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A Friend for Life / Ellis Fischel Cancer Center / Summer 2007

A survivor’s                                                    Easing

Columbia triathlete, mom and
professor refuses to let cancer
                                                                the pain:
                                                                When to seek palliative care

                                                                MU Scientists shine
                                                                light on tumor cells
rule her life
We are pleased . . .

                                              to present to you the inaugural issue of Ellis,
                                                          a magazine highlighting our patients,              about some of our research, including an
                                                          programs and accomplishments at Ellis              exciting project in which oncologists and
                                                          Fischel Cancer Center.                             engineers team up to detect cancer cells in
                                                                Our focus at Ellis Fischel is to improve     blood through the use of lasers and sound.
                                                          and extend the lives of cancer patients            We’ve also let two of our patients tell you, in
                                                          through treatment, discovery and ongoing           their own words, about the kind of care they
                                                          scientific investigation. We know that              have received at Ellis Fischel.
                                                          science saves lives — from the development               Additionally, we’ve highlighted the
                                                          of chemotherapy and radiation decades ago          kindness and generosity of community
                                                          to the ongoing treatments that continue to         members. Through fund-raisers such as the
Dr. Charles William Caldwell
Medical Director of Ellis Fischel                         be discovered and improved upon today.             Jay Dix Challenge to Cure Race, the Deon
                                                                As part of the University of Missouri-       Starman Memorial Golf Tournament and
                                                          Columbia and University of Missouri                our annual gala, “A Summer Celebration,”
                                                          Health Care, physicians and researchers at         citizens are helping benefit cancer patients
                                                          Ellis Fischel have unique opportunities to         here in mid-Missouri.
                                                          conduct ground-breaking, multidisciplinary               With these thoughts in mind, we
                                                          research and clinical trials in an outstanding     are pleased to present to you some of our
                                                          collaborative environment.                         current accomplishments and planned goals
                                                                In this issue of Ellis, you will learn       for Ellis Fischel Cancer Center.


Kristi Gafford
Executive Director of Ellis Fischel                       Charles William Caldwell, M.D., Ph.D.                 Kristi Gafford, M.P.H., M.B.A.
                                                          Medical Director, Ellis Fischel Cancer Center         Executive Director, Ellis Fischel
                                                          CRC Missouri Chair in Cancer Research                 Cancer Center

                                    Ellis Fischel Cancer Center, part of the University          Ellis is published for friends of Ellis Fischel Cancer Center.
                                    of Missouri Health Care system, is mid-Missouri’s            Editor: Velvet Hasner
                                    only hospital dedicated to cancer care. More                 Designers: Renette Reiske and Jason Kertz
                                    than 100 clinician specialists and other scientists          Contributors: Kim Figg, Kristi Gafford, Laura Neal, James Ray
                                                                                                 and Kathy Sevedge
                                    work together to improve and extend the lives of
                                                                                                 Photo Editor: David Owens
                                    cancer patients. Designated Missouri’s official
                                                                                                 For information on giving to University of Missouri Health
                                    state cancer center in 2004, Ellis Fischel offers
                                                                                                 Care’s Ellis Fischel Cancer Center, please contact Jim Salmo,
                                    comprehensive cancer care and cancer screening               associate vice chancellor of development, at (573) 884-3038
Ellis Fischel Cancer                services. Contact Ellis Fischel Cancer Center at             or e-mail
Center is named after a                                                                          The University of Missouri-Columbia does not discriminate
                                    (573) 882-2100 or visit
St. Louis surgeon who
                                                                                                 on the basis of race, color, religion, national origin, ancestry,
was devoted to the early
detection and treatment                                                                          sex, age, disability, sexual orientation or status as a disabled
of cancer.                                                                                       veteran or veteran of the Vietnam era. For more information,
                                                                                                 call Human Resources Services at (573) 882-4256 or the U.S.
                                                                                                 Department of Education, Office of Civil Rights.

