PHILADELPHIA INTERNATIONAL MEDICINE® NEWS BUREAU
Contact: Leonard N. Karp
215-575-3720
lkarp@philadelphiamedicine.com
June 23, 2006
For immediate release:
In this month's issue:
- Most Advanced Proton Therapy Treatment Facility To Be Constructed by University of Pennsylvania; Will Decrease Destruction of Surrounding Normal Tissue
- Study by Jefferson Surgeon Shows Age May Not Have To Be Deciding Factor in Cancer Surgery
- With Approval of Second Cancer Vaccine, Fox Chase Cancer Center Recalls Role in Discovery and Development of First Vaccine
Editors note: Research, new techniques and improved facilities by Philadelphia International Medicine hospitals and physicians may lead to new ways to treat some of our most challenging diseases. Below are just some examples from our hospitals.
Most Advanced Proton Therapy Treatment Facility To Be Constructed by
University of Pennsylvania; Will Decrease Destruction of Surrounding Normal Tissue
Philadelphia – The University of Pennsylvania Health System (UPHS) will begin construction on a new proton therapy treatment facility to provide patients with the most advanced and sophisticated form of cancer treatment available.
To be equipped by the Ion Beam Application, S.A. (IBA) company based in Louvain-la-Neuve, Belgium, the proton therapy center will be located adjacent to The Raymond and Ruth Perelman Center for Advanced Medicine, a $302 million structure that is now being built to house Penn’s outpatient cancer, cardiovascular, diagnostic, and surgical services.
The UPHS Proton Therapy Treatment Center will cost approximately $140 million and take about three years to complete. The first patient is expected to be treated in 2009. The UPHS Center – the first such facility between Boston and Florida – will greatly enhance the mission of the Abramson Cancer Center of the University of Pennsylvania to continually expand and integrate optimum patient services and clinical care.
Proton therapy is the most precise form of advanced radiation therapy available to treat certain cancers and other diseases. It works by precisely targeting a focused beam of high-dose radiation to a specific tumor site – thereby decreasing by up to 70 percent the destruction of surrounding normal tissue. Due to its exacting capabilities, proton therapy results in fewer side effects and clinical complications for patients; and, it enhances the physician’s ability to treat tumors close to critical organs and/or the spinal cord.
The UPHS program will be comprised of up to five treatment rooms, four gantries (the massive, 90-ton rotational machines designed to deliver the therapeutic beam at the precise angle prescribed by the physician), and one fixed-beam room. The proton therapy treatment center at UPHS will have the most advanced options available for patient positioning and comfort, and will include a separate research room. It also will be used to treat pediatric cancers, continuing the historically close relationship between UPHS and the Children’s Hospital of Philadelphia. The center will be the largest and most advanced ever built.
"We are delighted to be able to offer our patients such a progressive and successful treatment opportunity with IBA, a company with demonstrated expertise in the design and construction of proton therapy centers in the United States and around the world," said Ralph W. Muller, chief executive officer of the University of Pennsylvania Health System. "Through this partnership, UPHS will be able to provide the most advanced form of radiation therapy available to cancer patients. This will further enhance our existing cancer-treatment capabilities, which encompass the most sophisticated and effective medical and surgical therapies and include more than 100 current treatment clinical trials."
Study by Jefferson Surgeon Shows Age May Not Have To Be Deciding Factor in Cancer Surgery
Age doesn’t necessarily have to be the deciding factor for cancer surgery, Jefferson Medical College surgeons have found.
Pancreatic cancer surgeon Charles J. Yeo, MD, Samuel D. Gross Professor and chair of surgery at Jefferson Medical College of Thomas Jefferson University and Thomas Jefferson University Hospital in Philadelphia and Jefferson’s Kimmel Cancer Center, and his colleagues studied records of pancreatic surgery during the last 35 years and found that contrary to what many in and out of medicine may believe, major pancreatic cancer surgery can successfully be performed on patients in their 80s, 90s and even older.
In the study, reported recently in the Journal of Gastrointestinal Surgery, Dr. Yeo and co-workers examined records of nearly 2,700 cases of the standard Whipple operation for pancreatic disease, including cancer. Of these, about 1,000 operations were performed in the last four years. The Whipple procedure entails the surgical removal of the head of the pancreas, the duodenum (part of the small intestine), part of the common bile duct, the gallbladder and sometimes a portion of the stomach.
Of this group, 207 patients were 80 years old or older. Those who were 80 to 89 years of age had a mortality rate of 4.1 percent (8 of 197), and a complication rate of 52.8 percent. Those younger than 80 years old had a mortality rate of 1.7 percent, with a complication rate of 41.6 percent. Of 10 patients 90 or older, the researchers reported no deaths after surgery, though half had complications. Of those 80 to 89 years old, 59.1 percent lived for at least one year, while 60 percent of patients 90 years and older lived that long after surgery.
