aging and cancer - upmc hillman cancer center · aging and cancer 2 living with cancer in the...

UPMC Cancer Centers and University of Pittsburgh Cancer Institutes

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Aging and Cancer

Aging and CancerLiving with cancer in the golden years2

Global CollaborationscaBIG project fosters access to cancer data, treatment options8

Easing the BurdenOutreach program targets disparities in education, access to care

12

Team Goal: Preventing CancerEducation initiatives key to cancer prevention and early detection

14Seasons of Hope: A Future Without CancerPreview of the 2006 gala event20

C O N T E N T S

News Briefs 22

2University of Pittsburgh Cancer Institute

Cancer Discovery & Care is a publication of the University of Pittsburgh

Cancer Institute (UPCI) and UPMC Cancer Centers and is produced by UPMC

Corporate Communications. All rights reserved. No portion of this magazine

may be reproduced without written permission. Send suggestions, com-

ments, or address changes to Betsy Martinelli at UPCI/ UPMC Cancer Centers,

Office of Communications, UPMC Cancer Pavilion, 5150 Centre Ave., Room 1c,

Pittsburgh, PA 15232, or via e-mail at [email protected].

16

UPMC Cancer Centers and

University of Pittsburgh Cancer Institute


The National Cancer Institute, in its 2005 Cancer Trends Progress Report, announced thatthe nation is making great progress in reducing the burden of cancer in the United States.Death rates for the four most common cancers (prostate, breast, lung, and colorectal) con-tinue to decline and the rate of cancer incidence has been relatively stable. The reporthighlights the importance of prevention and early detection – as evidenced in the decrease inboth youth and adult smoking rates and the increased use of screening tests, especially forbreast and cervical cancer.

At UPMC Cancer Centers and the University of Pittsburgh Cancer Institute, we’ve devotedsignificant resources to educating the public about the importance of prevention and earlydetection. Our efforts reach thousands of people each year in a variety of innovative as well astraditional venues. And we have recently implemented programs to communicate these impor-tant messages to underserved populations, who bear a disproportionately high burden of cancerbecause of insufficient cancer prevention, early detection, or access to quality cancer care.

As the regional leader in cancer research and care, it is our responsibility to extend our knowl-edge about advances and insights about cancer prevention, early detection, and treatment intothe community as rapidly and effectively as possible. To that end, we have invested more than$750,000 over the past year to support patient education programs not only at the HillmanCancer Center, but throughout our community network in western Pennsylvania and beyond.

The Cancer Trends Progress Report also highlights considerable cancer-related health dispari-ties, especially in the African American and low socioeconomic populations, where the highestrates of both new cancers and cancer deaths are being seen. To eliminate disparities in cancerprevention, early detection, and effective treatment, and to improve detection and counselingfor those who are at increased risk of cancer, we are partnering with the University ofPittsburgh Graduate School of Public Health’s Center for Minority Health to reach theseunderserved communities. We ultimately hope to break down barriers to care through bettereducation, easier access to screenings and innovative cancer treatments, and, as needed, finan-cial counseling and assistance.

It is our responsibility as health care experts to ensure that everyone with cancer, or at risk for cancer, has access to the best resources to help them prevent or overcome their illness and to thereby lead productive, healthy, and full lives. This is our commitment to westernPennsylvania.

NEW VISION. NEW TOMORROW.

Ronald B. Herberman, MD

Hillman Professor of OncologyDirector, UPMC Cancer Centers and theUniversity of Pittsburgh Cancer Institute

It is our responsibility to extend

our knowledge about advances

and insights into cancer and its

treatment into the community as

rapidly and effectively as possible.



UPMC Cancer Centers Executive Leadership

Ronald B. Herberman, MDDirector

Stanley M. Marks, MDDirector of Clinical Services and Chief Medical Officer

Jeffrey E. Shogan, MDDirector of Business Services and Chief Business Officer

Charles E. Bogosta, MBAVice President, Cancer Services

David L. Bartlett, MDCo-Director of Surgical Oncology Services andChief, Division of Surgical Oncology

Brian Clark, MDDirector of Cancer Genetic Services

Dwight E. Heron, MDDirector of Radiation Oncology Services

James D. Luketich, MDCo-Director of Surgical Oncology Servicesand Director and Chief, Heart, Lung, andEsophageal Surgical Institute

Colleen McCabe Mantini, MPADirector of Government Relations

Betsy S. MartinelliManager of Communications

Gayle L. TissueChief Development Officer

Beth Wild Shiring, MBAChief Operating Officer

University of Pittsburgh Cancer InstituteExecutive Leadership

Ronald B. Herberman, MDDirectorHillman Professor of Oncology Associate Vice Chancellor, Cancer Research

Andrew S. Baum, PhDDirector of Behavioral Sciences and Cancer Control

Michael J. Becich, MD, PhDAssociate Director for Cancer Informatics

Charles E. Bogosta, MBAAssociate Director for Finance

Preet M. Chaudhary, MDDirector of Translational Research and Co-Leader, Hematologic Malignancies Program

Clare Collins, MA, MEdAssistant Director for Media Relations

Maryann Donovan, PhD, MPHAssociate Director for Research Services and Advancement

Kenneth A. Foon, MD Director of Clinical Investigations

Vijaya C. Gandhi, PhD, MBAAssociate Director for Administration andStrategic Planning

Michael T. Lotze, MDAssociate Director for Strategic Partnerships

Colleen McCabe Mantini, MPADirector, Governmental Relations

Shivendra V. Singh, PhDDirector of Basic Research

Emanuela Taioli, MD, PhDDirector of Cancer Prevention and Population Sciences

Gayle L. TissueAssociate Director for Development

UPCI Council

Sy Holzer, ChairElsie H. Hillman, Vice ChairCurtis AikenThomas BalestrieriG. Nicholas Beckwith IIIJames BroadhurstWilliam M. CooperHarriet CrawfordBarbara CrownJoseph W. DeNardoRobert C. DenoveDouglas P. Dick

