Summer 2012 - The University of Chicago Medicine Comprehensive ...

At the Forefront of Discovery ®UCCCC Lymphoma Experts Address Challenges ofTreating Slow-Growing CancerWhat started as a lump on hiseyelid took Bill Meyer down anuncertain path. The 61-year-oldSugar Grove, Illinois native was surprisedthat a biopsy revealed a somewhat rareform of non-Hodgkin lymphoma.“It scares the bejeebers out of youwhen they say you have cancer,” saidMeyer, president of his own wholesaleplumbing supply company. “Nobody saysit’s not life threatening, but nobody saysyou’re definitely going to die in a year,either.”At first, Meyer’s specific subtype ofnon-Hodgkin lymphoma was unclear, buteventually he was diagnosed with marginalzone lymphoma, which is often associatedwith autoimmune complications. Thechallenge then became figuring out whichcame first and how aggressively to treatthe slow-growing, or indolent, cancer.Diagnosis and TreatmentMarginal zone lymphomas are oftendriven by bacteria, and because prior studiesreported that antibiotics can be helpful,Meyer was treated with a course of doxycycline.His symptoms improved to thepoint that he was in remission for 2 years.“As we learn about what drives cancer,we have found that some lymphomas canbe related to environmental factors, likebacteria, and resolving that irritant mightbe helpful,” said Sonali Smith, MD, associateprofessor of medicine and director ofthe Lymphoma Program at The Universityof Chicago Medicine.In January 2011, Meyer was admittedto the emergency room with a depletedlevel of red blood cells known as hemolyticanemia. His hemoglobin count wasa mere 5 grams/dL, which is dramaticallylower than the normal 13 or 14 grams/dL.He was treated with prednisone, a steroid,and rituximab, an antibody therapy. Onthis treatment regimen, Meyer said heexperienced no side effects, often eatinga full meal and playing golf immediatelyafter treatments.A Successful OutcomeMeyer is pleased that the word-classhematopathologists at UChicago wereable to identify his subtype of lymphomaand felt confident in his doctor’s ability totreat it.“I would urge anyone who discoversthey have cancer to go to The Universityof Chicago [Medicine],” he said. “You’regoing to be seen by somebody thatspecializes in just the disease you have.”Meyer had to undergo another courseof rituximab, but remains in remissionsince last summer. He is now being monitoredto make sure his blood counts staywithin a normal range.“A lot of people stress the importanceof finding a cure, but in my opinion,research is going to lead to a point wherecancer is a manageable disease, like diabetes,”Meyer said, who also credits his wifeand family for supporting him through hisdiagnosis and treatment.Dr. Smith said with indolent lymphomas,there is often no need for therapyunless the patient develops symptomsor abnormal blood counts. She addedthat she often forms close relationshipswith her patients who have slow-growingcancers, as they meet regularly to checkfor changes in the lymphoma and carefullyweigh treatment decisions, often overa course of many years or even decades.“He’s done incredibly well. Our hopeis that he continues to do well and that wecan continue to build a solid relationship,”she said.Sonali Smith, MD, associate professor of medicine anddirector of the Lymphoma Program, said with slowgrowinglymphomas, therapy can be avoided unlessthe patient develops symptoms or abnormal bloodcounts.Focus on:Core FacilitiesUChicago Medicine Investigators ReapBenefits of BioinformaticsTechnology is revolutionizingeverything we do––and biology is noexception. The application of computerscience to biology, known as bioinformatics,has become increasingly important forconducting state-of-the-art research.“Next-generation sequencing instrumentsand other high-throughputtechnologies are now making it possibleto understand the genomic differencesbetween cancer tumors and normaltissue,” said Robert Grossman, PhD,professor of medicine and chief researchinformatics officer at The University ofChicago (UChicago) Medicine. “Butbecause of the size and complexity of thedata, this analysis can be overwhelming atfirst to researchers.”To address that challenge, a new corefacility has been developed to providebioinformatics expertise to UChicagoMedicine clinical, translational, and basicresearchers who need to analyze vastamounts of data from their experiments.The Bioinformatics Core is housedin the Center for Research Informatics(CRI), a UChicago Medicine centercreated in 2011 to provide a broad rangeof computational resources and expertisein biomedical informatics (cri.uchicago.edu). The CRI also supports educationalactivities, coordinates cross-departmentalresearch initiatives, and advocates forbiomedical informatics.ServicesThe Bioinformatics Core works closelywith the Genomics Core Facility toprovide informatics support for its userswho are producing large quantities of datafrom their next-generation sequencingexperiments. Bioinformaticians are availableto help investigators analyze DNAand protein sequences, as well as createand view 3-D models of protein structures.For investigators who wish to developbioinformatics expertise within their ownBioinformatics Core Scientific Director Robert Grossman,PhD, professor of medicine and chief researchinformatics officer at UChicago.laboratories, the Bioinformatics Core staffoffers training and information resources,such as commercial software tools, referencedatasets, and databases. Researcherscan also access bioinformatics capabilities,such as data storage, data management,and analytical tools, through a web-basedportal in a self-service environment.“One of the goals of the BioinformaticsCore is to make the required expertisebroadly available to UChicago Medicinecancer researchers,” said Dr. Grossman.In addition to these services, the BioinformaticsCore can help researchers withgrant writing by providing documentationof the bioinformatics expertise andtools available to conduct research. Thisallows investigators to accurately describethe high level of scientific research beingperformed, and as a result, may improvethe chances of grant proposals beingfunded.The core is initially focusing onproviding data analysis pipelines forgenetic studies using microarray and deepsequencing technologies, but may expandto provide expertise in other areas such asproteomics or genome-wide associationstudies. These services are essential for thesuccess of UChicago Medicine researchersconducting complex genetic studies.High School Students Help Create Community Awareness of Colorectal Cancer ScreeningsStudents from local high schools helped the UCCCC’s Office of CommunityEngagement and Cancer Disparities (OCECD) disseminate informationto community members about the importance of colorectal cancerscreenings for individuals 50 and older. The service learning/shadowingprogram was the final phase of the Empowering Neighborhood Resourcesin Combating Health Disparities (ENRICH’D) program. Students fromThomas Kelly, Percy Julian, and Chicago Vocational Career Academy havebeen working together with the OCECD since 2011 to address cancerdisparities in their own communities. During the OCECD’s colorectal cancerawareness campaign in March, students gave out surveys to patients atMercy Hospital & Medical Center. The surveys addressed beliefs aboutand barriers to colorectal cancer screening. Under the direction of KarenE. Kim, MD, MS, associate professor of medicine, the OCECD is leading astatewide initiative supported by the Illinois Cancer Partnership to provideover 2,000 colorectal cancer screenings in 45 community organizationsand hospitals.High school students from the ENRICH’D program helped during the colon cancer awareness campaign at MercyHospital & Medical Center by handing out surveys. The UCCCC’s Office of Community Engagement and Cancer Disparitiesis helping the Illinois Cancer Partnership lead a statewide initiative to increase colon cancer screenings.cancer.uchicago.edu 7