Focus On Cancer Year in Review: Immunotherapy for Leukemia

2012 was an exciting year for the Abramson Cancer Center. We are featuring blogs featured on the Focus On Cancer blog that highlight cancer treatment breakthroughs, coping tips and ideas, education and inspiration. Today, we are highlighting the immunotherapy and leukemia.

A front-page story in the New York Times details the progress of a Perelman School of Medicine team in using genetically engineered versions of leukemia patients' own T cells to fight their cancer; an approach which has now been used in 12 patients, 9 of whom responded to the therapy -- including two children.

Immunotherapy for Leukemia

A front-page story in the New York Times details the progress of a Perelman School of Medicine team in using genetically engineered versions of leukemia patients' own T cells to fight their cancer; an approach which has now been used in 12 patients, 9 of whom responded to the therapy -- including two children.

"Our goal is to have a cure, but we can't say that word," said the study's leader, Carl June, MD, the Richard W. Vague Professor in Immunotherapy in the department of Pathology and Laboratory Medicine and director of Translational Research in Penn's Abramson Cancer Center.

He hopes the new treatment will eventually replace bone-marrow transplantation, an even more arduous, risky and expensive procedure that is now the last hope when other treatments fail in leukemia and related diseases.

Cancer Information From a Reliable Source

The Focus On Cancer blog is committed to provide people with cancer and their caregivers educated information from a reliable source, the Abramson Cancer Center at Penn Medicine. Please subscribe to our blog to get updates about new cancer treatments at Penn, credible information from cancer experts at Penn, and inspiration from other people with cancer.

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Focus On Cancer Year in Review: Stand Up 2 Cancer and Penn

2012 was an exciting year for the Abramson Cancer Center. We are featuring blogs featured on the Focus On Cancer blog that highlight cancer treatment breakthroughs, coping tips and ideas, education and inspiration. Today, we are highlighting the partnership between the Stand Up 2 Cancer Foundation and Penn Medicine.

The SU2C Dream Team at Penn is actively researching better ways to prevent, diagnose and treat pancreatic cancer. Together, members of the Pancreatic Cancer Dream Team working to translate scientific breakthroughs into new treatment options faster than ever before.

About Stand Up 2 Cancer

Founded in 2008, SU2C has raised more than $180 million for innovative cancer research. Since its inception, SU2C has made grants to seven multi-disciplinary “Dream Teams” of researchers as well as to 26 young innovative scientists who are undertaking potentially high-reward projects to end the reign of cancer as a leading cause of death in the world today.

Eighty-five institutions are currently involved, including Penn Medicine’s Abramson Cancer Center.

The Penn Medicine SU2C Dream Team

As the fourth leading cause of cancer death in the United States, pancreatic cancer remains one of the most deadly forms of cancer. More than 90 percent of patients die within the first year of diagnosis. Recent advancements have had little impact, and a new approach is desperately needed.

The SU2C Dream Team at Penn is actively researching better ways to prevent, diagnose and treat pancreatic cancer. Together, members of the Pancreatic Cancer Dream Team working to translate scientific breakthroughs into new treatment options faster than ever before. Their research focuses on developing tests using advanced imaging technology to understand pancreatic cancer cells and developing new, personalized pancreatic cancer treatments based on their research.

Members of the Pancreatic Cancer SU2C Dream Team at Penn Medicine

Pancreatic cancer researchers at Penn Medicine are at the forefront of developing new, personalized approaches to pancreatic cancer treatment.

These Penn clinicians and researchers are part of the SU2C Pancreatic Cancer Dream Team.

Chi Van Dang, MD, PhD
Professor of Medicine, Hematology/Oncology
Director, Abramson Cancer Center
Director, Abramson Family Cancer Research Institute

Jeffrey A. Drebin, MD, PhD, FACS
John Rhea Barton Professor of Surgery
Chairman, Department of Surgery

Hank Kung, PhD
Professor of Radiology and Pharmacology
Department of Radiology
Perelman School of Medicine

Peter J. O’Dwyer, MBBCh, MD
Professor of Medicine, Hematology/Oncology
Perelman School of Medicine

Watch Stand Up 2 Cancer and Join the Conversation

Watch Stand Up to Cancer on Friday, September 7 at 8 pm ET, and join Penn Medicine on Twitter as we discuss pancreatic cancer and its treatment at Penn Medicine, and how researchers and clinicians on the SU2C Pancreatic Cancer Dream Team are changing the way cancer is treated today.

Cancer Information From a Reliable Source

Thank you for a fantastic 2012. The Focus On Cancer blog is committed to provide people with cancer and their caregivers educated information from a reliable source, the Abramson Cancer Center at Penn Medicine. Please subscribe to our blog to get updates about new cancer treatments at Penn, credible information from cancer experts at Penn, and inspiration from other people with cancer.

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Navigating the Way to Colorectal Screenings at Penn

Colorectal cancer is the second most common cause of cancer deaths in the United States. Although studies prove that screening reduces colorectal cancer morbidity and mortality and is recommended for everyone over the age of 50, only 60 percent of Americans have been screened.

Penn Medicine’s West Philadelphia Gastrointestinal (GI) Health Outreach and Access Program has worked to to improve the colorectal cancer screening rates in the West Philadelphia community.

Founded in November 2011 with seed funding from an anonymous donor, the Abramson Cancer Center of the University of Pennsylvania established the program, which provides education about colorectal cancer screening and physical navigation through the screening process for people who live in the following zip codes:

• 19104
• 19131
• 19139
• 19143
• 19151

Patient navigator, Alicia Lamanna, works with patients on a one-on-one basis and addresses barriers that might prevent them from getting a screening test. She also ensures patients understand the information by using language that is easy to comprehend.

Assisting patients every step of the way

The patient navigation program is committed to providing every patient the assistance and encouragement they need throughout the entire screening process.

The program provides the following:

• Help with scheduling a colonoscopy
• Education about the screening including literature, instructions for the screening preparation and motivational information
• Encouragement and support
• Reminder phone calls about the screening appointment
• Instructions for the day of screening
• Miralax-Dulcolax-Crystal Light prep free of charge
• Transportation assistance with Septa tokens
• Accompaniment to and from the screening exam

Finally, one week after the procedure, Alicia, communicates the physician's findings and recommendations both verbally and in writing to everyone who participates in the screening.

To qualify for the program patients must:

1. Be between the ages of 50 and 75
2. Live in one of the five participating West Philadelphia zip codes
3. Have an order or prescription for a colonoscopy from your Penn primary care physician

Whether the reasons are financial, insurance or personal — such as being embarrassed or nervous — that keep someone from getting a colorectal screening, the outreach program provides the assistance needed to obtain this life-saving screening.

Patient Navigation Works

A study to determine the feasibility, acceptability and use of the program was recently completed.

Of the 125 patients who completed a screening colonoscopy through this program, 46 (37%) were found to have at least one adenomatous (precancerous) polyp and 3 patients were found to have cancer 1 primary colorectal cancer, 1 metastatic breast cancer, 1 currently unknown origin (unpublished data). These results show that this program has great potential to prevent colorectal cancer.

In addition, satisfaction with the program has been high, with 92% strongly agreeing with the statement: “Overall, I am satisfied with the navigation services I received from the navigator.”

In addition, 36% of the patients who completed the program stated they would have been, “highly unlikely to have completed the colonoscopy without the patient navigator.”

Get More Information

For more information about the program and preventing colorectal cancer, visit the 2012 CANPrevent Colorectal Cancer Conference from the Abramson Cancer Center, or call Alicia Lamanna at 215-439-8281.