2     Ellis   Summer 2007               Ellis Fischel Cancer Center   A Friend for Life
                                                  SUMMER 2007                               Ellis Fischel lauded for
                                                                                            quality of care
                                                                                                  Ellis Fischel Cancer Center once again

4    It’s hats off for Byron
     Cancer treatment completed, Byron Hines can now
                                                                                            received a three-year accreditation from the
                                                                                            American College of Surgeons’ Commission on
                                                                                            Cancer. Ellis Fischel demonstrated compliance with
     focus on his favorite hobbies                                                          all 36 standards that represent the full scope of a
                                                                                            comprehensive cancer program. The cancer center
                                                                                            also received commendation on four standards.
                                                                                                  “It’s sort of like having the Good

6    A survivor’s story
     Sarah Breier-Mackie refuses to let cancer rule her life
                                                                                            Housekeeping stamp of approval — it means
                                                                                            we’re doing a very good job in terms of caring
                                                                                            for patients with cancer,” said Charles Caldwell,
                                                                                            M.D., Ph.D., medical director of Ellis Fischel
                                                                                            Cancer Center.
                                                                                                  Approximately 80 percent of all newly
                                                                                            diagnosed cancer patients are treated in cancer

8    Listening for cancer
     MU Researchers use lasers and light to seek out tumor cells
                                                                                            programs approved by the ACOS Commission
                                                                                            on Cancer. Accreditation requires the availability
                                                                                            of a full range of medical services along with a
                                                                                            multidisciplinary team approach to patient care.
                                                                                            Approval by the national commission is given only
                                                                                            to those facilities that have voluntarily committed
                                                                                            to providing the highest level of quality cancer care

10   Life after cancer
     Ellis Fischel Cancer Center provides support for survivors
                                                                                            and that undergo a rigorous evaluation process and
                                                                                            review of their performance. To maintain approval,
                                                                                            facilities with approved cancer programs must
                                                                                            undergo an on-site review every three years.
                                                                                                  “This recognition further validates the qual-
                                                                                            ity care we provide at Ellis Fischel every day,” said
                                                                                            Paul Dale, M.D., surgical oncologist, cancer

12   Power for the patient
     Multidisciplinary team provides patient-centered
                                                                                            liaison physician to the American College of Sur-
                                                                                            geons. Dale also serves as the Margaret Proctor
                                                                                            Mulligan Distinguished Faculty Scholar in Breast
                                                                                            Cancer Research.
     palliative care
                                                                                                  An on-site surveyor from the commission
                                                                                            interviewed several physicians and staff
                                                                                            members, toured clinical areas at University

13   Your gifts at work
     Special events bring hope and healing to patients
                                                                                            Hospital and Ellis Fischel Cancer Center
                                                                                            and conducted a chart audit. Areas receiving
                                                                                            commendation included outcomes analysis
                                                                                            activities and Ellis Fischel’s prevention and early
                                                                                            detection programs, which include the mobile
                                                                                            mammography vans. More than 3,000 women
                                                                                            were screened in the vans in 2006.

14   Spotlight
                                                                                                  Ellis Fischel was also recognized for
                                                                                            impressive enrollment rates of patients for
                                                                                            clinical trials. In 2006, more than 100 patients
                                                                                            were newly enrolled in clinical trials, and more
                                                                                            than 1,000 patients who had volunteered for
                                                                                            clinical trials continued being followed.
                                                                                                  Additionally, recent patient care

                                                                                            improvements, such as the establishment of
     ‘This is my family now’                                                                the Margaret Proctor Mulligan Breast Health
                                                                                            and Research Program, were highlighted as
     For more than 25 years, volunteer Lorraine Crews has
                                                                                            significant achievements.
     served patients and staff at Ellis Fischel

                                                            A Friend for Life        Ellis   Summer 2007     3
                                        hats off
                                                                       for Byron
4   Ellis   Summer 2007   Ellis Fischel Cancer Center   A Friend for Life
  Cancer treatment completed, Byron Hines can
  now focus on his favorite hobbies.