George A. FechterLee B. FosterChip GanassiKent G. GeorgeEdwin H. Gott Jr.Thomas B. GrealishRoy W. HaleyRobert W. HannanI. N. Rendall Harper Jr.The Honorable Melissa A. HartMark HartSakiko IshiiBill IslerWilliam KasslingMario LemieuxSally LevinEdward J. LewisJeffrey LiptonDavid MaloneKevin McClatchyLeslie McCombsMartin G. McGuinnKatie McSorleyBob MeyerThomas H. Nimick Jr.Eugene J. O’SullivanArnold PalmerBrian PattenThe Honorable John E. PetersonThe Honorable John R. PippyJane RoeschCynthia RothSusan C. Santa-CruzFrederic B. SargentSteve SchwarzwaelderDan ShapiraRobert SlagleLorene SteffesArthur H. StroydJanet B. Taber (honorary member)Thomas VanKirkLawrence M. WagnerThe Honorable Jack WagnerWilliam WattsThe Honorable John Weinstein

3University of Pittsburgh Cancer InstituteUPMC Cancer Centers2

The golden years are that time after retirement when days arefilled with hobbies, spending time with family and friends, andperhaps even traveling. They are also the years when cancer is most likely to occur.

Living With Cancer in the Golden YearsAging and Cancer According to the American Cancer Society, about 77 percent of all

cancers are being diagnosed at age 55 or older. Reports also show thatpeople 65 years or older have an incidence of cancer 10 times greaterthan the rate for younger people. The need for research about agingand cancer has never been more urgent, and the issue is particularlyrelevant in Allegheny County and western Pennsylvania, where theproportion of elderly residents is considerably higher than in almostany other region of the United States.

To address this important national health concern, the NationalCancer Institute (NCI) and the National Institute on Aging (NIA)have partnered to launch an initiative to accelerate research into therelationship between cancer and aging that includes a five-year grantof approximately $25 million. The University of Pittsburgh CancerInstitute (UPCI) is one of eight NCI-designated research centersacross the country receiving funding from this program.

“People age 65 and older are at the highest risk for cancer and tend to be the most neglected when it comes to cancer care,” explainsRonald B. Herberman, MD, director, UPMC Cancer Centers andUPCI, and principal investigator of the project, “Integrating Cancerand Aging at Pitt.” “Elderly patients face many physical and socialchallenges that younger people do not and often have additionalhealth problems that can make cancer more difficult to treat safelyand effectively,” says Dr. Herberman. Through laboratory and clinicalresearch studies, UPCI is developing ways to characterize the nature,severity, and likely effects of other health problems on cancer treatmentand the ability to cope with cancer. These studies seek appropriateinterventions to ease the burden of cancer in this population.

The NCI/NIA initiative outlined seven key areas of research for grantrecipients. “We chose three major areas of study — the immunobi-ology of cancer and aging, clinical trials, and behavioral andpsychosocial issues — based on our institute’s strength and expertise,”says Gurkamal Chatta, MD, Division of Hematology-Oncology,UPCI; associate professor of medicine, University of PittsburghSchool of Medicine; and program director of the “Integrating Cancerand Aging at Pitt” project.

By bringing together the collaborative efforts of basic researchers, clinicians, and behavioral medicine experts, the program ultimatelywill develop a spectrum of care strategies tailored to the individualhealth and functional status of the elderly cancer patient.

“People age 65 and older

are at the highest risk for

cancer and tend to be the

most neglected when it

comes to cancer care.”

Ronald B. Herberman, MD

Gurkamal Chatta, MD, and

Stephanie Studenski, MD,

are leading a team of

cancer and aging experts

who are working to

improve treatments and

quality of life for elderly

cancer patients.

UPMC Cancer Centers4

The Research ComponentsLeaders of the cancer and aging program are studying the basic sci-ence of DNA repair, immunobiology, and bone biology whiletargeting prostate cancer and myeloma — cancers that are moreprevalent in older people.

The NCI/NIA grant has been leveraged to obtain funding from addi-tional sources, expanding research efforts in the hope of gaining abetter understanding of the problems of the elderly cancer patient,and enhancing care. For example, Dr. Chatta and dendritic cellbiology expert Pawel Kalinski, MD, PhD, assistant professor of sur-gery, immunology, and infectious disease and microbiology, UPCI,have been awarded funding from the Department of Defense todevelop clinical trials of innovative vaccines for treatment of patientswith prostate cancer.

Laura Niedernhofer, MD, PhD, assistant professor, Department ofMolecular Genetics and Biochemistry, University of PittsburghSchool of Medicine, is currently spearheading the study of theimmunobiology of cancer and aging, with Dr. Chatta and MichaelShurin, MD, PhD, associate director, Clinical Immunopathology,UPCI. They are using a prostate cancer model to understand theeffect of age on the immune system’s ability to ward off cancer andthe body’s ability to respond to anti-tumor therapy. Their work isfunded by the Hillman Fellows Program for Innovative CancerResearch and other private contributions.

DNA repair processes must be constantly operating to correct anydamage to the DNA structure. As cells age, however, the repairprocesses may become overwhelmed or mistakes in the DNA mayhave accumulated. These aged cells have the option to become indefinitely dormant, commit suicide, or become cancerous.

Dr. Niedernhofer has taken a genetically engineered mouse that rapidly ages, due to a defect in a gene that is crucial for DNA repair, and crossed it with a mouse model of prostate cancer in order todetermine the overlap between cancer and aging. Ultimately, the hope is that such mouse models of cancer and aging will lead to a stem-cell-based treatment that will reduce aging and thereby possibly slowdown the progression of cancer.

Because patients with cancer have suppressed immune systems, andthe elderly are known to have weakened immune systems in general,UPCI scientists are seeking to improve the function of the immunesystem by testing some of its many components, such as T cells anddendritic cells. The hypothesis is that if a patient with cancer istreated effectively, his or her immune system will actually improve.Dr. Shurin is currently testing dendritic cell-based vaccines to repairthe immune system in the hope of reversing some of the immuno-suppression commonly seen in cancer. Abbe Vallejo, PhD, associateprofessor of pediatrics and immunology, University of PittsburghSchool of Medicine, has undertaken an exhaustive effort to defineand correct defects in aging T cells.