As an American College of Surgeons Commission on Cancer accredited Center, Penn’s Abramson Cancer Center is pleased to share these results with the public.

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Focus On Cancer Year in Review: New Brain Cancer Treatments at Penn

2012 was an exciting year for the Abramson Cancer Center. We are featuring blogs featured on the Focus On Cancer blog that highlight cancer treatment breakthroughs, coping tips and ideas, education and inspiration. Today, we are highlighting the brain cancer treatment at Penn.

There are new treatments for brain cancer at Penn. In this article, writer and cancer survivor Chris Wilson discusses new treatments in surgery, radiation and targeted therapies for brain cancer.

New Treatments for Brain Cancer

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2012- Focus on Brain Cancer Conference:
Discovery to Recovery. In this blog, she discusses treatments for brain cancer.

Neurosurgery:  The Crux of Treatment for Brain Cancer

"The neurosurgeon's goal is take out as much of the tumor as possible safely, " says Steven Brem, MD, conference chair, and director of neurosurgical oncology.

"Personalized medicine has become something of a buzz work in medicine, but it is true for brain cancer patients,” says  Donald O'Rourke, MD, associate professor of neurosurgery.

Penn neurosurgeons are using improved imaging techniques for "neuronavigation."  This approach provides real-time, 3D views for the surgeon as he operates - allowing for maximum safe resection of the tumor and avoiding normal tissue.  This is particularly crucial in preserving language function and motor skills.

Radiation Therapy:  The Full Spectrum of Options

"Penn has the largest, most advanced proton facility in the world, one of only 10 in the United States.  We also have the unique advantage of having all of our radiation facilities integrated under one roof, "
Robert Lustig, MD, professor of radiation oncology.

Radiation therapy plays a key role in the treatment of most brain cancers.  Penn offers the full range of treatment modalities including one of only 10 proton facilities in the country.  Patients often are unsure of the relative benefits or indications for different kinds of radiation therapy, for example, protons vs. the gamma or cyber knife. 

Radiation therapy treatment decisions for brain tumors are highly individualized and need to be made in the context of multidisciplinary planning.

Briefly stated, protons:

• Are more precise than conventional radiation therapy and do less damage to normal tissue
• Reduce side effects both short and long term 
• Deliver slightly more radiation to the tumor on a dose by dose basis
• Are effective in treating tumors near sensitive structures such as the spinal cord
• Can be used to "retreat" some patients with brain cancers

Dr. Lustig noted that Penn is now conducting clinical trials using protons for high-grade glioblastomas, grade III astrocytomas and pituitary adenomas, and will participate in an NCI-RTOG national study on protons for glioblastomas expected to begin soon.

He also noted that many patients encounter insurance issues in trying to get approval for proton therapy, although Medicare pays for most indications.

Stereotactic radiosurgery using the Gamma Knife® is another option for treating brain cancers.  Michelle Alonso-Basanta, MD, PhD, assistant professor of radiation oncology, explained that the original Gamma Knife was not designed to treat cancers, but that advances in technology and technique have made this a useful therapy for some patients with brain cancers.

"As with protons," she says, "we can deliver a very high dose of radiation to the target with little or no exposure of normal tissue to the radiation.  And, as with protons, the decision as to who will benefit from this approach is very individual."

Both stereotactic radiosurgery and protons offer the possibility of retreatment for patients who have undergone a previous course of radiation therapy and whose tumors have recurred.  In the past, these patients were not eligible for additional radiation therapy. 

Targeted Therapies: Changing Cancer Treatment

Penn Medicine has been a leader in immunotherapy research and in developing targeted vaccines for cancer for many years.  Bruce Levine, PhD, facility director, clinical cell and vaccine production facility describes work currently underway that involves activating T-cells, one of the mainstays of the body's defense system, to fight cancers. 

"If I could design T-cells to fight cancer," he says, "they would be potent, have a good memory, be persistent and numerous."

A new approach, developed at Penn, known as CAR (chimeric antigen receptor) T-cell therapy promises to be all of those things.  CAR uses a complex process to remove cells from the patients and own body and activate them to attack the tumor.  Penn is now in the process of developing clinical trials that will study the effects of CAR T cell therapy on glioblastomas with the EGRF v III mutation.

That mutation is the focus of work aimed at improving brain cancer treatment using chemotherapy as well.  Arati Desai, MD, MAS, is using bevacizumab (Avastin), a drug that inhibits blood vessel formation, in combination with another drug in patients with recurrent glioblastomas.  Phase II studies have demonstrated improved response rates and survival, although Desai acknowledges that some controversy exists about what those responses mean in terms of actual survival times.

Other clinical trials are aimed at attacking cancer cells from both the inside of the cell and the outside.

These include approaches using

• Immunotherapy
• Combinations of drugs that target multiple pathways
• Drugs that affect the environment around the tumor
• Drugs that block the critical M Tors pathway
• Drugs that target factors known to influence prognosis, such IDH1 and MGMT

"There isn't going to be a single drug or agent that is going to work for everyone," says Desai.  "It's not going to be the same answer for every patient."

Cancer Information From a Reliable Source

Thank you for a fantastic 2012. The Focus On Cancer blog is committed to provide people with cancer and their caregivers educated information from a reliable source, the Abramson Cancer Center at Penn Medicine. Please subscribe to our blog to get updates about new cancer treatments at Penn, credible information from cancer experts at Penn, and inspiration from other people with cancer.

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Happy Holidays From the Abramson Cancer Center

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Focus On Cancer Year in Review: New Treatment for Mesothelioma

2012 was an exciting year for the Abramson Cancer Center. We are featuring blogs featured on the Focus On Cancer blog that highlight cancer treatment breakthroughs, coping tips and ideas, education and inspiration. Today, we are highlighting photodynamic therapy for mesothelioma.

Penn was the first health system in the Philadelphia area to begin researching the use of PDT to treat cancer. Also known as photoradiation therapy, phototherapy or photochemotherapy, PDT brings together light-sensitive medication with low-level beams of light to destroy cancer cells.

Mesothelioma Treatment with Photodynamic Therapy

When treating patients with mesothelioma or pleural disease, Penn Medicine lung specialists offer more treatment options than most other health systems across the country and around the world.

One of those treatment options is photodynamic therapy (PDT).

Penn was the first health system in the Philadelphia area to begin researching the use of PDT to treat cancer. Also known as photoradiation therapy, phototherapy or photochemotherapy, PDT brings together light-sensitive medication with low-level beams of light to destroy cancer cells.

Mesothelioma is by definition a disease that is multifocal, meaning it occurs in several places in the lining of the lung simultaneously. This has traditionally made surgery as a treatment for mesothelioma difficult and ineffective.

PDT is used during surgery to increase the effectiveness of the treatment. It works by bringing together a light-sensitive medication with low-level beams of light to destroy cancer cells.  The medication is injected into the bloodstream and absorbed by the cancer cells. A light source is then applied to the area being treated. The light causes the drug to react with oxygen to form a chemical that kills the cancer cells. Photodynamic therapy can also work by destroying the blood vessels that feed the tumor.

PDT can only work in areas that the light can actually reach. It is effective in treating mesothelioma because it is a cancer that affects the lining of the lung. During the surgery, the light is applied to the pleural space, or area surrounding the lungs. Penn researchers continue working on ways to improve PDT’s effectiveness.

Associate Professor of Surgery, Joseph Friedberg, MD, is researchering ways PDT is uses to treat cancer, such as combining PDT with gene therapy or with tumor vaccines to stimulate the immune system to fight cancer.

