THE MAGAZINE OF UC DAVIS COMPREHENSIVE CANCER CENTER VOL 23 NO 1 / WINTER 2021
Colorectal cancer under 50 PAGE 6
Pancreatic cancer on the rise PAGE 10
Equalizing health PAGE 11 Learning from dogs fighting cancer PAGE 24
Cancer care in the era of COVID-19 PAGE 20 Dear Reader, BREAKING BARRIERS TO BEAT CANCER℠ Cancer does not respect pandemics. Synthesis is published Since the beginning of the current COVID-19 crisis, our UC Davis twice each year by the UC Davis Comprehensive Comprehensive Cancer Center has kept its doors open, providing Cancer Center. people with cancer the world-class services and care that they need. If you receive multiple Despite the many operational challenges and personal risks, our dedi- copies of this publication, cated team of physicians, providers, nurses and staff have come in please share them. To add every single day to ensure that our patients receive uninterrupted care. your name to the mailing list or change your address, In this issue of Synthesis, you will find inspiring stories of Northern please call 916-734-9450. Californians who didn’t let fear of the virus stop them from going to their EXECUTIVE EDITOR doctor. Their decision to continue pursuing cancer care in the face of a pandemic has Primo “Lucky” Lara, Jr., M.D. been inspiring to many and is very likely to positively influence their outcome. Director, UC Davis Comprehensive Cancer Center You will also read about lessons learned from COVID-19 in the realm of cancer health EDITORS disparities: that is, how health outcomes are shaped by conditions such as where you Stephanie Winn live, what you eat and drink, and how you make a living. Marie Kennedy
Our vulnerable communities in the rural areas of Northern California and the Central GRAPHIC DESIGNER Valley have lower household income, lower health insurance rates, and less education Barbara Hennelly than other areas of the state. And, they are exposed to considerable amounts of PHOTOGRAPHER pesticides, herbicides and toxic air contaminants. Wayne Tilcock
What role do environmental exposures play in our cancer rates? You’ll find out in this WRITERS issue how we are confronting that critical question, while also doing what we can to stop Stephanie Winn Marie Kennedy cancer before it starts, with specific outreach to Latino, Native American and African Josh Baxt American communities who carry most of the regional cancer burden. Nora Mealy
Also, in this issue of Synthesis, we showcase how we are tackling the toughest of The University of California does not discriminate on the basis of cancers, such as pancreatic cancer, which just this year took the lives of admired race, color, national origin, religion, Americans Ruth Bader Ginsburg, John Lewis and Alex Trebek. Our scientists and doctors sex, sexual orientation, disability, age, veteran’s status, medical are tirelessly developing new strategies to diagnose and treat pancreatic cancer with condition, ancestry or marital status. innovative new technologies found only at UC Davis. The University of California is an affirmative action/equal opportunity employer. Call 530-752-2071 You will learn, too, about our focused efforts to cure kids of cancer. Dedicated donors for more information. Speech or have created a fund to support a new position to help families manage the psychosocial hearing-impaired persons may call 530-752-7320 (TDD). issues facing them when their child is diagnosed with cancer.
We are also excited about our new comparative oncology training program through Scan this code to which we are joining forces with the world’s No. 1 ranked UC Davis School of Veterinary learn more about Medicine to try to save the lives of dogs with cancer while supporting development the UC Davis Comprehensive of new therapies for both dogs and humans. Cancer Center and its leadership. Thank you for your continued commitment to the UC Davis Comprehensive Cancer 16 Center. We could not continue what we are doing without your tireless support.
Thank you and stay safe!
Primo “Lucky” Lara, Jr., M.D. DIRECTOR, UC DAVIS COMPREHENSIVE CANCER CENTER
B SYNTHESIS cancer.ucdavis.edu 20
inTHE MAGAZINE this OF UC DAVIS COMPREHENSIVE issue CANCER CENTER VOL 23 NO 1 / WINTER 2021
ADVANCING SCIENCE 9 CHADWICK BOSEMAN 2 Female researchers make Actor’s death reflects a rise in significant findings in the most colorectal cancer rates among common cancer impacting women young adults 10 PANCREATIC CANCER AWARDS SPOTLIGHT ON THE RISE 4 Meet five cancer researchers Deaths of three icons are furthering tools and therapies in reminders of tragic toll the fight against deadly cancers. OUTREACH PEOPLE FOCUS 11 EQUALIZING HEALTH 6 THREE JOURNEYS Striving to reduce disparities 6 Colorectal cancer under 50 among vulnerable groups
FIRST STEPS BENEFACTORS 24 WE HAVE A LOT TO 14 CANDID CONVERSATION LEARN FROM DOGS Q&A with UC Davis Health FIGHTING CANCER CEO David Lubarsky 16 Unique UC Davis partnership 16 MEET SUPER FRITZ benefits both human and canine Special boy inspires donors to fund cancer patients new resource specialist position for 25 JOSIE THE DOG families facing pediatric cancer Hunting for a reprieve from cancer
COVER STORY 20 CANCER CARE IN THE ERA OF COVID-19 On a mission to get patients the
care they need in spite of COVID-19 WINTER 2021 1 ADVANCING SCIENCE
Two female UC Davis Comprehensive Cancer Center researchers conducted new studies that examined the risk factors and the right treatment for breast cancer, integrating race and ethnicity considerations into their work. The studies were published in recent issues of Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.
Study #1: Is being overweight or having dense breasts a breasts accounted for a large proportion of breast cancers risk factor for breast cancer, regardless of race or ethnicity? in white, Black, Hispanic and Asian women despite large UC Davis cancer researcher Diana Miglioretti and epidemiolo- differences in the prevalence of these risk factors across gist Michael Bissell collaborated on a study for the U.S. Breast these racial/ethnic groups: Cancer Surveillance Consortium. Dense breasts are an important risk factor for breast cancer The study was the first to directly investigate and report in both premenopausal and postmenopausal women of all important racial/ethnic differences regarding the risk of breast races/ethnicities examined, with breast density playing a larger role in premenopausal women. A high BMI is a strong risk factor for breast Female researchers make cancer among postmenopausal women, especially in Black women. Across all racial/ significant findings in the ethnic groups examined, dense breasts were a moderate-to-strong risk factor. In premeno- prevention and treatment pausal women, a high BMI was not significantly tied to future breast cancer risk except for a small percentage of white women. However, of the most common in postmenopausal women, a high BMI was a strong risk factor for all races examined. cancer impacting women The findings showed that if all overweight/ obese postmenopausal women achieved a cancer associated with body mass index (BMI) and breast normal BMI, breast cancer incidence could be reduced by density among premenopausal and postmenopausal white, 12%–15% in white, Asian and Hispanic women, and 28% in Black, Hispanic and Asian women. BMI reflects body weight Black women. adjusted for height. Women with a BMI over 25 are considered Sustained weight loss in women over 50 has been shown above normal and overweight. to reduce breast cancer risk. In addition, changes in lifestyle, The research appeared in the October 2020 issue of such as increasing exercise, reducing alcohol consumption Cancer Epidemiology, Biomarkers & Prevention and found and eating plenty of fruits and vegetables can also help in that a BMI in the overweight or obese range and dense maintaining a healthy body weight.
