molecular tumor board

Watch: Our new TV spot highlights precision cancer care at Markey

Our new TV spot tells the exciting story of how the UK Markey Cancer Center is using precision medicine to target cancer treatment to patients’ unique cancer cells. Watch the video below and learn more about how we’re harnessing the power of advanced medicine to find the best treatment for each patient.

Treating cancer at the molecular level

The future of cancer treatment is fighting the disease at the level of an individual gene, breaking down a diagnosis by analyzing each patient’s unique genetic characteristics. At Markey, our Molecular Tumor Board is leading this fight, bringing personalized, precision medicine to patients across Kentucky.

The Molecular Tumor Board, which is made up of more than a dozen leading clinicians and scientists, meets monthly to review individual cancer cases from across the Commonwealth, diving deep into patients’ genetic information, then collectively tailoring a precision treatment specifically for them.

Tailoring a precision treatment

Dr. Jill Kolesar

Dr. Jill Kolesar

“It’s well accepted that cancer is chiefly a genetic disorder,” says Dr. Jill Kolesar, a founding member and co-director of Markey’s Molecular Tumor Board. “The first genome that was sequenced took 13 years and $2.7 billion dollars. Now we can sequence a genome in an afternoon.”

Such significant advances in technology have helped spur precision medicine, but have also created large quantities of genetic information, Kolesar said. It’s up to the Molecular Tumor Board to interpret that vast amount of data and apply it to an individual’s cancer diagnosis and treatment.

Dr. Susanne Arnold

Dr. Susanne Arnold

Medical oncologist Dr. Susanne Arnold, Markey’s associate director for clinical translation and member of the Molecular Tumor Board, is helping lead this individualized approach to cancer treatment. A precision approach to diagnosis and analysis is the future of care, she said.

“You take a biopsy and do the genomic analysis, called next-generation sequencing, which helps us understand exactly what happened with that cell that resulted in cancer,” she explained.

But what might sound like a routine test in modern medicine is much more remarkable in these particular cases.

“Molecular medicine is actually discovering the information about a unique cancer in a specific person at a precise point in time,” she said. “Pinpointing this allows us to understand why it happened, why our treatment did or didn’t work, and how we can potentially stop (the cancer).”

In short, these tests allow for a remarkably detailed understanding of what goes wrong in cancerous cells. And that sort of comprehensive knowledge helps the tumor board choose the best treatment from among the many options available at Markey.

How the molecular tumor board works

Markey’s Molecular Tumor Board is not the first of its kind, but it is the first in Kentucky. And that’s significant, given the unprecedented rates of cancer across the state, most notably in the rural, eastern parts of Kentucky.

With the board meeting twice monthly, oncologists across the state can reach out for a recommendation for therapy based on their patient’s molecular signature.

There are more than a dozen scientific specialties represented on the board, and more than 300 years of experience in total. All of this is applied to a single patient as cases are presented to the board, and the inclusion of each patient’s own physician in the process ensures an intimate understanding of that patient’s condition and outlook.

Each patient’s cancer will be tested for all genetic mutations that are known to cause cancer, regardless of what type of tumor the patient has. The tumor board then uses the results of that test to choose possible treatment options that target the genetic mutations. Each mutation is evaluated for FDA-approved therapies for the patient’s tumor type, FDA-approved off-label therapies and any clinical trials available related to the patient’s specific mutations.

Taking into consideration the available treatment options, the Molecular Tumor Board will make a recommendation based on the best possible outcome for the patient.

For a single patient, for all of Kentucky

As more tumor boards are established across the country and more cases are reviewed, a bank of information will be available to doctors to help them determine the best course of action for patients with similar cases.

“Everything we discover is designed to help you, and by sharing this information in an anonymous way, it can help people across the country suffering with cancer. We’re all being connected through this process, and that’s a beautiful, beautiful story to tell,” Arnold said. “Imagine you are ‘Anne’ from Pikeville, Kentucky, but behind you is your doctor, the Markey Cancer Center, other NCI-designated cancer centers, the National Cancer Institute … and ‘John’ in New York City, who has the same mutation as you. The six degrees of separation suddenly disappear, and ideally you each benefit from the experience of the other.”