These are the areas of PDT research today at Penn, and in all likelihood, the innovations of tomorrow that will make mesothelioma easier to treat.

The outlook for mesothelioma patients is improving both in terms of quality and quantity of life, but those improvements depend on being treated at a center that has the expertise and experience to develop the individual treatment plans that are essential to obtaining the best outcomes.
 

Would you like to learn more about treatments for mesothelioma and pleural diseases?

The Penn Mesothelioma and Pleural Program offers a true multidisciplinary approach, presenting patients with essentially all treatment options offered worldwide and a number of treatments offered only at Penn such as PDT.

For more information about the Penn Mesothelioma and Pleural Program, call 215-662-9697.

A dedicated patient navigator will assist you with specific questions about mesothelioma and pleural diseases, and can help you schedule an appointment with a Penn specialist.

Helpful links:

• Learn more about the Penn mesothelioma program.
• Learn more about mesothelioma.
• Learn more about treatments for mesothelioma at Penn.
• Find a mesothelioma specialist at Penn.

Penn's Abramson Cancer Center is a national cancer center in Philadelphia providing comprehensive cancer treatment, clinical trials for cancer and is a cancer research center. The National Cancer Institute has designated the Abramson Cancer Center a Comprehensive Cancer Center, one of only 40 such cancer centers in the United States.

Cancer Information From a Reliable Source

Thank you for a fantastic 2012. The Focus On Cancer blog is committed to provide people with cancer and their caregivers educated information from a reliable source, the Abramson Cancer Center at Penn Medicine. Please subscribe to our blog to get updates about new cancer treatments at Penn, credible information from cancer experts at Penn, and inspiration from other people with cancer.

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Focus On Cancer Year in Review: The Basser Research Center

2012 was an exciting year for the Abramson Cancer Center. We are featuring blogs featured on the Focus On Cancer blog that highlight cancer treatment breakthroughs, coping tips and ideas, education and inspiration. Today, we are highlighting the Basser Research Center for BRCA.

A $25 million gift to the University of Pennsylvania from alumni Mindy and Jon Gray will establish a center focused on the treatment and prevention of cancers associated with hereditary BRCA mutations.

Basser Research Center for BRCA 1 and 2

A $25 million gift to the University of Pennsylvania from alumni Mindy and Jon Gray will establish a center focused on the treatment and prevention of cancers associated with hereditary BRCA mutations.

The Basser Research Center — BRC for BRCA — will support research on the BRCA1 and BRCA2 genes, harmful forms of which are linked to greatly increased risks of developing breast and ovarian cancer. The Center is named in honor of Mindy Gray’s sister, Faith Basser, who died of ovarian cancer at age 44.

Emphasizing outreach, prevention, early detection, treatment and survivorship, the Basser Research Center will contribute to all stages of research and clinical care related to BRCA-related cancers.

“We hope that the Basser Research Center will eliminate BRCA-related cancers and, in doing so, provide a road map for curing other genetic diseases,” Mindy and Jon Gray said. “We also want to make sure that families have a center dedicated to helping them with the complex issues arising from a BRCA diagnosis. As Penn graduates, we are fortunate that our alma mater has the world-class medical facilities and gifted researchers essential for this mission.”

The Center will be located within Penn’s Abramson Cancer Center at the Perelman School of Medicine. The gift will create an endowed professorship in the field of oncology to be known as the Basser Professorship, recruit additional faculty, enhance core technologies such as bioinformatics and DNA vaccine production, launch an annual lectureship and establish the Basser Prize to honor cutting-edge research.

The Grays’ gift will support research with a particular focus on interdisciplinary work and an acceleration of bench-to-bedside implementation of scientific findings.

Susan Domchek, associate professor of medical oncology and current director of the MacDonald Women’s Cancer Risk Evaluation Center at the Perelman School of Medicine, will serve as the founding executive director of the Basser Research Center and will lead its strategic direction.

Read the full press release about the Basser Research Center.

Learn more about the Basser Research Center.

Cancer Information From a Reliable Source

Thank you for a fantastic 2012. The Focus On Cancer blog is committed to provide people with cancer and their caregivers educated information from a reliable source, the Abramson Cancer Center at Penn Medicine. Please subscribe to our blog to get updates about new cancer treatments at Penn, credible information from cancer experts at Penn, and inspiration from other people with cancer.

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Stay Connected This Holiday Season

Tracy Lautenbach, MSW, LCSW, OSW, is the social work team leader for radiation oncology at Penn. In this article, she reminds those with cancer, or who are cancer survivors, to stay connected to the ones they love this holiday season.

Holidays are traditionally viewed as a time to celebrate with family and friends. 

However, sometimes people with cancer and their loved ones feel they are out of step with the rest of the world during the holidays. Patients and family members wonder how they will be able to take care of themselves while meeting the demands of the season. It is also a time when people become reflective about their illness and the what the future holds form them.

Sharing concerns with the people you love and who are your supports is a way to help you stay connected during this time.

How do you cope with the holiday season? We'd love to hear your suggestions in the comments section below.

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11 Tips for Holiday Eating

Debra DeMille, MS, RD, CSO is a nutritional counselor at the Joan Karnell Cancer Center. Debra has worked at Pennsylvania Hospital since 1988 with the last 12 years specializing in oncology. Debra guides individuals receiving chemotherapy and radiation as well as addressing survivorship issues including the use of integrative therapies.


She conducts cooking programs and group counseling sessions for cancer survivors.
You do not have to abandon all of your efforts for a healthier lifestyle because of the riches of the holidays. Take care of yourself over this next month in order to keep energized. Here are some ideas to get your started.

• Planning is the key. As you plan when you have company, plan healthy eating and exercise in advance. Keep healthy food in your refrigerator.
• Stay well rested and stay true to your exercise program.
• Eat before you go out shopping or visiting. Avoid being in a position where a meal is skipped due to a hectic schedule. When out at the mall, resist picking up a treat as a pick me up. It may just be that you are need of a glass of water.
• Eat regularly scheduled meals – don’t skip a meal to save yourself for a big event. This only results in over eating.
• When at parties or at buffets:
• Survey the food options before picking up a plate.
• Decide what foods you would enjoy the most instead of trying to eat it all. If you are on a modified diet, this will help keep the “overages” in reason.
• Only eat foods that look fresh. Are the hot items in a buffet on a heating element? Are cold items on ice? This is particularly important for those with impaired immunity.
• Avoid all drinks or salad dressings with raw egg such as eggnog or Caesar salad dressing.
• Eat to your comfort level. Avoid being excessively hungry or uncomfortably full.
• Don’t decorate your house with food. It’s too tempting to reach for the cookie tray.
• Consider abstaining from alcohol. Combining alcohol and medications can cause some serious side effects.

Most of all, enjoy the time that brings people together and start out the new year ahead of the game.

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Recovery for Brain Cancer and the New Normal

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2012- Focus on Brain Cancer Conference. In this blog, she discusses recovery from brain cancer and accepting a “new normal.”

"You are not alone." - Arbena Merolli, MSW, social worker at the Abramson Cancer Center

For some brain cancer patients, there comes a day when active treatment ends. That day can bring with it a myriad of mixed feelings, relief, happiness, anxiety and uncertainty. The end of treatment does not mean the end of the experience of having brain cancer.

Many people, even those who have been treated successfully, experience short and long term symptoms and effects of their treatment. These can include seizures, fatigue, memory loss, weakness and ongoing anxiety or depression. Some have physical or neurocognitive deficits that prevent them from returning to their old jobs or participating in activities that were previously important parts of their lives.