Such complication rates for individuals at least 80 years old are what would be expected, Dr. Yeo says, and involve conditions that afflict many that age, such as heart disease, diabetes and high blood pressure.
"The general aging population isn’t dying from pancreas disease," he notes. "They are dying from other causes. If there is a mass that is detectable in the pancreas, chances are that we can take it out safely and the patient will do well," Dr. Yeo says. "As the population ages, more individuals may be eligible for such surgery."
The five-year survival of those who were operated on for cancer is comparable to the general population, he says. "In the general population, five-year survival in healthy individuals at age 80 is 69 percent. In our study, it was 55 percent, which isn’t that much different."
For various reasons, many of those older than 80 have been told they are not candidates for pancreatic cancer surgery. "Whether it was because of other health issues, poor scans or just a mindset that operating on the pancreas after age 80 doesn’t make much sense, there have been reasons not to operate on these individuals.
"The take home message is, if an experienced group of surgeons safely perform the right operation, the patient likely will do fine," Dr. Yeo says. "Patients usually can leave the hospital in a week and can be on a survival curve that approaches the normal curve of the general population."
According to Dr. Yeo, new imaging techniques, improved early detection and screening of high-risk groups, and new therapies on the horizon have begun to change the way pancreatic cancer is viewed. "We’re actually making great progress when it comes to pancreatic cancer," he says.
Pancreatic cancer, the fifth-leading cause of cancer death in this country, takes some 30,000 lives a year. The disease is difficult to treat, particularly because it is frequently detected after it has spread to other areas on the body. Only 4 percent of all individuals with pancreatic cancer live for five years after diagnosis, and approximately 25 percent of those diagnosed with pancreatic cancer who undergo successful surgical removal of their disease live at least that long.
But recent figures give new hope: of those who live for five years after surgical resection, some 55 percent will be alive at least another five years.
With Approval of Second Cancer Vaccine, Fox Chase Cancer Center Recalls Role in Discovery and Development of First Vaccine
The recent U.S. Food and Drug Administration action (FDA) that approved Gardasil (Merck & Co. Inc) as the second vaccine developed with the ability to prevent a human cancer brings to mind the important role Fox Chase Cancer Center played in the discovery and development of the first such vaccine.
Gardasil can prevent the infection of two types of human papilloma virus (HPV), which account for about 70 percent of cervical cancer cases. Worldwide, cervical cancer causes more than 200,000 deaths each year, making it the second leading cause of cancer deaths among women. In the U.S., 9,710 women are diagnosed with cervical cancer each year and 3,700 women die of the disease.
The HPV vaccine is the second anti-cancer vaccine. The first such vaccine is the hepatitis B vaccine, developed in the Fox Chase Cancer Center laboratory of Baruch S. Blumberg, MD, PhD. Hepatitis B is responsible for many cases of primary liver cancer, one of the world’s three most deadly cancers, and has an annual death toll of about 1.2 million people worldwide (up to 5,000 Americans) as a result of liver cancer or cirrhosis, according to the World Health
Organization. Dr. Blumberg won the 1976 Nobel Prize for the discovery of the hepatitis B virus and was elected to the National Inventors Hall of Fame for the subsequent invention of the vaccine.
Dr. Blumberg commends the development and approval of the HPV vaccine and notes that it is an important milestone in the management of cervical cancer. He says the HPV vaccine is another piece of evidence that vaccines can be utilized to prevent human cancers associated with a virus.
"There are other cancers in which viruses are involved in the disease-causing process," Dr. Blumberg explained. "For many of these, prevention of infection could likely prevent the cancer. These include human T-cell leukemia in adults (Human T-cell leukemia virus, HTLV). Epstein-Barr virus is associated with a variety of cancers, including nasopharyngeal cancer and certain kinds of lymphoma such as Burkitt’s lymphoma and Hodgkin’s disease. Cancer of the stomach is associated with a bacterium, H. pylorii.
"There are probably other cancers, including common cancers, that are associated with viruses or other infectious agents," Dr. Blumberg pointed out. "A goal of preventive oncology programs, such as those at the Fox Chase Cancer Center, is to identify and understand these relations and provide appropriate vaccines."
Hepatitis B vaccine has been in widespread use for nearly 25 years and hundreds of millions of doses have been administered worldwide. Most countries have national vaccination programs and in many jurisdictions, including the United States, vaccination is compulsory.
The hepatitis B vaccine can prevent many of the potential cases of primary cancer of the liver, listed by the CDC as the fourth most common cancer in the world. In its website the CDC refers to the HBV vaccine as "the first cancer vaccine."
Fox Chase Cancer Center was founded in 1904 in Philadelphia as the nation’s first cancer hospital. In 1974, Fox Chase became one of the first institutions designated as a National Cancer Institute Comprehensive Cancer Center. Fox Chase conducts basic, clinical, population and translational research; programs of prevention, detection and treatment of cancer; and community outreach.