Dr. Mark Evers

Dr. Mark Evers

That is the crux of Markey’s ambitions: an individualized approach to each patient, but on a large scale. In an open letter released at the end of 2016, Dr. Mark Evers, director of Markey, made public a goal of the organization: to significantly reduce cancer incidence and mortality across the state, and the region, by the year 2020. It’s a lofty aspiration, but initiatives like the Molecular Tumor Board position Markey for success.

As Kolesar said, “When researchers and clinicians at the Markey Cancer Center decide something is going to benefit patients, like the Molecular Tumor Board, they say, ‘Let’s do it.’”

This team spirit spans the entire organization. Kolesar noted the collegiality and support for accomplishing goals at UK HealthCare.

“Dr. Evers, says, ‘You just tell me what you need, and we’ll make it happen, because that’s what we think the patients of Kentucky need,’” she said.

Such sweeping change, especially when it comes to issues as complicated and extensive as healthcare, rarely happens quickly. But a series of small successes, over time, can have an enormous ripple effect. The experts who make up the Molecular Tumor Board understand this, and it’s their reason for participating in and offering their time to such programs.

“By understanding the genetic makeup of our patients and their tumors, we can then help to direct their therapy,” Evers said.

The future of advanced medicine

Treatment options at UK HealthCare are more abundant than ever before. The Early Therapeutics Clinical Trials Center focuses on increasing patient access to phase I and phase II clinical trials will also have a major impact for Markey patients.

“[Previously,] if patients in Kentucky needed an earlier-phase clinical trial, they would have to go out of state,” said Kolesar, explaining the advantage of the initiative.

These early-phase studies can offer patients new treatment avenues for cancers that have proved difficult to target using standard therapies. Essentially, it allows Markey to participate in the development of new and novel treatments while offering patients first access.

Being at the forefront of medicine means incredible discovery, but for every breakthrough, there are new unknowns. This uncharted territory is a product of advancement and a reason for optimism.

“Do we have a therapy for every gene that’s broken? No. But we do have therapies for genes that are broken in non-small cell lung cancer, melanoma, breast cancer, colon cancer and a growing list every day. They are defined by their gene signature and by the gene that’s broken. That’s called targeted therapy,” Arnold said.

The hope is that this sort of targeting can be applied to all types of cancer, and Markey’s patients could be among the first to benefit.

“The Power of Advanced Medicine” is more than a slogan. It’s a guiding principle and a reminder that UK HealthCare prioritizes discovery in the name of our patients.


Next steps:

  • Markey is Kentucky’s only NCI-designated cancer center, providing world-class cancer care right here in the Commonwealth. Learn more about why patients choose Markey for their cancer treatment. For a second opinion or appointment, call Markey at 859-257-4488 or 866-340-4488 (toll free).
  • Learn more about the power of advanced medicine at UK HealthCare.
Meet the Researcher Day

UK cancer researchers welcome middle, high school students

Middle and high school students from across the region came to UK and UK HealthCare last week for an up-close look at what it’s like to be a cancer researcher.

“Meet the Researcher Day,” hosted by the UK Markey Cancer Center and the Leukemia & Lymphoma Society (LLS), is a field trip reward given to schools in the region that successfully raise more than $1,000 for the LLS’s Pennies for Patients campaign.

This year, students from Shelby County West Middle School, Mercer County Senior High School, Henry County Middle School and New Albany High School in Indiana won the opportunity to visit the Biomedical/Biological Sciences Research Building on UK’s campus and learn more about how the money they raised for Pennies for Patients will help further cancer research.

After an introduction by UK researchers Tianyan Gao and Craig Vander Kooi, the students received a tour of different cancer research labs and learned how to use basic lab equipment. The event also featured remarks from Dr. John D’Orazio, a pediatric oncologist and cancer researcher as well as LLS Honored Hero Brad Wilson, a UK chemical engineering student and two-time leukemia survivor. The students also heard a panel discussion about careers in science featuring D’Orazio and UK students Michael Gosky and Payton Stevens.

“I think it’s important that students get to see the lab spaces, meet the researchers and understand what the Leukemia & Lymphoma Society and Markey Cancer Center mission is: The cure for cancer,” said Shelia Gustafson, campaign director for the Kentucky and Southern Indiana Chapter of LLS.