The second half of Focus on Brain Cancer Conference brought together a diverse group - nurses, nurse practitioners, social workers and a team of experts in integrative medicine--as well patients to address these issues, and the "new normal" that comes with them.

Redirect

While some brain cancer patients return to their jobs, others find that they have to make changes. The panel of Arbena Merolli, MSW, Karen Albright, MSN, CRNP, and Lisa Lycksell, MSN, CRNP, conference panelists emphasized there are effective ways of controlling many symptoms, but that, in some instance, people have to "redirect," and learn to compensate. That may mean having a less stressful job, or one with shorter hours. For those who struggle with short memory issues, learning to take notes or write lists and reminders is often helpful. The panel urged patients who cannot return to work to find the things they love to do such as hobbies, activities and volunteer work. They also encouraged people to take advantage of available resources and get counseling to help them adjust to life after active treatment.

The three survivors who followed made those recommendations real and personal. One has had to modify his work life since his diagnosis five years ago, but now teaches CPR--and volunteers with his seven pound dog, Killer, as a pet therapist.

Another fights short term memory loss, but it has not kept him from getting his PhD in biology and teaching high school in the 21 years since he had a seizure on New Year's Eve and later learned that it was caused by a brain tumor.

And another survivor’s journey began in 2008 when she developed psychiatric symptoms, and had to insist to her doctor that "something was wrong with my brain," before getting the CT scan that revealed her tumor. Two years later, she repeated that struggle, this time with her insurance company before learning she had a recurrence. In that time, though, she has had two children and started a successful business.
 

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Patient Story: Proton Therapy for Non-Small Cell Lung Cancer

Kathy Brandt was diagnosed with non-small cell lung cancer in 2011 at her local hospital. After much research, and a recommendation from her brother-in-law, who is a physician, Kathy chose Penn Medicine for her lung cancer treatment, which included proton therapy. Today, Kathy is cancer free. 

Watch Kathy Brandt, a patient alum, tell her story about proton therapy for lung cancer. 

You hear the words cancer and it's truly terrifying.

It was basically just a checkup with my pulmonologist because I have emphysema. He sent me for a chest X-ray and that is when they found the tumor in my lung.

It was a terrifying time and thankfully I had strong family surrounding me - strong family helping me make decisions about what kind of treatment I should have.

After that initial diagnosis, when you feel like you have been hit with a ton of bricks, then the decision needs to be made where you are going to seek treatment. My brother-in-law, who is a physician, along with my pulmonologist suggested I go to Penn Medicine for treatment.

Penn Medicine was a wonderful choice for us. They used a team approach. I saw an oncologist, I saw a surgeon, and the radiologist is all located at Penn Medicine. It was very comforting to know that all these people are just working to take care of you and to make you better.

I was diagnosed with non-small cell lung cancer at the end of June. My surgery was the beginning of August and chemo started in September. It was finished in November. I started proton therapy for lung cancer in December, which lasted for 4 weeks.

Deciding to Have Proton Therapy for Non-Small Cell Lung Cancer

I decided to go with the proton radiation because of the cancer’s proximity to my heart and spine. I chose proton therapy because I knew it would be more precise and would have less side effects and that was very important to me.

The Proton Therapy Experience

Every day, I would leave work, come home, and my husband would take me to Penn for proton therapy. After the treatment, we’d go home and I’d spend time with my grandchildren and their parents, who were living with us at the time. My granddaughter was about 3 months old at the time. And I would take her, feed her, and just spend time with the people that meant the most to me.

I really felt wonderful. I continued to work the whole time I had proton therapy – I never missed a day of work, actually. I was a bit more tired than usual, but that was really the only side effect I felt.

When I completed proton therapy, I rang the bell. Everybody in the waiting room clapped, and we went home and I think I had a very big glass of wine after treatment was finished.

After Proton Therapy

Today, I don’t sweat the small stuff.

I would tell anyone to feel very comfortable going to Penn Medicine, and I would tell anyone to also feel very comfortable in choosing proton therapy simply because of the fewer side effects and its extreme precision. I would recommend Penn Medicine wholeheartedly. I cannot say enough good things about my experience.

Learn More About Proton Therapy for Non-Small Cell Lung Cancer at Penn Medicine

Proton therapy is a non-invasive, incredibly precise cancer treatment that uses a beam of protons moving at very high speeds to destroy the DNA of cancer cells killing them and preventing them from multiplying.

Unlike conventional radiation that can affect surrounding healthy tissue as it enters the body and targets the tumor, proton therapy’s precise, high dose of radiation is extremely targeted. This targeted precision causes less damage to healthy, surrounding tissue.

Learn more about proton therapy, or schedule a consultation with a radiation oncologist at Penn Medicine.

Watch the full video of Kathy's experience here. 

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HEADStrong Foundation Feeds Cancer Patients and Families at Penn

This November marked the 6th year the HEADstrong Foundation prepared and served a traditional Thanksgiving dinner to several floors of patients and families who are amidst treatment for blood cancer in the Rhoads Pavilion at Hospital of the University of Pennsylvania.

About the HEADStrong Foundation

The HEADstrong Foundation for blood cancer is committed to finding a cure for all blood cancers. The foundation is dedicated to its founder Nicholas Colleluori, who was diagnosed with non-Hodgkin lymphoma in 2005, and passed away in November, 2006.

The foundation strives on Nick’s quote, “Making use of the time you have and don’t stress the little things. Have a smile and enjoy what you can get out of life.”

Read more about the HEADStrong Foundation's founder.

Helping Patients with Blood Cancer and Their Families

Preparing, serving, and sharing the feast is just one way that the HEADstrong Foundation improves the quality of life for patients and families battling blood cancers. They also support lymphoma research taking place at the Abramson Cancer Center under the leadership of Stephen J. Schuster, MD.

This annual tradition which began as a Thanksgiving feast, is turning into an exciting new program, called HEAD’s Table. HEAD’s Table will expand their outreach into the blood cancer community through the nurturing act of serving a meal to patients, their families and medical personnel four times a year- March, June, November and December.

Thanks to HEADstrong for all that they do for the patients, faculty, and staff of the Abramson Cancer Center.

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Basser Event Promotes BRCA Research at Penn Medicine

More than 400 patients, friends and faculty of the Abramson Cancer Center celebrated the transformational gift from Jon and Mindy Gray to establish the Basser Research Center for BRCA in New York and Philadelphia this fall.

The Basser Center will focus on prevention and treatment options for those with a BRCA 1 or 2 mutation and will provide a place for people to discuss their options and participate in research studies.

From left:  Chi Van Dang, M.D., Ph.D., Susan Domchek, M.D., Jon Gray and Mindy Basser Gray, Amy Gutmann, Ph.D., and J. Larry Jameson, M.D., Ph.D.

View more photos from the Philadelphia and New York events on Penn Medicine's Facebook page.

About the Basser Research Center for BRCA

A $25 million gift to the University of Pennsylvania from alumni Mindy and Jon Gray will establish a center focused on the treatment and prevention of cancers associated with hereditary BRCA mutations.

The Basser Research Center for BRCA— BRC for BRCA — will support research on the BRCA1 and BRCA2 genes, harmful forms of which are linked to greatly increased risks of developing breast and ovarian cancer. The Center is named in honor of Mindy Gray’s sister, Faith Basser, who died of ovarian cancer at age 44.

Emphasizing outreach, prevention, early detection, treatment and survivorship, the Basser Research Center will contribute to all stages of research and clinical care related to BRCA-related cancers.