Diana Miglioretti, Candice Sauder, cancer researcher surgical oncologist
2 SYNTHESIS Welcome Researchers Study #2: Breast cancer survival rates after The UC Davis Comprehensive Cancer Center is having cancer as an adolescent or young adult increasing diversity in its researcher ranks as it A troubling new discovery has Candice Sauder, reduces health disparities. Two female scientists a surgical oncologist at the UC Davis Comprehensive with experience investigating social determinants Cancer Center, rethinking the best approach to of health have joined the research team. treating breast cancer in premenopausal women who had cancer as a child or young person and were treated with radiation. Laura Fejerman – Co-director of LUCHA Initiative and A recent study conducted by Sauder and co-director of the Women’s Cancer Care Program published in the September 2020 issue of Cancer Laura Fejerman focuses research on genetic and Epidemiology, Biomarkers & Prevention shows that non-genetic factors contributing to breast cancer survival rates among premenopausal women with risk and prognosis in Latinas. Her past work breast cancer were significantly worse if they had established a relationship between genetic been treated with radiation for a prior cancer when ancestry and breast cancer risk, in which U.S. they were young. and Mexican Latinas with more European ances- In fact, the women with breast cancer who had tors were at increased risk of breast cancer as a prior cancer and were treated with radiation had compared to women with more Indigenous American ancestors. roughly twice the risk of breast cancer-specific death Fejerman earned her doctorate in biological anthropology compared to similar-aged breast cancer patients who and master’s in human biology at the University of Oxford, had no previous cancer diagnosis. England. She completed her undergraduate degree in social Sauder and her colleagues turned to the California anthropology at the University of Buenos Aires, Argentina. Cancer Registry to analyze data from women ages Originally from Buenos Aires, Fejerman left Argentina in 12 to 50 diagnosed with primary or second primary 1998 to study in England. She and her husband, a fellow breast cancer between January 1, 1988, and Argentine, have two teenagers. Her husband is a political December 31, 2014. economy professor at UC Berkeley. A second primary cancer is a new cancer that occurs in someone who had cancer in the past. In the Shehnaz Hussain – Associate director of study, patients with second primary breast cancer population sciences were limited to those who had a first primary cancer Shehnaz Hussain’s research explores the treated with radiation between the ages of 12 and 39. intersection of infection and cancer. As a Surprisingly, women who typically have a better molecular epidemiologist, she looks at public prognosis with breast cancer — including those with health impacts while researching cancer hormone receptor-positive tumors, tumors without etiology, pathogenesis, chemoprevention lymph node involvement, stage 1 disease and women and early detection. of Asian or Pacific Island ethnicity — had a lower Her current research examines the disease survival rate after a second primary breast cancer. continuum from non-alcoholic fatty liver disease to liver cancer. As a result of the findings, Sauder says we need to She is focusing on the potential biological basis for disparities look for tailored treatment strategies for women with in liver cancer, which disproportionately affects Latinos. a second primary breast cancer. Hussain earned a master’s in epidemiology from Johns “In second primary breast cancers it is really impor- Hopkins University and a doctorate in epidemiology from the tant to consider all options for treatment,” said Sauder. University of Washington. She completed a first postdoctoral “At UC Davis Comprehensive Cancer Center, we feel fellowship in genetic epidemiology at the Karolinska Institute a one-size-fits-all methodology to treating breast in Sweden and a second fellowship in cancer prevention and cancer is likely not the best approach.” control at UCLA. The study was sponsored by UC Davis Health Along with science, Hussain enjoys outdoor adventuring and UC Davis Comprehensive Cancer Center. with her two young sons and her husband, an emergency room physician.
WINTER 2021 3 AWARDS SPOTLIGHT
Sepideh Gholami wins prestigious young investigator award UC Davis Health surgeon and cancer By studying the body’s immune response to tumors, she hopes researcher Sepideh Gholami was to develop more effective immunotherapeutic strategies. recently honored with the 2020 Gholami says she is honored to receive the award and is Society of Surgical Oncologists grateful to Steven George, UC Davis professor and chair of Young Investigator Award, which biomedical engineering, and many others who were instrumental was created in 2016 to promote in advancing this critical research. translational research, bringing new “I’m very excited about this project and tremendously grateful discoveries from scientific labs to of my mentors, who have expertise in bioengineering, immu- clinic settings. Gholami is the fifth nology, molecular biology and surgical oncology,” she said. “One person to receive the award. of the unique aspects about this research experience is that we The $25,000 grant will provide truly work as a team and learn from each other’s experience and seed funding to support the assistant perspective.” professor of surgery’s innovative efforts to improve cancer care. Gholami says she finds that by using this multidisciplinary Gholami investigates new tools to treat patients with metastatic approach, the UC Davis team’s research is providing the most colorectal and liver cancer. comprehensive approach for the best patient outcomes.
SUTCLIFFE ADVANCING PANCREATIC CANCER TREATMENTS WHILE TAKING NEW LEADERSHIP ROLE
Professor of Biomedical Engineering and Hematology/Oncology Julie Sutcliffe is making a difference in the pancreatic cancer fight while taking a new leadership role in the molecular imaging field. As part of its New Therapies Challenge Grants program, the Pancreatic Cancer Collective awarded her research team up to $4 million in additional funding to support their work on peptide receptor radionuclide therapy (PRRT). The team is co-led by Richard Bold, physician-in-chief of the UC Davis Comprehensive Cancer Center. This new grant builds on a previous $1 million grant from the Collective. To advance their PRRT work, the research team developed two peptides (pieces of proteins) that focus on αvβ6, a cell surface receptor commonly found in pancreatic cancer cells, and deliver radioactive isotopes to the tumor. One peptide/isotope combination helps identify the patients who are most likely to benefit from PRRT. The other is designed to help kill tumor cells. Promising preclinical results led to the second grant, which is supporting an early-stage human clinical trial to test safety and efficacy. In another recognition of her cancer research leadership, Sutcliffe was elected 2020 president of the World Molecular Imaging Society (WMIS). As president, she is working to strengthen alliances between academia and industry, improve education, and engage patients and advocates to help scientists better understand the issues they face. “It’s an honor to be elected president of WMIS,” said Sutcliffe. “I’m excited to work with all stakeholders to advance our field.”
4 SYNTHESIS ALVAREZ RECEIVES HYUNDAI HOPE ON WHEELS GRANT TO STUDY CHILDHOOD CANCER
Elysia Alvarez, assistant professor of clinical pediatrics, received a $50,000 Hyundai Hope On Wheels grant to advance her work with childhood cancer. Alvarez seeks to understand how the facilities where pediatric cancer patients receive care affect their survival. Because care location can be changed, this research could have a profound impact on cancer care. Specifically, Alvarez is studying whether a group of pediatric and young adult patients receiving care at specialized cancer centers have better outcomes. Her initial work focused on patients with rare non-rhabdomyosarcoma soft-tissue sarcomas. Alvarez’s efforts provide important data to better understand how care disparities affect survival, particularly in cancers that require complex care, such as non-Hodgkin’s lymphoma and acute myeloid leukemia. In addition to this study, support from Hyundai Hope On Wheels has funded efforts to develop the pediatric, adolescent and young adult oncology programs at UC Davis Health.
2020 Innovators of the Year Ramsey Badawi and Simon Cherry were honored at the 2020 Chancellor’s Innovation Awards as Innovators of the Year for their efforts to revolutionize how cancers and other diseases are studied and diagnosed after developing EXPLORER, a total- body scanning technology that provides comprehensive images of the entire body in seconds. Badawi, professor and vice chair of research in the Department of Radiology, and Cherry, distinguished professor in the Department of Biomedical Engineering, will receive $10,000, which they plan to use to fund pilot studies for new investigators using the EXPLORER system. EXPLORER can image the entire body simultaneously, providing new insights into how different systems interact in Ramsey Badawi and Simon Cherry real time. This approach is an improvement over traditional named 2020 Innovators of the Year positron emission tomography (PET) scanners. Typical PET scanners use short-lived radioactive tracers to illuminate how research and clinical total-body PET center in the world. organs and tissues function and can scan only 20-centimeter The technology has been used in groundbreaking studies segments at a time. EXPLORER can also produce much higher to help patients with latent states of HIV not responding to quality images than other PET scanners and can significantly conventional treatments; to measure cancer metabolism in reduce patients’ radiation exposure. the body; and to investigate systemic inflammatory responses The Food and Drug Administration approved EXPLORER in in patients to assist with staging and to measure response to late 2018 and, soon after, UC Davis Health opened its EXPLORER treatment. More than 600 research and clinical cases were Molecular Imaging Center in Sacramento, the first combined completed in the center’s first 18 months of operation.
