Conquering Colon Cancer - Renown Health

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Renown institute foR canceR 6 cover story WRITTEN by DoN Cox Continued from page 4 from methodist dallas medical Center. dr. schultheis is another one of those people. she came to Reno this year after finishing a one-year fellowship in colorectal surgery at greater Baltimore medical Center. dr. galanopoulos and dr. schultheis are part of a team of experts at the Renown Institute for Cancer that meets monthly to review cases. “the Institute really functions to bring all these specialists together,” dr. schultheis said. “It’s an integrated approach.” at the Renown Institute for Cancer, a colorectal cancer patient is treated by a highly-trained team of specialists. “the colorectal surgeon, the gastroenterologist, the radiation oncologist and the medical oncologist,” dr. schultheis said. “you treat as a team.” Quality care close to home audrey smith of Reno was diagnosed with advanced colon cancer in 2001. smith was told she had a large tumor. she said she was told to “think about getting my affairs in order.” Renown joURneY caNcer QuicK Fact: Fewer than half of Americans ages 50 or older have received a recent colorectal cancer screening test. With screenings and early detection, colorectal cancer has a 90% cure rate. smith was stunned. “It was a different language to me,” she said. “my chances were not considered good.” smith, 43, was treated by specialists at Renown. “they got me into surgery real quickly,” she said. “I was very fortunate. It was nice to know we have incredible doctors locally.” smith has three children. they were 6, 3 and 1 when smith underwent surgery. “I had a lot to live for,” said smith. without the Institute for Cancer, smith and other patients probably would have received their treatment at hospitals out of the area. they would have had to leave town to receive care. “there is a huge cost to that,” dr. galanopoulos said. “throughout the country, there are centers of excellence. most are at universities.” the Renown Institute for Cancer is such a center. “that’s what brought me here,” dr. galanopoulos said who arrived in July. several months ago, dr. galanopoulos removed a pancreatic tumor he described as “the size of a cantaloupe” from a patient at Renown. “she would’ve had to be transferred, probably by ambulance,” dr. galanopoulos said of a long-distance trip the patient would have made without the treatment available at Renown. “within five days she went from no diagnosis to (surgery).” treatment options Common treatment for colorectal cancer is surgery, sometimes followed by chemotherapy or radiation therapy. “for colon cancer, surgery is very important,” dr. schultheis said. “If the cancer has spread to the lymph nodes, you can continue with chemotherapy.” treatment for rectal cancer is slightly different, since that area is sensitive to radiation. “It really involves evaluating the tumor and how far the cancer has progressed,” dr. schultheis said. “depending on the level of progression, sometimes you will treat the patient first with radiation, or radiation and chemotherapy.” ■ bill manders, colorectal cancer survivor and local radio talk show host, speaks out about screening and prevention. — American Cancer Society at renown, colorectal patients are treated by a team of specialists. Drs. Galanopoulos, chen and schultheis, provide an integrated approach to treating colorectal cancer. victor K. chen, mD, msPH Victor K. Chen, MD, is a gastroenterologist at Gastroenterology Consultants in Reno specializing in digestive disorders and liver diseases. He earned his medical degree from University of Missouri in Kansas City School of Medicine. Dr. Chen also holds a masters degree in public health. Dr. Chen is board Certified in Gastroenterology and Internal Medicine. christos a. Galanopoulos, mD, Facs Christos A. Galanopoulos, MD, is the Cancer Liaison Physician at Renown Institute for Cancer. He also practices at General & Vascular Associates in Reno. He received his medical degree from Rush Medical College, and completed his residency in General Surgery at University of Illinois Medical Center affiliate hospitals. He is board Certified in General Surgery. Dr. Galanopoulos completed a HbP/ Foregut fellowship at Methodist Dallas Medical Center. mary e. schultheis, mD Mary E. Schultheis, MD, is a colorectal surgeon with General & Vascular Associates in Reno. She attended college at the University of Maryland and received her medical degree from Creighton University School of Medicine. Dr. Schultheis completed her residency in General Surgery at Saint Agnes Healthcare. She then completed a fellowship in Colon and Rectal Surgery at the Greater baltimore Medical Center. Dr. Schultheis is board Certified in General Surgery. Peace of mind Renown offers new screening for colon cancer Renown believes early detection is crucial to colon health. That is why we are offering a home screening kit for only $35. a fiT Test (fecal immunochemical Test) offers patients a more convenient home screening tool for colorectal cancer screening. The fiT test is more effective in detecting cancers and polyps than older and more widely used stool screening tests. Key patient benefits of the test include: • Higher sensitivity resulting in fewer false readings • More convenient for patients because it is easy to prepare and complete in the privacy of your own home • No dietary restrictions required With your home screening kit, you will receive everything you need, including full instructions and a pre-paid return envelope. a physician referral is not needed. To request your home screening kit, visit renown.org/fiTtest. renown.org 7
