Summer - Roswell Park Cancer Institute

pcinessSummer ’09

Summer ’09 | volume 12 | number 2F R O M T H E M A N A G I N G E D I T O RIn the early 1980s, when AIDS was elbowing its way to the forefront of viralnightmares, then-U.S. Surgeon General Dr. C. Everett Koop announced,“This is not an age for the faint of heart or soul.” In 1898, Dr. Roswell Parkwas probably harboring a similar thought, as he courageously faced thechallenges of establishing the nation’s first cancer center in a nation litteredwith misperceptions about the disease.As my former boss and Roswell Park’s go-to historian Dr. Edwin A. Mirandonce shared, Dr. Park lived at a time when cancer was widely held to bevenereal in origin. Because cancer was also thought to be contagious,patients were treated at home – not in hospitals – and were often confinedto the laundry room or kitchen. The stigma of cancer permeated the medicalprofession, and it was not uncommon for physicians to purposely leave offtheir curriculum vitae any position that involved caring for cancer patients.Many doctors were encouraged to pursue other specialties so as not to“tarnish” their reputations by getting lost in cancer’s wasteland of hopelessness.Times have certainly changed, as have our attitudes and perceptions aboutcancer. With research and education came awareness, and today, largely dueto the prevalence of this disease, few would repeat (with a straight faceanyway!) the old wives’ tales that persisted in Dr. Park’s time. But doesany part of the cancer stigma exist today and if so, are we doing all we canto change lingering perceptions and attitudes?In this issue, we discuss cancer stigma and what the experts are sayingstill needs to be done. Also included are the compelling frontline storiesof a few of Roswell Park’s own “attitude adjusters.”When it comes to cancer, we’re all in this together and we should continue tosupport, work with, and learn from each other and apply the lessons of the past.As simple as it sounds: A world without cancer depends on a world united.Colleen M. KaruzaManaging EditorCheck out our next issue: A Comprehensive Look at Colorectal Cancer

T A B L E O F C O N T E N T SD E P A R T M E N T S11 Myth BustersStraight Talk from the Experts13 Been There, Done ThatA Forum Where Patients Share Their Stories17 Voices CarryEmpowered and Aware23 Stop the Presses!Wow-Worthy News25 PopwatchThe RPCI Read on National Stories, Trends27 Nutrition & CancerEating Right28 SparksGen-Y All-Stars29 Technology BuzzThe Mechanics of Innovation31 Lab NotesPromising Research from RPCI38 Advocacy NewsTogether We Can!39 Who, When, Where?Our Spring/Summer Photo Album42 FrontlinersCareers at RPCIF E A T U R E S4 Whose Fault is it Anyway?6 All the World’s Their Stage7 Stigma of Cancer Down, But Not Out9 Colleen Zenk Pinter Faces Lifetime Drama10 Parents: Boys Need to Be Vaccinated, TooRoswellness is published three times a year by the Department of Marketing, Planning andPublic Affairs, Roswell Park Cancer Institute. All rights reserved. No portion of this magazine maybe reproduced without written permission of RPCI. Address changes should be sent toKim Bonds, Development Office, Roswell Park Cancer Institute, Buffalo, NY 14263, or emailto Kimberly.Bonds@RoswellPark.org. Suggestions and comments regarding this publication maybe emailed to Roswellness@RoswellPark.org or mailed to Colleen M. Karuza, Director ofPublic Affairs, Roswell Park Cancer Institute, Buffalo, NY 14263.CREATIVE STAFFManaging Editor Colleen M. KaruzaFeatures Editor/Writer Sue BanchichDevelopment Editor John C. SenallEDITORIAL BOARDChristine Ambrosone, PhD, Richard Cheney, MD, Stephen Edge, MD,Irwin Gelman, PhD, Maureen Kelly, RN, MS, Richard Matner, PhD,Tracey O’Connor, MD, Michael Zevon, PhDSpecial Advisor Michael A. Zevon, PhDCreative Services Director Benjamin RicheyCONTRIBUTING WRITERSGeorge Heidekat, Kerry Jones,Eric T. Rosenthal, Colleen M. KaruzaGraphic Production Manager Hillary A. BanasPhotography Benjamin Richey, Bill SheffADMINISTRATIONPresident & CEO Donald L. Trump, MD, FACPVice President for Marketing, Planning & Public Affairs Laurel A. DiBrogVice President for Development Cindy A. EllerOriginal Artwork Ann Frank

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Whose fault is it anyway?Is the “Shame and Blame” Game of Cancer Still Being Played?When the Black Death swept acrossEurope during the fourteenth century,wiping out half the population, noone knew about bacteria and their role inspreading disease. With no obvious explanationfor the catastrophe, the plague was interpretedas divine punishment for the sins of the afflicted.Terror of contagion led people to abandonbeloved family members when they fell ill.“Part of the mythology of canceris the subtle belief that if you’rediagnosed with cancer, you didsomething wrong.”More than 700 years later, the world continuesto struggle with fear and ignorance in theface of another mysterious and frighteningdisease—cancer. Though research is beginningto shed light on the nature of cancer, questionsremain unanswered about how and why itbegins, prompting some people to look forconvenient explanations based on the sin-andpunishmentmodel of the Middle Ages: Shegot cancer because she worked too hard–didn’texercise–was overly stressed–repressed heranger–was childless–was sexually promiscuous.“Part of the mythology of cancer is the subtlebelief that if you’re diagnosed with cancer, youdid something wrong,” says Michael A.Zevon, PhD, Chair of the Department ofPsychology at Roswell Park.It’s true, Dr. Zevon acknowledges, that somecancers are clearly linked to risk behaviors,such as smoking. But many cancers are notclearly associated with any specific risk factors,and this ambiguity can make people feel anxiousand vulnerable. Looking for reasons that oftenprove to be elusive, people may resort to“blaming” the cancer patient for his/herdisease. An explanation, even an erroneousone, that points to a behavior or an attributethat the blamer does not share often affordsa protective sigh of relief (“I’m not/I don’t__________ so I won’t get cancer.”) Regardlessof the reason, blame contributes to the psychologicalburden already faced by people whoare struggling with a life-threatening illness,and “that mythology produces a tremendouslystressful situation for the patient and the family,”says Dr. Zevon.The “you-brought-it-on-yourself” attitude is justone aspect of the stigma of cancer. Patientscan also be stigmatized by the mistaken beliefthat cancer is contagious. In some parts of theworld, women who have cancer may be forbiddenfrom touching their own children, or may beabandoned by their families or totally isolatedfrom the community. In American culture,“while there is much less open stigma, thereare real but subtle changes in attitudes,” notesStephen Edge, MD, FACS, Chair of theDepartment of Breast Surgery and MedicalDirector of the Breast Center at Roswell Park.“All of us have subtle biases that come fromstereotypes.”In addition to the emotional devastation it cancause the individual cancer patient, stigmatizationcan have far-reaching health effects. DeborahErwin, PhD, Director of the Office of HealthDisparities Research at Roswell Park, notes thatsome cultures tie gynecologic cancers so closelyto promiscuous sexual behavior that womenare embarrassed or ashamed to undergoscreening that could detect the disease earlier,when it could be treated more effectively.| f e a t u r ewww.roswellpark.org | 4

f e a t u r e |Blame contributesto the psychologicalburden already facedby people who arestruggling with a lifethreateningillness, andproduces a tremendouslystressful situation for thepatient and the family.for Educational Affairs, sees a parallel inthe evolution of public attitudes aboutHIV/AIDS. “If you don’t have experiencewith a disease, you relegate it to thetaboo, but as soon as it becomes morecommon, you have to deal with it and bemore accepting,” he points out. “In thebeginning, there was the idea that individualswho got AIDS deserved it and hadbrought it on themselves. Then the riskfactors transferred over into the heterosexualcommunity, and now everybody has todeal with the disease, so it’s not as taboo.In the same way, cancer was the eighthleading cause of death in the 1890s; todayit’s number two. Over time, it has becomemore prevalent, so people have had todeal with it.”“Some cultures think that only womenwho are immoral need to be screened,”she says. Although most cases of cervicalcancer have been linked to a sexuallytransmitted strain of the human papillomavirus(HPV), “the reality is, a womanmight have had one single, monogamousrelationship her whole life,” says Dr. Erwin.“Her partner might have been the onewho was promiscuous, but she ends upwith cervical cancer and the moralresponsibility for it.”Finally, “despite our progress in treatingcancer, there’s the mythology that a cancerdiagnosis is a death sentence,” addsDr. Zevon. That notion may lead to lossof employment opportunities or to friendsand family distancing themselvesemotionally from the cancer patient.But in reality, says Dr. Edge, “manypeople will be effectively treated forcancer and live long lives.”The good news about the cancer stigma,says Dr. Zevon, is that “people’s perceptionscan be changed.” There are two keys:increased access to accurate informationand greater exposure to people whohave cancer. Dr. Zevon notes that publiceducation efforts, outreach by cancerrelatedorganizations, and the news mediahave gone a long way toward expandingthe delivery of accurate information, whilecancer survivors have sped progress bytalking openly about their diagnoses.At the same time, adds Dr. Erwin, publiceducation programs, including the WitnessProject and Esperanza y Vida at RoswellPark, directly confront the notion of blameby stressing that cancer “is not punishmentfrom God. It’s somethingthat just happens to you, and youhave the opportunity to helpsomeone else by making sure theyget screened so they won’t haveto deal with this.”Arthur Michalek, PhD, RoswellPark’s Senior Vice PresidentIn every country and culture, “we have todo more with education,” he says. “Oncepeople become comfortable saying theword ‘cancer’ and discussing it, then youcan take the next step.”Need cancer support,resources? Have a question?Call 1-877-ASK-RPCI(1-877-275-7724).5 | roswellness

Celebrity patients changethe face of cancerago, when socialite Fanny Rosenow contactedThe New York Times about publicizing a support50yearsgroup for fellow breast cancer survivors, an editortold her that he would not print the words “breast” or “cancer,”recommending that she use the phrase “diseases of the chestwall” instead.* Since then, celebrity cancer survivors have helpedturn up the volume against the code of silence that kept peoplefrom talking frankly about cancer.| f e a t u r eFirst Lady Betty Ford was among the leaders, informing thenation in 1974 that she had undergone a radical mastectomyfor breast cancer. “Maybe if I as First Lady could talk about itopenly and without embarrassment, many other people wouldbe able to as well,” she told Time magazine. The impact ofher story rippled across the nation: at one clinic alone, thenumber of callers inquiring about breast cancer screeningsoared from 40 to 400 per day.Before her death in 1989 from ovarian cancer, “Saturday NightLive” comedienne Gilda Radner chronicled her struggle with thedisease in her autobiography, It’s Always Something. During herlife, she helped put the spotlight on a disease that often runs infamilies, and her death increased awareness that knowledge offamily medical history is critical to prevention and early diagnosis.Roswell Park named its international ovarian cancer registry in hermemory, and today the registry (www.ovariancancer.com) storesinformation about 1,936 families who have two or more relativeswith ovarian cancer, including 4,794 individual patients. Theinformation they have provided may hold clues critical to ourunderstanding of the disease, and the registry supports researchaimed at earlier detection.While taking part in a 1998 celebrity golf tournament to raisefunds for a mobile breast cancer diagnostic unit, RichardRoundtree, star of the film Shaft, stunned the crowd by announcingthat he was a five-year survivor of breast cancer. In a recent PBSinterview with Tavis Smiley, Roundtree recalled how he felt whenthe doctor delivered the diagnosis: “Is he questioning my manhood?”Noting that breast cancer “is still looked upon as a diseasethat only women can get,” today he’s working to set the recordstraight as an ambassador for Susan G. Komen for the Cure.After losing her husband, Jay Monahan, to colon cancer in 1998,Katie Couric waged a personal battle against the disease byencouraging early detection through colonoscopy. In 2000, the*Recounted in The Human Side of Cancer: Living with Hope, Coping withUncertainty, by Jimmie Holland, MD, and Sheldon Lewis (Harper Paperbacks, 2001)co-anchor of NBC’s Today Show helped relieve viewers’ fearand embarrassment of the procedure by giving them a front-rowseat as she underwent a colonoscopy. A study published laterin the Archives of Internal Medicine showed that the numberof screening colonoscopies shot up after the broadcast—a resultthat some researchers dubbed “the Couric effect.”Charlie’s Angel Farrah Fawcett, who recently passed away,courageously – and publicly – fought a three-year battle withanal cancer. Farrah’s Story, her “no-holds-barred” documentaryon her struggle with late-stage disease, was watched on NBCby nearly 9 million people.RPCI’s Tribute to Star PowerIn tribute to the Saturday Night Live comedienne, theRoswell Park Alliance Foundation annually presents the GildaRadner Courage Award to a cancer survivor whose publicbattle has given hope to cancer patients and focused nationalattention on cancer. Past recipients honored include MarvLevy, former head coach of the Buffalo Bills; actor BarryBostwick; Ted Kennedy, Jr.; comedienne Marcia Wallace; andRobin Roberts, co-host of CBS’ Good Morning America.Richard Roundtree photo courtesy J. Van Evers/Tavis Smiley. Betty Ford photo courtesy Gerald R. Ford Presidential Library.Gilda Radner photo courtesy Gilda Radner Familial Ovarian Cancer Registry, RPCI.www.roswellpark.org | 6

