UAMS Event April 17 to Feature End-of-Life Expert BJ Miller, M.D.

Palliative care and end-of-life expert BJ Miller, M.D., will speak at a UAMS-sponsored event April 17.

Palliative care and end-of-life expert BJ Miller, M.D., will speak at a UAMS-sponsored event April 17.

| LITTLE ROCK — A free event sponsored by the University of Arkansas for Medical Sciences (UAMS) will feature BJ Miller, M.D., a nationally recognized expert on palliative and end-of-life care.

“Not Whether, But How: An Evening with BJ Miller” is set for 6:30 p.m. April 17 at the Ron Robinson Theater, 100 River Market Ave., Little Rock. Although there is no cost to attend, seating is limited and preregistration is required at cancer.uams.edu/bjmiller.

Doors will open at 5:30 p.m., and concessions will be available for purchase.

BJ Miller, M.D., a palliative care physician from San Francisco, began his “formal relationship with death” at age 19 when he was involved in an accident that resulted in the amputation of one arm below the elbow and both legs below the knee.

Drawing on his expertise as a physician, a patient and the former executive director of Zen Hospice Project, Miller is an advocate for a health care system that maximizes quality of life and minimizes unnecessary suffering.

His TED Talk titled “What Really Matters at the End of Life” has garnered more than 8 million views and ranks among the most viewed talks online. He encourages his listeners to reorient and reframe our relationship to the inevitable and brings creative power and meaning-making to death.

This event is hosted by the UAMS Division of Palliative Medicine and funded by a grant from the Dorothy Snider Foundation in recognition of National Healthcare Decisions Day.


UAMS is the states only health sciences university, with colleges of Medicine, Nursing, Pharmacy, Health Professions and Public Health; a graduate school; hospital; a main campus in Little Rock; a Northwest Arkansas regional campus in Fayetteville; a statewide network of regional campuses; and seven institutes: the Winthrop P. Rockefeller Cancer Institute, Jackson T. Stephens Spine & Neurosciences Institute, Harvey & Bernice Jones Eye Institute, Psychiatric Research Institute, Donald W. Reynolds Institute on Aging, Translational Research Institute and Institute for Digital Health & Innovation. It is the only adult Level 1 trauma center in the state. UAMS has 2,727 students, 870 medical residents and five dental residents. It is the states largest public employer with more than 10,000 employees, including 1,200 physicians who provide care to patients at UAMS, its regional campuses, Arkansas Childrens Hospital, the VA Medical Center and Baptist Health. Visit www.uams.edu or www.uamshealth.com. Find us on Facebook, Twitter, YouTube or Instagram.

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Grateful Texan Holds Party for Myeloma Center

Myeloma patient Laura Drake and husband Marty of Idalou, Texas, celebrate her continued remission annually with a cocktail party in Lubbock with their friends. The party raises awareness of the disease and money, more than $5000, for the Myeloma Center.

Myeloma patient Laura Drake and husband Marty of Idalou, Texas, celebrate her continued remission annually with a cocktail party in Lubbock with their friends. The party raises awareness of the disease and money, more than $5000, for the Myeloma Center.

| March 21, 2019 | Texan Laura Drake loves a good party — especially when it’s raising money for a worthy cause. Since Drake’s remission from myeloma in January 2014, that worthy cause has been helping fellow myeloma patients at UAMS.

For the past three years, the 57-year-old church secretary and husband Marty, a cotton farmer, have celebrated each January by hosting a fundraising cocktail party in Texas to benefit the Myeloma Center.

“Marty and I have been blessed in our lives financially,” said Drake of Idalou, a small town outside of Lubbock. “We’ve always enjoyed ‘giving back’ but now raising money and awareness of multiple myeloma is our passion.”

Their donations to the center’s patient support fund assist others with gas, food, or lodging. So far, the Drakes have raised more than $5,000.

“The party came to be because we had mutual funds with a company that offered a $250 debit card to pay for expenses if you held a fundraiser for a charity,” Drake said.

The first year, the couple used the debit card to pay for wine and appetizers at a local winery, McPherson Cellar, and raised more than $1,000. The second year, they used it to ‘upgrade’ the appetizers at a party at the Texas Tech Club where the couple are members. They raised more than $1,000 that year, too.