Osteolytic lesions, or “punched out” areas of severe bone loss, areoften the result of many metastatic cancers, such as prostate, multiplemyeloma, breast, and lung. Dr. Chatta defines normal bone remod-eling as “the yin and yang of bone destruction and new boneformation.” In a healthy person, bone is destroyed and new bone islaid down at an equal rate. In a patient with bone cancer, that balanceis upset.

A complicating factor is women’s loss of bone density aftermenopause, which can be compounded by bone loss due to cancer.The goal is to have a treatment that would correct the imbalancebetween bone destruction and new bone formation. “Under thedirection of David Roodman, MD, PhD, director of the UPCI andUPMC Cancer Centers Myeloma Program, our clinical trials will tell us if these treatments will help or add additional complexities inelderly patients,” says Dr. Chatta. Dr. Roodman has received fundingfor the study of bone biology in myeloma patients from the MultipleMyeloma Research Foundation.

From Bench to Bedside


Aging and Cancer Living With Cancer in the Golden Years

Severe bone loss, acommon problem in theelderly, is also often theresult of many cancers.

Aging and Cancer Living With Cancer in the Golden Years

Florence Fiaretti, 65, is an ovarian cancer patient at UPMC CancerCenter at UPMC Passavant who has been battling her cancer for 15years with periodic chemotherapy treatments. She participated in thestudy in spring 2005. “It was very beneficial for me, because whenyou are going through chemo, you lose so much of yourself physicallyand mentally,” explains Mrs. Fiaretti. “Even though it was a simplesurvey, it motivated me to think about how I felt.” More importantlyfor Mrs. Fiaretti, it meant a lot to her to know someone cared enoughto do the project. “Sometimes you feel forgotten when you havecancer because your friends don’t know exactly what to say or how toapproach you. You have your family, but you still feel kind of lonely.This project made me feel like someone out there cared and listenedfor the first time.”

Ultimately, the survey makes it easier for the health care provider to understand what the patient is feeling during treatment. “Patientscan use the ‘Daily Activity Study’ as a tool to communicate with theirphysicians,” says Elizabeth Hile, MS, PT, NCS, a researcher underDr. Studenski. “This improved communication can be a key factor in the management of a patient’s treatment.”

Polishing the Golden Years

The 65 and older population segment in the United States isexpected to double from 35 million to 70 million by 2030. The ini-tiatives developed through the cancer and aging program, now in itsthird year, will continue to improve the quality of life and quality ofcare in elderly patients, not only at the Hillman Cancer Center butthroughout the UPMC Cancer Centers network and beyond. Drs.Herberman, Chatta, Studenski, and their associates plan to continueto propose innovative projects to secure funding that will focus onresearch and treatment for the aging cancer patient.


Novel TherapiesMembers of the “Integrating Cancer and Aging at Pitt” program haveworked to develop clinical trials that are more user-friendly for olderpatients, with more flexible criteria to enable more patients over theage of 65 to enroll.

William Powis, age 76, is a strong advocate of clinical trials. Sincebeing diagnosed with prostate cancer in the summer of 1993, he has undergone a radical prostectomy, followed by an orchiectomy,and numerous treatments, including radiation and hormonetherapy. A follow-up CT scan revealed six tumors in his lungs. In August 2005, a bone scan showed the cancer had moved to Mr. Powis’s sacroiliac.

In addition to his standard therapies, Mr. Powis has participated inthree clinical trials over the past three years. “I believe researchersneed to learn,” says Mr. Powis. “I know I can’t be cured, but maybe I can help someone else like my son or my grandson.”

Despite his recurrence, Mr. Powis still leads an active life. He helpscare for his daughter’s triplets and has traveled to Korea and Chinawith his grandson. “Through it all I feel good. I have no pain, I ameating well, and I am doing everything I want to do.”

Listening to What the Patient Has to SayAnother major goal of the cancer and aging program is to address thepsychosocial needs of the older cancer patient. “Naturally, in everycase we want to prolong the life of the patient, but with the olderperson there is another important consideration,” explains Dr.Chatta. “We want the elderly cancer patient to have a sustainedperiod of high quality of life, and that is where Dr. StephanieStudenski comes in.”

Stephanie Studenski, MD, MPH, Division of Geriatric Medicine,University of Pittsburgh School of Medicine, and co-principal investi-gator of the project, is leading an initiative to identify ways tosuccessfully involve older people in cancer and aging research, andlearn more about the older population’s experience when receivingcancer treatment. “We have found that most of our older cancerpatients do not want to drive a long distance to the Hillman CancerCenter for their treatment; they prefer to receive their treatment atone of the community UPMC Cancer Centers, closer to home,”explains Dr. Studenski.

Through the cancer and aging grant, Dr. Studenski launched the“Daily Activity Study,” a research study targeted to patients at thecommunity cancer centers as well as the Hillman Cancer Center. It isdesigned to measure their day-to-day experience while living with —and being treated for — cancer.

Traditionally, patients are given a long list of questions every fewmonths to determine health status or quality of life — addressingtheir pain, fatigue, and nausea, for example — and are asked to ratethemselves on a scale from one to five. These questions are then com-bined to create a summary score. The summary score is often verydifficult for the patient, family members, caregivers, and even clini-cians to understand due to lack of familiarity with the scales andscores. “Many cancer patients want to know about the effect of thecancer treatment on their overall function and independence,” saysDr. Studenski.

Through this new, simplified survey, clinicians are able to more easilyobtain information about a patient’s experience while receiving cancertreatment. Older cancer patients are asked to spend one minute a daykeeping a simple log of five important health states.

Patients from community locations, including UPMC Cancer Centerat UPMC Passavant, UPMC Cancer Center at UPMC McKeesport,and Arnold Palmer Pavilion at Oakbrook Commons, participated inthe 12-week study.

Daily Log of Five Important Health States1. Today I spent more than half of the day

in bed.