f e a t u r e |WhatAbout thePatient?Stigma of Cancer Down,But Not Out, Says PsychosocialOncology Pioneer Jimmie Hollandby Eric T. RosenthalWhen Jimmie C. Holland, MD, was ayoung wife and mother living inBuffalo, she often spent her eveningstalking in the kitchen with her husband James“Jim” F. Holland, MD, and his colleagues fromRoswell Park Cancer Institute (RPCI). Jim, amedical oncologist, was then Roswell Park’sChief of Medicine B.Jimmie had left her residency in psychiatry atMassachusetts General Hospital in Boston tomarry the medical oncologist in 1956. In Buffalo,she served part time on the psychiatry faculty atthe University at Buffalo’s School of Medicineand as head of psychiatry at Erie CountyMedical Center.At home, as she listened to the pioneeringcancer researchers describe their interactionswith patients, she would ask how the patientsfelt about their cancer. She had always hada strong interest in issues relating to thepsychological care and support of patientsfacing catastrophic diseases.Back then, she recalls, medical oncologists were“too busy” trying to save patients’ lives than topay much attention to the quality of those lives.“They were too engaged in the big problem offinding cures and thought my concerns were justtemporary stopgaps. But I was around when wesaw the first Hodgkin’s survivors. In the 1960s,we suddenly began to see people surviving.”Dr. Jimmie Holland7 | roswellness

“…stigma relates to anything that we areafraid of, don’t understand, and feel vulnerable to.”Dr. Holland went on to establish the first psychiatric service atMemorial Sloan-Kettering Cancer Center and is currently WayneE. Chapman Chair in Psychiatric Oncology and AttendingPsychiatrist in the Department of Psychiatry and BehavioralSciences. Considered one of the founders of psychosocial oncology,she helped launch some of the field’s leading professional societies,and authored many pioneering books and journal articles.Dr. Holland said that her husband and Emil Frei – another RPCIphysician and member of the Hollands’ “kitchen think tank”– began the Cancer and Leukemia Group B (CALGB) cooperativegroup at Roswell Park. (Both Holland and Frei, along with Emil J.Freireich, MD, and Donald Pinkel, MD, the founder of RoswellPark’s Pediatrics Department, went on to receive the 1972 LaskerAward for their contributions to pediatric acute lymphoblasticleukemia.)“When Jim was head of CALGB, he made the group multidisciplinaryat the National Cancer Institute’s request; [it had originallyonly included medical oncologists],” said Jimmie. “I figured withhis clout as chair, I’d ask him to start a psychiatry committee. Andthat’s how it happened, and it wouldn’t have happened if I hadn’tbeen married to him, believe me,” she says with a smile.Dr. Holland said that being involved in CALGB allowed thefledgling psychosocial oncology field to add quality-of-lifequestions into larger protocols, and that the first two psychosocialstudies were done with the cooperative group.“Cancer was stigmatized over the centuries,” said Dr. Holland,“because it was so fearful and fearsome a disease and nobodyhad any idea why you got it or how you got it.” Stigma oftenrelates to the shame or disgrace associated with something thatis socially unacceptable. “To me, stigma relates to anything thatwe are afraid of, don't understand, and feel vulnerable to.”Dr. Holland said the same thing happened with AIDS, noting shehad seen some of the first cases at Memorial Sloan-Kettering inthe early 1980s, and the great fear lessened once more wasunderstood about the disease. She added that what happenedwith the AIDS stigma was, to some degree, a shorter, decadeslongversion of the cancer stigma that spanned centuries.Finger-pointing or assigning blame for cancer’s causation hasalways been an added culprit, she said, which is why lung cancerremains the most stigmatized of cancers – although that stigmais starting to decline as the disease is being diagnosed inmore non-smokers.Today, Drs. Jimmie and James Holland are both in their 80s andstill working full time at their respective institutions, MemorialSloan-Kettering and Mount Sinai School of Medicine, where JimHolland is Distinguished Professor of Neoplastic Diseases.Jimmie is especially committed to having cancer patients’ distressrecognized as the sixth “vital sign” and seeing the Institute ofMedicine’s 2007 report on Barriers to Psychosocial Care ofPatients with Cancer in the Community integrated into practice.| f e a t u r eEric T. Rosenthal is Special Correspondent for Oncology Times.Food for Thought…How many Western New Yorkers know thatthe field of psychosocial oncology took rootin a kitchen in Buffalo, New York?www.roswellpark.org | 8

f e a t u r e |Colleen Zenk PinterACTRESS COLLEEN ZENK PINTERWhen viewers tuned in to the CBS daytime drama As the WorldTurns one day in 2007, many noticed that Barbara Ryan, one ofthe principal characters, had developed a slight lisp. Questionspopped up on fan websites: What’s going on?Today, watching scenes from that time is difficult for Colleen ZenkPinter, the Emmy Award-nominated actress who portrays BarbaraRyan on the show. She has sinceovercome the lisp—the result ofsurgery to remove the cancer andhalf of her tongue. She later underwentbrachytherapy to implantradiation rods into her reconstructedtongue. It’s an experience shedoesn’t want anyone else torepeat.Now Colleen has joined forces withRoswell Park Cancer Institute andthe Oral Cancer Foundation toeducate the public about the connectionbetween the human papillomavirus(HPV) and head and neckcancers. “I am just thrilled to helpRoswell Park spread the wordabout these types of cancers,” shesays. “I will talk with anyone whowill listen, as these cancers have norespect for gender or age. Bothyoung men and women need toknow that an HPV vaccine mightprevent this terrible disease.”FACES LIFETIME DRAMAIn October 2007, she appeared onCBS’ The Early Show to announceher diagnosis, describe her treatment,and urge the public toundergo annual screening for oralcancer. She also worked with thewriters and executive producer ofAs the World Turns to develop astoryline in which her characterdeveloped oral cancer, using the plot to educate viewers aboutthe diagnosis, treatment and emotional effects of the disease.Sharing her experience publicly was “very scary,” she admits,“but it was clear to me that I had to do something. I had to bevocal about this, because if I got it, there are thousands of otherpeople out there who are also in line to get it.”The decision was especially difficult because her doctors at Yale-New Haven Hospital felt her cancer was linked to a sexually transmittedstrain of the human papillomavirus. Although HPV is themost common sexually transmitted disease in the nation—it’s estimatedthat about 70% of American men and women will beinfected at some point during their lives—talking about it publicly“was uncomfortable,” says Ms. Zenk Pinter. For one thing, shehad children to consider: she andher husband, actor Mark Pinter,are the parents of six. “We havelived in a small community inConnecticut for over 20 years, andwe’re ingrained in the fabric ofthis community,” she notes.“I did not have complete supportfrom my family for going publicwith this. Some of my childrenthought I was doing somethingvery brave, and some did notwant me drawing attention tomyself with this at all. But noweveryone has jumped on thebandwagon.”Getting the word out that HPV islinked to oral cancer has beenpart of her educational mission,and that means confronting theinescapable fact that “it’s sexuallytransmitted. You can’t just contractit through the air.” Shebelieves that young men andwomen alike need to be vaccinatedagainst HPV—a position advocatedby Roswell Park physiciansand researchers (see story, nextpage).Her efforts to put the spotlight onoral cancer were recognized inMay 2009, when the New YorkUniversity College of Dentistry honored her with the StrusserMemorial Award for public service and outstanding contributionsto improved public health. Even more important from her perspective,she has learned how her work has helped protect thelives of other people. Letters and e-mail messages responding toher story “have been overwhelming,” she says. “When I get a letterthat says, ‘Thank you; I went for screening and they found thatI have oral cancer,’ then I know I really have helped people.”9 | roswellness

head and neck cancers treated at Roswell Park test positive forHPV. To date, the total is around 50 to 60 percent.There are more than 100 types of HPV—each identified bynumber—but only 70 have been described so far, explainsPopat. Some HPV viruses, including 16 and 18, are transmittedsexually—not just through sexual intercourse, but through anyskin-to-skin contact involving the mouth, vagina, vulva (theexternal female genitalia), penis, anus or fingers.HPV 16 and HPV 18 were previously identified as the causeof most cases of cervical cancer in the U.S. HPV has also beenimplicated in the development of some cancers of the vulva,vagina, anus, penis, and perineum (the area between thegenitals and anus).| f e a t u r ePARENTS:Boys Need to BeVaccinated, Too,Say RPCI ExpertsRoswell Park researchers are urging a national discussionabout the need to vaccinate both young men and womenagainst HPV 16 to prevent head and neck cancers. The callcomes amid growing evidence that certain cancers of the headand neck are strongly linked to HPV 16, a specific strain of thehuman papillomavirus (HPV) that is one of the most common sexuallytransmitted diseases in the U.S. It is estimated that about70% of Americans, both men and women, will be infected withHPV at some point in their lives.The types of cancer associated with HPV occur mostly at theback of the tongue, in the tonsils, and in the soft palate at theback of the throat, according to Thom Loree, MD, Chair of theDepartment of Head & Neck Surgery. Over the past 10 years,members of his department have seen a threefold increasein the number of throat cancers they treat.In 2007, Roswell Park researchers began testing all head andneck tumors treated at Roswell Park for the presence of HPVDNA, says Saurin Popat, MD, FRCSC, FACS, Attending Surgeonin Head & Neck and Plastic & Reconstructive Surgery. RoswellPark is one of few institutions in the nation to do that. Datafrom the ongoing testing have been combined with data fromarchived tumor samples to provide a clearer picture of how manyThere is no cure for HPV, just as there is no cure for the commoncold. In most people, an HPV infection will clear up on its own,but it can be passed on to other people during the infectionperiod—just as with the common cold. In some cases, the personmay continue to be infected for decades without any symptoms.During that time, the infected person can infect others withoutknowing it. Over time, this “silent,” chronic HPV infectionincreases the risk of developing certain cancers.In 2006, the FDA approved the use of Gardasil, a vaccine thatprotects against HPV 6, 11, 16 and 18, for females between theages of 9 and 26, to help prevent cancers of the cervix, vulva andvagina, as well as genital warts. The FDA has not approved thevaccine for males. The issue of extending approval to males toprotect against HPV-related cancers is under review, with adecision expected shortly.Loree, Popat and their colleagues see compelling evidencefor extending the vaccine’s protection to boys. Says Dr. Popat,“The side effects of the vaccine are so small, and the potentialbenefits are great.” He notes that patients with throat cancer“have to undergo major treatment lasting several months, withan additional four to six months of recovery. Their ability tospeak and swallow is affected. Generally, they do very well;however, it is a long, challenging road.”Based on the evidence to date, Dr. Loree says that “withincreased vaccination against HPV, you’ll see a decrease incervical cancer and in throat cancers.”The American Cancer Society estimates that 35,310 new cases oforal and oropharyngeal cancer are diagnosed every year—25,310of those in men—and that 7,590 people, including 5,210 men,die of those cancers. Smoking, the use of chewing tobacco, andheavy alcohol use remain the leading causes of cancers of thehead and neck.Visit www.roswellpark.org/hpv to learn more about theconnection between HPV and cancers of the head and neck.www.roswellpark.org | 10

