
Locally advanced, muscle-invasive bladder
revealed that there is a suboptimal use
aggressive program to treat patients with
motherapy in the NCDB. Thus, it appears
cancer is a challenging disease that re-
of chemotherapy to aid control of locally
locally advanced, muscle-invasive bladder
that the urologists and medical oncologists
quires a multidisciplinary approach, involv-
advanced muscle-invasive bladder cancer.
cancer. Moreover, BUMC promotes
at BUMC are much more aggressive in
ing both urologists and medical oncolo-
These findings are most likely a result of
research opportunities with the hope of
their treatment of muscle-invasive, locally
gists. Despite aggressive local therapy, a
lack of coordination between different
seeing continued improvement in patient
advanced bladder cancer than the national
significant portion of patients will eventually
specialties, in addition to other medical
survival from this disease.
average.
succumb as a result of distant metastases
comorbidities prohibiting chemotherapy
Figure 3 Observed Survival Urinary Bladder Cancer: Baylor vs. NCDB
Cumulative
Survival Rate
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 33
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
0.0 Yr.
0.5 Yr.
1.0 Yr.
1.5 Yr.
2.0 Yr.
Stage II (NCDB)
100
82.8
69.9
60.8
54.7
Stage II (BUMC)
100
100
91.7
91.7
83.3
Stage III (NCDB)
100
80.6
63.7
52.9
45.8
Stage III (BUMC)
100
92.3
84.6
69.2
61.5
Stage IV (NCDB)
100
61.3
41.5
29.7
22.7
Stage IV (BUMC)
100
83.3
58.3
41.7
33.3
Figure 3. Percent overall survival of patients with stage II (purple), stage III (green), or stage IV (blue)
bladder cancer at Baylor University Medical Center at Dallas (BUMC; dotted line) versus the National
Cancer Data Base (NCDB; solid line) over a 2-year period.
References
1.American Cancer Society. Cancer Facts and
Figures 2012. Atlanta, GA: American Cancer
Society, 2012.
2.Stein JP, Lieskovsky G, Cote R, et al. Radical cystectomy in the treatment of invasive
bladder cancer: long-term results in 1,054
patients. J Clin Oncol 2001;19:666–675.
3.Urinary bladder. In Edge SB, Byrd DR,
Compton CC, et al (eds). The AJCC Cancer
Staging Handbook, 7th ed. New York:
Springer, 2010.
4.Frazier HA, Robertson JE, Dodge RK, et al.
The value of pathologic factors in predicting cancer-specific survival among patients
treated with radical cystectomy for transitional cell carcinoma of the bladder and prostate.
Cancer 1993;71:3993–4001.
5.Poulsen AL, Horn T, Steven K. Radical cystectomy: extending the limits of pelvic lymph
node dissection improves survival for patients
with bladder cancer confined to the bladder
wall. J Urol 1998;160:2015–2019; discussion
2020.
6.Vieweg J, Gschwend JE, Herr HW, et al.
Pelvic lymph node dissection can be curative
in patients with node positive bladder cancer.
J Urol 1999;161:449–454.
7.Kirkali Z, Chan T, Manoharan M, et al. Bladder
cancer: epidemiology, staging and grading,
and diagnosis. Urology 2005;66:4–34.
8.Lawrentschuk N, Colombo R, Hakenberg OW,
et al. Prevention and management of complications following radical cystectomy for
bladder cancer. Eur Urol 2010;57:983–1001.
9.Grossman HB, Natale RB, Tangen CM, et al.
Neoadjuvant chemotherapy plus cystectomy
compared with cystectomy alone for locally
advanced bladder cancer. N Engl J Med
2003;349:859–866.
10.Sherif A, Holmberg L, Rintala E, et al.
Neoadjuvant cisplatinum based combination chemotherapy in patients with invasive
bladder cancer: a combined analysis of two
Nordic studies. Eur Urol 2004;45:297–303.
11.International Collaboration of Trialists.
Neoadjuvant cisplatin, methotrexate, and
vinblastine chemotherapy for muscle-invasive bladder cancer: a randomised controlled
trial. Lancet 1999;354:533–540.
12.Meeks JJ, Bellmunt J, Bochner BH, et al.
A systematic review of neoadjuvant and
adjuvant chemotherapy for muscle-invasive
bladder cancer. Eur Urol 2012;62:523–533.
13.Lehmann J, Retz M, Wiemers C, et al.
Adjuvant cisplatin plus methotrexate versus
methotrexate, vinblastine, epirubicin, and
cisplatin in locally advanced bladder cancer: results of a randomized, multicenter,
phase III trial (AUO-AB 05/95). J Clin Oncol
2005;23:4963–4974.
14.Lehmann J, Franzaring L, Thuroff J, et al.
Complete long-term survival data from a
trial of adjuvant chemotherapy vs control
after radical cystectomy for locally advanced
bladder cancer. BJU Int 2006;97:42–47.
15.Houédé N, Pourquier P, Beuzeboc P. Review
of Current Neoadjuvant and Adjuvant
Chemotherapy in Muscle-Invasive Bladder
Cancer. Eur Urol 2011;10:e20–e25.
16.Cognetti F, Ruggeri EM, Felici A, et al.
Adjuvant chemotherapy with cisplatin and
gemcitabine versus chemotherapy at relapse
in patients with muscle-invasive bladder
cancer submitted to radical cystectomy: an
Italian, multicenter, randomized phase III trial.
Ann Oncol 2012;23:695–700.
17.Costantini C, Millard F. Update on chemotherapy in the treatment of urothelial carcinoma. ScientificWorld Journal
2011;11:1981–1194.
18.Hussain M, Vaishampayan U, Du W, et
al. Combination paclitaxel, carboplatin,
and gemcitabine is an active treatment for
advanced urothelial cancer. J Clin Oncol
2001;19:2527–2533.
19.McCaffrey JA, Hilton S, Mazumdar M, et
al. Phase II randomized trial of gallium
nitrate plus fluorouracil versus methotrexate, vinblastine, doxorubicin, and cisplatin
in patients with advanced transitional-cell
carcinoma.
J Clin Oncol 1997;15:2449–2455.
20.Papamichael D, Gallagher CJ, Oliver RT, et
al. Phase II study of paclitaxel in pretreated
patients with locally advanced/metastatic
cancer of the bladder and ureter. Br J Cancer
1997;75:606–607.
21.Vaughn DJ, Broome CM, Hussain M, et al.
Phase II trial of weekly paclitaxel in patients
with previously treated advanced urothelial
cancer. J Clin Oncol 2002;20:937–940.
22.Sweeney CJ, Roth BJ, Kabbinavar FF, et al.
Phase II study of pemetrexed for second-line
treatment of transitional cell cancer of the
urothelium. J Clin Oncol 2006;24:3451–3457.
23.Galsky MD, Mironov S, Iasonos A, et al.
Phase II trial of pemetrexed as second-line
therapy in patients with metastatic urothelial
carcinoma. Invest New Drugs 2007;25:
265–270.
24.Galsky MD, Iasonos A, Mironov S, et al.
Phase II trial of dose-dense doxorubicin
plus gemcitabine followed by paclitaxel plus
carboplatin in patients with advanced urothelial carcinoma and impaired renal function.
Cancer 2007;109:549–555.
25.Witte RS, Elson P, Bono B, et al. Eastern
Cooperative Oncology Group phase II trial
of ifosfamide in the treatment of previously
treated advanced urothelial carcinoma.
J Clin Oncol 1997;15:589–593.
26.Stadler WM. Gemcitabine doublets in
advanced urothelial cancer. Semin Oncol
2002;29:15–19.
34 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report Bill Dippel: A Slam Dunk
When Bill Dippel turned 50, his physician recommended a screening
colonoscopy. “I felt great. I had no symptoms, but he talked me into it,”
Bill says. The test found a small polyp that turned out to be cancerous.
At Baylor Charles A. Sammons Cancer Center, Bill underwent a colon
resection, a surgical procedure that could be done laparoscopically
because the cancer was found so early. A lymph node tested positive
for cancer, so Bill also underwent six months of biweekly chemotherapy.
“The doctors and nurses at Baylor were spectacular. They were smart,
efficient, clear and candid, but really cared about me as a person.” Now
Bill, an attorney and avid basketball enthusiast, is back in action.
“My treatment at Baylor was a slam dunk.”
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 35
Education
Fellowship Programs
habits to continue their education in the
More than 20 multidisciplinary site tumor
In addition to patient care and research,
future.
conferences are held by Baylor Sammons
Cancer Center each month. The discus-
education has been a prime objective of
Fellows (left to right): medical oncology:
Laith Abushahin, MD; breast surgery:
Ethan Rogers, MD; medical oncology:
Sara Robinson, MD; body imaging: Natalie
McAllister, MD; medical oncology: James
Ewing, MD; Ying Cao, MD
Baylor Charles A. Sammons Cancer Center
“Baylor University Medical Center at Dallas
sions about diagnosis and treatment at
since its opening in 1976. Oncology has
is a teaching institution, and this is one
these conferences provide fellows with
emerged as one of the most exciting areas
reason why the level of clinical excellence
valuable information and perspective
of medicine. Dedication to lifelong learning
here is so high,” said Marvin J. Stone, MD,
about patient care. These trainees also
is important because new information con-
director of the medical oncology fellowship
attend a number of other oncology and
stantly changes practice. During fellowship,
program.
hematology conferences with basic science, clinical research, and journal club
trainees acquire the knowledge and skills
required of a front-rank oncologist and the
More than 6,000 new cancer patients are
formats. They engage in research projects,
seen at Baylor Sammons Cancer Center
many of which develop into presentations
annually. The fellows thus become familiar
at national meetings and published articles
with the design and interpretation of
in peer-reviewed medical journals.
advanced treatments as well as conventional approaches.”
In addition to medical oncology, fellowship
programs are offered in hematopathology,
Mentorship is emphasized during the
surgical breast oncology, breast imaging,
fellowship program, and many attending
and body imaging. All fellows have com-
physicians are considered role models.
pleted internal medicine training programs.
Oncology rotations are designed so that
Equipped with broad-based training and
each fellow spends one or two months
familiarity with the ongoing advances in
with one attending physician. The large
the field, Baylor’s oncology fellowship
amount of one-on-one time between the
graduates will be prepared to deliver qual-
fellow and the attending oncology physi-
ity and compassionate care to generations
cian maximizes the educational content
of patients.
for the trainees.
Oncology Education Abroad
Fellows also spend time in blood and
A group of health care professionals from
marrow transplantation, pathology, gyne-
Baylor University Medical Center at Dallas
cologic oncology, and radiation oncology.
traveled to Vietnam February 21 to March
36 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report 6, 2012, to work alongside local caregiv-
South Vietnam, this South Vietnamese city
ers and introduce new concepts, teach
was a site of intense fighting in the Vietnam
new techniques, and identify needs that
War. Now a large peaceful city bisected by
can be addressed on follow-up trips. The
the Sông Hương (Perfume) River, Huế is
team from Baylor consisted of two experts
home to approximately 950,000 residents
in breast cancer (Drs. John Pippen and
and the Huế College of Medicine and
Cynthia Osborne), two general medical
Pharmacy.
oncologists (Drs. Claude Denham and
Above: (left to right): Cynthia Osborne, MD;
Josie Divers, RN (front); John Pippen, MD;
Nate Green, MD; Claude Denham, MD;
Nguyen Van Cau, MD (back)
Nate Green, a former medical oncology
Working within the college’s oncology
fellow who now practices in Lincoln,
clinic were the Vietnamese hosts, Dr.
