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COVER
STORY - March
2001 by Richard Adkins Making Strides
Against Cancer
However, as we find ourselves gazing in awe at the many miraculous advances being made in modern medicine and science at the beginning of the twenty-first century, more Kentuckians than ever before are now finding out that a medical diagnosis of cancer is not at all the irrevocable death sentence it normally has been for patients in years before. Treatments for certain types of cancers such as breast, prostate, melanoma, and other types of skin cancers have made quantum leaps forward in early detection and other effective programs over the past 30 years. New advances in pharmaceuticals, chemotherapy and radiation treatments have also significantly increased the odds for patients suffering from these cancers more in favor of a full recovery and have resulted in ever higher survival rates for other common cancers such as lung, bone and colorectal (colon, stomach and gastrointestinal) cancers. A host of well-funded, expertly staffed, and well-equipped cancer care and treatment centers located across Kentucky are today providing the absolute best medical care presently available for patients suffering with cancer, comparable to such stellar and world-renowned institutions as the M.D. Anderson Cancer Center in Houston and Duke University’s vaunted Cancer Treatment Program in Durham, N.C. William J. John, oncologist and former assistant director of the Markey Cancer Center, researches and develops drugs for Eli Lilly Co. He says Kentucky’s facilities – if not the health of its populace – are up to par. “Quite frankly, cancer care in the state of Kentucky is state of the art,” he says. “There is very little that is not available, and the people who provide the care are knowledgeable and experienced. There remains a problem of access to the remote areas of the state, but improvements in that area have been seen with regional cancer centers and university-supported regional clinics.” Kentucky currently has the third highest cancer mortality rate in the nation, according to the U.S. Centers for Disease Control and Prevention (CDC). And the state is number one in the nation for per capita incidences of lung cancer – a fact generally attributed to heavy cigarette smoking throughout the region. Kentucky earns its third-place overall cancer mortality ranking by reporting 192 cases per 100,000 residents. The state ranks first in lung cancers, with 68.1 cases per 100,000 residents; fifth in colorectal cancers, with 19.8 cases per 100,000 residents; and third in cervical cancer with 10.8 cases per 100,000 residents. UK
Markey Cancer Center
In the course of sharing this dream with Lucille P. Markey, grand matriarch of horse racing’s storied Calumet Farm, Dr. Roach’s enthusiasm for the project was so contagious that Mrs. Markey not only agreed to help, but also made a commitment to match any funds he would raise from other sources. Unfortunately, Mrs. Markey did not live to see this “jewel” of her creation materialize. However, the Lucille P. Markey Charitable Trust, which she established upon her death, continued the spirit of her matching fund campaign, ultimately helping construct three buildings, funding an endowed chair and a major research program development grant, and providing seed monies to support the UK Women’s Cancer Facility. “There are only four or five cancer centers built with private money in the U.S. and the Markey Cancer Center is one of them,” said John Leshney, director of development at the Center. In September, the Center welcomed a new director, Dr. Alfred M. Cohen, direct from a previous post at the renowned Memorial Sloan Kettering Cancer Center, where he served as chief of the colorectal service in the Department of Surgery and the director of the Colorectal Cancer Disease Management Team. But he plans to continue emphasizing treatment and research for breast, gynecological, lung and prostate cancers as well as colorectal cancer. “We need to make a difference for many Kentuckians by emphasizing the most common problems,” Cohen said on his arrival last fall. “We need to continue to ensure that if Kentuckians come to Lexington or one of our satellite facilities they will receive the best and most current treatment possible. I believe that UK is in a unique position to improve the health care of an area of the country that is medically underserved.” In August, prior to Cohen’s arrival, the UK Chandler Medical Center announced that the CDC had approved a UK Markey Cancer Center grant proposal for funding to establish the Kentucky Prevention Research Center (PRC). This prestigious grant will award UK Markey Cancer Center about $1.8 million over three years, pending final approval from the CDC. In addition, The UK Markey Cancer Center was also ranked 18th overall nationally in cancer care in the 2000 edition of “America’s Best Hospitals” by U.S. News & World Report. The Kentucky PRC will conduct extensive research designed to reduce cancer incidence and mortality rates in central Appalachia through prevention and early detection efforts. Researchers at the Center will concentrate their work on cervical, colorectal and lung cancers and will focus their efforts in East Kentucky, West Virginia, western Virginia and eastern Tennessee. Dr. Stephen Wyatt, who will be principal investigator for the center, said that unlike research programs that seek to quantify problems, the new center will seek to develop more practical programs to reduce or prevent cancer in its targeted study areas. “It gives us the infrastructure to really start addressing a lot of key questions about cancer in Eastern Kentucky and central Appalachia,’’ said Wyatt, Markey’s associate director for cancer control. “And it puts us in company with some of the country’s elite institutions such as Harvard, Yale, and Johns Hopkins.’’ The idea for the center began more than two years ago, at a meeting between Wyatt and then newly elected U.S. Representative, Dr. Ernie Fletcher, a UK Medical School alumnus. Spurred on by Wyatt, Fletcher said he was able, through a bipartisan effort, to secure funding from the CDC for Kentucky. “If we can send men to the moon, we should be able to find a cure for cancer,’’ said Fletcher, whose 73-year-old mother is a cancer survivor. The UK Markey Cancer Center’s primary goals during the next three years are to begin in-depth studies to attempt to better understand the cancer problem and risk factors in central Appalachia; design, implement and evaluate intervention strategies; link the research to public health and clinical practice; and provide cancer prevention and control research training opportunities to clinicians and scientists throughout central Appalachia. The CDC currently is funding similar PRCs at 23 other institutions, including University of Michigan, University of North Carolina at Chapel Hill, University of California at Los Angeles, Harvard University, Yale University, and The Johns Hopkins University. Research at the PRCs is focused on behaviors that are linked to chronic diseases, such as diabetes, cardiovascular disease and oral health disease, with each Center having a specialty focus. The Kentucky PRC will be the only PRC in the nation with a focus solely on cancer. According to the CDC, researchers at PRCs also are very competitive for other research grants, obtaining about $500,000 to $1 million in research grants each year in addition to the core funding grant. “Grants such as these, which expand the UK Chandler Medical Center research base and enhance its national reputation, are key to the Medical Center’s goal of becoming a top-20 academic health center,” said James W. Holsinger Jr., M.D., Ph.D., chancellor of the UK Chandler Medical Center. “The Kentucky Prevention Research Center will further strengthen UK Markey Cancer Center’s Cancer Control Program and help central Appalachian residents and health care providers understand and address the barriers to cancer prevention and early detection,” added Dr. Wyatt. The first CDC-sponsored PRC was approved at the University of Texas in 1986 and the last new centers were added two years ago. Each facility has a distinct research theme – for example, the closest one to the Kentucky PRC at the University of West Virginia in Morgantown, West Virginia, fights heart disease and diabetes. Dr. James Marks, director of the CDC’s National Center for Chronic Disease and Health Promotion in Atlanta, said the creation of UK’s new School of Public Health was a key factor in helping the university land the prevention center. The center, along with others around the country, will seek ways of improving health in poor, rural or under-served areas. “The idea is to translate research from the ivory towers to the populations in greatest need,’’ Marks said. “We like to say that it’s moving medicine from the bench to the trench.” “These prevention research centers are hotly sought after, and not everybody who applies gets one. Getting this one is a real coup for Kentucky, and it’s a real plus for a new school of public health to have something like this,” added Dr. Marks. UK’s Wyatt said that the center’s first efforts would be devoted to programs to reduce lung cancer by lowering Kentucky’s smoking rate, which is the highest in the nation for both adults and teens. Other programs might look at ways to get people to eat more wisely and exercise more, which can reduce risks for certain cancers, and to be screened regularly for cancers that can be treated successfully if caught early. “We know that a fatty diet affects colorectal cancers,’’ said Wyatt. “What we don’t know is how to really change people’s eating patterns. So, we might look at various interventions, perhaps working with the Cooperative Extension Service, 4-H or other groups, to test interventions and see what works,’’ he added. According to CDC’s Marks, similar research by other prevention centers has produced measurable results. The Texas center developed a program for promoting exercise and healthy diets in elementary school students that has been adopted by several hundred schools there, he said. With the PRC funding now in place for UK’s Markey Cancer Center, the future looks much brighter than ever before when it comes to high-risk lifestyle factor awareness, treatment and cancer prevention programs for all Kentuckians and our immediate neighbors. The