“We hope that the Basser Research Center will eliminate BRCA-related cancers and, in doing so, provide a road map for curing other genetic diseases,” Mindy and Jon Gray said. “We also want to make sure that families have a center dedicated to helping them with the complex issues arising from a BRCA diagnosis. As Penn graduates, we are fortunate that our alma mater has the world-class medical facilities and gifted researchers essential for this mission.”

The Center will be located within Penn’s Abramson Cancer Center at the Perelman School of Medicine. The gift will create an endowed professorship in the field of oncology to be known as the Basser Professorship, recruit additional faculty, enhance core technologies such as bioinformatics and DNA vaccine production, launch an annual lectureship and establish the Basser Prize to honor cutting-edge research.

The Grays’ gift will support research with a particular focus on interdisciplinary work and an acceleration of bench-to-bedside implementation of scientific findings.

Susan Domchek, associate professor of medical oncology and current director of the MacDonald Women’s Cancer Risk Evaluation Center at the Perelman School of Medicine, will serve as the founding executive director of the Basser Research Center and will lead its strategic direction.

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Basser Center Story at Ovarain Cancer Research Fund

The Ovarian Cancer Research Fund provides an interview with Mindy Gray, “Wife, Mother, Sister, Philanthropist, and OCRF Board Member.” Mindy and Jon Gray are the founding donors of the Basser Research for BRCA.

 The ultimate goal of the The Basser Center is eradicating risks from BRCA-related cancers once and for all. The Center is focused on funding scientific research and giving brilliant research scientists the state-of-the-art facilities and the freedom to discover innovative paths to treatment, prevention and cure. With the leadership of Dr. Chi Dang, Director of the Abramson Cancer Center, and Dr. Susan Domchek, Executive Director of the Basser Research Center, we are confident that we can make huge progress towards this goal.

For more information, visit the Basser Research Center for BRCA online.

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More Gift Ideas for Someone with Cancer

Carly Roop RD, CSO, is a registered dietitian at the Joan Karnell Cancer Center (JKCC). She provides nutrition education and support to patients while addressing nutrition-related side effects from chemotherapy and radiation. Dietitians at JKCC provide educational nutrition programs that are open to patients as well as the community.

Can You Still Have a Merry Time Without Eating or Drinking?

It seems impossible to go anywhere or do anything without eating or drinking, especially, during the holidays. The calendar fills up with dinners, holiday parties or drinks after work and the morning talk shows feature gift ideas that are food-related as well, because I guess they figure we all have to eat.

However, if you know someone with cancer currently undergoing treatment or if you are going through treatment you know firsthand the effect it has on someone’s appetite or ability to eat.

I am amazed at the extent we are linked to food; food not only feeds us physically, but food feeds us emotionally, culturally, socially and psychologically. For some their aversion for food may only be temporary but for others they may never be able to eat normally again.

So what can you do at Christmas for someone with cancer who can’t or isn’t interested in eating? Hopefully, these ideas below will help you get your wheels turning:

• Bowling: I know that you can eat while you are bowling but when you think about all the people touching the balls…do you really want to?
• Paint your own pottery or take a painting class: I’ve seen painting classes on social coupon websites, and there is usually a BYOB option, if you are so inclined.
• Go to the Nutcracker: Unlike the movies, you are encouraged to finish your drink or snack before taking your seat.
• Have a spa day
• Make a book on tape or read someone to sleep: Who doesn’t like being read to?
• Make a mixed CD: This may sound high school, but your friend or family member will appreciate the time and thought you put into the gift and they may even like the songs!
• Go to amateurs’ night at comedy club: It’s a good time, and everyone loves to laugh.
• Take a walk or drive around to the neighborhood to take in the beautiful or garish Christmas displays
• Go to the museum
• Spend time putting together a gigantic jigsaw puzzle: I knew someone who would frame his puzzles after they were done and hang them as art
• Photography: Sometimes it’s more fun to be behind the camera
• Accessories: Shoes, for example, don’t have to be Louis Vuitton, but sometimes a new pair of shoes can make you feel like you have a new wardrobe.

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New Discoveries Toward Brain Cancer Recovery

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2012- Focus on Brain Cancer Conference:
Discovery to Recovery. In this blog, she discusses treatments for brain cancer.

Neurosurgery:  The Crux of Treatment for Brain Cancer

"The neurosurgeon's goal is take out as much of the tumor as possible safely, " says Steven Brem, MD, conference chair, and director of neurosurgical oncology.

"Personalized medicine has become something of a buzz work in medicine, but it is true for brain cancer patients,” says  Donald O'Rourke, MD, associate professor of neurosurgery.

Penn neurosurgeons are using improved imaging techniques for "neuronavigation."  This approach provides real-time, 3D views for the surgeon as he operates - allowing for maximum safe resection of the tumor and avoiding normal tissue.  This is particularly crucial in preserving language function and motor skills.

Radiation Therapy:  The Full Spectrum of Options

"Penn has the largest, most advanced proton facility in the world, one of only 10 in the United States.  We also have the unique advantage of having all of our radiation facilities integrated under one roof, "
Robert Lustig, MD, professor of radiation oncology.

Radiation therapy plays a key role in the treatment of most brain cancers.  Penn offers the full range of treatment modalities including one of only 10 proton facilities in the country.  Patients often are unsure of the relative benefits or indications for different kinds of radiation therapy, for example, protons vs. the gamma or cyber knife. 

Radiation therapy treatment decisions for brain tumors are highly individualized and need to be made in the context of multidisciplinary planning. 

Briefly stated, protons:

• Are more precise than conventional radiation therapy and do less damage to normal tissue
• Reduce side effects both short and long term 
• Deliver slightly more radiation to the tumor on a dose by dose basis
• Are effective in treating tumors near sensitive structures such as the spinal cord
• Can be used to "retreat" some patients with brain cancers

Dr. Lustig noted that Penn is now conducting clinical trials using protons for high-grade glioblastomas, grade III astrocytomas and pituitary adenomas, and will participate in an NCI-RTOG national study on protons for glioblastomas expected to begin soon.

He also noted that many patients encounter insurance issues in trying to get approval for proton therapy, although Medicare pays for most indications.

Stereotactic radiosurgery using the Gamma Knife® is another option for treating brain cancers.  Michelle Alonso-Basanta, MD, PhD, assistant professor of radiation oncology, explained that the original Gamma Knife was not designed to treat cancers, but that advances in technology and technique have made this a useful therapy for some patients with brain cancers.

"As with protons," she says, "we can deliver a very high dose of radiation to the target with little or no exposure of normal tissue to the radiation.  And, as with protons, the decision as to who will benefit from this approach is very individual."

Both stereotactic radiosurgery and protons offer the possibility of retreatment for patients who have undergone a previous course of radiation therapy and whose tumors have recurred.  In the past, these patients were not eligible for additional radiation therapy. 

Targeted Therapies: Changing Cancer Treatment

Penn Medicine has been a leader in immunotherapy research and in developing targeted vaccines for cancer for many years.  Bruce Levine, PhD, facility director, clinical cell and vaccine production facility describes work currently underway that involves activating T-cells, one of the mainstays of the body's defense system, to fight cancers. 

"If I could design T-cells to fight cancer," he says, "they would be potent, have a good memory, be persistent and numerous."

A new approach, developed at Penn, known as CAR (chimeric antigen receptor) T-cell therapy promises to be all of those things.  CAR uses a complex process to remove cells from the patients and own body and activate them to attack the tumor.  Penn is now in the process of developing clinical trials that will study the effects of CAR T cell therapy on glioblastomas with the EGRF v III mutation.