WINTER 2021 5 PEOPLE FOCUS
Colorectal cancer under 50: three journeys
Oncologist May Cho’s patients share their stories. Their journeys, not yet spread to other parts of the body. at times long and confusing, are a testament to the importance Rivera wanted her treatment to move more quickly. A colleague and of colon cancer screenings and advocating for your care. Their friend encouraged her to go to the positive outcomes provide hope for younger adults diagnosed UC Davis Comprehensive Cancer with colorectal cancer. Center, where the friend’s father had received excellent care. Just a few weeks later, Rivera received a call from UC Davis. “They reached out to me!” exclaimed Rivera. “Within the week I was meeting with Dr. Cho.” A tumor board, a group of cancer specialists to reach an opinion on how to handle a case, immediately reviewed Rivera’s case. She was set to start chemotherapy within two weeks, followed by radiation therapy and surgery. “Dr. Cho explained everything to me, and how it was going to work,” she said. “It was the quickest response I had ever received since the time of my diagnosis.” In December 2017, Rivera received excellent news: “Your cancer may have “DON’T LET ANYONE know your body best,” she said. “If you been over-staged. It looks like you TELL YOU THAT YOU don’t like the answer you’re getting, have a stage II cancer.” ARE TOO YOUNG” keep asking questions and get a Rivera would not need radiation. TERI RIVERA, SYMPTOMS AT 43, second opinion.” Her treatment consisted of surgery DIAGNOSIS AT 51 Not until almost seven years later, followed by a round of chemotherapy. It started eleven years ago. Teri Rivera, in July 2016, a primary care provider “There have been some difficult ups then age 43, began noticing blood suggested a colonoscopy, a common and downs, but I was treated by a very after using the bathroom. For years, procedure that can screen for thorough, understanding, caring and she was told the blood was due to colorectal cancer. Within the year, supportive team at UC Davis. I am hemorrhoids, which seemed a likely Rivera was diagnosed with stage III happy to say that currently I have no diagnosis for the young mother of five. colorectal cancer. She was 51. indication of cancer,” she said. But Rivera sensed that something At stage III, colorectal cancer may She is grateful for the support of her was not right. “Remember that you have spread to nearby lymph nodes but five children, now ages 14 to 32, and
6 SYNTHESIS other family and friends while going through treatment. For others finding themselves with a cancer diagnosis, she encourages them to be an advocate for their own care.
“SO YOUNG TO FACE SOMETHING SO HEAVY” NEIL PETERSEN, DIAGNOSED AT AGE 36 Neil Petersen was an avid backpacker and naturalist living in Weaverville, a remote part of Northern California. At 36 he was close to realizing his dream of opening a brewery when his life changed in early 2018. Petersen was rarely sick, but some flu-like symptoms prompted him to he wanted to be at the UC Davis His treatment included initial chemo- go to a clinic for help. He was given Comprehensive Cancer Center. Having therapy and then surgery, which was some pain medicine and did not pursue grown up in the Sacramento area, he scheduled right after Christmas further care. However, the symptoms knew about its positive reputation, followed by groundbreaking immuno- returned a few months later, along with and his parents still lived in the area. therapy monthly treatments that enable pain and trouble urinating. He drove He went to the emergency department the body’s immune system to fight the cancer cells. “I really appreciated the straightfor- Three patients in their 30s and 40s ward, honest, not-sugar-coated expla- nations the doctors offered me,” struggled searching for a diagnosis and Petersen said. Petersen also praised the holistic treatment until they found UC Davis care offered at UC Davis. He was fortu- nate to have support from UC Davis Comprehensive Cancer Center. social worker Sara Conning. “It helped keep my brain straight through this complex roller coaster that I had been himself to the nearest emergency at UC Davis Medical Center and was on,” he said. room, which was 45 minutes away. immediately admitted to the hospital Petersen finished his treatment in After a CT scan he received based on his condition. May of 2020 and is in remission. He will sobering news: he had a mass in his That’s where he met Cho. She told soon return to UC Davis for a robotic colon. Petersen that his tumor had grown from colostomy reversal by Wissam J. Halabi, “I was hospitalized immediately,” said his colon into his bladder, blocking his a surgeon trained in general surgery and Petersen. “The doctors started talking ability to urinate. colon and rectal surgery. He encourages about options, including a colostomy In October 2018, Petersen was anyone who experiences symptoms like bag and palliative care. I thought, ‘Let’s diagnosed with stage IV colorectal his to request a colonoscopy. slow down.’ I was aware that they did cancer with metastasis to the liver. At the time of Petersen’s cancer not have a cancer program.” “I was so young to face something diagnosis, he and a business partner Petersen immediately knew that so heavy,” said Petersen. had just closed escrow on a building
WINTER 2021 7 PEOPLE FOCUS
that would house their new brewery. “Dr. Cho told me to let her worry about the cancer and for me to worry about starting my brewery,” he recalled. Trinity County Brewing Company opened in May 2020!
“BE BOLD AND UNAPOLOGETIC” JENNIFER DUNN, DIAGNOSED AT AGE 40 Jennifer Dunn was having excruciating stomach pains, and she couldn’t find relief. “The pain was so intense,” said Dunn. “I started seeking treatment in as many places as I could.” budge that day until more was done.” — this team that opened their arms. Her journey included multiple visits Finally, a CT scan identified multiple It was a totally different relationship.” to various health care providers. Dunn lesions occupying 70% of her liver. When Gholami learned of the was a teacher living in Humboldt Later, a biopsy confirmed that her severity of the colonic obstruction, County, California, a rural area where disease was very advanced. she immediately sought out UC Davis doctors sometimes rotate through their Dunn thought of her daughter, surgeon Wissam J. Halabi. From there, services, making it challenging to obtain who was just 9 years old at the time. things moved fast: Dunn’s tumor was specialty care. “There has to be options,” Dunn thought. removed within 24 hours. She stayed in “It was always someone different — Her brother, a professor of evolu- the area to recover before returning to a health care professional meeting me tionary biology at Yale, searched for Humboldt. Oncologist May Cho oversaw for the first time, and we’d be starting a place for her to receive better care Dunn’s chemotherapy regimen. from zero again,” she said. and was recommended the UC Davis In April, despite the COVID-19 Dunn was 39 years old. Due to her Comprehensive Cancer Center. pandemic, Dunn and her family relo- young age, the possibility of a colon Soon after setting an appointment, cated to Sacramento to be close to the cancer center. Dunn’s husband secured a job teaching and her “I didn’t know oncologists pick up the 10-year-old daughter is distance learning with her elementary school phone and call! I was so surprised.” in Humboldt County. Dunn is participating in an innovative –JENNIFER DUNN treatment for patients with colon and bile duct cancers, in which chemo- cancer diagnosis was overlooked for Dunn received a call from Sepideh therapy is delivered both systemically more than a year. Gholami, a UC Davis surgeon-scientist and directly into her liver. She is one In 2019, two months after her 40th specializing in cancers of the gastroin- of the first patients to undergo the birthday, she made what would be a testinal tract, liver and pancreas. treatment at UC Davis. critical visit to the emergency room. “I didn’t know oncologists pick up “I have fortunately responded very “It became very hard to trust my own the phone and call! I was so surprised,” well,” said Dunn. body. The long ordeal had drained me said Dunn. “I had gone from feeling like By sharing her experience, Dunn of my confidence,” she said. “It was a ghost, going around asking everyone hopes to make a difference in someone desperation that helped me refuse to I could to help me find care, to — finally! else’s life.
8 SYNTHESIS Death of Chadwick Boseman highlights colon cancer among younger patients
The death of 43-year-old “Black Panther” Symptoms include rectal bleeding, often special liquid diet. Then they are given actor Chadwick Boseman in August 2020 misdiagnosed as hemorrhoids, changes anesthesia and typically have no memory has brought renewed attention to colon in bowel movement, new constipation of the procedure. The risks associated cancer and the need for regular screenings. or diarrhea, unexplained weight loss, with the procedure are very low May Cho is a medical oncolo- fatigue and bloating. All of these are compared to the immense benefit gist specializing in the treatment symptoms. You should be alarmed if of finding underlying disease that is of gastrointestinal cancer, the symptoms persist. Don’t wait more going undetected. including colorectal cancer, than two or three months. You should at the UC Davis Comprehensive see your doctor to seek procedures What kind of work is UC Davis doing Cancer Center. She also is such as a colonoscopy. to advance colorectal cancer research an assistant professor at the and care? UC Davis School of Medicine. She When should people start getting We work with our communities to offer answered some common questions screened for colon cancer? prevention screening and education. about colorectal cancer. The ACS guidelines now call for We also have several active clinical trials screening at the age of 45, rather studying colorectal cancer. What is colon cancer, or colorectal cancer? than 50, due to increasing rates of If you or someone you know is interested Colorectal cancer includes bowel cancer, colorectal cancer in younger patients. in participating in one of these studies, colon cancer and rectal cancer — any Precancerous polyps can be safely please reach out to your doctor to find cancer that affects the colon and the removed and prevent the development out more, or visit the list of cancer clinical rectum. According to statistics from the of colon cancer if nothing is found trials at the UC Davis Comprehensive American Cancer Society (ACS), the over- and there are no symptoms, then the Cancer Center. all lifetime risk of developing colorectal patient can be checked every 10 years. cancer is about 1 in 23 for men and 1 in If a person is having symptoms, don’t 25 for women. Hereditary, environmental wait. Advocate for yourself to get the and lifestyle factors can affect your risk screening done, even if your age does for developing colorectal cancer. not fall into the obvious guidelines.
