Baylor takes aim at the disease with advanced treatments
The significant advances of recent years in treating cancer can be seen every day at Baylor Charles A. Sammons Cancer Center at Dallas.
Just ask Carol Wilson, a school nurse and mother of two who lives in Mesquite, Texas. She knows firsthand the harrowing experience of going through leukemia, chemotherapy and an adult bone marrow stem cell transplant while in the supportive and patient-friendly environment at the Baylor Sammons Cancer Center. For more than 30 years, doctors on the medical staf at Baylor University Medical Center, along with Baylor nurses, have treated cancer, with particular emphasis on lung, colon, breast, prostate, gynecologic, and blod and bone marow cancers. The center has been recognized as one of the top 50 hospitals for cancer treatment and is an accredited cancer program through the American College of Surgeons Commission on Cancer. “We’re making lots of progress in terms of treatments. More of it has been on individual diseases than global cures.”
Wilson’s experience began unexpectedly on Valentine’s Day 2005 when she went to the doctor tired, congested and with a sore throat, thinking she had the flu or mononucleosis. It turned out to be advanced leukemia.
“My doctor gave me antibiotics, but at the last minute decided to run a blood test,” Wilson says. “The next day, she called me to say I had leukemia and to get to the hospital that night for a four-week stay. I later learned that if I hadn’t gotten in the hospital in those few days, I wouldn’t have made it.” Wilson spent the next month in the hospital undergoing daily doses of chemotherapy.
“It was pretty intense,” she admits. “I couldn’t eat and was throwing up all the time. Eventually they had to feed me through an IV. I lost weight and my hair.”
Still shocked by the diagnosis, Wilson credits the nursing staff at Baylor Dallas for helping her get through everything. “Through it all, the nurses were so nice and informative and accommodating to me and my family,” she says. “Everybody on the floor was just great.”
After consulting oncology doctors on the medical staff at Baylor Dallas, Wilson elected to seek a bone marrow transplant to keep the leukemia from returning — a very real threat.
“When I was still in the hospital, the doctor began to screen my sisters and brothers to see if there was a match for adult stem cells,” she said. “We found one with my second sister.”
The sister underwent a new procedure to harvest the adult stem cells and then transplant them. Wilson’s sister had several shots of medication to increase her cell production before being connected through two intravenous lines to a blood filtering machine. This machine selects the circulating stem cells and returns the remaining blood products to the donor, who reproduces adult stem cells. This process is known as apheresis.
After Wilson received intensive chemotherapy these adult stem cells were then infused into her blood system through an intravenous line.
“It’s like getting blood,” Wilson says. “It’s very anticlimactic. I asked the doctor if this was all there was to it, and he said ‘This is it.’”
Because she didn’t want to spend more time away from family, Wilson said Baylor Sammons Cancer Center accommodated her by making the blood and marrow transplant an outpatient procedure.
“That really helped,” she says. “I got to go home every night and see my kids.”
In April, Wilson reached her two-year cancer-free mark. That is a milestone for leukemia survivors because it’s when the chances of survival increase to 90% and the chances of the disease returning drop significantly.
Besides her oncologists, Wilson says she tapped into a rich array of other specialists at Baylor Dallas whenever she needed them.
“Who knew that there was such a thing as an ophthalmologist and a dermatologist who specialized in transplant patients?” she says. “And I was able to get to them not in a couple of days, but right there and then. There was never a time when I had to wait and see.”
The two-year process was an emotional ordeal for Wilson and her family. She attributes her survival to the Baylor Sammons Cancer Center staff.
“You’re not just a number or a patient there,” Wilson says. “You’re part of their group.”
Blood Cancers
Recent medical advances in the treatment of hematological
malignancies or blood cancers are helping fight leukemia,
lymphomas, multiple myeloma, myeloproliferative disorders
and myelodysplastic syndromes, says Barry Cooper, MD, medical
director of the hematological malignancies department
and a physician on the medical staff at Baylor University
Medical Center at Dallas.
“We’re making lots of progress in terms of treatments,” he says. “More on specific diseases than a magic bullet that cures all diseases.”
Among the major advances is the increasing use of blood and marrow transplants, which has had a profound effect on acute leukemia patient treatment, says Luis Pineiro, MD, an oncologist in the blood and marrow transplant (BMT) services program and a physician on the medical staff at Baylor University Medical Center at Dallas.
The hospital has been conducting bone marrow transplants since 1983, Pineiro says, and the long history has enabled researchers to make progress and move the therapy from younger and healthier patients to older and sicker patients.
“We can effectively treat at least half of the patients with leukemia with bone marrow stem cell transplants,” Pineiro says.
Baylor Dallas is one of the largest transplant units in North Texas, with five doctors and 25 beds in the hospital dedicated to bone marrow transplants, Cooper adds. In addition to treating leukemia, blood and marrow transplants can be an effective therapy for select patients with other disorders like multiple myeloma, lymphoma, aplastic anemia and myelodysplasia.
Baylor Sammons Cancer Center also is part of the National Marrow Donor Program (NMDP), a network of 500 centers in 35 countries that facilitates marrow and blood stem cell transplants for patients who need a transplant from an unrelated donor. Patients can search for a matching marrow or blood cell donor from more than 6 million volunteer donors and more than 50,000 cord blood units on the NMDP Registry, the largest donor registry in the world.
Besides finding family or unrelated donors, Baylor Sammons Cancer Center is increasingly turning to patients themselves to harvest adult stem cells, Cooper says.
“In select situations where the malignancy no longer involves the bone marrow, stem cells can be collected from the patient and reinfused after chemotherapy. This approach, autograft has less toxicity than using donor stem cells but is less intense and not an option for all patients,” he says.
Lung Cancer
The Baylor Sammons Lung Cancer Center is now offering a
simple, low-dose computed tomography (CT) screening to help
detect early forms of the deadly lung cancer.
In addition to testing, the Baylor Sammons Lung Cancer Center is treating about 1,500 patients annually, according to Richard Wood, MD, medical director of the Baylor Sammons Lung Cancer Center and on the medical staff at Baylor University Medical Center at Dallas.
Among the lung cancer therapies available at Baylor Dallas is the CyberKnife® — a sophisticated radiosurgery system that blends robotics, imaging and radiotherapy technology to deliver precise doses of radiation anywhere in the body. The CyberKnife® is used with about 100 patients a year.
The technology is a large robot, about 9 feet tall, that moves a linear accelerator around the patient to deliver beams of radiation one at a time. The CyberKnife® can reach any organ in the body. “It’s easy on the patient and provides localized radiation,” Wood says. “With the CyberKnife® we’ve seen a 95% survival rate in patients that are not good surgical candidates because of other risks.”
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A new screening procedure for lung cancer could make a dramatic impact on the most deadly form of cancer, says Richard Wood, MD, medical director of the Baylor Sammons Lung Cancer Center and a physician on the medical staff at Baylor University Medical Center at Dallas.
The hospital recently joined the International Early Lung Cancer Action Program, or IELCAP, a collaborative group of lung cancer experts from around the world that supports low-dose computed tomography (CT) screening. The group also is involved with a long-term screening study, which Baylor plans to join. 
Spiral CT scans allow doctors to detect lung cancer earlier, giving patients a better chance at survival.“Between 180,000 and 200,000 people in this country die of lung cancer every year,” Wood says. “That’s more than those who will die from breast, prostate and colon cancer combined.” Texans follow the national trend with close to 30% of all cancer deaths related to lung cancer, he says. The high death rates are a consequence of lung cancer not being detected early enough for treatment to be effective, Wood says. Often lung cancer symptoms, such as a cough, weight loss and/or blood sputum, occur only after the cancer has reached advanced stages, when the disease is not curable. Stage 1 lung cancer is the only stage at which a cure by surgery is highly likely, making screening vital to survival, Wood says. And that screening is now available. Baylor Dallas offers CT screening, a simple procedure that has proven to be effective by a study conducted through the lung cancer action program. Additionally, remarkable progress has been made in CT scanners over the past 20 years, Wood says. Sub-millimeter “slicing” scans can now be applied to the entire chest in a single breath-hold, allowing lung cancer to be detected when it is smaller. CT scans once yielding only 30 images can now offer more than 600 images — a key to effective diagnosis, Wood says. “It takes 20 seconds to do the scan — less time than to fill out the paperwork,” he says. In the Oct. 26, 2006, New England Journal of Medicine, the lung cancer action program study reported lung cancer was detected at its very earliest stage in 85% of patients using annual low-dose CT screening, and, when followed by prompt surgical removal, the 10-year survival rate was 92%. Wood recommends a CT scan particularly for patients who are between 40 and 70 years old and who have a history of smoking or exposure to secondhand smoke or an occupational exposure to asbestos, beryllium, uranium or radon. —Teresa Vonder Haar |
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Colorectal cancer
Advances are also being made with colorectal cancer, the
third most common form of cancer in the country and the
second leading cause of death, says Richard Boland, MD, chief
of gastroenterology and a physician on the medical staff at
Baylor University Medical Center at Dallas.
