Robert Burger, MD, Director, Women’s Cancer Center at Fox Chase Cancer Center

Some of you have probably read that an advisory committee (ODAC) to the U.S. FDA voted 12 to 1 against full approval of the drug Avastin in the treatment of advanced and metastatic breast cancer. Avastin, in combination with chemotherapy, is fully approved by the FDA for the treatment of other cancer types, such as metastatic colorectal cancer and advanced non-small cell lung cancer. We are privileged to have Dr. Massimo Cristofanilli, Chair of the Department of Medical Oncology and world renowned expert on this disease, discuss the reasons for this decision as well as the ramifications to patients in the future. He will address the potential impact on treatment options and research related to Avastin and other targeted therapies directed against the process of tumor angiogenesis. We welcome your comments and questions.

Be well,

Bob

The options and effectiveness of treatments for advanced breast cancer have increased significantly over the last few decades, and with it, dramatic improvement in overall survival. The 5-year survival rate for patients diagnosed from 1974-1979 was 10 percent, and has improved for patients diagnosed 1995-2000 to 44 percent. The numbers are even better today.

Oncologists are making this progress through the development and use of biological agents and chemotherapy – one of the major breakthroughs in breast cancer care – and researchers have designed even more treatments that improve patient quality of life.

Some Fox Chase patients have been prescribed Avastin to treat either advanced (metastatic), breast cancer or ovarian cancer. Developed by the Genentech unit of Roche, Avastin demonstrated an ability to significantly delay tumor progression in patients with advanced breast cancer, when combined with a variety of chemotherapy regimens.

Last week, follow-up data failed to show an advantage in survival for breast cancer patients using Avastin, and based on this data, an advisory panel to the Food and Drug Administration (FDA) has recommended the discontinued use of Avastin as a treatment option for breast cancer.

While this announcement could mean the FDA will decide to revoke approval for Avastin’s use in breast cancer care on September 17, 2010, it is important to understand this is only the first step in an involved process.  Avastin has shown promise and value to some patients but may not be appropriate for broader use specific to breast cancer: All of these facets will be discussed and weighed in the coming weeks.  Until the FDA makes its ruling in September, Avastin is available and a viable treatment option for those with metastatic breast cancer.

Avastin is also being explored by doctors, including our own Dr. Burger, as an effective treatment option for advanced ovarian cancer.  While research is still developing, Dr. Burger presented some very encouraging clinical trial results last month at the annual meeting for the American Society of Clinical Oncologists (ASCO).

If you are confused about any of the information you are reading in the news regarding Avastin or other cancer therapies, I encourage you to comment here or consult your doctor as to what is available and best for you.

Thank you,

Massimo Cristofanilli, M. D., F. A.C. P.
Professor and Chairman, Department of Medical Oncology
G. Morris Dorrance Jr. Endowed Chair in Medical Oncology

Robert Burger, MD, Director, Women’s Cancer Center at Fox Chase Cancer Center

What if you could help save a life while picking up your morning cup of coffee?

Well, this summer, you can! When you (or your friends and family) stop at any Pennsylvania Wawa convenience store, you can make a donation to benefit Fox Chase Cancer Center’s mobile mammography van, which helps women in our area receive much-needed breast cancer screenings. Now through Sunday, August 29, Wawa stores will display coin collection boxes by the register where you can simply drop your donation or extra change, and any funds raised will support our mobile mammography van.

Our mobile mammography van is the only one of its kind in the Philadelphia region: It provides more than 4,000 screenings at local workplaces and in the community to ensure women are able to detect breast cancer at its earliest stages. Making a donation at a Pennsylvania Wawa this summer will enable us to continue providing this essential service, which is making a difference in the lives of women like Julie Switzky.

In June 2007, Julie missed her yearly mammogram appointment. Her employer had scheduled the Fox Chase mobile mammography van to visit their offices, but she forgot the appointment. Her sister had just been diagnosed with breast cancer in March 2007, so she figured the likelihood that she would also have breast cancer was slim. Between this belief and her busy work schedule, rescheduling a mammogram was not a top priority on Julie’s list.

When Julie missed her appointment, the Fox Chase technicians called to reschedule, even promising to stay late on the last day of exams because they were booked. Julie went for her test and the mammogram detected that she had early Stage 2 breast cancer.