What was your reaction when you What’s involved in the screening? heard about the death of Chadwick A colonoscopy is the gold standard for Boseman due to colon cancer? screening and the preferred way to diag- He was so young and productive. It was nose gastrointestinal cancers. It is the so heartbreaking to hear but unfortu- only way you can really look at the colon nately it wasn’t much of a shock to me. and detect polyps. There are screening
The incidence of colorectal cancer tests that look at cancer DNA or blood in Commons Wikimedia / Skidmore Gage in people under 50 is on the rise and the stool (feces), but they are not as good I’m seeing this alarming trend in my a tool as a colonoscopy. The actor’s death clinic. We also are seeing a shift in the past couple decades, with most patients What do you tell patients who are reflects a rise in showing sporadic cancer. This could be nervous about colonoscopies? colorectal cancer due to environment or lifestyle changes, This is a cancer that can be prevented but we are trying to learn the cause. through early detection. A colonoscopy rates among is a routine procedure that we’ve been young adults What are the symptoms of colorectal doing for decades. The patient is asked cancer? Why are they overlooked? to prepare in advance, including a
WINTER 2021 9 UC Davis Comprehensive Cancer Center Center Comprehensive Cancer UC Davis patient holds on to hope repeatedly complained of feeling nauseous right after eating and felt a nagging pain in in pain anagging felt and eating after right nauseous feeling of complained repeatedly to back down.” back to abdomen. her of side right the cancer survivor cancer “Pancreatic cancer doesn’t care if there’s COVID-19,” said Weydert. “It’s not going going not “It’s Weydert. said COVID-19,” there’s if care doesn’t cancer “Pancreatic Pam Weydert Weydert’s daughter pleaded her with mother to get Weydert medical after attention Pancreatic Trebek are tragic reminders Justice Ruth Bader Ginsburg, civil rights rights civil Ginsburg, Bader Ruth Justice well as ‘Jeopardy!’ host Alex PEOPLE FOCUS PEOPLE and popular “Jeopardy!’ game show of people with the disease die within within die disease the with people of 10 and Ruth Bader Ginsburg as Ginsburg Bader Ruth and Passing of icons Lewis John passing of three luminaries who died died who luminaries three of passing recent developments in treatment, 90% 90% treatment, in developments recent Pancreatic cancer is often fatal and it’s on the rise from disease: the Supreme U.S. Court years offive diagnosis. leading cause of cancer-related death ominousthe ranking of being third the has which cancer, pancreatic of toll tragic Pancreatic cancer Despite is stubborn. host Alexhost Trebek. leader and congressman John Lewis, SYNTHESIS Their are deaths reminders of the In 2020, mourned the Americans
enough,” said out “Finding I Weydert. had pancreatic cancer me terrified Davis. UC at center cancer the at treatment of-the-art get in the way of getting medical care, and she quickly accessed state- accessed quickly she and care, medical getting of way the in get pancreas. pancreatic cancer to are advance. subtle until the often cancer starts that I could beat it.” beat Icould that is recovering from chemotherapy and surgery to remove a tumor in her her in atumor remove to surgery and chemotherapy from recovering is Pam Weydert is one of the lucky ones. The 66-year-old Stockton woman woman Stockton 66-year-old The ones. lucky the of one is Weydert Pam because I know it is a difficult cancer to beat. Dr. Bold gave me hope hope me gave Dr. Bold beat. to cancer adifficult is it Iknow because “Coming down with cancer during the coronavirus pandemic was bad Other than possible signs of jaundice early on, the symptoms of of symptoms the on, early jaundice of signs possible than Other Weydert is fortunate for two reasons: she didn’t let a global pandemic pandemic aglobal let didn’t she reasons: two for fortunate is Weydert
that trend. trend. that im- not has survival which for cancers cancer at UC the Davis Comprehensive Center. “In fact, it’s one of the few the of one it’s fact, “In Center. Cancer Center,” said Bold. proved substantially in nearly 40 years.” 40 nearly in substantially proved in the U.S. Unfortunately, it is expected expected is it Unfortunately, U.S. the in in cancer research have been unable Richard Bold, the physician-in-chief of of physician-in-chief the Bold, Richard the UCthe Davis Comprehensive Cancer cancer,” said pancreatic in to rein soon. place second into to move “It is disappointing that advancements that is advancements disappointing “It “We are doubling down on pancreatic pancreatic on down doubling are “We tochange determined is Bold
“If we can make progress fighting this this fighting progress make can we “If The are outcome when is patients best The UC Davis Comprehensive Cancer and treat and educate patients. educate and treat and at one of the five top-rated University of of University top-rated five the of one at coordinate develop trials, therapies, cancer centers together to share research, outcomes for pancreatic cancer patients treated are California in patients cancer cancer, including tobacco and alcohol use. early stages. Age, gender, stages. early race and family its in it todiagnose tools detection early no are there because mostly death of delivering radioactive isotopes directly isotopes directly delivering radioactive Teaming up to take on one of of one Teaming on take to up Center is hoping to change dramatically comes in.Cancer Center Consortium California comprehensive cancer centers. reduce your chances pancreatic of getting can you that ways and factors risk more will fund an early-stage clinical trial to test totest trial clinical early-stage an fund will UC Davis researchers are uncovering frequently. Yet, only 17% of pancreatic pancreatic of 17% Yet, only frequently. into pancreatic cancer cells (see page 4). page (see cells cancer pancreatic into insidious cancer, we can take on any treated by experts who see this cancer cancer this see who experts by treated bringing UC all comprehensive five which is by joining consortium, the type of cancer.”type tive grant recently awarded to UC Davis Davis toUC awarded recently grant tive history are thought to play a role, and and arole, toplay thought are history the “world’s worst cancers” worst “world’s the That’s where UC the Pancreatic A million $4 Pancreatic Cancer Collec Pancreatic cancer is a leading cause
-
Peabody Awards / Wikimedia Commons OUTREACH
EQUALIZING HEALTH
Striving to reduce disparities among vulnerable groups
he UC Davis Comprehensive Most UC Davis Comprehensive populations while initiating and leading Cancer Center serves a huge, Cancer Center patients (90%) live in 19 many of the cancer center’s community diverse community. Its primary counties in Northern California and the research studies. He places a strong serviceT area is the size of West Virginia Central Valley. They include a higher emphasis on screening, vaccination and is home to a heterogenous popula- percentage of Hispanics, Asian Americans and education strategies among racial tion, half of which lives in rural areas. and Native Americans than the national and ethnic minorities. This makes cancer care delivery average, as well as a large African “It’s far more effective to prevent particularly challenging because American population, which suffers cancer than to cure it,” he said. of the physical distances involved, the highest cancer burden in the U.S. Chen says that there are a number according to Moon S. Chen, Jr., Throughout his career, Chen has of outreach programs now being associate director for Community worked diligently to mitigate cancer deployed to reach diverse communities Outreach and Engagement. health disparities among underserved throughout the region.
