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UCSD<br />

<strong>Cancer</strong><br />

<strong>Center</strong> News<br />

An NCI-Designated <strong>Cancer</strong> <strong>Center</strong><br />

UNIVERSITY OF CALIFORNIA, SAN DIEGO<br />

GENETIC RISK<br />

<strong>FORCANCER</strong><br />

is a Family Matter<br />

Our Clinical <strong>Cancer</strong><br />

Genetics Unit<br />

provides the<br />

counseling, testing<br />

and ongoing support<br />

that helps families<br />

navigate through<br />

troubled waters.<br />

... STORY PAGE 4<br />

SPRING 2001


UCSD <strong>Cancer</strong> <strong>Center</strong> Foundation<br />

PRESIDENT OF THE FOUNDATION BOARD<br />

Frank M. Goldberg*<br />

VICE PRESIDENTS<br />

William T. Comer, Ph.D.*<br />

Howard Goldfeder*<br />

Andre R. Horn*<br />

Jerome S. Katzin, Esq.*<br />

Louis H. Knierim*<br />

Cinda K. Lucas*<br />

BOARD OF DIRECTORS<br />

J. Samuel Armstrong, IV<br />

Terry Ash<br />

Kathryn A. Bernert, Esq.<br />

Howard C. Birndorf<br />

Thomas A. Bologna<br />

Deborah J. Case<br />

Michael J. Changaris, Esq.<br />

Lois Crandell<br />

Jay de Groot<br />

Charles Faith<br />

Lee Goldberg<br />

Charles F. Gorder, Sr., Esq.*<br />

Donald W. Grimm<br />

Bruce R. Hazard<br />

Ernest Huang, Ph.D.<br />

Peter L. Jensen<br />

Jacqueline Johnson, Ph.D.<br />

Peter Johnson<br />

Maurice C. Kaplan, Esq.*<br />

Richard Levi<br />

George Liggins, M.P.H., Ph.D.<br />

Art Lujan<br />

Al Hugo-Martinez<br />

Joany Mosher<br />

Henry L. Nordhoff<br />

Tina Nova, Ph.D.<br />

Carrie M. O’Brien*<br />

Anne S. Otterson<br />

John W. Otterson, II<br />

Cynthia Polak*<br />

Kenneth D. Polin, Esq.<br />

Peter Preuss<br />

David E. Robinson<br />

Lawrence B. Robinson, Esq.<br />

Scott Cameron Smith<br />

Mary Rand Taylor<br />

John Walton<br />

Robert M. Wood, D.V.M., M.P.H.<br />

EX OFFICIO MEMBERS<br />

Osborne L. Bethea, Jr.<br />

Stephen E. Blank<br />

Robert C. Dynes, Ph.D.<br />

Edward W. Holmes, M.D.<br />

Dolores Landa<br />

Diana Lombrozo<br />

George S. Peck, Jr.<br />

ADVISORY BOARD<br />

John R. Bonn, Esq.<br />

Diane Clarke<br />

Audrey Geisel<br />

George L. Gildred<br />

Joseph W. Hibben<br />

Irwin Jacobs, Ph.D.<br />

Marianne McDonald, Ph.D.<br />

John H. Moxley, III, M.D.<br />

C. D. Pruett<br />

Ruth L. Schulman<br />

Walter Zable<br />

DIRECTOR,<br />

UCSD CANCER CENTER<br />

David Tarin, M.D., Ph.D.*<br />

DEPUTY DIRECTOR,<br />

CLINICAL OPERATIONS<br />

David W. Easter, M.D.<br />

DEPUTY DIRECTOR,<br />

RESEARCH OPERATIONS<br />

Thomas J. Kipps, M.D., Ph.D.<br />

DIRECTOR OF DEVELOPMENT<br />

T. Peter Anderson<br />

ASSOCIATE DIRECTOR OF<br />

DEVELOPMENT<br />

Geoffrey C. Graham<br />

ASSISTANT DIRECTOR OF<br />

DEVELOPMENT<br />

Cheryl D. Coate<br />

DEVELOPMENT ASSISTANT<br />

Maryann Lapthorn<br />

* Officers and Members of the<br />

Executive Committee<br />

UCSD <strong>Cancer</strong> <strong>Center</strong> News is a quarterly publication of the<br />

UCSD <strong>Cancer</strong> <strong>Center</strong> Foundation. Comments are welcome.<br />

UCSD <strong>Cancer</strong> <strong>Center</strong> Foundation<br />

9500 Gilman Drive #0658<br />

La Jolla, CA 92093-0658<br />

(858) 822-0022<br />

Executive Editor: T. Peter Anderson • Editor: Nancy Stringer<br />

Contributing Writers: T. Peter Anderson, Geoffrey C. Graham,<br />

Nancy Stringer<br />

Message<br />

from the<br />

Director<br />

Statistics now tell us that<br />

cancer will strike one of<br />

every three people at some<br />

point during their lifetime.<br />

This disease, either through a<br />

sporadic occurrence or because of an inherited susceptibility,<br />

will touch nearly every family.<br />

It is our commitment at UCSD <strong>Cancer</strong> <strong>Center</strong> to provide you<br />

the most advanced and compassionate care should cancer<br />

occur in your family.<br />

In addition, our <strong>Cancer</strong> <strong>Center</strong> is dedicated to preventing<br />

cancer whenever possible, reducing cancer risk through<br />

education and behavior modification, and improving the<br />

outcome of treatment through early detection. To this end,<br />

we have developed a number of innovative and successful<br />

programs.<br />

For example, the California Smokers Helpline — a free,<br />

telephone-based smoking cessation service — was developed<br />

by the <strong>Cancer</strong> <strong>Center</strong> in 1990 and has since grown to become<br />

