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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 M LE M ON N M AI RO TO LL O RT H VE AK O N O W PE AK HALL OLM MALC L FIRS X RCE ME DOWNTOWN DALLAS 0 G COM HASKEL T STATE FAIR GROUNDS BAYLOR SAMMONS CANCER CENTER I-30 RO BE RT B .C I-45 BAYLOR UNIVERSITY MEDICAL CENTER AT DALLAS CAMPUS I-30 RT H O AR N T AS ELM M AL E C I-35 H W C G O O LL H LI DA G I-3 I-35E LL RO G KE IN U W S ER DG AS AS W AS H TO AK H . N. CENTRAL EXPY Y. TZ N PE FW FI AK O LI US 75 5E LLWAY DALLAS N. TO I-3 VE US 17 5 O LM X UL LU M 3410 Worth St. Dallas, TX 75246 1.800.4BAYLOR 214.820.3535 BaylorHealth.com/DallasCancer