Nebraska), a second-year oncology fellow
Nguyen Van Cau, a medical oncologist,
(Dr. James Ewing), and an oncology nurse
and Dr. Phung Phuong, a surgeon. Dr. Cau
Below: The Sông Hương (Perfume) River
(Josie Divers, RN).
had one oncology fellow who helped with
Bottom: The team’s first view of the Huế
College of Medicine and Pharmacy
patient care. At least 10 nurses and other
Planning for the trip began when physi-
assistants also staffed the clinic. The clinic
cians of Baylor Sammons Cancer Center
was an air-conditioned building built in the
and Texas Oncology were contacted by
1980s. The first floor housed the Gamma
Health Volunteers Overseas (HVO). The
Knife center, and the upper floors housed
American Society of Clinical Oncology has
the clinics and inpatient hospital rooms.
partnered with HVO to provide relevant
Dr. Phuong, a surgeon by training, had
training on oncologic diseases and health
dual roles, as he planned, mapped, and
conditions in developing countries. In its
operated the Gamma Knife, in addition
quarter century of existence, HVO has
to operating and serving as a clinical
sent more than 4,000 volunteers to places
professor at the medical school. Dr. Cau’s
around the world and has completed
office (where most of the patients were
close to 8,000 assignments.
seen) was located on the second floor.
Also on site was the small pathology
The team was sent to Huế, a city in central
department, with processing and micro-
Vietnam that serves as the capital city
scope work done in the same room.
of the Thua Thien-Hue province. Due to
Several basic immunohistochemical stains
its location near the border of North and
were available for breast cancer, although
Right: A street vendor in Huế, Vietnam
selling fresh strawberries
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 37
Ki67, an immunostain used to measure
population lives in extreme poverty. Most
red epirubicin/paclitaxel as his adjuvant
a trip to Ho Chi Minh City or Hanoi, if the
the proliferation index in breast tumor
drugs and health care are subsidized by
breast cancer regimen. For patients unable
patient had the means to pay for it. Bone
specimens, was not routinely used. The
the Vietnamese government; however,
to afford rituximab, CHOP-etoposide was
marrow transplant also required going to
pathology reports did not always establish
there is an exception with trastuzumab
generally the preferred regimen for non-
one of the two larger cities in Vietnam.
orientation and distance of the tumor from
for HER2-positive breast cancer, which
Hodgkin’s lymphoma.
surgical margins. This was one issue the
is unsubsidized. Rituximab is partially
team addressed during their stay in Huế.
subsidized by the government and is for
The patients were treated in four inpatient
clinic, they found an interesting and
patients who can afford the large copay-
rooms, each of which had five beds. Men
challenging mix of cases. Many types
The gap in wealth in Vietnam is extreme.
ments. Dr. Cau was able to order almost
and women were in the same rooms with
of cancer reflected what would be
Those with connections to the Communist
any chemotherapy drug on the World
no concern for privacy. If there were more
expected in a busy oncology clinic, with
leaders live quite well, but the rest of the
Health Organization (WHO) list. He prefer-
patients than beds, the patients shared a
a tendency toward tobacco-related and
bed, with one at each end. Each room had
gastric malignancies. Breast cancer and
5 to 10 patients, with their respective fam-
other malignancies seemed to present at
ily members providing food and water.
a more advanced stage. This is probably
Once the team settled in to work in the
related, at least in part, to the lack of
Above: Dr. Denham visiting with some of the
oncology patients staying in the inpatient
rooms in the clinic
Right: A decorative archway in Huế
As in the inpatient rooms, patient confi-
screening or effective primary or second-
dentiality was not a concern in the clinic.
ary prevention programs. According to a
As many as four breast cancer patients
2010 WHO report, Vietnam is among the
might be in the same room at the same
countries with the highest smoking rates in
time for their follow-up visit. Each disrobed
the world, with a prevalence of more than
and was examined in turn. It seems that
45% in males aged 15 years or older. In
patients often see the doctor for a very
addition, >40% of health care providers
brief visit, lasting less than five minutes.
smoke. The high prevalence of smoking
Patients seemed to be in charge of hold-
and cervical cancer relay the need for bet-
ing their own records, and many would
ter primary prevention in Vietnam.
come in with their scans and radiology
films in hand. Computed tomography and
The area lacked a linear accelerator, which
ultrasound were locally available and were
has been used for more than 50 years for
performed quickly for the outpatients.
external beam radiation treatments for
The quality of the images was quite good.
cancer. Several local cancer recurrences
Positron emission tomography required
could probably have been prevented if
38 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report Left: Micah
Burch, MD
Right: Carolina
Escobar, MD
standard radiation treatment had been
College of Medicine and Pharmacy. Such
given either concurrently with or after
opportunities include modernizing the
Where Are They Now?
chemotherapy. Access to other types of
pathology department; providing instruc-
Baylor University Medical Center at Dallas prides itself on providing outstanding
radiation treatments would allow treatment
tion in the use of long-acting oral pain
educational and training opportunities to prepare the physicians of tomorrow. To
of a much wider range of cancers.
medicines and WHO’s pain relief ladder;
date, 50 physicians have completed the medical oncology fellowship program
organizing an outpatient hospice; making
at Baylor Sammons Cancer Center at Dallas. Approximately two thirds of them
The lack of palliative care and hospice
more efficient use of space in the clinic;
practice in the North Central Texas community. We are pleased to announce that
represented a great need for the people
training in mammography, breast conser-
two former fellows of the graduating class of 2011 have joined the medical staff
of Huế, and it is a topic the team can
vation, and more accurate sentinel node
at Baylor Dallas: Micah Burch, MD, a hematology/oncology fellow, and Carolina
explore on a subsequent trip. The use of
assessments; teaching medical students
Escobar, MD, a blood and marrow transplantation fellow.
long-acting narcotics was uneven. Patients
to help in improvement of oncology edu-
at the end stage of their cancer and in a
cation and screening; and providing
Dr. Burch completed his internship and residency in internal medicine at Scott
lot of pain could come to the clinic and
instruction in English as a second lan-
and White Hospital in Temple, Texas, followed by a chief residency in internal
receive injections of morphine, or a clinic
guage, as requested by the students.
medicine. He specializes in hematologic malignancies, benign hematology,
nurse could go to them if they were nearby.
multiple myeloma, myelodysplasia, lymphoma and bleeding disorders. Dr. Burch
Death was not discussed with patients;
The trip to Vietnam was an educational
the family was simply told “to be prepared
experience, not only for the students and
for anything.”
staff at the Huế Medical School and
Dr. Escobar received her medical degree, with distinction, from Universidad
Oncology Clinic, but for every member
Pontificia Bolivariana in Colombia. She served her internship at Emory University
The team gave several lectures to the
of the Baylor team. The medical staff,
in Atlanta, Georgia and returned to Colombia to practice medicine. Dr. Escobar
medical students on the basics of oncol-
students, and patients were extremely
then returned to the U.S. to complete an internship and residency in internal
ogy practice. The students were polite
welcoming. Through them, the team
medicine at LSU Health in Shreveport, Louisiana followed by a fellowship in
and respectful. Based on their questions
learned how the medical system in Huế
hematology and oncology at the Feist-Weiller Cancer Center in Shreveport. She
and interactions during the trip, they had a
runs and how to make a difference in their
specializes in blood and marrow transplantation and is board certified in internal
great interest in attaining more information
medical practices. The group was able
medicine, oncology and hematology by the American Board of Internal Medicine.
on how they could improve their medical
to list areas for improvement for future
practices and how practices differed in the
volunteer groups to address. Moreover,
United States and Vietnam.
from their experience working with the
medical staff in Huế, the team learned
There are opportunities to make a positive
about resourcefulness and to be thankful
impact on subsequent trips to the Huế
for many things they take for granted, such
is board certified in internal medicine and board eligible in medical oncology.
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 39
as state-of-the-art medical equipment, the
perform breast reconstructive surgery.
availability of experienced specialists, and
They thereby become the ‘total package’
up-to-date medical training. All in all, it
for tumor removal and reconstruction.”
was an extremely worthwhile trip, and
many participants plan on making it again.
Since the program’s inception, 25 surgeons have completed the fellowship,
Welcome to New Members
of the Medical Staff at Baylor
Charles A. Sammons Cancer
Center at Dallas
The Seeger Surgical Breast Oncology
including the four surgical breast oncolo-
Fellowship 30th Anniversary
gists currently on the medical staff at
The Seeger surgical breast oncology fel-
Baylor Dallas. “These former fellows are
lowship is in its 30th year at Baylor Univer-
not only an integral part of our current
sity Medical Center at Dallas. The fellow-
program, but they also support breast
ship was established with an endowment
oncology in the Dallas–Fort Worth area
from Mr. and Mrs. Wirt Davis in honor of
as well as the rest of the country, said Dr.
her parents, Helen Buchanan and Stanley
Jones. “With the development of more
Joseph Seeger. The program was originally
breast cancer programs in the United
headed by Harold Cheek, MD, the first sur-
States, we routinely get at least one inquiry
geon in North Texas to limit his practice to
a month from programs wanting to add a
diseases of the breast. At that time, it was
qualified surgical breast oncologist to their
the only surgical breast oncology fellow-
staff.”
ship in the country. Currently, 32 Society
of Surgical Oncology–approved fellowship
Site-Tumor Conferences
programs are available nationwide.
At Baylor Sammons Cancer Center, a key
element at the heart of our approach to
James Fleshman, MD
Chair of the Department of Surgery,
Baylor University Medical Center
at Dallas
Pavlos Papavasiliou, MD
Surgical Oncology
Keith Cavaness, DO
Surgical Oncology
The Seeger surgical breast oncology
patient care and education is the site-
fellowship is headed by Ronald C. Jones,
specific tumor conference program. Rather
MD, chief of surgery at Baylor Dallas.
than focusing solely on recommendations
“We are training surgeons dedicated to
for patient care, the site-specific confer-
surgical breast oncology, said Dr. Jones.
ences also aim at educating the medical
“In addition, some fellows from the Baylor
professionals attending the conference.
program finish and then go on to complete
Unlike tumor boards, the site-specific
a residency in plastic surgery in order to
tumor conferences offer continuing
40 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report Carolyn L.
Thomas, MD
medical education credit for physicians
was entitled, “The Grand Challenges of
who attend. Because several patients with
Hematopoietic Cell Transplantation.”
the same diagnosis are presented at each
Fellows’ Research
Management of Metaplastic Breast Cancer: Clinicopathologic
conference, attendees are provided with
The Stone Lectureship was instituted in
an in-depth view from specialists, accom-
2009 in honor of Marvin J. Stone, MD,
Carolyn L. Thomas, MD, a breast surgery fellow at Baylor University Medical
panied by lively discussion.
MACP. Dr. Stone served as chief of oncol-
Center at Dallas, was selected for a poster presentation at the 36th Annual
ogy at Baylor Dallas and director of Baylor
Symposium of the American Society of Breast Diseases in April 2012. The Meta-
Oncology Lectureships
Sammons Cancer Center from 1976 to
plastic Breast Cancer poster was also presented at the North Texas Chapter of the
The fourth annual Marvin J. Stone
2008. He currently directs the medical
American College of Surgeons in February. Dr. Thomas performed a retrospective
Lectureship was held at internal medicine
oncology fellowship program and the
review of 41 patients diagnosed with metaplastic breast cancer and treated at
grand rounds on April 10, 2012, in Beasley
internal medicine clerkship for third-year
Baylor between 1993 and 2010. Patients were identified through the Cancer
Auditorium at Baylor University Medical
medical students.
Registry and were reviewed for clinical and pathologic features, as well as treat-
Center at Dallas. This year’s recipient was
Features, Prognosis, and Response to Therapy
ment and outcomes. Although other studies have demonstrated lower overall
Frederick R. Appelbaum, MD, director
The Department of Surgery held the
survival and disease-free survival with metaplastic breast cancer compared with
of the Clinical Research Division, Fred
annual Harold Cheek Breast Lectureship
invasive ductal breast cancer, the Baylor study cohort experienced fewer local and
Hutchinson Cancer Research Center, and
on April 11, 2012, in Davis Auditorium at
distant disease recurrences than has been observed in other studies.
head of oncology, University of Washington
Baylor Dallas. This year’s lecture featured
School of Medicine. Dr. Appelbaum is also
Kelly K. Hunt, MD, FACS, chief, division of
president and executive director of the
surgical breast oncology at M. D. Ander-
Seattle Cancer Care Alliance, past chair
son Cancer Center and Hamill Foundation
of the Board of Scientific Advisors of the
Distinguished Professor in the Department
National Cancer Institute, and current chair
of Surgical Oncology at the University of
of the Leukemia Committee of the South-
Texas. Dr. Hunt presented “The Changing
west Oncology Group. Dr. Appelbaum has
Role for Auxiliary Surgery in the Manage-
authored more than 900 scientific publica-
ment of Breast Cancer.”
tions and was lead author on the first
paper to describe the successful use of
The Lloyd Wade Kitchens Lectureship
Celina Rockover Professor of Humanities at
Continuing Medical Education
autologous bone marrow transplantation
was held on August 28, 2012, in Beasley
the University of Texas at Dallas. Dr. Kratz’s
Symposia
in patients with refractory malignant lym-
Auditorium at Baylor Dallas. The featured
lecture topic was “The Art at the Heart of
An important function of Baylor Charles
phoma. Dr. Appelbaum’s presentation
speaker was Dennis M. Kratz, PhD, Dean,
Healing.”