Pennies for Patients is the annual fundraiser for the Student Series of the LLS. It encourages students to collect spare change during a three-week period early in the year. Funds raised support leukemia, lymphoma and myeloma research; patient and community service; public health education; and professional education.

For this year’s campaign, 485 schools across the region participated, raising more than $400,000 – a new record. The schools participating in Pennies for Patients had to raise a minimum of $1,000 to win the chance to attend Meet the Researchers Day. The four schools at Meet the Researchers Day this year were chosen in a random drawing, raising more than $10,000 combined for LLS.

Check out the video below for highlights from this year’s Meet the Research Day.


Next steps:

  • Learn more about clinical trials at Markey, which give patients access to the most up-to-date cancer research and innovations.
  • Markey is Kentucky’s only NCI-designated cancer center, providing world-class cancer care right here in the Commonwealth. Learn more about why patients choose Markey for their cancer treatment.
UK Markey Cancer Center Affiliate Network

Markey extends cancer network to Somerset

Lake Cumberland Regional Hospital in Somerset has announced a new affiliation with the UK Markey Cancer Center, the state’s only National Cancer Institute-designated cancer center.

The UK Markey Cancer Center Affiliate Network was created to provide high-quality cancer care closer to home for patients across the region and to minimize the effects of cancer through prevention and education programs, exceptional clinical care, and access to research.

By becoming a Markey affiliate, Lake Cumberland Regional Hospital will now be able to offer its patients access to additional specialty and subspecialty physicians and care, including clinical trials and advanced technology, while allowing them to stay in South Central Kentucky for most treatments.

The Markey Cancer Center Affiliate Network supports UK HealthCare’s overall mission of ensuring no Kentuckian will have to leave the state to get access to top-of-the-line healthcare.

“UK HealthCare doesn’t just serve Lexington and Central Kentucky – our mission is to provide all Kentuckians with the best possible care right here in the state,” said Dr. Michael Karpf, UK executive vice president for health affairs. “The Markey Cancer Center Affiliate Network allows us to collaborate with community hospitals to provide top-notch cancer care much closer to home – saving both travel expenses and time for the patients, in addition to keeping them close to their personal support system.”

Established in 1976, Lake Cumberland Regional Hospital is a 295-bed acute care facility, providing healthcare services for an 11-county service area in South Central Kentucky. With more than 40 physician specialties and nearly 200 physicians on staff, Lake Cumberland offers the most comprehensive services in the region.

“As we work toward fulfilling our mission of ‘Making Communities Healthier,’ it is clear to me that the relationship between Lake Cumberland Regional Hospital and the Markey Cancer Center will go a long way in achieving that goal,” said Tim Bess, Lake Cumberland Regional Hospital chief executive officer. “Our community will benefit greatly from this relationship. We are honored to partner with the UK Markey Cancer Center.”

Markey is one of only 69 medical centers in the country to earn an NCI cancer center designation. Because of the designation, Markey patients have access to new drugs, treatment options and clinical trials offered only at NCI centers.

Moving forward, Markey is working toward the next tier of designation – an NCI-designated Comprehensive Cancer Center. Currently, 47 of the 69 NCI-designated cancer centers in the country hold a comprehensive cancer center status. The Markey Cancer Center Affiliate Network will play a significant role in bringing that next level of cancer funding to Kentucky.

“The burden of cancer in Kentucky is huge, and unfortunately we have some of the worst cancer rates in the country,” said Dr. Timothy Mullett, medical director of the UK Markey Cancer Center Affiliate Network. “By collaborating with our affiliate hospitals across the state, we have the potential to make a serious impact on cancer care here in the Commonwealth.”

The UK Markey Cancer Center Affiliate Network began in 2006 and currently has 17 member hospitals across the state of Kentucky. Learn more.


Next steps:

Siddhi Shroff, a registered dietitian at Markey, spoke with us about her job here and the things she enjoys doing in her free time.