“I’m not sure I would have followed up with my mammogram if Fox Chase had not seen me that day,” recalled Julie. “The mammography van saved my life.”

By providing the mobile mammography van services to area workplaces and the greater community, we hope to give busy women like Julie the opportunity to make time for their health. We are very fortunate to have Wawa Charities Program as a partner and are extremely thankful for their support. So spread the word, and stop by your neighborhood Wawa today – and throughout the summer! Your donations will make a great impact in funding this crucial program.

Thank you for your continued support.

Be well,
Bob

Robert Burger, MD, Director, Women’s Cancer Center at Fox Chase Cancer Center

We know that cancer treatment can affect the way women feel about themselves. At the Women’s Cancer Center, we are dedicated to supporting women with their unique needs during cancer treatment.  In development is a salon that will feature wigs, makeup, and other products designed specifically for women with cancer. It will be a special place where women can discuss their concerns about beauty, learn what has worked for others, and feel at ease in private surroundings.

This week, a Fox Chase patient, Denise Portner, shares a special experience in which a national retailer is celebrating the beauty and strength of cancer survivors.

Please know that we think every one of you is beautiful.

Be well,

Bob

Last week, 25 survivors of breast cancer gathered in New York City for what is shaping up to be a powerful connection. It began as a photo shoot for the 25^th Anniversary of the White House Black Market (WHBM), the national chain of women’s clothing stores, and a sponsor of the support and educational organization, Living Beyond Breast Cancer (LBBC).  In honor of the store’s 25th anniversary, WHBM reached out to LBBC to help them find 25 survivors to be featured in the upcoming October catalog for breast cancer awareness month. LBBC circulated an email asking women to send in a full-length photo, a head shot, and a one-page description of your story.

I rode up on the train from from Philadelphia to New York with Jean Sachs, CEO of LBBC, who filled me in on the growing partnership between the organizations and the strength of the 103 stories that had been submitted. She didn’t know how the White House Black Market team was able to choose among them.

We arrived early afternoon June 30^th for the photo shoot at MILK Studios in the meatpacking section of the city.  The building featured offices of some notable companies including Tod’s, but the 8^th floor and penthouse floors featured huge production spaces in which various shoots were taking place.

We began on the penthouse level where we had lunch on a beautiful deck with a view of the river on a sunny day. There I met Linda Kish, BA, MS, CCRP, Assistant Vice President for Clinical Trials Operations at Fox Chase, who was also among the 25 chosen for this exciting event.

The first group of women had been photographed starting at 8:00 am, the noon group was underway, and Linda and I were among the 2:00 pm group. We met Glynis Rhodes from Philadelphia and Kathleen from Connecticut and began sharing our stories. One by one, we went back into the large space, noting the beautiful black and white portraits tacked up on a bulletin board.  While I had imagined that we would be modeling the store’s fall clothes, I soon realized that the shoot was all about capturing the essence of the survivors. The hairdressers, the make-up artists, the dressers and the photographers, were all focused on making it a great experience for us.

First stop was the dressing area where we put on black or blue jeans and chose from a selection of tops. The dressers recommended a few, but the final choice was whatever we felt most comfortable in. They took a snapshot for the creative director, and then we changed back into our street clothes and sat down in the chairs by the mirrors for hair styling. Some of the women were a few years beyond treatment and had a full head of hair. Others were still undergoing treatment.

The hair dressers made all of us feel beautiful. In my case, having finished treatment this spring, my hair is very short, which is a new look for me. I had brought along a wig, but it remained in my suitcase. I decided to go forward with the new me. I was treated to an expert stylist named Renoldo who shaped up my pixie “do” and showed me how to use the styling products. Then a makeup artist went to work and showed me a few tricks of the trade.  (You can toss the fancy brushes, ladies; fingers do just fine.)

We then put the just-steamed clothes back on and it was time for the shoot. I sat on a black stool dressed in a black turtleneck and black jeans surrounded by a white backdrop on three sides. The Rolling Stones were playing. The creative director and production assistants were looking at a bank of monitors which displayed an array of photos from the shoot. While I was waiting for direction, tapping my toes to the music (in black 4-inch booties, size 9, padded to fit), the photographer started snapping away. Just do what you feel like, he said. I figured what the heck, this is my one chance, so I went with it, and it seemed to work.

