Prostate Cancer: The Only Treatment Option Is Every Option

“There are two commonalities that unite cancer patients – the fierce desire to overcome their illness and the need for treatment options that will help them realize this goal.”
— Stephen M. Hahn, M.D., Chair, Department of Radiation Oncology


Stephen M. Hahn, M.D., Chair,
Department of Radiation Oncology

More than 1.1 million men in the United States will be diagnosed with prostate cancer in the next five years. The good news is that when detected early, prostate cancer is extremely treatable. And the news to remember is that Penn’s Abramson Cancer Center (ACC) has one of the largest, multi-disciplinary groups studying this disease globally including expert physicians and scientists from the pathology, radiation oncology, urology, hematology/ oncology, epidemiology, medicine and genetics specialties.
The caliber of the ACC’s research sets the quality of care above the rest with a cadre of faculty dedicated to investigating, understanding and eradicating prostate cancer.

Our multi-faceted, comprehensive approach allows patients and families to have the whole spectrum of prostate cancer care in one place, while providing patients the tools needed to identify the most appropriate treatment plan for their cancer. From surgery to radiation to immunotherapy, the ACC provides the highest level of clinical expertise.

SURGERY
The Division of Urology is a national leader in the surgical treatment of prostate cancer and is at the forefront of developing state-of-the-art surgical techniques. Thomas J. Guzzo, M.D., MPH, Assistant Professor of Urology, is trained in four innovative areas of surgery: open, robotic, laparoscopic and endoscopic procedures. With his comprehensive expertise, he is equipped to individualize surgical treatment options for prostate cancer patients. As with many of Penn’s urology physicians, his clinical reach expands beyond just one form of treatment.

PROTON THERAPY
Neha Vapiwala, M.D., Assistant Professor of Radiation Oncology and Chief of the Genitourinary Service, has the unique ability to offer patients a full spectrum of radiation therapy treatment options, including proton therapy. With the latest pencil beam proton technology, intensity modulated radiation therapy (IMRT), Trubeam, RapidArc, and Cyberknife technologies, Penn’s Radiation Oncology Department is the most comprehensive in the world. Located within the department of radiation oncology, the Roberts Proton Therapy Center offers patients the most advanced radiation therapy treatments to more precisely deliver high doses of radiation to tumors, optimizing efficacy while at the same time limiting side effects to patients. Dr. Vapiwala’s research focuses on identifying and understanding new molecular and imaging biomarkers to more accurately diagnose, stage and treat prostate cancer.

TARGETED THERAPIES/IMMUNOTHERAPY
Naomi B. Haas, M.D., Associate Professor of Medicine and Director, Prostate and Kidney Cancer Program, has collaborated with Carl June, M.D. in an exciting new immunotherapy trial that uses the patient’s own genetically engineered T cells to treat prostate cancer. Currently being tested in animal models, the opening of a phase I/II clinical trial for patients is in the near future, in part due to generous funding from the Prostate Research Foundation, and other philanthropic resources.

GENETICS
Timothy Rebbeck, Ph.D., Director, Center for Genetics & Complex Traits is co-leading one of the world’s largest initiatives in prostate cancer research to better understand disease outcomes and factors that contribute to patient survival. While prostate cancer is extremely treatable in the United States, this isn’t true in other parts of the world. Prostate cancer is the leading cause of cancer death for men worldwide. Dr. Rebbeck’s research is focused on discovering why certain populations are at an increased risk of mortality from prostate cancer. By understanding each patient’s own risks using genetics, biomarkers and other risk factors, treatments can be further tailored to identify patients who may benefit from aggressive treatments and those it is more appropriate to actively monitor in order to avoid unnecessary side effects of treatment.