                 ine-year-old Byron Hines is            “They were wonderful to him,” Shirley           he got there. He worked back and forth
                 looking forward to elk hunting    said. “Those nurses took the time with him.          with the people giving his chemotherapy.
                 in September and deer             They cried with him sometimes. They were             They worked really well with each other.”
                 hunting in November. These        just wonderful. I would recommend Ellis                   Byron seems to take the trials in
  will not be his first hunting trips — in fact,    Fischel and Children’s Hospital to everybody.”       stride. He loves hunting, fishing, being
  he captured his first deer at the age of 7             Members of Byron’s health care                  outdoors, telling stories and talking
  — but they will be his first big hunting trips    team included Steven Westgate, M.D.,                 about his seven older siblings. He has a
  since completing his cancer treatments.          a radiation oncologist at Ellis Fischel,             growing hat collection at home and usually
       Following emergency surgical removal        and pediatric hematology and oncology                brought a couple hats with him to medical
  of his right testicle in December 2005 at        physicians LaJuan Chambers, M.D.,                    appointments and hospital stays.
  Northeast Regional Medical Center in             and Barbara Gruner, M.D. Kim Ebersol,                     “The nurses are nice, and the doctors
  Kirksville, Mo., Byron was referred to Ellis     R.N., a clinical nurse specialist, worked            are good,” said Byron when asked about
  Fischel Cancer Center for further tests and      closely with the Hines family to keep them           his care. “They give me all the treatments
  treatments. He was diagnosed with Stage          informed of Byron’s health, treatments and           needed.”
  II embryonal rhabdomyosarcoma and has            appointments.                                             Shirley is proud of the way Byron has
  undergone two stomach biopsies, surgery to            “He had very serious radiation and              handled his disease.
  remove his appendix and part of his bowel,       chemotherapy treatments. The radiation                    “He’s matured a lot,” she said. “I think
  and radiation treatments. He completed           was every day for 20-25 days, and he only            the way the staff educated him from the
  chemotherapy in December 2006.                   had weekends off,” Shirley said. “It was very        beginning helped him be less afraid. Not
       Byron’s parents, Randy and Shirley          intense radiation.                                   knowing is scary for children. They can
  Hines of Novelty, Mo., are pleased with the           “Dr. Westgate was a good doctor,” she           handle a lot if they just know.”
  coordinated care their son received from Ellis   said. “He did a lot of studying and made
  Fischel and Children’s Hospital.                 phone calls and prepared for Byron before

                                                                                                           Kids with cancer –
                                                                                                           How do I act?
                                                                                                           The child life specialists at
                                                                                                           Children’s Hospital offer these
                                                                                                           tips for parents, grandparents
                                                                                                           and other loved ones of a child
                                                                                                           with cancer.
                                                                                                           • Treat them as “normal” kids.
                                                                                                             They are living with cancer, but
                                                                                                             it is not who they are.
                                                                                                           • Remind children to wear
                                                                                                             sunscreen, sunglasses and a
                                                                                                             hat outdoors.
                                                                                                           • Playing is a child’s way to work
                                                                                                             through emotions and scary
                                                                                                             situations. Assist the child with
                                                                                                             medical play.
Byron and Steven                                                                                           • Encourage the child to keep in
Westgate, M.D., model
some of the hats from
                                                                                                             touch with friends. Encourage
Byron’s collection.                                                                                          going to school.
Westgate, a radiation
oncologist at Ellis Fischel                                                                                • Involve siblings in all aspects of
Cancer Center, was a key                                                                                     the hospitalization and care. Do
player on Byron’s health
care team during his                                                                                         fun activities just with them.
struggle with cancer.

                                                                           A Friend for Life      Ellis   Summer 2007   5
A survivor’s
Columbia triathlete, mom and
professor refuses to let cancer
rule her life

             lmost five years ago, Sarah              trying to take care of a newborn and a 2-       swam three times a week.
             Breier-Mackie was initiated into        year-old, the last thing you think about is          On June 12, 2003, Sarah completed
             a special club. Membership has          giving yourself an abdominal exam.”             her last round of radiation therapy. The
             one criterion — a diagnosis of                Tests revealed Sarah had non-Hodgkin’s    next day, the family left for Ann Arbor,
cancer. Sarah joined more than 10 million            lymphoma. A new job awaited Gavin in            where Sarah was introduced to a lymphoma
Americans who have battled cancer and now            Ann Arbor, Mich., but the move was put on       expert at the University of Michigan Health
proudly call themselves cancer survivors.            hold until Sarah finished her chemotherapy       System. Mark Kaminski, M.D., is a well-
      “This is a journey that doesn’t stop           and radiation treatments. Sarah relied on       known oncologist who helped develop the
when your cancer treatment stops,” Sarah             old habits to remain strong through her         cancer-fighting drug, Bexxar.
said. “That’s when the real challenge begins.”       therapy. Growing up in Australia, she was            The family lived in Ann Arbor for
      Sarah, who lives in Columbia and is an         a swimmer, cross country runner, surf life      one year before moving to Columbia in
assistant professor at MU’s Sinclair School          saver and triathlete.                           July 2004. Gavin is an assistant profes-
of Nursing, was diagnosed with non-                        “I started running again after having     sor of radiology at MU and a diagnostic
Hodgkin’s lymphoma in December 2002.                 my son and was shocked when my                  radiologist at Ellis Fischel Cancer Center,
At the time, she was living in Melbourne,            oncologist told me to continue exercising,”     where Sarah receives surveillance care from
Australia, while her husband, Gavin,                 she said. “I thought he would tell me to        Michael Perry, M.D., the Nellie B. Smith
completed a fellowship in nuclear medicine           rest, but exercise helped counter the fatigue   Chair of Oncology. Both Sarah and Gavin
and radiology. Sarah had just given birth to         from therapy. Plus I needed to be in the        were drawn to Columbia based on the com-
the couple’s second child, Karl, when her            best shape possible, both mentally and          munity and career opportunities. Kaminski’s
physician discovered a mass in her abdomen           physically.”                                    recommendation that Sarah receive her care
during a postpartum examination.                           It was then Sarah decided her diagnosis   from Perry solidified the move.
      “At first I was embarrassed for not             would not control her life. She wanted to            “Dr. Perry and the rest of the staff offer
noticing the mass since I was a nurse,” she          continue doing what she loved, regardless of    a holistic mode of care,” Sarah said. “They
said. “But when you are running around               her condition. She ran nearly every day and     take care of my physical and emotional