Get to know Siddhi Shroff, foodie and registered dietitian at Markey

Siddhi Shroff, RD

For patients with cancer, maintaining proper diet and nutrition can make a world of difference. Siddhi Shroff, a registered dietitian at the UK Markey Cancer Center, spends her time helping patients understand their changing appetite and nutritional needs as they go through treatment. She’s also the author of our Markey Menu blog, which offers cancer-related nutritional tips, recipes, and health and wellness information.

We sat down with Siddhi to chat about her work at Markey, her interest in nutrition and what she enjoys outside of work.

How did you become interested in nutrition?

I have a nontraditional background, originally with a psychology degree, and took a break before coming back to grad school. I’ve always been a foodie and became very interested in nutrition and dietetics. I just got the point where I thought, “Why don’t I do something like this?”

I came here for grad school and learned about nutrition. That’s how I got exposure to the oncology setting during my dietetic internship rotations. It was a really different experience than I had been educated on, and it was interesting to see how individualized the cancer treatment process can be, specifically with nutrition. So I finished the rotation and then graduated, and I started here in May of last year!

What do you do as a registered dietitian at Markey?

On a daily basis, it’s hard to pin down a specific routine. In the clinics, we are here to provide nutritional counseling to patients as needed. We work as we get consulted. A doctor or nurse will see a patient in clinic, and they will flag anything of nutritional concern like poor appetite or unintentional weight loss. We come in to talk with the patient about whatever has been flagged and what the patient may be experiencing. We always let them know about general nutrition expectations and what they may experience due to side effects of treatments.

Aside from nutrition counseling, I participate in many other events and activities. Rachel Miller, RD, and I both host the Smoothie Day demonstrations, and I host the cooking demonstrations with local restaurants and chefs. Those are great for showing patients a different way to manage the changes in their nutrition. You can read a lot about the nutrition recommendations on the Markey Menu blog I write!

How do you spend time outside of work?

When I’m at home, I really enjoy reading and gardening. I have always been a foodie, so baking is another hobby. In general, I’m always working on my project of the day, whatever crafting I might be doing at the time. Of course, I watch my share of Netflix, too.

Have you read any good books or watched any good TV lately?

I’ve been reading lots of articles about how to be your best self – not only professionally, but outside of work in your daily life, too. It’s all around self-care.

My go-to shows are Friends, The Office, and Parks and Recreation. Those are the shows I can sit back to watch and unwind. I do like my HBO, too Game of Thrones especially.

Do you have any funny or unusual talents?

I do have this weird ability to always pick out a celebrity voice that’s narrating a commercial. So, let me think. John Krasinski from The Office is the Esurance guy. I’ve noticed Zach Braff has been in a few. Julia Roberts has done some Progressive commercials. Those are the ones that I can think of just off the top of my head!

If you could have dinner with any celebrity, who would it be and what would the meal be?

That is a hard question because I can think of plenty of strong women I’d love to meet right now, so it’s tough to pick just one. One person that does come to mind is Malala Yousafzai. She is a girl who was shot in the head by a Taliban gunman at the age of 15 and survived. Now, she is a pioneer for children’s rights and education throughout the world. She is even the youngest-ever Nobel Prize laureate. I really admire her work, but I’d also like to meet her just to talk to her about how to be strong in the face of adversity.

For the meal? I think I’d let her pick that. But I’d insist on picking something Italian like tiramisu for dessert.


Next steps:

NACCDO-PAMN

Markey hosts conference for nation’s elite cancer centers

Highlighting Lexington and the services and expertise of UK HealthCare, the UK Markey Cancer Center and the Markey Cancer Foundation served last week as hosts for the 2017 annual conference for the National Association of Cancer Center Development Officers (NACCDO) and the Public Affairs and Marketing (PAMN) Network of National Cancer Centers.

In total, 437 participants representing more than 75 cancer institutions attended this year’s conference, making it one of the highest-attended conferences since the joint event began in 1987.

The NACCDO-PAMN annual conference is an opportunity for public relations, marketing and development professionals who work for major cancer centers to network and learn more from their peers about the best practices for highlighting their center’s cancer research and clinical care.