That mutation is the focus of work aimed at improving brain cancer treatment using chemotherapy as well.  Arati Desai, MD, MAS, is using bevacizumab (Avastin), a drug that inhibits blood vessel formation, in combination with another drug in patients with recurrent glioblastomas.  Phase II studies have demonstrated improved response rates and survival, although Desai acknowledges that some controversy exists about what those responses mean in terms of actual survival times.

Other clinical trials are aimed at attacking cancer cells from both the inside of the cell and the outside. 

These include approaches using

• Immunotherapy
• Combinations of drugs that target multiple pathways
• Drugs that affect the environment around the tumor
• Drugs that block the critical M Tors pathway
• Drugs that target factors known to influence prognosis, such IDH1 and MGMT

"There isn't going to be a single drug or agent that is going to work for everyone," says Desai.  "It's not going to be the same answer for every patient."

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Immunotherapy and Leukemia

A front-page story in the New York Times details the progress of a Perelman School of Medicine team in using genetically engineered versions of leukemia patients' own T cells to fight their cancer; an approach which has now been used in 12 patients, 9 of whom responded to the therapy -- including two children.

"Our goal is to have a cure, but we can't say that word," said the study's leader, Carl June, MD, the Richard W. Vague Professor in Immunotherapy in the department of Pathology and Laboratory Medicine and director of Translational Research in Penn's Abramson Cancer Center.

He hopes the new treatment will eventually replace bone-marrow transplantation, an even more arduous, risky and expensive procedure that is now the last hope when other treatments fail in leukemia and related diseases.

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Gifts for Someone with Cancer

Carolyn Vachani, RN, MSN, AOCN, is an oncology advanced practice nurse at the Abramson Cancer Center. She has worked in the areas of medical hematology and oncology, bone marrow transplant, clinical research, radiation therapy and staff development. She is also the nurse educator for OncoLink.

Have you thought about holiday gifts for someone with cancer?

The holidays can be very stressful- particularly when you are already dealing with a cancer diagnosis or are the caregiver for someone with cancer. Perhaps you know someone in such a situation. Whether they are a family member, good friend or just the woman down the street you always pass when walking the dog, you may be thinking about their struggles this holiday season and want to show them you care. I encourage you to think outside the box of chocolates.

In my years of caring for and talking to people with cancer, I have never heard “so-and-so gave me the nicest box of chocolates.” What they do remember is the kind – and often free – gestures from people, no matter the time of year. A card with a kind note; a meal left on the front steps while they were at treatment; leaves raked when they just couldn’t do it themselves. Be the holiday helper who shops for and wraps all the kid’s gifts or decorates the house when the person had no energy to do it - remember to come back and un-decorate too! Deliver a holiday meal or invite them to yours.

You don’t need to spend money to show someone you care. Simple gestures can be so helpful - walk their dog, taking out the trash cans on trash day, call when you are going to the store and offer to pick up some items. A “gift” of your time and energy goes a long way to making someone feel cared about and special.

Have I got you thinking? Need more ideas? The OncoLink Holiday Survival guide has many more ideas for special gifts and shares survivor’s memorable gift stories.

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Cancer-fighting Recipe: Butternut Squash and Mac Casserole

This easy bake recipe gives a delicious, creamy appearance without the saturated fats of macaroni and cheese.

Butternut squash is the most nutrient dense of the winter squashes. It contains multiple carotenoids, Vitamin A, Vitamin C and fiber. The coconut milk adds to the creamy texture. Lower fat varieties are available if you are interested in cutting down the fat and calories.

Walnuts are my favorite nut as they are a good source of Vitamin E, Omega 3 fatty acids and melatonin. There are many ways to cut down on the total fat of this recipe if you are interested but remember, these are healthier fat choices. Substitute low fat coconut milk, sautee the onion in 1 Tbsp. of olive oil and decrease the walnuts to ¼ cup.

To save time, bake butternut squash whole when you have the oven on for any other reason. If butternut squash is already cooked and soft, you can save 20 minutes by blending the first 6 ingredients with an immersion blender. This makes a very creamy sauce.

Butternut Squash and Macaroni Casserole

Serves 8

Ingredients

• 2 tablespoons olive oil
• 1 large yellow onion, thinly sliced
• 1 butternut squash (about 2 lb.), peeled, seeded and cut in 1” cubes
• 1 can coconut milk
• Salt and pepper to taste
• 1 tb. Chopped sage
• ¾ lb. dried elbow macaroni
• ½ cup chopped walnuts
• ½ cup bread crumbs

Directions
Preheat oven to 350 degrees F. Lightly oil a 9x13” casserole dish; set aside.

Heat oil in a medium pot with the heat on medium. Add onions and cook, stirring often until soft (5-7 minutes). Add squash, coconut milk, salt and pepper and bring to a boil. Cover, reduce heat to medium low and simmer until squash is tender, about 20 minutes. Stir in sage and simmer 1 more minute. This part can be made ahead, up to 1 day in advance.

Meanwhile, bring a large pot of salted water to a boil. Add macaroni and cook until tender but still firm (about 8 minutes). Rinse in cold water, drain well and transfer to a large bowl. Transfer squash mixture to bowl with macaroni. Add walnuts and toss to combine. Transfer to prepared dish and top with bread crumbs. Bake until golden brown and hot (about 30 minutes).

Nutrition per serving: 400 cal, 21 grams of fat, 5 grams of fiber, 9 grams of protein

Recipe from Whole Foods

Debra DeMille, MS, RD, CSO is a nutritional counselor at the Joan Karnell Cancer Center. Debra has worked at Pennsylvania Hospital since 1988 with the last 12 years specializing in oncology. Debra guides individuals receiving chemotherapy and radiation as well as addressing survivorship issues including the use of integrative therapies.


She conducts cooking programs and group counseling sessions for cancer survivors.

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The Promise and Peril of Genetic Testing

Susan Domchek, MD, executive director of the Basser Research Center and an associate professor in the division of Hematology-Oncology in the Abramson Cancer Center was a guest on WHYY Radio's Radio Times, discussing advances in genetic testing.

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Immunotherapy for Lung Cancer

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2012- Focus on Lung Cancer Conference. In this blog, she discusses new ways in which lung cancer tumors are being used to create new treatments for lung cancer.

Demystifying the Immune System

"Lung cancer is a formidable foe with many ways of eluding the immune system--but we are developing multiple approaches to using immunotherapy as a treatment option." Gregory Beatty, MD, PhD

Our immune systems are sophisticated, highly evolved and multi-dimensional. They look for and attack invaders. They fight infections, heal wounds and maintain our body health. But do they recognize and fight cancer? And if not, why not?

The answer is complicated. The immune system does, at least in some instances, recognize and attack cancer cells, including lung cancer cells--but in many cases, it fails to eradicate these cells. New research indicates that cancer cells actually develop ways of co-opting the immune system, teaching it to help the cancer grow and spread. This says Dr. Beatty is "bad education," and the goal of immunotherapy research is to re-educate the immune system to attack cancer cells.

At Penn, researchers are using a number of approaches. These include:

• Cancer cells have the ability to produce STOP signals that prevent the immune system from recognizing them. One approach to immunotherapy is to develop specific antibodies that go after these STOP signals and block them. One example is the PD-1 blocking antibody.
• CAR-T or chimeric antigen receptors use specially engineered killer T-cells to attack cancer cells. These T-cells are harvested from the patients, go through an amazing process by which they are "re-programmed" to attack the patient's tumor, and then re-injected. The results for several cancers have been promising--with trials scheduled to begin for non small cell lung cancers.