Leonard Lawson Cancer Center “The Leonard Lawson Cancer Center offers each patient an individualized, aggressive treatment program through radiation therapy, chemotherapy, pain management and other group and family support therapies,” said Penny Stratton, outreach manager for PMH. “The additional services of hospitalization, surgery, pathology, diagnostic radiology, CT scan, MRI, ultrasound, nuclear medicine and pharmacy services are also available and are easily accessible to all who suffer from this terrible disease.” In order to provide such a full range of comprehensive physician and hospital services, the Center was originally built adjacent to the old Pikeville Methodist Hospital, but is now completely housed within the brand new PMH Tower – an 11-story, state-of-the-art medical center which just opened in December of last year at a cost of more than $75 million. PMH originally built the Leonard Lawson Cancer Center to provide residents of the otherwise isolated, mountainous area with sophisticated cancer treatment methods and a full line of support services in one convenient location. Initial funding for the center began with a generous gift from highway and road contracting magnate Leonard Lawson, president and founder of Mountain Enterprises, Inc. of Pikeville, who is also a cancer survivor. “Because cancer is such a complex disease, our philosophy is that each patient will go through a variety of diagnostic procedures before, during and after treatment. All diagnostic procedures that are ordered during treatment will be coordinated by the Cancer Care Center staff so that the patient may receive minimal disruption of treatment,” said Stratton. Cancer diagnostic services of surgery, pathology, diagnostic radiology, CT scans, ultrasound, nuclear medicine and laboratory tests all can be performed at the center, with the medical staff knowing of each other’s various testing results within precious moments. The Leonard Lawson Cancer Center also provides places for the physician specialists involved in the patient’s care to meet with the patient and patient’s family to discuss and plan the most effective course of treatment options. A state-of-the-art, 3-D treatment computer provides the most up-to-date technology and information available. Radiation Oncology is provided through a new Siemens Mevatron Linear Accelerator. This radiation device is used to treat both deep-seated and surface cancers with minimal exposure to surrounding tissue. A radiation simulator is also used in determining the exact location of the tumor and to help plan treatment. This process is extremely important in determining the amount of radiation to be given and in protecting surrounding tissue and organs from excess radiation. The Center’s Linear Accelerator is operated by a Board Certified Radiation Oncologist, R.S. Modur, M.D. Dr. Modur specializes in the treatment of cancer through radiation therapies. Dr. Modur was appointed to the Governor’s Task Force for Breast Cancer three years ago by Gov. Paul Patton, a Pikeville native. A subcommittee of the task force was established in 2000 for the standardization of treatment for breast cancer throughout Kentucky. Pikeville Methodist Hospital and the Leonard Lawson Center were also chosen as one of eight medical centers to be pilot sites for these standardized treatments. Chemotherapy and cutting-edge medical oncology treatments are also available at the Center. Vijaya Puram, M.D. is a Board Certified Oncologist/ Hematologist and Tamara Musgrave, M.D. is a Board Certified Oncologist/ Infectious Disease Specialist – one of only eleven so-designated to specialize in both disciplines in the entire nation. Pain management is also given a great deal of emphasis as part of the Center’s individualized approach to cancer treatment. The entire medical and administrative staff has made a commitment to their patients that they should not have to suffer unnecessarily from their often horribly painful disease. Leon Briggs, M.D., has been board certified in pain management at some of the nation’s leading medical institutions and is in charge of pain management and related therapies for the Center. The Center has also been approved through the National Surgical Adjuvant Breast and Bowel Project and Cancer Trial Support Unit (a service of the National Cancer Institute) to conduct clinical trials for cancer patients who meet certain criteria. Through these and other clinical trials, patients there will receive either a new, experimental treatment or drug being tested or the best available standard treatment for their specific cancer. The Center also focuses on giving cancer patients the one vital element that is crucial to their recovery and that money alone just cannot buy – hope. James
Graham Brown Cancer Center