“Americans have a 5% lifetime risk of getting colon cancer; the risk is twice as high with a family history,” says Boland.
Executive Police Chief Bob Knowles (left) had a lung tumor removed at Baylor and remains cancer-free today. After surviving prostate cancer, Raymond Williams (right) has battled lung and kidney cancer with the help of the staff at Baylor.
To focus on candidates with a family history of the disease, Baylor has established genetic screening through its Hereditary Gastrointestinal Cancer Risk Program. Through the program, patients can identify some forms of colon cancer.
“We start by doing genetic testing through reference laboratories, since most of the time the diagnosis can be made this way. When these approaches do not provide the answers we are looking for, we offer the opportunity to all patients to become a research subject, and grants from the National Institutes of Health cover the costs of the advanced testing we do in our lab,” Boland says. Genetic testing can cost several thousand dollars.
Prostate cancer is the second most common cancer type in men and the second leading cause of cancer death in men.
Boland tests around 100 families a year for genetic disorders that increase the risk of developing colorectal cancer. The most common of these are Lynch syndrome and familial adenomatous polyposis (FAP). Men with Lynch syndrome have about a 70% risk of developing colorectal cancer during their lifetime, while women with this genetic disorder have a 40% risk. Lynch syndrome is the cause in about 3-4% of all colorectal cancers, and FAPs account for approximately 1% of all colon cancer cases.
A typical scenario for the hereditary form of colorectal cancer is when three or more people — all on the same side of the family — have had colorectal (or uterine) cancer including one person under the age of 50. Often Boland’s group can get important information on the likelihood that there is a genetic component to the disease by obtaining a sample of the tissue from one of the tumors, which is routinely banked by hospitals. This can often exclude the possibility of a hereditary condition, or alternatively confirm the diagnosis and even identify the culprit gene involved.
Baylor University Medical Center at Dallas is the only medical center involved in a study looking at a possible link between the common JC polyoma virus and colon cancer.
“Almost 90% of colon cancer tissues harbor this virus, which carries an extremely powerful cancer-causing gene,” he says. The National Institutes of Health is funding the $1.3 million study, which will investigate the connection between the virus and colon cancer as well as work on developing a potential vaccine for this virus.
“We hope to have vaccines within five years for some people,” Boland says.
Genitourinary Cancer
Around 25 clinical trials on the same level as those in the
area of colon cancer can be found in Baylor’s genitourinary
cancers program, says Thomas Hutson, DO, PharmD, director
of the genitourinary oncology program and a physician on
the medical staff of Baylor University Medical Center at Dallas.
Genitourinary cancers include those of the prostate, bladder,
kidney and testes.
Prostate cancer is the second most common cancer type in men and the second leading cause of cancer death in men, with 30,000 deaths annually, according to the American Cancer Society (ACS).
Baylor Sammons Cancer Center is participating in the largest ever prostate cancer prevention study. The study examines whether the dietary supplements selenium and vitamin E protect men against prostate cancer, Hutson says. The GU program also is looking at vaccine approaches for prostate cancer, as well as new drugs.
Kidney cancer, which is rarer than prostate and colon cancer, will affect around 50,000 people in the U.S. this year and will cause about 13,000 deaths. : :
More information on cancer treatment at Baylor Dallas. For a physician referral, call 1-800-4BAYLOR or use our on-line physician directory.