Kentucky now has the unfortunate distinction of being first among all 50
states in overall cancer mortality and cancer incidence (covering all
cancer sites). Our cancer problem is distinct and prevalent, which
underscores Markey's mission to reduce the cancer mortality in our
region. Fortunately, our colleagues here are doing their part to make a
difference in the lives of our patients, and many of them are going
above and beyond by becoming more directly involved in communities and
organizations that fight the cancer battle alongside Markey every day.
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LEXINGTON, Ky. (Aug. 19, 2014) – A new web-based program developed by University of Kentucky Markey Cancer Center researchers will provide a simple, free way for healthcare providers to determine which brain tumor cases require testing for a genetic mutation.
Gliomas – a type of tumor that begins in the brain or spine – are the most common and deadly form of brain cancer in adults, making up about 80 percent of malignant brain cancer cases. In some of these cases, patients have a mutation in a specific gene, known as an IDH1 mutation – and patients who have this tend to survive years longer than those who do not carry the mutation.
The program, developed by UK researchers Li Chen, Eric Durbin, and Craig Horbinski, uses a statistical model to accurately predict the likelihood that a patient carries the IDH1 mutation and requires screening. Healthcare providers need only answer four questions in the application.
Gliomas are often tested for IDH1 mutation following surgery to remove the tumor, but undergoing this type of testing often requires stringent insurance pre-approvals due to rising healthcare costs, Horbinski says.
"Currently, there are no universally accepted guidelines for when gliomas should be tested for this mutation," Horbinski said. "Obtaining insurance pre-approval for additional molecular testing is becoming more commonplace, and this program will assist healthcare providers with an evidence-based rationale for when IDH1 screening is necessary."
Additionally, Horbinski notes that the program will help conserve research dollars by helping brain cancer researchers narrow down which specific older gliomas in tumor banks – previously removed in a time before IDH1 testing was routine – should be tested as data for research projects.
Horbinski's research on the program was published in the May issue of Neuro-Oncology. The work was funded through a grant from the National Cancer Institute, the Peter and Carmen Lucia Buck Training Program in Translational Clinical Oncology, and the University of Kentucky College of Medicine Physician Scientist Program.
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LEXINGTON, Ky. (Aug. 13, 2014) – Becker’s Hospital Review magazine has listed the University of Kentucky Albert B. Chandler Hospital among the nation’s “100 Hospitals and Health Systems with Great Oncology Programs” in its recently released compilation of leading cancer care providers in the United States. The UK Markey Cancer Center, whose clinical programs are integrated with Chandler, received a National Cancer Institute cancer center designation in July 2013.
According to the health care industry trade publication, organizations included on the 2014 list are “leading the way in terms of quality of patient care, patient outcomes and research.” Becker’s noted Markey's recent NCI designation, its 29 percent patient growth over the past five years, and its status as a Blue Distinction Center for Complex and Rare Cancers for 10 cancer types.
The Becker's Hospital Review editorial team selected hospitals for inclusion based on rankings and awards they have received from a variety of reputable sources. The following awards were considered as part of the criteria for inclusion on the list: U.S. News & World Report cancer rankings, Truven Health Analytics, CareChex cancer care rankings, National Cancer Institute designations, the American College of Surgeons Commission on Cancer accreditations, American Nurses Credentialing Center designations, and awards and Blue Distinction Center recognition from the BlueCross BlueShield Association.
LEXINGTON, Ky. (July 30, 2014) – As part of a weeklong tour across the state, the Smoke-Free Kentucky Coalition will be making a stop at the University of Kentucky Markey Cancer Center today at 11 a.m. to promote better health for Kentuckians through smoke-free policies. The event at Markey is one of several stops across the state as it heads to western Kentucky for the annual Fancy Farm Picnic.
At each stop, the Smoke-Free Coalition is rallying supporters and reaching out to legislators, urging them to join 24 other states in passing a comprehensive, statewide smoke-free law that covers all indoor workplaces and public places, including bars and restaurants. The goal of the tour is to get all Kentuckians, around the state, active and engaged in supporting smoke-free policy as the campaign gears up for the 2015 legislative session.
Secondhand smoke contains more than 7,000 chemicals, almost 70 of which are known to cause cancer, and is proven to cause heart disease, lung cancer, respiratory illnesses and even premature death. In fact, studies indicate that secondhand smoke exposure causes about 1,000 deaths a year in Kentucky.