A. Sammons Cancer Center at Dallas is
School of Arts and Humanities, Ignacy and
to serve as a regional center for continuing
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 41
medical education for health profession-
time with attendees. Two symposia have
als. This is accomplished by offering
been presented in 2012 on lung cancer
day-long symposia that present the latest
and gastrointestinal (GI) cancer.
information in the prevention, screening,
At the Stone Lectureship: Alan M. Miller, MD, PhD, Frederick R.
Appelbaum, MD, Kathy Stone, and Marvin J. Stone, MD, MACP.
Below: Site-tumor conference chiefs and moderators
evaluation, and management of specific
The inaugural GI Surgical Cancer
cancers. Expert faculty on the medical
Conference was held Feb. 11, 2012. This
staff at Baylor University Medical Center at
event focused on the diagnosis, treatment,
Dallas and from other institutions across
and management of GI cancers and was
the country provide up-to-date presenta-
attended by 70 medical professionals from
tions as well as one-on-one discussion
across North Texas. Expert faculty from
Baylor lectured on esophageal and gastric
cancers, diseases of the pancreas, and GI
malignancies, genetics, and postoperative
care. The keynote speaker was Herbert
Zeh, MD, assistant professor of surgery
in the Division of Surgical Oncology at the
University of Pittsburgh, as well as the
codirector of the University of Pittsburgh
Cancer Institute Pancreatic Cancer Center.
Dr. Zeh is one of the country’s leaders in
the use of the da Vinci® Surgical System
for robotic pancreatic surgery. This technology allows minimally invasive surgery
that enhances the surgeon’s ability to
see details and allows for more natural
movements in performing the Whipple
procedure, one of the most complex
surgeries performed to treat pancreatic
cancer. At his institution, this type of
robotic procedure compared with more
traditional methods has resulted in a
42 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report reduction in blood loss and need for trans-
open discussions led by a moderator were
fusion, shorter hospital stays, and a faster
initiated after each group of talks, allowing
recovery, reducing the time from surgery
the participants to ask questions of either a
to the start of chemotherapy treatment.
particular speaker or the panel of speakers.
Cases were presented, and an audience
The second annual North Texas Multidis-
response system was utilized to enhance
ciplinary Lung Cancer Symposium was
the interaction.
held on October 13, 2012. This day-long
event focused on recent advances in lung
Education in Palliative and
cancer, with residents, fellows, nurses, and
End-of-Life Care
physicians in attendance. Faculty from
One of the most difficult tasks for an
dying.” Moreover, less than 60% of these
oncologist-patient interactions were taped,
across the country presented the latest
oncologist is to discuss end-of-life issues
hospitalized patients had an advance
and the class viewed several tapes after
information on a number of topics. These
with a family when the patient is unable to
directive. To improve the physicians’ ability
each session and the remaining at the end
topics included the identification of
communicate his or her wishes. This is why
to communicate end-of-life issues and
of the day. Dr. Casanova asked physicians
patients who need to be screened as well
it is so vital for all people, not just cancer
advance planning to patients, a one-day
to critique themselves, and then he and the
as use of helical computed tomography
patients, to have an advance directive. An
interactive program modeled after the
group discussed the salient issues for each
for screening, the scope and frequency of
advance directive is more than just a living
EPEC™-O program (Education in Palliative
interaction. This course allowed oncolo-
follow-up after treatment, the importance
will; it can also include medical power of
and End-of-Life Care for Oncology) was
gists to not only watch how they might be
of a coordinated team approach for pre-
attorney and an out-of-hospital do-not-
offered to oncologists. This program was
viewed interacting with patients, but also
operative physiologic testing of the patient
resuscitate order. Patients may decide to
coordinated by Mark A. Casanova, MD,
see how other oncologists handled similar
to determine the feasibility of surgical
have one, two, or all three of these legal
a member of the palliative care team at
situations. The participants gave good
resection, the ways different interventional
forms as part of their medical file in prepa-
Baylor Dallas.
reviews for the course and found it benefi-
pulmonary techniques can be incorporated
ration for their potential need for end-of-life
into lung cancer treatment, the use of sur-
decisions.
cial to improving their practice. This course
The initial course, with 18 participants,
has been presented twice, and there are
offered three presentations by Dr.
plans to continue it, perhaps modify it for
therapy in stage III lung cancer, harnessing
A recent inpatient survey of oncology units
Casanova on communication, negotiating
other members of the health care team,
the immune system for treatment of lung
at Baylor University Medical Center at
goals of care and advanced care planning.
and offer it in select locations across the
cancer, molecular advances and targeted
Dallas found that less than 30% of
Each session was followed by interactions
Dallas–Fort Worth Metroplex to facilitate
therapies in non–small cell lung cancer,
patients had ever had a discussion with
of the oncologists with standardized
attendance of oncologists on the medical
and the status of treatment in small cell
their oncologist regarding their wishes “if
patients, who progressed through their
staff across Baylor Health Care System.
lung cancer. In addition to the lectures,
they were to become very ill or close to
illness with each session. All of the
gery versus chemotherapy and radiation
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 43
Laura Granado: A Full and Healthy Life
Because her sister had breast cancer, Laura Granado decided to go
through the Hereditary Cancer Risk Program at Baylor Charles A.
Sammons Cancer Center at Dallas. Genetic testing showed she was at
high risk for breast and ovarian cancer. She discovered a lump and after
a biopsy was diagnosed with breast cancer. At Baylor Dallas, Laura
underwent a double mastectomy followed by reconstructive surgery.
“I had great support from the hospital staff. My nurse navigator was
awesome. She listened to me and told me everything to expect.”
Laura is back to work and taking care of her family. “Thanks to Baylor,
I’m living a full and healthy life.”
44 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report Below:
April Blair at work
in a Baylor lab
Research
Hope for Advanced Melanoma:
growth factors and cytokines. Langerhans
New Developments in Cancer
cells (LCs), which are found in the epider-
Vaccines
mis, prime high-avidity, antigen-specific
Patients with resected stage IIIc/IV mela-
CD8+ T cells. These T cells are critical for
noma have a poor prognosis; treatment
a long-lived protective immunity that will
options are limited, and five-year survival
prevent relapse in patients with high-risk
rates are less than 30%. Karolina Palucka,
disease. Interstitial dermal CD14+ DCs,
MD, PhD, investigator and the Michael A.
on the other hand, are important in the
E. Ramsay Chair for Cancer Immunology
generation of humoral immunity, including
Research at Baylor Institute for Immunol-
the production of antibodies and memory
ogy Research, has been working for more
B cells. The most efficient vaccines may
than 10 years developing and testing
be those that target both types of DCs,
vaccines for the treatment of advanced
allowing stimulation of both cellular and
melanoma. To date, although a significant
humoral immune responses.
proportion of patients have developed a
tumor antigen–specific immune response,
For vaccine development, either CD34+
only a few have shown a durable objective
progenitor cells or monocytes are removed
tumor regression. Dr. Palucka is now using
from the patient’s blood by apheresis and
funding from Baylor Sammons Cancer
grown in culture with selected growth
Center’s Research Grant Program to
factors that affect differentiation and matu-
explore a new approach to vaccine devel-
ration. The resultant DCs are loaded with
opment that may point the way to more
tumor-specific antigens before being
effective treatment.
inoculated back into the patient. In earlier
studies, Dr. Palucka discovered that
Most of the vaccines developed by Dr.
monocytes that differentiate into DCs in
Palucka have involved dendritic cells
response to the cytokine interleukin-4
(DCs), the master controllers of immune
(IL-4) differentiate into interstitial dermal
processes in the human body. A key
DCs, whereas treatment with IL-15 leads
characteristic of DCs is their plasticity:
to the generation of cells with the proper-
they will mature differently and have dif-
ties of LCs.
ferent capabilities in response to different
Background:
Dendritic cells
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 45
Testing the effectiveness of an IL-15 vac-
to be untreatable. We are really entering
cine has posed several problems. It is a
a new area, where immune therapy will
difficult cytokine to produce and has only
become an everyday treatment of cancer,”
recently become available commercially.
said Dr. Palucka.
In addition, IL-15–induced DCs are more
Breast cancer
tissues
fragile than ordinary DCs and require
Research in Breast Surgical
special handling in the laboratory and clini-
Oncology: On the Lookout for
cal settings. Dr. Palucka has surmounted
Practice-Changing Results
these difficulties and is now testing the
A key component in maintaining the quality
immunogenicity of IL-15 DCs in patients
of breast surgical oncology is the incorpo-
with advanced melanoma in a pilot study
ration of the latest research findings into
cofunded by Baylor Sammons Cancer
day-to-day practice. This may involve a
Center’s Research Grant Program and by
clinician’s active participation in clinical
the National Institutes of Health. The IL-15
research studies, but it equally involves
DCs are loaded with nine to ten amino
awareness of potentially practice-changing
acid peptides derived from four melanoma
research being conducted around the
antigens. In addition to monitoring vaccine
country and around the world.
immunogenicity after two weeks, the study
will examine progression-free survival and
Sentinel lymph node (SLN) biopsy has
overall survival at 92 weeks.
become the standard of care for breast
cancer management, but many questions
If the results of the trial are positive, it will
remain as to best practices for this technol-
provide another piece of the puzzle that
ogy. Intraoperative assessment of the SLN
Dr. Palucka has been putting together over
typically involves touch imprint cytology
the last 10 years—how to provide long-
or frozen section stained with hematoxylin
lived protective immunity against a deadly
and eosin (H&E). Permanent section may
cancer. “We are in a revolutionary phase
use immunohistochemical staining in ad-
in developing immune therapy for cancer.
dition to H&E, allowing the identification
We are seeing some amazing responses in
of extremely small lesions (isolated tumor
patients with lung cancer and pancreatic
cells, defined as lesions not larger than 0.2
cancer who were classically considered
mm in diameter) that may not be visible
46 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report with H&E. How frequently would the treat-
Dr. Shiller is now involved with a follow-up
ment recommendation be made on the
study entitled “A retrospective evaluation
basis of intraoperative pathology change
of the sensitivity and specificity of diag-
after analysis of permanent sections? Are
nosing axillary lymph node status: bridg-
the types of lesions identified clinically
ing pathologic diagnosis with clinical
important?
outcomes over 5 years” (Baylor Research
Institute IRB #011-175). This study is
Michelle Shiller, DO, MSPT, a pathologist
reassessing the original patient group
on the medical staff at Baylor Dallas, has
to determine how pathology results
worked with surgeons to collect data for
influenced the clinical management of
two studies. In the first study, 488 con-
the patients. The study will determine if
secutive SLN biopsies were retrospectively
patients with a finding of micrometasta-
reviewed to determine the accuracy of
ses or isolated tumor cells underwent an
intraoperative pathology compared with
axillary lymph node dissection, and if not,
permanent section in identifying lesions
why. It will also reassess the status of the
in the SLN. The findings from this study,
SLN as a prognostic indicator by examin-
which were published in the April 2011
ing disease-free survival, recurrence, and
issue of Baylor University Medical Center
occurrence of ipsilateral or contralateral
Proceedings, indicated that the sensitivity
second primary tumors. The data from
and specificity of SLN biopsy at Baylor
this study are being acquired now and
University Medical Center at Dallas com-
will contribute to a breast cancer registry
pared favorably with percentages reported
that will ultimately be incorporated into the
in the literature. For macrometastases
new surgical oncology clinical research
(lesions >2.0 mm), the sensitivity was 88%;
database.
