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ChristianaCare Charts New Course With Nurse Robotics Research Fellowship
ChristianaCare, the first hospital system in the region to deploy collaborative robots, has once again broken new ground, this time with a nationally unique initiative that puts bedside nurses at the helm of robotics research and innovation. At a graduation ceremony April 30, ChristianaCare celebrated the first four clinical nurses completing the Nursing Research Fellowship in Robotics and Innovation — the first program of its kind in the nation. The fellowship was part of a larger three-year, $1.5 million grant from the American Nurses Foundation’s Reimagining Nursing Initiative. The grant supports ChristianaCare’s broader study on how collaborative robots impact nursing practice. Over eight months, nurses from different units and specialties participated in immersive research training and lectures designed to expand their knowledge, curiosity and professional growth. Their work culminated in national conference presentations and preparations for journal submissions. The inaugural Nursing Research Fellows in Robotics and Innovation are: Briana Abernathy, BSN, RN, CEN – case management, Christiana Hospital emergency department Elizabeth Mitchell, BSN, RN-BC – Christiana Hospital surgical stepdown unit Hannah Rackie, BSN, RN, C-EFM – Union Hospital maternity unit Morgan Tallo, BSN, RN, CCRN – Christiana Hospital cardiovascular critical care unit A ‘real seat at the table’ “When you create programs that empower nurses to lead, innovate and tackle meaningful challenges, you see real impact — not just in new skills and knowledge, but in job satisfaction, well-being and retention,” said Susan Smith Birkhoff, Ph.D., RN, program director of Technology Research & Education at ChristianaCare. “This fellowship is built on the belief that when nurses are given the space to learn and lead, they bring fresh ideas and collaborative solutions back to their clinical practice areas.” Created and led by Smith Birkhoff, the fellowship is a standout in the U.S. health care landscape: It gives bedside nurses the chance to step away from their daily routines and gain advanced research experience, an opportunity rarely available at the clinical level. While the fellowship directly trained four nurses, its reach extended well beyond thazt. Fellows shared what they were learning along the way, sparking wider interest in research across the health system. The research program was highlighted as a new knowledge and innovation exemplar in the latest evaluation by the American Nurses Credentialing Center, which in March awarded ChristianaCare its fourth Magnet designation — the gold standard for nursing excellence. Adriane Griffen, DrPH, MPH, MCHES, vice president of programs at the American Nurses Foundation, praised ChristianaCare’s responsiveness in shaping the program around nurses’ needs and building a model for future innovation. “What makes this fellowship stand out is its focus on giving bedside nurses a real seat at the table,” Griffen said. “When nurses are trusted to lead and have the right support, they develop solutions that are practical, sustainable and transformative. This fellowship shows how nurse-led innovation can grow from a local pilot into a model for improving care across the country.” Through the fellowship, nurses gained a deeper understanding of applying research methodology to advance robotics science at the intersection of nursing and hospital operations, which is groundbreaking and novel. “This is such an exciting and important moment for our profession,” said Danielle Weber, DNP, RN, NEA-BC, chief nurse executive at ChristianaCare. “Innovation is about improving care, easing the burdens on our teams and finding smarter ways to meet the complex needs of our patients. Tools like collaborative robots don’t replace the human touch, they help protect and elevate it.” Mitchell said she was initially intimidated when she saw the fellowship application because it had been years since she last engaged in formal research. Learning everything from literature reviews to abstract writing pushed her outside her comfort zone and gave her practical tools to take new ideas forward. The experience inspired her to return to school this fall to pursue a graduate degree. A ‘ripple effect’ “This fellowship reignited my enthusiasm for learning and gave me the skills and confidence to keep growing,” Mitchell said. “It’s been amazing to collaborate with other fellows and mentors, and I’m excited to apply what I’ve learned to improve patient care and strengthen our teams.” In addition to Smith Birkhoff, Kate Shady, Ph.D., RN, OCN, RN IV, served as a mentor to the fellows, bringing expertise from her hematology/oncology background. Kati Patel, MPH, provided key administrative coordination and support throughout the program. ChristianaCare continues its broader research into robotics integration, with findings from the multi-year collaborative robot study expected to be shared later this year. Shady said the fellowship is already influencing ChristianaCare’s nursing culture by expanding interest in research and evidence-based practice well beyond the initial group. The program’s ripple effect is helping build lasting infrastructure for nurse-led innovation across departments. “One of the most rewarding parts of this fellowship has been seeing these nurses step into new confidence and capability,” Shady said. “They began unsure about research, but by the end, they were reading studies, writing abstracts and mentoring peers — laying the groundwork for bigger change in how we advance nursing practice.” Learn more about nursing at ChristianaCare.