6    Ellis   Summer 2007         Ellis Fischel Cancer Center   A Friend for Life
“I was shocked when my oncologist
told me to continue exercising.”
                                                                                                                 – Sarah Breier-Mackie
health. The people at Ellis are my family.”      survivors in mid-Missouri. She created a
      Ellis Fischel has been at the forefront    partnered exercise program, SET (Survivor
of addressing survivorship issues, and           Exercise Team) for Life, with fellow survivor
physicians such as Perry understand the          and triathlete Mike Moore. More than
importance of preserving patients’ quality       50 Columbia Multisport Club members
of life both during and long after cancer        have already committed to partnering with
treatment ends.                                  cancer survivors to help them begin an
      “Survivorship is taking on a life of its   exercise program either before, during or
own,” he said. “Now that we have more            after cancer treatment.
long-term survivors, a recognizable group               Sarah also invited cancer survivors to
of advocates for appropriate follow-up care      join her to walk as a group in the Jay Dix
has developed. This is not a circumstance        Challenge to Cure Race, held April 14 in
where doctors and patients disagree with         Columbia. She sponsored cancer survivor
each other. We all want the best long-term       Shannon Dennis, who was diagnosed with              Sarah Breier-Mackie kisses her son, Karl, in
survival outcomes.”                              Hodgkin’s lymphoma in April 2005. The               2003. When she was diagnosed with cancer,
      Another family Sarah joined is the         single mother of two teenage boys finished           Karl was a newborn and her daughter, Annaliese,
Columbia Multisport Club, which has              her treatment in October 2005 and is an             was two years old.
given her the opportunity to compete             administrative assistant at University of
in triathlons. Sarah finished first in her         Missouri Health Care’s Mason Eye Institute.         She is training to run in the ING New York
division, along with the club’s national                Although Shannon is not a triathlete         City Marathon in November 2007, and has
championship, at a triathlon in Las Vegas        like Sarah, she followed a walking regimen          been selected to run in a team of seven other
in October 2006.                                 during her treatment. She plans to                  cancer survivors from across the nation
      “I’ve done some pretty big races, but      participate in future SET for Life group            in the LiveStrong Army sponsored by the
the race in Las Vegas has to be the most         walks and feels they will provide more than         Lance Armstrong Foundation.
memorable for me,” Sarah said. “After I          just a means to exercise.                                 Sarah plans to continue living her life
was diagnosed with cancer, I told myself I              “I know cancer survivors can gain            to its fullest. She still returns to Ellis Fischel
would never compete in another triathlon.”       benefits from a group like this,” Shannon            every three months for blood tests and every
However, her determination and will were         said. “People who have never gone through           six months for CT scans. However, Sarah
stronger than the disease and she proved         treatment truly don’t understand how hard           does not define herself by her disease.
that being a cancer survivor doesn’t have to     it is. It will be nice to be surrounded by                “I am a mother, a wife, a nursing
limit one’s life.                                people who will know exactly what I’m               professor and a triathlete, and I happen to
      Just after her win in Las Vegas, Sarah     talking about.”                                     be living with cancer,” she said. “I take one
attended the inaugural LiveStrong Summit                Meanwhile, Sarah will join a new group       day at a time and accept my limitations.
in Austin, which motivated her to improve        to further raise awareness of survivorship.         Cancer will never rule my life.”
awareness of survivorship in her own
community. The summit, an initiative of
the Lance Armstrong Foundation, was                  11 benefits of exercise
created to help broaden awareness and
                                                     Michael Perry, M.D., oncologist at                5. Improved self-esteem
address the unmet needs of people living
with cancer. In particular, it was the words         Ellis Fischel, recommends exercise                6. Reduced anxiety and
of Elizabeth Edwards, wife of Democratic             to patients undergoing cancer                        depression
presidential hopeful John Edwards, that              treatment. Possible benefits of
most affected Sarah at the summit. Edwards’          exercise include:                                 7. Decreased nausea
comments were given prior to her relapse             1. Maintained or improved                         8. Increased ability to maintain
with breast cancer. Sarah also found strength
                                                        physical abilities                                social contact
in Edwards’ words following her relapse.
      “Basically Elizabeth said that she             2. Prevention of muscle wasting                   9. Better ability to control
could start living, or start dying,” Sarah              caused by inactivity                              weight
said. “That embodies survivorship, in my                                                               10. Improved quality of life
opinion. We must live with cancer.”
                                                     3. Reduced risk of heart disease
      Following the summit, Sarah developed          4. Prevention of osteoporosis                     11. Less dependence on others
a way to give back to cancer patients and                                                                  to do normal activities