“This year, we no longer had mutual funds with the company offering the debit card but the Texas Tech Club sponsored the fundraiser for us,” Drake said of the club overlooking the university’s football field.

The first two years, their guests were asked to make a minimum donation of $10. This year, they were asked to make a donation of at least $20.

The Drakes’ most recent party this January featured heavy hors d’oeuvres, cocktails and door prizes of lunch and dinner, all donated by the Texas Tech Club. Local musicians Kenny Maines and Jenni Dale Lord performed for about 75 attendees, including Marty’s dad, Jimmy. The party raised $3,040.

Friends of Laura and Marty Drake of Idalou, Texas, recently gathered in nearby Lubbock to raise awareness of myeloma and money for Laura's fellow patients at the Myeloma Center.

Friends of Laura and Marty Drake of Idalou, Texas, recently gathered in nearby Lubbock to raise awareness of myeloma and money for Laura’s fellow patients at the Myeloma Center.

Drake was diagnosed with the rare blood disease in the spring of 2013.

“I was referred to a doctor in Texas,” she said. “But through my own research, I discovered UAMS. Everything pointed to the fact that I should come here.”

“This is the best place to go for multiple myeloma because of all the research that takes place here,” Drake said of the Myeloma Center recently during her biannual visit with her physician Frits van Rhee, M.D., Ph.D. “And the doctors here all specialize in myeloma.”

“This place is not just on the cutting-edge of research, it also became my comfort zone. I knew everything done here would be exactly right.” She came to the Myeloma Center eight times over her first year for about three and half weeks each time and was treated with chemotherapy and a tandem stem-cell transplant.

Drake and her husband remain in touch with patients and caregivers they met during her treatment, including some of the spouses of patients who’ve died.

Drake, who completed three years of maintenance therapy in July 2017, looks forward to her twice yearly visits to the Myeloma Center.

“I enjoy coming back so I can see all of the people who loved me through the hard times,” she said. “There is a built-in support group among the patients, and the staff treats you like family.”

 


Rasco Symposium Offers Insights on GI Cancer Therapy, Research

Rasco Symposium course director A. Mazin Safar, M.D., (left) pauses a moment with keynote speaker Ryan B. Corcoran, M.D., Ph.D., (center) and Issam Makhoul, M.D., director of the UAMS Divisions of Medical Oncology and Hematology, during the event.

Rasco Symposium course director A. Mazin Safar, M.D., (left) pauses a moment with keynote speaker Ryan B. Corcoran, M.D., Ph.D., (center) and Issam Makhoul, M.D., director of the UAMS Divisions of Medical Oncology and Hematology, during the event.

| About 125 health care professionals gathered March 8 at the UAMS Winthrop P. Rockefeller Cancer Institute to learn about the latest advances in gastrointestinal (GI) cancer diagnosis and therapy.

The 22nd Annual Charles William Rasco, III Symposium on Colorectal Cancer and GI Malignancies offered a full day of educational presentations designed for all spectrum of specialists caring for GI cancer patients. Participants included physicians, nurses, pharmacists, social workers, researchers and others working in the field.

A. Mazin Safar, M.D., associate professor in the Divisions of Medical Oncology and Hematology in the UAMS College of Medicine, served as course director.

Rasco Sympsosium participants attend one of the sessions offered throughout the day-long event.

Rasco Sympsosium participants attend one of the sessions offered throughout the day-long event.

“Colorectal and other gastrointestinal cancers affect far too many Arkansans, and we are committed to providing them with the most advanced therapies available. Educational events such as the Rasco Symposium are important vehicles for us to exchange ideas with our colleagues in other disciplines and review some of the latest research and treatment options so we can best serve our patients’ needs now and in the future,” said Safar.

A keynote address titled “Clinical Applications of Liquid Biopsy in the Management of GI Cancers” was presented by Ryan B. Corcoran, M.D., Ph.D., director of the Gastrointestinal Cancer Center Program and the scientific director of the Termeer Center for Targeted Therapy at the Massachusetts General Hospital Cancer Center. Corcoran also is an assistant professor of medicine at Harvard Medical School.

Additional topics covered included noninvasive screening for colorectal cancer, the role of neoadjuvant radiation in GI cancers, nutritional support for GI cancer patients and colostomy management, among others.