ACTIVE SURVEILLANCE
Active surveillance, or diligently monitoring the prostate over time, may be an excellent treatment option for men whose cancer is not aggressive. This option is supported in the urologic cancer community and consistently recommended to many prostate cancer patients. Alan J. Wein, M.D., FACS, Ph.D. (Hon), Chief, Division of Urology, iterates the validity of active surveillance as a treatment option, saying that “surgery or radiation is not always the best option for every patient.” Active surveillance includes regular biopsies, digital rectal exams and regular Prostate Specific Antigen (PSA) testing – a blood test to detect chemicals in the bloodstream that may cause prostate problems, such as enlarged prostate, infection or cancer.

OUTCOMES
Justin E. Bekelman, M.D., Assistant Professor of Radiation Oncology, studies the effectiveness of treatments for prostate cancer. His research aims to generate the evidence needed to support patients’ treatment decisions, thereby addressing the essential purpose of comparative effectiveness research. By combining data from federally-sponsored cancer registries with hospital-based registries across the United States, Dr. Bekelman’s research will track and compare the outcomes of hundreds of thousands of men with prostate cancer.

To support prostate cancer research and patient care, contact Sarah Evans at (215) 746-3005 or saraheva@upenn.edu.

Personalized Diagnostics: Revolutionizing Cancer Treatment

“Personalized diagnostics are the key to personalized medicine – and Penn has the vision to see this is the crucial next step in providing the best outcomes for patients.”
– David B. Roth, M.D., Ph.D., Chair, Department of Pathology and Laboratory Medicine

Sitting at the forefront of personalized medicine, Penn Medicine’s Department of Pathology and Laboratory Medicine and the Abramson Cancer Center (ACC) are launching the new Center for Personalized Diagnostics. With its roots in the same lab where the Philadelphia chromosome was discovered, this research and patient care center will provide clinicians with critical information regarding their patient’s disease – and allow them to offer customized, safer, and more effective treatments.

There are approximately 20,000 genes encoded in the three billion DNA base pairs that make up the human genome. Current genetic testing for cancer patients searches for mutations within single genes in a limited number of cancer genes. There are more than 480 genes which are known to be mutated in cancer, with subsets of these genes acting as “drivers” of cancer development in specific tissue types. Through the new technology of massively parallel sequencing, also known as “Next Generation Sequencing,” mutations in large subsets of these cancer-associated genes can be detected in parallel through a single laboratory assay. By targeting large panels of genes with known prognostic and therapeutic implications, this technology offers clinicians the ability to make informed decisions by looking across the genomic landscape of a patient’s individual cancer.

A New Universal Platform for Cancer Immunotherapy A glimpse into the future includes a universal platform for personalized cancer therapy based on immune cells known as T cells. Researchers at Penn Medicine have devised, for the first time, a potential system for adaptable, engineered immune cells that can attack specific tumor types based on which abnormal proteins, called antigens, are expressed by an individual patient’s tumor cells. Through Penn Medicine’s Clinical Cell and Vaccine Production Facility, physicians can harness and engineer a patient’s own cells as part of medical care to provide a targeted personalized therapy.

While this research is still in the early clinical trial phase, Penn Medicine researchers predict a future where a highly personalized platform for cancer therapy would begin with a patient’s tumor being analyzed at the Center for Personalized Diagnostics. When the antigens expressed by a patient’s tumor cells are determined, their T cells will be engineered and given back to them to attack the patient’s tumor antigens – causing an individualized tumor attack.

The new Hematologic Malignancies Translational Center of Excellence at the ACC – a center redefining diagnostics and therapeutic approaches to blood cancers to provide effective targeted therapies – will build upon cutting-edge technologies developed at Penn Medicine. The new 2 Prevent Recurrent Breast Cancer Translational Center of Excellence is focused on studying cells that remain in the body after treatment to uncover how they relate to the original tumor, where they live and grow, and how they relate to the relapsed tumor. Collaborations between the laboratory and the clinic will continue to strengthen our understanding of these diseases and bring us closer to offering personalized diagnostics and precision cancer care.

