Emory cancer center earns national honor

Atlanta Business Chronicle - by Urvaksh Karkaria Staff Writer

Gov. Sonny Perdue told a standing-room only crowd at Emory Winship Cancer Institute Monday the center's freshly minted designation as a national cancer center is like the "Good Housekeeping seal of approval."

Emory Winship Cancer Institute's freshly minted designation as a national cancer center is like the "Good Housekeeping seal of approval," Gov. Sonny Perdue told a standing-room only crowd Monday.

"This is not a declaration or a distinction that's given lightly," Perdue said. "This marks an important milestone in our fight against cancer. This designation now means that Emory joins the ranks of the most elite cancer centers in the country."

Winship Cancer Institute received the coveted national cancer center designation after two decades of trying, Atlanta Business Chronicle first reported April 10.

Winship is the first in Georgia to get the gold-plated certification, which will open the spigot to millions of dollars in research funding and lure high-profile clinical trials and talent to the state.

Georgia has lagged behind many other Southeastern states by not having a designated cancer center. With the announcement, Emory joins an elite group of about 25 NCI national cancer centers nationwide. Several Southern states, including Alabama, Florida and South Carolina, have NCI cancer centers.

"Georgia's greatest infrastructure defect is now corrected," Bill Todd, CEO of the Georgia Cancer Coalition, said referring to designation.

With the national cancer center title under its belt, Emory plans to apply for NCI’s Comprehensive Cancer Center status in two years, a source said.

The national cancer center designation designation will bring $4.2 million in grant funding to Winship for the next three years. Perdue said.

The additional money will add to NIH cancer funding at Emory. which has more than tripled over the past six years, Emory University President James Wagner noted.

Emory would also be eligible for a larger pool of funding from federal and private sources, such as the American Cancer Society, Susan G. Komen for the Cure and the Department of Defense.

The cancer center designation will make Winship a talent magnet, too — attracting top researchers and oncologists.

Winship unsuccessfully applied for the designation in the mid-1990s.

It failed because the NCI did not feel the cancer center had enough basic science research capability at the time. Winship has since invested in expanding the research program, both in scope and manpower.

The NCI questioned Emory’s commitment for a cancer center because it did not have a stand-alone cancer facility. The agency noted Emory’s leadership, at the time, did not fully support the need for a NCI Cancer Center designation.

Since then, Emory has invested millions of dollars in the Winship Institute.

Tarceva

Here is the link to some information about the drug Tarceva that Pops will start taking soon.

Rowed to Recovery

For Carol Rowe's birthday this year, Mom (Nano) decided to give Carol the gift of participating in the Atlanta 3 Day 60 Mile walk benefiting Susan G. Komen For The Cure. At first, it was just Mom and Dad (aka Pops and Nano) who were dedicated to undertaking such a challenge to raise money and train to go the distance. But as the word spread, people couldn't turn down the opportunity to celebrate Carol's life in hopes of helping find a cure for breast cancer... and all cancer for that matter. So, today there are 16 walkers on the "Rowed to Recovery" team. A name that Carol came up with herself. There has been an overwhelming response to this walk and the fight against Breast Cancer and support for Carol Rowe. The walk is in Atlanta on October 24-26, 2008. If you want more information about the walk, to join the "Rowed to Recovery" Team or to donate please use the link below.

3 Day benefiting Susan G. Komen For the Cure

Oral Cancer Foundation

Just spent some time at the Oral Cancer Foundation website. It seems that there is just so much more to learn about what Pops is going through. It seems that Pops has a form of oral cancer that is pretty rare. They have a message board that is really active and full of support and hope. Check it out!

Stage IVa

It looks like Pop's has an updated diagnosis of his cancer to a Stage IVa. Here is some information from the OncologyChannel regarding Staging of Head and Neck Cancer.

"Staging is the process of describing the extent to which cancer has spread from the site of its origin. It is used to assess a patient's prognosis and to determine the choice of therapy. The stage of a cancer is determined by the size and location in the body of the primary tumor, and whether it has spread to other areas of the body."