The Rasco Symposium honors the memory of Charles William Rasco III, who died from colon cancer in 1994.

Participants also had the opportunity to visit booths representing a number of programs and services related to research and treatment of gastrointestinal cancers.


March 14, 2019

Isabelle Racine Miousse, Ph.D.

Isabelle Racine Miousse, Ph.D

Assistant Professor Department of Biochemistry and Molecular Biology UAMS College of Medicine Research Interest Statement Cancer cells fundamentally differ from healthy cells in the way they metabolize the amino acid and methyl donor methionine. This phenomenon is known as methionine dependence. It manifests as an increased reliance on an exogenous supply of methionine for growth…


UAMS-led Study Shows Potential to Alter Neck Dissection Surgery by 21 Percent in Head and Neck Cancer Patients

Brendan C. Stack Jr., M.D., served as co-investigator on an international study examining the effectiveness of PET/CT scans in determining whether a head and neck cancer patient's malignancy has spread to their lymph nodes.

Brendan C. Stack Jr., M.D., served as co-investigator on an international study examining the effectiveness of PET/CT scans in determining whether a head and neck cancer patient’s malignancy has spread to their lymph nodes.

| LITTLE ROCK — A study led by University of Arkansas for Medical Sciences (UAMS) surgeon Brendan C. Stack Jr., M.D., has shown the potential to alter neck dissection surgeries in about 21 percent of head and neck cancer patients.

Stack served as co-investigator on the international study examining the effectiveness of PET/CT scans in determining whether a patient’s cancer has spread to their lymph nodes. The study’s results were published Feb. 15, 2019 in the Journal of Clinical Oncology.

For patients found to have positive lymph nodes, a surgery called neck dissection, which involves an incision across the neck, is required to remove the positive nodes.

If a patient’s cancer has not spread to the lymph nodes, neck dissection surgery may not be required, reducing the patient’s pain and recovery time.

“Our study showed that when a patient has negative nodes on a PET/CT scan, 96 percent of the time the result is truly negative. With a high level of confidence, we can say to a patient that if your neck is negative on PET/CT, there is probably no need for a neck dissection,” said Stack, professor in the UAMS College of Medicine Department of Otolaryngology-Head and Neck Surgery.

Cancers that are collectively known as head and neck cancer usually begin in the squamous cells inside the moist surfaces of the head and neck. These cancers can affect the oral cavity, throat, larynx (voicebox) and nasal cavity.

While it was commonly assumed by physicians that a negative scan of the neck meant there was no need for a neck dissection as part of cancer therapy, this assumption had never before been established in a prospective, multi-institution trial.

The study was conducted from August 2010 to December 2016 in 23 centers around the world. Of the total 287 patients enrolled, 42 were from UAMS.

“More patients participated in this study at UAMS than at any other center,” said Stack, who developed the concept 18 years ago with co-investigator Val J. Lowe, M.D., professor of radiology at the Mayo Clinic in Rochester, Minnesota.

“Our first article hypothesizing this concept was published in the journal Cancer in 2001. Now, almost two decades later, we have shown that with the help of PET/CT technology it may be possible to significantly reduce the number of neck dissections performed on head and neck cancer patients,” said Stack.

PET scan is a type of nuclear medicine imaging that uses a small amount of radioactive material, called a tracer, to determine the severity of disease. In the case of this study, the tracer used was fluorodeoxyglucose, or FDG, a molecule similar to glucose.

CT imaging uses X-ray equipment to produce images of the inside of the body. When combined, PET/CT gives doctors the ability to see the body’s abnormality in relation to the anatomy, making it a more precise scan.

Another major result of the study involves the mapping of positive lymph nodes in the neck.

“There has been no other area of the body that has been mapped this way as it relates to PET scanning,” Stack said, adding that it could be beneficial for other types of surgeons to use the study’s results in determining the likelihood of positive lymph nodes in their own patients.

The study was initiated by the American College of Radiology Imaging Network, which later joined with the Easter Cooperative Oncology Group. Results were presented at the American Society of Clinical Oncology annual meeting in Chicago in June 2017, and a two-year patient follow-up concluded in December 2018.