                                                                        A Friend for Life        Ellis   Summer 2007    7

    MU Scientists:

    for             cancer
    Lasers and light seek out tumor cells

                                                                                                      Paul Dale, M.D., and John Viator, Ph.D., have
                                                                                                      created quite a buzz with their photoacoustic
                                                                                                      detection research. They appear here just
                                                                                                      prior to a CNN interview for the station’s
                                                                                                      “Welcome to the Future” program, which
                                                                                                      aired in November 2006.

                                                                 esearchers at Ellis Fischel Cancer   M.D., Ph.D., medical director of Ellis
“The only reason there                                           Center and the University of         Fischel Cancer Center and CRC Missouri
could be melanin in the                                          Missouri-Columbia are finding         Chair in Cancer Research; and Xudong Fan,
human blood is if there                                          cancer cells that circulate in the   Ph.D., an assistant professor of biological
are melanoma cells.                                bloodstream with the use of photoacoustics.        engineering.
                                                   The technology uses lasers, sound and light             “The concept came about when Dr. Viator
Our method can help                                to find skin cancer cells in a vial of blood.       and I sat down to discuss my interest in surgery
doctors plan treatment                                   “No one has ever studied this before,”       and cancer patients and his interest in lasers
to battle the spread of                            said Paul Dale, M.D., surgical oncologist at       and photonics, or applications of lasers,”
                                                   Ellis Fischel Cancer Center. “We didn’t have       Dale said. “We came up with the idea that
the disease.”                                      ways of measuring circulating cancer cells.”       we could identify tumor cells by the way they
                       – John Viator
                                                         Dale is director of surgical oncology        absorb light.”
                                                   at MU and the Margaret Proctor Mulligan                 In lab tests, the research team sought
                                                   Distinguished Faculty Scholar in Breast            out melanoma — a type of skin cancer
                                                   Cancer Research. He is collaborating on            — cells. Melanoma was chosen, Dale said,
                                                   the research with John Viator, Ph.D., an           because such cells contain melanin which
                                                   assistant professor of biological engineering      means the cells are darker and rapidly absorb
                                                   and dermatology at MU; Charles Caldwell,           light. When Viator shines the light of a laser

8    Ellis   Summer 2007         Ellis Fischel Cancer Center   A Friend for Life
onto the cancer cell, the cell absorbs the light quickly and it           Researchers are hoping that through their photoacoustic
sends out a pulse of energy, whereas non-cancerous cells do         research they will be able to develop a much simpler process
not. A small listening device developed in Viator’s lab picks       for monitoring patients for disease progression by just having a
up the pulse of energy, signaling that the laser has hit a cancer   tube of blood drawn once a month.
cell. The sound waves produced by melanin cannot be heard                 “The biggest benefit of all is that it would give patients
by the human ear but can only be detected through the use of        a peace of mind — just knowing that their cancer hadn’t re-
specialized equipment.                                              turned,” Dale said. “We would be able to follow patients more
      “The only reason there could be melanin in the human          closely and find metastasized cells before they have grown very
blood is if there are melanoma cells,” Viator said. “Our            big. This technique also could be used to determine how well a
method can help doctors plan treatment to battle the spread         patient is responding to a certain type of chemotherapy.”
of the disease.”                                                          Dale and Viator’s team is working with other scientists to
      Skin cancer is typically signaled by a patient’s skin spot.   develop ways to detect other types of cancer, such as breast or
A dermatologist does a biopsy on the spot. If the biopsy finds       colon cancers. Because of melanin, melanoma is the only type of
that it is melanoma, surgical oncologists perform a sentinel        cancer whose cells strongly absorb all wavelengths of light and
node biopsy — removing the cancer surgically and evaluating         emit sounds that stand out from other cells. Ulus Atasoy, M.D.,
if the cancer has spread to lymph nodes. If the cancer has not      assistant professor of surgery, is working with the team to add ar-
spread, Dale said, the patient is likely to do well. When it has    tificial materials to cells in blood samples to act as light absorbers
spread to lymph nodes, the patient’s survival rate decreases by     — and ultimately noisemakers.
half. In that case, the cancer is much more likely to come back           “If we can overcome some engineering hurdles, the device
so patients must continually undergo extensive testing, such as     may easily be found in every cancer treatment center in the
X-rays, CT and PET scans.                                           nation, if not the world,” Viator said.

