CTCAINNOVATORQuarterly Insights for Patients of Cancer Treatment Centers of America®

I S S U E 7, W I N T E R 2019

While the American Cancer Society recently reported a 27 percent decline in the rate of cancer deaths between 1991 and 2016, over 1.7 million new cases were diagnosed in the United States last year alone, according to the National Cancer Institute. Although cancer will not be eradicated any time soon, new treatment options are helping patients today and will continue to do so. Here are seven predictions on the future of cancer care from leading experts at Cancer Treatment Centers of America® (CTCA):

1. Technology will improve patient/physician interaction “The patient/physician relationship in oncology will be strengthened by technological advances in data sharing, artificial intelligence and wearable devices,” says Pamela Crilley, DO, Chair, CTCA® Department of Medical Oncology. Improvements in monitoring devices will be a game-changer for caregivers, for example, allowing them to share information more easily from their homes.

2. A better understanding of the immune system will lead to new cancer treatments “While aging certainly increases the risk of developing cancer, some people’s immune systems are helping them remain cancer free for years,” says Maurie Markman, MD, President, CTCA Medicine & Science. “What is it about their systems that wards off cancer for decades?” This question and observation are paving the way for future discoveries.

3. Precision medicine will continue to evolve “We are at the tip of the iceberg of precision medicine,” says Ankur Parikh, DO, CTCA Medical Director, Precision Medicine. “As we collect genomic profile data on our patients, we should be able to identify specific populations that will respond better to various therapies, some of which may utilize the immune stystem.”

4. As cancer becomes more treatable, it will be handled like a chronic condition “I predict that cancer will be considered a manageable, chronic disease like diabetes,” says Katherine Anderson, ND,

FABNO, Chief, CTCA Division of Naturopathic Medicine. “Along with greater longer-term survival, there will be more options to manage symptoms.”

5. Nurses will become primary for patient care “Nurses will be viewed as experts in cancer care and the main conduit of information between the medical team, the patient and their family,” says Fran Paschall, MBA, DNP, RN, CENP, CTCA Chief Nurse Executive. “They will become true partners with the patient and family on their cancer journey.”

6. Lifestyle issues will become even more central to cancer care “More people will demand programs to help with early detection, prevention and enhancing quality of life when facing a cancer diagnosis. Lifestyle will be addressed as part of standard of cancer care,” predicts Carolyn Lammersfeld, MBA, MS, RD, CSO, LD, Vice President, Integrative Care Services.

7. The future of cancer care will rely on technological wonders “Microscopic robots (nanobots) and ‘big data’ may be used to detect and analyze cancers in the future,” predicts Arturo Loaiza-Bonilla, MD, Vice Chair, CTCA Department of Medical Oncology. From there, Dr. Bonilla foresees a personalized pharmacy database that will instantly assess patients’ genomic information along with possible drug interactions.”

Jennifer Jameson, Medical Technologist, CTCA Tulsa

CANCER IN THE YEAR AHEAD AND BEYOND

CTCA oncology leaders offer predictions

Scott Price, MD, Vice Chair, CTCA Department of Radiology

Our Journey of HopeOur Journey of Hope (OJOH) is a cancer care ministry developed at Cancer Treatment Centers of America by Rev. Percy McCray, Jr., CTCA Director of Faith-Based Programs. It provides ministry leaders with tools and training to extend education and assistance to their churches and communities. OJOH is centered around prayer, counsel, visits and spiritual support in order to bring hope to cancer patients and their caregivers, family and friends.

Rev. McCray, who has worked with CTCA for nearly 23 years, began OJOH in 2003 after a bedside visit with a patient in his role as chaplain at the first CTCA hospital in Zion, Ill. He explains, “I was helping her with her advanced directive. She was weak and could barely hold a pen to sign her documents. She wanted spiritual support.”

When the patient returned 30 days later for further treatment, Rev. McCray was stunned. “I am not suggesting in any way there was anything I did or did not do. When she walked through the door, I barely recognized her,” he explains. “She had gained strength and energy. She told me, ‘I realized just how important that visit was for me. It was different from what I experienced from my church community.’ She asked if I would be willing to sit down with her pastor, and I did just that.”