The Cancer Clinical Trials and Regulatory Affairs office provided internal support for the study while it was being conducted at UAMS.

“Ideally, research should provide information that is both usable and capable to being built upon. I’m glad to say that researchers at another institution are already designing a follow-up trial to ours, which will develop this concept even further,” said Stack.


UAMS is the states only health sciences university, with colleges of Medicine, Nursing, Pharmacy, Health Professions and Public Health; a graduate school; hospital; a main campus in Little Rock; a Northwest Arkansas regional campus in Fayetteville; a statewide network of regional campuses; and seven institutes: the Winthrop P. Rockefeller Cancer Institute, Jackson T. Stephens Spine & Neurosciences Institute, Harvey & Bernice Jones Eye Institute, Psychiatric Research Institute, Donald W. Reynolds Institute on Aging, Translational Research Institute and Institute for Digital Health & Innovation. It is the only adult Level 1 trauma center in the state. UAMS has 2,727 students, 870 medical residents and five dental residents. It is the states largest public employer with more than 10,000 employees, including 1,200 physicians who provide care to patients at UAMS, its regional campuses, Arkansas Childrens Hospital, the VA Medical Center and Baptist Health. Visit www.uams.edu or www.uamshealth.com. Find us on Facebook, Twitter, YouTube or Instagram.

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March 11, 2019

Myeloma Center Staff Share Recent Discoveries at 2018 American Society of Hematology Conference

Clinical Trials

More than 30,000 clinicians and researchers gathered at the American Society of Hematology Conference in San Diego, California, this past December. Several representatives from the UAMS Myeloma Center presented a total of 24 abstracts on our recent discoveries, including three prestigious oral presentations. Here are lay summaries of those presentations:  Personalized Therapy in Multicentric Castleman…


Bill Signing Propels UAMS Cancer Institute’s Quest for NCI Designation

(From left) Arkansas Sen. Missy Irvin; UAMS Chancellor Cam Patterson, M.D., MBA; and Rep. Michelle Gray look on as Gov. Asa Hutchinson (seated) signs Senate Bill 151 in support of the UAMS Cancer Institute's quest for National Cancer Institute Designation.

With the stroke of a pen, Arkansas Gov. Asa Hutchinson brought the UAMS Winthrop P. Rockefeller Cancer Institute one step closer to its goal of achieving National Cancer Institute (NCI) Designation.


Cancer Diagnosis Gives UAMS Medical Student New Perspective

Third-year UAMS College of Medicine student and cancer survivor Corbin Norton (center) with his medical oncologist Rashmi Verma, M.D., (right) and nurse Jason Guenther, R.N.

Third-year UAMS College of Medicine student and cancer survivor Corbin Norton (center) with his medical oncologist Rashmi Verma, M.D., (right) and nurse Jason Guenther, R.N.

| With his first medical licensing exam in the books, Corbin Norton was ready to relax.

“It was a really tough exam. I had been studying for weeks,” the 27-year-old UAMS College of Medicine student said.

An Atlanta native, Norton landed at UAMS after his brother, then a resident in the Department of Otolaryngology, suggested he give it a look.

“Little Rock wasn’t even on my radar, but he gave me a tour and I was really impressed,” he said.

After being accepted into the college in 2016, Norton left his job at the Centers for Disease Control, moved to Arkansas and delved headfirst into the challenges of medical school.

“My brother was getting excellent training in his residency at UAMS, so I felt confident the College of Medicine would also be a good choice for me,” he said.

It was about two years later, after Norton completed his first licensing exam and was preparing to enter his third year of med school, when he noticed something alarming: a bump had developed on the back of his testicle.

With his newly acquired medical knowledge top of mind, Norton immediately knew he fell squarely in a high-risk group for testicular cancer. According to the American Cancer Society, about half of testicular cancers occur in men between the ages of 20 to 34, and the cancer is more common in white men than in African-Americans or Asian-Americans.

“Knowing I fit into that category, I was a little worried,” he said.

A visit to Norton’s primary care physician temporarily eased his fears when he was told the bump appeared to be a simple cyst. When it began to hurt a few weeks later, the same doctor determined it to be a condition known as epididymitis, an inflammation of the tube at the back of the testicles that stores and carries sperm.