"Staging involves using the letters T, N and M to assess tumors by:"

"-the size of the primary tumor (T);
-the degree to which regional lymph nodes (N) are involved. Lymph nodes are small organs located along the channels of the body's lymphatic system which store special cells that fight infection and other diseases); and
-the absence or presence of distant metastases (M) - cancer that has spread from the original (primary) tumor to distant organs or distant lymph nodes."

"Each of these is categories is further classified with a number 1 through 4 to give the total stage. Thus a T1-N1-M0 cancer would describe a T1 tumor, N1 lymph node involvement, and no metastases."

"Once the T, N and M are determined, a "stage" of I, II, III or IV is assigned:"

"-Stage I cancers are small, localized and usually curable.
-Stage II and III cancers typically are locally advanced and/or have spread to local lymph nodes.
-Stage IV cancers usually are metastatic (have spread to distant parts of the body) and generally are considered inoperable."

"The staging system for head and neck cancers is a bit complicated. Though the nodal and metastasis staging systems are the same for all the different anatomical regions of the head and neck, the tumor staging systems are different. The nodal and metastasis staging systems are outlined below. Each region's tumor staging system is presented separately on one of the linked pages."

A Mango a Day...

Check out this article Andres found about how eating certain fruits like mangoes, grapes and strawberries can help stop the spread of cancer cells in the head and neck... According to Yahoo!News:

"Lupeol, a compound in fruits like mangoes, grapes and strawberries, appears to be effective in killing and curbing the spread of cancer cells in the head and neck, a study in Hong Kong has found."

"An experiment with mice showed lupeol worked most effectively with chemotherapy drugs and had almost no side effects, scientists at the University of Hong Kong said in a report published in the September issue of the journal Cancer Research."

"'It can suppress the movement of cancer cells and suppress their growth and it is found to be even more effective than conventional drugs (eg. cisplatin),' said Anthony Yuen, a professor at the University of Hong Kong's surgery department."

Layman's Terms

Susan just sent me the link to the American Cancer Society's webpage. There they do a great job of explaining things in layman's terms so I can understand them.

Here is what the ACS says about the surgery...

"In most cases, the cancer and some of the surrounding salivary gland or soft tissue will be surgically removed. If the cancer is high grade (more likely to grow and spread quickly) or if it has already spread to lymph nodes, the head and neck surgeon will usually remove lymph nodes from the same side of the neck in an operation called a neck dissection. Before surgery, ask your surgeon exactly what will be done during the operation, whether there are other options, and what side effects you can expect. Make sure that your surgeon has experience in the technique.
Salivary gland surgery: Since salivary gland tumors occur in the parotid gland about 80% of the time, we will first describe surgery of the parotid gland. Surgery is complicated by the fact that the facial nerve, which controls movement on the same side of the face, passes through the gland."

"Most parotid gland cancers start in the outside part of the gland, called the superficial lobe. These can be treated by removing only the superficial lobe. This usually spares the facial nerve and does not interfere with facial movement."

"If your cancer has spread into deeper tissues, the surgeon will remove the entire gland and might also remove your facial nerve. If your surgeon has mentioned this surgery as a possibility, ask about operations to repair the nerve and ways to treat side effects caused by removing the nerve. If the cancer has invaded other tissues near your parotid gland, these tissues might also need to be removed."

I also had some questions about what causes parotid gland cancer and the ACS says they still don't know a lot about what causes it...

"We know very little about the actual causes of most salivary gland cancers. Researchers have found that some salivary gland cancers have DNA abnormalities in certain genes. Abnormalities of some genes may change the way a cell grows or multiplies, or how the cell is recognized by the immune system. Exposure to radiation or certain carcinogens (cancer-causing chemicals) may result in these DNA changes but in most cases their cause is not known."

3 days to go

Well, 3 days and counting until the surgery. I spoke to dad today and he seems optimistic, as usual. I am glad he has such a positive attitude about his surgery. I think his attitude can only help the outcome of his surgery and rubs off on all of us. He is always so positive!

