May 24, 2015
Florida cancer center profiles

Photo: Jose Perez

Sylvester Comprehensive Cancer Center hopes to develop a better understanding of virus-induced cancers.

Cancer Crusaders

Florida cancer center profiles

What's in the works at cancer centers around the state.

Janet Ware | 4/30/2014

‘One-Stop Shop for Blood Cancer'

Mayo Florida boasts more the 20 blood cancer specialists.

Mayo Clinic

Although relatively uncommon compared to many other cancer types such as lung, breast, colorectal and prostate, blood cancers can be particularly aggressive and sometimes difficult to treat.

"We are a kind of one-stop shop for blood cancer treatment," says Dr. Asher Chanan-Khan, who serves as chair of the Jacksonville clinic's division of hematology/ oncology. "No matter how rare or how complicated the case, we have a specialist for it. "

Mayo Florida's division of hematology/ oncology boasts more than 20 cancer specialists offering expertise in both non-malignant and malignant conditions, including multiple myeloma, lymphoma and acute and chronic lymphocytic leukemias. Hematologists from all three campuses — the other two are in Scottsdale, Ariz. , and Rochester, Minn. — meet regularly via video link to discuss specific cases.

Says Chanan-Khan: "At any given time, we may have 35 experts across three facilities discussing a single case. That's an immense amount of intellectual power devoted to making the right decision for a patient. "

For many, the solution is a bone marrow transplant, and Mayo is northeast Florida's only bone marrow transplant center. Candidates awaiting transplants there undergo pre-op treatments that are often both physically and psychologically traumatic.

"Typically, patients undergoing these procedures are admitted to the hospital for six to 10 weeks and cooped up in a single room," says Chanan-Khan. "Their immune systems are so fragile they can't get out. They can't be with people. It's a tough way to live. "

Beginning this fall, however, Mayo Florida will offer bone marrow transplants as an outpatient procedure. Patients won't be coming back and forth between hospital and home for treatment — that's still too risky — but they will be housed in a more home-like setting. Mayo is prepping a hotel inside the hospital itself, where bone marrow transplant patients can kick back in easy chairs and sleep in hotel beds during the course of their treatment. They'll be able to freely walk around the hospital grounds.

"Physically, their outcome will be the same," says Chanan-Khan, "but psychologically, they'll be much better off than if they were locked up as they used to be. "

Dr. Asher Chanan-Khan: "At any given time, we may have 35 experts across three facilities discussing a single case. "

Building Projects

Baptist Health and Cleveland Clinic are expanding their facilities to treat cancer.

Baptist Health South Florida

The Miami hospital plans to break ground this summer on the 395,000-sq. - ft. , $400-million Miami Cancer Institute, which will be located on the hospital's campus and connect to the hospital. Along with offering clinical services that include radiation, bone marrow transplants and diagnostic imaging, the institute will include a research facility. The new institute will be the frst facility in south Florida to offer proton therapy, which enables radiation to be more prefrom Cisely targeted at cancerous tumors. The proton therapy will be marketed both to patients in south Florida and throughout Latin America and the Caribbean. In addition, Baptist, which operates six other hospitals and more than 30 outpatient facilities in the region, also says it is in discussions with Miami Children's Hospital to collaborate on offering proton therapy to children. Baptist CEO Brian Keeley says the new facility will be a "world-class destination" for those seeking care.

Cleveland Clinic Florida

From his office at Cleveland Clinic Florida in Weston, cancer center Director Dr. Steven Roshon can look out on the shape of cancer care to come. When the 143,000-sq. -ft. structure currently taking shape outside his window finally opens to patients in February 2015, a new era will begin in the diagnosis and treatment of cancer at Cleveland Clinic.

"Having the opportunity to develop and build a new cancer center," says Roshon, "is like starting over. We'll be able to be more comprehensive than in the past, more able to participate in true multidisciplinary care. "

Construction on the building began in November following a $30-million donation — the largest in Cleveland Clinic Florida's 25-year history — from longtime patient and clinic supporter Pauline Braathen. The five-story structure to be named the "Egil and Pauline Braathen Facility" will house the expanded Pauline Braathen Neurological Center and Cleveland Clinic Florida's Cancer Center. Total cost of the project is expected to be $90 million, with the bulk of funds coming from philanthropic sources.