  With expertise in biological
  engineering, John Viator,
  Ph.D., is contributing to
  cancer research through
  the use of lasers and other
  high-tech tools. His team
  is seeking better ways to
  detect skin cancer.

                                                                   A Friend for Life     Ellis   Summer 2007   9
Patient Care

                                                    Life after
                                                     Survivors want more from life, and Ellis Fischel
                                                     is helping them find it

                                                                ore than 10 million people      treatment, including infertility, cosmetic
                                                                in the United States have       changes, depression, impaired organ
                                                                experienced a cancer            function and a higher risk for a second
                                                                diagnosis and treatment.        or recurring cancer. At the end of their
                                               This ever-expanding number, which has            cancer treatment, it may not be clear to
                                               tripled since the 1970s, is the result of        the survivors who should coordinate their
                                               earlier detection of the disease as well as      follow-up care, and how they will continue
                                               advances in technology and treatments that       to be monitored to prevent or diagnose
                                               include a combination of chemotherapy,           recurring cancer.
                                               radiation therapy and surgery.                        Ellis Fischel Cancer Center is at the
                                                    Ellis Fischel Cancer Center is contrib-     forefront of survivorship care. In 2006,
Save the date!                                 uting to the increased number of survivors
                                               through comprehensive screening programs,
                                                                                                Laura Neal, M.S.W., M.P.H., L.C.S.W.,
                                                                                                coordinator of patient and family services,
Cancer survivors, families                     the most advanced cancer care, and state-of-     and Kathy Sevedge, R.N., M.A., A.O.C.N.,
and friends are invited to                     the-art research to help find better ways to      clinical support coordinator, attended
                                               treat and eventually cure the disease.           a National Cancer Institute-funded
celebrate National Cancer
                                                    “We’re curing more and more people          survivorship course developed by the
Survivors Day from 12 to 2                     who have cancer, but some will have long-        City of Hope in Pasadena, Calif. From
p.m. Saturday, July 7, at Ellis                term health effects from the treatments          an applicant pool of 300 cancer centers
Fischel Cancer Center. The                     used for treating the cancer,” said Charles      and hospitals, Ellis Fischel was one of 50
celebration of life event will                 Caldwell, M.D., Ph.D., director of Ellis         institutions chosen to send representatives
                                               Fischel Cancer Center and CRC Missouri           to the course.
feature a barbecue, games
                                               Chair in Cancer Research. “We’re trying to            “We felt very honored to be chosen,”
and music. Information on                      direct research toward preventing long-term      Neal said. “The goal of the program is
survivorship topics will also                  side effects and managing the problems better,   to raise awareness of long-term cancer
be available at the event.                     as well as educating survivors themselves.”      survivorship issues. Survivors are telling us
There is no cost to attend.                         Survivorship issues are of increasing       that it’s not OK for them just to be happy
                                               importance now that people are living            to be alive anymore. We need to focus on
For more information, please
                                               longer with cancer. Cancer survivors need        long-term satisfaction for them.”
call Laura Neal, coordinator                   information and support long after their              Taking the lead from the 2005 Institute
of patient and family                          cancer treatment ends. They can face             of Medicine report, “From Cancer Patient
services, at                   .               a variety of health complications after          to Cancer Survivor: Lost in Transition,”