They showed me the shots on the monitor and made sure I was okay with them, and then it was done. I hung out talking with some of the women who were waiting their turn, and then a group of us went to the 8^th floor to videotape our stories.

This studio had a couch set up surrounded by lighting and sound fixtures. When it was my turn, I was set up with a microphone pack and seated by myself on the sofa. The interviewer sat across from me off-camera. (I half expected David Letterman to come in, although Ellen would be my first choice).

The interviewer asked questions that led me to tell my story, and then introduced a question that everyone would be asked:

Has your definition of beauty changed since having cancer?

My response was yes. It has broadened. The simple answer is that if you feel good and are comfortable with yourself, that’s beauty.  But it wasn’t always easy during treatment. There were times this past year when I felt quite alien with a wig, expanders, scars, and a port.  But, for some reason, probably due in part to a loving husband and the support of family and friends, I didn’t feel ugly; I felt like a beautiful woman who had expanders, scars, no hair and a port. That is what I wish for all women going through treatment. Cancer is as much a mental challenge as a physical one.  Our conception of physical beauty is circumscribed by our culture and the media, and the image is narrow and damaging to the majority of women who don’t fit it.  I am inspired by women of other cultures, who celebrate individuality and personal style, who wear scarves so beautifully and who adorn themselves with beaded jewelry. All of us as we age are forced to expand our conception of what is beautiful. The more broadly we can think, the more beauty we can see in ourselves and others, and the happier and healthier we’ll all be.

The next day, on July 1^st, twenty-two of the women in the group gathered outside the CBS studios in New York to appear on the Early Show. We had been outfitted by the White House Black Market at the stores near us. We all looked wonderful, and although we were a bit upstaged by the puppies on set, we had a marvelous time connecting. (Watch the video)

But the real adventure has just begun. The emails and Facebook pictures have been flying, and the experience of being together and hearing how other women have overcome adversity has made us feel more beautiful in our skin and comfortable the way we are.  We plan to reunite in October when the catalog is released.  I encourage all of us involved with the Women’s Cancer Center at Fox Chase to share our stories with each other, whether it is in the waiting room, on this blog, or through Fox Chase’s Love Versus Cancer site. We empower each other with our stories of success.

All the best to you,

Denise Portner

Read Denise’s story

E-mail Denise

P.S. Once we returned home, I learned that another Fox Chase breast cancer survivor, Jill Scheetz, was in our group. In 2002, at the age of 37, Jill was just getting back into shape after the birth of her daughters. She considered herself to be physically active and a healthy eater. “My only vice was a caffeinated iced tea almost every day.” Her doctor recommended she stay away from caffeine because she had a benign tumor which was removed from her breast when she was 18. When her left breast began to hurt, Jill made an appointment for a mammogram (it had been 5 years since her last one). I invite you to read the rest of her story here.

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Photography courtesy of Diego Uchitel

Robert Burger, MD, Director, Women’s Cancer Center at Fox Chase Cancer Center

Last week, my colleagues in medical oncology, Massimo Cristofanilli and Lori Goldstein, and I were invited to present at the second national conference on next generation Comprehensive Breast Centers of Excellence here in Philadelphia. Participants included administrative and clinical leaders representing community hospitals, academic medical centers, health systems and long-term care facilities. As leaders in this field, it was truly our privilege to share with at the grass roots level the development of the Women’s Cancer Center at Fox Chase.

Our mission is to serve as a comprehensive cancer resource for women with or at risk for breast and gynecologic cancers that would effectively promote and integrate excellence in clinical care and research for the gamut of risk assessment, prevention, screening and diagnostics, treatment and survivorship.

During his presentation, Massimo Cristofanilli, MD, FACP, chairman of medical oncology at Fox Chase, discussed our tradition of integrating team science and discovery with research in order to provide personalized intervention for women with or at risk for these cancers. It includes both clinical and research programs which encompass the continuum of care from risk assessment, prevention, screening and diagnostics, treatment, support, education through survivorship. With an expanded patient navigation program, women who become part of the Center will be offered individualized, compassionate care with a focus on wellness, stress reduction and quality of life and access to our full scope of research opportunities.

Lori Goldstein, MD, director of the Breast Evaluation Center at Fox Chase, had the opportunity to present the evolution of this integrated program.