To find out more information about how smoke-free policies are good for health and businesses visit: www.smokefreekentucky.org
LEXINGTON, Ky. (July 30, 2014) — The phrase "we caught it early" is possibly the best news a patient can hear in the midst of a cancer diagnosis. Combating cancer in its earliest stages, when the disease is localized to a certain part of the body, gives patients the best chances of survival.
Screenings for breast, skin, colon, prostate and other forms of cancer are touted for saving lives through early detection. Many health care providers recommend cancer screenings as a precautionary measure, especially for high-risk patients. But in the case of lung cancer, the leading cause of cancer death in the United States, the patient's decision to undergo a screening process is more complex.
According to University of Kentucky psychologist Dr. Jamie Studts, lung cancer screening is an algorithm, not an event. Patients aren't always aware of the physical and psychological consequences of the lung cancer screening process, which can lead to false positive results, invasive biopsy procedures, harmful radiation exposure and anxiety caused by an ongoing process.
Studts, a researcher in the UK Department of Behavioral Science and the Cancer Prevention and Control Program of the Markey Cancer Center, is working to develop an online tool that will help individuals at high risk for lung cancer navigate the lung cancer screening decision-making process. He said the decision to undergo lung cancer screening should be well-informed and aligned with the patient's personal values. Studts is collaborating with Dr. Margaret Byrne, a health economist and medical decision-making researcher at the University of Miami, on this project, which is funded by a grant awarded from the National Cancer Institute.
"Screening is for asymptomatic, healthy people to find out there's something wrong," Studts said. "You are committing to a series of events that will lead to either learning you don’t have cancer, or detecting and treating it."
A number of factors, including the Affordable Care Act's provision of accessibility to cancer screening services and results from a 2011 National Lung Screening Trial conducted by the National Cancer Institute, have reinvigorated the public's interest in lung cancer screening. The National Lung Screening Trial reported a 20 percent relative reduction in mortality for high-risk individuals who received a low-dose computed tomography (CT) scans. But the report also identified substantial risks and limitations to lung cancer screenings, which included overdiagnosis and relatively high false positive rates. The rate of false positive occurrence in the study of a high-risk population was 39 percent. With high rates of false positive scans and ongoing follow-up treatment, Studts said widespread lung cancer screening could be a costly burden for government-funded health care but could also prevent very expensive treatments for late stage lung cancer.
Studts and his fellow researchers have proposed a decision-making aid that is designed to accomplish three objectives: disperse knowledge, empower the patient and clarify individual's values. The aid will present accurate information about the screening process and calculate feedback that's tailored to the individual. The tool will also empower the individual to discuss the decision with their health care provider by providing a prompt list of potential questions. Finally, the values clarification component of the tool will explore the patient's personal preferences regarding the lung cancer screening process. For instance, if a patient is ultimately unwilling to undergo surgery for a lung biopsy, the tool can determine that they will likely experience minimal benefit from a screening.
"The goal is to help people interpret what they learn in the context of what’s important to them regarding their goals in health," Studts said. "They will learn about lung cancer screening options, benefits, harms and uncertainties associated with the modality.”
To develop the provider education program, Studts has collaborated with a team of University of Kentucky experts, including Dr. Eric Bendsadoun, a pulmonologist and director of the lung cancer screening program; Dr. Susanne Arnold, a medical oncologist who is part of the multidisciplinary lung cancer screening program; Dr. Michael Brooks, a cardiothoracic radiologist; Dr. Mark Dignan, a cancer prevention and control researcher; Dr. Eric Durbin, a cancer research informatics expert; and Dr. Brent Shelton, a cancer biostatistician.
The next step in their research will be conducting a clinical trial to test the decision-making aid among high-risk individuals, or high pack-year smokers, in Florida and Kentucky. Recently, Studts, along with Dr. Tim Mullet, a cardiothoracic surgeon at UK, received funding from the Kentucky Lung Cancer Research Program to develop an online continuing education program geared toward educating health care providers about lung cancer screening and how to discuss the lung cancer screening question with their patients. Eventually, he envisions dispersing a comprehensive educational toolkit on lung cancer screening to clinics and hospitals.