To support the Center for Personalized Diagnostics, contact Evelyn Schwartz at (215) 898-8625 or evelynsz@upenn.edu.

Patient Profile: An Encouraging Journey through Personalized Care

“Everyone knew the details of my diagnosis and made me feel as if I were the only patient at the Abramson Cancer Center.” —Beverly Ensor

In 2006, 72 year-old Beverly Ensor, a retired nurse and part owner of a local bed and breakfast in Philadelphia, was not feeling well and sought guidance from her family doctor. Her doctor suggested that she have a colonoscopy, and when the procedure later revealed that there was a cancerous lesion, she decided to turn to Penn’s Abramson Cancer Center (ACC) for further diagnosis.

And, she is glad that she did. Beverly was diagnosed with colorectal cancer, and immediately began treatment at the ACC. Colon cancer is the third most common type of cancer in both men and women, and is the second leading cause of death from cancer in the United States. Beverly received her care from Peter J. O’Dwyer, M.D., Director, Developmental Therapeutics Program and her GI medical oncologist and James Metz, M.D., Vice Chair, Clinical Division, Department of Radiation Oncology, and established a close relationship with both of them.

“Beverly presented with metastatic colorectal cancer, so we took a very personalized approach to her care,” said Dr. Metz. Her team of physicians at the ACC treated her disease very aggressively – including two surgical resections, after her initial chemotherapy and radiation therapy.

As advances continue, new treatment options are added to the arsenal of comprehensive care. Dr. Metz explains Penn’s unique ability to offer many new treatment modalities all in one location, “Now with proton therapy here at Penn, radiation for colorectal cancers is even less invasive and more targeted for hard-to-reach areas of the body. It allows us to treat tumors even more aggressively while ensuring a good quality of life.”

During her care at the ACC, Beverly was most impressed by how well-managed she thought her case was handled, and is very thankful. “From my point of entry, I knew I had a team I could rely on. Everyone knew the details of my diagnosis and made me feel as if I were the only patient at the Abramson Cancer Center,” recalls Beverly.

Today, nothing seems to slow Beverly down. She continues to manage the bed and breakfast that she helped to establish in 1985, and five years after her treatment, she is a happy and healthy cancer survivor.

Answering the Jordan Challenge

Through October, alumni have generously given $1.3 million to the John Morgan Scholars Program. Through the Jordan Family Challenge, started by the late Henry A. Jordan, M’62, RES’67, and his wife, Barrie, these donations have been matched to create $2.6 million in endowment for student financial aid. The Challenge has $1.5 million in gifts as its goal and ends Dec. 31. We talked with a few recent donors about why they gave:

“My grandfather, who was a general practitioner, graduated from the Penn School of Medicine in 1886,” said John Carlisle Brown, M’62. Dr. Brown, the grandson, is the rare individual with links to the University that span parts of three centuries.

“I am proud that my grandfather and father also went to Penn Med and gratified to see how well the School is doing,” Dr. Brown said. Dr. Brown’s father, who graduated in 1920, was the only board-certified obstetrician/gynecologist in the Atlantic City, NJ area from the 1930s to around World War II and estimated having delivered over 10,000 babies in his career.

“Making a gift through the Jordan Challenge, for our class at least, feels like an appropriate memorial to Henry and tribute to his family and their strong advocacy for students.”

“I’ve been very blessed in my career and the foundation for it began at Penn,” said Doug Jacobs, M’71, GM’72.

Dr. Jacobs pursued psychiatry at Penn, signature strength when he studied here as well as today, and many families are grateful that he did. The not-for-profit he leads, Screening for Mental Health, Inc., pioneered large-scale mental health screening and education programs. Today the programs are used in schools, hospitals, and clinics for mental health issues, including depression, bipolar disorder, generalized anxiety disorder, post-traumatic stress disorder, alcohol use disorders, eating disorders, and suicide intervention. During the last five years, the U.S. Department of Defense has used Dr. Jacobs’ work to screen families and returning soldiers. You can see the public service announcement for this program here:http://www.youtube.com/watch?v=Wagcer3twJA

Dr. Jacobs remembers Penn “as a wonderful place to go to medical school.” In choosing to give back through the Jordan Challenge, Dr. Jacobs hopes to ensure future Perelman School students will benefit in the same way he did from a Penn education: “I look at it as a responsibility to the generation coming up.”