The Breast Evaluation Center is a multi-disciplinary team of surgical oncologists, medical oncologists and radiation oncologists who, in conjunction with diagnostic imaging and pathology, evaluate patients with newly diagnosed breast cancer in a single visit. Patients are provided with a comprehensive state-of-the-art care plan and opportunities to participate in therapeutic, behavioral and translational research. Weekly tumor boards are held to review all patients.

Lori stressed the importance of patient education sessions conducted by breast nurse educators and social workers in order to reach our goal of providing patient-centered care for breast cancer patients on their journey from diagnosis to survivorship.

During this 3 day conference, we were joined by national leaders who offered valuable tools and advice during their presentations, that included accreditation for breast care centers, development and launch of a breast patient navigation program, tracking outcomes to improve the patient experience, state-of-the-art hospitals and developing a survivorship program.

From My Perspective

From my perspective, the development of a female gender specific program has been completely logical. Women at risk for or who experience these cancers share a great deal of common ground. The known biologic linkage between breast and ovarian cancer, for example, may affect a given patient or her entire family. Those at risk for or affected by breast and gynecologic cancers often have common psychosocial needs and may share many of the same physiologic effects of preventive methods and cancer therapy.

I was invited to this conference to share our experience building the new Women’s Cancer Center from the ground up. Operationally, the center aims for a patient centered and, (at the same time) evidence based approach, including streamlined access for patients and referral sources,  effective communication systems, enhancements in patient navigation, and attention to wellness and peace of mind. This mission is aligned with the strategic plan of Fox Chase as a whole. I think this alignment in  strategic plans between the center and the institution as a whole is vital to the center’s success.

If you would like a tour – or more information – I encourage you to contact Bonnie Miller, RN, BSN, OCN, Administrative Director, Women’s Cancer Center.

Be well,

Bob

Robert Burger, MD, Director, Women’s Cancer Center at Fox Chase Cancer Center

At the Women’s Cancer Center, we are dedicated to women’s overall health, whether you are in cancer treatment or trying to monitor possible health risks.  One issue that women sometimes overlook is their bone health.  Many women don’t get the recommended daily dose of 1,000 – 1,300 mg of calcium or 400-1,000 IU of vitamin D, which can lead to osteopenia and osteoporosis in later life.  Fox Chase offers a DEXA (Dual Energy X-Ray Absorptiometry) scan that serves as an easy and painless test for bone density, and is something that you should be thinking about to monitor your bone health.  We asked Kathryn Evers, MD, Director of Mammography, to explain how the test works and who is a candidate for a DEXA scan.

Be Well,

Bob

Bone density is an issue not many people actively think about on a regular basis.  They know that lifting weights will add a toned appearance to their arms and legs, and that drinking milk “does a body good.”  But what affects bone density and why should we test it?

Several factors contribute to a person’s bone density including heredity, diet, physical activity, and certain  medications or treatments.  For instance, some chemotherapy agents and hormones used in cancer treatment can contribute to bone loss.  The less dense a woman’s bones are, the more easily she will experience fractures, bone pain or tenderness, and issues with posture.

The DEXA scan measures an individual’s bone density compared to the normal density for her age.  It scores bone density as numbers on a scale, which fall into one of the following categories:  normal (-1 or above), osteopenia (between -1 and -2.5), and osteoporosis (-2.5 or lower).

There are already a variety of medications and lifestyle changes that can be prescribed to manage the symptoms of osteoporosis.  Osteopenia, on the other hand, is a much more controversial diagnosis in terms of treatment.  This category is used to denote when someone has a less than normal bone density, but not low enough to be classified as osteoporosis.  It is a gray area and one in which it is important to have a discussion with your doctor about a course of action based on your individual needs.

Likewise, it is difficult to mark an exact age at which every woman should begin getting a DEXA scan.  As women reach post-menopausal age, they must be diligent about guarding themselves against osteoporosis.  We recommend that women who do not have an increased risk for osteoporosis start around age 60 and then have a test done every other year.  For women at higher risk for bone loss – such as cancer patients going through chemotherapy and hormone therapy – a doctor may suggest starting earlier and monitoring density every year.  Most insurances will cover a DEXA scan for post-menopausal women, and Medicaid will cover the test once a woman reaches 60.

For those of you wondering what it entails, the DEXA scan is very quick and simple.  There are no fasting periods or medicines to take in preparation for the scan; you need only wear comfortable clothing that does not have any zippers or metal on it.  Before getting the scan, it is important to tell the diagnostic team member whether you’ve had surgery on your back, pelvis, or hips, however, so that she can properly account for any differences in the images.