a statewide service that has assisted more than 100,000 callers<br />

to quit. Based upon our success, other states have established<br />

similar programs. We also have developed cancer education<br />

programs promoting early detection in our local African-<br />

American, Pan-Asian and Hispanic communities, and have<br />

adapted these educational programs for the deaf and hearingimpaired<br />

community. As with the Smokers Helpline, these<br />

efforts have captured the attention of health educators<br />

throughout the nation and, in some cases, have provided the<br />

foundation for similar programs in other states.<br />

An important part of our commitment to cancer prevention<br />

and early detection is genetic counseling and testing. Our<br />

Clinical <strong>Cancer</strong> Genetics Unit is the subject of this issue’s<br />

cover story. I hope you’ll take a moment to read about this<br />

service, which is so important to patients dealing with the<br />

possibility of carrying a gene that could affect loved ones in<br />

their family.<br />

The service, under the direction of Dr. Linda Wasserman, is<br />

an outstanding example of the <strong>Cancer</strong> <strong>Center</strong>’s “interactive”<br />

approach to providing quality care.<br />

UCSD <strong>Cancer</strong> <strong>Center</strong> News<br />

2


In this team, genetics physicians and<br />

counselors partner with cancer prevention<br />

and risk-reduction specialists, and<br />

with genetics researchers who study heritable<br />

risk factors for cancer at the molecular<br />

level and molecular pathologists<br />

who are teasing out the most basic steps<br />

that cause inheritable disease. All of this<br />

knowledge, gleaned from different disciplines<br />

— medicine, psychology, epidemiology,<br />

biology, pathology, and others<br />

— is brought together for the benefit<br />

of patients. The aim is to provide outstanding,<br />

scientifically validated clinical<br />

care coupled with human compassion<br />

and understanding.<br />

Interactivity is a<br />

common thread<br />

running throughout<br />

the many and varied<br />

programs of the<br />

<strong>Cancer</strong> <strong>Center</strong>.<br />

Often, we invite scientists<br />

from other<br />

institutions to visit<br />

for up to a year and<br />

share their expertise with us. In the year<br />

2000, for example, we hosted distinguished<br />

visiting professors from leading<br />

academic institutions in Australia, Chile,<br />

Greece, Italy, Japan, Korea and Spain.<br />

”All of this knowledge,<br />

gleaned from different<br />

disciplines, is brought<br />

together for the benefit<br />

of patients.”<br />

Our newest Distinguished Visiting<br />

Professor is Dr. Eiichi Tahara, Professor<br />

of Pathology, Emeritus, of Hiroshima<br />

University. Dr. Tahara is one of Japan’s<br />

most respected figures in cancer research<br />

and is internationally known for his scientific<br />

contributions to the field, particularly<br />

in the area of gastro-intestinal<br />

cancers. He will collaborate with many<br />

of our senior investigators and will mentor<br />

our younger members.<br />

This kind of interaction provides a rich<br />

experience for the visitor and the member,<br />

bringing new thinking, new insights<br />

and new methods to both sides.<br />

This issue of UCSD <strong>Cancer</strong> <strong>Center</strong> News<br />

is brimming with articles that I believe<br />

you will find interesting and informative.<br />

For example, Dr. Richard Boland has<br />

discovered a strong link between a common<br />

human virus and colorectal cancer,<br />

which he believes may be responsible for<br />

a large percentage of non-hereditary<br />

colon cancer. And Dr. Asad Bashey is<br />

studying a type of blood stem-cell transplant<br />

as a treatment for kidney cancer.<br />

This holds potential as an important<br />

advance as there are few treatment<br />

options available for patients with this<br />

type of cancer. You will also want to read<br />

about ductal lavage, a new procedure<br />

that can detect pre-malignant and<br />

malignant breast cells<br />

long before they<br />

become visible<br />

tumors. This service is<br />

being offered to<br />

women at high risk<br />

for developing breast<br />

cancer through our<br />

Breast Care Unit,<br />

directed by Dr. Anne<br />

Wallace.<br />

In another bit of good news, I’m delighted<br />

to report that we have recruited a<br />

new Associate Director for<br />

Administration. Ira Goodman joins us<br />

May 1 from the Kaplan Comprehensive<br />

<strong>Cancer</strong> <strong>Center</strong> of New York University<br />

where he served as Associate Director for<br />

Administration for 17 years. This is a<br />

position of key importance to UCSD<br />

<strong>Cancer</strong> <strong>Center</strong>, and Ira brings a depth<br />

and breadth of experience that will be an<br />

enormous benefit to our <strong>Center</strong>. We<br />

welcome him with enthusiasm.<br />

I hope you enjoy this issue of UCSD<br />

<strong>Cancer</strong> <strong>Center</strong> News. I look forward to<br />

the opportunity each quarter to bring<br />

you good news about the <strong>Cancer</strong> <strong>Center</strong>.<br />

David Tarin, M.D., Ph.D.<br />

Director, UCSD <strong>Cancer</strong> <strong>Center</strong><br />

IN THIS ISSUE<br />

Clinical <strong>Cancer</strong><br />

Genetics<br />

4<br />

Viral Link<br />

to Colon <strong>Cancer</strong><br />

6<br />

New Hope<br />

for Kidney <strong>Cancer</strong><br />

8<br />

Early Warning<br />

for Breast <strong>Cancer</strong><br />