10   Ellis   Summer 2007   Ellis Fischel Cancer Center   A Friend for Life
Did you know that almost 4 percent
of Americans are cancer survivors?
staff members are now working to increase
awareness and educate health care providers
about the needs of cancer survivors. Neal
and Sevedge have presented a grand rounds
lecture, as well as lectures to staff, students
and the public. Also, they are planning an
upcoming fall oncology conference which will
be dedicated to the topic.
      Programs and services already in place
to address the psychosocial concerns among
survivors include support groups for lung
cancer funded by the Lance Armstrong
Foundation, and blood cancer support
groups hosted in partnership with the
Leukemia and Lymphoma Society. These
groups offer patients an after-treatment
connection to others with similar diagnoses
and to health care providers.
      The Lymphedema Therapy Clinic, the
only one in Mid-Missouri, was established
to help people suffering from a swelling of
a body part, usually an arm or leg, often
following surgery where lymph nodes are
removed. Researchers estimate that 30-
40 percent of women who are treated for            Karen Wingert, R.N., a licensed physical therapist, examines a patient at Ellis Fischel’s Lymphedema
breast cancer must cope with lymphedema            Therapy Clinic. Lymphedema – the extreme swelling of a limb – is a common side effect of surgery
                                                   that is often necessary to treat breast cancer patients.
and its impact on all aspects of life —
health, physical abilities and psychosocial
functioning. The clinic offers education,
treatment such as manual lymphatic drainage
massage, compression bandaging and
                                                      The best defense against cancer
exercise, and follow-up care.
      Future areas for development include                 Early detection — finding a                         Cancer Screening Services,
the creation of care summaries so that both
                                                      cancer early before it has spread                  located at Ellis Fischel Cancer Center,
survivors and health care providers will have
a comprehensive understanding of the care             — gives you the best chance for a                  offers screenings for breast, colon,
given for a survivor’s specific cancer diagnosis.      cure. Knowing about and following                  rectum, uterine, cervical, prostate, skin,
This effort will be piloted with women being          guidelines for cancer screening could              thyroid, testicular, mouth, ovarian
treated for breast cancer and will be expanded        save your life. The American Cancer                and lymph node cancers. To make an
to all other patients.                                Society recommends that all men and                appointment with Cancer Screening
      Other activities in progress include            women get cancer-related checkups as               Services, please call (573) 882-8511.
a community event to celebrate National               part of general health visits beginning            The staff can offer advice on the most
Cancer Survivors Day in July 2007 and the             as early as age 20 for some cancers.               appropriate screenings for you and
establishment of a survivorship clinic for                                                               answer any questions you have.
long-term follow-up care.

                                                                            A Friend for Life      Ellis   Summer 2007   11
Patient care

for the                        patient
Multidisciplinary team provides                                                                          When to consider
patient-centered palliative care                                                                         palliative care

                                                                                                              The Missouri Palliative Care Pro-
           atients with life-limiting illnesses              “Our palliative care program is             gram is open to adults with life-limiting
           deserve options when it comes               all about maximizing the good while               illness, typically with a life expectancy of
           to their treatment and care.                minimizing the bad for our patients,”             one year or less. Palliative care may be the
           University of Missouri Health               Anderson said. “We focus on quality of            right choice for a patient, patient’s family
Care’s new palliative care program provides            life while honoring each and every patient’s      and health care team if the patient:
each patient with choices for his or her               choice on how they would like to proceed
specific needs and concerns.                            with their treatment and care.”                   •   Is seeking assistance and support
      The Missouri Palliative Care                           Palliative care should not be reserved          with making complex decisions and
Program treatment plan provides various                for end of life, Anderson said, but provided          determining goals for end-of-life care
resources such as staff, equipment and                 for patients with life-limiting illnesses, even
medications to help improve and sustain                if death is not imminent. Anderson and his        •   Is enduring an unacceptable level of
all aspects of quality of life. The program            colleagues offer palliative care at the time          pain or other symptom distress
is led by medical director Clay Anderson,              of diagnosis of a life-limiting illness. At
M.D., Charles R. and Veta G. Claiborn                  the same time, they provide other medical         •   Is making frequent emergency room
Distinguished Faculty Scholar.                         treatments for patients with cancer, chronic          visits for the same diagnosis
      Since joining Ellis Fischel Cancer               organ failure, frailty or dementia.               •   Has been hospitalized frequently for
Center and the MU School of Medicine                         “We also address the needs of patients          the same diagnosis in the past 30 days
faculty in 1997, Anderson has become an                that extend beyond their physical symptoms
expert in treating patients with melanoma              — including depression, and existential and       •   Has a prolonged stay in the hospital
and has been instrumental in developing                spiritual concerns,” Cunningham said.                 without signs of improvement
programs for pain management, palliative                     Given the realities surrounding
care and end-of-life care. He is also a board          palliative care, the individualized care          •   Is in an intensive care unit with a
member and past chair of the Missouri End              plan attempts to identify and fulfill as best          poor prognosis
of Life Coalition.                                     as possible the goals and wishes of the
      With the help of Mary Cunningham,                patient. The program addresses advanced           •   Is seeking assistance in determining
M.S., A.P.R.N., Tammy Reeder, R.N.,                    care planning, including discussion and               hospice eligibility or appropriateness
and Julieanne Hagedorn, R.N., Anderson                 completion of legal surrogate assignment,              The Missouri Palliative Care team
provides a patient-centered program. Each              living wills and do-not-resuscitate orders.       is accepting patients for advice about
patient’s physical symptoms, medications,                    “People in the end stages of chronic        advanced disease symptom management,
diagnostic study results, family and home              illness are a vulnerable population,”             opinions about palliative care or to help
situation, functional status, connection to            Anderson said. “We are here to serve              with creating palliative care plans. For
the faith community, and personal values,              patients, families and providers in the most      more information about the program,
goals and wishes will influence his or her              appropriate way.”                                 please call (573) 884-7103.
treatment plan.