“I was inspired early,” said Katherine Martien, M’82. “I met Dr. Walter Gamble as a young trainee and recent Penn graduate at the Children’s Hospital of Boston. Walter and Anne opened their lives to me—offering home cooked meals and a model of harmonious balance between work and family. He mentored me through those challenging, early years and my contribution to the Challenge honors his visionary philanthropy. ”

Walter, M’57, and his wife Anne endowed the 21st Century Scholars— a program that provides students full tuition for the entirety of medical school. This year’s entering class includes 14 Gamble Scholars. Like Dr. Gamble, Dr. Martien steadfastly believes that alleviating the huge debt burden of medical school frees young physicians to select the career that’s right for them.

Dr. Martien chose to become a neurodevelopmental pediatrician specializing in the autism spectrum and other disorders. For her, financial aid is also about striking that balance the Gambles personify so well.

“I want to help give recent graduates the best head start when it comes to being able to embark on family, travel, and life experiences beyond those in the medical profession.”
Finally, she is passionate that scholarships will bring the best students to medicine and to the Perelman School: “Ultimately, this is about the strength of the individuals we train, and how they will go forward and contribute to medicine and society.”

“I am who I am because of my time at Penn,” said Michael Balk, M87, RES 90.

“What attracted me the most at my interview was the diversity,” he said. “In our class we had a former commander of a nuclear submarine, a professional dancer—a really exciting mix of backgrounds and personalities.

“It was a warm and creative place to be, a place where you became a good doctor. In my first few weeks I met a group of friends who stayed very close in those years. When I saw them again at our 25th reunion it was as if no time had passed.

Today Dr. Balk is a managing partner at Northside Cardiology in Atlanta, Georgia. “My years at Penn were a defining time,” he said. “Giving to the Challenge just made sense. Your gift gets an automatic boost, and it’s a great use of the money—helping talented students to experience this fabulous institution.”

First John Morgan Scholars Named – as Deadline for the Jordan Challenge Closes in

The impact of the Jordan Scholarship Challenge is already visible. This fall, the inaugural recipients of the John Morgan Scholarships were named: Ian Danford, M’16, Nicolette Taku, M’16, and Janqian Zhang, M’16.

“I am incredibly grateful for the Morgan Scholarship,” said Mr. Zhang. “Without donations like this, I would not have been able to attend Penn Medicine. I just want to express my gratitude for my donors’ kindness and to let them know I will not take such generosity for granted; I will work hard every day throughout my medical school career in order to become the best physician I can be.”

Perelman Scholars Arrive

Raymond and Ruth Perelman’s unprecedented gift to Penn Medicine was the culmination of years of involvement with the School and the University of Pennsylvania. Their philanthropy was also spurred by a sense of urgency about health care in America. As Ray told the Philadelphia Inquirer days after the gift was announced, “The key is to get brilliant students into the system who will make brilliant doctors.”

This year, by funding 12 new full scholarships, the Perelman gift allows the School to continue the tradition of attracting extremely driven students with great intellect, wide-ranging interests, and the desire to make a difference through medicine.

The inaugural Perelman Scholars include a lawyer who has worked on drafting policy guidelines on women’s health for the Republic of Uganda, a molecular biology major published as an undergraduate, and a 2008 Olympian who received a team silver medal in fencing and who, having deferred her education due to her athletic pursuits, is very excited about the School’s early start to clerkships. The Scholars also include a few bungee jumpers, a Tournament of Roses princess, and a young woman who speaks for many of our students when she says, “It has been my dream to take part in a profession centered on an intrinsic love for humanity.”