Studts said the current research suggests that lung cancer screening has minimal benefits for individuals younger than 55. Still, many Americans with a history of high pack-year smoking will face the decision of whether to be screened for cancer in their lifetime. Studts believes it will be helpful to implement an online tool that will help guide members of the high-risk population through a decision-making process.
"We’re interested in delivering high quality patient centered care – helping people be engaged in their health care choices and helping health care providers engage in these choices too."
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LEXINGTON, Ky. (Aug. 6, 2014) – The Louisville Ironman – a triathlon consisting of a 2.4-mile swim in the Ohio River, a 112-mile bike ride, and a 26.2-mile run – is a competition that would test even the toughest of wills.
But for University of Kentucky radiation oncologist Dr. Jonathan Feddock, the competition is about more than achieving a personal goal – Feddock, an accomplished triathlete, is using his athletic talents to help provide better care for the cancer patients he treats. When he competes in the Aug. 24 Ironman, he'll be doing so to raise money to pay for renovations and updates to the brachytherapy program at the UK Markey Cancer Center.
Brachytherapy is a specific form of radiation treatment where radiation sources are placed inside or close to the area requiring treatment.
”The main benefit to using brachytherapy for the treatment of cancer is that this is the only method of radiation treatment where we can make radiation appear exactly where we want to," said Feddock. "If your goal is to treat a tumor with curative doses of radiation and not treat the normal parts of the body immediately next to it, then brachytherapy is the best option.”
The total estimated cost for the brachytherapy project is approximately $1.2 million dollars, and Feddock has a specific goal to reach – he is trying to raise $200,000, with the remaining $1 million to be matched through the University, independent philanthropists, and department funds. The proposed changes would consolidate all areas involving brachytherapy, including moving the implant procedure room and the radiation treatment room into a combined space, and upgrading the current brachytherapy equipment.
Brachytherapy treatment is commonly used to treat most gynecologic cancers, as well as malignancies of the breast, prostate, and skin. Under Feddock’s leadership, the radiation medicine department has developed a niche practice that uses brachytherapy for recurrent tumors in patients who have previously received radiation. As a result, UK sees patients from all over the country.
Unfortunately, Kentucky holds the distinction of having some of the highest cancer rates in the country – including being No. 8 in the U.S. for cervical cancer incidence. The availability of brachytherapy in the state is limited, and as a result, Markey provides brachytherapy services for essentially all patients coming from central, eastern and southern Kentucky.
Currently, Markey patients receive their brachytherapy implants in the Ben F. Roach Building, but have to be transported down a long hallway to the radiation treatment room in the UK Albert B. Chandler Hospital. Because the radiation therapy treatment and recovery rooms require a shielded vault, consolidation is not an easy process.
However, Feddock points out, the renovations will improve staff efficiency and the overall patient experience, in addition to allowing his team to see even more patients per day.
"Currently, the setup and logistics of brachytherapy treatment limit me to no more than two cases a day," Feddock said. "As our patient population grows, there's a real need to streamline the process so we can see more patients. I believe the proposed changes would allow me to treat three to four patients a day."
Feddock is determined to reach his goal, and he's even implemented a clever strategy to bring in donations. After speaking with members of the World Triathlon Corporation, he has been given special permission to begin the Ironman in Louisville this year in last place – and he's encouraging donors to "bet against him" by pledging a small amount for every single person he passes in the race. With close to 3,000 competitors ahead of him, that's a lot of potential donations.
The plan becomes more impressive when you look at his track record: in 2011, Feddock finished 30th in the Ironman; in 2013, he finished 17th.
”While I'm approaching some corporate sponsors and individual philanthropists about making larger donations, I think crowdfunding is the key here," Feddock said. "Every single dollar helps, and if a lot of different people contribute just a small amount, it will add up. By pledging even a small donation, you'll be making a huge impact on cancer care for women and men across Kentucky."
Dr. Marcus Randall, chair of the Department of Radiation Medicine, says his team fully supports Feddock's undertaking.
“Dr. Feddock’s commitment to his patients and to UK HealthCare is inspirational to us all," Randall said. "The department is strongly supporting Dr. Feddock, which shows that we truly have 'skin in the game' when it comes to giving our patients the best treatment possible.”
To support Feddock's mission and improve patient care at the UK Markey Cancer Center, visit his personal fundraising page, Ironcology.net for details on how to donate. All donations are processed through the Markey Cancer Foundation.
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