Right now, there are no immunotherapy agents approved by the FDA to treat lung cancer, but clinical trials are underway in patients with advanced disease, and are planned as adjuvant therapy for patients who undergo potentially curative surgery as a means of reducing the risk if recurrence.

To learn more about immunotherapy clinical trials at Penn, call Abramson Cancer Center Clinical Trials Service Toll Free: 1-855-216-0098, Local: 1-646-354-4221 Monday through Friday, 8:30 am to 5:30 pm or email ACCStudies@emergingmed.com

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Brain Cancer Experts Behind the Scenes at the Abramson Cancer Center

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2012- Focus on Brain Cancer Conference. In this blog, she discusses the experts behind the scenes at the Abramson Cancer Center.

"For 10 years, we have been talking more about hope than progress, but in the last couple of years, we are seeing big differences using new drugs and targeted therapies. We aren't really sure why this is occurring, but we know that our mission is to move from discovery to recovery."- Steven Brem, MD, Conference Chair, and Director of Neurosurgical Oncology.

In 2012, 23,000 people will be diagnosed with cancers of the brain and spinal cord. In adults, 75 percent of those will be glioblastomas.

Cancer treatment today depends on having a team of experts, working together, pooling their knowledge and insight to develop the best care plan for every individual patient. Patients get to know their surgeons and medical oncologists, even their radiation therapists, but seldom interact with other members of the team whose contributions are critical.

The Focus on Brain Cancer Conference offered patients and family members the opportunity to hear from those experts, the pathologist, the radiologist, and in this instance, a scientist who works with mathematical models to understand brain cancer. Their talks were a clear indication of the progress being made in understanding brain cancers--advances that translate directly into improvements in treatment.

Pathologists Identify Genetic Subtypes of Brain Cancers

Maria Martinez-Lage, MD, opened the conference by explaining the information that pathologists use to identify and classify brain cancers. She noted that brain cancers are not staged like other cancers, but rather assigned a grade from I to IV, with four being the most common and most aggressive adult brain tumor, glioblastoma. She also noted that glioblastoma is no longer viewed as one disease--rather there are four subtypes characterized by different molecular profiles.

Pathologists now look for several key factors in diagnosing and categorizing glioblastomas. These include:

• IDH1 mutation: A gene mutation that occurs more often in lower grade tumor and indicates a favorable prognosis
• MGMT: A genetic mutation that occurs in some glioblastomas that is an indicator or whether a tumor will respond to chemotherapy
• ECFRvIII : A gene mutation found in some glioblastomas and other cancers that indicates a more aggressive tumor--but also responds to specific targeted therapy

This kind of information has a direct impact on the treatment decision-making process. Research is currently underway to find other genetic mutations that can be targeted. Penn has also opened a Center for Personalized Diagnostics a combined research and patient care facility that is focused on the next generation of gene sequencing for cancer.

The cause of glioblastoma is generally unknown. There are some very rare familial syndromes that increase the risk, and some association with toxins and high doses of ionizing radiation, but most cases occur without an identifiable cause.

Watch a video about how the Center for Personalized Diagnostics is changing the way tumors are targeted.

Radiologists Pinpoint Critical Differences in Tumors

MRIs are the mainstay of brain cancer diagnosis and treatment assessment--a reality illustrated by the fact that the great majority of patients at the Penn Medicine Conference have had 10 or more MRIs. MRIs provide more information than CT scans without using radiation. According to Ronald Wolf, MD,PhD new approaches to imaging, however, are yielding rich new information about biology, anatomy and functioning of brain cancers that is changing treatment for many patients. These include:

• Angiogenesis: The formation of blood vessels by the cancer
• Cellularity: The cellular composition of the tumor
• Metabolism: The rate at which the tumor is consuming nutrients
• Anatomy: The exact shape and location of the tumor

Why are these important? These factors help predict how the tumor will behave. A brain cancer with a high tumor blood volume, for example, is generally higher grade and more aggressive than those with lower blood volume. They are also more likely to be the tumors that are positive for the EGFRvIII mutation.

Powerful imaging tools also allow for more precise "mapping" of specific areas of brain, those that control motor skills or language--which guide the surgeon in removing as much of the tumor while sparing normal tissue.

"These new tools," says Dr. Wolf, "give us a more accurate clinical profile, which allow us to tailor treatment decisions to the individual."

"The Big Tent": Science and Medicine Today: Engineers, Physicists and Mathematicians for Brain Cancer Treatment

Most cancer patients don't think of engineers, physicists and mathematicians as having anything to do with their treatment, but today's medicine often involves scientists from a broad range of disciplines. Christos Davatzikas, Ph.D., is one of them, an engineer at Penn, who is developing sophisticated mathematical models of the location, grade, type and size of glioblastomas to help understand more precisely how these tumors grow. His analysis provides critical data that helps predict which brain cancers will recur. One key finding confirmed by Davatzikas's data is that certain parts of the brain are more likely to develop high grade, aggressive tumors than others.

"We are using this information to inform clinicians as well as patients," he says. " If we can predict recurrence, we can provide more effective therapy to patients who need it and stop ineffective therapy for patients who are not benefitting from it."

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Cancer Fighting Recipe: Spicy Kale with Fried Grapes and Frizzled Onions

Kale’s strong and sometimes bitter flavor comes from its sulfur-containing compounds, which are converted into isothiocyanates (ITCs) when its leaves are broken by blending or chopping. ITCs have proven immune boosting and anticancer effects, making this the perfect dish for combating those fall sniffles!

Lacinato kale has long and slender leaves and is usually more tender than its cousin curly kale. Other braising greens such as Swiss chard, beet greens or mustard greens are great substitutes.

 

 

 

Spicy Kale with Fried Grapes and Frizzled Red Onions

Serves 6
Ingredients

• 2 tablespoons extra-virgin olive oil, divided
• 2 teaspoons balsamic vinegar
• ⅛ to ¼ teaspoon red pepper flakes
• 1 medium red onion, halved and thinly sliced lengthwise
• 1¼ teaspoons salt, divided, plus extra for serving if needed
• 1¼ cups halved seedless red grapes
• 1½ bunches Lacinato kale (about 6 ounces)--stems removed, leaves stacked, rolled and sliced crosswise into wide ribbons

Directions

1. In a small bowl, whisk together 1 tablespoon of the olive oil with the balsamic vinegar and the red pepper flakes. Set aside.
2. In a large skillet set over medium-high heat, add the remaining 1 tablespoon of olive oil. Add the onion and ½ teaspoon salt and cook, stirring often, until the onion is brown and frizzled around the edges, about 4 minutes. Add the grapes and cook until browned, about 2 minutes.
3. Pour the oil-balsamic mixture into the pan and immediately add the kale. Use tongs to stir and turn the kale into the onion-grape mixture. Once the kale starts to wilt, after about 1 minute, turn off the heat and transfer the kale mixture to a serving bowl. Taste and season with the remaining ¾ teaspoon of salt. Serve warm or at room temperature.

Nutrition per serving: 80 calories; 4.5 grams of fat; 5 grams of sugar; 1gram of protein
Recipe from the Tasting Table Test Kitchen www.tastingtable.com

Carly Roop RD, CSO, is a registered dietitian at the Joan Karnell Cancer Center (JKCC). She provides nutrition education and support to patients while addressing nutrition-related side effects from chemotherapy and radiation. Dietitians at JKCC provide educational nutrition programs that are open to patients as well as the community.

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5 Easy Yoga Poses to Do Anywhere

The practice of yoga calms the mind by providing a deep feeling of relaxation and balance. Did you know that the very basics of a yoga practice can be done during your “everyday” life at any place or any time?