Amy Gutmann, President of the University of Pennsylvania, Dean J. Larry Jameson,
 and Ray Perelman welcome the Perelman Scholars

On October 18, Mr. Perelman had the opportunity to meet some Perelman Scholars and other students at the unveiling of the Perelmans’ portrait, which will be displayed in the Biomedical Research Building. “Ruth and I are two people who cared very much about helping you make your dreams come true,” Mr. Perelman said when he addressed the students. “I hope you will always know how much we believed in you—believed in your talents and in your dedication to the science and art of healing.”

Recruiting the best students is an ongoing critical concern and the future of medicine depends on the students of today. For some Perelman Scholars, and many other financial aid recipients, scholarship aid made a Penn Medicine education possible.

“Penn Medicine has a reputation for excellence,” said Melissa Asmar, M’16. “Without this gift, I may not have been able to attend this prestigious school. Being a Perelman Scholar will help me to achieve my goal of furthering the frontier of medicine.”

Our students are the future of medicine. The Perelman Scholars program will continue to be a driving force in medical research, patient care, and most importantly, training the new doctors our country needs so much.

Bill Smilow thanked his "physicians and friends" for making this
day possible by their lifesaving care and by introducing him to the
 research advances taking place on the Penn campus.

Smilow Family Names Center for Translational Research

Largest Capital Gift of the University’s $3.5 billion Making History Fundraising Campaign to Date

“My son Bill and I believe that Penn shares our philosophy on making an immediate impact on peoples’ lives,” said Joel Smilow, former chairman and chief executive officer of Playtex Products, Inc. “We are delighted to make this significant contribution to advancing health care in our nation and around the world.”

While the exact gift amount remains undisclosed, Joel and William Smilow have made the largest capital gift to date to the University of Pennsylvania’s $3.5 billion Making History fundraising campaign. Their gift is among the top gifts in Penn Medicine’s history and names the Smilow Center for Translational Research in the Raymond and Ruth Perelman School of Medicine.It also establishes the William Smilow Professorship in the field of cardiovascular medicine and the William Smilow Award for Innovation in Clinical Excellence. Penn’s medical bioinformatics program will also receive funding to enhance the analysis and integration of data from a wide range of sources.

 

A prominent silhouette in the Philadelphia skyline, the 531,000 square-foot, state-of-the art Smilow Center was described as “the envy of the nation’s most prestigious research scientists,” by National Institutes of Health Director Francis S. Collins, MD, PhD, at the building’s 2011 opening. The eight floors of the Smilow Center for Translational Research are each the size of a football field, with more than 700 laboratory work stations and 180 research bays throughout. More than 100 lead researchers and 900 staff members from a wide range of departments, centers, and institutes work in the building.

“We are enormously grateful to Joel and Bill Smilow for their profoundly generous gift, which will help ensure that Penn is at the vanguard of innovative medical research and cures,” said University of Pennsylvania President Amy Gutmann. “The Smilow Center for Translational Research provides a state-of-the-art environment where eminent physicians, researchers and scientists at Penn Medicine will work side-by-side to advance medical science. The Smilows are noted for their significant philanthropic works throughout the nation, and Penn is very proud to be the recipients of their first gift here in Philadelphia.”

Chestnut Hill resident William Smilow, president and founder of Great Oak Holdings, Inc., serves on the Penn Medicine Cardiovascular Institute Leadership Council. “My family feels a deep connection with both the communities where we live and the challenges that touch our lives,” he explained. “We feel it is important to inspire compassionate and visionary giving in others, and are proud to help promote the wide range of medical discovery that will take place at the Smilow Center. We hope that others will follow our lead in supporting Penn’s transformative research.”

To learn more about supporting translational research laboratories and programs at Penn, please contact Donna Piarulli at piarulli@upenn.edu or 215.898.0578.