Aston University collaboration to develop injectable paste which could treat bone cancer
A £110k grant from Orthopaedic Research UK is to help to conduct the work Study is a collaboration with The Royal Orthopaedic Hospital Researchers to use gallium-doped bioglass to produce a substance with anticancer and bone regenerative properties. Professor Richard Martin Aston University is collaborating in research to develop an injectable paste which could treat bone cancer. The Royal Orthopaedic Hospital has secured a £110,000 grant from Orthopaedic Research UK to conduct the work. The project will see researchers at the hospital and the University use gallium-doped bioglass to produce a substance with anticancer and bone regenerative properties. If proved effective it could be used to treat patients with primary and metastatic cancer. Gallium is a metallic element that when combined with bioactive glass can kill cancerous cells that remain when a tumour is removed. It also accelerates the regeneration of the bone and prevents bacterial contamination. A recent study led by Aston University found that bioactive glasses doped with the metal have a 99 percent success rate of eliminating cancerous cells. Dr Lucas Souza, research lab manager at the hospital’s Dubrowsky Lab is leading the project. He said : “Advances in treatment of bone cancer have reached a plateau over the past 40 years, in part due to a lack of research studies into treatments and the complexity and challenges that come with treating bone tumours. Innovative and effective therapeutic approaches are needed, and this grant provides vital funds for us to continue our research into the use of gallium-doped bioglass in the treatment of bone cancer.” Professor Richard Martin who is based in Aston University’s College of Engineering and Physical Sciences added: “The injectable paste will function as a drug delivery system for localised delivery of anticancer gallium ions and bisphosphonates whilst regenerating bone. Our hypothesis is that this will promote rapid bone formation and will prevent cancer recurrence by killing residual cancer cells and regulating local osteoclastic activity.” It is hoped the new approach will be particularly useful in reducing cancer recurrence and implant site infections. It is also thought that it will reduce implant failure rates in cases of bone tumours where large resections for complete tumour removal is either not possible, or not recommended. This could include incidents when growths are located too close to vital organs or when major surgery will inflict more harm than benefit. It could also be used in combination with minimally invasive treatments such as cryoablation or radiofrequency ablation to manage metastatic bone lesions. Dr Souza added: “The proposed biomaterial has the potential to drastically improve treatment outcomes of bone tumour patients by reducing cancer recurrence, implant-site infection rates, and implant failure rates leading to reduced time in hospital beds, less use of antibiotics, and fewer revision surgeries. Taken together, these benefits could improve survival rates, functionality and quality of life of bone cancer patients.” Other members of the team include the hospital’s Professor Adrian Gardner, director of research and development and Mr Jonathan Stevenson, orthopaedic oncology and arthroplasty consultant, Dr Eirini Theodosiou from Aston University and Professor Joao Lopes from the Brazilian Aeronautics Institute of Technology. ENDS About the Royal Orthopaedic Hospital NHS Foundation Trust The Royal Orthopaedic Hospital NHS Foundation Trust is one of the largest specialist orthopaedic units in Europe, offering planned orthopaedic surgery to people locally, nationally, and internationally. The Trust is an accredited Veteran Aware organisation and a Disability Confident Leader. Ranked 8th in the 2024 UK Inclusive Top 50 Employers list, the Royal Orthopaedic Hospital is the highest-ranking NHS organisation for its commitment to diversity and inclusion. The Royal Orthopaedic Hospital has a vibrant research portfolio of clinical trials, observational studies and laboratory studies exploring new treatment options, new approaches in rehabilitation and therapy, and new medical devices. This research is delivered by our researchers and clinicians spread across the Knowledge Hub, our home for education and research, and the Dubrowsky Regenerative Medicine Laboratory, a state-of-the-art lab opened in 2019. About Aston University For over a century, Aston University’s enduring purpose has been to make our world a better place through education, research and innovation, by enabling our students to succeed in work and life, and by supporting our communities to thrive economically, socially and culturally. Aston University’s history has been intertwined with the history of Birmingham, a remarkable city that once was the heartland of the Industrial Revolution and the manufacturing powerhouse of the world. Born out of the First Industrial Revolution, Aston University has a proud and distinct heritage dating back to our formation as the School of Metallurgy in 1875, the first UK College of Technology in 1951, gaining university status by Royal Charter in 1966, and becoming The Guardian University of the Year in 2020. Building on our outstanding past, we are now defining our place and role in the Fourth Industrial Revolution (and beyond) within a rapidly changing world. For media inquiries in relation to this release, contact Nicola Jones, Press & Communications Manager on 07941194168 or email: n.jones6@aston.ac.uk
