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CONNECTIONS
2013
Summer Edition
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Blending Next Generation Care with a Tradition of Caring and Compassion
Jivesh Sharma, MD
Amy Cripps, MD
Sam Mathew, PA-C
Christopher Jordan, DO
Khusroo Qureshi, MD
Chad Amosson, MD
Timothy Nichols, MD
American Society of Clinical Oncology Updates from Chicago Conference
By: Amy Cripps, M.D.
“Building Bridges to Conquer Cancer”
was the theme of this year’s American
Society of Clinical Oncology meeting,
held May 21–June 4 in Chicago.
Many topics were presented. One
stands out for its simplicity — a test that
decreases mortality from cervical cancer. In the United States, the decline of
cervical cancer cases and deaths is in large
part due to screening in the form of PAP
smears. However, this is not the case
in India where screening is not readily
available due to scarce resources. Almost
142,000 cases of cervical cancer occur
each year and more than 77,000 Indian
women die of the disease. When viewed
from a global perspective, these figures
account for approximately 30% of the
burden of cervical cancer worldwide.
Ordinary vinegar holds promise for
saving thousands of women from dying
of cervical cancer—the most common
and most deadly cancer among Indian
women. A randomized, controlled trial
conducted among 150,000 women in
Mumbai slums over a 15-year period
show that biennial screening for cervical
cancer by trained nonmedical personnel using acetic acid reduced cervical
cancer mortality by 31%. Sixty seconds
NexGen Oncology
By: Jivesh Sharma, M.D.
after applying vinegar to the cervix using
a cotton swab, precancerous lesions
turn white and can be discerned from
pink healthy tissue with the naked eye
— something that primary health care
workers can be trained to easily identify
with high accuracy. If implemented in
developing countries that have little or
no access to Pap screening, this easy-touse procedure could ultimately prevent
22,000 deaths from cervical cancer in
India and 72,000 deaths in low-resource
countries worldwide each year, according
to Plenary Session Presenter Surendra
S. Shastri, MD, of the Tata Memorial Hospital, India.
Hematology and Oncology care continues to evolve at an ever faster pace.
The area of new oral anticoagulants has
undergone a major transition with the
advent of Xa inhibitors like Xarelto that
do not require PT/ INR monitoring. In
the realm of cancer therapies, we see the
continued arrival of new generations of
therapies including many highly effective oral agents. For many cancers such
as prostate and kidney cancers, we now
have multiple lines of options. Recent
studies have shown dramatic improvements in treating common cancers such
as lung, breast and colon cancers as better characterizing of the biology of the
cancers begins to define optimal choices
of agents.
At NexGen Oncology, we not only
provide care that adheres to national care
guidelines but also provide access to
the latest and most sophisticated tissue
testing of tumor samples. We are also
contributing to education and research
to advance cancer care. Our team shares
a deep commitment to helping train upcoming providers who will become part
of next generation cancer care.
NexGen Oncology remains committed to serving patients in North Texas as we have done for nearly 20 years. We focus on
implementing the newest forms of personalized medicine tools, technology and treatments to our patients.
______________________www.MyCancerCenter.com____________________
CONNECTIONS
Summer Edition
Page 2
Our Providers
Jivesh Sharma, M.D.
Board Certification: American Board of Internal Medicine, American Board of Internal Medicine/Medical Oncology
Fellowship: Medical Oncology, University of Texas Health Science Center, San Antonio
Residency: Internal Medicine, University of Texas Health Science Center, San Antonio
Medical Degree: University of Texas medical Branch, Galveston
Appointments: Clinical Faculty, Presbyterian Hospital of Dallas; Instructor and Clinical Fellow (1991-1993), University of Texas
Health Science Center, San Antonio
Special Interests: Breast cancer, gastrointestinal tumors, lung cancer, cancer translational research, (accelerating delivery of new drugs)
Amy Cripps, M.D.
Board Certification: American Board of Internal Medicine; American Board of Internal Medicine/Medical Oncology
Fellowship: Medical Oncology, University of California–San Francisco
Residency: Internal Medicine, Alameda County Medical Center
Medical Degree: University of Texas Health Science Center, Houston
Appointments: Clinical Instructor (2011-2012), University of California–San Francisco
Special Interests: Breast cancer, colon cancer, cancer drug development
Chistopher Jordan, D.O.
Board Certification: University of Texas Southwestern Medical Center, Dallas, Texas
Fellowship: University of Texas Southwestern Medical Center, Dallas, Texas
Residency: University of North Texas Health Science Center, Fort Worth, Texas
Medical Degree: Kansas City University of Medicine and Bioscience , College of Osteopathic Medicine, Kansas City, MO
Special Interests: All adult cancers with research history in lung cancer, supportive and palliative care, clinical trials
Sam Mathew, PA-C
M.S. Degree, Physician Assistant: Texas Tech University Health Sciences Center, Midland
B.S. Degree in Clinical Laboratory Science: Texas Tech University Health Sciences Center, Lubbock
Special Interests: Chemotherapy/oncology drugs and their indications, dosing, side effects, and proper administration
palliative care, hospice care
Khusroo Quereshi, M.D.
Board Certification: American Board of Internal Medicine and American Board of Medical Oncology
Fellowship: Medical Genetics at Case Western Reserve, University Hospital, Cleveland, Medical Oncology, The Roswell Park
Cancer, Institute in Buffalo
Residency: SUNY Nassau University Medical Center, New York
Medical Degree: University of Karachi
Special Interests: Colon cancer, pancreatic cancer, cutting-edge research, familial genetics and research on developing and
identifying new molecules that could be used in the fight against prostate cancer
Chad Amosson, M.D.