2. Today I left home without the help ofanother person.

3. Today I had more difficulty getting dressedand bathing than usual.

4. Today I had more difficulty with my mobility.

5. Symptoms I’ve experienced today:


“This project made me

feel like someone out

there cared and listened

for the first time.”

Florence Fiaretti,

ovarian cancer survivor


But if an oncologist could quickly perform the equivalent of a WorldWide Web search of thousands of cancer studies and millions ofpatient records, that brain cancer might seem less rare. The oncolo-gist could quickly home in on treatment options that had goodoutcomes for other patients.

Dr. Becich is a leader in a three-year pilot project to develop justthose capabilities through UPCI’s component of the CancerBiomedical Informatics Grid, or caBIG. “Essentially, it’s a kind ofauthorized-users-only Internet for the cancer community,” he says.

“A grid that securely and confidentially connects all the research andpatient records in the country.”

caBIG is a collaboration among approximately 50 NCI-designatedComprehensive Cancer Centers, in which UPCI is playing a majorrole, to develop a network for sharing the data that each center collects, along with tools to unite the wide array of systems used bycancer research institutions and hospitals. The ultimate goal is toprovide easier access to potentially life-saving advances in prevention,early detection, and treatment of cancer.


“Say a doctor at an institution has a patient with a rare form of brain cancer,” posits Michael Becich, MD, PhD, professor

of pathology, associate director for Oncology Informatics at the University of Pittsburgh Cancer Institute (UPCI), and

director of the Benedum Oncology Informatics Center. “While combing journals and lists of clinical trials may reveal

something that could help the patient, it’s time consuming and always risks missing an important treatment

opportunity.”

caBIGG L O B A L C O L L A B O R AT I O N S

Project Fosters Access to Data, Development of Therapies


“When it comes to clinical research trials, there is not a standardmechanism for constructing, collecting, analyzing, and reporting thedata,” says Douglas Fridsma, MD, assistant professor of medicineand principal investigator of a caBIG contract to UPCI to developthe BRIDG model, or the Biomedical Research Integrated DomainGroup model. BRIDG is a collaboration among researchers atUPCI, other NCI cancer centers, the pharmaceutical industry, andorganizations that promulgate standards for clinical research andhospital data systems.

“We pay a price for the dispersed nature of today's research datastorage,” Dr. Fridsma says. For example, a patient in a clinical trialdevelops a serious condition and is the only one in the trial with thisproblem: Is the drug causing a rare side effect, or is the problem justa coincidence?

By pooling the data among multiple trials, systems based on stan-dards like BRIDG can spotlight patterns of rare side effects muchsooner, and with statistical significance. This could mean the differ-ence between a dozen patients experiencing a side effect in a trial,and thousands experiencing it when the drug is approved and widelyprescribed.

The array of data systems used by cancer research institutions andhospitals to organize and store information use a variety of computerlanguages and vocabularies. “The first step in bringing together thevast, largely untapped information in the cancer research commu-nity's databases has to be creating a common vocabulary andclassification system to knit all those computer systems together,”says Rebecca Crowley, MD, assistant professor of pathology. Dr.Crowley is principal investigator of caTIES — the Cancer TextInformation Extraction System.

Dr. Crowley’s work aims to link millions of records of pathologysamples at different institutions. These samples are critical to thediagnosis, grading, and staging of cancers and are one of the mostvaluable, though largely untapped, tools in cancer research.

Dr. Crowley has collaborated with the University of Pennsylvania toconnect more than 60,000 pathology reports, which are now sharedon the caGRID (the World Wide Web of cancer). By this spring,more than a million records — formerly locked in hospital laborato-ries and clinical trial repositories — will be available to researchers.

caBIG and its component projects aim to deconstruct the vocabu-lary, syntax, and higher structures of medical and research records sothat computers can make “apples-to-apples” comparisons.

“It’s a gradual process of building up layer by layer by layer,” says Dr. Crowley. Creating a dictionary of synonyms and annotating textrecords allows computers to scan them far more effectively, sheexplains. “Even though it’s free text, the annotations let us get veryquickly to the right reports.” This greatly facilitates discovery andvalidation of tumor biomarkers critical to the formulation of newtreatments.

“Security and patient confidentiality are other features built intocaTIES and the other caBIG projects from the onset,” Dr. Crowleyadds. “The program gives researchers only the data they need whilestripping out names and other personal information.”

Today, BRIDG has been adopted by Health Level Seven, which is anAmerican National Standards Institute-accredited organization devel-oping standards for clinical and administrative data for hospitals andother health care organizations nationwide. The Clinical Data

Standards Interchange Consortium (CDSIC) is now using BRIDGto help it develop new standards for research data management. Andthe Food and Drug Administration intends to use BRIDG to con-nect data from both of those systems in an attempt to streamline itsdrug evaluation process. Dr. Fridsma was just awarded a prestigiousnational award from CDSIC for his pioneering work in this effort.

“In the next phase of caTIES we’ll have two additional adopters,Thomas Jefferson University in Philadelphia and WashingtonUniversity in St. Louis,” Dr. Crowley says. “Additionally, we’ll beramping up the number of cases; by next year, we’ll probably haveseveral million.”

As for the overall caBIG project, “we’re about halfway through thethree-year pilot,” says Dr. Becich. “By March 2006 we will haveimplemented our tools at six sites. That’s an incredibly short periodof time to get these kinds of tools implemented.”

The real payoff of caBIG will come in the years after the systemgains wider adoption, says Dr. Fridsma. “I believe in this workbecause I really think it’s the way we’re going to reduce the pain anddeath from diseases like cancer.”

caBIGG L O B A L C O L L A B O R AT I O N S

Linking the millions of

records of pathology

samples at different

institutions — one of the

most valuable and largely

untapped tools in cancer

research — is critical to

the diagnosis, grading,

and staging of cancer.

