|CANCER & TREATMENTS FOR CANCER CENTER PATIENTS PREVENTION & RISK ASSESSMENT CLINICAL TRIALS & RESEARCH LIVING WITH CANCER|
Please note: This article is part of the Cancer Center's News Archive and is here for historical purposes. The information and links may no longer be up-to-date.
Michigan Oncology Journal Summer 1999
A unique Multidisciplinary Program for Patients with Bone Metastasis will soon open at the U-M Cancer Center. Led by J. Sybil Biermann, M.D., assistant professor of Surgery and director of Orthopaedic Oncology Services, the clinic will generate concise, coordinated and comprehensive treatment plans for patients with symptomatic bony metastasis. Involving faculty from orthopaedic surgery, radiation therapy, pain service, physical medicine and rehabilitation, pharmacy and medical oncology, the clinic will incorporate new modalities with an overriding goal of returning patients to as full a function and pain-free existence as achievable. To refer a patient, call 800-865-1125.
The Cancer Center's Breast and Ovarian Cancer Risk Evaluation Program provides education, risk assessment, counseling, and genetic testing when appropriate for women concerned about their risk for developing breast and/or ovarian cancer. Any indivi-dual concerned about their risk for developing breast or ovarian cancer and interested in developing a plan to manage this risk is eligible to be seen in the clinic. The program began offering commercial testing under a University of Michigan IRB-approved protocol in January of 1997. If you have a patient who is interested in this program, contact 800-865-1125.
U-M offers a Multidisciplinary Clinic for Patients with Pituitary Disorders. Patients are evaluated by Dr. William Chandler, a neurosurgeon with operative experience with 1,000 pituitary tumors, and Dr. Ariel Barkan, an endocrinologist specializing in disorders of the pituitary. Many other highly qualified experts are available as needed in fields such as neuroophthalmology, neuroradiology, radiosurgery and skull base surgery. Complete diagnostic testing, including laboratory tests and radiologic imaging, is readily available. The latest in both medical and surgical treatment of pituitary disorders is immediately available. All types of radiation therapy are offered including radiosurgery. Commonly seen disorders include Cushing's disease, acromegaly, prolactinomas, pituitary tumors, craniopharyngiomas and hypopituitarism. Appointments can be made by calling (734) 936-5020.
A comprehensive book on the current diagnosis and treatment of brain tumors titled Brain Tumors was recently published by Oxford University Press (New York/Oxford - 1999). The authors are Harry S. Greenberg, M.D. (neuro-oncology), William F. Chandler, M.D. (neuro-surgery) and Howard M. Sandler, M.D. (radiation oncology).
Blood and Marrow Transplantation: Immunotherapy for the 21st Century
Bone marrow transplantation is a major curative therapy for hematologic malignancies. This symposium will provide an overview of recent advances in BMT, specifically in BMT immunobiology. World-renown BMT specialists, including Hans-Jochem Kolb, M.D., from University of Munich; Rainer Storb, M.D., from Fred Hutchinson Cancer Research Center; and John Wagner, M.D., from University of Minnesota, will join the University of Michigan faculty in state-of-the-art presentations. Plenary session lectures in the morning will be followed by smaller, interactive breakout discussions in the afternoon. This symposium will be of interest to physicians and other health professionals involved in the care of patients with hematologic malignancies.
2nd International Prostate Cancer Symposium for the
Patient (health care providers welcome)
1st International Betty Ford Breast Cancer Symposium
for the Patient (health care providers welcome)
Edward McGuire, M.D.
John T. Wei, M.D.
John Park, M.D.
Joseph Cerny, M.D.
The University of Michigan Comprehensive Cancer Center is participating in the second breast cancer prevention trial sponsored by the National Surgical Adjuvant Breast and Bowel Project (NSABP). This study, known as STAR (Study of Tamoxifen And Raloxifene), is being conducted throughout the United States and Canada. Participants will be randomized to receive either tamoxifen (Nolvadex) or raloxifene (Evista). Eligible patients include post-menopausal women with lobular carcinoma in situ (LCIS), atypical hyperplasia, a family history or other significant risk factors. Patients are ineligible if they have a history of previous intraductal or invasive carcinoma of the breast, DVT, PE, CVA, or TIA. Current coumadin, cholestyramine, estrogen or progesterone use is prohibited.