9<br />

‘Haute Event’<br />

10<br />

Philanthropy Notebook<br />

Back Page<br />

3<br />

UCSD <strong>Cancer</strong> <strong>Center</strong> News


GENETIC TESTING<br />

Is it right for you?<br />

<strong>Cancer</strong> Genetics Service Now Available<br />

<strong>Cancer</strong> touches almost<br />

every family. It’s not<br />

unusual to know of a<br />

parent, grandparent, aunt<br />

or uncle who has cancer. But when<br />

several family members are affected, it<br />

may indicate a hereditary susceptibility<br />

to cancer.<br />

While only a small percentage of<br />

cancers are associated with an inherited<br />

genetic mutation, people with<br />

these mutations can have a lifetime<br />

risk of developing cancer that is<br />

significantly higher than that of the<br />

general population.<br />

For example, a woman’s average lifetime<br />

risk of developing breast cancer<br />

is 12 percent. If she carries a mutation<br />

in one of the currently known breast<br />

cancer genes — BRCA1 or BRCA2 —<br />

her lifetime risk may be as high as 85<br />

percent. Mutations in these genes also<br />

confer an increased risk for ovarian<br />

cancer. Average lifetime risk for ovarian<br />

cancer is 1.4 percent in the general<br />

population, but may be as high as 15<br />

to 40 percent in women with changes<br />

in BRCA1 or 2. Alterations in the<br />

breast cancer genes are also associated<br />

with a somewhat increased risk for<br />

colon and pancreatic cancer in men<br />

and women, and an increased risk of<br />

prostate cancer and breast cancer in<br />

men. Not all people with changes in<br />

these genes go on to develop cancer,<br />

however.<br />

Knowledge is Key<br />

“Genetic counseling and testing may<br />

provide important information to<br />

people with a family history of cancer<br />

who are concerned about<br />

their cancer risk,” said Linda<br />

Wasserman, M.D., Ph.D.,<br />

director of the <strong>Cancer</strong><br />

<strong>Center</strong>’s Clinical <strong>Cancer</strong><br />

Genetics Unit. “This kind<br />

of information affects the<br />

whole family and so we<br />

encourage that spouses,<br />

siblings and adult children<br />

be involved, if that<br />

fits with a particular<br />

family. Often, individuals<br />

considering genetic<br />

testing for themselves<br />

will wish to discuss<br />

the issues involved in<br />

testing with their<br />

family. When this is<br />

the case, involving<br />

everyone in the<br />

counseling process<br />

provides an<br />

opportunity for<br />

all to hear the<br />

same information and discuss the<br />

issues together. However, all patients<br />

are given the option of privacy.”<br />

Genetic privacy with regard to insurance<br />

companies and employers are a<br />

concern of many patients. Ways to<br />

safeguard privacy and confidentiality<br />

are carefully discussed with each<br />

patient.<br />

The Clinical <strong>Cancer</strong> Genetics Unit<br />

provides its counseling and assessment<br />

services at no charge. If a<br />

patient decides to proceed with genetic<br />

testing, the cost can vary from $500<br />

to $2700, depending on the particular<br />

genetic test. Many health plans now<br />

provide coverage for such testing.<br />

“Counseling is a critical component of<br />

genetic testing for cancer susceptibility,”<br />

said Eric Rosenthal, Ph.D., M.S.,<br />

the Clinical <strong>Cancer</strong> Genetics Unit<br />

genetic counselor. “Along with a careful<br />

review of the individual’s personal<br />

and family history of cancer, it is<br />

important to discuss the potential<br />

benefits and risks of genetic testing to<br />

determine if this information is going<br />

to be helpful to the individual.”<br />

For those who are concerned about<br />

their cancer risk, it is important to get<br />

as much information as possible<br />

UCSD <strong>Cancer</strong> <strong>Center</strong> News<br />

4


about their family tree and the exact kinds of cancers that<br />

have affected relatives.<br />

A <strong>Cancer</strong> History<br />

“Our assessments are most useful when we know the history<br />

of cancer in all the blood relatives. That includes parents,<br />

grandparents, siblings, children, grandchildren, aunts,<br />

uncles and cousins,” said Rosenthal. “We need to know<br />

what types of cancers family members had, and the ages at<br />

which they were diagnosed.” The team assesses this family<br />

history to help determine whether the history suggests a<br />

heritable risk, whether the types of cancers in affected family<br />

members is consistent with known syndromes for which<br />

genetic testing might be available, and the degree of cancer<br />

risk of unaffected family members. When genetic testing is<br />

appropriate, the team arranges for the testing. Based upon<br />

the test results, team members will develop an individualized<br />

risk management plan. The plan may include recommendations<br />

for:<br />

■ Monitoring or screening for early detection of cancer<br />

■ Prophylactic surgery<br />

■ Changes in diet and exercise<br />

■ Lifestyle modifications, such as ceasing smoking<br />

■ Clinical trials in cancer prevention<br />

For further information about the services of the Clinical<br />

<strong>Cancer</strong> Genetics Unit at UCSD <strong>Cancer</strong> <strong>Center</strong>, please call<br />

Eric Rosenthal at (858) 657-7066.<br />

Linda Wasserman, M.D., Ph.D.<br />

Dr. Wasserman, Assistant Professor of Clinical<br />

Medicine, is director of the <strong>Cancer</strong> <strong>Center</strong>’s Clinical<br />