m y t h b u s t e r s |The HelplesslyHopeless Guinea Pig...and other clinical trial mythsClinical trials, or clinical research studies, take the first stepstoward introducing new and better ways of preventing, diagnosingand treating cancer, by evaluating their use in people.Without them, there would be no progress toward cancer cures.Clinical trials may study new ways of preventing cancer inhealthy people through drugs, diet, and exercise; new drugsfor treating cancer patients; or better ways of using currenttreatments, such as chemotherapy and radiation.People who take part in clinical trials stand to benefit frompromising new treatments that are not available to everyone.Participants also have the opportunity to contribute valuableinformation to research that might help other cancer patientsin the future.Many people misunderstand the purpose of clinical trialsand how they are conducted. Here are some commonmyths—and the facts that patients and their families needto make informed decisions about whether to participate.✖ The Myth: In a clinical trial, you are little more than a humanguinea pig in a lab experiment.✔ The Truth: In designing clinical trials, physicians have twoconcerns: that all patients who participate receive the highestquality medical care, and that rigorous scientific principles arefollowed to allow meaningful conclusions to be drawn.Compelling evidence must exist that suggests that the investigationaldrug or other therapy is at least as good as the standard.In every clinical trial, patient welfare and safety are themajor considerations.✖ The Myth: Because Roswell Park is a research institute, allpatients treated there must take part in clinical trials.✔ The Truth: About half of all Roswell Park patients areeligible to participate in clinical trials, but it is only an option.It is entirely the patient’s decision to enroll or not.✖ The Myth: Once you are enrolled in a clinical trial, you mustcontinue, even if you change your mind.✔ The Truth: Clinical trial participants always have the right towithdraw—at any time, for any reason.✖ The Myth: If you take part in a clinical trial, you might receivea placebo (a pill, liquid or powder that contains no medicine;sometimes called a “sugar pill”) instead of real medicine.✔ The Truth: Few cancer clinical trials use placebos, and theyare never given to cancer patients in place of treatment. Cancerpatients who take part in clinical trials must receive at least thebest standard treatment available. In many cases, they willreceive a new and better therapy being evaluated.✖ The Myth: If you are thinking of enrolling on a clinical trial,you won’t be told in advance about everything that’s going tohappen.✔ The Truth: The rights and interests of people who enroll inclinical trials are carefully protected by an Internal Review Board(IRB) and the Food & Drug Administration (FDA). In a processcalled informed consent, anyone who is thinking about enrollingin a clinical trial must receive detailed information about thestudy so they can make an informed decision about participating.✖ The Myth: You should enroll in a clinical trial only if there areno other treatment options left.✔ The Truth: Most cancer patients should consider participatingin a clinical trial as one of their treatment options. There aretrials for all different types and stages of cancer. Participants aremonitored carefully throughout the trial, so they receive excellentcare and can be the first to benefit from new treatmentsbefore they are available to everyone.Look for more information in the next issue of Roswellness about Roswell Park’s thriving Phase I clinical trialsprogram. To learn more about clinical trials or to find open clinical trials at Roswell Park, visit www.roswellpark.org(click on Patient Care --> Clinical Trials) or call 1-877-ASK-RPCI (1-877-275-7724). You can also search for open clinicaltrials across the nation at the National Institutes of Health website, at www.clinicaltrials.gov.11 | roswellness

S T R A I G H T T A L K F R O M T H E E X P E R T SDoes stresscause cancer?a: Let me start by saying this is a very complicated question. Right now,the available information does not support the belief that stress causescancer. While researchers have studied the relationships among behavior,emotions, stress and cancer, a number of articles in the popular press havegrossly oversimplified the findings about these very complex processes.Unfortunately, these articles will often say, “If you don’t handle your angerright, you’re going to get cancer! If you don’t quit your job because you’reunhappy, you’re going to get cancer!”| m y t h b u s t e r sMichael A. Zevon, PhD,Chair of the Department of Psychology,answers a common questionabout stress and cancer.That warning message is often tied to the subtle belief that if you’re diagnosedwith cancer, you did something wrong. While there are clear associationsbetween certain behaviors and risk factors—smoking being the mostobvious—blaming people who are diagnosed with cancer is never warranted.Blame can result in shame and interfere with active engagement in treatment.The bottom line? We have a long way to go toward knowing whether, or how,stress contributes to the onset of cancer.▲ David Rose (seated), with daughter Marsha Sperduti (left)and granddaughter Jacqueline.Got a question for one of our cancer experts? Send it via email to Roswellness@roswellpark.org or mail it to Colleen Karuza,Public Affairs Office, Roswell Park Cancer Institute, Elm & Carlton Streets, Buffalo, NY 14263.Got Questions? We Got Answers!Every year, Roswell Park’s Cancer Information Specialists field some 20,000 calls and10,000 e-mails from people across the nation who need authoritative answers to theircancer questions:I think cancer runs in my family; what should I do?What treatments are available for the type of cancer I have?What are the side effects of chemotherapy drugs?Am I eligible for any clinical trials at Roswell Park?The Cancer Information Program has been an information lifeline for 67-year-oldBob Fescemyer, a prostate cancer survivor and the mayor of Oakmont, PA. In aMay 21, 2009 interview with the Pittsburgh Post-Gazette, Mr. Fescemyer noted thatboth his parents had cancer, his wife is a cancer survivor and one of their sons hasadvanced prostate cancer. Stressing the importance of self-education for cancerpatients and their families, he said he has called 1-877-ASK-RPCI so frequently thathe once apologized to the Cancer Information Specialist who answered his call.“She said, ‘We’re here for you, whenever you need us.’”Elaine Bauer, Manager of the Cancer Information Program and Roswell Park’sCommunity Cancer Resource Center (CCRC), says Cancer Information Specialists inthe CCRC also answer cancer-related questions, for both callers and walk-in visitors.Do you have a cancer question? Call 1-877-ASK-RPCI (1-877-275-7724),Monday–Friday, 9 am–5:30 pm or visit the CCRC on the second floor of theRoswell Park hospital.The “Cancer Answer” Team: (standing) DJ Jones, ColleenKing, Diane Litzinger and Elaine Bauer; (seated) James Hartwww.roswellpark.org | 12

e e n t h e r e , d o n e t h a t |MaryFlanigan:AttitudeAdjusterFrom the time of her first leukemia diagnosis atage six, Mary Flanigan became an outspokenambassador for every cancer patient whoseillness has attracted the attention of other people.After missing most of first and second grade becauseof lengthy hospital stays, she entered third grade witha Broviac catheter attached to the outside of her chestto provide access for future chemotherapy infusions.“You could see it—it was out there,” she remembers.So the inevitable question came up when she and herclassmates were changing into their gym clothes:“What is that?” “This is my Broviac,” she explainedfrankly. “This is where I get chemo.” The questionwasn’t meant to be hurtful, so her answer wasn’tdefensive. “They were just intrigued,” she explains.Things were a little different when she learned at age15 that her leukemia had recurred. She and her boyfriend,Eric Bennett, an athlete, had started dating just a monthearlier. “I told him, ‘I understand if you can’t deal with this.You can just be my friend right now,’” says Mary.He brushed her worries aside. As her treatmentsprogressed, he ignored cruel comments from someof his teammates who made fun of Mary’s bald headand her round face, swollen from the steroids she tookto boost the effectiveness of the chemo. Before everygame, he rubbed her head for good luck. His loveand support, and the kindness of others close to her,took the edge off the painful wisecracks.Recognizing the burden of the medical bills Mary’sfamily faced, her teachers at Williamsville North HighSchool in Amherst, New York, raised money so shecould buy a dress for the senior prom. “They were allso nice,” she says. She wore a wig that evening, butfound it uncomfortable—“it was like wearing a ski hat,24/7”—and her boyfriend gave her an out. “I had thewig on, and he looked at me and said, ‘Aren’t yousweating?’ I said, ‘Yeah,’ and he said, ‘Just take it off.’So I did, and everyone was just dancing around mewith my little bald head.”It was harder to go bald in the wider world andendure the dumbstruck, open-mouthed stares ofstrangers in malls and restaurants—stares that camemostly from older adults.“A lot of people think that kids will say some reallymean things, but honestly, the kids were more understandingthan many of the adults. I couldn’t even eatwithout being stared at.”She knows that educating other people is the onlyway to stop the stares. That’s why, despite a grueling13 | roswellness

… A F O R U M W H E R E P A T I E N T S S H A R E T H E I R S T O R I E Sschedule—she works 40 hours a week and also attends classes full time at BuffaloState College—she often volunteers to speak publicly about her experiences as acancer survivor.“I might not be in treatment now, but I want to doanything I can to make other people more comfortableso that someone else who is diagnosed doesn’t get thejaw-drop stare while they’re trying to have dinner.”For several years, she was an artist and ambassador for The Paint Box Project ®holiday card and gift program at Roswell Park. In 2008, she became a source ofinformation and inspiration as one of Roswell Park’s Stars of Hope. She talkedabout the effects of her cancer diagnosis as a guest on WBEN Radio’s “SandyBeach Show.” She appeared in a Roswell Park video testimonial urging New YorkState legislators to sustain funding for the Institute. Through Roswell Park’sCancer in the Classroom program (developed by the departments of Pediatrics,Psychology, and Social Work and sponsored by The Steadfast Foundation forCarly’s Club), she has helped area teachers understand the needs of pediatriccancer patients. Recently, she appeared as the host of a video about RoswellPark’s School Outreach Program, another initiative supported by The SteadfastFoundation, which helps ease the transition for pediatric cancer patients who arereturning to the classroom after treatment.And as someone who received donated blood products many times during hertreatment, she expressed her gratitude eloquently at the Donor Center’s recentappreciation luncheon for Roswell Park blood donors. “The donors were movedby her story and impressed with her poise,” says Maria Turner, Marketing andCommunications Director of Lab Medicine.Mary is also preparing to make a very personal contribution to someone she hasnever met. When her hair began to reappear after chemotherapy, “my originalthought was that I wanted the longest hair ever, because I haven’t had any forfive years,” she says. But now that her dark tresses are waist-length, she’s thinkingof other girls who might be embarrassed after losing their hair as a result ofmedical conditions or treatments. So very soon she’ll have her lovely hair cutto provide one of them with a wig.Prescriptionfor change?Mary’s take on akid’s-eye view of cancer“When you’re six years old andyou’re around someone your ownage who has cancer, you might think,Oh, my grandma died of that,” saysMary Flanigan. “Kids immediatelythink of the elderly. You’re supposedto be old if you’re sick, so if you’re akid with cancer, that’s a stigma rightthere. They think if you’re a kid,you’re supposed to be invincible.”She believes kid-to-kid cancereducation is received better thanadult-to-kid education, “because theinformation is coming from the actualkid who’s a cancer patient—andanother kid puts everything in thesimplest terms. You get the informationfrom someone you trust andsomeone who’s just like you.”| b e e n t h e r e , d o n e t h a tA senior majoring in public communications, Mary feels strongly that “whenpeople don’t hear it from the horse’s mouth, they make up their own stories,and that’s how rumors start.” But she recognizes that the frank approach shetakes in sharing her story isn’t possible for every cancer patient. “Everyone dealswith it differently,” she says. “I’m extremely open. It’s not a big issue for me.”She’s not doing it for herself—after all, her hair has grown back, her face is nolonger swollen. “I might not be in treatment now,” she says, “but I want to doanything I can to make other people more comfortable so that someone else whois diagnosed doesn’t get the jaw-drop stare while they’re trying to have dinner.That’s going to vanish one of these days, and I want to be part of the turnaround.”Bald was beautiful indeedafter Mary Flanigan (withboyfriend Eric Bennett) ditchedher uncomfortable wig (inset)before her junior prom in 2005.If you’re a cancer patient between the ages of13-26 and want to connect with other young cancerpatients and survivors, visit Yroswellpark.com.www.roswellpark.org | 14

e e n t h e r e , d o n e t h a t |Kaitlyn Schneider’sEarly (Cancer) EducationThe transition from elementaryschool to middle school is hardenough for most kids, but it hit 11-year-old Kaitlyn Schneider with a doublewhammy. She was entering sixth grade atFrontier Middle School in Hamburg, NewYork, when she found out she had non-Hodgkin’s lymphoma. Home-schooledduring her lengthy treatment, she missedthe first year of middle school — justwhen her friends from elementary schoolwere beginning to form attachments tostudents entering Frontier Middle fromthree other area elementary schools.“Her friends started branching out,”recalls her mother, Jennifer Schneider.“They started hanging out with otherpeople, because Kaitlyn didn’t alwayshave the energy to be with them. Theyjust didn’t understand the total impactof the cancer treatments, or that she stillneeded to be with them.“She had to give up her childhood a littlebit. That was difficult for my husband andme to see.”Fortunately, her involvement with Carly’sClub for Kids & Cancer Research atRoswell Park put her in touch with otheryoung cancer patients who knew firsthandwhat she was going through. Sponsoredby pediatric donations to Roswell Park,Carly’s Club organizes parties, groupactivities, outings to Sabres games andother events that bring pediatric patientsand their families together.When Kaitlyn returned to school,there were occasional comments—one student referred to her as“the girl with cancer”—but for themost part, Jennifer says, peopleseemed “a little more educatedabout cancer patients, probablypartly because of Roswell Park’soutreach programs.”The School Outreach Programhelps pave the way for apediatric patient’s return to theclassroom by helping classmatesand the teacher understand thenature of the disease and thepossible effects of treatment,including hair loss. A secondprogram, Cancer in the Classroom,provides area teachers, school nursesand other school personnel with asense of “what these kids experiencewhen they go back to school,” saysMrs. Schneider. She and Kaitlyn havevolunteered as speakers for Cancerin the Classroom, and “it felt goodto help other kids who were goingthrough the same thing,” says Kaitlyn.Now 15 and entering her sophomoreyear at Frontier High School, Kaitlynhas reconnected with many of herold friends and made new friendsby joining a rowing team at the WestSide Rowing Club. “Now that she’sin high school, the kids are moremature,” says her mom. “Things aregetting back to normal for her.”“It definitely helped me,” says Kaitlyn.“I met a lot of my friends through Carly’sClub. We didn’t really talk about whattype of cancer we had, but it gave us thesense that other people were goingthrough the same thing.”Kaitlyn Schneider (left) withfriends at a Carly’s Club event15 | roswellness

