2019 Annual Retreat On Cancer Research in New Jersey

This year's retreat was as informative and interesting as in years past.

The morning began with the Public Forum on ScreenNJ - Cancer Prevention , Education and Detection. Dr A Stroup started off the session talking about cancer burden in NJ. 

NJ Cancer Burden

Cancer Disparaties

Dr M Steinberg talked about Lung Cancer screening and treatment. Lung cancer is the leading cause of cancer death in women. He also made note of the fact that smoking affects nearly every organ of the smokers body. If a smoker stops smoking,  over time the risk of heart attack and stroke will drop. If you have 30 pack years of smoking ( smoke one pack a day for 30 years) then  Low Dose CT screening is available to you as a screening tool.

Screening option

Dr Natalie Pereira discussed Colorectal Screening and noted that it takes about 10 years for a abnormal polyp to become malignant cancer. The risks for colorectal cancer are age, family history, polyps, Lynch Syndrome and eating high quantities of fat or red meat.

Symptoms of colorectal cancer

Screening Recommendations

Dr Kinney shared information on the ScreenNJ Statewide program. Less than 60% of the eligible population in NJ has been screened for colorectal cancer and 10% of the eligible population in NJ has had lung cancer screening. We need to educate residents of NJ that these screening tests are available to them.

The Keynote speech was by Dr Steve Rosenberg, Chief of Surgery at the NCI. He presented an overview of the development of cell transfer therapy. There are a number of Immunotherapies using immune cells to recognize and kill cancer cells . He then focused on using those therapies to treat epithelial cancers. Epithelial cells are found in the linings of most organs - ovaries are one of those organs. Cell transfer therapy has had durable regressions in melanoma and in recent research in other epithelial cancers.

After lunch I listened to a short talk on Nanotechnology Approach for Precision Targeted Therapy for Ovarian Cancer by J Sapiezynski, a student at the Earnest Mario School of Pharmacy, Rutgers. He used liposomes as a dose delivery system for cisplatin and SiRNA.

During the poster session I was able to chat with researchers who presented the results of the  Gynecologic Cancer Patients' and Supporters' Reports of Sharing (and Holding Back)Cancer-Related information during Onoclogy Visits Study. Eighteen patients ( during cycles 2 and 5 of their treatment)  and sixteen caregivers took part in the study. The theme that "Everything is easy to share" showed that patients found it easiest to discuss side effects with their oncology team. Yet there was also a theme of "Nothing held back...except" when patients or caregivers felt uncomfortable sharing some information - such as embarrassing information or prognosis.

I am so pleased to see that important research is taking place right here in my home state.

Dee
Every Day is a Blessing! 

Upcoming Public Forum on ScreenNJ - May 2019

For the past few years I have attended a number of public forums as part of the Annual Retreat on Cancer Research in NJ. You may read about the one I attended in 2018 on HPV cancers here  and  the one I attended in 2017 about precision medicine here

If you are an cancer advocate or just a resident interested in learning more about screening I invite you to register for this year's Public Forum about ScreenNJ - Cancer Prevention Education and Detection. Presentations this year include Cancer Burden in NJ, Colorectal Prevention and Detection, Lung Cancer Screening , and information on the ScreenNJ State Program. This year's forum is on May 23, 2019 from 8:30 am - 10:00 am at the Rutgers Student Center in New Brunswick, NJ.

Registration is free and may be found at:

www.mpi-evv.com/2017NJCR/2017PFReg.asp

I hope to see you there!

Dee
Every Day is a Blessing! 

2017 Annual Retreat on Cancer Research Public Forum Highlights

I was pleased to have the opportunity to attend yesterday's Public Forum segment of the 2017 Annual Retreat on Cancer Research in New Jersey presented by the Rutgers Cancer Institute of New Jersey (RCINJ) and the New Jersey Commission on Cancer Research. This years Forum topic was Precision Medicine. The Event took place at the Rutgers College Avenue Student Center.