The scan is done lying down on your back, with your legs slightly raised by a supporting block.  The scan generally takes 15 minutes or less, and can often be scheduled the same day you request it, or while you are here for another appointment.

The results are read by one of our diagnostic team leaders, and sent to your doctor, who will discuss them with you.

So whether you’re at the Women’s Center for a mammogram, the Risk Assessment Program, or cancer treatment, stop by and speak to someone about scheduling a DEXA scan. By the way, osteoporosis affects men too, particularly men with prostate cancer who are receiving hormone therapy. They are at an increased risk for bone loss and should consider a DEXA scan, as well.

In the meantime, take care of yourself by doing weight-bearing exercise (light weights are fine), and getting the recommended doses of calcium (1,000 – 1,300 mg) and vitamin D (400 – 1,000 IU) that helps in the absorption of calcium.

All the best,

Kathryn Evers

Robert Burger, MD, Director, Women’s Cancer Center at Fox Chase Cancer Center
After a long winter, summer is finally here and off to a warm start. I know that many of you are taking advantage of the sun by going to the beach, working in your garden, or just spending more time outside. But are you protecting your skin while enjoying these activities? This is an important question, since a recent survey by the American Academy of Dermatology found that only 35 percent of people surveyed were aware that any type of ultraviolet rays are unsafe for your skin, and that skin cancer is the most common of all cancers.

To provide some helpful guidelines, I asked Stuart Lessin, MD, Fox Chase’s Director of Dermatology, to offer sun safety advice and to explain how genetic factors can increase the risk of skin cancer. For more information on how to keep your skin safe, please see Dr. Lessin’s recent skin cancer segment with the CW Philly’s Liz Keptner.

Be well,
Bob

By now, most of us have read about studies linking tanning beds to melanoma and non-melanoma skin cancers. The incidence of skin cancer has increased over the past 50 years as people spend more time outdoors and associate a tan with an attractive appearance. According to the American Academy of Dermatology, 72 percent of those polled nationally believe that tanned skin looks good. But you don’t have to deliberately tan to be at risk for skin cancer. Whether you are outdoors to tan or are simply doing errands, you can burn your skin and increase your risk of skin cancer. Being aware of the risk and how to protect yourself can help.

First, try to avoid the sun when it is most intense, around mid-day. If this is not possible, wear sun-protective clothing such as long sleeves, a hat, and sunglasses, as well as a sun-block between 30-50 SPF on any exposed skin. Not all sun-blocks are created equal, so check the label to make sure it includes both UVA and UVB protection.

To address a common myth, while we all need Vitamin D to aid calcium absorption and build bone strength, it’s not necessary to sit in the sun to get it. Studies show that food and oral supplementation (vitamins) are the best sources for Vitamin D.

Be aware of how long you are out in the sun amid the distractions of daily life. What people refer to as a “base” tan will not prevent you from burning later, despite popular belief. It takes the average person only 15 minutes to burn, with fair complected individuals burning in as little as five minutes. Apply two coats of sun-block and keep reapplying a new coat every two hours or seek shade if you know you will be outside for long periods of time.

We also recommend getting a baseline skin examination and then doing a self-examination regularly throughout the year. Individuals without a family history should see a dermatologist at least once as a young adult to see where they fit in terms of their risk and become educated. Then on your birthday, or when you’re trying on bathing suits for the season, take a look at your “birthday suit.”

Think of it this way: Our skin is like a garden, and a lot of things can grow as a result of skin exposure and aging. Most are not harmful, but we need to look for the weeds. Non-melanoma skin cancer usually presents itself as red, persistent bumps that slowly enlarge and then bleed. Check to see if there are any such bumps or suspicious looking moles that you do not remember, and follow up with your doctor if you have any concerns.

Finally, although external factors within our control greatly contribute to skin cancer, our genetic makeup may also come into play.

While 90 percent of melanomas are spontaneous, family history is involved in 10 percent of cases. About 3 percent of the population has an inherited gene mutation and the highest risk of developing melanoma in their lifetime. People with more than two first-degree relatives (parents, siblings, grandparents) who have been diagnosed with melanoma are considered to have a strong family history of skin cancer.