140,000 MDsCouldn’t be Wrong!In the May/June issue of AARP The Magazine, Roswell Park and sevenother cancer hospitals were listed as the nation’s best!In compiling the list of best hospitals, Consumers’ Checkbook, a nonprofitorganization, surveyed 140,000 doctors from across the country. The doctorswere asked whether, and where, they would recommend patients seek carein other communities for extremely difficult cases of cancer. Roswell Park waslisted among the “Doctors’ Faves” for specialized cancer care.| o f n o t eWith more than 34 million readers nationwide, AARP The Magazine is theworld’s largest-circulation magazine and the definitive lifestyle publication forAmericans 50+.In MemoriamJohn J. “Jack” Black, PhD, retired Roswell Park scientist and the husbandof Susan Black, Director of Physical and Occupational Therapy, died April 6,2009. Dr. Black was recognized worldwide for his groundbreaking researchon pollution-related cancer in GreatLakes fish. His work focused publicattention on the need for morestringent environmental standards.John J. Black, PhDpictured with wife SusanMichael DoranMichael Doran and Matthew Schnirel, bothMatthew Schnirelattorneys with the Buffalo firm Doran & Murphy,were killed in the crash of a small plane outside Cleveland on April 28, 2009.Mr. Doran was among the top 10 fundraisers for the 2008 Ride for Roswell. Atthe time of his death, he was working to raise awareness of the Stacey ScottLung Cancer Registry at RPCI—aimed at early detection of lung cancer inhigh-risk patients—among his clients who had been exposed to asbestos.Mr. Schnirel raised funds for Carly’s Club for Kids & Cancer Research as aCarly’s Crossing swimmer.www.roswellpark.org | 16

v o i c e s c a r r y |Across bordersAn inspirational tale ofheart, health & homelandIn many respects, Kashmir is a paradise. Bordered by snowcappedmountains and watered by rivers tumbling from theHimalayas, it harbors yaks and snow leopards, and its fertilevalleys produce apples and mulberries and exotic flowering plants.But with limited financial resources, the region struggles to provideits 10 million inhabitants with basic education and adequate healthcare. That’s of special concern to Khurshid Guru, MD, Surgeonin Urologic Oncology and Director of Robotic Surgery at RoswellPark, because Kashmir is his homeland. “There are lots of ruralareas, poorly equipped schools, little healthcare and limitedresources,” he says.Two years ago, he established the Guru Charitable Foundationto encourage the education of young people and promote bettermedical care in the region. The educational side of the foundationcurrently provides scholarships for 245 children in grades 8-12whose families earn less than the equivalent of $1,000 (U.S. currency)per year.The scholarships pay for the children’s tuition, books and examinationfees, but even more important, “for children who have a recordof greater than 80% attendance, we plan to provide the parentswith a stipend for each day of school attended,” explains Dr. Guru.That money is an incentive for families to keep their children inschool rather than sending them out to work to help support thefamily. Dr. Guru hopes a chance at education will enable youngpeople to rise above illiteracy and poverty so they can lead theregion into a new era of peace and progress.Roswell Park’s Division of Cancer Prevention and Control,is working closely with Dr. Guru in developing the lengthysurvey. “This is extremely exciting to me, because it’s agrassroots epidemiology study that involves researchersgoing out in the field,” says Mr. Ciupak. “It’s the first timethis work has been done in that area, to collect healthinformation on a population that we have no informationabout. The possibilities for developing programs andaddressing health issues is wide open.”Dr. Guru has also recruited several other Roswell Parkfaculty to assist with cancer-related projects, includingChristine Ambrosone, PhD, Chair of the Departmentof Cancer Prevention and Control; Stephen Edge, MD,FACS, Chair of Roswell Park’s Department of BreastSurgery and Medical Director of the Breast Center; andJames Marshall, PhD, Senior Vice President for CancerPrevention and Population Sciences. Says Dr. Edge,“It's inspiring to see the depth of Dr. Guru’s commitmentand the work he’s putting into the program to improvehealth in his home country.”Much of Dr. Guru’s attention focuses on educating womenabout breast cancer. “There is no breast cancer awarenessprogram there,” he notes. “In that region, health care forwomen is not very good. And because of the social taboo,women don’t come forward for breast cancer care. That’swhy there is so much advanced disease.“It's my goal to establish a breast cancer program acrossthe country. The foundation is hiring master of sciencestudents who will go house to house to teach womenabout breast self-examination in their homes.”Health educators will use publications developed byRoswell Park’s Breast Center and translated into Kashmiriand Urdu, the two principal languages of the region.The foundation is also tackling health education from severalpoints, including televised public service announcements focusingon diabetes, high blood pressure and the dangers of smoking.Pamphlets are being distributed to teach parents how to treatdehydration—a common health hazard for children—andstressing the importance of breastfeeding.On a larger scale, the foundation is launching theregion’s first-ever survey to begin identifying thegreatest health problems in Kashmir. Results of thesurvey will provide a starting point for designingadditional education and health-interventionprograms that will have the greatest impact. GregoryCiupak, Scientific Research Project Administrator in17 | roswellness

E M P O W E R E D A N D A W A R EHelen Cappuccino, MD, a Roswell Park breastsurgeon (see related story, page 20), hopes totravel to Kashmir to help with those efforts.In a region with only one or two mammographycenters, breast self-examination could be thefirst line of defense against breast cancer.“Women will know what to look for, the dangersigns, so they’ll know to go to the hospital ifThe foundation’s ambitious goals reflectDr. Guru’s love of his homeland and its people.It is also a tribute to the memory of his latefather, Dr. Abdul Ahad Guru. Just as Dr. KhurshidGuru is a pioneer in the field of roboticsurgery—he has performed more roboticcystectomies than anyone in the world—hisfather was a pioneering cardiac and vascular“Breast cancer is one of the fastest-growing cancers in Kashmir.Imagine going to a place that has never known breast cancerscreening! You could change the whole face of disease there.”| v o i c e s c a r r ysomething is going on,” says Dr. Cappuccino.“I'm also happy to offer any of the clinicalexpertise I have in breast surgery to take careof patients in need while we’re there.”“Breast cancer is one of the fastest-growingcancers in Kashmir,” says Dr. Guru. “Imaginegoing to a place that has never known breastcancer screening! You could change the wholeface of disease there.”surgeon who performed the first open-heartsurgery in Kashmir and established theregion’s first private medical school. He tookthe first step for Kashmir. From half a worldaway, his son takes the next.Learn more about the mission of theGuru Charitable Foundation in Kashmirat www.GuruFoundation.org.Glimpses of government public schools in Sopore, Kashmir that are involvedin the Guru Foundation’s “Save the Future” Scholars ProgramDr. Guru (second from right) and members ofthe foundation discuss grassroots projectsat one of the participating schools.www.roswellpark.org | 18

E M P O W E R E D A N D A W A R Ev o i c e s c a r r y |Gynecologychair extendsRoswell ParkinfluenceworldwideEndowed fellowship willimprove women’s healthcareShashikant Lele, MD, has seen firsthandthe tragic effects that poverty can have onaccess to quality healthcare. “In manycountries, people are severely lacking in themost basic of primary care—don’t eventhink about specialized care for things likecancer or specific cancers,” says Dr. Lele,Chair of Gynecologic Oncology at RowellPark. “A lot of women might get ovariancancer or cervical cancer and never knowthey had it—they just get a tumor and die.Quality care is available only for those whocan afford it, and only in the big cities.”Dr. Lele wants to help change that. Thanks togenerous initial gifts from the Gerald Lippesand Robert Castellani families, he will leada new fellowship program to bring youngdoctors from around the world to RoswellPark for advanced training in the field.“These are doctors who are alreadypracticing,” he explains. “They want tolearn the discipline and surgical techniquesthat we use here—how protocols are run,how to do studies—but their countriesdon’t have fellowships, and they can’tafford to come here.”The Shashikant B. Lele, MD, EndowedFellowship will pay for airfare and apartmentrental assistance for fellows admitted to theprogram. Each will stay approximately threeto four months. During that time, underDr. Lele’s wing, they’ll acquire expertisebased on their medical or scientificinterests as they train at one of America’sleading comprehensive cancer centers.Dr. Lele adds that the program will alsobe open to American doctors, providedthey are practicing in cities of great needand lack leading-edge training. But mostwill hail from such places as Turkey, India,Taiwan, Greece and other parts of the world.Initial gifts toward the $750,000 endowmentgoal were given as a tribute to the manwho, for more than four decades, hashelped move the gynecology field forwardwhile contributing immeasurably to the livesof countless women and their families.“When you are in the fight of your life,you want the best of the best fighting withyou, and that’s Dr. Lele,” says RosemaryCastellani. “He represents all that shouldbe passed on to the next generation ofdoctors—expertise, passion and unparalleleddevotion to his patients.”Lele believes the long-term impact of theendowment will be far-reaching. “My hopeis that these doctors will become ourambassadors when they go home, offeringfuture collaborations in clinical or laboratoryresearch,” he says.“My main goal, though, is simply tohelp internationally underserved people,whether in the U.S. or another country.I want them to go back and practicemedicine that will help improve thehealthcare of women.”Read more about Dr. Lele’s work or make a gift toward the newendowment today at www.roswellpark.org/giving, orcontact Linda Kahn at 716-845-7606, or at linda.kahn@roswellpark.org.19 | roswellness

Cappuccinos in Kenya“Gettingback tothe basicsof whywe choseto go intomedicine.”Roswell Park breast surgeon Helen Cappuccino, MD, and her husband, Andrew,an orthopedic surgeon, wasted no time when they traveled to Kijabe, Kenyaseveral months ago to volunteer their medical services. “We flew through thenight, landed in the morning and went straight to the hospital and started operating,”says Dr. Cappuccino. With their 17-year-old son along to assist them, the couplespent 12 to 14 hours each day performing spine surgeries on patients who otherwisewould not have had access to the surgical care they needed. For the two surgeons,the journey was a way of “getting back to the basics of why we chose to go intomedicine,” says Dr. Cappuccino.The Cappuccinos were especially gratified by the outcome for a 12-year-old boynamed David whose curved spine, deformed by tuberculosis, had forced him tohunch over when he walked. Following surgery, he stood straight and tall.In anticipation of returning to assist more patients in the future, the coupleleft behind more than $100,000 worth of equipment donated by severalcompanies. But their mission is twofold, Dr. Cappuccino points out— “notonly to do the surgery, but to begin to educate the doctors in the communityabout how they can do things like this themselves.| v o i c e s c a r r y“Teaching them will require multiple trips, but if we do our job correctly,afterward they won’t need us. They will be able to take care of people intheir own community, people in the immediate region, and refugees.People from Somalia and many, many other countries would find theirway to the tiny hospital in this safe haven.”She notes that Kijabe is a religious community, and “the people arejust a joy to be around.” She hopes the connections that she, herhusband and their son made during their stay will “shrink the globalcommunity so people will know there are friends out there they canturn to in times of need.”▼ Drs. Helen and Andrew Cappuccino at work in the operating room in Kijabe, Kenya. ▼Cradling her son, a mother waits asDrs. Helen and Andrew Cappuccinoperform spinal surgery on her daughter.www.roswellpark.org | 20