After an introduction and welcome by Shridar Ganesan, MD, PhD (RCINJ),  Dr. Kim Hershfield spoke on The Promise and Practice of Precision Oncology. After a short review of the structure of the cell and DNA, she described how oncogenes and tumor suppressor genes work. In the past, treatments were based on the organ where the cancer was found and the cancer's histology. Today knowledge of a tumor's gene mutations can lead to the use of a targeted therapy. Knowledge of the mutations that can cause a cancer has increased in the past few years and researchers like those at RCINJ are working to understand the impact of those mutations and develop targeted therapies for them.

Another avenue of recent study is the use of a  liquid biopsy. With a liquid biopsy, a blood sample is examined for circulating DNA from a cancer tumor.

As Dr. Hershfield mentioned Precision Medicine is at the "toddler" stage.  But every day researchers are looking to develop new treatments, test combination therapies, understand and reduce side effects, understand pathways, all with the goal of providing the best treatments for cancer patients.

The second speaker was Hetal Vig, MS a genetics counselor from RCINJ who spoke on Capturing the Spectrum of Hereditary Cancers: A Moving Target in the Setting of Targeted Therapy. Cancer may develop due to mutations that are germline ( hereditary) or sporadic. When examining a patient's family history it is important that both the maternal and paternal sides of the family are examined.

As an example, Ms Vig mentioned how BRCA mutations increase a person's risk for breast, ovarian and pancreatic cancers. Every person has two of each gene. When you have a germline mutation the mutation comes from the egg or sperm. If you are born with a BRCA mutation in one gene and over time you should develop a BRCA mutation in the second gene you can develop cancer. When you have a sporadic cancer  you are born with no mutations in either gene but over time for some reason both your genes develop a BRCA mutation which can lead to cancer. So there are less steps to go through when you start out with a hereditary mutation to develop cancer. And it also explains why most sporadic cancers develop later in life since it takes more time for the mutations to occur.

Ms Vig also talked about incidental findings on genetic testing results. A framework needs to be developed regarding how to share those findings with patients. Interpreting the complex genetic test results many patients receive should be done by a trained genetic counselor.  (I agree 100%.)

The final speaker of the morning, Dr Eric Singer , RCINJ spoke on Ethical Issues in Precision Oncology. Dr Singer's talk began with a discussion of clinical trial design and informed consent. Do patients really know that the trial they are taking part in is for research and may not offer them any benefit? Dr Singer also mentioned incidental findings and how those findings should be shared with patients. Dr Singer mentioned that is is important that health care providers protect patients from misinformation.

He also stressed the need for oncologists to know their patient's goals. Part of the discussion could include the cost the patient will have to bear when taking new expensive targeted therapies.The patient / health care provider discussion could include: Will the treatment extend survival? Will the treatment have toxic side effects? What patient reported outcomes have other patients provided? Is the decision to use the treatment performance-based or value-based?

I was happy to see in each of the presentations the patient being central to the treatment decision. 

After the Forum I took some time to view the posters outside the Multi-purpose room. Here is one of particular interest to those with ovarian cancer.

Impact of Body Mass Index on Ovarian Cancer Survival Varies by Stage
Elisa Banderas et al
This study looked at the impact of obesity on ovarian cancer survival
It included over 1100 women with epithelial ovarian cancer diagnosed between 2000-2013 at Kaiser Permanente Northern California. "There was no evidence of an association between BMI( body mass index) on overall or ovarian cancer-specific survival" but they found a strong association by stage.
Conclusion: "Associations of obesity with ovarian cancer survival differ by stage, with decreased survival among those with localized disease and increased survival among those with late-stage disease. "

I look forward to next year's Retreat.

Dee
Every Day is a Blessing! Thankful for the doctors, researchers and staff throughout the state of NJ who are striving to understand cancer and make their patient's lives better.