When you find yourself caught up in the hustle and bustle this holiday season, give yourself the gift of “instant yoga” by practicing these quick and simple techniques…anywhere…anytime:

Staying Grounded During the Holidays: 5 Easy Ways to Take Yoga off of the Mat

Standing Pose

The next time you are in the middle of a busy mall and feel overwhelmed by the crowds, take a few second to ground yourself by standing with your feet hip’s distance apart, relaxing your shoulders and fixing your gaze straight ahead. Take a few release breaths in through your nose and out through your mouth. This will reset your body and mind to allow you to continue with the remainder of your shopping!

Alternate Nostril Breathing

If holiday shopping gives you a headache, try inhaling and exhaling through each nostril by closing off one nostril and breathing in to a count of 8 and exhaling out of the other nostril to a count of 16. Do a few rounds of this ancient yogic breathing practice slowly for relief of stress and anxiety.

Shoulder Rolls

When lines at the cashier drive you crazy and cause stress, draw your attention to your shoulders and take a nice, long inhale bringing your shoulders up to your ears, circle them back and down. While you are at it, circle your neck around a few times while inhaling and exhaling slowly. You will feel a renewed sense of calm.

Lion’s Pose

Are those office parties making you tired of talking, smiling and socializing? Go to a quiet place and try this pose by opening up your mouth wide and sticking out your tongue. Making the sound of a roaring lion helps, too. Sounds funny, but this ancient pose is a great release for the facial muscles and really helps if you have been doing a lot of talking.

Meditate

The best way to get through the holiday season feeling happy, healthy and whole is starting each day with a few minutes of meditation. Just sitting silently with your eyes closed at any point during your day is very helpful to keep yourself in balance. Remember, it doesn’t have to be for a long period of time…even just one minute of silent meditation in the midst of a busy holiday season will go a long way!

Join Us for FREE Yoga Sessions

The Abramson Cancer Center offers FREE yoga classes to patients, caregivers and survivors every Tuesday and Thursday from 2 to 3 pm. Contact Fern Nibauer-Cohen by email at Fern.Nibauer-Cohen@uphs.upenn.edu or phone at  215-662-3919 for more information.

Fern Nibauer-Cohen is the associate director of program development in the department of radiation oncology at Penn Medicine. She received her certification to teach yoga from Yoga On Main in Manayunk, PA and has completed the level one certification of the “Teaching Yoga to Cancer Patients Program” from Integral Yoga. 

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Surgery, Radiation and Proton Therapy for Lung Cancer Treatment at Penn

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2012- Focus on Lung Cancer Conference. In this blog, she discusses new treatments in radiation and proton therapies for lung cancer patients. 


"At Penn, we care about the total patient experience,” says John Kucharczuk, MD. “ We know that for most people, the diagnosis of lung cancer is their first experience with this disease. As doctors, we need to recognize what that means to people, understand their anxiety level.”

Surgery for Lung Cancer

At Penn, the highest quality of surgical care for lung cancer encompasses understanding what it means to have this disease and undergo treatment. Penn has one of the largest divisions of thoracic surgery in the country, one that includes a dedicated surgical unit staffed with nurses who care only for patients who have undergone this kind of surgery.

Surgeons work as a team with experts from other disciplines to assure optimal care for every patient, and are leaders in developing new technologies and approaches that minimize the invasiveness of surgery, while maximizing the therapeutic effect. These include innovative approaches to lung sparing surgery, robotic platforms and the use of photosensitizers to improve local control of tumors.

Skill and technology are critical, but underlying the Penn program is an active commitment to preserving quality of life for patients. To Dr. Kucharczuk and his team, that involves engaging with each patient to understand what quality of life means to that person, and working to tailor the treatment to the individual.

Radiation and Proton Therapy for Lung Cancer

"Lung cancer treatment is a 'team sport.' We see ourselves as a group of physicians who have the privilege of caring for you. Effective treatment is truly a partnership with our patients." Ramesh Rengan, MD.

For many lung cancer patients, radiation therapy is an important part of their treatment. Penn offers a number of options to patients with most kinds and stages of lung cancer. These include:

• Conventional radiation therapy utilizing 3-D imaging and IMRT
• Protons
• Stereotactic body radiation

Charles Simone, MD, emphasized that there are two major components in delivering effective radiation therapy to lung cancer patients.

• Where is the cancer? This means locating the tumor as precisely as possible. Penn is one of the few centers that has integrated PET scanning and metabolic evaluation of tumors into this process.
• How do we target the cancer? This means getting as much of the radiation dose to the tumor while sparing normal tissue.

The exact type of radiation used depends on the patient--the kind and extent of the cancer, and the overall health or other conditions that might exist. Newer options, such as stereotactic body radiation are making it possible to treat older, sicker or more advanced patients.

Proton therapy is another option for patients with locally advanced lung cancers, the most common diagnosis. Penn is one of only eight centers in the United States that offers proton therapy--a technique that allows more precise, targeted delivery of radiation to the tumor. Protons have the potential to reduce side effects from therapy while being equally effective in treating the cancer.

See all the presentations from the Focus On Lung Cancer Conference here. 

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Advances in Diagnosing Lung Cancer

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2012- Focus on Lung Cancer Conference. In this blog, she discusses new imaging and diagnostic advances for lung cancer.

Defining Risk, Reducing Deaths from Lung Cancer

The National Lung Screening Trial (NLST) demonstrated that regular, low dose CT screening for people at high risk of developing lung cancer reduces the death rate by 20 to 25%.

That trial, the largest screening trial in history, also raised a number of questions.

• Who is at high risk? The NLST included people over the age of 55 with a 30 pack year history of smoking. Should that definition be broadened to include younger people, or those with less of a smoking history?
• What are the appropriate protocols for evaluating various types of lung lesions discovered on these CT scans? In some instances, the lesion is clearly a lung cancer--or clearly not one, but if you do CT scans of people's lungs, you discover a lot of lesions that are not as clear cut. Following those lesions can mean additional studies, or even invasive procedures such as biopsies. It is important to have low dose CT scans done in a center that has the expertise to evaluate and follow any findings.
• What is the appropriate amount of time after treatment to switch to low dose CT for follow up? Lung cancer survivors are also at higher risk of developing a recurrence of their tumors, or even a second cancer. Penn currently recommends making that change at the five-year mark.

Learn more about CT scans to detect lung cancer.

Imaging for Lung Cancer is Critical

"It takes a village to care for a lung cancer patient." Andrew Haas, MD, PhD

Until they are diagnosed with a potentially serious disease such as lung cancer, few people realize what a critical role diagnostic radiology plays in the treatment process. The ability to "see" the tumor is essential to accurate diagnosis and staging, which is, in turn, essential to optimal treatment planning.

For lung cancer patients, the ability to both see and reach the tumor--and biopsy it in the least invasive way possible is also important. In order to do molecular profiling, now standard for lung cancer patients, it is necessary to have tissue for the pathologist to analyze. New imaging techniques and technologies are improving that process, allowing interventional radiologists to reach deep into previously inaccessible airways to visualize smaller and smaller tumors, and extract the needed tissue. The instruments they use are increasingly smaller and more flexible, often employing robotic technology and navigational aids much like the ones we use in our GPS systems.

The line between diagnostic radiology and treatment has all but disappeared. Today, Penn interventional radiologists treat common side effects of lung cancer and its treatment such as pleural effusion and airway blockages.

On the horizon....new imaging technologies that will make it possible to deliver therapies directly to the tumor.

View all the presentations from the 2012 Focus On Lung Cancer Conference here. 

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