for micrometastases (lesions 0.2–2.0 mm),
the sensitivity was 72%; and for isolated
In assessing the latest research findings
tumor cells, the sensitivity was 60%.
presented at national meetings, clinicians
Specificity was 100% in all cases.
must judge carefully whether a study is
potentially practice changing. Barry Wilcox,
MD, a radiation oncologist on the medical
staff and medical director of radiation
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 47
oncology at Baylor Dallas, commented
The Surgical Oncology Research
diagnosis, type of treatment, and treat-
the department is currently capable of
on a recent clinical trial that attracted
Database: One-Stop Shopping for
ment outcomes.
running antibody tests for 200 different
attention at the 2010 meeting of the Ameri-
High-Quality Clinical Patient Data
can Society of Clinical Oncology. In this
Two years ago, the Division of Surgical
study, 636 patients with early stage, estro-
Oncology was created as an academic
(EDW) is a central repository of Baylor
The department can isolate DNA and
gen receptor–positive breast cancer who
subunit of the medical staff at Baylor
information used to support enterprise
RNA from surgical specimens to look
were 70 years of age or older were ran-
University Medical Center at Dallas.
analytics, reporting, and research. The
for mutations in oncogenes and tumor
domized to receive either tamoxifen alone
This new division was created to increase
database contains information from
suppressors. As more biomarkers of
or tamoxifen plus radiation after lumpec-
the academic activities of clinical surgeons
data sources across the enterprise,
specific targeted pathways are identi-
tomy. At 10.5 years follow up, the addition
and to provide infrastructure for the sup-
including patient demographics, ADT
fied, more information will be collected.
of radiation resulted in a 6% reduction in
port of clinical research. Currently, the
(Admit, Discharge, Transfer), financial,
recurrence, but no difference in survival.
division has 18 surgeons as members.
clinical, and operational systems. Data
These results were much anticipated, buy
The progress on the creation of the
are extracted from multiple systems
Texas Provider Network, Texas Oncol-
they are not necessarily practice-changing,
research database will support the devel-
and then structured and organized in a
ogy, PA, Neuro Oncology Associates,
according to Dr. Wilcox. “These results
opment of new avenues for research in
manner which allows the various types
Pathologists Biomedical Labs, etc.
present an additional treatment option for
the cancer center.
of information to be analyzed at various
older women. Radiation therapy is typically
proteins, approximately 1% of the pro• The Enterprise Data Warehouse
tein complement of the human genome.
• Physician practices including Health
levels of detail. Information in the EDW
To facilitate the research process, the
offered to patients over 70, but discussion
One of the major assets of housing the
is presented through a variety of meth-
Division of Surgical Oncology is continuing
with the patient has to be individualized
research database at Baylor Dallas is the
ods, including executive dashboards,
the development of the Surgical Oncology
as to the risks and benefits that apply for
contribution to the research enterprise.
operational scorecards, and scheduled
Clinical Research Database, or SOCRD.
that specific patient. Many women are just
This large patient base is the foundation for
and ad hoc reports.
SOCRD will serve as a meta-registry,
not keen on taking radiation therapy. They
the continued excellence in patient care.
may have significant comorbidities or have
Until now, however, it has been difficult for
difficulty in getting to and from the cancer
where multiple databases can be con• The Department of Pathology at Baylor
nected in a useful way. The database will
a researcher to collect patient data for a
Dallas works closely with surgical on-
provide a central location where informa-
center for daily treatments over a five- to
study because the data is housed in vari-
cologists to provide diagnosis, assess-
tion from all these sources can be stored,
six-week period. Whatever the reason,
ous locations:
ment of adequacy of surgical resec-
validated, and accessed for clinical
tion, and additional information about
research.
they would like to know if they are putting
themselves at serious risk by saying ‘no.’
• Baylor Sammons Cancer Center main-
prognosis that may influence treatment
We now have data to give them some
tains a tumor registry on patients treated
decisions. According to George Snipes,
Clinicians and information technology
solid information.”
at the center, including information on
MD, PhD, medical director of Molecular
experts from Baylor Dallas have worked
cancer type, site, disease stage at
Pathology at Baylor Dallas, reports that
with an outside vendor to complete a
48 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report “proof of concept” beta test of the meta-
regulatory requirements. “The protection
disciplined and scientific methodology in
One of the tools which is used to protect
registry, drawing initially on data from
of confidential information is critical, and
how we put things into and pull them out
confidentiality is the use of de-identified
the EDW, tumor registry, and pathology
we will guarantee that protection through a
of this meta-registry,” said Dr. Preskitt.
data. According to Angelia Drake, a
systems, and focusing on individual tumor
sites. With the successful completion of
that test, phase II of the development
was launched on December 1 of 2011; it
SOCRD Strategy
incorporates additional registries and 52
tumor sites (i.e., breast, colon, hepatocel-
Baylor Services Project
Registry Groups
Curated Data
Comprehensive
Solid Tumor™
Master File
lular carcinoma, etc.). These registries and
data sets are continuing to be validated;
however, multiple registries within SOCRD
Data Sources
Landing Field
Study-Specific
Registries
are already in production.
The working group from Baylor Dallas
Breast
Cancer
Study 1
EDW
includes Drs. Preskitt and Snipes, Angelia
of Surgical Oncology, Jennifer Peattie,
C. and Harold C. Simmons Transplant
Breast
Cancer
Study 2
Tumor
Registry
Institute, as well as a team of division
Scott Celinski, MD, Keith Cavaness, DO,
John C. O’Brien, MD, Michael Grant, MD,
and Robert Goldstein, MD, and pathologist, Michelle Shiller, DO, MSPT. They are
working together on the infrastructure of
the database, building it to be comprehensive, robust, and dynamic, while maintaining HIPAA-required confidentiality and
Remedy Thyroid Cancer
Remedy Esophageal
Cancer
Remedy Skin Cancer
members, Baylor’s Information Systems
(BIS), and experts, including surgeons
Remedy Melanoma
Remedy Stomach
Cancer
Drake, program manager of the Division
clinical applications manager with Annette
Remedy Colorectal
Cancer
Data
Source #3
Aggregated
Operational Data
LiverPancreas
Cancer
Registry
Remedy Oropharyngeal/
Salivary Cancer
Remedy Small Bowel
Cancer
Cohort Analysis
Feasibility
Analysis
Remedy Liver/Bile Duct/
Gallbladder Cancer
Other
TBD
Remedy Sarcoma
Remedy Adrenal Cancer
Remedy Brain Cancer
Research-Ready
Data
to Fast Track
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 49
long-term goal for SOCRD is to include
of-life surveys, etc. “This will be a dynamic
information,” said Dr. Snipes. “In this era
advanced colorectal cancer”; Cynthia
a de-identifying tool which allows the
database,” said Dr. Snipes. “We need to
of precision medicine, if we can connect
Osborne, MD, “Effect of exercise during
physician-investigators to query
follow patients for as long as we can. We
our pathologic data with outcome data,
adjuvant chemotherapy infusion for breast
de-identified subjects/data to determine
won’t be closing too many files.” He quali-
we can do a better job of identifying and
cancer;” and Arianne Theiss, PhD,
counts or confirm a hypothesis before
fied this; however, to take into account
validating new molecular markers.”
“Metabolite profiling of disease progres-
obtaining IRB approval. For example, a
studies which require that data not be
Dr. Preskitt believes SOCRD will be an
sion in colitis-associated cancer.”
physician interested in a clinical ques-
changed, “In some cases, such as drug
important tool in recruiting young, well-
tion about a specific patient group (e.g.,
trials, we need to lock down the data. In
trained surgical oncologists to Baylor
Emerging Technology Projects
women over 50 with advanced breast
order to achieve this, we will take ‘snap-
Dallas. “Baylor is attractive to them
These grants through the Baylor Research
cancer who smoke) could query the sys-
shots’ at various times, while still maintain-
because of our large and diverse patient
Institute provide funding to investigators
tem to determine the number of patients
ing the fluid quality of the database.”
population. But they are looking for a more
to access emerging technology, such as
academic environment, and SOCRD is
genomics, proteomics, and metabolomics,
meeting these criteria. If the results of
the de-identified data obtained supports
As mentioned, SOCRD is being developed
going to be a major step in that direction,”
which require advanced equipment or
pursuing a clinical study, they would be
in cooperation with an outside vendor,
said Dr. Preskitt.
technology not readily available to them.
brought to the division’s Research Com-
Remedy Informatics (aka RemedyMD),
mittee for review/approval to move forward
who will also be involved in long-term
Progress of Research Grants
nology, the investigators use these funds
with development of the study and the
management of the database and training
In 2012, Baylor Charles A. Sammons
to pay for the tests. Joyce O’Shaughnessy,
IRB process.
sessions for database users at Baylor
Cancer Center at Dallas awarded six
MD, had one grant in this area entitled
Dallas Similar vendors have been involved
grants to investigators, for a total of
“Comprehensive phosphoproteome
While SOCRD was initially populate
in the establishment of meta-registries for
$642,000. The award category, investi-
pathway analyses of metastatic breast
with a core set of data, the database
Cleveland Clinic, University of California-
gators, and grant titles are listed below.
cancer tissues that have undergone whole
also includes several modules, such as a
Davis and University of Texas-South-
registry builder and a configuration tool
western. SOCRD will utilize cloud storage
Pilot Projects
which enables the building of individual
provided by Amazon, so the amount of
Three projects sought to generate initial
Trainee Grants
registries, a query builder which allows us
data which can be added will be limited
data so that the investigator could suc-
These grants provide funding to residents
to perform ad hoc and standard queries,
only by budgets, not by technology.
cessfully prepare an application for
and fellows in a Baylor Health Care
extramural peer-reviewed funding. The
System–approved postgraduate training
and a dashboard builder which supports
Rather than obtain the equipment or tech-
genome and transcriptome sequencing.”
viewing the data for clinical research.
Everyone involved with SOCRD is excited
investigators and their grants were as
program conducting a research project
Additional sources of data will come into
about the potential of this new tool to fa-
follows: Ajay Goel, PhD, “Development of
involving the treatment, diagnosis, or etiol-
the database, including data from clinical
cilitate research at Baylor Dallas. “SOCRD
novel epigenetic biomarkers for predicting
ogy of cancer. Graduate students working
trials, follow-up data on patients, quality-
will provide a rich source of clinical
therapeutic outcome in patients with
in a Baylor Research Institute laboratory
50 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report Clinical Oncology
Research
Coordination
Office staff
with a Baylor investigator as their primary
mentor are also eligible. Meghan Koch,
DO, received an award for a project titled
“Methods of sample preparation for highresolution mass spectrometry in patients
with ovarian cancer.”
Clinical Oncology Research
Coordination Office
The Clinical Oncology Research Coordination Office experienced its second
straight year of continued growth in 2012.
The office manages more than 100 active
protocols, of which 68 are open to enrollment at three Baylor locations, Baylor
University Medical Center at Dallas, Baylor
All Saints Medical Center at Fort Worth
and Baylor Medical Center at Irving. Trials
are available for a variety of tumor types,
including hematologic malignancies (leukemia, lymphoma, and multiple myeloma),
bone marrow transplant, breast cancer,
melanoma, lung cancer, brain cancer,
head and neck cancer, and gynecologic
malignancies including ovarian, fallopian
tube and endometrial cancer. The office
also continues to support several cooperative groups and consortia, including
the Southwest Oncology Group, Gynecologic Oncology Group, Multiple Myeloma
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 51
Research Consortium, and Brain Tumor
Trials Collaborative.
In 2012, the number of open trials increased by 55%. As a result, enrollment in
oncology trials increased by 26%. A goal
for the coming year is to increase enrollment in clinical trials by 10% and increase
Patient Accruals by Tumor Type
the number of trials available to patients
by 10%.