13UPMC Cancer Centers12

Outreach Program Targets Disparities in Education, Access to Care

EASING THE BURDEN

With the highest mortality rate of any racial or ethnic group for all cancers combined, African Americans bear

a disproportionate burden of cancer.AAmerican Cancer Society statistics show

that African Americans bear a dispropor-tionate burden of cancer — with the highestmortality rate of any racial or ethnic groupfor all cancers combined and for mostmajor cancers. African American men, in particular, have a 20 percent higher inci-dence and a 40 percent higher death ratefrom all cancers combined than white men.

UPMC Cancer Centers and the Universityof Pittsburgh Cancer Institute (UPCI), rec-ognizing the need for better prevention anddetection strategies targeted specifically tothe African American and underservedpopulations, have implemented a variety of programs to enhance cancer educationopportunities, provide easier access toscreenings, treatment and care, and asneeded, financial counseling and assistance.The goal of these programs is to ease theburden of cancer in the African Americanand other underserved communities.

These new outreach initiatives are an exten-sion of UPCI’s African American CancerProgram. Initially established more than 10years ago to identify and eliminate barriersthat prevent African Americans from

obtaining access to cancer diagnostic andtreatment services, this community-focusedprogram offers cancer screenings inHomewood, Braddock, Duquesne, andAliquippa. The program encompasses self-help groups for African Americancancer survivors, including the annual“Celebration of Life” dinner for survivors.Members of the African American CancerProgram also work with the CancerAwareness Coalition, a group composed ofmore than 15 health care and communityorganizations in Allegheny County, toincrease access to care at UPMC CancerCenters.

In 2005, UPMC Cancer Centers andUPCI established two new working com-mittees to further address the burden ofcancer for underserved populations inwestern Pennsylvania. Working in conjunc-tion with the University of PittsburghGraduate School of Public Health’s Centerfor Minority Health, these teams are devel-oping new strategies to make informationabout prevention, early detection, and thebest treatment options more accessible toAfrican Americans and other underservedpopulations.


Working with the Healthy Black Family Project offers unique opportunities to provide

lifesaving information about cancer prevention and control in a community setting.


“UPMC Cancer Centers is a leader intranslational research and offers ourpatients cutting-edge therapies throughclinical trials,” says Timothy Carlos, MD,co-chair of a working group to educateboth referring physicians and the generalpublic about clinical trials and howAfrican Americans can benefit from theseoptions. “We need to more aggressivelyeducate the public about these options,especially in underserved communities.”

The partnership with the Graduate Schoolof Public Health’s Center for MinorityHealth (CMH) builds upon a foundationof trusted relationships in the AfricanAmerican community established by CMHover the past ten years. In 2005, CMHlaunched the Healthy Black Family Projectwhich has enrolled more than 2,000African American families in an ongoingprogram of health promotion and diseaseprevention. The program has field offices at the Kingsley Association in East Liberty,and Hosanna House in Wilkinsburg, andwill expand into the Hill District andNorth Side of Pittsburgh this year.

“The Healthy Black Family Project pro-vides an excellent platform for reachingAfrican Americans with lifesaving informa-tion on cancer prevention and control,”said Stephen B. Thomas, MD, CMHdirector and co-chair of the working group.The CMH operates the CancerInformation Service in southwesternPennsylvania and brings expertise indelivery of community-based interventionsthat are culturally competent and scientifi-cally sound.

Each month, UPMC Cancer Centers andCMH sponsor a cancer education seriesthrough the Healthy Black Family Projectat various community locations. Focusingon a specific cancer type, the weekly seriesincludes a variety of educational events,including a general informational session,an “Ask the Doctor” session, and an oppor-tunity to talk with other cancer survivors.“We are incorporating cancer education in-between other popular health initiatives,such as yoga, nutrition, stress reduction,and physical activity classes,” explains Dr. Thomas. “People are drawn to thehealth promotion classes and, once there,stay for the cancer education. It has been a great success.”

Financial burdens are another major barrierto cutting-edge care for underserved popu-lations. Due to disparities in health carecoverage, many may not be able to takeadvantage of new screening and treatmentoptions. A second working group was estab-lished to address these financial disparities.

As a result of the recommendations from thisworking group, on Jan. 1, 2006, UPMCCancer Centers initiated a one-year pilot program to provide financial assistance topatients with prostate, lung, breast, or coloncancer at four UPMC facilities: HillmanCancer Center, Magee-Womens Hospital of UPMC, UPMC McKeesport, andUPMC Braddock.

According to Lyn Robertson, DrPH, associate director for patient care services andcancer education at UPMC Cancer Centersand administrator of the program, “We wantto ensure that patients with a diagnosis of

cancer will have access, regardless of financialmeans, to the latest innovations in treatmentand care for their cancer.”

UPMC Cancer Centers has established a$750,000 limited fund to help underinsuredor uninsured patients obtain the best possiblecare, including participation in clinical trialsof innovative cancer treatments. “We willwork with each patient to explore all fundingpossibilities,” explains Dr. Robertson. “Thispool of funding is a safety net for those whohave no other options to cover their care.”

The financial assistance program is beingpromoted to patients through a variety ofcommunity organizations, includingAfrican American community centers,physicians, and clergy. “We are targetingleaders in the community who can helpinfluence those in need to take advantageof the care we have available, regardless offinancial means,” says Dr. Robertson.

It is estimated that nearly 140,000 newcases of cancer were diagnosed in theUnited States’ African American populationduring 2005. Implementing more proactivestrategies to educate the community willultimately reduce racial and ethnic dispari-ties in cancer prevention, screening, andtreatment, resulting in earlier detection,better access to new therapies, and mostimportantly, reduce their burden of cancer.


EASING THE BURDEN


More than 36,000 patients are treated eachyear at UPMC Cancer Centers’ network of46 locations in the western Pennsylvaniaregion and beyond. As the need for cancercare continues to grow, professionals fromthe Hillman Cancer Center and theUniversity of Pittsburgh Cancer Institute(UPCI) have implemented several commu-nity outreach and patient educationprograms to meet the needs of a diversepopulation. The goal is to teach peopleabout cancer prevention and early detection— close to home.