If you know of any family members who were diagnosed with melanoma, consider visiting the Fox Chase Risk Assessment Program to discuss your personal risk with a professional.

With just a few precautions, you can enjoy the summer and keep your skin safe.

Take Care,

Stuart Lessin

Robert Burger, MD, Director, Women’s Cancer Center at Fox Chase Cancer Center

Our patients who have ovarian cancer may have experienced a therapy called Avastin (bevacizumab) to inhibit progression of the disease. Some have taken part in a clinical trial in which I have been involved as lead investigator. Yesterday, I presented results of this exciting, high-profile trial before 15,000 fellow oncologists and researchers during a plenary session at the 46^th Annual Meeting of the American Society of Clinical Oncology (ASCO) in Chicago. (Watch a brief portion of my plenary session, courtesy of MedPage Today):

Study Makes National Headlines: Read the New York Times article here. The story was also covered by Wall Street Journal, Los Angeles Times, USA Today, BusinessWeek, Reuters, NASDAQ, US News & World Report, WCAU-NBC TV Philadelphia and others.

The results from this international, multi-center Phase III clinical trial showed that adding Avastin to standard frontline chemotherapy for women with advanced ovarian cancer (specifically, epithelial ovarian, primary peritoneal and fallopian tube cancer) and then continuing a maintenance dose of the drug afterward significantly extends progression-free survival. Women receiving the new treatment regimen saw no worsening of their disease for 14.1 months, compared to 10.3 months for women receiving standard therapy.

The randomized, double-blind, placebo-controlled trial was conducted by a network of researchers known as the Gynecologic Oncology Group (GOG) and sponsored by the U.S. National Cancer Institute.  What is particularly exciting about this trial is that it marked the first time a molecularly-targeted agent has been part of a validated strategy for treating advanced ovarian cancer. It was also the first time a maintenance dosing approach involving any therapy has been outlined for the disease. Additionally, ongoing analysis of the trial data may offer insights into genetically-defined subgroups of patients who benefited more than others, pointing to the possibility of more personalized, even more effective treatment for ovarian cancer in the future.

Before this, we could treat ovarian cancer patients only with surgery and chemotherapy involving relatively toxic agents. Now, we have a third type of more targeted therapy to offer patients, potentially opening the way to even greater progress in years to come.

According to the American Cancer Society, approximately 22,000 new cases of ovarian cancer will be diagnosed this year, and about 15,000 women will die from their disease. Ovarian cancer is the eighth most common cancer among women, excluding non-melanoma skin cancers.

The trial, dubbed GOG-0218, enrolled 1,873 previously untreated women with advanced disease from 336 sites in four countries (U.S., Canada, South Korea, and Japan). The women were randomly assigned to one of three treatment protocols: standard chemotherapy (carboplatin and paclitaxel) plus placebo, followed by placebo maintenance for up to 10 additional months; standard chemotherapy plus bevacizumab followed by placebo maintenance; and standard chemotherapy plus bevacizumab followed by bevacizumab maintenance. The type and frequency of bevacizumab-associated side effects were similar to those seen in previous cancer studies involving the drug.

Bevacizumab, a humanized monoclonal antibody, is an angiogenesis inhibitor, meaning that the drug limits tumor growth by interfering with the formation of new blood vessels to supply the tumor with needed nutrients. It acts by inhibiting the function of a naturally occurring protein called vascular endothelial growth factor, or VEGF, which is overproduced in many cancers and stimulates new blood vessel formation.

The study, GOG-0218, was launched in September 2005 while I was at the University of California, Irvine, and  I continued as lead investigator when I came to Fox Chase in September 2008. The co-authors on the study come from Roswell Park Cancer Institute; the University of Arizona Cancer Center; the University of Oklahoma Health Sciences Center; Brody School of Medicine; James Cancer Hospital at the Ohio State University; the University of California, Irvine, Medical Center; the Seattle Cancer Care Alliance; Minnesota Oncology and Hematology; and State University of New York at Stony Brook.

These findings are encouraging and offer hope to women with metastatic disease. I want to thank all of the women who participated in this clinical trial as well as all of our patients who are involved in clinical trials to move science forward.  One of the most exciting aspects of working at Fox Chase Cancer Center is the opportunity to be on the leading edge of discovering new treatments and to know that you’re offering your patients the most current options. I welcome your questions about the use of Avastin in treating ovarian cancer, and will update you on the future developments in this trial.