Members of the UK HealthCare community who presented during the the three-day conference included Kentucky Neuroscience Institute’s Dr. Dan Han as well as Robert DiPaola, dean of the UK College of Medicine. Han hosted a session with Kentucky Chef Ouita Michel focused on neurogastronomy, the study of how the brain influences our perceptions of what we eat. Their interactive presentation explored the unique application of using neurogastronomy to help cancer patients whose taste and appetite have been affected by treatment. DiPaola was on-hand to lead a panel discussion of cancer center directors.

Conference participants also had the option of attending a “Markey patient experience tour” highlighting six of the cancer center’s integrative medicine offerings: a cooking demo, art therapy, music therapy, narrative medicine, jin shin jyutsu, hand massage/aromatherapy and a UK HealthCare Arts in HealthCare tour.

“We were honored to host our fellow cancer center colleagues here in Lexington for this year’s conference,” said Mike Delzotti, president of the Markey Cancer Foundation. “We enjoyed not only the opportunity to provide valuable education and information for other cancer communicators across the nation, but also the chance to show off some of the things that make Markey, and Kentucky, so special.”

Check out the video below for more highlights from the conference.


Next steps:

Kate Zaytseva, one of four project leaders on the COBRE grant for the Center for Cancer and Metabolism, and postdoc Naser Jafari are studying the importance of an enzyme called fatty acid synthase in controlling survival and spread of colorectal cancer.

UK wins $11.2 million NIH grant to study cancer-obesity link

UK has been awarded an $11.2 million grant from the National Institutes of Health to study the link between cancer and metabolic disorders, including obesity. The prestigious award will enable UK to launch the UK Center for Cancer and Metabolism (CCM).

The Centers of Biomedical Research Excellence (COBRE) grant to study the metabolism of cancer comes from the NIH’s National Institutes of General Medical Sciences and will fund the UK Center for Cancer and Metabolism over the next five years.

Kentucky has disproportionately high incidences of both cancer and metabolic disorders – our state leads the nation in cancer deaths and is in the top 10 for highest obesity rates in the country. While scientists have long known of a direct link between obesity and cancer, the need for further research into this field is a necessity for Kentuckians.

Senate Majority Leader Mitch McConnell of Kentucky, an advocate of the 21st Century Cures Act, contacted NIH Director Francis S. Collins on behalf of UK’s grant application.

“In an effort to improve healthcare access and outcomes for my constituents, UK has long made a priority of undertaking important research specific to Kentucky and the Appalachian region,” McConnell said.

“Over the years, UK and its Markey Cancer Center have developed one of the strongest cancer research, prevention and treatment programs in the country, as demonstrated by the center’s 2013 NIH National Cancer Institute designation, which I was proud to support. I was also pleased to assist UK in securing this competitive grant to advance and strengthen this critical health research for Kentucky by enabling advanced research focusing on the development of novel therapies for cancer treatment.”

Kentucky Representative Andy Barr echoed McConnell’s sentiments, noting that support and funding for innovative cancer research remains a priority.

“The awarding of this competitive grant is a recognition of the University of Kentucky as a national leader in biomedical research,” Barr said. “I have consistently supported the National Institutes of Health because these investments not only contribute to our local communities and institutions, they will improve and even save lives by advancing new treatments and cures. I am confident the healthcare services provided by the NCI-designated Markey Cancer Center and the research done by UK scientists funded by this grant will help us to find better ways to fight cancer, which will benefit patients and families in Kentucky and around the world.”

Linking metabolism and cancer

The UK Center for Cancer and Metabolism capitalizes on highly specialized institutional strengths in cancer and advanced metabolomics tools to focus on the underlying mechanisms that link dysfunctional metabolism to cancer. Recent studies have shown that the metabolic powerhouse of cells – the mitochondria – can influence how aggressive a cancer becomes.

UK has internationally renowned experts in the field of cancer and metabolism, and new state-of-the-art technology has improved the ability to understand how metabolism impacts cancer.

“As the University for Kentucky, we are uniquely positioned to conduct this level of sophisticated research thanks to the presence of a diverse array of biomedical researchers, clinicians and our leading academic medical center,” UK President Eli Capilouto said. “Research and development is at the core of economic and human development, and it is why UK is Kentucky’s most instrumental change agent, health provider and economic engine. The progress we make offers the brightest future and best hope for Kentucky.”