For several years following that visit, Rev. McCray traveled around the country to local churches and community centers three weekends out of every month to present the OJOH curriculum. When this schedule was no longer sustainable, he and his small team offered free trainings for the faith community at CTCA hospitals.

Over the course of five years, nearly 2,400 spiritual leaders from over 1,400 churches across the United States, South Africa, Europe, the Caribbean, South America and Canada have traveled to CTCA to receive the training. Rev. McCray and his team also designed the OJOH Leaders Network, providing online faith, spirituality and health resources. The program is already more than 26,000 members strong.

“My wish is to bring this message of faith and hope to as many as possible,” says Rev. McCray. “We are not done.”

INTERVENTIONAL ONCOLOGY Radiology as the foundation for improving patient careA previous issue of CTCA Innovator introduced interventional oncology (IO) as an increasingly important field driven by evolving technological innovation for cancer care and diagnosis. In this issue, Scott Price, MD, Vice Chair of the CTCA Department of Radiology, provides insight into interventional radiology (IR), one of the four IO pillars in this field. The other IO pillars are pulmonology, gastroenterology and pain management.

IR uses image-guided technology to perform minimally-invasive procedures to diagnose and treat a variety of cancers.

“CTCA, along with a few major academic medical centers, is among a handful of programs offering all four IO approaches with cancer-focused experts,” says Dr. Price. “All CTCA hospitals offer interventional radiology performed by highly trained physicians.”

An expert in liver-directed therapies, Dr. Price says IR can be effective in treating both primary liver cancer as well as metastatic liver cancer. Some tumors associated with these cancers can be treated with radioactive beads, chemotherapy beads or heat probes in lieu of major surgery. Many of the procedures, he explains, can be performed with very small incisions and completed either with an overnight hospital stay or as an outpatient.

Advancements in tools and technology have helped IR, which can offer less invasive options to patients with a wide variety of cancers. IR also has helped to advance diagnostic procedures. Dr. Price recalls a recent patient with a lump in her neck that needed a biopsy.

“In the past, she may have had to endure surgery,” he says, “but with CT scans, ultrasound and small needles, we were able to biopsy with greater ease for the patient. Our goal is to give patients more time at home with their loved ones and less time recovering in the hospital.”

Rev. Percy McCray, CTCA patient Hector N. and Evelyn N.

CTCA releases sixth Patient Treatment Results reportIn 1597, Sir Francis Bacon said, “information is power.” Centuries later, cancer patients looking for treatment options on the Internet are finding that too much information can leave them feeling powerless. Resources detailing treatment effectiveness, survivorship rates and quality of life data are simply not readily accessible, despite the dizzying amount of information available to patients.

CTCA, however, has made the availability of such relevant and targeted information about cancer therapies a guiding principle. For each of the past six years, CTCA has published its Patient Treatment Results, a comprehensive reporting of patient treatment outcomes for 11 cancer types. The publication provides data on five-year survival rates, treatment effectiveness, and patient self-reported quality of life data.

“We believe all patients should have access to as much information as possible in order to make the most informed decisions about their care,” says Maurie Markman, MD, President, CTCA Medicine & Science. CTCA was among the first cancer care providers in the nation to make treatment results available to the general public and we are proud to offer that kind of transparency to our patients.”

Patient Treatment Results can be found on cancercenter.com/ctca-results.

OBESITY’S GROWING ROLE IN LIFESTYLE-DRIVEN CANCERS

By Anthony Perre, MD | Chief, CTCA Division of Outpatient Medicine

According to the American Society of Clinical Oncology (ASCO®), an estimated 84,000 cancer diagnoses annually are attributed to obesity, and researchers now have linked it to 12 types of cancer. Being overweight or obese increases the risk of breast cancer by 20-40 percent, colorectal cancer by 30 percent and gallbladder cancer by 20-60 percent.