WINTER 2021 11 OUTREACH
for tobacco use and offered treatment. tobacco treatment by sixfold over the People who use tobacco are strongly past couple of years, thanks to implemen- TAKING THE FLAVOR OUT encouraged to take part in the tation efforts with the cancer center clinic OF TOBACCO PRODUCTS UC Davis Comprehensive Cancer staff. With additional telephone outreach The UC Davis Comprehensive Cancer Center Center Stop Tobacco Program (SToP), led by Shulkin, over 700 patients with played an important role in educating local and statewide policy makers and the public about which includes two highly successful cancer who use tobacco have been flavored tobacco products. programs that double the chance of reached by the program team. Leading up to the City of Sacramento’s local staying tobacco-free: “We tell patients that when they come ban of flavored tobacco products in spring UC Davis Health’s Health Management to the cancer center, UC Davis will 2019, the cancer center hosted an educational and Education offers online classes provide them with the best available care roundtable with academic and community partners, including partners from the African that focus on strategies to quit for their cancer,” said Tong. “Tobacco American community who wanted menthol tobacco. Led by Cari Shulkin, a certi- treatment is an important part of that care.” cigarettes banned in the new law. As a result of fied tobacco treatment specialist targeted marketing, more than 80% of African Americans who smoke use menthol-flavored nurse, classes are provided by a Searching for the basis of breast cancer cigarettes, leading to high rates of lung cancer multidisciplinary team and incorporate Laura Fejerman, associate professor in the in these communities. behavior modification, nutrition, Department of Public Health Sciences and In the fall of 2019, UC Davis internist and medications and relapse prevention. co-director of the Women’s Cancer Care tobacco expert Elisa Tong was invited to present at a joint committee hearing of the The California Smokers’ Helpline, Program at the cancer center, joined the California Assembly about flavored tobacco the state quitline, which is affiliated faculty this past September with clear products and vaping at the height of the EVALI with UC Quits, offers one-on-one goals: She wanted to better understand (E-cigarette Vaping Associated Lung Injury) epidemic. During the last legislative session, counseling support for quitting all breast cancer in Latina women and reduce state lawmakers passed restrictions on the tobacco products including e-ciga- disparities in access to prevention and sale of most flavored tobacco products in rettes and is offered in multiple care services. California, a ban that was signed into law by Gov. Gavin Newsom. languages (Spanish, Chinese, Korean She has made important headway and Vietnamese). It also is available in understanding the basis of breast for the hearing impaired, as well as cancer among Latinas. For instance, friends and family seeking resources she has identified a genetic variant that to help loved ones quit. The Helpline is suspected to protect against breast Targeting the biggest cause of cancer is mailing free nicotine patch two- cancer and is present only in women of According to Elisa Tong, an internist week starter kits to eligible smokers. Indigenous American ancestry, who have who directs tobacco cessation “Stopping tobacco use is relatively low incidence of the disease. initiatives at the cancer not only important for “Genetic studies are important because center, no cancer cancer prevention they can provide a basis for more targeted prevention strategy but also for cancer screening, as well as inform has the potential patients under- research in therapy,” said Fejerman. to make a bigger going cancer Fejerman has joined the Latinos United impact than treatment,” said for Cancer Health Advancement Initiative preventing or stop- Terri Wolf, cancer (LUCHA), which she co-leads with Luis ping tobacco use. center nurse Carvajal-Carmona, professor in the She cites at least 12 program manager UC Davis Department of Biochemistry cancers that are for SToP. She and Molecular Medicine. caused by tobacco. explained that tobacco The LUCHA team reaches out to the With the support of the use can impede healing from Spanish-speaking community to educate Cancer Center Cessation Initiative surgery or radiation treatments and them about cancer and facilitate access to from the National Cancer Institute (NCI) increases the metabolism of some information, screening and clinical trials. and UC Davis Health, Tong and her cancer drugs, which can require double Fejerman noted many barriers for this popu- team have integrated tobacco treatment dosages and increase exposure to lation to overcome, including language diffi- into cancer care. Every patient who associated toxicity. culties, lack of health insurance and in some enters the cancer center is screened Tong noted that SToP has increased cases, tenuous residency status.
12 SYNTHESIS “UC Davis is doing very well vaccination and respond to OTHER PROGRAMS in terms of closing gaps parent concerns. ADDRESSING HEALTH in health disparities “Broken leg — DISPARITIES among different ethnic vaccinate!” became Other UC Davis Comprehensive Cancer Center programs promoting cancer prevention and groups,” she said. “But a rallying cry to detection and working to reach vulnerable we can do better, drive home the populations include: and I look forward point that no oppor- EXPLORER. Cancer screening, diagnostics to continuing to help tunity should be and treatment monitoring received a boost in these efforts.” missed to promote from the EXPLORER scanner created at UC Davis Health, which can capture a high- vaccination in quality 3D image of the whole human body Increasing patients seen at in the time of a single breath. EXPLORER is HPV vaccination the clinic, no matter what a combined positron emission tomography (PET) and X-ray computed tomography (CT) Vaccination against the human medical problem they come in for. scanner. A recent supplemental grant, in papillomavirus (HPV) has notoriously The techniques worked, with 61% collaboration with the Office of Community low acceptance rates compared with of the clinic’s Native American adoles- Outreach and Engagement, is helping to bring the benefits of EXPLORER to racial and ethnic other childhood vaccines in the U.S. cents undergoing complete vaccination minorities in the region. With advice from our This very common virus can cause six at the end of the intervention — more Community Outreach and Engagement Advi- types of cancer, which the HPV vaccine than double the baseline rate. sory Board, we are preparing YouTube videos to describe the benefits of total-body scans for is highly effective in preventing. “Because we were able to change the earlier detection of cancer in racial and “American Indian and Alaska Native the culture within the clinic, we anticipate ethnic minorities. women have the highest rates of that the gains will continue,” said Dang. Hepatitis B screening, vaccination among HPV-associated cancers,” said Julie She is currently implementing an Asians. Asian Americans comprise about 6% of the population but have about 60% of the Dang, executive director of the UC Davis NCI supplemental one-year grant that burden of chronic hepatitis B, a viral infection Comprehensive Cancer Center Office of expands the program to nine more coun- that is one of the most common causes of liver Community Outreach and Engagement. ties with particularly low vaccination rates. cancer worldwide. At UC Davis, reducing the impact of hepatitis B has been a decade-long “This is why we have especially focused The region is home to a large concentra- team science effort, and it’s working. Liver on this group to enhance immunization.” tion of rural, Latino agricultural workers cancer is now the fifth leading cause of cancer A collaboration between the UC Davis and traditional Russian-speaking immi- in our region rather than the fourth. Comprehensive Cancer Center and grants. The project will assess factors UC Davis is partnering with the largest Northern Valley Indian Health (NVIH) related to vaccine hesitancy among these primary care provider of Southeast Asians in Sacramento County to increase hepatitis B brought Dang’s team into the NVIH groups, then pilot tailored interventions. surface antigen screening among pregnant Willows Clinic in Glenn County where they women so that perinatal transmission of trained health care providers and primary Taking action on multiple fronts hepatitis B can be eliminated. Along with other efforts, END B, a grant from the U.S. care support staff to encourage HPV The cancer center has a clear mandate to Department of Health and Human Services’ reduce disparities in health outcomes, Office of Minority Health, will be helping spare explained Chen, who is proud of the the next generation from hepatitis B-linked liver cancer deaths. many efforts the cancer center is taking throughout the region through cancer CLOVER. Colon cancer, Lung cancer, Obesity, Vaccine-preventable illness and livER cancer prevention such as tobacco use abate- help spell “CLOVER” and are responsible for ment and HPV vaccination promotion, a great deal of disease burden in people ages increasing access to screenings, and 50 and older. Erik Chak, assistant professor of gastroenterology and hepatology, is piloting laboratory-based work to uncover the a National Institutes of Health-funded pilot genetic bases of disparities. program to more efficiently bundle cancer “No population is too hard to reach, screening and reduce cancer-related racial disparities. The program uses Epic Healthy it’s just that they are hardly reached,” Planet, a platform to manage complex patient he concluded. “We are working to data and optimize care. change that.”