301
300
266
2009
Contributions at the American
2010
Society of Clinical Oncology Meeting
2011
At the 2012 meeting of the American
250
Society of Clinical Oncology, 32 abstracts
featured authors from Baylor Sammons
Cancer Center. Baylor Sammons research-
192
200
ers were first authors on seven abstracts—
three by Thomas E. Hutson, DO, PharmD,
two by Joyce O’Shaughnessy, MD, and
150
one each from Carlos Becerra, MD, and
136
Cynthia Osborne, MD. Twelve of the 32
abstracts related to genitourological
93
100
94
80
75
cancers; nine to breast cancer; three to
85
78
gastrointestinal cancers; three to early
63
63
45
50
57
50
39
phase trials; two to neurological cancers;
56
two to melanoma; and one to sarcoma.
38
35
29
23
15
23
6
19
14
22
0
Breast
Chest
GI
GU
Gyn
Hematology
Neuro
Other
Skin
52 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report 2012 List of Publications
1. Anasetti C, Logan BR, Lee SJ, Waller
EK, Weisdorf DJ, Wingard JR, Cutler CS,
Westervelt P, Woolfrey A, Couban S, Ehninger G, Johnston L, Maziarz RT, Pulsipher
MA, Porter DL, Mineishi S, McCarty JM,
Khan SP, Anderlini P, Bensinger WI, Leitman SF, Rowley SD, Bredeson C, Carter
SL, Horowitz MM, Confer DL; Blood and
Marrow Transplant Clinical Trials Network
(Agura E). Peripheral-blood stem cells
versus bone marrow from unrelated donors.
N Engl J Med. 2012;367(16):1487-96.
2. Antelo M, Balaguer F, Shia J, Shen Y, Hur
K, Moreira L, Cuatrecasas M, Bujanda L,
Giraldez MD, Takahashi M, Cabanne A,
Barugel ME, Arnold M, Roca EL, Andreu M,
Castellvi-Bel S, Llor X, Jover R, Castells A,
Boland CR, Goel A. A High Degree of LINE1 Hypomethylation Is a Unique Feature of
Early-Onset Colorectal Cancer. PLoS One.
2012; 7(9):e45357.
3. Armand P, Kim HT, Zhang MJ, Perez WS,
Dal Cin PS, Klumpp TR, Waller EK, Litzow
MR, Liesveld JL, Lazarus HM, Artz AS,
Gupta V, Savani BN, McCarthy PL, Cahn
JY, Schouten HC, Finke J, Ball ED, Aljurf
MD, Cutler CS, Rowe JM, Antin JH, Isola
LM, Di Bartolomeo P, Camitta BM, Miller
AM, Cairo MS, Stockerl-Goldstein K, Sierra
J, Savoie ML, Halter J, Stiff PJ, Nabhan
C, Jakubowski AA, Bunjes DW, Petersdorf
EW, Devine SM, Maziarz RT, Bornhauser M,
Lewis VA, Marks DI, Bredeson CN, Soiffer
RJ, Weisdorf DJ. Classifying cytogenetics
in patients with AML in complete remission
undergoing allogeneic transplantation: a
CIBMTR study. Biol Blood Marrow Transplant 2012;18(2):280-8.
4. Barry S, Ha KY, Laurie L. Carcinoma of the
breast in men. Proc (Bayl Univ Med Cent).
2012;25(4):367-8.
5. Blackwell KL, Burstein HJ, Storniolo AM,
Rugo HS, Sledge G, Aktan G, Ellis C,
Florance A, Vukelja S, Bischoff J, Baselga
J, O’Shaughnessy J. Overall Survival
Benefit With Lapatinib in Combination With
Trastuzumab for Patients With Human
Epidermal Growth Factor Receptor 2-Positive Metastatic Breast Cancer: Final Results
From the EGF104900 Study. J Clin Oncol.
2012;30(21):2585-92.
6. Blum JL, Barrios CH, Feldman N, Verma S,
McKenna EF, Lee LF, Scotto N, Gralow J.
Pooled analysis of individual patient data
from capecitabine monotherapy clinical
trials in locally advanced or metastatic
breast cancer. Breast Cancer Res Treat.
2012;136(3):777-88.
7. Boland CR. Lynch syndrome: new tales
from the crypt. Lancet Oncol. 2012;13(6):
562-4.
8. Boland CR. Taking the starch out of hereditary colorectal cancer. Lancet Oncol. 2012;
13(12):1179-80.
9. Bracarda S, Hutson TE, Porta C, Figlin RA,
Calvo E, Grünwald V, Ravaud A, Motzer
R, Kim D, Anak O, Panneerselvam A, Escudier B. Everolimus in metastatic renal cell
carcinoma patients intolerant to previous
VEGFr-TKI therapy: a RECORD-1 subgroup
analysis. Br J Cancer 2012;106(9):1475-80.
10. Brim H, Lee E, Abu-Asab MS, Chaouchi M,
Razjouyan H, Namin H, Goel A, Schäffer
AA, Ashktorab H. Genomic Aberrations
in an African American Colorectal Cancer
Cohort Reveals a MSI-Specific Profile and
Chromosome X Amplification in Male Patients. PLoS One. 2012;7(8):e40392. Epub
2012 Aug 6.
11. Burch M, Cooper B. Fondaparinux-associated heparin-induced thrombocytopenia.
Proc (Bayl Univ Med Cent). 2012;25(1):13-5.
12. Buzdar AU, Xu B, Digumarti R, Goedhals L,
Hu X, Semiglazov V, Cheporov S, Gotovkin E, Hoersch S, Rittweger K, Miles DW,
O’Shaughnessy J, Tjulandin S; on behalf
of the NO16853 trial group. Randomized
phase II non-inferiority study (NO16853)
of two different doses of capecitabine in
combination with docetaxel for locally
advanced/metastatic breast cancer. Ann
Oncol 2012;23(3):589-97.
13. Cairncross G, Wang M, Shaw E, Jenkins R,
Brachman D, Buckner J, Fink K, Souhami
L, Laperriere N, Curran W, Mehta M. Phase
III Trial of Chemoradiotherapy for Anaplastic
Oligodendroglioma: Long-Term Results of
RTOG 9402. J Clin Oncol. 2012 Oct 15.
[Epub ahead of print]
14. Calvo E, Escudier B, Motzer RJ, Oudard S,
Hutson TE, Porta C, Bracarda S, Grünwald
V, Thompson JA, Ravaud A, Kim D, Panneerselvam A, Anak O, Figlin RA. Everolimus in metastatic renal cell carcinoma:
subgroup analysis of patients with 1 or 2
previous vascular endothelial growth factor
receptor-tyrosine kinase inhibitor therapies
enrolled in the phase III RECORD-1 study.
Eur J Cancer 2012;48(3):333–339.
15. Cao Y, Panos L, Graham RL, Parker TH 3rd,
Mennel R. Primary cutaneous angiosarcoma of the breast after breast trauma. Proc
(Bayl Univ Med Cent) 2012;25(1):70–72.
16. Cho DC, Hutson TE, Samlowski W, Sportelli
P, Somer B, Richards P, Sosman JA, Puzanov I, Michaelson MD, Flaherty KT, Figlin
RA, Vogelzang NJ. Two phase 2 trials of
the novel Akt inhibitor perifosine in patients
with advanced renal cell carcinoma after
progression on vascular endothelial growth
factor-targeted therapy. Cancer. 2012 Jun 6.
[Epub ahead of print]
17. Choueiri TK, Ross RW, Jacobus S,
Vaishampayan U, Yu EY, Quinn DI, Hahn
NM, Hutson TE, Sonpavde G, Morrissey
SC, Buckle GC, Kim WY, Petrylak DP, Ryan
CW, Eisenberger MA, Mortazavi A, Bubley
GJ, Taplin ME, Rosenberg JE, Kantoff PW.
Double-blind, randomized trial of docetaxel
plus vandetanib versus docetaxel plus placebo in platinum-pretreated metastatic urothelial cancer. J Clin Oncol 2012;30(5):507–
512.
18. Collea RP, Kruter FW, Cantrell JE, George
TK, Kruger S, Favret AM, Lindquist DL,
Melnyk AM, Pluenneke RE, Shao SH,
Crockett MW, Asmar L, O’Shaughnessy
J. Pegylated liposomal doxorubicin plus
carboplatin in patients with metastatic
breast cancer: a phase II study. Ann Oncol
2012;23(10):2599-605.
19. Cortes J, Calvo V, Ramírez-Merino N,
O’Shaughnessy J, Brufsky A, Robert N,
Vidal M, Muñoz E, Perez J, Dawood S,
Saura C, Di Cosimo S, González-Martín
A, Bellet M, Silva OE, Miles D, Llombart A,
Baselga J. Adverse events risk associated
with bevacizumab addition to breast cancer
chemotherapy: a meta-analysis. Ann Oncol
2012;23(5):1130-7.
20. Craig DW, O’Shaughnessy JA, Kiefer JA,
Aldrich J, Sinari S, Moses TM, Wong S,
Dinh J, Christoforides A, Blum JL, Aitelli CL,
Osborne CR, Izatt T, Kurdoglu A, Baker A,
Koeman J, Barbacioru C, Sakarya O, De La
Vega FM, Siddiqui A, Hoang L, Billings PR,
Salhia B, Tolcher AW, Trent JM, Mousses
S, Von Hoff DD, Carpten JD. Genome and
transcriptome sequencing in prospective
refractory metastatic triple negative breast
cancer uncovers therapeutic vulnerabilities. Mol Cancer Ther. 2012 Nov 19. [Epub
ahead of print]
21. Crown J, O’Shaughnessy J, Gullo G.
Emerging targeted therapies in triplenegative breast cancer. Ann Oncol. 2012;23
Suppl 6:vi56-vi65.
22. Ding YC, McGuffog L, Healey S, Friedman
E, Laitman Y, Shimon-Paluch S, Kaufman B,
Liljegren A, Lindblom A, Olsson H, Kristoffersson U, Stenmark Askmalm M, Melin B,
Domchek SM, Nathanson KL, Rebbeck TR,
Jakubowska A, Lubinski J, Jaworska K,
Durda K, Gronwald J, Huzarski T, Cybulski
C, Byrski T, Osorio A, Ramony Cajal T,
Stavropoulou AV, Benítez J, Hamann U,
Rookus MA, Aalfs CM, de Lange J, MeijersHeijboer HE, Oosterwijk JC, van Asperen
CJ, Gomez-Garcia EB, Hoogerbrugge N,
Jager A, van der Luijt RB, Easton DF, Peock
S, Frost D, Ellis SD, Platte R, Fineberg E,
Evans DG, Lalloo F, Izatt L, Eeles RA, Adlard
J, Davidson R, Eccles DM, Cole T, Cook
J, Brewer C, Tischkowitz M, Godwin AK,
Pathak HB, Stoppa-Lyonnet D, Sinilnikova
OM, Mazoyer S, Barjhoux L, Leone M,
Gauthier-Villars M, Caux-Moncoutier V, de
Pauw A, Hardouin A, Berthet P, Dreyfus
H, Fert Ferrer S, Collonge-Rame MA,
Sokolowska J, Buys SS, Daly MB, Miron A,
Terry MB, Chung WK, John EM, Southey
MC, Goldgar DE, Singer CF, Tea Maria
MK, Gschwantler-Kaulich D, Fink-Retter A,
Hansen TV, Ejlertsen B, Johannsson OT, Offit K, Sarrel K, Gaudet MM, Vijai J, Robson
ME, Piedmonte M, Andrews L, Cohn DE,
Demars LR, Disilvestro P, Rodriguez GC,
Toland AE, Montagna M, Agata S, Imyanitov EN, Isaacs C, Janavicius R, Lazaro
C, Blanco I, Ramus SJ, Sucheston LE,
Karlan BY, Gross J, Ganz PA, Beattie MS,
Schmutzler RK, Wappenschmidt B, Meindl
A, Arnold N, Niederacher D, Preisler-Adams
S, Gadzicki D, Varon-Mateeva R, Deissler H,
Gehrig A, Sutter C, Kast K, Nevanlinna H,
Aittomäki K, Simard J, Spurdle AB, Beesley
J, Chen X, Tomlinson GE, Weitzel JN, Garber JE, Olopade FI, Rubinstein WS, Tung N,
Blum JL, Narod SA, Brummel S, Gillen DL,
Lindor NM, Fredericksen Z, Pankratz VS,
Couch FJ, Radice P, Peterlongo P, Greene
MH, Loud JT, Mai PL, Andrulis IL, Glendon
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 53
G, Ozcelik H, Gerdes AM, Thomassen M,
Jensen UB, Skytte AB, Caligo MA, Lee A,
Chenevix-Trench G, Antoniou AC, Neuhausen SL. A non-synonymous polymorphism in IRS1 modifies risk of developing
breast and ovarian cancers in BRCA1 and
ovarian cancer in BRCA2 mutation carriers. Cancer Epidemiol Biomarkers Prev.