Cleveland Clinic treats 1,100 cancer cases each year. With the new facility, says Roshon, doctors will be able to treat many more. "Our goal is to increase our current volume significantly. "

Revolutionary Treatment

Moffitt's new two-drug treatment for skin cancer could greatly improve survival odds.

Moffitt Cancer Center

Melanoma accounts for fewer than 2% of skin cancer cases in the U. S. , according to the American Cancer Society, but it represents 75% of skin cancer deaths each year. In January, researchers at Moffitt Cancer Center in Tampa announced a revolutionary two-drug therapy for treating advanced melanoma that could greatly improve those odds.

"Ten years ago, a diagnosis of melanoma meant you were going to die. Today, patients are living longer and having good quality of life," says Dr. Jeffrey S. Weber, director of Moffitt's Melanoma Research Center of Excellence.

The new therapy combines two drugs marketed by GlaxoSmithKline — Mekinist (trametinib) and Tafinlar (dabrafenib) — which have been used separately to block cell signaling. Moffitt researchers in 2010 discovered that by using the two drugs in combination they could block cancer cell growth. A subsequent clinical trial at Moffitt, which showed a 76% success rate for melanoma patients treated with the two-drug combo, proved them right. Many patients have been on the two-drug combo for almost four years, says Weber, with minimal side effects and the ability to work their normal schedules while undergoing treatment.

"There's no question that the two drugs work better together," he adds. "Not only are we seeing some of the longest survival rates in metastatic cancers — this is one of the few scenarios where a combination of two drugs reduces some of the toxic effects patients experienced when the two drugs were used alone. "

"This is one of the few scenarios where a combination of two drugs reduces some of the toxic effects patients experienced," says Dr. Jeffrey S. Weber.

Attacking Viruses

Sylvester Comprehensive Cancer Center hopes to develop a better understanding of virus-induced cancers.

Sylvester Comprehensive Cancer Center

Dr. Enrique A. Mesri (left): "These viruses are able to infect our bodies for a very long time. "

Viruses are known to cause 12% of all human cancers. And although most cases of virus-induced cancers have been deemed preventable by vaccination, this group of cancers remains among the least understood of all.

Dr. Enrique A. Mesri, a member of the Viral Oncology Program at Sylvester Comprehensive Cancer Center and an associate professor, graduate program director and director of AIDS malignancies of the Miami Center for AIDS research in the department of microbiology and immunology at University of Miami's Miller School of Medicine, hopes to change that.

Mesri and his team recently analyzed six cancer-causing viruses: Epstein-Barr virus (EBV), high-risk human papillomaviruses (HPVs), hepatitis B and C (HBV and HCV), human T cell lymphotropic virus-1 (HTLV-1) and Kaposi's sarcoma herpesvirus (KSHV).

"What we learned," says Mesri, "is that all these viruses are able to infect our bod- ies for a very long time because they have the capability of hiding from the immune system and growing within infected cells. So they are not killed by the immune system, but divide indefinitely and grow out of control — essentially, what we know as cancer cells. "

Typically, viral infections are counteracted by the body's natural immune response before they have a chance to trigger cancer. Vaccines against cancer viruses enhance immunity and can prevent cancer by blocking the infection in the first place. Two vaccines aimed specifically at viruses known to cause high rates of cancer are already showing promise: Hepatitis B vaccine to prevent liver cancer and HPV vaccine to block HPV-related cervical carcinomas.

Of particular interest to Mesri, however, is KSHV, the virus associated with Kaposi's sarcoma, a cancer that became epidemic in the U. S. in the 1980s along with the spread of AIDS. Kaposi's sarcoma might have remained a rare cancer of the elderly, says Mesri, had it not come into association with the AIDS-causing virus HIV, which destroys the body's immune response and allows cancers caused by KSHV to develop.

Mesri's team has identified the actual genes of KSHV that cause cancer in cells and has determined how they are able to deregulate the growth of infected cells. The team is continuing to study variations among AIDS patients with and without Kaposi's sarcoma with the hope of eventually determining why one infected person develops cancer and another does not.

Says Mesri, "Understanding how cancer happens in the context of the ‘war on cancer' is like ‘knowing the enemy. ' Based on what we learn in the laboratory about its weaknesses — its Achilles' heel, you might say — we can better develop more effective therapies. "

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