From left to right: Teresa Martens, M.S.N., R.N. (NVIH Outreach Director); Chester Austin, M.D. (NVIH Medical Director); Sharon McClure (NVIH Quality Assurance Manager; Arzoo Mojadeedi, R.N. (NVIH Outreach Director); Julie Dang, Ph.D., M.P.H. (Executive Director, Office of COE); WINTER 2021 13 and Ulissa Smith, M.P.H. (COE Program Coordinator). BENEFACTORS
Candid conversation with UC Davis Health CEO David Lubarsky, M.D., M.B.A.
How do you see the UC Davis Comprehensive Cancer The UC Davis Comprehensive Cancer Center is unrivaled Center evolving in the future? and unparalleled in the region. We enroll many patients in Right now, our cancer center is an amazing resource for clinical trials, but we need to strive to enroll diverse popula- patients, offering superior health care and outcomes, and a tions in these trials. great deal of research; but I see it evolving in terms of helping to eliminate health disparities for populations we haven’t yet In what ways do you think we could further reduce the reached with the latest therapies, diagnostic techniques and cancer burden in our region? sub-specialist support. We are uniquely positioned to We’re all about advanced If we can cure pancreatic cancer, address health disparities diagnostics. That includes asking because of our urban location, questions about what increases we can cure any cancer — but with African American neighbor- individual cancer risks. What is it we are not going to do it alone. hoods and other communities about our environment, our heri- of color nearby, and most impor- tage, our ZIP code, our genetic code that triggers cancer? tantly, we are trusted. This was evident during the recent Pfizer That’s the Holy Grail. And, we are actively chasing it. COVID-19 vaccine trial we conducted, which had some of the largest percentages of minority participation in the country. What makes our cancer center unique? There are also demographic differences in the underserved There are only 51 National Cancer Institute (NCI)-designated populations in rural areas we serve in Northern California comprehensive cancer centers in the country and we are one and the Central Valley. We are committed to increasing our of them. The designation is important because it signifies that community partnerships in these rural areas to not only get we are a select cancer center moving the boundaries of care them into critical cancer research trials but also give them for cancer patients, especially with the ability to conduct access to premium cancer diagnostics and treatment. early-stage FDA cancer trials. What are the challenges we face in our mission to fight cancer? We want to stop cancer before it starts. That means under- standing the toxins present in industries such as agriculture and the living conditions that expose certain rural populations, such as farmworkers, to environmental and social conditions that put them at risk for cancer. More research is needed, and we also need creative solutions to increase access to care. The cancer center is advancing telemedicine in these remote areas. One of the silver linings of the coronavirus crisis is that we have demonstrated we can do more with virtual office visits, including patient moni- toring, easy access to films, and even virtual tumor boards.
14 SYNTHESIS “We are humbled by the generosity of donors UC Davis Comprehensive Cancer during this unprecedented year, and grateful Center Points of Excellence
for the continued commitment to supporting Treating 24 types of cancer, from the clinical and translational research to stop, rarest to the most common. prevent and treat cancer. All of this is possible Recognized by U.S. News & World Report as one of the nation’s Best Hospitals in because of your financial support. Philanthropy cancer care. gives us the flexibility to adapt while keeping The region’s only clinic for managing the the needs of individuals and families at the long-term effects of treatment on child- center of our cause. It is through the generosity hood cancer survivors. of our donors that we will persevere, innovate More than 400 adult and pediatric cancer clinical trials underway are providing at every opportunity and beat access to novel or personalized therapies this disease.” and early Phase 1 trials. More than 100,000 patient encounters Primo “Lucky” Lara, Jr., M.D. each year, and the only National Cancer Director, UC Davis Comprehensive Cancer Center Institute-designated comprehensive cancer center in California’s Central David Lubarsky, UC Davis Health CEO and Primo “Lucky” Valley and inland Northern California. Lara, Jr., director, UC Davis Comprehensive Cancer Center
How are we leveraging partnerships with other are not going to do it alone. Collaborating with other University of California cancer centers? UC comprehensive cancer centers is critically important. We are working hand and glove with our affiliated cancer centers through the University of California Cancer What do we need to make it all happen? Consortium to share research, assets and capabilities so To give everyone the best odds of surviving cancer, we need we can have a bigger impact in the cancer fight. Together, to constantly upgrade and expand our facilities. This is why we comprise 10% of the NCI-designated cancer centers we need help from other people — to make the research in the U.S., making us the largest cancer center in the happen, to fund the clinical trials, to bring the complex cancer world, treating more cancer patients and conducting cases into the UC for research. We depend on grateful more cancer clinical trials than anyone else. By collabo- patients and others, such as corporations, to give back and rating through the UC Cancer Consortium, we accumulate help us prevent future patients. Our goal is to put ourselves knowledge and complete clinical trials in a shorter time out of business. frame. That’s critical to finding cures faster and more There are countless stories of lives cut short by cancer. economically. Those stories would disappear if we made the right invest- For instance, our Institute for Regenerative Cures ments and instead they could be replaced with stories about partners with UCSF to take the body’s own defense families that were not broken apart, and children who didn’t mechanisms against cancer, T cells, grow them in cultures lose a mother or a father, or parents not worried about the and supercharge them to create cancer-fighting CAR T hereditary risk they’ve passed along to their child. cells. We’re about to roll out a new line of CAR T cell We have to be smarter and think carefully. There is so therapies at 20% of the previous prohibitive cost. We much to be done to remove this scourge, one cancer at a time. also started a UC Pancreatic Cancer Center Consortium Everybody wins when there is greater health for all. That’s to address the toughest of all cancers. If we can cure why we’re here and that’s what the UC Davis Comprehensive pancreatic cancer, we can cure any cancer — but we Cancer Center is all about.
WINTER 2021 15 BENEFACTORS
MEET
Special boy inspires Fritz Stark loves superheroes. He’s also a bit generous donors to fund of a superhero himself. Fritz was diagnosed with B-Cell Acute Lymphoblastic Leukemia when he was new resource specialist just 2 years old. But procedures and hospital position for families stays couldn’t keep this high-energy kid down, facing pediatric cancer and friends and neighbors started calling him “Super Fritz” for his can-do attitude. This super- star is now cancer-free and will soon celebrate his eighth birthday.
16 SYNTHESIS Anjali Pawar, a pediatric hematology “Many people give money for research for a cure. oncologist at the UC Davis Compre- What is left out are funds for a non-medical hensive Cancer Center, fondly remem- bers Fritz Stark’s first year of treatment. facilitator to guide and assist families at the One memory in particular stands out. time their child is diagnosed with cancer.” “The peach trees were flowering outside the cancer center and Fritz – RUTH FLOWERS was waiting outdoors for his infusion therapy and was excitedly doing flips on the grass. The children go with was diagnosed, we were in constant with our social workers, in addressing ‘what is’ and not ‘what if.’ That’s the contact with the Starks and heard the many requirements and needs that kind of joy they bring to us providers,” about the challenges navigating their these families face, and allow the team said Pawar. new family routines and employment to have more time to focus on the Despite his carefree attitude, Fritz’s responsibilities, seeking responses to psychosocial needs of our patients,” parents, Anna and Ben Stark, said their non-medical questions of concern and, said Marcio Malogolowkin, a board- son’s three-year fight with cancer most importantly, handling the insur- certified pediatric hematologist- wasn’t easy, even with big brother ance hurdles.” oncologist and chief of the Division Payne, two years older, stepping in to Both grateful for the care they of Pediatric Hematology-Oncology. help. Now, Fritz is a big brother himself. received at the UC Davis Comprehen- The Starks and the Flowers are His baby brother Duke arrived just as sive Cancer Center, the Flowers and thrilled that the position is becoming Fritz’s cancer was going into remission. the Starks decided to start the Super a reality. The three Stark boys are keeping Fritz & Friends Fund to create a new “Fritz undoubtedly received the best their family busy these days, but Anna resource specialist position at the medical care from a comprehensive and Ben know how difficult the cancer cancer center. team of doctors, nurses and child life journey with a child can be and now “This resource specialist will partner specialists,” shared Anna Stark. “The they want to give back.