The CCM will bring together highly complementary disciplinary strengths at UK in cancer, metabolism and data sciences, coupled with sophisticated metabolomics tools and advanced cancer imaging capabilities, to strengthen the university’s cancer research enterprise by providing a thematically focused multidisciplinary infrastructure dedicated to defining the role of metabolism in the development and treatment of cancer.

“Research is at the heart of any progress we hope to make in bridging health gaps in the Commonwealth,” said Lisa Cassis, UK vice president for research. “Increased funding opportunities through the 21st Century Cures Act, and in particular this COBRE focused on cancer and metabolism, will enable the university to foster the development of the next generation of scientists who will lead our efforts in translating basic research findings into promising new therapies.”

Fighting back against cancer in Kentucky

The scientific discoveries achieved through the CCM will continue to help the UK Markey Cancer Center in its mission to conquer cancer in the Commonwealth. As Markey prepares to renew its National Cancer Institute Cancer Center designation, and simultaneously compete to become a Comprehensive Cancer Center later in 2017, Markey Director Dr. Mark Evers emphasizes the need for increased cancer research funding and continuing to push for new discoveries.

“Nowhere in the country is it more important to have this level of cancer research underway,” Evers said. “Kentuckians face a unique set of health issues, but we at the UK Markey Cancer Center are distinctly positioned to help solve the problem. Being an NCI-designated cancer center means being a leader in research as well as clinical care and outreach. This funding will allow us to translate our findings into potential new therapies for cancer patients from Kentucky and beyond.”

The CCM leverages expertise with mentors and collaborators from across multiple UK centers, disciplines and departments. The multidisciplinary collaboration is indicative of the type of work ongoing at UK and UK HealthCare every day.

“This new funding is another example of the vital importance to the people of Kentucky – and this region – in having an academic medical center at the University of Kentucky,” said Dr. Michael Karpf, UK executive vice president for health affairs. “The synergy and collaboration between researchers and clinicians to further studies in cancer can only be done at a place like this, where people are working together to make a difference in the lives of patients now and for generations to come.”

Promoting collaboration

COBRE grants also use this platform to develop promising early-stage investigators with enhanced skillsets in exciting new areas of cancer research and to enhance their success in competing for NIH grant support. The grant promotes collaborative, interactive efforts among researchers with complementary backgrounds, skills and expertise.

Four junior investigators, mentored by teams of clinicians and scientists from a variety of disciplines, departments, and colleges at UK, will lead major projects investigating an aspect of cancer metabolism:

  • “Role of vitamin D in protecting against cachexia in cancer patients,” led by Travis Thomas, Department of Clinical Sciences, UK College of Health Sciences
  • “Role of serine biosynthesis pathway in breast cancer,” led by Yadi Wu, Department of Pharmacology and Nutritional Sciences, UK College of Medicine
  • “Role of RORα in breast cancer metastasis,” led by Ren Xu, Department of Pharmacology and Nutritional Sciences, UK College of Medicine
  • “Role of fatty acid synthase in colorectal cancer,” led by Kate Zaytseva, Department of Toxicology and Cancer Biology, UK College of Medicine

The CCM is co-led by program directors Daret St. Clair, professor and James Graham Brown Foundation Endowed Chair in the UK Department of Toxicology and Cancer Biology, and Peter Zhou, professor in the UK Department of Molecular and Cellular Biochemistry.

“Having the kind of environment where learning and collaboration are placed at the forefront is why we were chosen for this grant, and we hope to continue that throughout the life of this center,” St. Clair said. “It will also enable us to reach out to new and talented researchers who want to come to UK to become new project leaders and continue the work we’re doing.”


Watch the video below to learn more about the Center for Cancer and Metabolism.


Next steps:

A new study, done in part at the UK Markey Cancer Center, shed light on why lung cancer cells can resist therapeutic cancer treatment.

Markey research sheds light on lung cancer formation and treatment

A new study co-authored by a researcher starting her laboratory at the UK Markey Cancer Center shows that in certain genetic situations, one non-small cell lung cancer subtype can change into another subtype.

This lung cancer “lineage switching” could explain why some cancers are resistant to therapeutics, and this research examines exactly how the lineage switch can happen. The work was a collaborative effort between laboratories in Kentucky, New York and Boston.