<strong>Cancer</strong> Genetics Unit, and of the Molecular Genetics<br />

Laboratory in the Division of Medical Genetics. She<br />

also heads the DNA Sequencing and the Molecular<br />

Pathology Shared Resources; these are large laboratories<br />

that provide sophisticated technical services to<br />

researchers throughout the <strong>Cancer</strong> <strong>Center</strong>. Her own<br />

research focuses on the relationship between genetic<br />

differences in estrogen metabolism and breast cancer,<br />

and on the detection and quantification of circulating<br />

breast cancer cells in peripheral blood. She received her<br />

Ph.D. in psychology from UCLA and was a practicing psychologist for 15 years<br />

before attending medical school at UCSD. She did her residency in anatomic<br />

pathology at UCSD and a postdoctoral fellowship in molecular oncology, funded<br />

by the American <strong>Cancer</strong> Society, at the Ludwig Institute for <strong>Cancer</strong> Research.<br />

.Eric Rosenthal, Ph.D., M.S.<br />

Rosenthal recently joined the UCSD <strong>Cancer</strong> <strong>Center</strong> as<br />

a board certified genetic counselor in the Clinical<br />

<strong>Cancer</strong> Genetics Unit. Before coming to UCSD he provided<br />

genetic counseling for participants in a clinical<br />

genetics research program at the University of Utah.<br />

He is a graduate of a genetic counseling training<br />

program jointly directed by Johns Hopkins University<br />

and the National Human Genome Research Institute<br />

of the NIH. He received his Ph.D. in Cell and<br />

Developmental Biology from Harvard University and<br />

worked as a research biologist for nine years before<br />

becoming a genetic counselor. His current research<br />

interests involve issues of how individuals and families cope with genetic<br />

disorders and how health care providers can more effectively meet their needs.<br />

ARE YOU<br />

AT RISK?<br />

Family histories with one or<br />

more of the following features<br />

may suggest a hereditary cancer<br />

risk:<br />

■ <strong>Cancer</strong>s diagnosed at unusually<br />

young ages, such as breast<br />

cancer under age 40, or colorectal<br />

cancer under age 55<br />

■ Three or more affected individuals<br />

across two generations<br />

■ Individuals diagnosed with<br />

more than one primary cancer<br />

— additional cancers that are<br />

not a recurrence or metastasis<br />

of an earlier tumor<br />

■ Unusual cancers, such as<br />

breast cancer in a male<br />

5<br />

UCSD <strong>Cancer</strong> <strong>Center</strong> News


On the Trail<br />

of Colorectal <strong>Cancer</strong>…<br />

Is it possible that a common human virus could be<br />

responsible for causing colorectal cancer, the third leading<br />

cause of cancer deaths among both men and women?<br />

UCSD <strong>Cancer</strong> <strong>Center</strong><br />

researchers asked this<br />

question in 1994, launching<br />

a small but intense line of investigation<br />

that now may be paying off.<br />

The team, led by C. Richard Boland,<br />

M.D., Associate Director for Clinical<br />

Research, has made recent discoveries<br />

that point to the JC virus (JCV)<br />

as a possible culprit in a large percentage<br />

of cases.<br />

Antibodies to JCV can be found in<br />

80 to 90 percent of the population.<br />

In healthy people it is considered a<br />

harmless passenger.<br />

Boland’s team has found that JCV<br />

normally lives in the colon, but that<br />

it is found in far greater amounts in<br />

cancerous colon tissue than in normal<br />

colon tissue.<br />

“We know this JC virus character lives<br />

in the neighborhood, and that he and<br />

his friends are always found at the<br />

scene of the crime, but we haven’t yet<br />

proven that he’s the perpetrator.”<br />

“What we have at this point is a very suspicious smoking<br />

gun,” says Boland, a widely known and respected<br />

Richard Boland and lab manager, Jennifer Rhees review research data.<br />

authority in colorectal cancer. “We know this JC virus<br />

character lives in the neighborhood, and that he and his<br />

friends are always found at the scene of the crime, but<br />

we haven’t yet proven that he’s the perpetrator.”<br />

Closing In<br />

The team is closing in, however. In the laboratory,<br />

they have inserted the virus into normal colon cells<br />

and watched as it perverted the orderly workings of<br />

the cells.<br />

“This tells us that JC virus, while widely considered<br />

to be harmless, has the capacity in certain circumstances<br />

to disrupt the internal mechanisms of normal<br />

UCSD <strong>Cancer</strong> <strong>Center</strong> News<br />

6


colonic cells,” Boland said.<br />

Now, moving in even closer, they have discovered<br />

that JCV in cancer tissue has a<br />

rearranged DNA sequence not seen in JCV<br />

in normal tissue. The rearrangement<br />

involves the area called the promoter region,<br />

which is the “on-off” switch for the virus.<br />

This most recent finding may explain why<br />

the virus is able to live in the intestinal<br />

tract and not cause any harm most of the<br />

time, but cause serious harm under some<br />

circumstances.<br />

Super Sleuths<br />

“By doing some sophisticated manipulation,<br />

we were able to track the transforming gene<br />

taken from JC virus after inserting it into<br />

colon cells,” Boland said. “When this gene<br />

was introduced, these cells developed the<br />

kind of chromosomal damage that is seen in<br />

the majority of colorectal cancers.”<br />

The transforming gene from the virus<br />

makes a protein that can also cripple the<br />

cell’s normal ability to limit chromosomal<br />

instability, setting the stage for the aberrant<br />

cell to reproduce itself without the usual<br />

constraints. This is a hallmark of cancer.<br />

“So as this research continues, we are gradually<br />

building more evidence that this virus<br />

generates chromosomal instability that, over<br />

time, gives rise to colorectal cancer,” he said.<br />

Boland added that if their work proves the<br />

JC virus is important in the formation of<br />

colorectal cancer, it might be feasible to<br />

develop a vaccine against the virus, similar<br />

to vaccines for hepatitis B and polio.<br />

Boland’s work is being funded through a<br />

grant from the National <strong>Cancer</strong> Institute<br />

and UCSD <strong>Cancer</strong> <strong>Center</strong>.<br />

WHAT YOU SHOULD KNOW<br />

About<br />

Colorectal <strong>Cancer</strong><br />

E<br />

very year approximately 130,000 new cases of colorectal<br />

cancer are diagnosed in the United States, and more<br />

than 56,000 people die from the disease. While colorectal<br />

cancer is one of the most common types of cancer, it is also<br />

one of the most preventable and, if detected early, one of<br />

the most curable.<br />

“Screening is very important in curing this disease,” says<br />

Barbara Parker, M.D., director of UCSD <strong>Cancer</strong> <strong>Center</strong>’s<br />