Be well,

Bob

Robert Burger, MD, Director, Women’s Cancer Center at Fox Chase Cancer Center

In my blog last week, I noted some of the highlights of the opening of the Inflammatory Breast Cancer (IBC) Clinic, which we were honored to share with guests from around the country. Today, I’ve invited one of our guests, Patti Bradfield, to share some of her thoughts about her visit to Fox Chase.

In 2003, Patti’s daughter, Tina, was diagnosed with inflammatory breast cancer that had already metastasized to her liver. Tina asked her mom to write about this under-reported and overly misdiagnosed type of breast cancer. When no one would publish her story, Patti turned to television and met the staff KOMO TV in Seattle, Washington. There, she found a reporter, Michelle Esteban, who wanted to help educate the masses. Esteban went on to win three Emmy’s for her continued coverage of inflammatory breast cancer and the issues surrounding its diagnosis.

On August 29, 2007 Patti lost her beloved daughter, Kristine “Tina” Turck. Patti strongly believes that knowledge is power and the only way to beat IBC. Along with Dr. Cristofanilli and Jenee Bobbora, Patti founded the Inflammatory Breast Cancer Foundation, whose mission is to educate the public about IBC – so that future generations will not be surprised by this uncommon diagnosis.

Be well,

Bob

On May 11, 2010, the Inflammatory Breast Cancer Foundation was honored to be present at the Inflammatory Breast Cancer (IBC) Clinic ceremony at Fox Chase Cancer Center. We were all moved as we listened to Fox Chase president and CEO, Dr. Michael Seiden, speak about his personal experience losing his wife to breast cancer, followed by his passion for raising awareness of IBC. He discussed the need for continued research and clinically-directed physicians who specialize in IBC.

For too long, IBC has flown under the radar of most physicians and has been misdiagnosed repeatedly, which ultimately leads to death in many occasions.  With the opening of this clinic on the East Coast, more women (and men) will have access to the treatment they so badly need.

Our Foundation’s mission was, and still is, education first.  Without proper education of both the public and doctors to the needs of patients (who have often traveled from doctor to doctor just for a proper diagnosis), there can be no  research.  Education and research truly go hand in hand.

Some of the nation’s top breast cancer researchers at Fox Chase invited our group into their labs and provided a status update on their groundbreaking research.

During our visit to Fox Chase, we were also invited to take a tour of the AstraZeneca Hope Lodge of the American Cancer Society, which sits less than a mile from the hospital. After the tour, I personally felt that if I ever had to be treated, I would go to Fox Chase, knowing that there were not only devoted doctors, but caring people at Hope Lodge who can ease some of the mental burden in a very serene environment.  Although the grounds of Hope Lodge are picturesque, it is the people who make each patient’s stay so special – especially when compared to a hotel or other facility.

Along with the opening of the IBC clinic, we had the opportunity to meet with many survivors and advocates from across the country, many of whom traveled great distances to be with us for this momentous occasion.

On behalf of the IBC Foundation, I would like to thank everyone who came from so far away, and especially to Dr. Cristofanilli, for making everyone’s life a little easier, given the topic of Inflammatory Breast Cancer.

Best wishes to you,

Patti Bradfield

President, Inflammatory Breast Cancer Foundation

Robert Burger, MD, Director, Women’s Cancer Center at Fox Chase Cancer Center

Earlier this month, Fox Chase Cancer Center announced the opening of its Inflammatory Breast Cancer Clinic, the first such facility in the region. The new clinic, led by noted breast cancer clinician and researcher Massimo Cristofanilli, MD, FACP, focuses on the treatment of patients with inflammatory breast cancer (IBC). IBC accounts for about one percent of all breast cancers diagnosed in the United States. It can be difficult to diagnose because it rarely causes a breast lump and may not show up on a mammogram. It is considered one of the most aggressive forms of breast cancer, making early diagnosis vital to saving lives.

Dr. Cristofanilli came to Fox Chase from The University of Texas M. D. Anderson Cancer Center, where he founded and served as executive director of the Morgan Welch Inflammatory Breast Cancer Program and Clinic, which treats more cases of inflammatory breast cancer than any other facility in the world. The program and clinic honor Morgan Welch, one of Cristofanilli’s youngest patients. Welch was diagnosed with metastatic inflammatory breast cancer at the age of 24. Dr. Cristofanilli joins me to tell you more about IBC and our new clinic.