“Now that we have a glimpse into the molecular mechanism of lineage switching, we can begin to learn how to manipulate this phenomenon for better therapeutic outcomes,” said study co-author Christine Fillmore Brainson, assistant professor in the UK Toxicology and Cancer Biology department.

Previously, it was unclear which cells in the adult lung can be the “cells-of-origin” of the two major subtypes of non-small cell lung cancer, namely adenocarcinoma and squamous cell carcinoma. Likewise, it was unclear what differences in DNA organization define the two distinct lung cancer subtypes. The existence of adenosquamous lung tumors, clinically defined by the presence of both glandular adenocarcinoma lesions and fully stratified squamous lesions within the same tumor, suggested that both adenocarcinomas and squamous cell carcinomas could come from the same cells in the lung, but clear evidence for this theory was lacking.

Published in Nature Communications, the study showed that adenocarcinoma cells can change to squamous cells due to reorganization of their DNA in specific ways. Beginning with a mouse model of adenosquamous lung tumors, researchers validated the genetics by comparing it to human adenosquamous lung tumor – the genetics are often the same, including activation of the oncogene KRAS and the deletion of the tumor suppressor Lkb1. The team then used transplant assays to demonstrate that established adenocarcinoma tumors could transition to squamous cell carcinomas in the mouse lung.

Lastly, the group isolated different lung cells, and demonstrated that only certain lung cells could give rise to tumors capable of undergoing the lineage switch.

“This data is exciting because it shows which cells in the lung can give rise to adenosquamous tumors,” Brainson said.  “And the technique we used to transform the isolated cells can be applied to many lung cancer models.”

Oncologists have observed this “lineage switching” after the failure of EGFR tyrosine kinase inhibitor treatment, when it is clinically justifiable to take a second biopsy. However, second biopsies are not normally done after chemotherapy, a practice that Brainson thinks could be revised to understand the exact mechanisms of therapy resistance.

In addition to Brainson, the manuscript was co-authored by Haikuo Zhang of the Dana-Farber Cancer Institute in Boston. The research was a collaborative effort between the laboratories of Carla Kim at Boston Children’s Hospital, where Brainson was based for her post-doctoral studies; Hideo Watanabe at Icahn School of Medicine in New York; and Dr. Kwok-Kin Wong at Pearlmutter Cancer Center in New York.

This work was funded in part by the American Cancer Society, the Lung Cancer Research Foundation, the V Foundation for Cancer Research, the March of Dimes, the National Cancer Institute, the Gross-Loh Family Fund for Lung Cancer Research and Susan Spooner Family Lung Cancer Research Fund at the Dana-Farber Cancer Institute


Next steps:

Kentucky’s death rate from cervical cancer ranks among the top 10 in the nation. But many of these deaths are preventable by regular Pap smears.

Pap smears: Your best weapon against cervical cancer

It’s an unfortunate fact that Kentucky has one of the highest cervical cancer death rates in the country. The good news is many of these deaths are preventable through regular screenings called Pap smears.

Pap smears collect cells from the cervix, which are examined under a microscope to find cancer and pre-cancer. If pre-cancer is found, it can be more easily treated, stopping cervical cancer before it really starts.

There are no obvious symptoms of cervical cancer until it reaches advanced stages, so having regular Pap smears is important. Federal guidelines recommend women ages 21 (or three years after first intercourse) to 65 have a Pap smear every three years during their annual pelvic exam. Individual circumstances can vary, so talk to your doctor about how often you should have a Pap smear.

Ways to improve test results

According to the American Cancer Society, there are several ways to make your Pap smear results more accurate:

  • Try not to schedule an appointment for a time during your menstrual period. The best time is at least five days after your menstrual period stops.
  • Don’t use tampons, birth-control foams or jellies, other vaginal creams, moisturizers or lubricants, or vaginal medicines for two to three days before the Pap test.
  • Don’t douche for two to three days before the Pap test.
  • Don’t have vaginal sex for two days before the Pap test.

