Winning against cancer—
research, discovery, treatment
The war against cancer has numerous allies at the Health Science Center. In 1997 the San Antonio Cancer Institute, a partnership of the Health Science Center and the Cancer Therapy & Research Center, received a "comprehensive cancer institute" designation, the highest designation given by the National Cancer Institute. The San Antonio center is one of only two in Texas.
Among numerous advances over the past 25 years, the institution’s researchers and care providers have helped establish treatment protocols that saved thousands of lives, established the largest breast tumor bank in the world, discovered three genes linked to cancer formation, and headed a national, multicenter study that found a new and improved test to detect recurrent bladder cancer.
In the early 1970s William L. McGuire, MD, established the oncology division of the department of medicine and the largest breast tumor bank in the world, with more than 100,000 specimens. The tumor bank is still maintained by the division of medical oncology and its chief, C. Kent Osborne, MD. Since Dr. McGuire’s death in 1992, the division has helped develop and test clinical assays to measure estrogen receptors in patients’ tumors, and factors to help determine if a particular breast tumor will recur. Physicians worldwide use these tools when planning a patient’s treatment.
Breast cancer kills almost 50,000 women every year in the United States. Because of basic research performed by Drs. McGuire and Osborne, patients diagnosed with breast cancer now receive more tailored treatment. Instead of radical mastectomies they may undergo a lumpectomy, chemotherapy or hormonal therapy, or any combination thereof.
Dr. Osborne was the first research investigator to show that the epidural growth factor (EGF) stimulates breast cancer cells. Therapies based on this finding are now in clinical trials. Dr. Osborne has conducted clinical trials for other new therapies, including the principal endocrine agent currently being used to treat breast cancer, the antiestrogen drug tamoxifen. He has shown that tamoxifen blocks breast cancer cell growth in the early cell cycle. A major focus of his recent tamoxifen studies has been to find out why some tumors become resistant to its effect. Dr. Osborne’s research also extends to the drug Faslodex, which may help with tumors that are resistant to tamoxifen. For his research work, Dr. Osborne received the prestigious Komen Award of Scientific Distinction in 1994 and again in 1995, and the Brinker International Award for Breast Cancer Research in 1995.
With Jaime R. Garza, MD, DDS, assistant professor and division head of plastic and reconstructive surgery, Dr. Osborne provided data that pointed to the need for new legislation, passed by the Texas Legislature in 1997, designed to reimburse women for breast reconstruction following surgery.
Also, Dr. Osborne works with Daniel D. Von Hoff, MD, an internationally known drug development expert who is clinical professor in the department of medicine/oncology at the Health Science Center and director of research for the Cancer Therapy & Research Center (CTRC), and with Gary M. Clark, PhD, professor in the department of medicine/oncology, biomathematician and key senior investigator for the cancer research projects.
Cancer research is one of the main focuses of the Health Science Center’s Institute of Biotechnology (IBT), headed by director Wen-Hwa Lee, PhD, professor of molecular medicine. The IBT, located in the Texas Research Park in far west San Antonio, was dedicated in 1990 and Dr. Lee, world renowned for his research of "tumor suppressor" genes, was hired as director.
Dr. Lee and his colleagues, including Eva Y. H. P. Lee, PhD, found that three genes linked to cancer formation—BRCA1, BRCA2 and ATM—also are involved in DNA repair. In persons with mutated forms of these three genes, the "fix-it" response to environmental damage appears to be defective, leading eventually to cancer formation. The objective of the IBT studies at cellular and molecular levels is to provide data that can be translated quickly to the bedside of cancer patients, through collaborations with clinical researchers at the Health Science Center.
DNA, found in the cells of living things and containing the genetic blueprint, takes a constant beating from harmful agents in the environment. Fortunately, cells have built-in "fix-it" mechanisms that patch the torn places and keep us going. Our DNA is repaired.
But sometimes, the fix-it mechanism is impaired or doesn’t work. Genetic damage progresses, resulting in undesirable conditions such as cancer.
Early detection of cancer greatly impacts patient outcomes. Many researchers at the Health Science Center have made contributions in this area, including Michael Sarosdy, MD, professor of surgery and chief of the urology division. He headed a U.S. multicenter study that found a new test improves detection of recurrent bladder cancer over the standard non-invasive method. The new test provides positive or negative results in five minutes.
More than 50,000 Americans are diagnosed with bladder cancer each year. It is one of the most highly curable types of cancer, if detected early. However, its recurrence rate is between 50 percent and 80 percent, making life-long monitoring essential.
Treatments for another type of cancer—liver tumors—are urgently needed to help the nearly 20,000 individuals newly diagnosed with the growths in this country each year. Pioneering a new treatment using heat is Health Science Center physician Gerald D. Dodd III, MD, professor of radiology and staff radiologist at the Audie L. Murphy Memorial Veterans Hospital, a component of the South Texas Veterans Health Care System, and University Hospital.
Dr. Dodd already has treated dozens of patients in a study using thermal ablation, a new, minimally invasive technique that heats the tumors to kill them. During the procedure, a special needle is inserted into the liver tumor through a small abdominal incision. The tip of the needle emits energy that heats the tumor but leaves surrounding tissue intact. The dead tissue is slowly reabsorbed by the body. The ablation is done as an outpatient procedure and patients leave the hospital six hours after treatment.
"From preliminary results, we’ve concluded that thermal ablation is a promising method for treating liver tumors," Dr. Dodd said. The procedure may be the only option for patients who aren’t candidates for conventional liver cancer surgery.
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