specialized Gastrointestinal <strong>Cancer</strong>s Unit. “Thousands of lives<br />

could be saved each year if more people took advantage of<br />

available screening procedures.”<br />

Screening for people at average risk and without symptoms<br />

should begin at age 50 and include an annual fecal occult<br />

blood test, a simple procedure that checks a stool sample for<br />

hidden blood; an annual rectal examination by a health care<br />

provider; and every 5 to 10 years either a flexible sigmoidoscopy<br />

or a colonoscopy, both of which enable the physician<br />

to view the interior of the colon to look for and remove any<br />

precancerous growths that can eventually develop into cancer.<br />

Parker also encourages making lifestyle changes that may<br />

reduce risk of developing colon cancer. These changes include<br />

consuming a diet low in fat, and high in fiber, calcium, fruits<br />

and vegetables; participating in regular physical activity; and<br />

avoidance of cigarette smoking.<br />

Although two large studies have not shown a decreased risk<br />

in patients consuming a low-fat, high-fiber diet, many<br />

questions remain unanswered, particularly relating to the role<br />

of vegetables. Additionally, a low-fat, high-fiber diet may be<br />

beneficial for the prevention of other chronic diseases. The<br />

National <strong>Cancer</strong> Institute is currently studying certain drugs<br />

(inhibitors of cyclo-oxygenase) and the nutrients folic acid<br />

and calcium for the possibility that these agents may reduce<br />

polyps and colon cancer.<br />

If colorectal cancer is detected at its earliest stage, the fiveyear<br />

survival rate is about 90 percent. Found after it has<br />

spread to lymph nodes, the five-year rate drops to about 50<br />

percent. If the disease has metastasized to distant sites, the<br />

5-year survival rate falls to 5 percent.<br />

7<br />

UCSD <strong>Cancer</strong> <strong>Center</strong> News


New Information Service<br />

ON OUR WEB SITE<br />

UCSD <strong>Cancer</strong> <strong>Center</strong> is making<br />

access to cancer information<br />

easier than ever with a new<br />

service on our Web site.<br />

The <strong>Cancer</strong> Information Service (CIS) of<br />

the National <strong>Cancer</strong> Institute provides<br />

answers to commonly asked questions in<br />

a monthly column called “Ask the CIS.”<br />

Just visit the <strong>Cancer</strong> <strong>Center</strong>’s homepage<br />

at http://cancer.ucsd.edu and click on<br />

the “Ask the CIS” logo for new topics<br />

each month. Here is a sampling of topics<br />

you’ll find:<br />

■ Non-drug Treatments for <strong>Cancer</strong> Pain<br />

■ Inflammatory Breast <strong>Cancer</strong><br />

■ Clinical Trials<br />

■ Post-Traumatic Stress Disorder<br />

■ Cell Phones and <strong>Cancer</strong><br />

■ Environmental Tobacco Smoke<br />

■ Metastatic <strong>Cancer</strong><br />

In addition, to talk with a CIS cancer<br />

information specialist, individuals can call<br />

the <strong>Cancer</strong> Information Service toll-free at<br />

1-800-4-CANCER between 9 a.m. and<br />

4:30 p.m. These information specialists<br />

provide callers with individualized<br />

answers to questions about cancer prevention,<br />

diagnosis, treatment, symptoms<br />

and risks, and clinical trials. CIS staff<br />

answer calls in English and Spanish, and<br />

from deaf and hard-of-hearing callers.<br />

New Hope<br />

for Kidney <strong>Cancer</strong><br />

Physicians with<br />

the UCSD<br />

Blood and<br />

Marrow Transplant<br />

Program are evaluating<br />

an experimental<br />

type of stem cell<br />

transplant for its<br />

effectiveness against<br />

advanced kidney<br />

cancer, a disease<br />

known to be highly<br />

resistant to conventional<br />

therapy and usually fatal.<br />

This approach, which uses<br />

blood stem cells donated by the<br />

patient’s matched sibling or<br />

matched unrelated donor, has<br />

shown promise in a small<br />

research study recently conducted<br />

at the National Institutes of<br />

Health. In that study of 19<br />

patients, 53 percent had either<br />

complete or partial regression<br />

of their disease. Some patients<br />

have remained completely free<br />

of disease more than two years<br />

after treatment.<br />

Researchers attribute these<br />

results to an immune response<br />

that the donor cells develop<br />

against the recipient’s cancer, a<br />

phenomenon known as a “graft<br />

versus tumor response.” This is<br />

often seen in certain leukemias<br />

and lymphomas, but kidney<br />

Dr. Asad Bashey, M.D., Ph.D.<br />

cancer is the first<br />

solid tumor to<br />

exhibit the<br />

response.<br />

“The NIH study was<br />

small, but the results<br />

were so dramatic we<br />

believe they represent<br />

a tremendous<br />

advance against this<br />

disease,” said Asad<br />

Bashey, M.D., Ph.D.,<br />

a member of UCSD <strong>Cancer</strong><br />

<strong>Center</strong> and assistant professor<br />

of medicine at UCSD School of<br />

Medicine. “These early results<br />

are particularly exciting when<br />

you consider that we’ve had<br />

precious little to offer patients<br />

who were not helped by conventional<br />

therapy.”<br />

The UCSD clinical trial is open<br />

to patients with a sibling who<br />

can donate stem cells for the<br />

transplant. For patients lacking a<br />

suitable sibling donor, an alternative<br />

trial is designed to use<br />

matched unrelated donors<br />

obtained through the large<br />

volunteer donor database from<br />

the National Marrow Donor<br />

Program. For further information<br />

about this study call the<br />

UCSD Blood and Marrow<br />

Transplant Program,<br />

(858) 657-6840.<br />

Correction: In the Winter 2001 issue of UCSD <strong>Cancer</strong> <strong>Center</strong><br />

News we mistakenly identified Thomas J. Kipps, M.D., Ph.D., as<br />

leader of the <strong>Center</strong>’s Translational Oncology Program. That post is<br />

now held by Edward D. Ball, M.D. We regret the error.<br />

…Editorial Staff<br />

UCSD <strong>Cancer</strong> <strong>Center</strong> News<br />

8


Magnifying the Search<br />

for Breast <strong>Cancer</strong><br />

Researchers have known for decades that most breast<br />

cancer starts in the cells lining the milk ducts. Until<br />

recently, though, there was no way to see how these<br />

cells were behaving until they formed a lump that could be<br />

felt or seen on a mammogram.<br />

A new method called ductal lavage allows doctors to collect<br />

milk duct cells and look for possible early warning signs of<br />

breast cancer. UCSD <strong>Cancer</strong> <strong>Center</strong> is among the first in<br />

the nation to offer ductal lavage to women at high-risk for<br />

breast cancer.<br />

In a recent clinical study, ductal lavage detected abnormal<br />

cells in 24 percent of the high-risk women who enrolled in<br />

the study. All of the women had non-suspicious mammograms<br />

and physical exams within the 12 months prior to<br />

their participation.<br />

“Ductal lavage gives us the ability to look for the very<br />

beginnings of abnormal changes,” said Anne Wallace, M.D.,<br />

director of UCSD <strong>Cancer</strong> <strong>Center</strong>’s Breast Care Unit.<br />