Today, dad told me that they are going to perform a surgery called a "neck dissection". I found a couple good sites that explained what is going to happen. Here is one of them.

HealthAtoZ.com reported, "Cancers of the head and neck (sometimes inaccurately called throat cancer) often spread to nearby tissues and into the lymph nodes. Removing these structures is one way of controlling the cancer."

"Of the 600 hundred lymph nodes in the body, about 200 are in the neck. Only a small number of these are removed during a neck dissection. In addition, other structures such as muscles, veins, and nerves may be removed during a radical neck dissection. These include the sternocleidomastoid muscle (one of the muscles that functions to flex the head), internal jugular (neck) vein, submandibular gland (one of the salivary glands), and the spinal accessory nerve (a nerve that helps control speech, swallowing and certain movements of the head and neck). The goal is always to remove all the cancer but to save as many components surrounding the nodes as possible."

"Radical neck dissections are done in a hospital under general anesthesia by a head and neck surgeon. An incision is made in the neck, and the skin is pulled back to reveal the muscles and lymph nodes. The surgeon is guided in what to remove by tests done prior to surgery and by examination of the size and texture of the lymph nodes."

Living Will

I spoke to mom today about a living will. We had an intellictual conversation about it because it would be silly to go into surgery without it. Actually, it is stupid for any one of us to drive down the road without having one. I sent her a link to a place that does them quick and apparently accurately . They have a 2 day turn around, so just in time for surgery.

Legalzoom.com says, "A Living Will is a document which lets you decide whether or not to be kept on artificial life support. Often, these documents also appoint someone to make important health care decisions on your behalf in case you are unable to do so. LegalZoom can help you quickly and easily take control of your health care decisions by preparing a customized living will online."

"As competent adults, we have the right to make decisions in advance as to whether or not we would like to decline life support when it is clear that death is imminent or a state of coma becomes permanent. Today, life support systems can keep an individual's body alive for years, even if the brain is no longer functioning or the person is in constant pain."

Pre-op appointment

Today dad went in for his pre-op appointment. I was waiting anxiously for his call all morning. He called at about 2pm with some updated news regarding the stage of his cancer of the Parotid Gland. He said they graded it at least a stage 2, possible stage 3. They will know more when they go in for surgery on Friday.

Stage 0—precancer
Stage 1 —small cancer found only in the organ where it started
Stage 2 —larger cancer that may or may not have spread to the lymph nodes
Stage 3 —larger cancer that is also in the lymph nodes
Stage 4 —cancer in a different organ from where it started

I was in shock that it had spread into his lymph nodes. I guess I just thought that they would go in and take out the tumor and the cancer would be gone. I guess this is more serious than I let myself believe. I guess denial can have its place. On the phone with dad, I acted strong like things would be just fine, but I had a pit in my stomach. Dad sounded almost relieved. Not sure why, but he mentioned that he felt better knowing that his doctors were the best in the country and that he would be in good hands at Emory. I feel good about his doctor and hospital also, but that didn't take away from the dreadful fact that this cancerous tumor was spreading into his lymph nodes.

I did some more reading online about this surgery and came across some information that scared me. I talked to Susan today who's father is struggling with multiple myeloma. She always makes me feel better. She has been through so much with her dad. I am so blessed to have her to talk to.

Well, Zach and I are flying up to Atlanta on Wednesday to be there for the surgery. I know having Zach there will be good for dad and mom. He is such a good boy. I know that he will be a great distraction during this time.

Parotid Gland Tumor

So, dad did not have a stroke or bell's palsy. He has a tumor on his parotid gland. Here is what the Mayo clinic says about it... "Located in front of the ears, the parotid glands are one of the body's major salivary glands. They extend to the area beneath the earlobe along the lower border of the jawbone. Of all the salivary glands, about 80 percent of all tumors are most often found in the parotid gland. Only about 20 percent of parotid gland tumors are malignant."

Dad is scheduled for a biopsy on September 12, 2007. They should know more information about how to treat the tumor after this biopsy. I like the odds that only about 20 percent of the parotid gland tumors are malignant.