But for Norton, the diagnosis of epididymitis didn’t ring true.

“I didn’t really think that was the problem,” he said, since epididymitis is most commonly caused by sexually transmitted diseases he does not have.

However, Norton followed the doctor’s orders and tried an over-the-counter pain killer, hoping it would relieve the increasing discomfort.

As days went by and the pain worsened, Norton decided it was time to see a specialist and made an appointment in the Urology Clinic at UAMS.

His treatment began with a round of antibiotics, but they offered no relief. It was then that an ultrasound was performed and revealed the true cause of Norton’s pain: a tumor of about 2.5 centimeters in his testicle.

“The ultrasound was on a Friday, and then it was a whirlwind,” Norton said. His family arrived from Atlanta, and there was talk over the weekend of going home for treatment. Ultimately, though, Norton decided that UAMS was where he was meant to be.

“I’m a med student here. People know me, and I know the doctors and nurses. There was a level of familiarity that was comforting. Plus, I knew I would get the best care here,” he said.

Early the next week, Norton met with his surgeon, Mohamed Kamel, M.D., and surgery was scheduled for Wednesday, a mere five days after his diagnosis. Norton also made the decision to bank his sperm prior to surgery, as treatment for testicular cancer can lead to infertility.

“I can’t say enough about Dr. Kamel. He answered all of my questions, even the simple ones. He was really in my corner and pushed to get things done on my behalf,” he said.

Kamel is an associate professor in the UAMS College of Medicine Department of Urology.

After the surgery, it was determined that Norton’s cancer, which had already spread to his lymph nodes, was a nonseminoma tumor with a high embryonal component, meaning it was an aggressive form of the disease that affects the precursors to sperm cells known as germ cells.

Genetic testing also determined him to have the isochromosome 12p gene mutation, which contributed to the tumor’s invasive and aggressive nature and, at times, its resistance to treatment.

Rashmi Verma, M.D., a medical oncologist in the UAMS Winthrop P. Rockefeller Cancer Institute, oversaw Norton’s chemo regimen, which included four stays in the hospital, as well as outpatient treatments.

“Chemotherapy for testicular cancer involves three drugs that require the patient be monitored around the clock,” said Verma, assistant professor in the UAMS College of Medicine Division of Medical Oncology.

While low blood counts delayed Norton’s treatment for a few days, Verma’s close attention to his condition allowed her to restart the chemotherapy regimen as soon as his counts were back up.

“We monitored his blood counts every 48 hours and started chemo again as soon as it was safe to do so,” she said.

Verma also worked closely with Norton and his family to ensure he avoided any potential risk of infection while home between hospital stays. Had he contracted an infection or pneumonia, his treatment could have been delayed for weeks, resulting in the possible development of residual cancer, she said.

“Dr. Verma was always very straightforward, and I appreciated that,” he said.

Finally, about four months after his surgery, Norton received the call he had been waiting for.

“I had a CT scan on January 31, and Dr. Verma called the next day to tell me I was cancer free. I was beyond relieved,” he said.

In total, Norton took about a five-month leave of absence from the College of Medicine and will return full time to his studies in March 2019.

“Everyone at the College of Medicine has been very supportive. At first I wanted to power through and avoid falling behind in school, but they reassured me I didn’t need to feel guilty for taking time off to care for my health,” Norton said.

With his treatment successfully completed, Norton said he’s now ready to put this experience behind him and get back to life, using his own experience as a patient to help guide his future as a more empathetic and understanding physician.

“Being a med student, I had to remind myself that it was OK to be the patient. Cancer makes you accept new roles in life that you never expected,” he said.


UAMS Graduate Student Receives Prestigious NCI Fellowship

UAMS Graduate School student has received a fellowship from the National Cancer Institute to support his melanoma research.

UAMS Graduate School student has received a fellowship from the National Cancer Institute to support his melanoma research.

| A prestigious fellowship from the National Cancer Institute (NCI) will allow UAMS Graduate School student Brian Koss to advance his melanoma research.

The Ruth L. Kirschstein National Research Service Award for Individual Predoctoral Fellows (F31) will provide Koss with a three-year award of $124,851 to fund his research focusing on the protection of tumor-infiltrating immune cells in melanoma patients.