PROVI DI NG A U N I F I E D VOICE

As director of cancer education for UPMCCancer Centers, Lynda Tunon, MSN, RN,OCN, is responsible for ensuring that con-sistent, high quality education is availableacross the cancer centers network. In addi-tion to patient education, Ms. Tunonoversees professional education, cancer pre-vention and community educationprograms, outreach programs for students,and a recently implemented patient naviga-tion program at the Hillman Cancer Center.

Ms. Tunon leads a working group of morethan 90 representatives from the networksites who provide their expertise in patienteducation to create cancer education mate-rials on newly approved cancer drugs andradiation treatments as well as clinical trialsand nutritional issues related to treatment.

These materials are made available to staff aswell as to patients and the public. In addi-tion, each representative trains other staffmembers about patient education resourcesthat are available at their respective sites. Thegroup meets once a month via videoconfer-ence to discuss patient education outreachand available materials, and to share ideasabout how to promote cancer awareness.

“A roundtable discussion allows representa-tives to share patient education projects andactivities they are hosting at their sites,” saysMs. Tunon, “and to ask questions or bounceideas off each other.”

The meeting also provides an opportunityfor representatives to learn about newlyapproved cancer drugs and clinical trials thatare open to patients through UPCI.

“The videoconferencing capability is won-derful,” says Chris Carlisle, RN, OCN,clinical manager, UPMC Cancer Centers’Beaver, North Hills, St. Margaret, and NewCastle locations. “The staff does not have todrive to Shadyside to attend the monthlymeetings. They are still able to focus onpatient care for a large part of the day byparticipating from their network locations.”

The monthly meeting adjourns with a briefbook-sharing of newly released books that areavailable to purchase for, or recommendedto, patients and staff dealing with cancer.

PAT I E NT E D U C AT ION AT TH EH I LLM AN C ANCE R CE NT E R

The Gumberg Family Library, a patientand family education and informationcenter at the Hillman Cancer Center, isthe hub of patient education activities forthe cancer centers network. In addition tothe hundreds of books, pamphlets, videos,and CDs at the Gumberg Family Library,a staff of four is available to help a newlydiagnosed patient, caregiver, or familymember face cancer and take the next stepsto cope with the disease.

“While it has many aspects of a traditionallibrary, including five computers forpatient use, we like to tell patients andfamily members that it’s a place to comeand talk with a cancer professional,” Ms.Tunon explains. “We’re more than just aresource for information. We are a resourcefor support, too.” The staff includes twonurse educators, an oncology social worker,and an administrative coordinator. Theyassist in finding resources, answer ques-tions about cancer, and discuss ways todeal with the emotional, financial, andphysical aspects of caregiving. These pro-fessionals also offer small, individualizedclasses that provide topic-specific instruc-tion for each patient and family members.Known as the “Drop in and Learn” series,the classes are very informal, to ensure alevel of comfort is maintained for the

Patients and family members throughout theUPMC Cancer Centers network can access

educational resources from the Gumberg FamilyLibrary located at the Hillman Cancer Center.


E D U C AT I O N I N I T I AT I V E S K E Y TO C A N C E R P R E V E N T I O N A N D E A R LY D E T E C T I O N

Team Goal:Preventing Cancer

UPMC Cancer Centers’ teamof education specialists,including (left to right)Marian Bragdon, KayLowmaster, Lynda Tunon,Susan Sherwin, and MarinaPosvar, is taking importantmessages about cancer prevention and early detection to the community.


patient. A wide range of topics is covered,including: Chemotherapy, FamilyCaregiver Education, Ask the Nurse, Askthe Dietitian, Ask the Pharmacist, and Askthe Social Worker.

“We do our best to answer any generalquestions the patient may have,” says Ms.Tunon. “However, questions specific to thepatient’s treatment plan are referred to thepatient’s cancer treatment team.” TheGumberg Family Library is free and alsoopen to the general public.

WE LCO M I NG N EW PAT I E NTS

Facing a diagnosis of cancer and under-standing the health care system in generalcan be a trying experience for new patients.To help alleviate stress and frustration, thepatient navigation services program wasrecently implemented at the HillmanCancer Center to provide individualizedassistance to patients, family, and caregivers.“Dealing with cancer and the many stagesof diagnosis and treatment is a long andtrying journey for patients and their fami-lies,” says Marina Posvar, patient navigationservices coordinator. “From the very firstvisit, we’re here to be a familiar and helpfulface throughout that journey.”

Each new patient is greeted with a packet ofinformation about the wide variety of serv-ices provided by UPMC Cancer Centersand the Hillman Cancer Center. They arethen personally escorted by a patient navi-gator to the Gumberg Family Library wherethey may talk to a professional or find infor-mation about their disease or treatment.The patient navigators are available to assistwith any needs the patient may have onsubsequent visits to the Hillman CancerCenter.

In August 2005, the patient navigator pro-gram expanded beyond the Hillman CancerCenter to encompass education and preven-tion in underserved communities. Volunteersare trained about the importance of earlydetection of colorectal, breast, cervical, andprostate cancers specifically, and how to talk

to people about these cancers. These volun-teers are then dispatched to the communityto spread the word about the importance ofearly detection and treatment. “The goal is tobreak down barriers such as transportationand financial need and help people get screen-ings and treatment,” Ms. Tunon explains.

E D U C AT ION AN D PR EVE NT IONI N TH E CO MM U N ITY

Experience has demonstrated that the keyto preventing cancer is knowledge aboutthe avoidable risk factors for the majorforms of cancer. The number one priorityfor Kay Lowmaster, MSW, LCSW, pro-gram coordinator, prevention andcommunity outreach, UPMC CancerCenters, is to educate people in the com-munity about the risk factors for cancerand to stress the importance of early detec-tion for various types of cancer. Her effortsinclude traditional community outreach,such as “Prevention and Early Detection”seminars for churches and women’s andmen’s groups, as well as participation athealth and wellness fairs. She also hasdesigned a “Lunch and Learn” lecture forlocal businesses, such as Alcoa and DuquesneLight, to enhance employee wellness.