Renown institute foR canceR 8 cLiNicaL triaLs WRITTEN by DoN Cox leading-edge medicine clinical trials look to improve treatment, prevention of colorectal cancer “ T he maIn dRIvIng foRCe BehInd ClInICal tRIals Is to ContInually ImpRove the standaRd of CaRe foR CanCeR patIents” said tejvir singh, md, hematologist/oncologist with Reno oncology associates and principle Investigator team member for Renown Institute for Cancer. the study for clinical trial nsaBp R-04 is designed to determine the effectiveness of a new treatment for patients with rectal cancer. for one part of the trial, doctors are combining a particular drug, Capecitabine, with radiation in pre-surgery treatment. nsaBp R-04 is one of more than 141 clinical trials administered to more than 870 patients or participants at the Renown Institute for Cancer. the discoveries made in those trials can save lives. “Reno now has access to all types of clinical trials,” dr. singh said. “this means that patients in the area have access to leadingedge medicines and treatments.” these medical research studies of potential treatments, known as phase II and phase III trials, are sponsored by the national Cancer Institute. phase II clinical trials contain fewer than 100 participants and are intended to determine if a new treatment has an effect on a certain cancer and examine how the new treatment affects the human body. phase III trials have more than 100 participants and are used to compare the new treatment, or a new use of a treatment, with the current standard treatment. people volunteer for clinical trials to determine if new treatment methods are more effective than the current. participants either receive the current standard of care or the new treatment in conjunction with the current standard of care. no participant in a clinical trial involving cancer treatments through Renown Institute for Cancer receives a placebo. colorectal cancer patients may benefit “Capecitabine has been found to be beneficial in late stage rectal and colon cancer,” dr. singh said. standard pre-surgery treatment for rectal cancer combines another drug, 5-fluorouracil with radiation. drugs used in chemotherapy, such as oxaliplatin, Capecitabine and fluorouracil, work in different ways to stop Renown joURneY caNcer QuicK Fact: 1 in 3 cancers may be related to what you eat. Research shows that brassica vegetables — including broccoli, brussels sprouts, cauliflower and cabbage — may reduce your risk of colorectal and prostate cancers. tumor cells from dividing so the cells stop growing and die. Radiation therapy uses high-energy X-rays to damage tumor cells. doctors are assessing whether radiation therapy is more effective when combined with Capecitabine or 5-fluorouracil before surgery in treating operable rectal cancer. earlier trials were used to determine appropriate dosages of the drug and the likelihood of success. “Is using Capecitabine in combination with radiation going to be better than combining 5-fluorouracil?” dr. singh said. that’s the question for clinical trial nsaBp R-04. the clinical trial with Capecitabine will conclude next year. But doctors will observe patients for three more years before reaching conclusions. “reno now has access to all types of clinical trials.” Tejvir Singh, MD, Hematologist/ Oncologist and Principle Investigator for Renown Institute for Cancer bringing clinical trials to renown each potential trial is carefully evaluated before volunteers are sought and treatments begin. Beth ahart-valk, Rn, oCn, the lead cancer nurse who coordinates the cancer clinical trials, presents possible clinical trials to the Institutional Review Board (IRB). the IRB is made up of healthcare professionals and people in the community. IRB members make sure the risks are reasonable when compared to the possible benefits. they also watch the trial progress from beginning to end. the Principle investigator group at the institute for cancer meet regularly to track progress of open trials as well as consider new clinical trials. back row, pictured from left to right: Dr. conrath, Dr. reddy, Dr. Dardick, Dr. singh, Dr. bowman, Dr. shields. Front row, pictured from left to right: Dr. schiff, Dr. Palmer, Dr. reganti, Dr. Galanopoulos. Not pictured: Dr. abrass, Dr. rost. “we consider certain clinical trials that would be a good study for our community, based on what sort of cancers we’re diagnosing and treating at Renown,” ahart-valk said. “there is not much benefit to the community in opening a study on a disease that’s rare in our area.” If a trial is approved, dr. singh and other investigators enroll patients who wish to participate in the trial, provided they meet the eligibility criteria for the study treatment. “there is a long process of getting IRB approval and consent,” dr. singh said. for the Capecitabine trial, there were 13 points listed under the eligibility criteria. “most studies have very strict eligibility criteria that must be met for participant enrollment. however, this should not stop patients from inquiring if a clinical trial would be appropriate for them,” ahart-valk said. ■ For a list of trials currently open to volunteers, see page 10. For more information about Renown’s clinical trials and research, please visit www.renown.org/cancer. clinical trial update In Vol. 1 Issue 1 of Renown Journey we told you about the Selenium and Vitamin E Prevention Trial (SELECT), which investigated whether the supplements of Selenium and Vitamin E can prevent or reduce the occurrence of prostate cancer. Since that issue, The National Cancer Institute announced the data found that selenium and Vitamin E, taken alone or together did not prevent or reduce the risk of prostate cancer. Trial participants have been asked to stop taking the study supplements but will continue to receive followup checks. 48 men participated in the Renown study. tejvir singh, mD Tejvir Singh, MD, is a principle investigator team member at the Institute for Cancer. He also practices at Reno oncology Consultants in Reno. Dr. Singh earned his medical degree from G.S.V.M. Medical College in India. He is board Certified in oncology and Medical oncology. renown.org 9
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