Meet the Flowers Ruth and Paul Flowers are big fans of Fritz. Long-time family friends of the Starks, they’ve also spent time at the cancer center. Paul Flowers credits Jeanna Welborn, director of the Cytogenetics and Bone Marrow Labs and an expert in blood cancers, with excellent care after he experi- enced symptoms that luckily turned out to be a false alarm. “We were extremely impressed with the way we were treated — as patients and family at UC Davis,” shared Ruth Flowers. They are ready to give back, too. “For anyone getting a cancer diag- nosis, it is beyond scary, especially when it is a family whose child is diagnosed with cancer,” said Flowers. “After Fritz
WINTER 2021 17 BENEFACTORS
front desk team and the medical techs “Many people give money for RESOURCE SPECIALIST POSITION were joyful people to be around. We research for a cure. What is left out are Directing key support to help children and loved the pediatric infusion center, also funds for a non-medical facilitator to their families: known as the ‘juice caboose,’ and can’t guide and assist families at the time their Identify financial assistance, including gas wait to watch this new family resource child is diagnosed with cancer,” said cards and transportation programs to cover economic needs, especially for position be realized and flourish, too.” Flowers. “There needs to be a profes- underserved members of the community. Pediatric cancer is hard on families, sional specialist to help the family navi- Navigate health insurance challenges. and the journey is complicated by pres- gate through their emotional, practical, sures unrelated to actual medical care. and financial struggles.” Recommend mental health resources for patients and family members to help The resource specialist position will balance the needs of the entire family and strengthen and enhance the support reduce stress. that the UC Davis Comprehensive Provide checklists and personal guidance Cancer Center provides to loved ones once home from the hospital to include house cleaning resources, childcare and families. options and other practical needs. “Watching us go through the experi- Work with schools to address educational ence, Ruth and Paul recognized the loss, provide tutoring resources and non-medical struggles that Ben and I, as ensure that siblings are also not impacted. parents, were up against following Fritz’s Navigate social services to support fami- diagnosis. It was the most challenging lies managing a child’s cancer care. time of our lives,” said Anna. “Yet, the Advise working parents going through Flowers knew what was missing. They employment challenges and assist in arranging family leave. got to the heart of it.” It is through this realization and the Initiate scholarships for childhood cancer survivors. shared experience of fighting cancer that the Super Fritz & Friends Fund was born. The goal is to raise $250,000 initially to fund the resource specialist position for the first two years.
Other childhood cancer families support the idea Michelle and Jason Hurst agree the resource specialist position is needed. Their daughter, Taylor, was only 5 when she was diagnosed with high-risk T-cell acute lymphocytic leukemia, an aggressive and unique form of Leukemia. Taylor and Fritz met while receiving treatment at the UC Davis cancer center. Taylor is now 10, is in remission, and has been out of treat- ment for over two years. “To have the community step up and SUPER FRITZ SPENDS TIME WITH HUGGIE, fund this position is amazing. To have this community support is priceless,” THE UC DAVIS FACILITY DOG WHO SUPPORTS expressed Taylor’s mom, Michelle Hurst. KIDS WITH CANCER. “When we hurt, we all hurt. When we win, we all win.”
18 SYNTHESIS The UC Davis cancer center is grateful for the generosity of Paul and Ruth Flowers and others who have already donated to the Super Fritz & Friends Fund. If you would like to donate, please make checks payable to UC Davis Foundation, Super Fritz & Friends Fund, and send to 4900 Broadway, Suite 1150, Sacramento, CA 95820, or go online to give.ucdavis.edu/CCAD/324631.
We are curing kids of cancer
The UC Davis Comprehensive Cancer Center is the only center in the region with a pediatric oncology program.
“We’re working to bring leading-edge therapies to our young patients, making sure that the national trials through the Children’s Oncology Group, as well as other trials, are open to our patients,” said Marcio Malogolowkin, a board-certified pediatric hematologist-oncologist and chief of the Division of Pediatric Hematology-Oncology.
According to the ACS, about 11,000 children in the United States under the age of 15 were diagnosed with cancer in OTHER RESOURCES 2020. Childhood cancer rates have been gradually rising for FOR ADOLESCENTS AND the past few decades. Because of major treatment advances YOUNG ADULT PATIENTS in recent decades, 84% of children with cancer now survive WITH CANCER five years or more. The UC Davis Comprehensive Cancer Center is one of only a few Pediatric cancer represents less than 1% of all cancer in the hospitals to offer a robust program U.S., and only 4% of the billions of dollars the U.S. government for adolescent and young adult spends annually on cancer research is directed toward treating cancer patients, ages 15 to 39. childhood cancer. The challenge is that frequently, pediatric The Adolescent and Young Adult cancer programs compete for the same funding sources. Oncology Program was developed to “Working with other investigators, we are developing novel acknowledge and meet head-on the therapies to address the challenges of pediatric cancer,” shared unique needs of patients in this group. Malogolowkin. “For example, Dr. Reuben Antony, a neuro- The mission is to provide high- oncologist, is partnering with our pediatric genomic medicine quality, evidence-based, coordinated colleagues in studying therapies to treat plexiform neurofi- care that promotes the physical, bromas, a problem seen in more than a third of patients with psychological and emotional health neurofibromatosis, which causes significant disfigurement and of adolescents and young adults morbidity for these pediatric patients.” with cancer during and after therapy. The program empowers patients by The pediatric oncology program at UC Davis is unique in that sharing the resources and knowledge it is embedded in the cancer center. Oncologists work with needed to live an independent and inpatient care teams at the UC Davis Children’s Hospital to fulfilling life. care for our children with cancer. Everything is designed with the specific needs of the pediatric patient in mind.
“When you save a child, you’re saving 50–60 years of a productive life,” said Malogolowkin.
WINTER 2021 19 COVER STORY
Cancer care in the era of COVID-19
Clinicians at the UC Davis Comprehensive Cancer Center and other facilities within UC Davis Health are on a mission to get patients the care they need in spite of COVID-19. It is critical that patients keep on schedule with annual check-ups and cancer screenings such as mammograms, Pap smears and colonoscopies. Appointments with their health care providers should not be delayed if there are concerns about such tests or a change in the patient’s health. And, if any treatment is required, it is imperative for treatment to begin without delay. The cancer center is fully staffed, just as it was pre-pandemic, and precautions are being taken to ensure patient safety.
20 SYNTHESIS Colorectal cancer survivor Teri Rivera cautions against delaying cancer screenings. Learn more about her personal journey on page 6.
WINTER 2021 21 COVER STORY
“We’re working to prevent post-pandemic threatening consequences,” said Bold. them from seeking care, such as living deaths that could have been avoided — Fear isn’t the only concern that in remote areas without transportation. people with cancer, heart disease or keeps some patients from getting UC Davis Health was already on track other serious conditions who were afraid the care they need. Because of the to solve that problem through telemedi- to come in for treatment due to COVID- economic downturn associated with cine, or virtual doctor visits, and the 19,” said Richard Bold, physician-in-chief COVID-19, many people have lost their coronavirus crisis has accelerated tech- of the UC Davis Comprehensive Cancer jobs and, as a result, their employer- nology advancements. Center. “Cancer doesn’t wait, and we’re sponsored health insurance. They may “Some of the lessons we’re learning worried that people with otherwise treat- be faced with high premiums or out-of- from COVID are changing how we able disease will delay care as the pocket costs. UC Davis Health wants deliver health care now and into the pandemic persists.” to make sure that financial challenges future,” said Bold. “Telemedicine is a UC Davis Health restricts the num- don’t prevent people from getting the really good example.” ber of visitors, screens patients and care they need. While some procedures still need to employees for infection daily, mandates “We have developed programs to be performed in person, telemedicine masks, maintains social distancing, help people access affordable insurance offers patients a way to connect with and provides ample sanitizer and hand if they are uninsured or assist them with their physicians, review X-rays or lab washing facilities, and most staff have changing insurance to get more appro- results, discuss treatment options or been vaccinated. Going to a UC Davis priate coverage,” said Bold. “We don’t conduct follow-up visits from the comfort medical facility for care is probably want cost to be a barrier to getting care.” of home. As many as 20% of cancer safer than a trip to the grocery store. center visits are now conducted via tele- “Outside your home, it’s one of the Embracing telemedicine medicine, which can be convenient for safest places you can be, and delaying Even before COVID-19, patients some- parents caring for children at home or medically necessary care can have life- times faced difficulty that prevented people who cannot take time off work.