v o i c e s c a r r y |Save alife at lunchYou don’t often have theopportunity to savesomeone’s life, especiallywhile you’re eating a sandwich.But volunteers from WesternNew York businesses aredoing that on a regular basisthrough the Save a Life atLunch program of RoswellPark’s Donor Center. To makeit more convenient for peopleto donate blood to RoswellPark patients, the DonorCenter offers a door-to-doorshuttle service that picks themup from their places of business,collects their blood, feeds them,and whisks them back to workin approximately one hour.“They make it very convenient,”says Bob Schuster,one of several volunteers fromSynacor, a company headquarteredin downtown Buffalothat provides services forinternet service providers.He reclines in the donor chair,a cup of yogurt and dish offresh fruit besidehim as he waits to get started.A first-time donor, he saysgiving blood “is somethingI’ve always wanted to do.I’ve had family come throughRoswell Park, and I’d like tohelp in any way I can.”Lunchtime donations helpmeet a critical need, saysMaria Turner, Marketing andCommunications Director ofLab Medicine. “Roswell Parkuses more blood productsthan all the hospitals inWestern New York combined.That’s because we’re a cancerhospital. Chemotherapy andradiation can interfere with thebody’s production of platelets,and they can also destroyhealthy red blood cells.”Blood is also critical forpatients whose bone marrowis not functioning properly toproduce healthy blood cells.Ms. Turner launched Save a Lifeat Lunch in 2004 to increasewhole-blood collections, butthe first donors had to get toRoswell Park on their own.“Then Dr. RichardCheney, Chair ofPathology andLaboratoryMedicine,suggested wecontact ourJoseph Pitzonka (left) and TimothyAce, both from Synacor, rolled uptheir sleeves to help save lives at Roswell Park.Transportation Department tosee if we could shuttle peopleover,” recalls Ms. Turner.Once donors no longer facedthe hassle of finding a parkingspace, especially after returningto work, the program really tookoff. Since then, more than 70organizations have participated.“Some groups sign up asmany as 30 donors, and wehave to break them up overtwo or three days,” she says.Donors have a choice of eithera free brown-bag lunch—eatenduring the donation processor taken with them on the wayout—or a sit-down luncheoncatered by Roswell Park’sSunflower Café. Either way,Ms. Turner says, the cost ofproviding lunch for donors is asmall price to pay forlifesaving blood.Save a Life at Lunch isunique among the nation’sblood banks, she adds. “Thereare mobile operations wheredonations are taken atemployers’ work sites orother sites in the community,but nobody else provides ashuttle service and freelunch.”The donors themselves attestto the program’s appeal.Stephen Barnes of Cellino &Barnes law firm (who prefersthe bag lunch) is among thosewho donate through the program.“There’s such a need,and we think it’s the least wecan do,” he says. “Many, ormaybe even most of us, havehad a family member or friendwith cancer who has beentreated at Roswell Park.”Anita Humphreys, Roswell Park’sBlood Donor Coordinator,adds that donors are inspiredwhen they walk through thefirst floor of the hospital to theDonor Center and see the verypatients they will be helping.“They know the blood isstaying right here at RoswellPark and is going directly toa patient,” she says.To find out how your company can get involved, emailAnita Humphreys at Anita.Humphreys@roswellpark.org,call her at 716-845-7667, or visit the Donor Centerwebsite at www.roswellpark.org/donorcenter.21 | roswellness

E M P O W E R E D A N D A W A R EBaby’s First Gift?The Gift of Life| v o i c e s c a r r y“We arepleased to beable to offerthe parents ofnewborns theopportunity tohelp in thisimportantresearch.”Babies born at Mount St. Mary’s Hospital and Health Center in Lewiston, New York, aremaking important contributions to research at Roswell Park. With the permission of anewborn’s parents, blood from the baby’s umbilical cord is processed and stored atRoswell Park for use in various studies. The collection effort is led by Meir Wetzler, MD,Chief of Roswell Park’s Leukemia Division.Cord blood is used to nourish the baby before birth, but is no longer needed—and isusually thrown out—after the baby is delivered. But it is rich in stem cells, the body’sbuilding blocks, which may hold the key to understanding and treating leukemia andother diseases. Unlike stem cells collected from adults, those found in cord blood are lesslikely to have been exposed to viruses. Nothing is destroyed or harmed in the collection ofcord blood stem cells, so there are no moral issues, as with the use of embryonic stem cells.Judy Wesolowski, MD, Chief of Maternity Services at Mount St. Mary’s Hospital, saysabout 400 babies are born each year at Mount St. Mary’s. Since their collaboration withRoswell Park began in November 2008, about 40 families have agreed to the collectionof their babies’ cord blood.“We are pleased to be able to offer the parents of newborns the opportunity to help inthis important research,” says Dr. Wesolowski. “Many have a relative who is afflicted withcancer, and this research may help.”www.roswellpark.org | 22

S T O P T H E P R E S S E S !w o w - w o r t h y n e w s |Drawn to ExcellenceRPCI hopes to garner the “Nobel Prize” for Nursing“In Magnet hospitals,patient outcomes are better, andtheir length of stay is shorter.”Lisa Boris, RN, BSN, likes to think of it as “the Nobel Prize for nursing.”Designation as a Magnet Hospital for Nursing Excellence is an honor earnedby fewer than 5% of all hospitals in the U.S. For the first time, RPCI is on aquest for that distinction, given by the American Nurses Credentialing Center(ANCC), the nation’s largest nursing accrediting and credentialing organization.The Magnet label helps patients identify hospitals where they’ll receive the bestcare. “In Magnet hospitals, patient outcomes are better, and their length of stayis shorter,” notes Maureen Kelly, RN, MS, RPCI’s Vice President of Patient CareServices and Chief Nursing Officer. “U.S. News & World Report has addedMagnet status as one of the criteria for evaluating the top 100 cancer centersand top 100 hospitals in the U.S.”Applying for Magnet status “is a rigorous process,” explains Ms. Boris, NurseManager of RPCI’s Upper and Lower GI Centers. For starters, members of thenursing staff have been hard at work on a 3,500-page document that demonstrateshow RPCI measures up in 20 different areas of nursing quality that theANCC calls “forces of magnetism.” ANCC reviewers want hard evidence thatRPCI nurses understand their roles in the corporate mission and vision; that theadministration listens to their ideas and fosters an atmosphere in which they areimportant members of the medical team; that the Institute provides a safe andpleasant work environment for them; and that the care they deliver contributesdirectly to the highest quality care for patients.23 | roswellness

The Magnet seal of approval also helpsin recruiting talented nurses who arelooking for the best places to work, andMs. Boris notes that RPCI already hassolid proof that it belongs in that category.“We have a waiting list of peoplewho want to come here,” she says. Onemajor attraction: the option of workingthree 12-hour days followed by fourdays off—an arrangement that grewfrom the nurses’ request for “a work-lifebalance.”Mary Ann Long, RN, MS, RPCI’sDirector of Patient Care Services andMagnet Director, says the waiting listincludes both recent grads and nurseswith extensive experience, who aredrawn to RPCI by the emphasis onpatient care. “Our nurse-to-patient ratiosare excellent,” she explains, “whichgives nurses the opportunity to spendtime not only on quality care but also toeducate patients and families about continuedcare outside the hospital. Webuild a partnership with the patient andhave better outcomes as a result.”The Institute also encourages its morethan 600 nurses to further their education,with pay incentives for earning amaster’s degree or PhD, and strong supportfor nurse-led research. “Some ofthe best ideas come from our frontline,bedside nurses,” says Ms. Boris. “Theysee firsthand the needs of our patients,and they’re making a difference inresearch. The administration is tellingthem, ‘Your ideas matter.’”After the application package is deliveredFebruary 1, 2010, the ANCC willbegin evaluating how well RPCI fulfillsthe 20 “forces of magnetism.” If thedocument passes muster, an ANCCaccreditation team will visit Roswell Parkover three days to ask candid questionsof the nurses and other staff about theInstitute’s nursing model.Lisa Boris is confident of the outcome.“There’s nowhere better to go for cancercare than Roswell Park, and our nursingcare reflects that,” she says proudly.“We already know that. We want everyoneelse to know it, too.”| w o w - w o r t h y n e w swww.roswellpark.org | 24

T H E R P C I R E A D O N N A T I O N A L S T O R I E S , T R E N D Sp o p w a t c h |➢Confused byScreening Guidelines?The RPCI PositionDr. James MohlerDr. Nefertiti duPont ➢Talk with your doctor about the PSA test and learn how your PSAstatus should be considered along with other risk factors, such asfamily history and ethnicity, to guide diagnosis and treatment.Pap SmearsProstate CancerScreeningThe American Urological Association has issued new guidelinesfor the age at which men should begin the prostate-specificantigen (PSA) test to detect prostate cancer. The new guidelinessuggest that men have a “baseline” PSA test at age 40 ratherthan 50, but also suggest that yearly PSA testing may be toooften for many men, such as those found to have very low PSAlevels who presumably do not have cancer, or men who areolder or in poor health.James Mohler, MD, Chair of the Department of Urology andfounder of the Prostate Program at Roswell Park, says the newguidelines “are a step in the right direction, but PSA and digitalrectal exams may not be initiated soon enough for men in thehigh-risk group – African-American men or those with a familyhistory, especially if they have a brother or father who was diagnosedwith prostate cancer before age 65.” Mohler, Chair of theNational Comprehensive Cancer Network (NCCN) ProstateCancer Treatment Panel and member of the NCCN EarlyDetection Guidelines Panel, recommends that all men get abaseline PSA at age 45 and that men in the high-risk categoryget the baseline at age 35.Here’s one thing women don’t seem to be outgrowing: the needfor a regular Pap test. Some previous research suggested that thetest might be unnecessary after age 50, but a new study reportsthat women over 50 have nearly the same risk for cervical canceras younger women do.Reporting online in the British Medical Journal, researchersevaluated data on nearly 220,000 women ages 45 to 54 who hadhad three consecutive negative Pap tests and another 445,000younger women with three negative tests. They found that theincidence of cervical cancer among older women (ages 45 to54) was comparable to what they found among younger women(ages 30 to 44). The older group had 36 cases per 100,000,and the younger group had 41 cases per 100,000. The studyconcludes that, among women who have regular and normalscreening histories, age does not affect cervical cancer risk.The study underscores what the American College of Obstetriciansand Gynecologists (ACOG) has been saying for many years, saysNefertiti duPont MD, MPH, Assistant Professor of Oncology atRoswell Park. “ACOG has long been an advocate of Pap tests inhealthy women until the age of 65 or 70,” she says. “Womenwith a history of cervical cancer, DES (diethylstilbestrol) exposure,new sexual partners, or who are immunocompromised shouldcontinue Pap screening regardless of age.“The Pap test is one of the best screening tests available forwomen, and since its introduction, the incidence of cervicalcancer has declined dramatically. While the Pap test does notneed to be performed every year in most women over 30,I still encourage patients to see their gynecologist annuallyfor a pelvic and physical examination.”25 | roswellness

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E A T I N G R I G H Tn u t r i t i o n & c a n c e r |*GrilledVeggies **Preparation Time: 20 minutesNumber of Servings: 6Cups of Fruits and Vegetables Per Person: 1.00INGREDIENTS:2 Tbsp vegetable oil2 cloves garlic, finely chopped3 sweet potatoes, cut into 1-inch slices3 cobs of corn, cut into 2-inch sections1 eggplant, cut into 1/2-inch slices12 green onions, trimmedNutrition FactsGrilled VegetablesServing Size 1/6 recipeAmount Per ServingPreparedCalories 190 Calories from Fat 50% Daily Value (DV)*Total Fat 6g 9%Saturated Fat 1g 3%Trans Fat 0g 0%Cholesterol 0mg 0%Sodium 55mg 2%Total Carbohydrate 34g 11%Dietary Fiber 8g 32%Sugars 8gProtein 5gVitamin A 190%Vitamin C 25%Calcium 6%Iron 8%* Percent Daily Values are based on a2,000 calorie diet.Next time you fire up the grill, consider a healthy, meat-free menu and try thisrecipe for grilled vegetables. The green onions give them a little kick…PREPARATION STEPSMix oil and garlic in a large bowl. Add vegetables and toss. Place vegetableson broiler pan or grill. Cook 10 minutes, turning twice, until vegetables aretender. Place vegetables on a platter. Serve.*Christina Dibble is the Director of Nutritional Services at RPCI.**Recipe and nutritional information courtesy of FruitsandVeggiesMatter.gov.DIABETIC EXCHANGE:Fruit: 0Vegetables: 1Meat: 0Milk: 0Fat: 1Carbs: 2Other: 0Diabetic exchanges are calculated basedon the American Diabetes AssociationExchange System. This site roundsexchanges up or down to equal wholenumbers. Therefore, partial exchangesare not included.27 | roswellness