Ms. Lowmaster’s one-hour lecture andslide presentation explains what cancer isand dispels some common myths aboutthe disease. It also focuses on early detec-tion for breast, prostate, cervical, and coloncancer, and includes information on cancerprevention, covering such topics as tobaccouse, sun safety, nutrition, and physicalactivity. The presentation is followed by aquestion and answer session. “People areoften hesitant to openly ask personal ques-tions in front of their peers, so I am alwayswilling to stay afterward to talk with them,”says Ms. Lowmaster. “I am happy to begetting the word out, and if I make a dif-ference with even one or two people, that’sa success.”

In addition to her responsibilities as com-munity outreach coordinator, Ms.Lowmaster is also the coordinator of the

UPMC Cancer Centers’ chapter of UsTOO International. Ms. Lowmaster beganvolunteering with this prostate cancer sup-port group 10 years ago, and now facilitatesthe Us TOO Prostate Cancer Educationand Support Group, and coordinates theUs TOO Peer Counseling Program.

The support group, which also is open tospouses and family members, holdsmonthly meetings at the Hillman CancerCenter. The meetings consist of a guestspeaker, who is an expert in some area ofprostate cancer, followed by an optionalopen discussion forum. Ms. Lowmasteralso implemented a 12-member steeringcommittee to ensure survivors have inputregarding the direction of the group. InNovember 2005, the chapter received aChapter Spotlight Award from Us TOOnational headquarters in Chicago and wasrecognized as one of the most outstandingchapters in the country.

Ms. Lowmaster also coordinates freeprostate cancer and skin cancer screeningsas part of her prevention and communityoutreach program.

START I NG I N TH E CL A S SROO M

General education about cancer preventionneeds to begin early in life. Two UPMCCancer Centers outreach programs offerschools in the Pittsburgh area an opportunityto supplement their regular curriculum withcancer prevention information. SusanSherwin, community programs educator, andMarian S. Bragdon, RN, MEd, ONC, aretwo UPMC Cancer Centers professionalswho travel to elementary and high schools toteach cancer prevention. Sherwin’s “HealthyChoices for Students: A Cancer AwarenessProgram for School Aged Children,” a cancerprevention program for grades two throughseven, with a special concentration on fifthgrade, teaches children about the negativeeffects of tobacco use, good nutritionalhabits, and skin care. The program isexpected to reach more than 5,000 studentsthis school year. Ms. Bragdon’s “HealthyChoices for High School Cancer PreventionProgram” teaches students about preventionon a larger scale, and often requires Bragdonto call on her formal medical education tofield more complex questions about cancer.“I truly enjoy working with students becausethey are very interested in learning about

cancer,” says Ms. Bragdon. She has reachedmore than 25,000 students with her program,which continues to grow in popularity.

Both women provide the students with age-appropriate activity packets that are collatedby the Hillman Cancer Center’s VolunteerServices department, and brochures from theAmerican Cancer Society. The hope is thatthe prevention information provided to thestudents will extend to the home, to beshared with family and friends.

TH E N E XT ST E PS

Thousands of patients, students, friends,and families have been touched by theeducation programs offered by UPMCCancer Centers and the University ofPittsburgh Cancer Institute. As advances in cancer care and treatment rapidly occur,it is important to continue to offer patientsand the community a variety of opportuni-ties to access this information — ultimatelysaving lives by preventing cancer.

“We’re more than

just a resource

for information.

We are a resource

for support too.”

Lynda Tunon,MSN, RN, OCN

Team Goal: Preventing Cancer

Education about cancer preventionneeds to begin early and be continually reinforced.

Patient navigatorsfamiliarize newpatients with themany supportresources availableat the HillmanCancer Center.


The 2006 gala event, to benefit patient care and cancerresearch, will take center stage on Wednesday, May 3, at theUPMC Sports Performance Complex on Pittsburgh’s South Side.

Presenting sponsors for the event are PNC and the University ofPittsburgh Medical Center, with Honorary Chairs Elsie and HenryHillman joined by Honorary Celebrity Chairs Kit and ArnoldPalmer. Event co-chairs are Sandra and Thomas Usher andSharon and James Rohr. Daniel Rooney is the inauguralPittsburgh-Ireland Ambassador.

Hillman Cancer Center is the flagship facility of the UPMC CancerCenters’ clinical care network and home to the research activi-ties of the University of Pittsburgh Cancer Institute.

Since opening in 2002, the Hillman Cancer Center has becomethe region’s preeminent provider of care and research. Morethan 85 new medical and research physicians have beenrecruited to the region, leading innovative treatment approachesfor a wide variety of cancers including leukemia and lymphoma,a better understanding of DNA repair, a search for new virusesthat contribute to the cause of certain cancers, development ofinnovative approaches to cancer prevention and early diagnosis,molecularly targeted drugs, and of therapeutic cancer vaccinesand other biological approaches to treatment. Funds raised willsupport these and other programs.

For more information about sponsorship opportunities or to purchase tickets, contact the UPMC Cancer Centers/University of Pittsburgh Cancer Institute DevelopmentDepartment at 412-623-4777.

Seasons of Hope:

The Pittsburgh Wine Festival will be heldWednesday, May 3, through Saturday, May 6, 2006. Another sell-out crowd isexpected for the May 4 VIP and GrandTasting at Heinz Field and other events, allbenefiting the University of PittsburghCancer Institute. This year’s Festival willexpand to a wider audience with the inclu-sion of wine, food, and culture-relatedevents and seminars.

Also new this year are private wine dinners,to be held in the homes of prominent com-munity leaders, including Barbara Barry,Peter Karlovich and Steve Herforth,Triciaand Bill Kassling, Laura and Claude Kronk, Kevin McClatchy, Peggy and JackOffenbach, Teri and Damian Soffer, andothers. Each dinner will feature a stellarvintner together with their chef for an out-standing evening of fine wine and culinaryexcellence.

