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Closing the cancer divide: Global oncology summit seeks to make cancer a priority worldwide

Global oncology summit at Fred Hutch seeks to make cancer a priority worldwide

April 1, 2015 | By Mary Engel / Fred Hutch News Service

Panel at the Global Oncology Symposium

Dr. Ted Trimble, director of the National Cancer Institute's Center for Global Health, speaks on a panel at the Global Oncology Symposium at Fred Hutchinson Cancer Research Center Tuesday.

Photo by Robert Hood / Fred Hutch News Service

Childhood leukemia is curable 90 percent of the time – one of the success stories noted in the three-part PBS documentary “Cancer: The Emperor of all Maladies,” which concludes tonight. But as thoroughly as the six-hour film explores both progress and disappointments in cancer treatment, it tells only part of cancer’s story – what is happening in the United States and other developed countries. In sub-Saharan Africa and other low-income countries, a child – or an adult – with cancer is far more likely to die than live.

“One of the biggest single predictors of whether you will survive [cancer] is where you live,” said Dr. Corey Casper, head of Global Oncology at Fred Hutchinson Cancer Research Center. “And that is something we should not tolerate.”

Casper welcomed more than 200 physicians, researchers, policymakers, patient advocates, and medical and public health students from around the nation and the world Tuesday to Fred Hutch to talk about how to make cancer a priority globally, not just in wealthy countries. 

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Easing cancer's heavy financial burden

HICOR and its stakeholders hammer out solutions to help reduce costs at second annual Value in Cancer Care Summit

April 1, 2015 | By Diane Mapes / Fred Hutch News Service

Dr. Scott Ramsey, director of HICOR

"We’re open to seeing ideas from everyone – patients, providers, payers and delivery systems," said HICOR Director Dr. Scott Ramsey.

Photo by Robert Hood / Fred Hutch News Service

The first few months (or years) after a breast cancer diagnosis can be nerve-wracking for patients. After an unrelenting merry-go-round of blood tests, scans, surgeries, chemo infusions and radiation blasts, everything comes to a screeching halt. The oncologist tells the patient to go home, to heal and to come back in three months, then six months, then a year. But in-between those checkups, a host of questions arise.

Is this normal? Is that normal? And the biggest question of all: Has the cancer come back?

Patients, anxious for answers, may push for tumor-marker tests or advanced imaging tests like PET or CT scans even though they’re not exhibiting any signs of a recurrence. Oncologists – or even primary care physicians – will also order tests for asymptomatic patients to provide peace of mind for everybody, including themselves.

But these tests can come with a cost, monetary and otherwise:  over-testing can lead to misdiagnosis, overtreatment, unnecessary exposure to radiation and even more anxiety for those patients who receive a false positive result. Testing when not warranted doesn’t necessarily help cancer patients; in fact, it may simply drive up the economic – and human – burden of cancer care.

But what can be done about it? And where do you start?  

The Hutchinson Institute for Cancer Outcomes Research, or HICOR, plunged into this financial fray yet again on Monday at its second annual Value in Cancer Care Summit, a working meeting designed to address just these kinds of care and cost-focused issues. 

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An unexpected life: Patient, doctor recount bone marrow transplant progress

The history of blood stem cell transplant is as personal as it gets for one patient and doctor

March 30, 2015 | By Susan Keown / Fred Hutch News Service

Dr. Jerry Liebermann in his kitchen at home

Dr. Jerry Liebermann, a 37-year leukemia survivor, cooks at home with his wife, Dr. Linda Harris, in the background.

Photo by Robert Hood / Fred Hutch News Service

As a 22-year-old, Dr. Jerry Liebermann had his whole life ahead of him ― until the day when, suddenly, he didn’t.

After his gums wouldn’t stop bleeding from a routine wisdom tooth extraction, Liebermann was diagnosed with chronic myeloid leukemia and given three years to live. Seeing the distant finish line of his life shift in a moment into sharp, near focus, he grew deeply depressed.

“I just felt like my life had ended and it was all over,” Liebermann said.

But it wasn’t over. Liebermann’s diagnosis was in 1978, that's 37 years ago.

What saved his sanity was help from a psychiatrist, who “taught me to keep on living in my mind no matter what my body was up to,” Liebermann said. What saved his life was hearing about Fred Hutchinson Cancer Research Center, at that time the only cancer center Liebermann could find that was willing to treat him with a transplant of a donor’s bone marrow.

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Good news at Fred Hutch: Celebrating our achievements

March 27, 2015 | By Fred Hutch staff

Dr. Anne McTiernan

Dr. Anne McTiernan, Fred Hutch

Photo by Robert Hood / Fred Hutch News Service

We want to recognize the excellent work and achievements of our staff and faculty and highlight them each week in this space.

Dr. Anne McTiernan on expert panel that reports strong link between alcohol consumption and liver cancer

Three or more drinks a day significantly increase risk, but coffee can decrease risk

Consuming three or more alcoholic drinks a day is linked to a significant increase in the risk of developing liver cancer, according to a report released this week by World Cancer Research Fund International. Fred Hutch cancer prevention researcher Dr. Anne McTiernan was on the international expert panel that has provided the clearest indication to date of how many drinks may actually cause liver cancer.

