WV Executive

In the not-too-distant future, cancer scientists believe, patients will have access to cancer treatments specifically designed for their bodies and their diseases. For West Virginians, that future is taking shape at West Virginia University's Mary Babb Randolph Cancer Center (MBRCC). "The concept of this cancer center is to put the laboratory researchers, the clinical researchers, the cancer prevention specialists and the patient care professionals all under one roof-and make sure that they all talk to one another," says Eddie Reed, M.D., cancer center director. "It has worked amazingly well and has already proven invaluable to thousands of West Virginians. The cancer center was created out of a need felt across the state-for a place that has a clear mission to reduce the burden of cancer on people and families in West Virginia. We are reminded of that every day in the faces we see in the waiting room-we're working for real people who have real needs."

More than 3,000 patients a month are treated at the Mary Babb Randolph Cancer Center and the Betty Puskar Breast Care Center, but the cancer center's impact is felt far beyond the campus. Tens of thousands of women benefit from cancer screenings performed by primary care providers trained by the cancer center. WVU partners with teachers, coaches and parents to bring cancer prevention messages to young people in schools statewide.

Not everyone can come to Morgantown for regular screenings, so a substantial part of the WVU cancer prevention effort is carried throughout the state. WVU has trained hundreds of primary care health professionals in cancer screening techniques. WVU's cancer team has gained respect across the country for its approach. The National Cancer Information Service depends on WVU to provide accurate, dependable cancer information to callers in a multi-state region that includes millions of citizens; top research institutes seek partnerships with WVU cancer scientists, and patients travel from all parts of the state, and from other states and countries, for cancer care.

Reed, who established his research credentials in a long career at the National Cancer Institute, brought a new focus on translational research to WVU when he was recruited in 2001. That is the important phase where promising basic science research discoveries are "translated" into potentially useful drugs and treatments.

The Effects of Research

William Petros, PharmD, is analyzing the effects of anti-cancer drugs in real time, during courses of chemotherapy treatment. Balancing the benefits of chemotherapy against their considerable risk of toxic side effects is one of the most difficult tasks for oncologists. Petros, who heads the anti-cancer drug development program at the cancer center, is assisting that process by developing new information about individual patients' metabolism of cancer drugs.

Petros, working with colleagues at Duke University, tests blood concentrations of the drugs in the hours and days immediately following high-dose chemotherapy. Using this data, he can help develop an individualized profile of how the patient is retaining and metabolizing the various agents. The dosages in the latter days of treatment can be fine-tuned to achieve the best result with the lowest chance of toxicity.

In addition to getting the best available treatment for current patients, the work being done by Petros and others at WVU is building a powerful database of patient drug experiences that will be of immense value in determining future cancer treatments. They are identifying specific genetic markers that are associated with specific cancers, and patients' reactions to cancer drugs, that will allow physicians and pharmacists to tailor a cancer treatment to a patient's genetic pattern. Petros serves as a consultant to several pharmaceutical companies, advising them on ways to design new and better drugs.

The expertise assembled at the Mary Babb Randolph Cancer Center makes it an attractive place for pharmaceutical companies to introduce improved treatments - and often, the team at MBRCC has access to new drugs and protocols.

Over the past several years, WVU has established a state-of-the-art proteomics facility, which is more advanced than at most other cancer centers, says Dan Flynn, PhD, associate director of basic research. The lab enables scientists to identify molecular changes associated with specific cancers.

The existence of this lab, the success of WVU researchers in several areas of basic science associated with cancer-cell growth, and the coordinated prevention and patient care programs have made WVU an attractive research partner for some of the nation's leading cancer institutions. WVU is a member of the Regional Cancer Center Consortium for the Biological Therapy of Cancer, along with The Ohio State University, Ontario Cancer Institute, Penn State Cancer Institute, Penn State Milton S. Hershey Medical Center, Taussig Cancer Center, the Cleveland Clinic Foundation, and the University of Pittsburgh Cancer Institute.

WVU's successful research programs have drawn attention and respect from colleagues across the country, and from funding agencies. Competitive research funding for cancer studies at WVU has risen to $15.4 million in the past three years, and the combination of Federal and private research investment is creating a research boom on the Morgantown campus. Plans are in the works for a substantial expansion of both patient care and laboratory space for the Cancer Center.

The concentration of research efforts in Morgantown is spilling over to the private sector, as well. Protea Biosciences, Inc., led by scientist-entrepreneur Stephen Turner, is West Virginia's first biotechnology startup, and is developing commercial applications for the proteomics technology created by WVU researchers. Last year, the company signed an agreement with a national pharmaceutical firm to provide proteomics services to its researchers.

The leading-edge research and treatment at WVU is not limited to pharmaceutical approaches. Oncologists, surgeons, radiologists and other specialists work together in teams to diagnose cancer, determine the best course of treatment and apply the latest and best techniques toward recovery. As part of the MBRCC's commitment to patient care, patients are often scheduled for appointments with multiple specialists on the same day, relieving them of the burden of repeated trips to Morgantown. Often, the team will identify a patient as a candidate for one of the advanced techniques pioneered by WVU faculty members.

Ankesh Nigam, MD, chief of surgical oncology is a leader in the use of minimally invasive procedures to fight liver cancer. One new tool Nigam has at his disposal kills cancerous cells with a powerful burst of radio waves. "Radio frequency ablation is often the only potentially curable treatment to fight advanced cancer in the liver," Nigam says.

If the disease has spread widely throughout the organ, surgery is impossible because removing the entire liver would be fatal. Nigam can place a radio frequency needle directly into a liver tumor and heat it with an electric current until the cancerous cells are dead. The process is very localized, preserving most of the surrounding healthy liver tissue. "I believe that radio frequency ablation may be the way we treat most liver tumors in the future," Nigam says. "It is a technique that offers a chance for cure in situations in which there was none before."

In other cases, the team may assign a patient to one of more than 45 clinical trials currently in progress at WVU. "Clinical trials give patients access to the treatments that show the most promise for success," Reed says. "They're the final step before a new treatment is released to the medical community for widespread use. Our patients have the opportunity to benefit from these developments early - and sometimes that's a life-saving difference."

Experts agree, the key to eradicating cancer deaths is in early detection and treatment

Early detection of breast cancer can have a dramatic impact on a patient's chances for survival. The five-year survival rate for breast cancer detected and treated at an early stage is 95 percent. By Stage III, when the cancer has spread to surrounding tissue, it is only 36 percent. It drops to just 7 percent for late-stage cancers that have spread to organs.

According to Judith Schreiman, M.D., director of the WVU Betty Puskar Breast Care Center, every breast care patient at WVU benefits from the latest cancer detection technology. Schreiman and other experienced radiologists on the Puskar Center staff supplement their trained eyes with a computer-aided detection device that draws attention to suspicious features on digitized mammograms. A radiologist typically reviews a mammogram and then activates the ImageChecker monitor to see if any areas have been highlighted. If an image is marked, the radiologist goes back to the mammogram to review this part of the image in closer detail. "Early diagnosis and mammographic screening with the benefit of the ImageChecker system could prevent many breast cancer deaths each year in West Virginia," Schreiman says. "It allows us to provide our patients all the benefits of early detection and improve overall cancer management and treatment."

The combination of laboratory and clinical research, prevention and detection, and top-level cancer care is making a difference in West Virginia, Reed says. "We know it from our patients. More and more healthy adults are getting regular screenings. We're seeing more of the cancer patients at earlier stages, where we can do the most good. And there's a real awareness on the part of many West Virginians of their own ability to make lifestyle changes to fight cancer. I'm very positive about our future."