Patients undergoing radiation therapy for certain types of cancer at ChristianaCare’s Helen F. Graham Cancer Center & Research Institute will be the first in Delaware to benefit from a cutting-edge treatment system that increases accuracy and precision, enhances patient comfort and minimizes side effects. ChristianaCare expects to begin scheduling patients in early 2026 to receive treatment with the Varian Ethos™ system equipped with HyperSight. The innovative radiotherapy system leverages artificial intelligence and the fastest on-table imaging in the field to enhance precision and increase the likelihood of effectively treating tumors. “As leaders in cancer treatment and care, we continually strive to stay at the forefront of medicine for our patients, and this new technology is a game-changer,” said Thomas Schwaab, M.D., Ph.D., Bank of America endowed medical director of ChristianaCare’s Helen F. Graham Cancer Center and Research Institute. “Adaptive radiation therapy enables members of the patient’s treatment team to create a new treatment plan every day in real-time based on the patient’s needs and anatomy in that moment as well as any changes observed during their therapy.” In traditional radiotherapy, a plan is established at the beginning of treatment and followed through the treatment course. Adaptive radiotherapy allows for real-time modifications to the plan based on periodic assessments while the patient is on the radiation table. Human anatomy changes quickly through normal bodily function even during treatment. In the context of radiation therapy, even slight shifts or alterations in the body while being treated can significantly impact effectiveness. The advanced technology in the system enables real-time imaging on the radiation table to be completed in seconds, rather than minutes – a dramatic improvement that transforms targeting accuracy and patient comfort. “This advancement will allow us to deliver personalized treatments, enabling radiation oncologists to make necessary treatment decisions even more quickly and accurately,” said Lindsay Romak, M.D., radiation oncologist at the Graham Cancer Center. “This will provide clinically meaningful benefits for patients who require radiotherapy for a wide range of cancers, including those of the prostate, bladder, abdomen and head and neck.” Artificial intelligence powers patient treatments Leveraging the power of artificial intelligence to capture and analyze rapid images in real time, the technology quickly detects changes in the patient’s anatomy and tumor size, shape or position. Using real-time imaging data, the system automatically suggests adjustments to the treatment plan to account for these changes, which is key to achieving better patient outcomes. The system also uses artificial intelligence when determining the distribution of the radiation dose, ensuring the tumor receives the optimal amount of radiation. This streamlines the workflow making the entire process of adaptive radiotherapy more efficient. "The integration of artificial intelligence into our treatment processes underscores our dedication to incorporating the most innovative treatments for our patients. With this technology, our patients can anticipate shorter treatment times and potentially fewer sessions, significantly enhancing their overall experience,” Laura Doyle, Ph.D., chief clinical physicist at the Graham Cancer Center said. Adaptive radiation therapy is covered by Medicare and most insurance carriers. The system will be located in the radiation oncology suite at the Graham Cancer Center. Equipment installation is expected in the fall of 2025 with patient use starting in early 2026. ChristianaCare’s Radiation Oncology Department is recognized by the American Society of Radiation Oncology Accreditation Program for Excellence. Its radiation oncologists are leaders in adapting the very latest imaging and treatment advances into clinical practice. The team also helps write the standards for best practices in care delivery and teaches other doctors and health care professionals in this specialty. With this latest advancement, ChristianaCare’s Helen F. Graham Cancer Center and Research Institute continues to solidify its position at the forefront of cancer care in Delaware and beyond, underscoring its commitment to improving patient outcomes and quality of life.
Aston University develops novel bone cancer therapy which has 99% success rate
Bioactive glasses, doped with gallium developed to create a potential treatment for bone cancer Lab tests have a 99 percent success rate of killing cancerous cells Method could also regenerate diseased bones. Bioactive glasses, a filling material which can bond to tissue and improve the strength of bones and teeth, has been combined with gallium to create a potential treatment for bone cancer. Tests in labs have found that bioactive glasses doped with the metal have a 99 percent success rate of eliminating cancerous cells and can even regenerate diseased bones. The research was conducted by a team of Aston University scientists led by Professor Richard Martin who is based in its College of Engineering and Physical Sciences. In laboratory tests 99% of osteosarcoma (bone cancer) cells were killed off without destroying non-cancerous normal human bone cells. The researchers also incubated the bioactive glasses in a simulated body fluid and after seven days they detected the early stages of bone formation. Gallium is highly toxic, and the researchers found that the ‘greedy’ cancer cells soak it up and self-kill, which prevented the healthy cells from being affected. Their research paper Multifunctional Gallium doped bioactive glasses: a targeted delivery for antineoplastic agents and tissue repair against osteosarcoma has been published in the journal Biomedical Materials. Osteosarcoma is the mostly commonly occurring primary bone cancer and despite the use of chemotherapy and surgery to remove tumours survival rates have not improved much since the 1970s. Survival rates are dramatically reduced for patients who have a recurrence and primary bone cancer patients are more susceptible to bone fractures. Despite extensive research on different types of bioactive glass or ceramics for bone tissue engineering, there is limited research on targeted and controlled release of anti-cancer agents to treat bone cancers. Professor Martin said: “There is an urgent need for improved treatment options and our experiments show significant potential for use in bone cancer applications as part of a multimodal treatment. “We believe that our findings could lead to a treatment that is more effective and localised, reducing side effects, and can even regenerate diseased bones. “When we observed the glasses, we could see the formation of a layer of amorphous calcium phosphate/ hydroxy apatite layer on the surface of the bioactive glass particulates, which indicates bone growth.” The glasses were created in the Aston University labs by rapidly cooling very high temperature molten liquids (1450o C) to form glass. The glasses were then ground and sieved into tiny particles which can then be used for treatment. In previous research the team achieved a 50 percent success rate but although impressive this was not enough to be a potential treatment. The team are now hoping to attract more research funding to conduct trials using gallium. Dr Lucas Souza, research laboratory manager for the Dubrowsky Regenerative Medicine Laboratory at the Royal Orthopaedic Hospital, Birmingham worked on the research with Professor Martin. He added: “The safety and effectiveness of these biomaterials will need to be tested further, but the initial results are really promising. “Treatments for a bone cancer diagnosis remain very limited and there’s still much we don’t understand. Research like this is vital to support in the development of new drugs and new methodologies for treatment options.” Notes to Editors Multifunctional Gallium doped bioactive glasses: a targeted delivery for antineoplastic agents and tissue repair against osteosarcoma Shirin B. Hanaei1, Raghavan C. Murugesan1, Lucas Souza1, Juan I.C. Miranda1, Lee Jeys2,3, Ivan B. Wall3, and Richard A. Martin1 1. College of Engineering and Physical Sciences. Aston University, Aston Triangle, Birmingham, B4 7ET, UK 2. Oncology Department, The Royal Orthopaedic Hospital, Birmingham, B31 2AP, UK 3. College of Health and Life Sciences. Aston University, Aston Triangle, Birmingham, B4 7ET, UK DOI 10.1088/1748-605X/ad76f1 About Aston University For over a century, Aston University’s enduring purpose has been to make our world a better place through education, research and innovation, by enabling our students to succeed in work and life, and by supporting our communities to thrive economically, socially and culturally. Aston University’s history has been intertwined with the history of Birmingham, a remarkable city that once was the heartland of the Industrial Revolution and the manufacturing powerhouse of the world. Born out of the First Industrial Revolution, Aston University has a proud and distinct heritage dating back to our formation as the School of Metallurgy in 1875, the first UK College of Technology in 1951, gaining university status by Royal Charter in 1966, and becoming The Guardian University of the Year in 2020. Building on our outstanding past, we are now defining our place and role in the Fourth Industrial Revolution (and beyond) within a rapidly changing world. For media inquiries in relation to this release, contact Nicola Jones, Press and Communications Manager, on (+44) 7825 342091 or email: n.jones6@aston.ac.uk
#Expert Research: Can CBD effectively impede growth of heterotopic lung cancer?
Lung cancer is the most chronic form of cancer and the leading cause of cancer mortality in the world, according to studies by the American Lung Association. Despite recent advances in medical oncology, metastatic lung cancer remains incurable; however, a new discovery by Augusta University researchers has brought new hope to tackling the illness. That discovery, which stems from a joint preclinic study conducted by scientists from the Dental College of Georgia and the Medical College of Georgia at Augusta University and Medicinal Cannabis of Georgia, LLC, was published in the May 2023 issue of Human Cell. The study was led by Babak Baban, PhD, associate dean of research, immunologist and professor at DCG and one of the founders of Medicinal Cannabis of Georgia, an Augusta-based biomedical research and developmental company. The study revealed for the first time that inhalant cannabidiol, commonly referred to as CBD, can effectively impede growth of heterotopic lung cancer. “The central core of our research has been studying inflammatory diseases and for that we picked two different directions: one is centered around chronic inflammation in our system and the other is neurologic diseases such as dementia. Because of their impressive anti-inflammation effects, CBD, CBC and other cannabinoids have attracted our attention,” Baban said. “We have had some exciting findings before, and based on those, we built a new model of lung cancer. This is the first time the effect of the CBD has been assessed in inhalant format using an inhaler. This makes it more translatable into humans and more accurate,” he said. “Obviously, we are just as excited about our discoveries on mechanisms by which CBD worked. They help advance our understanding of the pathophysiology of lung cancer. We have seen some effects on plasticity and cancer stem cells, which appear to be crucial for tumors to regenerate and renew themselves.” Unlike most anti-angiogenesis drugs, inhalant CBD at the experimental dosage did not show any detectable side effects or toxicity. The findings support the notion that inhalant CBD has enough beneficial effects as a viable complementary modality to be included in combination with current standard treatments for lung cancer. Additionally, inhalant CBD delivered using a precisely metered dose is non-invasive, and has high translational value, warranting further research through clinical trials for lung cancer and possibly some other malignancies. “The cannabis plant has over 113 cannabinoids, two of which are very famous: THC and cannabidiol, or CBD. We have conducted extensive research on medicinal cannabis since 2014, but cannabis has been utilized for medicinal purposes for over 1,000 years,” Baban said. “It is not until recently we have started understanding a little better mechanisms how cannabidiols like CBD work.” Babak Baban is a professor, immunologist and associate dean for research at the Dental College of Georgia at Augusta University where he has served for 13 of his 20 years as a translational and clinical immunologist. Babak is available to speak to media about this important topic - simply click on his icon now to arrange a time to speak today.
Nicholas Petrelli, M.D., Receives Lifetime Achievement Award
Nicholas Petrelli, M.D., Bank of America Endowed Medical Director of ChristianaCare’s Helen F. Graham Cancer Center & Research Institute, has received the Lifetime Achievement Award from Tulane University School of Medicine in New Orleans, Louisiana. Petrelli is a 1973 graduate of the school. Dr. Petrelli, center, receives the Lifetime Achievement Award from Julius L. Levy, Jr., M.D., past president, Tulane Medical Alumni Association, left, and Lee Hamm, M.D., senior vice president & dean of the School of Medicine, and the James R. Doty Distinguished Professor and Chair, Tulane University School of Medicine, New Orleans, Louisiana. The award recognizes an alumnus of the school who has made significant contributions to the field of medicine and has offered outstanding leadership in the community. Under Petrelli’s leadership at ChristianaCare since 2001, the Helen F. Graham Cancer Center & Research Institute has become a national model for multidisciplinary cancer care and a top enroller in U.S. clinical research trials. The Graham Cancer Center is a National Cancer Institute Community Oncology Research Program and one of only five hybrid academic community cancer centers in the nation. Through the work of the Graham Cancer Center and partnerships with health care providers, community organizations and the state to improve the prevention, diagnosis and treatment of cancer, Delaware’s cancer mortality rate has dropped twice as fast as the national rate. In addition, the state is outpacing the nation in reducing deaths from a number of cancers. Delaware has gone from number one in cancer mortality 22 years ago to number 17 today. Petrelli has numerous achievements in cancer care and research. He has established several firsts for Delaware, including a multidisciplinary disease center site, the Cawley Center for Translational Cancer Research, a tissue procurement center, an adult genetic counseling program, a statewide high-risk family cancer registry consisting of more than 500,000 individuals and an innovative oncology express unit to provide patients with cancer a way to address urgent care needs without having to go to the emergency department. Among his accomplishments on the national level are the first primary care practice established at a cancer center and the first gene editing research program integrated into a community cancer center. Through a unique research partnership with the Ellen and Ronald Caplan Cancer Center of The Wistar Institute, he has brought cutting-edge cancer treatments and diagnostics to Delawareans. And in a ground-breaking collaboration among the government, community organizations and the Graham Cancer Center nearly 10 years ago, Delaware ended the disparity between Black and white people for colorectal cancer screenings and mortality, which continues to this day. Petrelli has received numerous awards and has authored 360 peer-reviewed manuscripts and 31 book chapters. He has served on advisory panels of the National Cancer Institute, the American Society of Clinical Oncology, the American Cancer Society and the Society of Surgical Oncology. He was president of the Society of Surgical Oncology from 2007 to 2008. In 2013 he received the Order of the First State Award, the highest honor in the state, from Delaware Gov. Jack Markell. In 2019 he received the James Tilton award (named for the first U.S. Army Surgeon General) from the Medical Society of Delaware.
Cancer Program Earns Reaccreditation From the Commission on Cancer
Report cited zero deficiencies and highlights leadership, innovative programs and strong research program The Commission on Cancer, a quality program of the American College of Surgeons, has granted three-year reaccreditation to the cancer program at ChristianaCare’s Helen F. Graham Cancer Center & Research Institute, one of the original National Cancer Institute Community Cancer Centers Program sites in the U.S. ChristianaCare has received accreditation since 1951. To earn accreditation, a cancer program must meet 34 quality care standards, be evaluated every three years through a survey process and maintain levels of excellence in the delivery of comprehensive patient-centered care. The Commission cited zero deficiencies during its site visit and in its final report. “Earning this prestigious accreditation with no deficiencies cited is a testament to the unparalleled expertise and quality of care our entire team at the Graham Cancer Center provides to our patients and community across the continuum of cancer care,” said Nicholas Petrelli, M.D., Bank of America Endowed Medical Director of the Helen F. Graham Cancer Center & Research Institute. “Patients in the communities we are privileged to serve can be assured of groundbreaking cancer treatments, innovative technology, state-of-the-art research, prevention, education and the most caring, dedicated team anywhere.” “Innovative programs that address community need” The Graham Cancer Center was recognized in the reaccreditation report for taking a multidisciplinary approach to treating cancer as a complex group of diseases that requires consultation among surgeons, medical and radiation oncologists, diagnostic radiologists, pathologists and other cancer specialists. This multidisciplinary partnership results in exceptional patient care. In its performance report, the Commission on Cancer praised the Graham Cancer Center’s leadership that has built a “culture of continual process improvement across all areas from prevention, screening, treatment and support for the patient.” It highlighted “innovative programs that address community need,” such as its on-site primary care practice and its Oncology Express Unit, which offers urgent care for patients with advanced disease. The report also stated that the “research trial offerings are a strong point.” Clinical trials test new drugs and combinations of treatments, as well as new techniques using surgery, radiation therapy, gene therapy, immunotherapy and biologics. ChristianaCare is among the national leaders in cancer clinical trials; patient enrollment rates into clinical trials at the Graham Cancer Center are at 29% which is seven times the national average. A national standard for accreditation The Commission on Cancer accreditation program provides the framework for the Graham Cancer Center to improve its quality of patient care through various cancer-related programs that focus on the full spectrum of cancer care including prevention, early diagnosis, cancer staging, optimal treatment, rehabilitation, life-long follow-up for recurrent disease and end-of-life care. When patients receive care at a Commission on Cancer-accredited facility, they also have access to information on clinical trials and new treatments, genetic counseling and patient-centered services including psycho-social support, a patient navigation process and a survivorship care plan that documents the care each patient receives and seeks to improve cancer survivors’ quality of life. Like all Commission on Cancer-accredited facilities, the Graham Cancer Center maintains a cancer registry and contributes data to the National Cancer Database, a joint program of the Commission on Cancer and American Cancer Society. This nationwide oncology outcomes database is the largest clinical disease registry in the world. Data on all types of cancer is tracked and analyzed through the database and used to explore trends in cancer care. Cancer centers, in turn, have access to information derived from this type of data analysis, which is used to create national, regional and state benchmark reports. These reports help facilities with their quality improvement efforts. Established in 1922 by the American College of Surgeons, the Commission on Cancer is a consortium of professional organizations dedicated to improving patient outcomes and quality of life for patients with cancer through standard-setting, prevention, research, education and the monitoring of comprehensive, quality care. There are currently more than 1,500 Commission on Cancer-accredited programs in the U.S. and Puerto Rico that diagnose and treat more than 70% of all patients newly diagnosed with cancer.
For the first time in Delaware, and likely the nation, cancer specialists have co-authored a consensus statement and clinical pathway for the management of colon cancer that has spread to the peritoneum or abdominal wall. The statement has been published in the Jan. 10 online issue of Surgical Oncology. The statement aligns the state’s major health care providers on a standardized, evidence-based approach to the treatment of this kind of colon cancer. This will ensure patients throughout the state will receive optimal care and equitable access to the most appropriate treatment options and clinical trials. Medical and surgical oncologists from ChristianaCare’s Helen F. Graham Cancer Center & Research Institute, Tunnell Cancer Center at Beebe Healthcare and TidalHealth Allen Cancer Center prepared the statement entitled, “Consensus Statement and Clinical Pathway for the Management of Colon Cancer With Peritoneal Metastases in the State of Delaware.” The statement was published on behalf of the State of Delaware Peritoneal Surface Malignancies Task Force. “Consensus among cancer specialists on how to treat colon cancer patients with peritoneal malignancy will assure that these patients have access to the specialized treatment they need at an experienced cancer center right here in Delaware,” said co-author Nicholas J. Petrelli, M.D., Bank of America endowed medical director of the Helen F. Graham Cancer Center & Research Institute. “As cancer care providers, we know how important it is for patients to be close to home for their cancer care.” “Getting cancer physicians throughout the state to agree on who is eligible for treatment and the right sequence of therapies was no small task,” said lead author Jesus Esquivel, M.D., co-director of Beebe Healthcare’s Peritoneal Surface Malignancy Program. “Thanks to Dr. Petrelli’s leadership, coupled with the support of a very committed task force, we have been able to make this happen on a statewide level.” In about 10% to 20% of cases, colon cancer is found in the peritoneum, the lining of the abdomen that covers the abdominal organs. Historically, patients with peritoneal metastases have a worse prognosis. However, numerous studies show five-year survival rates for patients whose peritoneal cancer can be surgically removed approach the rates of those with successful surgery for metastatic liver disease. “We are looking at a complicated group of patients with advanced colon cancer and a generally poor prognosis, who historically have been treated in a non-uniform fashion despite medical evidence to suggest which therapies are most effective,” Esquivel said. Combining surgery and heated chemotherapy The Delaware pathway includes a combination treatment of surgery and heated chemotherapy, starting with cytoreductive surgery (CRS) to remove all visible cancer in the peritoneum. Hyperthermic Intraperitoneal Chemotherapy (HIPEC) with Mitomycin C is then delivered on the operating table for 90 minutes. Mounting clinical evidence shows this one-two punch can significantly extend survival in well-selected patients when compared with standard systemic chemotherapy. Currently, due to a steep learning curve, only about 120 hospitals in the U.S. have the necessary capability and expertise to perform these procedures. In Delaware, only ChristianaCare and Beebe Healthcare can offer patients CRS with HIPEC. Some patients who are not immediate candidates for surgery may benefit from systemic therapy (chemotherapy/immunotherapy) as a first-round treatment. Others on the pathway may be recommended for systemic therapy alone and potential participation in an appropriate clinical trial. Four-tier scoring system To help providers determine the best form of treatment for each individual patient, the Delaware pathway introduces the Peritoneal Surface Disease Severity Score (PSDSS). The scoring system uses four tiers of estimated disease severity based on a three-point scale that includes symptoms, extent of peritoneal dissemination and primary tumor histology. “With the Delaware pathway in place, our goal is to ensure that multidisciplinary evaluation begins at the time of diagnosis so that each patient is selected for the right sequence of currently available therapy depending the individual cancer,” Esquivel said. “Not only are we recommending a uniform treatment modality for patients, but our framework facilitates data reporting and evaluation that will add to the body of knowledge about this disease and how best to treat it.” Although there is plenty of medical evidence to suggest which therapies are most effective, until now, efforts by Esquivel and others to achieve consensus worldwide have not translated into a universally accepted clinical pathway for the management of this disease. Delaware is a unique launching pad for such a pathway. “As cancer care providers we know how important it is to work together on behalf of our patients,” said Petrelli. “Delaware is uniquely suited to this effort not only because of its size, but also because of the collaborative relationships we have built through groups like the Delaware Cancer Advisory Council and Consortium and most specifically for this effort, the Delaware Peritoneal Surface Malignancy Task Force.” The Delaware Health Information Network (DHIN) is another important resource to assist physician collaboration. Nearly 100% of the state’s medical providers are linked in. The DHIN launched in 2007 as the first operating statewide health information exchange in the country. “I don’t expect 100% of patients to be included in the pathway, but I see it as the best opportunity for patients to maximize benefits and minimize suffering or unnecessary treatment,” Esquivel said. “As a health care provider who treats patients with advanced cancer, I know that is the best one can hope for short of a cure. “With consensus on evidence-based clinical pathways, we can offer increasing numbers of patients the assurance that whether you live in northern or southern Delaware, you can rely on getting the best treatment available for your cancer.”
Adding Onsite Primary Care Practice in Cancer Center Earns National Innovator Award
ChristianaCare’s Helen F. Graham Cancer Center & Research Institute is the recipient of The Association of Community Cancer Center’s (ACCC) 2022 Innovator Award for its person-centered model of care that embeds a primary care provider in the cancer center for patients undergoing treatment who do not have a primary care provider. The Graham Cancer Center is among the first cancer programs in the nation to offer a program of this kind to its patients. “Earning the prestigious ACCC Innovator Award for our primary care practice is an accomplishment that belongs to our entire cancer care team which has worked long and hard to develop this unique program designed to improve our patients’ long-term health,” said Nicholas J. Petrelli, M.D., Bank of America endowed medical director of the Helen F. Graham Cancer Center & Research Institute. Patients diagnosed with cancer frequently have one or more concurrent chronic diseases, including heart disease, high blood pressure, COPD and diabetes. Cancer treatment can make these chronic medical problems worse, so it is important for patients to continue to see a primary care provider during their treatment, which can also help eliminate unnecessary emergency department visits. The new Primary Care Practice builds on the success of the Graham Cancer Center’s Oncology Express Unit, a program that offers urgent care to cancer patients in distress during treatment. “We conducted an informal survey that found as many as 15 percent of our patients did not have their own primary care provider,” said Cancer Program Clinical Director Cindy Waddington, MSN, RN, AOCN. “Having a primary care provider onsite working closely with the entire cancer care team helps ensure that essential patient care beyond cancer treatment is not delayed,” Waddington said. Patients are referred to the practice by their oncologists for any non-cancer health concerns. Since opening in January 2021, the program has received referrals to care for 234 patients. “Primary care in oncology has been a long-standing challenge for cancer patients and cancer programs,” said Family Nurse Practitioner Debra Delaney, RN, MSN, ACNS-BC, FNP-BC, who provides primary care services at the Graham Cancer Center. “Thankfully, we’ve been able to solve that challenge by addressing the whole person and promoting healthy living for the long-term.” Delaney helps patients manage their chronic medical conditions by monitoring their labs, refilling prescriptions and coordinating and communicating about any referrals they many need. “Following their cancer treatment, we help our patients transition to another practice, so they can continue to receive care for their primary care needs,” she said. The ACCC featured the program on its BuzzBlog. According to the ACCC, Innovator Award winners demonstrate the ability to advance the goals of improving access, quality and value in cancer care delivery, while also providing replicable solutions for other cancer programs and practices.
Questions about colon cancer? Our experts are here to help with your coverage
Every year, National Colorectal (colon) Cancer Awareness Month is observed during the month of March in an effort to raise awareness of the importance for colon cancer screenings. The recognition offers health care providers the opportunity to educate the general public about a disease that can be preventable, but can sometimes be seen as difficult for patients to discuss with their doctors. In the spirit of education, one of Augusta University’s experts has provided some insight into the subject of colon cancer. Dr. Asha Nayak-Kapoor is an associate professor of medicine in the Division of Hematology/Oncology in the Department of Medicine at the Medical College of Georgia at Augusta University. Nayak is certified by the American Board of Internal Medicine in Hematology and Oncology Specialties. Q: What are the primary risk factors for colon cancer? “Risk factors for colon cancer include: being overweight or obese, not being physically active, certain types of diets, smoking, alcohol use, being older, a personal history of colorectal polyps or colorectal cancer, a personal history of inflammatory bowel disease, a family history of colorectal cancer or adenomatous polyps, having an inherited syndrome. Common symptoms of colorectal cancer include: bloody stool or rectal bleeding, an ongoing change in bowel habits (diarrhea, constipation, chance in stool consistency), abdominal pain or cramping, gas or persistent abdominal discomfort, you feel like your bowels are not voiding completely, weakness, fatigue, or unexplained weight loss.” Q: How can a person protect themselves from the risks of colon cancer? “Colon cancer is largely preventable if patients undergo screening tests, like a surveillance colonoscopy starting at 45 years or earlier depending on family history. Many lifestyle-related factors have been linked to colorectal cancer. In fact, the links between diet, weight, and exercise and colorectal cancer risk are some of the strongest for any type of cancer. Getting to and staying at a healthy weight may help lower your risk. A diet that's high in red meats (such as beef, pork, lamb, or liver) and processed meats (like hot dogs and some luncheon meats) raises your colorectal cancer risk. Cooking meats at very high temperatures (frying, broiling, or grilling) creates chemicals that might raise your cancer risk. It’s not clear how much this might increase your colorectal cancer risk. Stop smoking. It is best not to drink alcohol. People with a history of colorectal cancer in a first-degree relative (parent, sibling, or child) are at increased risk. The risk is even higher if that relative was diagnosed with cancer when they were younger than 50, or if more than one first-degree relative is affected.” Q: It sometimes seems that colon cancer prevention is aimed more towards men compared to women, but cancer.org lists the risks at 1 in 23 (4.3%) for men and 1 in 25 (4.0%) for women. Is there a reason why perhaps a stigma about colon cancer affecting men more has been created? “According to focus group studies, it can be seen as a taboo topic that is uncomfortable to discuss, and it is not discussed as openly in public as prostate and breast cancer screenings. It can seem embarrassing or humiliating, and can be seen as distasteful dealing with prolonged bowel preparation.” Nayak is a member of several committees, including Onyx and Bayer Speaker Bureau for Nexavar, MCG Cancer Center Molecular Oncology Programme, and MCG Cancer Center Gastrointestinal Tumor Board Committee. If you are a journalist looking to know more about colorectal cancer and would like to speak with an expert for your stories, then let us help. Nayak is available to speak with media about this important subject. Simply click on her icon now to arrange an interview today.