Be well,

Bob

Patients with inflammatory breast cancer often face challenging odds, first to be promptly and accurately diagnosed and then to receive the most effective treatment. With the opening of this new clinic, Fox Chase Cancer Center is dedicating itself to improving both diagnosis and care for inflammatory breast cancer patients.

In October 2006, I opened the first clinic solely dedicated to IBC. The subsequent year we had the official dedication of the Morgan Welch Inflammatory Breast Cancer Research Program and Clinic. Morgan Welch was one of my youngest patients with IBC. She died of widespread metastatic disease with her husband and family by her side. On her last visit she asked me to continue the fight against this terrible disease not for her anymore but for other women affected by IBC. During the following years, I learned from every woman with IBC and I realized how the complexity of this disease requires a tremendous effort in education for the public and medical personnel.

Moreover, more research is needed involving scientists from disciplines traditionally not involved in breast cancer studies. Fox Chase offers the opportunity for reaching out to women and physicians in a strategically significant geographic region represented by the north east of the United States.

Along with an outstanding clinical team, Fox Chase’s scientific resources in immunology, virology and tumor biology, developmental therapeutics and Phase I program represent outstanding opportunities for expanding our knowledge about the disease and introduce new and more effective therapies.

Fox Chase’s new IBC clinic offers patients a coordinated team of cancer care specialists who follow them through examination, care, and any continued monitoring. I believe in multidisciplinary team science as the most appropriate way to ensure that patients are getting top quality care.

May 11, 2010: To mark the opening of the new clinic, we were very fortunate to host an enthusiastic group of men and women, many of whom are actively involved in the Inflammatory Breast Cancer Foundation. These folks traveled from around the United States to visit Fox Chase Cancer Center and celebrate the opening of our Inflammatory Breast Cancer Clinic. Following are some photos from our day together:

I look forward to meeting you,
Massimo Cristofanilli

Robert Burger, MD, Director, Women’s Cancer Center at Fox Chase Cancer Center

Cancer has proven to be as tough a challenge as any over the years.  Its complexities make it difficult to eradicate through a single solution, but as I walk the halls of Fox Chase Cancer Center and learn of the work our staff is doing, I am emboldened by the advancements we are making to ever-better understanding the disease.  It is through the work of those such as Joy Little, PhD, a postdoctoral fellow in the laboratory of Erica A. Golemis, PhD, who recently presented her team’s research regarding the role of protein NEDD9 in the development of aggressive breast cancer at the 2010 annual meeting of the American Association for Cancer Research (AACR), that we are continuing to gain precious insight into the tendencies of particular cancers.  Dr. Little is a two-time recipient of the AACR Scholar-in-Training Travel Award, given to young investigators, as well as a National Cancer Institute postdoctoral award to further pursue the study of NEDD9 biology.   I’ve invited Dr. Little to share some of the highlights of her presentation with the Strong Together community as these are some of the steps we are taking today to better ensure the health and happiness of our patients tomorrow.

Be well,

Bob

While there is a lot of research describing contributors to cancer formation, it is always truly exciting when studies show that the loss or absence of something prevents cancer from occurring, which was the case in our study.

Our team examined populations of mice engineered to overexpress the HER2/neu gene, some of which possessed the protein NEDD9 while others did not.  In those mice with the NEDD9 gene, 89% developed tumors over an 18-month period, while only 29% of mice without the NEDD9 gene developed tumors.  These findings show NEDD9 is critical in the formation of breast tumors induced by high levels of the cell-surface receptor HER2/neu in mice, a novel role for NEDD9.

The fact that in the majority of our animals, HER2-driven tumors – known to be one of the most aggressive forms of the disease – don’t form without NEDD9 is new information we can use to view NEDD9 as a potential biomarker.  If tumors show higher levels of NEDD9, it could be they are more aggressive, which can inform a patient’s care.

We, as researchers, are now poised to delve deeper into discovering what about the biology of NEDD9 makes it crucial in the formation stages of HER2-driven tumors. One day, pharmacological targeting of NEDD9 could also be therapeutically relevant, but first we’ll need to understand more about the why of the what we’ve just discovered. I look forward to hopefully sharing that update with the Strong Together community sooner rather than later, too!

Best wishes,

Joy Little, PhD