People who are overweight or obese are nearly twice as likely to develop cancers of the esophagus, gastric cardia, liver or kidney. In addition, obese patients are likely to have other co-morbidities, such as diabetes, joint pain and heart disease, which makes cancer treatment even more difficult.

Weight management, exercise and nutrition programs are important elements of the CTCA approach to treating the whole person, not just the cancer. If you are struggling with weight control, your care team stands ready to help design a plan that meets your individual needs. We have found that in many cases when we help patients gain control of their weight, we have an easier time managing their cancer treatment.

DR. SCHINK APPOINTED CTCA CHIEF MEDICAL OFFICERJulian Schink, MD, was recently appointed CTCA Chief Medical Officer. In addition to the deep clinical leadership experience he brought with him to CTCA in May 2017, Dr. Schink currently serves as the CTCA Chief of Gynecologic Oncology and performs in a regional clinical leadership capacity at CTCA Chicago, where he also cares for patients at both the Comprehensive Care and Research Center in Zion, Ill. and the CTCA Chicago Outpatient Cancer Center in Downtown Chicago.

Dr. Schink received his Doctor of Medicine degree from the University of Texas Health Science Center at San Antonio. After medical school, he completed his residency training in obstetrics and gynecology at Northwestern University Medical School in Chicago, followed by a fellowship in gynecologic oncology at the University of California, Los Angeles Medical School.

Dr. Schink has been published in several medical journals, including over 125 publications in oncology and women’s health. He has authored more than 10 chapters in oncology textbooks focusing on gestational trophoblastic disease. He has also served as principal investigator and co-investigator for many large clinical trials responsible for improving and expanding cancer treatment options for patients.

Dr. Schink has been a member of and held leadership positions at several medical organizations, including the American College of Obstetricians & Gynecologists, the Society of Gynecologic Oncologists and the Gynecologic Cancer Foundation. Dr. Schink has also won several awards for his outstanding clinical work, including listings in America’s Top Doctors, The Best Doctors in America and Chicago Super Doctors.

Julian Schink, MD

STAKEHOLDER SPOTLIGHT

A new multi-specialty outpatient suite, home to the recently launched Pulmonary Specialty Group, is opening in Philadelphia on the campus of CTCA. The group will be headed by five CTCA Philadelphia physicians, including Jeffrey Hoag, MD, MS, FCCP, Chief of Staff at CTCA Philadelphia; Christopher Halpin, MD, Pulmonologist, Critical Care and Sleep Medicine Physician; Jason Lu, MD, FCCP, Pulmonologist and Critical Care Medicine Physician; Emil Abramian, MD, Director of Interventional Pulmonology; and David Visco, MD, FCCP, Chief, CTCA Division of Hospital Medicine. For more information on the Pulmonary Specialty Group, please call 215-537-LUNG (5864).

DR. MARKMAN PRESENTS AT GIANTS OF CANCER CARE® SYMPOSIUMMaurie Markman, MD, President, CTCA Medicine & Science, recently presented the Giants of Cancer Care® lecture at the 36th annual CFS® Chemotherapy Foundation Symposium: Innovative Cancer Therapy for Tomorrow®. Dr. Markman, a 2018 Giants of Cancer Care inductee, discussed “viewing ovarian cancer as a chronic illness and increasing need for both therapeutic ‘precision’ and a focus on quality-of-life.”

DR. BONILLA PROVIDES GLOBAL WEBINARParticipants from 16 countries joined Arturo Loaiza-Bonilla, MD, MSEd, FACP, Vice Chair of the CTCA Department of Medical Oncology, in a recent webinar, “Personalized Medicine: Ensuring More Patient-Centered Cancer Care.” The webinar was part of the Bristol-Myers Squibb Pharmaceuticals (BMS) Global Advocacy educational programming.