“It can offer high-risk women unique, early information<br />

when used in conjunction with mammography and breast<br />

examination.”<br />

During ductal lavage, a tiny microcatheter is inserted into<br />

the duct through its natural opening on the nipple. (The<br />

use of topical anesthetic prevents discomfort for most<br />

women.) A teaspoon of saline is flushed through the<br />

microcatheter to “rinse” the duct to collect cells. The fluid<br />

is sent to a laboratory for analysis.<br />

For more information about ductal lavage, call the <strong>Cancer</strong><br />

<strong>Center</strong>’s toll-free information line: 1-866-558-7933.<br />

A Treatment Against Metastasis?<br />

UCSD <strong>Cancer</strong> <strong>Center</strong><br />

researchers have obtained<br />

evidence that the common<br />

anticoagulant drug heparin diminishes<br />

metastasis of certain cancers in<br />

mice by interfering with interactions<br />

between platelets (a type of normal<br />

blood cell) and specific molecules on<br />

tumor cell surfaces.<br />

The researchers, reporting in the<br />

March 13 issue of the Proceedings of<br />

the National Academy of Sciences, say<br />

these findings make a compelling<br />

argument for initiating clinical trials<br />

of heparin in patients with newly<br />

diagnosed cancer.<br />

“The notion of using anticoagulants<br />

to inhibit metastasis is not new,” said<br />

the study’s senior author Ajit Varki,<br />

M.D. “However, our new findings suggest<br />

that heparin therapy to prevent<br />

the spread of cancer in humans<br />

should be revisited.”<br />

Animal studies in the ‘60s and ‘70s<br />

showed that heparin — which is<br />

delivered by injection or intravenously<br />

— inhibits metastasis. Follow-up<br />

human studies focused instead on the<br />

use of oral anticoagulants, which are<br />

easier to manage than heparin. Those<br />

attempts failed, however, and research<br />

in this area stalled.<br />

The new research, led by Lubor<br />

Borsig, Ph.D., a postdoctoral fellow<br />

working in Varki’s laboratory, details<br />

heparin’s precise mechanism and<br />

explains why earlier clinical trials<br />

using oral anticoagulants failed.<br />

“Our findings show that the antimetastatic<br />

effect of heparin is not due<br />

to its ability to prevent blood clotting,<br />

as was previously thought, but rather<br />

its blockage of early tumor-platelet<br />

interactions in the bloodstream,” said<br />

Borsig. “Oral anticoagulants work by a<br />

completely different mechanism and<br />

do not block these interactions.”<br />

When cancer cells break away from the<br />

original tumor and enter the bloodstream<br />

they attract platelets, which<br />

bind to sugarcoated molecules on the<br />

cancer cell surface, forming a cloak.<br />

This platelet cloak appears to protect<br />

the tumor cells from the body’s natural<br />

defense system, enabling them to<br />

establish new tumors in other parts of<br />

the body. Heparin interferes with formation<br />

of the platelet cloak, apparently<br />

leaving tumor cells exposed to<br />

attack by white blood cells.<br />

This work involved an active collaboration<br />

with UCSD <strong>Cancer</strong> <strong>Center</strong> laboratories<br />

for Histology (directed by<br />

Nissi Varki, Ph.D.) and Digital<br />

Imaging (directed by James<br />

Feramisco, Ph.D.), and with the San<br />

Diego Supercomputer <strong>Center</strong> (David<br />

Nadeau). It was supported by a grant<br />

from the National <strong>Cancer</strong> Institute.<br />

9<br />

UCSD <strong>Cancer</strong> <strong>Center</strong> News


Sizzles for<br />

UCSD <strong>Cancer</strong> <strong>Center</strong><br />

Richard Levi and his daughter<br />

Lonnie Levi Israel<br />

Lee and Frank Goldberg<br />

Dolores Landa and<br />

Diana Lombrozo<br />

Chef Jeffrey Strauss and<br />

assistant, Pamplemousse<br />

Grille, Solana Beach<br />

Black tie and ball gowns were the order<br />

of the evening March 3 as 650 friends of<br />

cancer research gathered at the Sheraton<br />

San Diego Harbor Island Hotel and Marina to<br />

savor the gourmet magic of the 20th Annual<br />

Celebrities Cook for the UCSD <strong>Cancer</strong> <strong>Center</strong>.<br />

In keeping with this year’s theme of “Hot Haute<br />

Cuisine,” 10 noted chefs representing restaurants<br />

from Honolulu to Washington, D.C., offered up<br />

some of their most creative appetizers during a<br />

two-hour reception that preceded a formal sitdown<br />

dinner and dancing in the Sheraton’s<br />

Grande Ballroom.<br />

Event Co-chairs Dolores Landa and Diana<br />

Lombrozo led the volunteer efforts of the UCSD<br />

<strong>Cancer</strong> <strong>Center</strong> Associates in staging another<br />

successful gala, which will net approximately<br />

$300,000 for the <strong>Cancer</strong> <strong>Center</strong>’s research and<br />

community outreach programs. The dedication of<br />

the evening to the memory of Harriet Levi, a<br />

longtime Associates volunteer and benefactor of<br />

the <strong>Cancer</strong> <strong>Center</strong>, inspired an outpouring of<br />