Board Certification: Radiation Oncology
Residency: Baylor College of Medicine (Chief Resident)
Medical Degree: University of Texas Medical School
Bachelor of Science Degree in Genetics: Texas A & M University, Magna Cum Laude
Timothy Nichols, M.D.
Board Certification: Radiation Oncology
Residency: University of Maryland School of Medicine
Medical Degree: University of Maryland Medical Center (Chief Resident), American Cancer Society Fellow
Bachelor of Science Degree in Physics: University of Maryland
CONNECTIONS
Summer Edition
Page 3
Ischemic Heart Disease Risk Following Radiation in Women with Breast Cancer
I
n the age of technology, there have been
significant advances in the outcomes of
patients following treatments for various
cancers. As a physician who has been
in medicine long enough to see many of
these advances, it is hard not to reflect on
where we are and where we were, and to
evaluate whether what we are doing now
has impact on health down the road. We
have certainly improved survival rates for
many cancers, with improved therapies
(Chemotherapy and Radiation), as well as
surgical procedures. Because of where we
are, and often times have questions asked
about cancer survival, there still leaves
some questions regarding other health issues. A very recent article in New England
Journal of Medicine by Sarah C. Darby,
PhD, Professor of Medical Statistics at
Oxford University has answered one of
these very important questions.
In a population-based case-control
study, 2168 women from 1958-2001
were evaluated who received radiation
for breast cancer. The findings were not
By: Chistopher Jordan, D.O.
completely unexpected, but certainly
significant, nonetheless. Women who
underwent radiation of the right breast
showed no significant changes in risk
for ischemic heart disease compared to
women who did not receive chest wall
radiation. However, women who underwent radiation to the left breast showed a
6.67 times higher rate of ischemic heart
disease than the control population.
As patients begin to return to the care
of their family physicians and internists,
it is imperative the patients and their
respective clinicians understand the aggressive monitoring for ischemic heart
disease when radiation therapy to the left
breast has been delivered. The risk becomes more evident after a 5-year interval
from radiation therapy, and as women are
more prone to atypical symptoms, closer
screening with stress testing, imaging
and heart catheterizations becomes more
important in this population. With the
predominant portion of the heart on the
left side, it is not surprising that this risk
is elevated following left breast radiation,
but vigilance is necessary to prevent major
cardiac events as a result of radiation. No
doubt, the radiation machines used today
are significantly advanced compared to
those even in 2001, when this study population ended, but women are still having
exposure of radiation to their heart tissues
despite best efforts of radiation oncologists to protect the heart.
With women living longer following
treatments for breast cancer, it is important to understand the long term sequelae
of therapies we are delivering. We know
certain chemotherapies can weaken heart
muscles and lead to congestive heart failure; some raise the lifetime risk of people
to develop acute leukemias, but despite
our best efforts to protect the heart from
exposures, heart disease needs to be
added to the rigorous survivorship screening diagnoses and appropriate diagnostic
tools and proper timelines should be in
place to reduce the incidence of major cardiac events following left breast radiation.
New TomoTherapy®
H™
The TomoTherapy H Series breaks new boundaries in making personalized radiation therapy an
option for all cancer patients across the entire spectrum of radiation oncology
•
•
•
•
H Series technology is the gold standard for image guided IMRT treatment delivery – maximizing conformity and target
dose uniformity.
Its sophisticated, multi-leaf collimator contours a closely deifined treatment field. Combined with TomoEdge technology, the H Series contours the beam to match the contour of the patient’s tumor (s). The result is a balanced treatment delivery as unique as each patient.
The H Series CTrue image guidance system delivers daily, 3D CT images to monitor tumor size and shape. Treatment is adjusted to match the margins of the tumor as it shrinks, sparing healthy tissue.
Simultaneous treatment of multiple tumors is possible with this advanced technology, resulting in shorter treatment times and greater comfort for patients. Average treatment time is 15 minutes.
10425 North Central Expressway • Dallas, Texas 75231 • 214-954-7734
www.PremierCancerCenters.com
CONNECTIONS
Summer Edition
Page 4
Blending Next Generation Care with a Tradition of Caring and Compassion
Dr. Cripps on Joining NexGen
During medical school, my first clinical
rotation was in oncology at MD
Anderson in Houston. I realized early
on, this was a field I could make an
impact in. I feel honored to be part of an
area in medicine where you develop very
special relationships with patients and
their families. I see the importance of
treating not just the diseases but the side
effects of treatments and being mindful
of the psychosocial impact as well. I am
blessed to have found Dr. Sharma and
the wonderful staff at NexGen Oncology
and look forward to being part of our
continued growth.
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Our specially trained providers,
nurses, and staff provide the following
services:
• Patient Evaluation and Treatment
• Personal Support, and Education
• Hematology Services
• Infusion Services
• Palliative Care
• Research Studies
• Hereditary Cancer Screening
• Second Opinion Clinic:
For many cancers, no one
particular treatment is clearly
the best for all patients. This is
the motivation for patients to seek a second opinion, which
is a perfectly acceptable and common practice in oncology care.
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Our Staff
Nishu Wadhawan,
MBBS, MBA
Chief Operating Officer
Kimberly Hooks,
RN, BSN, OCN
Administrator of Clinical Services
Asha Sharma,
Medical Office Administrator