2012;21(8):1362-70.
23. Fizazi K, Scher HI, Molina A, Logothetis
CJ, Chi KN, Jones RJ, Staffurth JN, North
S, Vogelzang NJ, Saad F, Mainwaring P,
Harland S, Goodman OB Jr, Sternberg
CN, Li JH, Kheoh T, Haqq CM, de Bono
JS; COU-AA-301 Investigators (Hutson
T). Abiraterone acetate for treatment of
metastatic castration-resistant prostate
cancer: final overall survival analysis of the
COU-AA-301 randomised, double-blind,
placebo-controlled phase 3 study. Lancet
Oncol. 2012;13(10):983-92.
24. Finkelman BS, Rubinstein WS, Friedman
S, Friebel TM, Dubitsky S, Schonberger
NS, Shoretz R, Singer CF, Blum JL, Tung N,
Olopade OI, Weitzel JN, Lynch HT, Snyder
C, Garber JE, Schildkraut J, Daly MB,
Isaacs C, Pichert G, Neuhausen SL, Couch
FJ, Van’t Veer L, Eeles R, Bancroft E, Evans
DG, Ganz PA, Tomlinson GE, Narod SA,
Matloff E, Domchek S, Rebbeck TR. Breast
and ovarian cancer risk and risk reduction
in Jewish BRCA1/2 mutation carriers. J
Clin Oncol 2012;30(12):1321-8.
25. Fitzpatrick MC, Carter BW. Pulmonary mucormycosis complicating cutaneous blastic
plasmacytoid dendritic cell neoplasm. Proc
(Bayl Univ Med Cent). 2012;25(3):287-8.
26. Fleming MT, Sonpavde G, Kolodziej M,
Awasthi S, Hutson TE, Martincic D, Rastogi
A, Rousey SR, Weinstein RE, Galsky MD,
Berry WR, Wang Y, Boehm KA, Asmar L,
Rauch MA, Beer TM. Association of rash
with outcomes in a randomized phase
II trial evaluating cetuximab in combination with mitoxantrone plus prednisone
after docetaxel for metastatic castrationresistant prostate cancer. Clin Genitourin
Cancer 2012;10(1):6–14.
27. Freytes CO, Zhang MJ, Carreras J, Burns
LJ, Gale RP, Isola L, Perales MA, Seftel M,
Vose JM, Miller AM, Gibson J, Gross TG,
Rowlings PA, Inwards DJ, Pavlovsky S,
Martino R, Marks DI, Hale GA, Smith SM,
Schouten HC, Slavin S, Klumpp TR, Lazarus HM, van Besien K, Hari PN. Outcome
of lower-intensity allogeneic transplantation
in non-hodgkin lymphoma after autologous
transplantation failure. Biol Blood Marrow
Transplant. 2012;18(8):1255-64.
28. Garcia M, Choi C, Kim HR, Daoud Y,
Toiyama Y, Takahashi M, Goel A, Boland CR, Koi M. Association between
recurrent metastasis from stage II and III
primary colorectal tumors and moderate
microsatellite instability. Gastroenterology
2012;143(1):48-50.e1.
29. Gasche JA, Goel A. Epigenetic mechanisms in oral carcinogenesis. Future Oncol.
2012;8(11):1407-25.
30. Goel A, Boland CR. Epigenetics of
Colorectal Cancer. Gastroenterology. 2012
143(6):1442-1460.e1. Gopal AK, Ramchandren R, O’Connor OA, Berryman RB,
Advani RH, Chen R, Smith SE, Cooper
M, Rothe A, Matous JV, Grove LE, Zain J.
Safety and efficacy of brentuximab vedotin
for Hodgkin lymphoma recurring after allogeneic stem cell transplantation. Blood.
2012;120(3):560-8.
31. Hinson SA, Silva EG, Pinto K. Ovarian serous cystadenofibromas associated with a
low-grade serous carcinoma of the peritoneum. Ann Diagn Pathol. 2012;31(6):547-55
32. Hur K, Han TS, Jung EJ, Yu J, Lee HJ, Kim
WH, Goel A, Yang HK. Up-regulated expression of sulfatases (SULF1 and SULF2)
as prognostic and metastasis predictive
markers in human gastric cancer. J Pathol.
2012;228(1):88-98.
33. Hur K, Toiyama Y, Takahashi M, Balaguer
F, Nagasaka T, Koike J, Hemmi H, Koi
M, Boland CR, Goel A. MicroRNA-200c
modulates epithelial-to-mesenchymal
transition (EMT) in human colorectal cancer
metastasis. Gut. 2012 Jul 10. [Epub ahead
of print]
34. Infante JR, Fecher LA, Falchook GS,
Nallapareddy S, Gordon MS, Becerra C,
Demarini DJ, Cox DS, Xu Y, Morris SR,
Peddareddigari VG, Le NT, Hart L, Bendell
JC, Eckhardt G, Kurzrock R, Flaherty K,
Burris HA 3rd, Messersmith WA. Safety,
pharmacokinetic, pharmacodynamic, and
efficacy data for the oral MEK inhibitor
trametinib: a phase 1 dose-escalation trial.
Lancet Oncol. 2012;13(8):773-81.
35. Jennings AW, Preskitt JT, Vallera RD. Extraadrenal pheochromocytoma and vagal
paraganglioma. Proc (Bayl Univ Med Cent).
2012;25(2):152-4.
36. Kathiria AS, Neumann WL, Rhees J, Hotchkiss E, Cheng Y, Genta RM, Meltzer SJ,
Souza RF, Theiss AL. Prohibitin attenuates
colitis-associated tumorigenesis in mice
by modulating p53 and STAT3 apoptotic
responses. Cancer Res. 2012;72(22):577889.
37. Khandani AH, Cowey CL, Moore DT, Gohil
H, Rathmell WK. Primary renal cell carcinoma: relationship between 18F-FDG uptake
and response to neoadjuvant sorafenib.
Nucl Med Commun. 2012;33(9):967-73.
38. Kotsopoulos J, Lubinski J, Lynch HT, KimSing C, Neuhausen S, Demsky R, Foulkes
WD, Ghadirian P, Tung N, Ainsworth P,
Senter L, Karlan B, Eisen A, Eng C, Weitzel
J, Gilchrist DM, Blum JL, Zakalik D, Singer
C, Fallen T, Ginsburg O, Huzarski T, Sun P,
Narod SA. Oophorectomy after Menopause
and the Risk of Breast Cancer in BRCA1
and BRCA2 Mutation Carriers. Cancer Epidemiol Biomarkers Prev. 2012;21(7):108996.
39. Kroeker TR, O’Brien JC. Outcomes of
combined oncologic resection and carotid
endarterectomy in patients with head and
neck cancer. Head Neck 2012 Jan 20
[Epub ahead of print]
40. Leary RJ, Sausen M, Kinde I, Papadopoulos N, Carpten JD, Craig D, O’Shaughnessy
J, Kinzler KW, Parmigiani G, Vogelstein
B, Diaz LA Jr, Velculescu VE. Detection of chromosomal alterations in the
circulation of cancer patients with wholegenome sequencing. Sci Transl Med.
2012;4(162):162ra154.
41. Li J, Koike J, Kugoh H, Arita M, Ohhira T,
Kikuchi Y, Funahashi K, Takamatsu K, Boland CR, Koi M, Hemmi H. Down-regulation
of MutS homolog 3 by hypoxia in human
colorectal cancer. Biochim Biophys Acta
2012;1823(4):889–899.
42. Lin TL, Levy MY. Acute myeloid leukemia:
focus on novel therapeutic strategies. Clin
Med Insights Oncol. 2012;6:205-17.
43. Link A, Becker V, Goel A, Wex T, Malfertheiner P. Feasibility of Fecal MicroRNAs as
Novel Biomarkers for Pancreatic Cancer.
PLoS One. 2012;7(8):e42933.
44. Mann S, Patel P, Matthews CM, Pinto K,
O’Connor J. Malignant transformation of
endometriosis within the urinary bladder.
Proc (Bayl Univ Med Cent). 2012;25(3):2935.
45. Martins FC, De S, Almendro V, Gönen M,
Park SY, Blum JL, Herlihy W, Ethington G,
Schnitt SJ, Tung N, Garber JE, Fetten K, Michor F, Polyak K. Evolutionary Pathways in
BRCA1-Associated Breast Tumors. Cancer
Discov. 2012; 2(6):503-511.
46. Moinpour CM, Donaldson GW, Liepa AM,
Melemed AS, O’Shaughnessy J, Albain
KS. Evaluating health-related quality-of-life
therapeutic effectiveness in a clinical trial
with extensive nonignorable missing data
and heterogeneous response: results from
a phase III randomized trial of gemcitabine
plus paclitaxel versus paclitaxel monotherapy in patients with metastatic breast cancer.
Qual Life Res 2012 Jun;21(5):765-75.
47. Motzer RJ, Hutson TE, Olsen MR, Hudes
GR, Burke JM, Edenfield WJ, Wilding G,
Agarwal N, Thompson JA, Cella D, Bello A,
Korytowsky B, Yuan J, Valota O, Martell B,
Hariharan S, Figlin RA. Randomized phase
II trial of sunitinib on an intermittent versus
continuous dosing schedule as first-line
therapy for advanced renal cell carcinoma.
J Clin Oncol 2012 Apr 20;30(12):1371-7.
48. Nadler E, Forsyth M, Satram-Hoang S,
Reyes C. Costs and clinical outcomes
among patients with second-line non-small
cell lung cancer in the outpatient community setting. J Thorac Oncol 2012;7(1):212–
218.
49. O’Shaughnessy JA. Breast cancer in
focus: treatment options for triple-negative
metastatic breast cancer. Clin Adv Hematol
Oncol 2012;10(1):43–45.
50. O’Shaughnessy JA, Kaufmann M, Siedentopf F, Dalivoust P, Debled M, Robert NJ,
Harbeck N. Capecitabine monotherapy: review of studies in first-line HER-2-negative
metastatic breast cancer. Oncologist 2012
17(4):476-84.
51. Owen RG, Kyle RA, Stone MJ, Rawstron
AC, Leblond V, Merlini G, Garcia-Sanz R,
Ocio EM, Morra E, Morel P, Anderson KC,
Patterson CJ, Munshi NC, Tedeschi A,
Joshua DE, Kastritis E, Terpos E, Ghobrial
IM, Leleu X, Gertz MA, Ansell SM, Morice
WG, Kimby E, Treon SP. Response assess-
54 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report ment in Waldenström macroglobulinaemia:
update from the VIth International Workshop. Br J Haematol. 2012 Nov 15. doi:
10.1111/bjh.12102. [Epub ahead of print]
52. Palucka K, Banchereau J. Cancer immunotherapy via dendritic cells. Nat Rev Cancer
2012;12(4):265–277.
53. Patel P, Fischer L, O’Connor J. Retroperitoneal ganglioneuroma incidentally found in
a patient presenting with renal colic. Proc
(Bayl Univ Med Cent). 2012;25(3):291-2.
54. Patil S, Figlin RA, Hutson TE, Michaelson
MD, Negrier S, Kim ST, Huang X, Motzer
RJ. Q-TWiST analysis to estimate overall
benefit for patients with metastatic renal
cell carcinoma treated in a phase III trial of
sunitinib vs interferon-α. Br J Cancer. 2012
May 8;106(10):1587-90.