generosity in support of the event.<br />

Honorary chairs were Rebecca and John <strong>Moores</strong>.<br />

Honorary co-chairs were Lee and Frank Goldberg,<br />

along with Audra and Howard Birndorf.<br />

Miriam and Jerry Katzin<br />

Executive Chef David Abella,<br />

Roy’s, La Jolla<br />

Left to Right: Tom Franklin, Michael Bartell, Rusti Bartell-Weiss (front),<br />

Melissa Bartell, Ina Bartell (front), Richard and Liz Bartell,<br />

Suzy and Steve Weiss<br />

Virginia Monday, Audrey Geisel, Alex Butterfield<br />

and Ruth Grobstein<br />

UCSD <strong>Cancer</strong> <strong>Center</strong> News<br />

10


Gorder Walk Offers<br />

Family Fun to Fight Melanoma<br />

V<br />

olunteers in the fight against<br />

melanoma will take new strides<br />

toward a cure when the 8th Annual<br />

Bruce Brunner Gorder Memorial<br />

Melanoma Walk-a-thon returns to<br />

UCSD’s La Jolla campus in June. The<br />

event provides a festive morning of<br />

fun to raise funds for research into this<br />

increasingly common form of cancer.<br />

<strong>Cancer</strong> <strong>Center</strong> Foundation Board<br />

member Chuck Gorder will once again<br />

chair the walk, slated for Saturday,<br />

June 23, in memory of his son Bruce.<br />

The Gorder Walk-a-thon is a familyfriendly<br />

event that attracts participants<br />

of all ages and fitness levels.<br />

There will be<br />

prizes for the team<br />

with the largest number<br />

of participants and for the<br />

team that raises the largest amount in<br />

contributions.<br />

As in previous years, proceeds will<br />

benefit melanoma cancer research at<br />

UCSD <strong>Cancer</strong> <strong>Center</strong>. The significance<br />

of this philanthropy was highlighted<br />

during the past year with the<br />

announcement that the memorial<br />

fund had helped to support development<br />

of a new drug-combination<br />

therapy that has proven superior to<br />

existing treatments in extending<br />

patient lives.<br />

Contributions<br />

to the Gorder<br />

Walk-a-thon<br />

are welcome in<br />

all amounts, with<br />

sponsors at a level of $500 or above<br />

receiving recognition in the event program.<br />

The Walk has raised over<br />

$500,000 since its inception. This year,<br />

Gorder has set a goal to raise $100,000,<br />

the first $25,000 of which he has<br />

pledged to match.<br />

To register or to find out about other<br />

ways to help, please contact Cheryl<br />

Coate in the <strong>Cancer</strong> <strong>Center</strong><br />

Foundation office, 858-822-1390 or<br />

e-mail ccoate@ucsd.edu.<br />

Foundation Appoints<br />

Two New Board Members<br />

T<br />

he UCSD <strong>Cancer</strong> <strong>Center</strong><br />

Foundation is pleased to<br />

announce the recent addition to its<br />

Board of Directors of two leaders in<br />

the San Diego community, Deborah<br />

J. Case of Jamul, and Robert M.<br />

Wood, D.V.M., of Escondido.<br />

Case has extensive experience in<br />

retail merchandising management<br />

with Saks Fifth Avenue. She is<br />

presently the San Diego Area<br />

Manager for Saks and the General<br />

Manager for the Fashion Valley store,<br />

after having held prior positions<br />

with Saks in Beverly Hills, Woodland<br />

Hills and San Francisco, and in Boca<br />

Raton, Florida. For the past two<br />

years, she has played an instrumental<br />

role in the success of Saks Fifth<br />

Avenue’s local “Fashion Targets<br />

Breast <strong>Cancer</strong>” promotion to raise<br />

funds for breast cancer research at<br />

UCSD <strong>Cancer</strong> <strong>Center</strong>.<br />

Wood brings to his role over 30 years<br />

of experience in business consulting,<br />

program development and project<br />

management for public agencies and<br />

private corporations. He earned a<br />

Doctor of Veterinary Medicine<br />

degree from the University of<br />

Minnesota. His varied professional<br />

background includes leadership in<br />

higher education administration and<br />

significant expertise in scientific<br />

research, market development, and<br />

new product management. Wood’s<br />

family has a history of philanthropy<br />

to cancer research at other nationally<br />

prominent institutions besides the<br />

UCSD <strong>Cancer</strong> <strong>Center</strong>.<br />

<strong>Cancer</strong> <strong>Center</strong> Director David Tarin<br />

expressed his enthusiasm for the<br />

new Board appointments: “Debbie<br />