The 10-member panel, which analyzed 34 studies from around the world involving more than 8 million men and women and more than 24,000 cases of liver cancer – also found strong evidence that:

  • Being overweight/obese can cause liver cancer.
  • Foods contaminated by aflatoxins, which are produced by a fungus found in inappropriately stored food, can cause liver cancer. Foods commonly contaminated by the fungus, called Aspergillus, include cereals, spices, nuts, dried fruit and figs from warmer regions of the world.

Other established causes of liver cancer include cirrhosis of the liver, long-term use of oral contraceptives containing high doses of estrogen and progesterone, chronic viral hepatitis and smoking.

The panel also found:

  • Drinking coffee decreases the risk of liver cancer, but further research is needed to determine how much and what type of coffee may confer a protective effect. 
  • There is limited evidence that eating a diet rich in fish and engaging in physical activity may confer protection against liver cancer.

The bottom line, McTiernan said, is to maintain a healthy weight and avoid alcohol or drink only in moderation, which amounts to no more than two drinks a day for men and one for women.

Liver cancer, which is the second most common cause of cancer death worldwide, accounted for 746,000 deaths in 2012.

The report was part of the WCRF’s Continuous Update Project, or CUP, which analyzes global cancer prevention and survival research linked to diet, nutrition, physical activity and weight.

‘The successes kept you going’: 40 years of bone marrow transplantation

On the eve of ‘Emperor’ cancer documentary, Dr. Fred Appelbaum recounts 40 years of difficult and exhilarating advances in bone marrow transplantation

March 27, 2015 | By Mary Engel / Fred Hutch News Service

In this video extra, Dr. Fred Appelbaum shares a story about how he came to work on bone marrow transplantation at Fred Hutch and of patients who “stick with you” forever.

Dr. Fred Appelbaum was a medical student in 1970 when he stumbled upon Dr. E. Donnall Thomas’ initial description of bone-marrow transplantation in a medical journal and was transfixed.

“I thought it was so cool that this was even possible,” said Appelbaum, now deputy director and executive vice president of Fred Hutchinson Cancer Research Center. In 1978, he leapt at the chance to work alongside Thomas at Fred Hutch, helping to refine the pioneering technique that transformed leukemia and related cancers, once thought incurable, into highly treatable diseases.

Today more than 1 million people around the globe have received blood stem cell transplants to treat dozens of different diseases, and researchers at Fred Hutch continue to build on that work to find innovative new treatments.  Transplants are one of the most significant advances in the history of cancer treatment, which is chronicled in the Pulitzer Prize-winning book “The Emperor of All Maladies: A Biography of Cancer” by Dr. Siddhartha Mukherjee. The book has been made into the six-hour documentary, “Cancer,” by Ken Burns and Barak Goodman and will air on PBS Monday, Tuesday and Wednesday. 

Recently, Appelbaum sat down to talk about 40 years of transplants at Fred Hutch, from the early, heart-wrenching challenges to the latest innovations in immunotherapy, which harnesses the body’s own immune system to fight cancer. 

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Understanding Angelina Jolie Pitt’s medical choices

Actress, filmmaker lauded for raising awareness and saving lives, but her actions also bring up questions

March 25, 2015 | By Diane Mapes / Fred Hutch News Service

Angelina Jolie Pitt

Angelina Jolie Pitt's disclosure that she had her ovaries and fallopian tubes removed has raised awareness about cancer related to the BRCA mutations — and also some questions.

File photo by Matt Sayles / AP

In late 2009 at the age of 40, Amy Byer Shainman, a mother of two from Jupiter, Florida, found out that she carried a BRCA1 genetic mutation, which put her at high risk for both breast and ovarian cancer. Tests showed that she inherited the gene from her father.

After sifting through her options with a genetic counselor and high-risk oncologist, she decided to go ahead with two preventive surgeries. In March of 2010, she had a complete hysterectomy, removing her healthy uterus, fallopian tubes and ovaries. Then in September of that year, she had a preventive nipple-sparing mastectomy followed by immediate reconstruction with implants.

At the time, her daughter was 8 and her son was 5, both far too young to understand why anyone would intentionally remove a healthy body part. Or to grapple with the realities of what it means to carry a genetic mutation that puts you at high risk for certain cancers.

“At that point, we discussed it in an age-appropriate manner,” she said. “I told them, ‘Mommy’s going into the hospital for a Mommy check-up.’”

Shainman knew she would eventually explain the decision to her children but wanted to wait for the right moment. That moment came when Angelina Jolie Pitt revealed in May 2013 that she had undergone a preventive double mastectomy in order to hip check a BRCA1-driven breast cancer, a drastic but effective way to beat the devil at his own game.

“My daughter had seen a story online and turned to me and said, ‘Oh my god, Mom. What is up with that Jolie lady? She, like, cut off her boobs or something,’” said Shainman. “In that exact teenage tone. I took that as my cue to explain to her what she’d done — and what I’d done.”

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