Sponsors include Comcast, PennsylvaniaLiquor Control Board, PNC, UPMC andothers. For more information about partici-pation in the private dinners, please contactthe UPMC Cancer Centers and Universityof Pittsburgh Cancer Institute DevelopmentDepartment at 412-623-4700. Or visitwww.pittsburghwinefestival.com for furtherinformation about the 2006 PittsburghWine Festival.

Uncork a fine opportunity —THE PIT TSBURGH WINE FEST IVAL

A F U T U R E W I T H O U T C A N C E R

Gala event takes center stage in May 2006

A preview party for the 2006 gala was held in October2005 at the Jay Verno Studios. Gala sponsors andmembers of the Circle of Hope — donors who havemade contributions of $10,000 or more in a calendaryear — were updated on accomplishments made inpatient care and research at the Hillman Cancer Center.Details about the May 3, 2006 event, Seasons of Hope,were also announced. Honorary Chairs Elsie andHenry Hillman (above with Ronald Herberman, MD)introduced the 2006 event co-chairs Sandra andThomas Usher and Sharon and James Rohr (above left,Sharon Rohr not pictured).


and carboplatin, a standard, approved chemotherapy.The trial seeks to determine if the combinationtherapy shrinks tumors in women with recurrentovarian cancer.

TELCYTA is activated by GST P1-1, an enzymefound in increased quantities in cancer cells, andtargets tumors that over-express this enzyme.Scientists believe GST P1-1 plays an important rolein the development of resistance to commonly usedchemotherapeutic drugs.

Women who enroll in the study will be randomizedto receive either the combination of TELCYTA andcarboplatin or Doxil®, a standard-of-care therapy forrecurrent ovarian cancer.

Fund for Patients In Need Established

UPMC Cancer Centers has established a fund tohelp cancer patients overcome financial barriers to completing their treatment by providing partial,short-term assistance with health care-related costs.The Patient Assistance Fund is designed to help eligible patients with costs such as transportation,medical equipment, nutrition, prosthetic devices,and lodging for themselves or family members.According to medical oncologist Barry C.Lembersky, MD, many patients receiving cancertreatment experience a substantial loss ofincome due the impact of both the diseaseand the therapy, creating an undue burdenon those already in financial need.Some of these patients may makedecisions to forego their treatment,with dire consequences for survivaland quality of life. Contact the UPCI Development Department at 412-623-4700 for more information about the fund.

Cancer Centers NetworkContinues to Expand

UPMC Cancer Centers opened two new radiationoncology facilities in late 2005 — the RadiationOncology Center at Jefferson Regional MedicalCenter, a program of Jefferson Regional MedicalCenter and UPMC Cancer Centers, located south ofPittsburgh on the Route 51 corridor, and UPMC/Jameson Cancer Center in New Castle. In addition,UPMC Cancer Center at UPMC Northwest in VenangoCounty joined the network, offering both medical andradiation oncology services at this hospital-basedlocation. Through the UPMC Cancer Centers network,patients have convenient access to cutting-edge ther-apies and technologies, as well as support servicesat 46 locations throughout western Pennsylvania andadjacent areas of Ohio and West Virginia.

Rendell Visits Hillman Cancer Center

Governor Edward G. Rendell visited the HillmanCancer Center to learn about advances in transla-tional research and patient care at UPMC CancerCenters and the University of Pittsburgh CancerInstitute. After touring laboratory facilities and treat-ment areas, Governor Rendell met with clinical and research leadership to discuss the impact on cancer research and economic development of Pennsylvania’s tobacco Master SettlementAgreement funding. These funds are used to recruitnew, high quality faculty and to support the initiationof a variety of research programs that are vital toimproving cancer prevention, diagnosis, and treatment activities.

Protein May Inhibit Head andNeck Tumor Growth

A protein associated with the growth of head andneck tumors may be a tumor suppressor that couldprevent the spread of cancer when it is expressedabove normal levels, according to a study publishedin the Feb. 1 issue of the Journal of the NationalCancer Institute (JNCI).

The study, led by Jennifer Grandis, MD, director,Head and Neck Cancer Program, University ofPittsburgh Cancer Institute, and professor of otolaryngology and pharmacology, University ofPittsburgh School of Medicine, is the first to showthat the expression of a protein called STAT1 mayplay a vital role in preventing head and neck tumorgrowth. STAT1 belongs to a family of proteins called signal transducers and activators of transcrip-tion that have been linked to tumor progression inmany cancers.

Dr. Grandis and colleagues compared the expres-sion of STAT1 in squamous cell carcinoma of thehead and neck tumors to its expression in normaltissue samples. They found that STAT1 wasexpressed in lower levels in the tumor cells than inthe normal cells. Upon chemically altering theexpression of STAT1 to increase its levels, thecancer cells diminished and died.

Magee-Womens HospitalLaunches Ovarian Cancer Clinical Trial

Magee-Womens Hospital has announced its participation in a research study evaluating a newcombination therapy for women with recurrentovarian cancer. The trial, referred to as ASSIST-3(Assessment of Survival in Solid Tumors 3), is aphase III clinical trial consisting of a combination ofTELCYTA (TLK286), a new type of chemotherapy,

N E W S B R I E F S

A publication of UPMC Cancer Centers and

the University of Pittsburgh Cancer Institute

UPMC Cancer Pavilion

5150 Centre Ave.

Pittsburgh, PA 15232

1-800-533-UPMC (8762)

www.UPMCCancerCenters.com



UPMC Cancer Centers offers cancer patients

exceptional care and innovative treatments

close to home. Working in tandem with the

University of Pittsburgh Cancer Institute,

western Pennsylvania’s only National Cancer

Institute-designated Comprehensive Cancer

Center, UPMC Cancer Centers provides the

latest advances in cancer prevention, detection,

diagnosis, and treatment at community-based

locations throughout the region. The University

of Pittsburgh Cancer Institute comprises the

academic and research activities for cancer at

the University of Pittsburgh and the University

of Pittsburgh Medical Center.

For information about supporting

cancer research efforts and patient

care at the University of Pittsburgh

Cancer Institute and UPMC Cancer

Centers, contact us at 412-623-4700.

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