Koss, a third-year student in the UAMS Graduate Program in Interdisciplinary Biomedical Sciences, is now one of a select few scientists at UAMS ever to receive an F31 fellowship from the NCI.

“Becoming a National Cancer Institute-funded fellow has positioned Mr. Koss for immediate success during his graduate training, and also has primed him to become a nationally competitive cancer researcher in the future. These awards are highly competitive, so receiving this fellowship is a testament of Mr. Koss’s hard work, innovation and desire to help cancer patients in Arkansas and across our nation,” said Alan Tackett, Ph.D., associate director for basic research in the UAMS Winthrop P. Rockefeller Cancer Institute.

Koss is in his third year as a member of Tackett’s lab team at the UAMS Cancer Institute.

“Melanoma tumors apply many repressive factors on immune cells, which can prevent the success of standard immunotherapies,” Koss said.

Immunotherapy is a type of treatment that stimulates a person’s own immune system to recognize and destroy cancer cells. It has been found to be a very successful method of treatment for many, but not all, patients with melanoma, the deadliest form of skin cancer, and is now considered standard of care for the disease.

Koss’ research has revealed a method to protect immune cells in the harsh melanoma microenvironment which is known to prevent successful outcomes for some patients. His fellowship award will allow him to further define his findings and apply them to preclinical models of melanoma.

“This fellowship is impactful not only for Mr. Koss, but also for UAMS, as it highlights the innovative cancer research at the Winthrop P. Rockefeller Cancer Institute and supports our ongoing mission to become a National Cancer Institute-Designated Cancer Center,” Tackett said.


Cancer Survivor Hits High Notes, Inspiring Fellow Myeloma Patients

| Even during his own battle with myeloma, Jay Edwards, 60, of Fort Worth, Texas, is always looking for opportunities to comfort and inspire fellow patients at the UAMS Myeloma Center.

The musician shares his soothing sounds on the saxophone whenever he has the chance. One memorable occasion was when, as a patient in the midst of treatment, he was playing on the sun porch of UAMS’s myeloma inpatient unit on F7 with one of his musician sons, Jay Jr. of Atlanta, Georgia.

“I was playing there, had my IV cord coming out of my shirt, and was getting hung up in it,” he recalled, laughing. “When I got finished, one of the other patients told me, ‘You know, people, who don’t have myeloma are reassuring us all the time, but when I walked in here and saw that chemo going through you just like me it makes a big difference. It’s an example for me.’”

“So you just never know what kind of effect you can have on people,” he said.

Another time during his treatment, Edwards was in the breakroom one night preparing spaghetti for his wife, Ruth.

“A lady came in and asked which patient I was with and when I told her I was the patient she was very surprised. She said, ‘You’re the patient? And you’re in here fixing dinner for your wife?’ She told me her husband was going through a tough time and asked if I could visit with him in his room.

“While I was a patient at UAMS, I got to visit with a lot of people,” he said.

Edwards’ journey with the rare blood disease began in 2016 after going to the emergency room for high blood pressure and learning he had an aortic aneurysm. Additional testing revealed multiple myeloma and he had a stem cell transplant that year.

The former Fayetteville resident was referred by Highlands Oncology Group in Fayetteville to the UAMS Myeloma Center. After six cycles and six months in the hospital, Edwards has been in remission since 2017.

“I feel good and I’m cancer free,” he said. He sees his physician, Frits van Rhee, M.D., Ph.D., every six months.

“Everybody in this place is awesome,” Edwards said of the Myeloma Center. “You are in the best hands at UAMS. The doctors and staff are so comforting. They really care, they work wonders and it shows.”

The Sherrill native continues to share his music with others through his CD, “Yes, Jesus Loves Me” and live performances. His most recent chance at the Myeloma Center came in early February before a presentation by van Rhee. Edwards and another of his five children, son Jerjuan Edwards of Bentonville, performed as patients and family members arrived.

“The music is therapeutic for me and the listeners,” said Edwards. “It’s important to me to share music because it’s uplifting, soothing and as that lady told me, it means so much more coming from a fellow patient, to see that you can be at peace in the middle of your storm. No matter what life throws your way, if we take it positively, our journey is so much brighter and myeloma is just a bump in the road.”


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