DR. BECHARA MARKS LUNG CANCER AWARENESS MONTHTo mark lung cancer awareness month in November, Rabih Bechara, MD, FCCP, Interventional Pulmonology Director, CTCA Lung Cancer Institute, presented at the American Lung Association’s LUNG FORCE Expo in South Florida on the topic of Immunotherapy & Future Endoscopic Treatments of Lung Cancer. Dr. Bechara is on both the National and the Southeast Board of Directors for the American Lung Association (ALA). He is pictured with Abigail Obre, National Manager of External Affairs & Communications for CTCA and Board Chair, South Florida ALA.

Maurie Markman, MD

Arturo Loaiza-Bonilla, MD, MSEd, FACP

l to r: Dr. Lu, Dr. Hoag, Dr Abramian, Dr. Visco, Dr. Halpin

CLINICAL HIGHLIGHTS Pulmonary Clinic Opens at CTCA Philadelphia

Rabih Bechara, MD, FCCP and Abigail Obre

PULMONARY HEALTH AWARD WINNER

Lamar White, RRT, CTCA Phoenix Respiratory TherapistThe PHIL (Pulmonary Health and Illnesses of the Lungs Award) is the “only nationally recognized hospital-based recognition program dedicated to honoring outstanding respiratory therapists who provide exemplary care and treatment for patients with respiratory illnesses.” Lamar White, RRT, CTCA Phoenix Respiratory Therapist, recently received the award. “It is a dream come true to be a part of a team that operates with the Mother Standard® of care as its backbone,” he says. Lamar is caring, kind, compassionate and professional, and makes connections with each patient, according to Elizabeth (Betti) Grab, MHA, RRT, RCP, Cardiopulmonary Manager. One patient remarked that Lamar “went out of his way to make me feel less stressed. He answered all of our questions and made sure we were comfortable.” Congratulations and thank you, Lamar, for all you do!

“It is a dream come true to be a part of a team that operates with

the Mother Standard® of care as its backbone.”

Lamar White, RRT, CTCA Phoenix

“Like anything in life, there are ups and downs. I love to focus on the ups with my

patients and provide them with a surplus of encouragement.”

Vilma Ritacca, BSN, RN Care Manager, CTCA Chicago

“Being chosen for the DAISY Award is one of the proudest moments of my

career. My wonderful CTCA co-worker family creates the atmosphere that

allows the holistic Mother Standard of care that we all strive for.”

Patrick Nobles, BSN, RN Special Care Unit, CTCA Tulsa

“I truly understand the Mother Standard of care. I lost my brother

and father to cancer. My father had the most compassionate nurses and

doctors. I hope that for the rest of my career, I can always make my patients feel as special and cared about as my

own father.”

Kelley Mitchell, RN Cardiology Nurse, CTCA Atlanta

“I honestly feel the culture at CTCA constantly drives us all to deliver the

‘Mother Standard’. I am proud to stand by all of our patients and do whatever I can to make their tough journey just a

little more bearable. “

Faith Scafidi, LPN Patient Care Coordinator

CTCA Philadelphia

“Like many other nurses, I always try to do my best and do not expect an award in return. I am humbled and

honored to receive the DAISY.”

Mary Tarczewski, RN, BSN, CEN Staff Nurse, CTCA Philadelphia

STAKEHOLDER SPOTLIGHTDAISY AWARD WINNERS

CTCA in the Media

Dr. Julian Schink discusses cervical cancer treatment findings in Insider

Julian Schink, MD, CTCA Chief Medical Officer, discusses recent findings that shed light on early-stage cervical cancer treatments in an Insider article. New research shows that minimally-invasive surgery, laparoscopy, was less effective than open surgery for this type and stage of gynecological cancer. “It is our responsibility, as we adopt new technologies, to confirm the changes we make are effective,” says Dr. Schink.

Drs. Seeley and Neufeld discuss opioid addiction prevention in Morning Consult

Neil Seeley, MD, Chief, CTCA Division of Anesthesia, and Nathan Neufeld, DO, Chief, CTCA Division of Pain Management, were featured in a recent edition of Morning Consult in a piece discussing opioid addiction prevention. They call for a “joint effort from lawmakers, the medical community and patients” to oppose the nationwide epidemic by shifting dialogue from treatment to prevention. Regarding cancer patients, they say, “we must act now before we get to a stage where we are treating the cancer only for the patient to suffer the consequences of an opioid dependence in survivorship.”