Check with your doctor

Because Pap smears are often done during pelvic exams, many people confuse the two. The pelvic exam is part of a woman’s routine checkup that may help find other types of cancers and reproductive problems. During a pelvic exam, the doctor examines the reproductive organs, including the uterus and the ovaries, and may do tests for sexually transmitted disease.

Be sure to check with your doctor to see if you had a Pap smear during your pelvic exam.


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Dr. van Nagell has worked with countless patients, faculty and students, but his legacy will likely be Markey's Ovarian Cancer Screening Program.

Listen: Dr. van Nagell talks about his life-saving work at Markey

In 1987, Dr. John van Nagell started the UK Markey Cancer Center’s Ovarian Cancer Screening Program, an ongoing research endeavor that provides free ovarian cancer screenings by transvaginal ultrasound to women across Kentucky.

Now in its 30th year, the program has provided free screenings to more than 46,000 women and found 775 ovarian tumors and 103 malignancies. Screenings are provided to women over the age of 50 and to those over the age of 25 who have a family history of ovarian cancer.

Van Nagell was recently honored for his years of clinical, research and educational work on a national level, earning the Society of Gynecologic Oncology’s Distinguished Service Award for 2017.

We sat down with Dr. van Nagell to discuss his reaction to the award and what keeps him motivated in his fight against ovarian cancer in Kentucky. Listen to the conversation below.


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Despite being largely preventable, colorectal cancer is the third most common in the U.S., and Kentucky ranks first in the nation for incidence.

Most colorectal cancer is preventable; here’s what you need to know

Dr. Jitesh Patel

Written by Dr. Jitesh Patel, colorectal surgeon at the UK Markey Cancer Center.

Colorectal cancer is the third most common cancer in the U.S. In Kentucky, the disease is particularly bad: Our state ranks first in the nation for colorectal cancer incidence and seventh in deaths. More than 2,500 new cases of the disease are diagnosed each year in Kentucky, and colorectal cancer takes the lives of more than 800 Kentuckians annually. The good news is colorectal cancer is a largely preventable disease.

Cause of colorectal cancer

The disease originates when healthy cells from the innermost layer of the colon or rectum change and grow uncontrollably, forming abnormal tissue growths called polyps. These growths are usually benign, but they can eventually become cancerous if they aren’t removed in time.

Risk factors and symptoms

Age, genetics and lifestyle are all possible risk factors for colorectal cancer. The disease typically affects men and women age 50 and older, and people are more likely to have the disease if others in their family have had it. Additional risk factors include obesity, lack of exercise, smoking, high alcohol use, and a diet high in red or processed meat and low in calcium, fruits and vegetables.

Colorectal cancer signs are often ignored because the disease may start with few or no noticeable symptoms. Some observable symptoms include:

  • Change in bowel habits.
  • Recurrent abdominal pain or discomfort.
  • Rectal bleeding.
  • Weakness or fatigue.
  • Unintentional weight loss.

How it can be prevented

Regular screening tests, including colonoscopies, are recommended for everyone starting at the age of 50 as well as for people at a younger age who are at high risk of developing the disease. African-Americans should be screened starting at age 45. Colonoscopies can actually prevent colorectal cancer by finding the precancerous lesions/polyps, allowing your doctor to remove them before they become malignant and cause serious harm.

In addition to screenings, changing some of your lifestyle habits can help you lower your risk of colorectal cancer. Proactive lifestyle changes include exercising regularly, opting for a diet rich in vitamins and calcium, quitting smoking, and lowering alcohol consumption.

Treating colorectal cancer

Treatment depends on the stage of the cancer. Surgery to remove the cancer is usually the first and only required treatment in early stages. However, in more advanced stages, when the disease has spread into nearby tissue and organs, chemotherapy before and/or after the surgery and targeted therapy drugs may also be necessary.

Colorectal cancer is about 90-percent treatable when discovered in its earliest stages. While a colonoscopy may not be a fun experience, it could very well save your life.


Next steps:

  • Learn more about Markey’s gastrointestinal cancer team, which provides comprehensive, personalized care for cancers including colorectal cancer.
  • With other life events keeping her busy, Claudia Hall almost skipped a routine screening for colorectal cancer. She decided to keep the appointment, and it’s a decision that saved her life. Read Claudia’s story.