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Cancer Center & chef Emeril Lagasse team up to help fight rare cancer
ANN ARBOR, Mich.- When actor Robert Urich died of cancer last spring, many Americans heard for the first time the name of the disease that killed him: sarcoma. But for those who had treated and supported him during his illness, that public recognition was the first step in helping thousands of others who have the same rare and deadly form of cancer.
Now, in Urich's memory, an unlikely pair is leading an effort to raise public awareness about sarcoma, and money for research to find new treatments. The University of Michigan Comprehensive Cancer Center, where Urich received treatment from a team of noted sarcoma specialists that extended his life, is teaming up with Urich's close friend and former co-star, celebrity chef Emeril Lagasse.
Together with Urich's wife Heather and friends in the entertainment industry, they're hoping to kick sarcoma awareness and research up a notch, so that others can live. Among the plans: a celebrity golf tournament this month in Hollywood, to add to the more than $250,000 already raised by the Urich Sarcoma Research Fund. Besides Lagasse, the tournament's other co-chairs are hockey great Wayne Gretzky and NBC president of enterprises and syndication Ed Wilson.
"Robert's death forced this issue into the spotlight, and for those of us who loved him, it's important to us to help others who suffer with this cancer," says Lagasse. "Hopefully the Urich fund will help improve the odds of people suffering with sarcoma. If it helps one person, I know it would have made a difference to Robert."
For Urich's doctor, Larry Baker, D.O., who helps lead the U-M Cancer Center's noted sarcoma team, the time is right to expand and accelerate sarcoma studies.
"Little more than half of sarcoma patients are cured today. That's a dramatic difference from 30 years ago, but we still have a long way to go to make it for everybody," says Baker. He sees new drugs like the ones Urich received, and new knowledge about the genes involved in sarcoma tumors, as reasons for optimism. "For someone who has been seeing cancer patients, in particular sarcoma patients, for 35 years, I can't tell you how exciting it is to participate in this kind of work."
U-M researchers are trying to understand why sarcoma grows and spreads so quickly and becomes resistant to treatment in some people, like Urich, while others live with it for years, says Baker, who is deputy director of the U-M Cancer Center and a professor of hematology and oncology in the Department of Internal Medicine of the U-M Medical School.
This knowledge may even help research into other, more common forms of cancer - just as the discovery of the cancer gene p53 in sarcoma cells several years ago led to the discovery of the same gene's role in breast and prostate cancer.
Scientists are also looking for new ways to attack sarcoma, by finding and targeting new drugs against tiny molecules produced by sarcoma tumor cells. One such precisely targeted drug, called imatinib or Gleevec, has shown great promise in sarcoma patients at the U-M. The Food and Drug Administration approved Gleevec earlier this year for use in leukemia and lymphoma, blood cancers related to sarcoma. The U-M's clinical trial of Gleevec for sarcoma continues.
U-M researchers are also finding ways to reduce the sickening side effects, and the delivery time, of the chemotherapy drugs many sarcoma patients take. This past spring, a chemotherapy pill that Baker and his team helped develop and test was approved by the FDA for sarcoma.
In addition to finding ways to treat sarcoma, Lagasse and the U-M sarcoma team want to help improve diagnosis of the stealthy and dangerous cancer. That means spreading the word about what sarcoma is, and its symptoms and risk factors, so that the public and health care professionals can be on their guard to spot sarcomas early when they're most treatable.
Making this harder is the fact that sarcoma is not one cancer but a whole class of cancers that start in the body's connective tissue: bones, muscles, joints and more. The joint form, which killed Urich, is called synovial sarcoma; other forms include osteosarcoma and Ewing's sarcoma in the bones, rhabdomyosarcoma in the muscles, and fibrosarcoma in connective tissue.
Taken all together, sarcomas make up only 5 percent of all cancers - the other 95 percent are mainly carcinomas, tumors in gland tissues such as breast, prostate, ovarian and lung. This means the number of people diagnosed each year is low.
"Of 100,000 Americans, 5,000 may have cancer, and of those 5,000, three or four may have a sarcoma," Baker explains. "That translates to about 8,000 to 10,000 patients a year." Sarcoma can occur in everyone from newborn babies to elderly adults, and though it can sometimes run in families, the tumors have no clear risk factors like, for instance, lung cancer does.
Besides being rare and stealthy, sarcoma is a wily foe. "Sarcomas start as a local problem, where the tumor begins, whether it's in the thigh or buttock or knee or chest. But it also presents a problem of spreading, through the blood stream," says Baker. "One of its unique features is its invasive ability to get into the blood and to go wherever blood goes, most often the lungs."
Where sarcoma begins, a tumor can often grow very large before it produces symptoms, Baker explains. "Because of its location, it often first causes pain. The tumor gets big enough, it puts pressure on the nerves or blood vessels, which can make it so that the tissues don't get enough oxygen, and that causes pain." Because sarcomas often occur in the arms or legs, the tumors can even grow without being noticed until they cause a lump or interfere with the ability to walk.
Of course, not every lump is a tumor, Baker cautions. "The problem with sarcomas is that most of the lumps in our bodies, in fact, are quite benign. Our problem is trying to figure out which one is really threatening - and which one is just a simple bump."
But if pain near a lump persists, and there isn't a reason to think the lump was caused by something else, Baker suggests visiting a physician for an exam and an X-ray or MRI scan. That may be followed by a biopsy - a brief operation to take a sample of the lump for testing.
Once a sarcoma is diagnosed, Baker stresses the importance of being treated at a center such as the U-M Comprehensive Cancer Center, whose sarcoma team sees many patients a year and has an active research program. The National Cancer Institute recognizes the U-M sarcoma program as one of very few "comprehensive" programs in the nation, because of its excellence in patient care, research and education of young cancer specialists.
Robert Urich traveled to the U-M for his surgery, radiation therapy and other treatment because of the reputation of its sarcoma program. He received follow-up treatment in Los Angeles under the supervision of Baker and other U-M physicians.
"At the U-M, we have recognized that the diagnosis and treatment of sarcomas is sufficiently complex that it requires bringing together people with all sorts of excellent clinical skills: pathologists and radiologists, orthopaedic and surgical oncologists, radiation oncologists, pediatric and medical oncologists," says Baker. He co-directs the program with orthopaedic surgeon and bone cancer specialist Sybil Biermann, M.D., who often performs limb-sparing surgery to remove sarcoma tumors without removing arms and legs, as was done in the past.
"If you come here on one of our sarcoma clinic days, you would see all these doctors, their nurses, their students and fellows meeting together to discuss the patients they've seen. The patients actually 'belong' to the team," he adds. "There's no question that this approach has led to significant improvements in the care of patients."
Like they did for Urich, the U-M team tries to give each sarcoma patient the best treatment possible. But many times, even that can't stop the disease's eventual progress. That's why Baker and Lagasse stress the importance of the Urich Fund's activities.
"When you got to know Bob Urich as I got to know him, you knew he was a man who was gregarious and outgoing, and pretended that his cancer was a small problem in life, and there were many bigger problems," says Baker. "Emeril is carrying on that tradition, doing what he can to honor his friend that he knew so well and loved so much."
Adds Lagasse, "Robert as an individual touched my life in a lot of ways - as a human being, as a father, as an actor, as a mentor. So anything that I can do to support him and Heather, and the Urich Fund, for this deadly cancer, is incredibly important to me."
Facts about sarcoma: