In this issue

Darcy Burbage receives top nursing society award

Medical Genetics programpoints to the future of medicine

New partnerships speed discovery research

New colorectal cancer program spotlights world-class cancer care

Trial of new lung cancer screening could advance early detection

Brother and sister recognized for their fundraising efforts

National Cancer Institute Web site features Helen F.Graham Cancer Center

Issue No. 21 / April 2010

Through research, evidence-based practice and community outreach, ChristianaCare’s Helen F. Graham Cancer Center plays a leading role in Delaware’s rapidlydeclining cancer incidence and mortality rates.

Formerly first in the nationfor cancer incidence and mortality, Delaware nowranks number eight in cancerincidence and 11th in cancermortality. Rates for cancermortality in Delaware aredropping faster than any-where else in the country, at twice the national rate.

Reducing cancer health disparities

Disparities in incidence andmortality rates betweenwhite and African American Delawareans are disappearing, thanks in part to joint programs such as Screening for Life. No disparity in colorectal screening existed betweenAfrican Americans and Caucasians in 2008. And cancer incidence rates among AfricanAmericans are dropping three times faster than among whites.

cancerupdateHelen F. Graham Cancer Center leadershipreduces cancer in Delaware

(continued on next page)

Rates for cancer

mortality in Delaware

are dropping faster than

anywhere else in the

country, at twicethe nationalrate.

(L-R) Nicholas J. Petrelli, M.D., William Bowser, Esq., chair of the AdvisoryCouncil of the Delaware Cancer Consortium, and Stephen Grubbs, M.D.,before a March meeting of the consortium. Not present in the photo is James Spellman, M.D., from Beebe Hospital, Tunnel Cancer Center.

(continued on next page)

2 Christiana Care Health System2 Christiana Care Health System

Helen F. Graham Cancer Center leadershipreduces cancer in Delaware

(continued from previous page)

Undergirding the Graham Center’s work is participation as one of only 16 sites in the National Cancer Institute’s (NCI)Community Cancer Centers Program.Because community hospitals treat 85 percent of cancer patients, the programenhances community-based cancer care by:

• Increasing the number of patients (particularly minorities) in clinical trials.

• Collecting, storing and sharing tissue and blood samples for cancer research.

• Developing a national database of medical records through NCI’s CancerBiomedical Informatics Grid (caBIG).

• Following a multidisciplinary teamapproach to cancer care.

• Decreasing cancer health disparities.

Research“Ninety percent of the progress in cancercare and research results from clinical trialssponsored by the National Cancer Institute,”says Nicholas J. Petrelli, M.D., Bank ofAmerica endowed medical director of theHelen F. Graham Cancer Center. “Ourpatient accrual rate into clinical trials is nearly seven times the national average—26 percent, compared to the national rate of 4 percent.”

Under the leadership of PrincipalInvestigator Stephen S. Grubbs, M.D.,the NCI Community Clinical OncologyProgram (CCOP) at Christiana Care is running more than 100 research studies on preventing and treating cancer. “CCOPsproduce high-quality clinical research andare the vehicles that elevate communityquality cancer care,” says Dr. Grubbs.

The Center for Translational Cancer Research,a collaboration with the University ofDelaware and Nemours/A.I. duPontHospital for Children, engages in vital biomarker and stem cell research. Foundedin 2003, the Tissue Procurement Center(TPC) has more than a thousand specimensand a corresponding patient database on NCI’s caBIG. Because of the TPC, theGraham Center received a $4.6 million grantto participate in the NCI Cancer GenomeAtlas Project.

Genetic counseling and gene testingThe Graham Center runs genetic counselingand gene testing programs throughout thestate—offering, as needed, prophylactic surgery, chemoprevention and increasedsurveillance to people with gene alterations.

Multidisciplinary disease site centersGiving new meaning to treating the whole person, the Graham Center has established 16 multidisciplinary centers—from disease-focused ones such as theHepatobiliary-Pancreatic and Head andNeck centers to ones focused on quality oflife, such as the Wellness and Survivorshipcenters. As part of the team, nurse naviga-tors guide patients through the labyrinth ofcancer care, helping with everything fromscheduling to transportation. The centerscoordinate support services—nutrition counseling, social services, psychology and palliative and pastoral care—and promote positive communication bothamong physicians and between physiciansand their patients and families.

Dr. Petrelli credits the centers with increas-ing patient visits to the Graham Center from

At the Helen F. Graham CancerCenter:

62%of cancer patients

in Delaware

receive their care.

100+research studies

on preventing and

treating cancer.

$4.6million grant to

participate in the

NCI Cancer

Genome Atlas

Project.

16multidisciplinary

centers focusing

on treatment and

quality of life.

“Ninety percent of the progress in cancer care and research resultsfrom clinical trials sponsored by the National Cancer Institute.”

— Nicholas J. Petrelli, M.D.Bank of America endowed medical director of the Helen F. Graham Cancer Center

(continued on page 3)

Cancer Update 3

03 04 05 06 07 08 09

about 60,000 in 2003 to morethan 134,000 in 2009. Thatmeans more than 60 percent ofall cancer patients in Delawarereceive their care at the GrahamCenter, according to theDelaware Cancer Registry.

Community outreachWithout engaging participants in their own healthcare, the most cutting-edge research and innovativepractices will not change the health of communities.Christiana Care is highly successful in educatingcommunities about the importance of preventionand early intervention.

In churches and community centers, at festivals and health fairs—as they test blood pressure and cholesterol levels and give flu shots,members of the Graham Center Outreach team talk with people and build relationships with such community groups as the AfricanAmerican Warriors Against Prostate Cancer, who then take the message to their communities.

Solving the relentless problem of health disparities has commandedthe attention and dollars of major health care foundations and government agencies for two decades. Yet, the disparities remain virtually unchanged—except in Delaware. Christiana Care’s Helen F. Graham Cancer Center is leading the way in cancer prevention,treatment and research. z

ONS is a national professional organization of 37,000registered nurses and other health care professionalscommitted to excellence in oncology nursing. Theaward is named for Pearl Moore, a charter member of ONS who served as CEO for more than 25 years.

The award recognizes Burbage’s significant contribu-tions to the oncology nursing profession at the localand regional levels. She is recognized for her manyperformance improvement projects that haveenhanced the quality of care of patients with breast

cancer, and for being a well-respected leader and mentor.

“To have been selected toreceive this award namedafter a pioneer in the field ofoncology nursing is an honor,” says Burbage. “It is atestament to the many talented nurses, physicians,managers and support staff who have mentored methroughout my career, as well as to the patients whoallowed me into their lives.” z

Darcy Burbage, RN, MSN, AOCN, CBCN, clinical nurse specialist at the Christiana Care Breast Center at the Helen F. Graham Cancer Center, is the 2010 recipient of the Pearl Moore Making a Difference Award from the Oncology Nursing Society (ONS).

Darcy Burbage receives top nursing society award

Darcy Burbage, RN, MSN,AOCN, CBCN

In 2009, the Helen F. Graham

Cancer Center had 134,000

patient visits, which is more than

double the 60,000 patient visits

recorded in 2003.

60,112

134,000

135,000

0

4 Christiana Care Health System

The program encompasses pediatrics,maternal-fetal medicine, cardiology andcancer, leading us to the cutting edge ofresearch and treatment. One goal is todevelop an infrastructure to diagnoseinherited disorders while tailoring treat-ments based on a patient’s unique geneticprofile. The program provides full clinical genetic services in Delaware. Until now, adults in need of genetic testingtraveled to Philadelphia or Baltimore.

“The future of medicine is genetics,” saysBruce Boman, M.D., Ph.D., director ofCancer Genetics and Stem Cell Biology at the Helen F. Graham Cancer Center. “Many diseases have genetic components.”

All cancers result from genetic changes incells. In about 5 to 10 percent, includingbreast, ovarian, colorectal, pancreatic andprostate cancers, as well as melanoma, the

genetic changes are inherited from one orboth parents.

“When we know about a person’s risk factors, we can tailor prevention strategiesto help lessen the likelihood that cancerwill develop,” says Zohra Ali-Khan Catts,MS, CGC, director of Cancer GeneticCounseling. “We can screen to catch cancer early, when it is most curable.”

Researchers are discovering genetic links tomany more conditions and will learn muchmore through a collaboration between theCenter for Heart & Vascular Health and theHelen F. Graham Cancer Center. “We willhave a combined database, which offersunparalleled opportunities for research,”says William Weintraub, M.D., FACC,John H. Ammon Chair of Cardiology anddirector of the Christiana Center forOutcomes Research. z

Medical Genetics program points to the future of medicine

Building on scientific advances, Christiana Care’s new Medical Genetics programis transforming the diagnosis, treatment and prevention of many diseases.

Zohra Ali-Khan Catts,MS, CGC

William Weintraub, M.D.,FACC

Bruce Boman, M.D., right, works in the Center for TranslationalCancer Research with post-doctoral fellow Lynn M. Opdenaker.

Other partners in the Alliance are the University ofDelaware (UD), Nemours/A.I. duPont Hospital forChildren and Thomas Jefferson University. Leadingthe Alliance is UD’s new dean of the College ofHealth Sciences, Kathleen Matt, Ph.D.

“One shared objective is to create more opportunitiesfor interdisciplinary and translational cancer care,”Dr. Matt says. “One of my biggest goals is to drawupon our collective vision and expertise to shortenthe pipeline between discovery and delivery, so thatnew knowledge can have an effect on people’s livesright now.”

A springboard for collaboration is the Center forTranslational Cancer Research (CTCR) at the Helen F.Graham Cancer Center. The CTCR was the site of thefirst local coordinated effort to unite clinicians withresearchers at UD’s Department of Biological Sciencesto translate laboratory science more quickly intoimproved clinical tools for screening, preventing and treating cancer. Christiana Care’s TissueProcurement Center provides human tissues for a variety of translational investigations.

“By bringing groups from various disciplines at the university to work together with clinicians at the

Helen F. Graham Cancer Center,we can begin to develop integrat-ed solutions to complex problemsthat surround the diagnosis, pre-vention and treatment of cancer,cancer recovery and quality oflife,” Dr. Matt says.

Starting with transformationaleducation programs that integrate various health professions for collaborative research, symposia andclinical opportunities, Dr. Matt’s vision of a continuumof cancer care extends well beyond her college frame-work, through the Alliance and to the community.

Comprehensive cancer care is the hallmark of the Helen F. Graham Cancer Center, with 16 distinct multidisciplinary disease centers, or MDCs. Dr. Matt’sown research interests as a neuroendocrinologist haveprompted exploration of joint studies with ClinicalNurse Specialist Cindy Waddington, RN, MSN, AOCN,and the team at the Mind, Body and Spirit WellnessMDC into the physiological effects and benefits of holistic, or complementary, cancer treatments.z

New partnerships to speed discovery research UD health sciences dean shares her vision

The Helen F. Graham Cancer Center at Christiana Care plays a keyrole in the Delaware Health Sciences Alliance by being focused notonly on finding innovative treatments for cancer,but also on getting them to patients sooner.

“ Relationships we develop with our patients are unique and rewarding. We may be their ‘bright spot’ on a dark and scary journey, but I am constantlyin awe of their grace and kindness in the face of illness.”

—Laurie KonopkaPatient physician access coordinator for the Oncology Pain and Symptom Management Practice

Kathleen S. Matt, Ph.D.,DHSA executive directorand dean, UD College ofHealth Sciences

Cancer Update 5

6 Christiana Care Health System

The Colorectal Cancer program―theonly one in Delaware and one of justa few in the region―offers patients the latest treatments and research benefits, and brings together cancercare experts at ChristianaCare and area organizations.

“The Colorectal Cancer program is an example ofChristiana Care taking a leadership role to do more to address this disease,” saysNicholas J. Petrelli, M.D.,Bank of America endowedmedical director of the HelenF. Graham Cancer Center.“We offer a wealth of expertise in colorectal cancer screening, prevention, treatment and research.”

The new program will spur growth and public awareness of the corner-stones of cancer care at the Helen F.Graham Cancer Center, with clinical/surgical expertise in colorectal cancerprevention, diagnosis and treatment;a tumor registry for research onhereditary cancers; a cancer geneticsprogram and high-risk family registry; and tissue procurement fortranslational research and the CancerGenome Atlas Project. A unique feature is the Rectal/Anal CancerMultidisciplinary Center, offering thelatest research, treatment and man-agement options for colorectal cancer.

The new program also strengthensour leadership role and widens opportunities for accruals to nationalchemotherapy and radiation oncologyclinical trials, including those sponsored by the National SurgicalAdjuvant Breast and Bowel Project(NSABP). Dr. Petrelli chairs theNSABP’s Colorectal Committee.

Project Leader Bruce Boman, M.D.,Ph.D., Center for TranslationalCancer Research (CTCR) director of Cancer Genetics and Stem CellBiology, sees broader opportunities

for translational andclinical research.“The ColorectalCancer program catalyzes the CTCR’sability to conductcolon cancer stem-cell research aimedat finding curativetreatments, whilepotentially doubling

the number of active research proto-cols through new collaborations andincreased accruals.”

Dr. Boman is the institutional principal investigator for theAPTIUM GI Consortium, an elitegroup of institutions collaborating toaccelerate research in gastrointestinalcancers. He also is the protocol chairfor the upcoming NSABP nationalcolon cancer prevention trial. Thetrial seeks to determine if Crestor®, a cholesterol-lowering statin, can prevent new colon tumors from forming in patients who have hadcolon cancer surgery.

Key to the design and development of the Colorectal Cancer program are the scientists in the CTCR, cancer genetics and high-risk familycancer registry, the Christiana CareSection of Colorectal Surgery, theDepartment of Pathology, theDepartment of Medicine section of Gastroenterology & MedicalOncology, the Department ofRadiation Oncology, and CommunityOutreach and Education. z

New colorectal cancer program spotlights world-class cancer care

Bruce Boman, M.D., Ph.D.

“We offer a wealth ofexpertise in colorectal

cancer screening, prevention, treatment

and research.”—Nicholas J. Petrelli, M.D.

Bank of America endowed medical directorof the Helen F. Graham Cancer Center

The Helen F. Graham Cancer Center at Christiana Care is launching a newColorectal Cancer program with an impressive list of colorectal cancer care services.

Christiana Care is recruiting lung cancer patients to the trial who are diagnosed but have not received any therapy to participate in the test, which uses a molecu-lar marker that binds to cancer cells and fluoresces red under ultraviolet light.

“This trial has the potential to develop a useful alternative to invasive needlebiopsy or bronchoscopy, which are currently used to establish the diagnosis oflung cancer,” says Thomas Bauer, M.D., principal investigator. “If accurate, thismethod could be used to diagnosis other cancers, too.”

Dr. Bauer, chief of Thoracic Surgery, has led several lung and esophageal cancer studies. For more information or referrals, call 302-623-4450. z

Researchers at the Helen F. Graham Cancer Center taking part in aphase II and phase III clinical trial could help launch a potentially keydiagnostic test for early stage lung cancer.

Trial of new lung cancer screening could advance early detection

Brother and sister recognized for fundraising on behalf of theHelen F. Graham Cancer Center

Kids Kickin’ Cancer’s Alicia and Brandon Lewandowskiwon the 2009 Youth in Philanthropy Award from the

Association of Fundraising Professionals. Theirorganization―founded in honor of their dad,who died of cancer at 37―has raised more than$84,000 for the Helen F. Graham Cancer Centerthrough an annual 5K run/walk, golf and soccertournaments, and other fundraising activities. z

“This trial has the potential to develop a useful alternative to invasive needle biopsy orbronchoscopy, which are currently used to establish the diagnosis of lung cancer.”

—Thomas Bauer, M.D., chief of Thoracic Surgery, Helen F. Graham Cancer Center

Brandon and Alicia Lewandowski celebrate with Gov. Jack Markell at the 2009 Philanthropy Day Awards at Deerfield Golf and Tennis Club.

Helen F. Graham Cancer Centerexpansion wins award

The Helen F. Graham Cancer Center expansion won “Project ofthe Year, 2009” in the health care category from Mid-AtlanticConstruction magazine. The award honors the finest examples of design and construction in Virginia, Maryland, Delaware, Pennsylvania and the District of Columbia. z

Thomas Bauer, M.D.

Cancer Update 7

One of only 14 cancer centers in the nationselected for the National Cancer Institute

Community Cancer Centers Program.

Cancer Update is produced by Christiana Care Health System. Entire publication © Christiana Care Health System, 2010. All rights reserved. 10CANC88

Christiana Care is a private not-for-profit regional health care system and relies in part on the generosity of individuals, foundations and corporations to fulfill its mission.

P.O. Box 1668Wilmington, Delaware 19899www.christianacare.org

Non-Profit Org.US Postage

PAIDWilmington, DEPermit No. 357

8 Christiana Care Health System

Brenda Rabeno, operationsmanagement coordinator forThe Cancer Genome AtlasProject and Rajiv Haravu,senior systems analyst in IT and project manager forcaBIG applications, deployedthe first caBIG application atChristiana Care, caTissue.The application supports thedaily operations of the tissueprocurement lab.

NCI site features Helen F. Graham Cancer CenterVisit the National Cancer Institute’s Cancer BiomedicalInformatics Grid (caBIG®) Web site for a video about ChristianaCare’s Helen F. Graham Cancer Center. A member of NCI’sCommunity Cancer Center Program, Christiana Care uses caBIG’svast information network, designed to promote knowledge anddata sharing among the entire cancer community, to acceleratediscovery and ultimately improve patient outcomes. z

Find the site athttp://cabig.cancer.gov/action/casestudies/ChristianaCare