G E N - Y A L L - S T A R SHair Today…Cure TomorrowLake Shore teens and others shave their heads and raise funds for research| s p a r k sBrett Klaczyk“I’m doing thisfor my brother,who died in 2005of a brain tumor.He’s the one whoinspired me todo this. But it’s apart of everyone’slife—everyone isaffected by cancer.”Any teenager will tell you: at your average high school, looks are very important.So what would compel thousands of young people across Western New York toshave their heads bald—in front of their peers, no less?More than 1,500 teens did just that this spring, raising more than $120,000 by goingbald or cutting 10 inches of their hair through the Goin’ Bald for Bucks program.Goin’ Bald was founded in 2002 by Anthony George, a science teacher at Lake ShoreHigh School. Tony started the program in honor of his sister, Cathleen, who lost herbattle with cancer in 2004. Encouraged by his class, he collected pledges to shave hishead in solidarity with his sister—and his students started joining in. Just eight yearslater, the program has raised more than $500,000 for Roswell Park.Tony was joined by more than 150 Lake Shore students, siblings, parents and otherfaculty at the school’s event on March 13. One of the students, Brett Klaczyk, hadn’tcut his hair since 2007. “I’m doing this for my brother, who died in 2005 of a braintumor,” said Brett. “He’s the one who inspired me to do this. But it’s a part of everyone’slife—everyone is affected by cancer,” he shared before losing his shoulder-length locks.To Terrence Redman, Lake Shore’s principal, seeing his students and staff take part inthe program was a lesson in the capacity of young people to do good. “Teenagerscare,” said Redman, as he surveyed the room. “Teenagers are very compassionateindividuals. And once you start giving back, you continue giving back. They take thatfirst step that says, ‘What can I do to help someone else?’”Visit YouTube.com/rpcicreative to learn more about how young people at schoolsacross our region are making a difference for cancer cures, and check out our video tohear from Brett, Principal Redman and even more Goin’ Bald participants. (Or sign upto get your school, company or organization involved!)www.roswellpark.org | 28

t e c h n o l o g y b u z z |T H E M E C H A N I C S O F I N N O V A T I O NTechnologySavvyDid you know that RPCI...• will soon perform its 1,000 throbot-assisted surgery?• leads the world in robot-assistedsurgery for bladder cancer?• was the first treatment center inWestern New York and one of onlya handful in North America to offerstereotactic body radiation therapy?• was the first in the region and oneof only 42 centers in the nation tohave an iMRI Navigation Suite? iMRImakes it possible to create updatedMRI scans of the brainduring surgery.• has a Gamma Knife program that isranked among the nation’s top five?Second Trilogy offers targetedradiation treatment to more patientsRoswell Park has installed a second Trilogy System to expand access to state-of-theartradiation treatments. Typically, most cancer patients receive small doses of radiationevery day over several weeks, but with the Trilogy’s pinpoint precision, “in cases whereimage-guided radiation therapy (IGRT) is an appropriate treatment, we can use it todeliver much higher doses over just a few days,” explains Michael Kuettel, MD, PhD,MBA, The Barbara C. and George H. Hyde Chair in Radiation Medicine. “In additionto shorter treatment times, patients experience greater comfort during the procedure,fewer side effects and the potential for better outcomes.”The Trilogy’s targeted radiation delivery protects healthy tissue near the tumor site. Insome cases, IGRT may even eliminate the need for surgery or shrink inoperable tumorssufficiently to make surgery possible. In other cases, it may have the potential to curepatients whose treatment would otherwise focus only on relieving pain and reducingother effects of a tumor.The system is used to treat a wide range of cancer sites, including breast, head andneck, liver, lung, pancreas, and prostate, and can be used to zero in on tumors closeto such critical structures as the spinal cord. “Because the Trilogy system can deliverradiation in several ways, it gives us greater flexibility to design the best treatmentplan for each patient,” notes Dr. Kuettel.Roswell Park is the first New York Stateinstitution equipped with Perfexion ,the most advanced Gamma Kniferadiosurgery system available, for patientswith head and neck cancers. Roswell Park’sGamma Knife program is among thenation’s top five, treating more than 300patients annually.The outpatient treatment, which does notrequire general anesthesia, targets tumorsby hitting them all at once with 192 intersectinggamma ray beams. The precision ofradiation delivery protects normal tissuenear the tumor site. For some kinds oftumors, the treatment is more effective thanstandard radiation therapy. And becauseGamma Knife radiosurgery does notinvolve opening the skull, it eliminates therisk of infection and bleeding that can occurduring conventional surgery. It is thereforean attractive option for patients who,because of coexisting medical conditions,are not candidates for surgery.The cutting-edge radiosurgery technology“offers another treatment option forpatients diagnosed with head and neckcancers, enabling them to avoid a majorPath to“Perfexion”leads to Roswell ParkDr. Dheerendra Prasadsurgery, and in other cases to receive radiationa second time after a prior therapy,”says Dheerendra Prasad, MD, MCH,Director of the Gamma Knife Program.Gamma Knife technology makes it possiblefor physicians to treat both benign andmalignant brain tumors—including manythat would otherwise be inoperable—aswell as lesions in the head and neck andcervical spine.“For the past decade, I have been activelyinvolved in the design, development andrefinement of the software and hardwareassociated with this technology,” says Dr.Prasad. “This latest version of the GammaKnife incorporates features for added safetyand accuracy, and sets a new standard ofquality in the field of radiosurgery.”The newest Gamma Knife installation waspurchased partly with donations fromdonors across Western New York. Gifts willalso support a lectureship to bring togetherinternational leaders in the field to sharebest practices.29 | roswellness

Robotic SurgeryAdds Life to YearsAmherst woman self-refers to Roswell Parkand sets stage for others to benefit| t e c h n o l o g y b u z zNancy Gambino was alarmed whenshe began noticing blood in herurine about once every fourmonths. She consulted her doctor and acommunity urologist, who told her initiallythat she had a urinary tract infection. Butwhen she also began feeling persistentdiscomfort in her lower back, she wentback. Further tests revealed severalgrowths in her bladder, and immediatesurgery was recommended.“I then had seven surgeries to try toremove the tumors, plus six roundsof chemotherapy,” says Mrs. Gambino.“It was both exhausting and frustrating,so I self-referred to Roswell Park for asecond opinion.”Surgeons in RPCI’s Urologic Oncologydepartment diagnosed her cancer asdeep and invasive, having spread into themuscle of the bladder. To keep it fromspreading further, her bladder would haveto be entirely removed. And time was ofthe essence: recent studies have shownthat waiting more than 90 days to removeinvasive bladder cancer can increase therisk of dying by more than 112%.“When they said I would lose my bladder,I was devastated,” recalls Mrs. Gambino.“But I thought, If this will save my life…Ihave a lot of living to do. I wanted tokeep going and see my grandkids growup. I was healthy, and I had faith.”Mrs. Gambino was among the firstpatients to benefit from Roswell Park’spioneering use of minimally invasiverobotic surgery for bladder removal.This approach reduced Ms. Gambino’sblood loss by half over traditional opensurgery, and post-surgery complicationswere greatly reduced. The robotictechnique was also used to create a newbladder (“neobladder”) for Mrs. Gambino,using part of her intestine and colon.“I was at first fearful,” says Mrs. Gambino,“and I knew it would take some time toget used to, but a co-worker who is anurse, and my sister-in-law, both offeredto help me through the transition. I wascatheterized for only two months, and myneobladder has been working wonderfullyover these three years.”Mrs. Gambino has resumed her activelifestyle, traveling abroad to Italy with herhusband, Peter, who has been by her sideat every single Roswell Park appointment.“Roswell Park has given me my lifeback—at a quality I was used to,” sheadds. “Now, each six-month check-up tome is just like coming home.”HELP MOREPATIENTS THROUGHROBOTIC SURGERYRPCI has launched a new campaignto expand its ability to offer the benefitsof robot-assisted surgery to morepatients. The campaign also will helpraise funds to meet the urgent nationalneed for a best-in-class robotic surgicaltraining facility. With your help, thecollaborative WNY Robotic SurgicalCenter at Roswell Park will expand theuse of robotic surgery to patients withcancers including:· prostate· bladder· gynecological· colorectal· thoracic· upper gastrointestinalHelp RPCI take advantage of agenerous $708,210 commitment fromthe John R. Oishei Foundation!Call Linda Kahn at 716-845-7606,or visit RoswellPark.org/Roboticsto make your secure gift or formore information, including videotestimonials and audio podcasts.www.roswellpark.org | 30

P R O M I S I N G R E S E A R C H F R O M R P C Il a b n o t e s |Attack strategyhelps researchers IDnew drug forbreast andcolon cancerDr. William CanceWhen protein meets protein at theboundary of a cell, life-and-deathmessages are transmitted.Normally, cell growth and other healthyactivities are controlled by interactionsbetween incoming regulatory proteinmolecules and the cell’s receptormolecules. But regulatory proteins canrun wild, triggering the uncontrolledcell growth we call cancer.Concentrating on the points where regulatorand receptor molecules connect hasgiven Roswell Park researchers a novel,fast-track strategy for finding a drug toblock the connection—and has led to theidentification of a compound that stopsthe spread of breast and colon cancers.William Cance, MD, Roswell Park’sSurgeon-in-Chief and leader of theresearch team, along with VitaGolubovskaya, PhD, and ElenaKurenova, PhD, both AssociateProfessors of Oncology, is focusing onfocal adhesion kinase (FAK), a protein thatcontrols normal cell activity but which canencourage cancer growth when it is“overexpressed.” Earlier research hadlinked interaction between FAK and thereceptor protein Mdm2 with the developmentof breast and colon cancer. “Werealized that if we could keep themapart—stop them from interacting—we mightbe able to force cells to behave normally. Sowe went looking for the ‘docking sites’ wherethe molecules bind,” said Dr. Cance.Tiny as they are, protein molecules arecomplex and precisely constructed. Whenthey interact, they align so that a specificsite on one binds to a specific site on theother. Dr. Cance explains, “You’ve seenfootage of a space shuttle orienting itselfas it approaches the International SpaceStation. They can connect only when theshuttle’s docking assembly lines up exactlywith the port on the space station. Andif there’s already another spacecraft in theport, the shuttle can’t dock.”Studying computer models of FAK andMdm2, the team identified the locationsand—of great importance—the shapes ofthe binding sites. Shape matters, becauseone molecule fits into the other as specificallyas a key fits a lock. The shape of theMdm2 docking site gave the team oneclue to the FAK-blocking molecule theywere looking for. The ideal compoundwould also have to be effective whentaken orally, a characteristic that computersimulations can identify.The team then consulted a NationalCancer Institute (NCI) database of “smallmolecule” compounds—drug-like substancesthat do not usually occur in thehuman body—and searched for moleculesthat could dock with Mdm2 to block FAK.“We could sit back and let the computerrun the data, simulating each compoundin as many as a hundred different conformationsto see whether it could bind intoour site,” says Dr. Cance.Computer screening narrowed the fieldfrom 140,000 compounds to 24 candidates.Then the team took samples of the24 compounds into the lab and testedeach one on live breast, melanoma, colonand pancreatic cancer cells. “Tests onlaboratory models confirmed that M13blocks the formation of breast and coloncancers,” says Dr. Cance.The research, which began when Dr.Cance was at the University of Florida,was funded by the NCI. “The attractionof working at Roswell Park is its incredibletranslational science,” says Dr. Cance.“We have natural collaborators, scientistsand clinicians, to take our work from labbench to bedside. Without the technologies—andthe people—that enabled us tosee where and how proteins interact, wecould never have identified M13 thisquickly.”31 | roswellness