– DR. RICHARD BOLD PHYSICIAN-IN-CHIEF, UC DAVIS COMPREHENSIVE CANCER CENTER
22 SYNTHESIS Not deterred by COVID-19 When Grace Parker’s breast cancer returned, and she needed surgery, she refused to be deterred by COVID-19.
“It was my fourth cancer recurrence,” said Parker. “I knew I couldn’t wait because cancer doesn’t take a break during a pandemic. I said, ‘Heck, yeah!’ when my doctor scheduled me for surgery in April.”
Parker was reassured by the COVID-19 safety precautions in place, and was relieved when she learned that her tumor was removed successfully. Subsequent scans showed that the cancer had not spread, and she continues to come in for follow-up care.
Marlene Blake has a similar story. With several masses discovered in Reaching vulnerable populations both breasts, she could not wait and her surgery was scheduled for March, during COVID-19 just as the first wave of the pandemic was underway.
What impact is COVID-19 having on cancer prevention, control and survival? “Whether there’s coronavirus or not, I wanted to fight cancer with the best The UC Davis Comprehensive Cancer Center is collaborating with 17 other possible approach,” Blake said. “Was cancer centers to study the situation, thanks to funding from the National I fearful of having surgery during a Cancer Institute. pandemic? Of course, but there was The UC Davis cancer center’s grant is focused on diverse communities. no reason to panic. It was a reasonable decision to move forward.” “We are the only center being funded to study six sets of vulnerable popula- tions, a total of 1,000 people: African Americans, Chinese, Hmong, Latinos, Like Parker, Marlene Blake was reassured by the precautions she witnessed. The Native Americans, Vietnamese and rural residents to determine the impact staff members, who answered all of her COVID-19 is having on cancer-related behaviors,” said co-director of the study, questions and explained everything they Moon S. Chen, Jr., associate director for Community Outreach and Engagement. were doing to keep her safe, particularly The study is the first of its kind and will allow the outreach and engagement impressed her. Her successful surgery and follow-up care mean she can move team and clinicians to better tailor how they communicate and partner with on with her life without worrying about these vulnerable populations to enhance trust and better serve them. cancer. The research team’s premise is that one size does not fit all. In some instances, the researchers are making contact by phone or virtual conversations. For others, online surveys and even in-person contact is helpful. For instance, Native Americans living in rural communities often come to community health centers Marlene Blake and Richard Bold to pick up their medications, providing an opportunity for direct outreach. To improve outreach and engagement of African Americans, the study team is conducting focus groups to better understand how to enhance video visits for cancer care. “We recognize that, in terms of our approach to each of these vulnerable groups, what may work in one population may not work in others,” said Associate Professor David Cooke, who heads General Thoracic Surgery and is co-directing the study. “We’re attempting to meet people where they live. If they’re comfort- able with telemedicine, we will use telemedicine. If they prefer in-person contact, we will do that.”
WINTER 2021 23 FIRST STEPS
We have a lot to learn from dogs fighting cancer
When it comes to dog years, cancer can Curing cancer in people and Kent, who specializes in veterinary have a big impact. Dogs 10 years and older pets will take collaboration oncology and directs the UC Davis Center have a 50% chance of dying from cancer, When the family dog gets cancer, it can for Companion Animal Health, says and human oncologists are studying feel as devastating as when any loved cancer found in dogs is very similar the disease in canines in the hopes of one is battling the disease. Giving these to cancer found in humans. benefiting both animals and humans. companion animals the benefit of “Dogs have coevolved with humans,” Thanks to its unique partnership with leading-edge research and therapeutics— said Kent. “That means they have been the country’s top-ranked UC Davis School including clinical trials — not only helps exposed to the same environment as of Veterinary Medicine, the UC Davis pets live longer, but also supports the humans, including some of the same Comprehensive Cancer Center is one of development of new therapies for both carcinogens.” the few institutions to study what the dogs and humans. National Cancer Institute (NCI) calls UC Davis program directors Xinbin comparative oncology. Chen, Michael Kent and Robert Canter Now, UC Davis has received the first sought the training program grant and say NCI grant in the country to fund a tackling complex cancers across animal comparative oncology training program, and human species presents a rare oppor- which was launched on August 1, 2020. tunity for both veterinarians and physi- The Ruth L. Kirschstein Institutional cians to play a crucial role in basic and National Research Service Award T32 translational research. The goal is to training grant supports institutions devel- recruit and retain these clinician-scien- oping or enhancing research career devel- tists to help address a national need for opment opportunities for pre- and post- more comparative oncology researchers. With intact immune systems similar doctoral research fellows. In this first-of- to those of people, dogs can benefit from its-kind federal grant, more than $2 million Recruiting diverse training many of the same cancer treatment has been awarded to UC Davis for a five- candidates is a major focus breakthroughs as humans, including year program to train the next generation The program will leverage diversity immunotherapies that work by helping of comparative oncology researchers. and inclusion recruitment programs the immune system recognize and attack cancer cells. UC Davis receives first-ever federal “Treating canines with cancer as comparative oncology training grant well as humans facing the devastating disease allows us to take a more holistic at UC Davis as it seeks to draw approach as we compare immunological candidates from underrepresented responses and the success of various student populations. therapies. And, dogs deserve to benefit “Oncologists who treat humans and from cancer trials at UC Davis, too,” oncologists who treat companion animals said Canter, who is a surgical oncologist have a lot to learn from each other, at the UC Davis Comprehensive Cancer especially when they come from diverse Center. backgrounds,” said Chen, who teaches Canter said comparative oncology at both the veterinary school and the represents the best of both medical medical school. “We desperately need worlds and is crucial to advancing more research in this area because we the understanding of tumor biology, think we can solve some of the toughest speeding development of therapies, and hurdles facing cancer researchers if giving hope to patients — whether they we join forces.” are people or pets.
24 SYNTHESIS Hunting for a reprieve from cancer
As a bird dog, Josie is one of the best. The 9-year-old chocolate lab goes everywhere with her owner and is a popular guest at the Cordelia Duck Club, tucked away in the Suisun Marsh. She is very social, extremely good at her sport and would really be missed if she weren’t around. In June, her devoted owner noticed she was bleeding slightly around her chin. An exam revealed a small growth on the roof of her mouth. Like oral melanoma in humans, Josie’s cancer was aggressive by the time it was discovered. Josie was given only two to four months to live. Fortunately for Josie, UC Davis human oncologist Robert Canter and veterinary oncologist Michael Kent had just launched a clinical immunotherapy trial to keep cancers in canines from metastasizing or spreading. Josie entered the clinical trial and was infused with NK, or natural killer cells, that came from a healthy dog. The NK cells attack tumor cells and prevent them from creating new tumors. It is too early to tell if the immunotherapy will work for Josie but, six months later, she is back duck hunting. Josie is doing what she loves, and her family knows they’ve done all they can for a dog who puts a smile on everyone’s faces — especially during visits to the duck club.
WINTER 2021 25 NONPROFIT ORG US POSTAGE PAID Davis, CA 2279 45th Street Permit No. 3 Sacramento, CA 95817-2230
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We have better cancer treatments Synthesis — the art of bringing distinct elements together to today because people like you participated form a cohesive whole — is the name of our magazine and our in a clinical trial. strategy as the Central Valley’s only National Cancer Institute-
designated comprehensive cancer center. Leveraging UC Davis We have better cancer treatments strengths in innovative cancer models and technologies, precision
today because people therapeutics, transformative imaging and mitigation of cancer like you participated in a clinical trial. risks and disparities, we aim to reduce the cancer burden in
our region and beyond. Uniting physicians, scientists and public If you’re interested in exploring ASKnew YOURtreatment DOCTOR options, IF A a CLINICALclinical health experts, we are committed to making cancer discoveries trial mayTRIAL be IS right RIGHT for FORyou. YOUAsk your doctor today about clinical trials. and delivering them quickly to patients so they have the best
possible outcomes. Breaking Barriers to Beat Cancer
Synthesis — linking the best in cancer science to improve
patients’ lives — is our promise. Comprehensive 26 SYNTHESISCancer Center A Cancer Center Designated by the National Cancer Institute
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