55. Porta C, Calvo E, Climent MA, Vaishampayan U, Osanto S, Ravaud A, Bracarda S,
Hutson TE, Escudier B, Grünwald V, Kim D,
Panneerselvam A, Anak O, Motzer RJ. Efficacy and safety of everolimus in elderly patients with metastatic renal cell carcinoma:
an exploratory analysis of the outcomes of
elderly patients in the RECORD-1 trial. Eur
Urol 2012;61(4):826–833
56. Powles T, Hutson TE. Difficulty in predicting
survival in metastatic renal cancer. Lancet
Oncol. 2012; 13(9):859-60.
57. Santarpia L, Qi Y, Stemke-Hale K, Wang
B, Young EJ, Booser DJ, Holmes FA,
O’Shaughnessy J, Hellerstedt B, Pippen J,
Vidaurre T, Gomez H, Valero V, Hortobagyi
GN, Symmans WF, Bottai G, Di Leo A, Gonzalez-Angulo AM, Pusztai L. Mutation profiling identifies numerous rare drug targets
and distinct mutation patterns in different
clinical subtypes of breast cancers. Breast
Cancer Res Treat. 2012 Jul;134(1):333-43.
58. Scher HI, Fizazi K, Saad F, Taplin ME,
Sternberg CN, Miller K, de Wit R, Mulders P,
Chi KN, Shore ND, Armstrong AJ, Flaig TW,
Fléchon A, Mainwaring P, Fleming M, Hainsworth JD, Hirmand M, Selby B, Seely L,
de Bono JS; AFFIRM Investigators (Hutson
T). Increased survival with enzalutamide in
prostate cancer after chemotherapy. N Engl
J Med. 2012;367(13):1187-97.
59. Shahriar R, Alexander CT, Quirk CR,
Keglovits L, Van Vrancken M. Numb chin
syndrome as the initial presentation of posttransplant lymphoproliferative disorder.
Proc (Bayl Univ Med Cent). 2012; 25(3):
243-5.
60. Shen Y, Takahashi M, Byun HM, Link A,
Sharma N, Balaguer F, Leung HC, Boland R,
Goel A. Boswellic acid induces epigenetic
alterations by modulating DNA methylation
in colorectal cancer cells. Cancer Biol Ther
2012;13(7):542–552.
61. Shia J, Zhang L, Shike M, Guo M, Stadler
Z, Xiong X, Tang LH, Vakiani E, Katabi N,
Wang H, Bacares R, Ruggeri J, Boland CR,
Ladanyi M, Klimstra DS. Secondary mutation in a coding mononucleotide tract in
MSH6 causes loss of immunoexpression of
MSH6 in colorectal carcinomas with MLH1/
PMS2 deficiency. Mod Pathol. 2012 Aug 24.
doi: 10.1038/modpathol.2012.138. [Epub
ahead of print]
62. Silva EG. The Stromal Origin of Some Epithelial Ovarian Neoplasms: “Fere ex nihilo”.
Int J Gynecol Cancer. 2012;22(6):906-7.
63. Sonpavde G, Choueiri TK, Escudier B,
Ficarra V, Hutson TE, Mulders PF, Patard JJ,
Rini BI, Staehler M, Sternberg CN, Stief CG.
Sequencing of agents for metastatic renal
cell carcinoma: can we customize therapy?
Eur Urol 2012;61(2):307-16.
64. Sonpavde G, Matveev V, Burke JM, Caton
JR, Fleming MT, Hutson TE, Galsky MD,
Berry WR, Karlov P, Holmlund JT, Wood
BA, Brookes M, Leopold L. Randomized
phase II trial of docetaxel plus prednisone
in combination with placebo or AT-101, an
oral small molecule Bcl-2 family antagonist,
as first-line therapy for metastatic castration-resistant prostate cancer. Ann Oncol
2012;23(7):1803-8.
65. Sonpavde G, Watson D, Tourtellott M,
Cowey CL, Hellerstedt B, Hutson TE,
Zhan F, Vogelzang NJ. Administration of
cisplatin-based chemotherapy for advanced
urothelial carcinoma in the community. Clin
Genitourin Cancer 2012;10(1):1-5.
66. Sosman JA, Kim KB, Schuchter L, Gonzalez
R, Pavlick AC, Weber JS, McArthur GA,
Hutson TE, Moschos SJ, Flaherty KT,
Hersey P, Kefford R, Lawrence D, Puzanov
I, Lewis KD, Amaravadi RK, Chmielowski
B, Lawrence HJ, Shyr Y, Ye F, Li J, Nolop
KB, Lee RJ, Joe AK, Ribas A. Survival in
BRAF V600-mutant advanced melanoma
treated with vemurafenib. N Engl J Med
2012;366(8):707-14.
67. Stone MJ, Bogen SA. Evidence-based
focused review of management of hyperviscosity syndrome. Blood 2012;119
(10):2205-8.
68. Su F, Viros A, Milagre C, Trunzer K, Bollag
G, Spleiss O, Reis-Filho JS, Kong X, Koya
RC, Flaherty KT, Chapman PB, Kim MJ,
Hayward R, Martin M, Yang H, Wang Q, Hilton H, Hang JS, Noe J, Lambros M, Geyer
F, Dhomen N, Niculescu-Duvaz I, Zambon
A, Niculescu-Duvaz D, Preece N, Robert
L, Otte NJ, Mok S, Kee D, Ma Y, Zhang C,
Habets G, Burton EA, Wong B, Nguyen
H, Kockx M, Andries L, Lestini B, Nolop
KB, Lee RJ, Joe AK, Troy JL, Gonzalez
R, Hutson TE, Puzanov I, Chmielowski B,
Springer CJ, McArthur GA, Sosman JA,
Lo RS, Ribas A, Marais R. RAS mutations
in cutaneous squamous-cell carcinomas in
patients treated with BRAF inhibitors.
N Engl J Med 2012;366(3):207-15.
69. Takahashi M, Cuatrecasas M, Balaguer F,
Hur K, Toiyama Y, Castells A, Boland CR,
Goel A. The Clinical Significance of MiR148a as a Predictive Biomarker in Patients
with Advanced Colorectal Cancer. PLoS
One. 2012;7(10):e46684.
70. Takahashi M, Sung B, Shen Y, Hur K,
Link A, Boland CR, Aggarwal BB, Goel A.
Boswellic acid exerts anti-tumor effects
in colorectal cancer cells by modulating expression of the let-7 and miR200 microRNA family. Carcinogenesis.
2012;33(12):2441-9.
71. Thomas VT, Hinson S, Konduri K. Epithelialmesenchymal transition in pulmonary carcinosarcoma: case report and literature review. Ther Adv Med Oncol 2012;4(1):31-7.
72. Thompson P, Roe D, Fales L, Buckmeier
J, Wang F, Hamilton SR, Bhattacharyya A,
Green SB, Hsu CH, Chow HH, Ahnen DJ,
Boland CR, Heigh RI, Fay DE, Martinez E,
Jacobs E, Ashbeck EL, Alberts DS, Lance
P. Design and baseline characteristics of
participants in a phase III randomized trial
of celecoxib and selenium for colorectal
adenoma prevention. Cancer Prev Res
(Phila). 2012 Oct 11. [Epub ahead of print]
73. Tran HT, Liu Y, Zurita AJ, Lin Y, BakerNeblett KL, Martin AM, Figlin RA, Hutson
TE, Sternberg CN, Amado RG, Pandite
LN, Heymach JV. Prognostic or predictive
plasma cytokines and angiogenic factors
for patients treated with pazopanib for
metastatic renal-cell cancer: a retrospective analysis of phase 2 and phase 3 trials.
Lancet Oncol. 2012;13(8):827-37.
74. Ubel PA, Berry SR, Nadler E, Bell CM,
Kozminski MA, Palmer JA, Evans WK, Strevel EL, Neumann PJ. In a survey, marked
inconsistency in how oncologists judged
value of high-cost cancer drugs in relation
to gains in survival. Health Aff (Millwood).
2012;31(4):709-17.
75. Vogelzang NJ, Bhor M, Liu Z, Dhanda R,
Hutson TE. Everolimus vs. Temsirolimus for
Advanced Renal Cell Carcinoma: Use and
Use of Resources in the US Oncology Network. Clin Genitourin Cancer. 2012 Oct 11.
pii: S1558-7673(12)00183-8. doi: 10.1016/j.
clgc.2012.09.008. [Epub ahead of print]
76. Williams JC, Hamilton JK, Shiller M, Fischer
L, Deprisco G, Boland CR. Combined juvenile polyposis and hereditary hemorrhagic
telangiectasia. Proc (Bayl Univ Med Cent).
2012 Oct;25(4):360-4
77. Witta SE, Jotte RM, Konduri K, Neubauer
MA, Spira AI, Ruxer RL, Varella-Garcia
M, Bunn PA Jr, Hirsch FR. Randomized
Phase II Trial of Erlotinib With and Without
Entinostat in Patients With Advanced NonSmall-Cell Lung Cancer Who Progressed
on Prior Chemotherapy. J Clin Oncol.
2012;30(18):2248-55.
78. Yurgelun MB, Goel A, Hornick JL, Sen A,
Turgeon DK, Ruffin MT 4th, Marcon NE,
Baron JA, Bresalier RS, Syngal S, Brenner
DE, Boland CR, Stoffel EM. Microsatellite instability and DNA mismatch repair
protein deficiency in Lynch syndrome
colorectal polyps. Cancer Prev Res (Phila)
2012;5(4):574-82.
79. Zarghouni M, Vandergriff C, Layton KF,
McGowan JB, Coimbra C, Bhakti A,
Opatowsky MJ. Chordoid glioma of the
third ventricle. Proc (Bayl Univ Med Cent).
2012;25(3):285-6.
80. Zurita AJ, George DJ, Shore ND, Liu G,
Wilding G, Hutson TE, Kozloff M, Mathew
P, Harmon CS, Wang SL, Chen I, Chow
Maneval E, Logothetis CJ. Sunitinib in
combination with docetaxel and prednisone in chemotherapy-naive patients with
metastatic, castration-resistant prostate
cancer: a phase 1/2 clinical trial. Ann Oncol
2012;23(3):688-94.
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 55
Philanthropy
Baylor Health Care System already has
at Baylor. These funds have been used
enviable recognition in safety, quality,
to support patient-centered programs
strong leadership, and clinically advanced
like patient navigation and the Virginia R.
bedside care. It also has a strong history
Cvetko Patient Education and Support
of philanthropic support. But excellence is
Center; to further our research and conduct
perishable. Sustaining it requires not just
clinical trials that offer potential life-altering
stewardship, but innovation and invest-
results for the patients we serve today; to
ment. Through the generous support of
purchase the latest technology and capital
philanthropic leaders in our community,
equipment that advance treatments and
Baylor has the opportunity to define the
nurture healing; and to recruit and train the
future of cancer care in North Texas.
best and brightest physicians of the future.
Over the past year, Baylor Health Care
Philanthropy allows us to continue our ser-
System Foundation has raised more than
vices uninterrupted, to make the necessary
$3 million in support of cancer initiatives
investments and to maintain the qualities
that make Baylor unique and special. And
that makes us all better.
T. Boone Pickens’ $10 million
Investment in Baylor
In September, Baylor Health Care System
Foundation announced that legendary oil
and gas entrepreneur and philanthropist
T. Boone Pickens pledged $10 million in
support of Baylor initiatives. In recognition
of this gift, and in a move that links the
innovative business leader with a leading
cancer program, Baylor honored Boone
T. Boone Pickens, Becky Hotchkiss and Joel Allison, President and
CEO, Baylor Health Care System, ring the bell to celebrate
by naming its new cancer hospital Baylor
T. Boone Pickens Cancer Hospital.
56 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report “No matter what industry you’re in, from
to have a relationship with a leader known
energy to health care, it takes bold people
for giving to institutions aligned with a
who have vision, a commitment to excel-
focus on caring for the whole patient.
lence, and a passion for efficiency to
We are proud of his endorsement,” said
reach new levels of success,” said
Rowland K. Robinson, president of Baylor
Pickens. “Baylor brings that attitude and
Health Care System Foundation.
commitment to providing health care to
all North Texans, whether it is advanced
2012 Celebrating Women Luncheon
prevention, screening, diagnosis, or
Baylor Health Care System Foundation
treatment.”
hosted its 13th annual Celebrating Women
luncheon in October at the Hilton Anatole
At Baylor T. Boone Pickens Cancer
hotel in Dallas. Celebrating Women has
Hospital, Pickens and Baylor honored
raised more than $19 million over the past
the donor’s 50-year friendship with the
13 years to benefit Baylor Health Care
late Harley Hotchkiss, a fellow oilman,
System’s breast cancer initiatives.
philanthropist, and former owner of the
NHL Calgary Flames. Two years ago,
The keynote address, delivered by award-
Harley traveled from Canada to Baylor to
winning actor and best-selling author Rob
seek treatment for his late-stage prostate
Lowe, was enjoyed by more than 1,350
cancer. Unfortunately, his disease was
luncheon attendees. After losing his
advanced, and in June 2011, he passed
mother, grandmother and great-grand-
away. A plaque at the cancer hospital
mother to breast cancer, Lowe has been
commemorates Pickens’ lifelong friend-
a passionate advocate for research and
ship with Harley.
early detection.