R E S E A R C H B R I E F SStubborn DiseasesTackled byStubborn ResearchersThree Roswell Park research studies, presented at the 2009 American Society of Clinical Oncologyannual meeting, give hope to cancer patients with refractory disease.| l a b n o t e sIn a phase I clinical trial, a research team, led by Marwan Fakih, MD (Medicine), tested a newcombination of drugs (Vorinostat and 5-FU) in colorectal cancer patients who did not respondto standard drug therapies. Of the 24 patients who participated, one had a partial responselasting more than one year, and 12 patients had stable disease.Francisco J. Hernandez-Ilizaliturri, MD (Medicine and Immunology), and his colleaguesevaluated the biological effects of the drug combination Obatoclax-Bortezomib in non-Hodgkinlymphoma laboratory models. The team found that Obatoclax and Bortezomib are highly activeagainst several lymphoma cell lines and tumor cells derived from patients with untreated or highlyrefractory lymphomas. When used in combination, the drugs demonstrated synergistic action.Targeted therapies have improved survival rates for patients diagnosed with chronic myeloidleukemia. However, patients who develop resistance to these therapies have few options.In a phase II clinical trial, Roswell Park investigators, under the direction of Meir Wetzler, MD(Medicine), evaluated Omacetaxine, one of the next generation of novel therapies, in 65patients with refractory chronic myeloid leukemia. Patients experienced treatment responsesin both the white blood cells and the marrow cells.Cancer Drug Shows Early PromiseAgainst Metastatic DiseaseA new oral drug, KX2-391, which first demonstrated efficacy in preclinical studies,is now showing benefit in early-stage clinical trials. Alex A. Adjei, MD, PhD,Senior Vice President for Clinical Research and the Katherine Anne Gioia Chairin Cancer Medicine, evaluated KX2-391, which was designed by Buffalo-basedKinex Pharmaceuticals, LLC, in a multi-center Phase I trial with 32 patients withmetastatic solid tumors. The drug belongs to a family of targeted cancertherapies called src kinase inhibitors.In this clinical study, seven of the patients experienced prolonged stable diseaseof at least four months. These included two patients with papillary thyroid carcinoma,two with carcinoid tumors and one each for prostate, pancreas, and head andneck cancers. Notes Dr. Adjei: “We believe KX2-391, which targets the enzymesthat play critical roles in cancer metastasis, merits further examination in futureclinical studies.”www.roswellpark.org | 32

W O W - W O R T H Y N E W Sd o n o r d o l l a r s d e l i v e r |“To be in thisprogram and tobe proactive is,to me, the nextbest thingto a cure.”–Lisa LaksSabres’ Alumni Shootfor Breast Cancer AwarenessAssociation commits $200,000 to program for high-risk womenLisa Laks (center) and her daughters, Rebecca (18) and Jessica (21), take active steps to manage their genetic risks, thanks to the Breast Cancer Risk Assessment andPrevention Program.isa Laks, LPN, a nurse inthe Roswell Park BreastCenter, helps instill hopein women on a daily basis byassisting them with the physicaland emotional symptomsof the disease. It’s a role shetakes personally, because hermother died of breast cancerwhen she was in her fifties.So in 2006, when Roswell Parksurgeon Swati Kulkarni, MD,FACS, developed a clinicspecifically for high-riskwomen, Ms. Laks jumped atthe chance to participate.“I have a very strong historyof breast cancer in my family,”said Ms. Laks. “So to be inthis program and to beproactive is, to me, thenext best thing to a cure.”Ms. Laks spoke recently afterthe announcement by theBuffalo Sabres AlumniAssociation of a $200,000commitment to fund the workof Roswell Park’s BreastCancer Risk Assessment andPrevention Program. Thegift—given through RoswellPark’s Partners for Progressinitiative—will come in theform of an endowment so thatan annual base of support ismaintained over time. Fundswill be raised through thegroup’s annual Wine Festival,held each November atHSBC Arena.Directed by Dr. Kulkarni, theprogram assists all who areconcerned about their risk ofdeveloping breast cancer dueto their personal family history,reproductive history or previousbiopsy results.Women receive:• comprehensive breastcancer risk assessments• regular clinical breast exams• breast imaging• genetic counseling andtesting, and• education about breast cancerrisk-reduction strategies.The endowment will also supportnew research of potentialchemopreventive strategies.One current clinical researchstudy is enrolling premenopausalwomen at highrisk of breast cancer to determineif whole flaxseed has thepotential to reduce their riskfor the disease.Dr. Kulkarni says the strategicemphasis on a separate clinicfor women who do not havecancer also offers an additionalbenefit. “Women who are atincreased risk but do not havecancer often find it stressful tobe seen in a clinic that focusesprimarily on breast cancerpatients, and therefore choosenot to be evaluated. This giftwill help ensure that womenhave access to the resources,education and care they needto make beneficial decisionsabout their health.”Past proceeds from theBuffalo Sabres AlumniAssociation Wine Festivalhave supported the redesignof patient consultation roomsand the MammographyCenter in the Roswell ParkBreast Center.For more information, watch the video atwww.roswellpark.org/mmnr.Learn more about Partners for Progress atwww.roswellpark.org/partners.33 | roswellness

Do you think the economy will get back to normal within amatter of months or years? That’s a question we often hearin the news, or talk about with family and friends. How has itaffected your own charitable giving to the causes you support?A recent Washington Post poll found that Americans’ charitablegiving has followed the trends of changes in spending (e.g., noteating out, delaying vacations, etc.) and that 46% of individualshave reduced their charitable giving over the past six months.Another national study revealed that almost exactly the samenumber, 48%, say they will either give less in the coming yearor are still undecided.At the Roswell Park Alliance Foundation, we’ve been workingdiligently to address these challenges through a variety of costcuttingmeasures. We’ve examined and re-examined every lineitem in our fundraising budget to keep expenses lower than everbefore. Our goal remains what it always has been: ensuring thatthe maximum possible amount of your donation goes directlyto cancer research and patient care. But we need everyone’shelp to ensure our success.The urgency of cancerIn the same national polls, many donors said they might switchsome of their support to organizations serving “urgent needs”(food, clothing, shelter) during this time. I believe that RoswellPark’s fight against cancer remains an urgent need. This year,cancer is expected to take the lives of 562,340 Americans(including more than 100,000 in our own state!).Is finding a curean urgent need?1.48 million Americans say “yes”by Lee Wortham, Chair, Roswell Park Alliance FoundationSo, on behalf of all of Roswell Park’s 26,041 patients—and theadditional 1.48 million Americans who will hear the words “youhave cancer” this year, I thank you for your generosity, advocacyand sacrifices that will help us continue this very urgent fight.Lee Wortham is a partner at Barrantys LLC, a multi-family officebased in Buffalo, NY. Read more about the Roswell Park AllianceFoundation or make a gift today atwww.RoswellPark.org/Giving.The Many Shades of HopeA lot has happened in the cancer world over two decades.Foremost among them? The 10-year survival rate forchildhood cancer now reaches almost 75%. Through it all,The Paint Box Project ® card and gift program, presentedby Upstate Pharmacy, has benefited thousands of youngpatients, while raising almost $7 million for cancer research.Your help is needed today to continue our progress. Learnmore about the benefits of becoming a corporate partner ofour very special 20th anniversary collection!Visit PaintBoxProject.com today or call Alicia Becker at716-845-8119 for your free sponsorship package or toarrange a personal presentation for your office.| d o n o r d o l l a r s d e l i v e rThrough my Roswell Park experiences, I have watched theheartbreak experienced by a family with a seven-year-old childenduring chemotherapy; the pain of a 42-year-old husband wholost his young wife and now raises his daughter alone; and theutter loneliness experienced by a 70-year-old woman whosehusband’s cancer was simply caught too late.Finding cures for cancer is urgent. Cancer doesn’t care thatour economy is still recovering. It is a relentless killer withoutprejudice. It is not taking a vacation or sitting this year out.Now, more than ever, your gifts matter to keep research movingforward. Every dollar. Every dime.www.roswellpark.org | 34

d o n o r d o l l a r s d e l i v e r |Volunteer Office HonorsGenerous BenefactorLegacy gift will have lasting impactThe Volunteer Services Office has been renamed in honorof Frances Lucille Hanes, a resident of Bradford, PA, whorecently left a generous bequest to Roswell Park in her will.Mrs. Hanes’ gift will directly support new research into thecauses and prevention of cancer, as well as quality of lifeprograms for Roswell Park’s patients.Mrs. Hanes, a Roswell Park donor since 1991, was inspired tomake her first gift after the death of her second husband, whohad been treated for throat cancer. Her sister-in-law also wastreated for cancer during her lifetime. Mrs. Hanes continued togive $20 and $50 donations until her death, before making herfinal bequest.“She would be so honored to see her name next to theVolunteer Services office,” said family member Virginia Lunn.“She always wanted to volunteer at a hospital and never foundthe time. She admired the work of Roswell Park.”For more information about Legacy Giving, see our ad on page 41.“Family Man” InspiresInvestment in Leukemia ResearchDick died just a year after his diagnosis, leaving behind a lovingwife and two children. Now a generous $200,000 endowmentfund, established through the estate of his mother, Verna J.Babcock, will honor his memory by supporting new leukemiaresearch at Roswell Park. Mrs. Babcock passed away in March2008 at age 93.Family members Harry and Kathryn Babcock and Christa Caldwell (center)Prior to his death from leukemia at 39 years old in January1977, Richard Babcock left a legacy of memories for hisfamily and friends.“He was a family man,” says his brother, Harry Babcock, “andhe was in the process of changing careers from banking tobecome a history teacher. That was his passion.”Kathryn Babcock, Dick’s sister-in-law, says their family is comfortedthat his life will be remembered this way. “It gives uspeace of mind to see his legacy carried on to benefit otherfamilies,” she says.To his brother Harry, the gift represents an investment in therapid progress being made in the field. “Back then, it was rarefor someone to live more than six to eight weeks after beingdiagnosed with leukemia,” he reflects. “You heard those wordsand you knew it was probably a death sentence. We felt fortunateto have a whole year with Dick. Now you can live 10 or 15years or more. We hope that this fund will help find more cluesthat could extend life for others.”35 | roswellness

“Adopt a Work of Art”“Three times around the nurses’ station.” In the days followingher cancer surgery in 2005, Teresa LaBanca walked the sameroute through the 7 West wing of the Roswell Park hospital,each step taking her closer to recovery. Along the way, she tooktime to enjoy the artwork on display. “It made a world of difference,”she says. “It helped me a great deal.”One piece in particular caught her attention—a photo ofCentral Park in winter: snow blanketing the ground, streetlightsreflected on the wet pavement. The image evoked lovingmemories of her daughter, Marguerite LaBanca, a lifelongresident of Manhattan who “loved Central Park. It meanta lot to her.”In memory of Marguerite, who died of breast cancer in 2002,Mrs. LaBanca has “adopted” the Central Park scene, created byphotographer Harry Stainrook. A plaque installed next to thephoto now honors her daughter’s memory.Mrs. LaBanca adopted the photo by providing a gift to RoswellPark’s Adopt a Work of Art program, which generates fundsto expand the art collection on display at the Institute. Newacquisitions make it possible to install artwork in both privatespaces, such as the clinics, and public spaces, and to rotateartwork periodically for a fresh look.RoseAnn Berardi, a member of the Art Committee and TeresaLaBanca’s daughter, says she experienced “a tangible appreciationfor the benefits of having art on the wall, especially in the clinic,”when she walked “three times around the nurses’ station” withher mother. “Though no one chooses to have cancer, it is a giftto have my mother healthy again and to see what patients andtheir supporters go through; there is a blessing in that.”“The artwork meets many needs,” adds Susan Zebro. “It’s greatfor patients and their families to have art to focus on.”Works available for adoption can be viewed online; visitwww.roswellpark.org/AboutUs/AdoptArt and click on“View Collection.” Arrangements may also be made in advanceto view adoptable pieces in person, by calling Debra Miga,Assistant Coordinator of Volunteer Services, at 716-845-5708.| d o n o r d o l l a r s d e l i v e rThe adoption plan originated with the Roswell Park ArtCommittee, whose members select, install and maintainartwork throughout the campus. How does the plan work?Susan Zebro, Chair of the Art Committee, says the grouphas identified specific works from the Roswell Park permanentcollection that sponsors may adopt for a five-year period, atfour different gift levels: Blue ($500); Yellow ($1,000); Green($1,500); and Red ($2,000), according to the value of the pieceselected. The identified works in the adoption program wereacquired through the Collectors Gallery at the Albright-KnoxArt Gallery. The artwork remains in place at Roswell Park, nextto a plaque identifying the sponsor or the person honored.Comprising more than 600 works of art, from whimsicalsculptures to serene landscapes and captivating photography,the Roswell Park collection was begun through the generosityof Jean Knox, and continues with a generous grant from theCameron Baird Foundation and donations to the Roswell ParkAlliance Foundation. As the nation’s economic downturncuts deeper into the budget for new acquisitions, the ArtCommittee looks to the Adopt a Work of Art programfor additional funds to continue its mission.A larger-than-life projection lets RoseAnn Berardi (left) and her mother, TeresaLaBanca, step into a favorite painting of Central Park.www.roswellpark.org | 36