Through such services, rapid test results and drug information are obtained from well-trained pharmacists and technicians. Registered dietitians help patients maintain a nutritional diet and proper meal/medication schedules. Rehabilitation Services assist patients with pain management and provide physical therapy. The Quality of Life Coordinator provides wigs, breast prostheses, financial assistance/counseling and referrals to community programs. Chaplains provide a nurturing environment and emotional encouragement for patients and families, and the quality of life coordinator leads regular support group meetings. Cancer patient care is enhanced through these comprehensive support services at every stage of cancer treatment. The Brown Center has also made groundbreaking inroads into cancer diagnosis through extensive use of Positron Emission Tomography (PET) technology. The PET is an advanced molecular imaging procedure that measures chemical changes that occur before visible signs of disease are present on traditional MRI or CT scans. The use of the PET can significantly reduce the time for diagnosis and eliminate the need for costly redundant testing or invasive surgical procedures. “The PET is an effective tool in examining the entire body for disease in a single procedure which will improve the treatment of patients with many different cancers, cardiac diseases and neurological disorders,” said Dr. Elliott Turbiner, U of L’s Chief of Nuclear Medicine. U of L Health Care and Louisville’s Jewish Hospital share the PET services provided by Mobile PET Systems, Inc., alternating the scheduled number of days each week. Another highly visible affiliate of U of L’s Brown Center which receives regular national attention is The Institute for Cellular Therapeutics, established in 1996. The department is headed by Suzanne T. Ildstad, M.D., a U of L Professor of Surgery and one of the nation’s best-recognized leaders in the growing field of cellular therapeutics. She is also lauded as a pioneer in the expanded use of bone marrow transplantation to fight various diseases. Dr. Ildstad’s seminal accomplishment to date has been the discovery of the “facilitating cell” which helps bone marrow transplants take hold in a recipient’s body. Five FDA approved Phase I clinical trials are currently underway at the Institute for the treatment of: leukemia, induction of tolerance for solid organ transplants (two trials), severe aplastic anemia, and sickle cell disease. “With the current challenges faced in today’s health care environment, it is clear that the correct balance of the basic sciences and clinical research is essential to swiftly transition the discoveries made in the laboratory into the clinical setting,” said Dr. Ildstad. “Our clinical focus will develop therapeutic approaches to allow for the successful and safe use of bone marrow transplantation for the treatment of a number of disease processes,” said Dr. Illdstad. “The implementation of this therapy will have a significant impact on patients afflicted with life-threatening diseases such as leukemia, autoimmune disorders, rejection of solid organs following transplantation, red blood cell diseases, enzyme deficiencies and AIDS,” she added. Cutting-edge scientific techniques, understanding and the nurturing of faith, uniting body and spirit. This is truly what practicing medicine is all about. And it is a major reason why one doesn’t have to talk long to a patient at any of the quality cancer care treatment centers across Kentucky without hearing one of them say, “There is always hope. Cancer is no longer a signed, sealed and delivered death sentence.”
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Copyright 1996-2001, by Kentucky Business Online. All rights reserved. Editorial
content is copyright 2001, Lane Communications Group The Lane Report is a trademark of Lane Communications Group. All other trademarks are the property of their respective owners. |
Psychologists and
researchers confirm that it’s almost everyone’s
worst nightmare and one of our biggest, nagging fears,
living as we do in a modern industrialized world
seemingly overflowing with all sorts of carcinogenic
substances at every turn – in our water, our air,
our homes, and even in the foods we consume. It’s
the inherent and paralyzing fear of the dreaded “C
word,” cancer. 
Based on the early
success of the McDowell Network, and with the
encouragement and leadership of Dr. Ben Roach, M.D., one
of the founding directors of the Network, the vision of
the organization quickly expanded to include the elements
of cancer research and treatment. Dr. Roach was joined by
a number of notable community leaders in 1978 to
establish a private, non-profit foundation, the McDowell
Cancer Foundation, for the purpose of raising funds to
construct and support a state-of-the-art cancer research
and treatment facility at the UK Chandler Medical Center.
The Leonard Lawson
Cancer Center officially opened in Pikeville Methodist
Hospital in 1996 and was built to provide east Kentucky
cancer patients with top-notch cancer care in an
environment that caters to the cancer patient’s
individual and special needs without having to endure the
two-hour-plus drive to Lexington, Louisville or
Cincinnati.
In addition to a
dedicated, interdisciplinary cancer team, a variety of
support services are also available to ensure that
patients’ medical, physical, emotional and spiritual
needs are met. The Mint Jubilee Cancer Resource Center
provides the peaceful, relaxed environment that is
essential to any cancer patient’s recovery. Staffed
by a full-time Quality of Life Coordinator, the resource
center offers a wealth of literature to educate patients
and their families.