“T. Boone Pickens’ gift reinforces that
The event, chaired by Pam Busbee and
Baylor is a world-class health care system.
Pam Perella, recognized Mary Anne Cree
It provides a valuable platform for us to
and the men and women of Sammons
talk about Baylor’s defining culture and to
Enterprises, Inc. with the Circle of Care
show the positive impact we have in our
Award. The award is given to those who
communities. We are excited and honored
have served as advocates, volunteers,
Above: Pam Perella, Rob Lowe and Pam Busbee, at Celebrating
Women
Below: Joel Allison, President and Chief Executive Officer, Baylor
Health Care System, Mary Anne Cree, and Rowland K. Robinson,
President of Baylor Health Care System Foundation.
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 57
Above: Andy and Joan Horner
Below: Artist’s rendering of the completed
Joan Horner Interfaith Prayer Garden
educators, or donors and have made a
cutting edge is to come away with an
difference in the campaign against breast
optimism and excitement that is extraordi-
cancer. Caren Prothro served as this year’s
nary,” said Lowe. “Everyone in this room is
honorary chairman. Claire Emanuelson,
a living example of how far we’ve come—
Peggy Meyer, Robyn Conlon, and Jennifer
walking miracles of medicine, faith and
Sampson were this year’s underwriting
perseverance. There is little doubt that as
chairs.
more lives are saved, even better news is
just around the corner. If we didn’t believe
“There is so much hope in today’s war
that, we wouldn’t be here.”
on cancer. To talk to the doctors on the
The Joan Horner Interfaith Prayer
Garden
Gardens are inspirational, healing, restorative, and beautiful. They can be a sight to
behold, boasting vibrant colors and hearty
greenery. And thanks to a generous gift
from the Joan and Andy Horner Family, we
will all be able to enjoy the natural beauty
and tranquility of a new interfaith garden,
located in the heart of Baylor University
Medical Center at Dallas, by late next
spring, 2013.
The Joan Horner Interfaith Prayer Garden
will feature natural limestone pathways and
abundant planting, where water features
on both sides of the garden will generate
soothing background noise and help
provide privacy. The garden is designed
with quiet nooks and seating for prayer and
contemplation and is centrally located so
58 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report patients staying in any of the hospitals at
legacy and contribute to finding a cure.
Baylor Dallas can see the garden from
To that end, they held their first cancer
their rooms. The original garden was
benefit golf tournament in 1997 in memory
donated by the Wayne Family Foundation
of E. K., with all proceeds going to cancer
and will be expanded in new and different
research at Baylor.
ways, while still incorporating Bradley and
Ernestine Wayne’s legacy.
This September, the Boon family celebrated their 14th tournament. In all, this
Over the years, the Horners have been
tournament has raised nearly $700,000
loyal supporters of the Foundation, and
in support of cancer research at Baylor.
their generous gifts provided significant
support for a number of Baylor’s cancer
“Clinical trials give patients hope when
programs. The Horner Family Chapel in
standardized therapy is no longer working.
the Baylor Charles A. Sammons Cancer
To be a destination cancer center, we
Center was named in recognition of their
must be a driver in clinical trials, and that
support.
is our goal,” said Rowland K. Robinson,
president of Baylor Health Care System
Boon Family Crusade for Cancer
Foundation. “We appreciate the Boon
Research
family’s continued support and partnership
E. K. Boon was diagnosed with renal cell
in this fight against cancer.”
carcinoma in 1992. During his battle with
the disease, he participated in a genetics
research program through his physicians
on the medical staff at Baylor Health Care
System. His physicians advised him that
his disease was too far advanced for the
research to save his life; however, E. K.
was confident his efforts would contribute
to saving the lives of other cancer patients.
When E. K. lost his battle with cancer in
1996, his family wanted to continue his
The Future of Cancer Care is Here | Baylor Charles A. Sammons Cancer Center at Dallas 59
Contact Information
Referrals
Baylor Sammons Cancer Center at Dallas
Patient Navigation Program
Physician ConsultLine
214.820.3535
1.800.9BAYLOR
Administration
JaNeene Jones, RN, FACHE
Vice President/Oncology,
Baylor Health Care System
Chief Operating Officer,
Baylor Sammons Cancer
Center/Baylor T. Boone
Pickens Cancer Hospital
214.820.2800
Alan M. Miller, MD, PhD
Medical Director, Baylor
Sammons Cancer Center
214.820.2881
Sylvia Coats
Director of Administration
214.820.3433
Eric Presson, MHA, FACHE
Director, Blood and Marrow
Transplant/Oncology, Baylor
Health Care System
214.820.7833
• Breast and ovarian
• Gastrointestinal
214.820.9600
214.820.2692
Integrative Medicine Program
214.820.2608
Medical Oncology and Other
Internal Medical Subspecialties
Robert G. Mennel, MD,
Director214.820.9611
Oncologic Pathology
Peter Dysert, MD, Director
Liver and Pancreas Disease
Center214.820.1756
214.820.3021
214.820.4141
Blood and Marrow Transplant
Inpatient Services
214.820.2744
• Be The Match®214.820.4279
• Outpatient Center
214.370.1500
• Cutaneous Lymphoma
Clinic
214.370.1500
• Graft-Versus-Host
Disease
214.370.1500
W.H. & Peggy Smith Breast
Center214.820.9600
214.820.2881
•
•
•
•
Breast cancer prevention
research trials
Breast Care for Lifetime™
Breast health education
Personal risk evaluation
Oncology Outpatient Clinic
214.820.6767
Bone and Soft Tissue Tumor Clinic
Cardiology Services
Dental Clinic
FitSteps for Life®
Head and Neck Clinic
Physical Medicine and Rehabilitation
Radiology Services
Skin Cancer Screening Clinic
Skull Base Clinic
Speech Therapy
Supportive and Palliative Care Services
214.820.7285
Office of Scientific Publications 214.820.3549
Clinical Oncology Research
Coordination214.818.8471
Baylor Institute for Immunology
Research214.820.7450
Yong-Jun Liu, MD, PhD,
Director
Baylor Research Institute
Michael A.E. Ramsay, MD,
President
US Oncology/Texas Oncology
Research214.370.1000
Joanne L. Blum, MD, PhD,
Site Leader
Support Services
A. Webb Roberts Center for
Continuing Education
214.820.2317
Cancer Registry
214.820.3976
Concierge Desk
214.820.2617
Patient Navigation
214.820.3535
Marketing and Public Relations 214.820.2116
Ernie’s Appearance Center
214.820.8282
• Prostheses and specialty care items for cancer patients
• Nutraceuticals
Sammons Events and
Community Relations
214.818.8473
Screenings214.820.6767
• Head and neck cancer (April)
• Skin/melanoma (monthly)
Smoking Cessation Program
Research
214.820.2430
• Diagnostic mammography
• Screening mammography
214.820.6767
Radiosurgery Center
Clinical Oncology Research
Coordination214.818.8471
Darlene G. Cass Women’s
Imaging Center
Lymphedema Prevention and
Treatment Services
•
•
•
•
•
•
•
•
•
•
•
Cancer Center Programs
Department of Oncology
Chief of Oncology, Baylor
Health Care System
Gynecologic Oncology
C. Allen Stringer, Jr., MD,
Director214.370.1300
Surgical Oncology
John T. Preskitt, MD, Director 214.826.6267
Baylor Health Care System
Foundation214.820.3136
Alan M. Miller, MD, PhD
Cancer Genetics Program
Radiation Oncology
Barry N. Wilcox, MD, Director 214.370.1400
Marvin J. Stone, MD
214.820.3445
Medical Director of Oncology
Medical Education
John McWhorter, MHA
President, Baylor University
Medical Center at Dallas
Divisions
214.820.2687
Breast Cancer Prevention
Research Trials
214.820.9600
Joyce A. O’Shaughnessy, MD,
Director
• Dental Clinic—Oncology
Outpatient Clinic
214.820.6767
• Martha Foster Lung Care
Center
214.820.9791
Virginia R. Cvetko Patient
Education and Support
Center214.820.2608
•
•
Patient/family education
and support programs
Patient resource centers/
oncology libraries
Baylor Health Care System
Valet Parking
214.820.8077
Patient Transport
214.818.6400
60 Baylor Charles A. Sammons Cancer Center at Dallas | 2012 Annual Report Campus and Area Maps
Baylor Sammons Cancer Center and
Floyd Street
Baylor T. Boone Pickens Cancer Hospital
Lot 26
are located on the campus of Baylor
Floyd Street
University Medical Center at Dallas, and
Lot 9
(BIR only)
are accessible from U.S. 75 (North Central
Hall Street
CBD
Link
Wadley
Tower
Baylor
College of
Dentistry
rk B
r Pa
Roberts
Hospital
Parking Garage 10
lvd.
Jonsson
Hospital
Lot 46
Underground
Parking
Garage 8
Lot
25
Underground Parking Garage 3
(Staff)
Baylor Hamilton
Heart & Vascular
Hospital
DART®
Rail Station
at Baylor
Worth
Street
Tower
Lot 19
Emergency
Department
Baylor
T. Boone
Pickens
Cancer
Hospital
Pickens Cancer Hospital is available in
(Patient/Visitor)
Parking
Garage 6
(Staff)
Worth Street
D
Baylor Charles
A. Sammons
Cancer Center
The campus is also accessible via the
DART Green Line to Baylor University
Parking
Garage 5
(Patient/Visitor
and Staff)
Elevator to
Level 3
for Skybridge
2nd Floor
Skybridge
Healing Garden
garage 4 or valet in front of the hospital.
Parking
Garage 4
Bass
Hall
Underground
Parking Garage
Medical Center station. Baylor Sammons
Baylor
School of
Nursing
Lot 14
Lot 40
D
Blv
d.
Pauline Street
rk
Pa
Hall Street
.
air
–F
lvd
XB
D Patient Drop-Off
Lot 13
Lot 42
Crutcher Street
ink
lm
Valet Parking
Underground Parking
Garage 39
DL
lco
CB
Ma
Self Parking
Lot 41
Washington Avenue
Center in garage 4.
Baylor
Medical
Pavilion
Junius Street
Junius Street
adjacent to Baylor Sammons Cancer
Cancer Center is a two-block walk.
Barnett
Tower
Underground Parking Garage 30
Self-parking is conveniently located
Self-parking for the new Baylor T. Boone
Hoblitzelle
Hospital
Truett
Hospital
Nussbaumer Street
–Fai
entrance and other nearby locations.
Washington Avenue
Gaston Aveue
Gaston Avenue
A map on the facing page illustrates
Valet parking is available at the front
Lot 27
Lot 9
Expressway/I-45) and I-30.
highway access to the medical center.
Baylor
Institute for
Rehabilitation
(BIR)
Lot 28
Baylor Tom Landry
Fitness Center
Lot 43
Victor Street
Lot 44
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BAYLOR SAMMONS
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BAYLOR UNIVERSITY
MEDICAL CENTER
AT DALLAS CAMPUS
I-30
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3410 Worth St.
Dallas, TX 75246
1.800.4BAYLOR
214.820.3535
BaylorHealth.com/DallasCancer