A Phase I trial of adenovirus-mediated wild type p53 gene therapy for recurrent malignant glioma. Replacement gene therapy is being studied in patients with malignant astrocytic brain tumors who have failed previous treatment with surgery, radiation and up to one course of chemotherapy. The tumor suppressor gene p53 is deleted in up to 70% of patients with malignant astrocytomas and may be responsible for unregulated tumor cell growth. In glial tumor cells grown in a dish, the replacement of p53 has been shown to slow tumor growth and cause tumor cell death. In this gene therapy trial, the tumor will be biopsied and have a small piece surgically removed. Then the replacement p53 gene wrapped with an adenovirus will be injected into the tumor. After three days a second surgery will be performed, the tumor will be removed, and the injected tissue from the first operation will be analyzed for p53 gene delivery and production of its protein. After tumor removal, the walls of the cavity will be injected with p53 to treat the tumor. The patient will then be followed over time with MRI scans to determine toxicity, tumor response and progression. As the study proceeds, the amount of p53 injected will be increased to determine the maximum safe dose.
A phase I trial evaluating the feasibility and toxicity of combined arterial perfusion-induced whole body hyperthermia and melphalan for the treatment of patients with advanced, unresectable solid tumors of the abdomen and pelvis. This novel therapy has been given the acronym SHOT (systemic hyperthermic oncologic therapy). Eligible patients are those over the age of 18 with advanced, unresectable intra-abdominal or pelvic solid malignancies who have failed or refused standard, conventional therapies. The SHOT plan calls for three hyperthermia treatments, each approximately one month apart. Each session takes place with the patient under general anesthetic in the operating room or in the Surgical Intensive Care Unit. Vascular access is gained via the femoral artery and either the femoral vein or the internal jugular vein. The patient is placed on an extracorporeal perfusion circuit, and the perfused blood is heated to 42ˇC. With the arterial cannula placed in the iliac artery, the infradiaphragmatic tissues are preferentially heated, while those above the diaphragm maintain temperatures that are 1ˇ to 1.5ˇC cooler. Melphalan is added to the perfusion circuit once infradiaphragmatic temperatures have reached 42ˇC, and the perfusion continues for 90 minutes. The expected post-operative hospital stay is three days.
Study using the Gamma Probe-guided Sentinel Node Localization technique for patients with early (T1 and T2) cancer of the oral cavity. The tremendous success with this technique seen in breast cancer and melanoma will be applied to oral cavity cancer. Eligible patients include those with early, untreated oral cavity cancer and clinically negative necks whose primary tumors are no greater than three centimeters in depth. Preoperatively, Technetium Tc 99 Sulfur Colloid is injected peri-lesionally and the labeled or sentinel node is localized intraoperatively and removed prior to a selective neck dissection. Ultimately, the goal of the study is to establish the Sentinel Node Technique as an accurate staging method that can replace a staging neck dissection in this group of patients.
Research effort to evaluate the role of selective neck dissections in a large cohort of head and neck cancer patients with limited neck disease. Our goal is to perform less radical surgery while maintaining clinical effectiveness and preserving better shoulder function and quality of life. Eligible patients include those with untreated neck metastasis < 3 cm from primary sites in the oral cavity, oropharynx, and (T1) supraglottic larynx. By using the selective neck dissection, as opposed to the more extensive modified radical dissection, we expect comparably low recurrence rates in the neck and less shoulder dysfunction. Prospective, longitudinal quality life and shoulder function assessments will be performed.
Families needed for U-M Prostate Cancer Genetics Project. Led by Cancer Center physicians Drs. Kathleen Cooney and James Montie, researchers have demonstrated that the gene locus HPC1 contributes to prostate cancer susceptibility particularly in families who fulfill one or more of the following clinical criteria: 1) men with prostate cancer in three consecutive generations, 2) three men with prostate cancer in a nuclear family (e.g. father and two sons) or 3) two men with prostate cancer diagnosed before age 55 years. The project is continuing to recruit families in which two or more living members have been affected with prostate cancer and also individuals who were diagnosed at age 55 years or younger, regardless of family history. Participants are not required to travel to Ann Arbor, and investigators cover the cost of enrollment. Participants will be asked to provide medical and family history information, to contact other affected family members and to donate a small blood sample.