Dr. Citrin offers advice on breast cancer team composition in Conquer

In a recent Conquer article, Dennis Citrin, MB ChB, PhD, Medical Oncologist, CTCA Chicago, discusses the importance of including several care team members for breast cancer patients, including the genetic counselor and reconstructive surgeon as well as dietitian and pain management specialist, among others. Dr. Citrin also suggests the patient must be at the center of care coordination, “empowered to ask questions and to be educated in order to make the best possible treatment decisions in partnership with his or her care team.”

Dr. Perre discusses cancer survivorship plans in Healthline

Anthony Perre, MD, Chief, CTCA Division of Outpatient Medicine, discusses survivorship care plans in a recent Healthline article. “Cancer survivors can get lost in transition,” says Dr. Perre. “For patients who have completed treatment for cancer, life doesn’t just go back to normal at the snap of a finger… A comprehensive, integrative model looks to encompass the best attributes of medical oncology and primary care.”

Julian Schink, MD

Anthony Perre, MD

Neil Seeley, MD & Nathan Neufeld, DO

Dennis Citrin, MB ChB, PhD

CLINICAL TRIAL FEATURE

Contessa - a phase III clinical study for patients with advanced breast cancerABOUT THE CONTESSA STUDYThis is a multi-national, multi-center, randomized, open-label, parallel group phase III study. This study will compare the efficacy of tesetaxel plus a reduced dose of capecitabine versus the approved dose of capecitabine alone based on progression-free survival in patients with HER2-negative, HR-positive, locally advanced/metastatic breast cancer that was previously treated with a taxane in the neoadjuvant or adjuvant setting.

ABOUT TESETAXELTesetaxel is an investigational chemotherapy agent that belongs to a class of drugs known as taxanes, which are widely used in the treatment of cancer. Tesetaxel is a capsule taken orally. To date, more than 500 patients have been treated with tesetaxel in clinical studies.

ELIGIBILITY

Note: This is only a partial list of eligibility criteria.

• Male or female and at least 18 years old

• Have histologically or cytologically confirmed breast cancer

• Have HER2-negative disease based on local testing guidelines by the American Society of Clinical Oncology (ASCO®) or the College of American Pathologists (CAP)

• Have prior therapy (at least one completed dose) with a taxane-containing regimen in the neoadjuvant or adjuvant setting

• Have adequate hematologic, hepatic and renal function

• Have Eastern Cooperative Oncology Group (ECOG) performance status 0, 1 or 2

AVAILABILITYAll five CTCA hospitals

Please speak with your care team if you think this trial may be right for you. For more information, visit cancercenter.com/clinical-trials.

© 2019 IPB

Please send all comments and questions about this

newsletter to CTCAInnovator@ctca-hope.com. The newsletter is now also available on myctca.com.

Cancer Fighters offer connection and hopeCTCA Cancer Fighters® is a nationwide community—nearly 40,000 strong—dedicated to the idea that no one should ever fight cancer alone. Cancer Fighters connect with others to offer and receive the support needed to fight cancer. They also have access to valuable benefits—online and in person:

• Make friends coast to coast using the online directory and keep up with all Cancer Fighters activities on the Facebook page.

• Enjoy inspiring stories, healthy recipes, tips for caregivers, hospital updates and more in the monthly Cancer Fighters e-newsletter.

• Find local and hospital events at the Cancer Fighters Event page.

• Connect one-on-one via phone or email through Cancer Fighters Care Net. These specially trained members offer support by sharing their experiences.

• Find support and inspiration in members’ stories or share your own story and inspire others with the interactive Story Builder on cancerfighter.com.

• Find information, advice and inspiring events through nationally recognized cancer support organizations.

Be part of everything happening with Cancer Fighters. Stop by the Cancer Fighters Corner to learn more and become a member today! Please also visit www.cancerfighter.com.

Cancer Fighter, Cheryl A.