E V E N T S B E N E F I T I N G R O S W E L L P A R Ku p c o m i n g e v e n t s |Make a Splash forPediatric Cancer CuresSuit up on Sunday, August 16, for the seventh annual Carly’s Crossing, presentedby Creditors Interchange. Join hundreds of swimmers of all ages at Gallagher Beachon Buffalo’s waterfront to raise funds for pediatric cancer research and patient careat Roswell Park. You don’t have to be an expert swimmer to take part—with bothnon-competitive and timed courses, there are options for everyone to have fun inthe sun for a great cause.Register today at www.CarlysCrossing.org or watch our video about the event.Or contact Robin Hace at 716-845-4100 or robin.hace@roswellpark.org.Round and RoundGet Tahoe-Bound!Seeking a 20-mph glimpse of sparkling lakes, awe-inspiring mountains and breathtakinglandscapes? Sign up for Team Cure Challenge today and raise critical funds for RoswellPark while getting into the best shape of your life!Registration is also currently open for running, walking, swimming or cycling in other eventsacross the United States, including Orlando and Nashville. Or, stay close to home and registerfor beloved local events: the Turkey Trot, Shamrock Run or Buffalo Marathon.Take the Lake Tahoe Challenge (September 25-27) for scenic views of Nevada and California.No experience is necessary. Visit www.TeamCureChallenge.com today to register or learnmore. Or contact Emily Smaldino at 716-845-3179 or emily.smaldino@roswellpark.org.De-fense Against Cancer!Limited tickets are still available for the nineteenth annual All-Star Night, presented by HSBC.Roswell Park’s premier white-tie gala will be held Saturday, October 24, at Shea’s PerformingArts Center.Join us for a glamorous evening and the awarding of the 2009 Gilda Radner Courage Awardto NFL Hall-of-Famer and prostate cancer survivor Mike Haynes. Haynes is a former defensiveback standout for the New England Patriots and LA Raiders. Along with proceeds from theevent benefiting Roswell Park, this year’s auction will raise funds specifically for the WesternNew York Robotic Surgical Center at Roswell Park. (See related story, p. 30.)To reserve tickets or explore sponsorship opportunities, please contact Mary RoseMcDermott at (716) 845-3517 or maryrose.mcdermott@roswellpark.org.37 | roswellness

T O G E T H E R W E C A N !New Prostate CampaignEncourages Men to Get ScreenedRoswell Park Cancer Institute is launching a new initiative toincrease early detection of prostate cancer. Calling on mento “Aim for a Cure,” Roswell Park’s Prostate Club will kick offSaturday and Sunday, Sept. 5 and 6, at the Walden GalleriaMall in Buffalo. The event will encourage men age 50 andup to be screened for prostate cancer.The kick-off event at the Galleria Mall will provide informationabout prostate cancer, the importance of early detection,methods of detection, where to have testing done, and howuninsured men can get tested. The Prostate Club is co-sponsoredby Blue Cross/Blue Shield and WGRZ-TV, Channel 2.For more information about the Prostate Club, contactRoswell Park’s Marketing Department, at 716-845-1784.To learn about prostate cancer screening, diagnosis andtreatment, visit www.ProstatePros.com.| a d v o c a c y n e w sAdvocacy at Work!The 2009-2010 New York State Budget process presentedchallenges for Roswell Park Cancer Institute. Faced with anenormous budget deficit, Governor David Paterson had initiallyproposed cutting $14.7 million from state support to RoswellPark, but the final version of the budget restored $14.5 million,narrowing the budget gap.Donald Trump, MD, President and CEO, credits the restorationto the advocacy of state legislators, especially Senators WilliamT. Stachowski and Antoine Thompson, and Commissioner ofHealth Dr. Richard Daines, who “demonstrated their supportof our mission and vision.” Dr. Trump says he is grateful to “thethousands of Roswell Park faculty and staff, as well as communityleaders and others, who lent their support in emphasizing toour elected officials Roswell Park’s impact on the health andeconomic vitality of our region.”Lisa Damiani, Roswell Park’s Executive Director of GovernmentAffairs, directed the advocacy efforts. Leaders of all the localhealth insurers, plus former patients and community leaders,participated in a video presented to elected leaders explainingwhat Roswell Park means to them, to cancer care and research,and to the community. Institute leadership, including members ofthe Board of Directors, traveled to Albany to meet with membersof both the Senate and Assembly to drive home the messagethat “Roswell Park is an important investment for New YorkState,” says Ms. Damiani. “We are important to the WesternNew York economy, we provide a valuable service in the researchand patient care we provide, and significant cuts would undomany years of investment.”Senator William T. Stachowski with Lisa DamianiThat message was underscored by the collection of nearly 3,000postcards from Roswell Park faculty and staff, patients, volunteersand members of the community, all urging legislators to protectfunding for Roswell Park. The postcards were delivered to theGovernor’s office, and legislators in both houses received lists ofthe names of their constituents who took part in the campaign.Despite the restoration of funds, Dr. Trump cautions that existingeconomic uncertainties present ongoing challenges, especiallybecause new taxes and hospital fees built into the budget willcontinue to burden Roswell Park. He says Roswell Park mustremain fiscally responsible and explore all other promisingsources of revenue, especially those that could generate newpositions and opportunities.www.roswellpark.org | 38

O U R S P R I N G / S U M M E R P H O T O A L B U Mw h o , w h e n , w h e r e ? |A Carly’s Club Sleepover at the Buffalo Zoo isenjoyed by Lucas and Logan Murray (brothers ofCarly’s Club member Elliot Murray—hiding in sleepingbag!) and Carly’s Club member Sean McNamara. Seemore photos at www.CarlysClub.org.Buffalo Sabres Coach Lindy Ruff and HockeyAnalyst Mike Robitaille were the featured guestsat Roswell Park’s June 13 “Celebrating You” ProstateCancer Event.Here’s one piece of luggage that shouldn’tget lost – a take-home health message fromRoswell Park for Buffalo Niagara InternationalAirport travelers. The messages appear in theairport’s baggage area.Grace and Áine Reaney cheer on family and friendsparticipating in the Team Cure Challenge BuffaloMarathon, Half-Marathon and Relay held May 23along the waterfront. More photos atwww.TeamCureChallenge.com.39 | roswellness

In conjunction with the Amherst Chamber ofCommerce’s Business After Hours program,Roswell Park recently hosted a “Meet the Docs”night at its newly expanded Amherst Centersatellite. WBEN radio talk show host Sandy Beach,who interviewed Roswell Park’s President & CEODr. Donald L. Trump, broadcast his show livefrom the Center.| w h o , w h e n , w h e r e ?Bienvenue! Forty Belgian, Swiss and Frenchnationals visited Roswell Park in July as partof the Buffalo-Lille Association study tour.Touring the high points and landmarks of theQueen City, the group consisted of leadersin the fields of business, medicine, education,art and architecture.Patient Dawn Hamilton is overcome with emotionupon seeing her New Era New Hope baseball capunveiled by New Era product designer JoanneSchmid. The cap, inspired by Dawn’s own cancerjourney, is one of three designs now for saleat www.paintboxproject.com.Prostate cancer survivor and Us Too AdvocateBill McLaughlin threw out the first pitch at theRide for Roswell Day with the Bisons in June.And here’s another reason to cheer: Coca-ColaField is now entirely smoke-free!www.roswellpark.org | 40

T H O S E W H O M A K E A D I F F E R E N C Ep r o f i l e s i n g i v i n g |If it’s between Uncle Sam and my favoritecharity, guess where my IRA will go.Your retirement plan or IRA can be subject to multiple taxes that canreduce by as much as 70% what you plan to leave to your family.There’s a charitable alternative that Roswell Park donors like DonTimby and others have taken advantage of to benefit both your familyand Roswell Park. Make the Roswell Park Alliance Foundation thebeneficiary of all or part of your retirement plan, and leave other,less tax-burdened assets to your heirs.We’ll receive a gift, and they’ll receive more from your estate. It’s agood choice for Roswell and for you.To learn more, or to notify us of a legacy gift you have planned,please call 716-845-4391 or visit www.RoswellPark.org/Legacy.Don Timby, cancer survivor and RPCI donorNot intended as legal, tax, or investment advice.Share your story in 3 easy steps.1. Visit myRoswellPark.com2. Click on “Sign Up”3. Register to win a free t-shirtCancer survivors:Share your story.myRoswellPark.com41 | roswellness

C A R E E R S A T R P C I“Cultural competence is an additionalresource for healthcare providers.We don’t have to change the way wedeliver care, but we do need to care forthe individual as well as the illness.”| f r o n t l i n e r sReggieProfile:ClarkDIRECTOR OF DIVERSITYEntering the lobby of the Roswell Park hospital, you maycross paths with a family of Amish visitors, a Sikh doctor,or a female patient in the traditional hejab, or headscarf,worn by Muslim women. Though it may be less obvious froma visual perspective, the people around you will also reflect arange of ages and cultures, native languages and educationalbackgrounds. Reggie Clark wants to make sure all of them feelwelcome at Roswell Park, whether they come for treatment,education or employment opportunities.Director of Diversity in the Human Resources Department,Mr. Clark describes himself as “one of the first points of contactfor people from outside Roswell Park.” By building relationshipswith community organizations outside the Institute, he helpsencourage skilled and talented people from all backgrounds toconsider employment opportunities at Roswell Park. Recently,he addressed 100 people at VESID, the New York State Officeof Vocational and Educational Services for Individuals withDisabilities, to describe the hiring process at Roswell Parkand talk about career paths.Internally, he reviews statistical patterns that reflect Roswell Park’shiring, promotion and retention practices, to ensure that diversityis reflected through all departments and at all levels. “The biggestmisconception is that it’s about quotas,” he says. But being awareof patterns in gender, race, age and other differences helps ensurethat all people “can see themselves being successful here. It alsomeans removing any barriers, real or perceived, to their access tojobs, education and professional development.”Mr. Clark is also working with the nursing staff to create a committeefor culturally competent care that will provide additionalassistance to the healthcare team in addressing the needs ofdiverse patients and their families. “Religion and culture arejust a couple of aspects of diversity that often influence howpatients prefer to receive care,” he explains. “Cultural competenceis an additional resource for healthcare providers. Wedon’t have to change the way we deliver care, but we do needto care for the individual as well as the illness.”With a master’s degree in organizational leadership, Mr. Clark isnow working on a second master’s degree in human resourcedevelopment from the Rochester Institute of Technology. Hesays anyone who is interested in entering the human resources/diversity field should hold a minimum of a bachelor’s degree inbusiness, human resources, psychology or a similar area; an MBAor master’s degree in industrial relations or human resourcesdevelopment is preferable.He notes that his own interest in the field was driven by“the idea of helping people find rewarding careers, as well asproblem-solving and providing solutions. I also enjoy humaninteraction, and I find it easy to empathize with others.”For people of all backgrounds, that contributes to the warmwelcome at Roswell Park.www.roswellpark.org | 42

Elm & Carlton Streets • Buffalo, NY 14263NON-PROFIT ORG.U.S. POSTaGePaidBUFFalO, New YORkPeRmIT NO. 61Thousands Ridefor Millions!Buffalonians put their money where their mettle isWe’re known for the chicken wing… Frank Lloyd Wrighthomes… and being neighbors to one of the naturalwonders of the world. But as the economy continues itschallenging ascent, Buffalonians of every stripe were known onSaturday, June 27, for something even more remarkable: beingamong our country’s most dedicated cancer fighters.Over 8,500 individuals gathered at the University at Buffalo (andearlier in the day at Roswell Park for the Peloton ride to UB) toride or volunteer in the 14th annual Ride For Roswell. Together,they raised well over $2.2 million—breaking the $10 millioncumulative fundraising mark for the event. Funds will supportcutting-edge research to find cures and save lives.“I feel as if God let me survive so I could help other people fight,too,” said rider and volunteer Amanda Twentyfive, a Hodgkinlymphoma survivor. “I can’t ignore the gift of life I was givenwhen my cancer went into remission.”See complete coverage of the Ride, including photos and videos,at RideConnect.org!Thank you to our dedicated Ride presenting sponsor, Wegmans, andBig Wheel sponsors, including Praxair, Sahlen’s, The Talking Phone Book,University at Buffalo and WGRZ-TV.