and Bob bring a level of enthusiasm<br />

to their involvement with the<br />

<strong>Cancer</strong> <strong>Center</strong> that inspires all of us<br />

who are joined in the crusade at<br />

UCSD to defeat cancer. We are most<br />

fortunate to be the beneficiaries of<br />

their volunteer service.”<br />

Special Events<br />

CALENDAR<br />

JUNE 23, 2001:<br />

8th Annual Bruce Brunner Gorder<br />

Memorial Melanoma Walk-a-thon<br />

UCSD Campus (behind the School of<br />

Medicine) 8:30 - 10:30 a.m.<br />

No entry fee; donations encouraged!<br />

Call (858) 822-1390<br />

AUGUST 26, 2001:<br />

8th Annual Luau & Longboard<br />

Invitational<br />

Scripps Institution of Oceanography, La Jolla<br />

7:00 a.m. - 5:00 p.m.<br />

Contact Steve Blank, (858) 822-2293<br />

OCTOBER 18-20, 2001<br />

14th Annual Pete Lopiccola<br />

Memorial Marlin Tournament<br />

Cabo San Lucas, Baja California, Mexico<br />

Call (858) 822-1390 or the For Pete's Sake<br />

hotline at (619) 475-4636<br />

OCTOBER 18-23, 2001<br />

3rd Annual Saks Fifth Avenue<br />

“Fashion Targets Breast <strong>Cancer</strong>”<br />

Saks Fifth Avenue stores in Fashion Valley<br />

Mall and downtown La Jolla<br />

Contact (858) 822-1390<br />

11<br />

UCSD <strong>Cancer</strong> <strong>Center</strong> News


PHILANTHROPY NOTEBOOK<br />

As part of our ongoing commitment to help you<br />

make the most of your philanthropic support of<br />

the <strong>Cancer</strong> <strong>Center</strong> and other non-profit organizations,<br />

we are pleased to provide you with the<br />

following information on a unique way to use<br />

charitable remainder trusts.<br />

Charitable Trusts to<br />

Fund Educational Expenses<br />

Every spring marks a special turning point in the lives of<br />

thousands of teenagers: high school graduation. And each<br />

year many young people go on to begin their college studies.<br />

College can be a very special rite of passage, but as most<br />

parents and grandparents know, it<br />

can also be an expensive one.<br />

A growing number of charitably<br />

inclined individuals have discovered<br />

the value of a charitable remainder<br />

trust to fund the educational<br />

expenses of their children or<br />

grandchildren, and to maintain<br />

their philanthropic goals.<br />

Take for example Mr. and Mrs.<br />

Appleton, who promised to help<br />

pay for their granddaughter’s college<br />

expenses many years ago. To do<br />

this, the Appletons considered a<br />

variety of options, including selling<br />

their highly appreciated securities;<br />

however, this option would have<br />

Donors<br />

Mr. & Mrs. Appleton<br />

Charitable<br />

Remainder<br />

Trust<br />

Cash, marketable securities<br />

or other appreciated assets<br />

Income to child<br />

or grandchild<br />

for educational<br />

expenses<br />

Charitable<br />

Remainder Gift<br />

after 4 years<br />

generated a significant capital gains tax on the profit from<br />

the sale.<br />

Ultimately, the Appletons chose to fund a charitable<br />

remainder trust with their appreciated assets. A charitable<br />

remainder trust can be established for a specific period of<br />

time up to 20 years.<br />

In the Appletons’ case, they created a charitable remainder<br />

trust to provide four annual payments to their granddaughter<br />

during her college career. After the four-year<br />

period, the remaining assets in the trust were distributed to<br />

the Appletons’ favorite charity.<br />

Additionally, the Appletons benefited<br />

because they received a charitable<br />

income tax deduction during the<br />

year the trust was established, and<br />

the securities were sold free of capital<br />

gains tax by the charitable remainder<br />

trust.<br />

For further information about charitable<br />

remainder trusts and how they<br />

can fulfill your financial goals, contact<br />

Geoff Graham, Associate<br />

Director of Development, at (858)<br />

822-0024 or gcgraham@ucsd.edu.<br />

This article is not intended to offer<br />

legal or tax advice. Specific circumstances<br />

may vary and services of an<br />

attorney and/or professional advisor<br />

should be obtained.<br />

UCSD <strong>Cancer</strong> <strong>Center</strong><br />

9500 Gilman Drive #0658<br />

La Jolla, CA 92093-0658<br />

(858) 822-0022<br />

Non-Profit Org.<br />

U.S. Postage<br />

PAID<br />

San Diego, CA<br />

Permit #1909

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