12   Ellis   Summer 2007           Ellis Fischel Cancer Center   A Friend for Life
Planning committee members Angie McDaniel, Laura Pierson, Dave Starman and Joyce Roth pres-
ent a check for the Deon Starman Memorial Golf Tournament proceeds to Charles Caldwell, M.D.,
Ph.D., medical director of Ellis Fischel Cancer Center.

Your gifts at work
Special events bring hope and healing to                                                              The 2007 Ellis Fischel Gala will feature song
                                                                                                      stylist Patti Austin.
Ellis Fischel patients

              ifts to Ellis Fischel Cancer Cen-   brosis at University Hospital and a certified        A Summer Celebration
              ter from a caring community         clinical research associate at the Quintiles
                                                                                                           The 2007 Ellis Fischel Gala, “A
              play an essential role in helping   laboratory in Columbia.
                                                                                                      Summer Celebration,” will be held on
              save lives. All funds raised for
Ellis Fischel stay here in Columbia to help
                                                  Save the date                                       Saturday, Aug. 25, at the Lodge of Four
                                                       The 2007 Deon Starman Memorial                 Seasons in Lake Ozark, Mo. Proceeds from
us provide the very best care to patients,
                                                  Golf Tournament will be held Monday,                this year’s event will benefit cancer research
fund innovative cancer research programs
                                                  June 18, at Columbia Country Club. All              by directing funds toward the purchase of
and bring us closer to finding effective treat-
                                                  proceeds from the tournament will be                a high throughput DNA sequencer. This
ments and cures for cancer.
                                                  donated to Ellis Fischel to help in the             tool will help researchers unravel genetic
Deon Starman Memorial                             fight against breast cancer.                         information in their search for a better
                                                       The two-person best ball tournament            understanding of certain types of cancer.
Golf Tournament                                   will begin with a Shotgun start at 1 p.m.                This will be the 11th edition of this
     The Deon Starman Memorial Golf               For more information or an entry form,              spectacular event, which has generated
Tournament is dedicated to the memory of          please contact Columbia Country Club                more than $725,000 for Ellis Fischel
Deon Starman. It was Deon’s wish for this         at (573) 449-4734.                                  Cancer Center. For more information about
tournament to make significant contribu-                                                               the gala, please call (573) 882-4872 or toll
tions in the effort to find a cure for breast      Jay Dix Challenge to Cure                           free at (866) 260-4517.
cancer, which is the most prevalent cancer             Columbia Multisport Club hosts the
among women and the second leading                annual Jay Dix Challenge to Cure Race,              Giving to Ellis Fischel
cause of cancer deaths in the United States.      which was established in memory of Jay                   Your gift to Ellis Fischel — no
The 2006 tournament raised $15,500 for            Dix, M.D., the late medical examiner for            matter the size — is a gift to help bring
breast cancer research and treatment.             Boone and Calloway counties and chief               an end to cancer. All philanthropic
     Dave and Deon Starman of Colum-              of forensic pathology at the University of          contributions to Ellis Fischel Cancer
bia began the tournament in 2000. Deon            Missouri-Columbia’s School of Medicine.             Center are tax-deductible. For more
passed away in December 2004. A health                  The 2007 event, held April 14, raised         information on giving, please call the Office
care professional, Deon Starman under-            more than $20,000 to support cancer                 of Development at (573) 882-4806, or
stood the importance of research. She held        research and the Jay Dix Lectureship at Ellis       complete and return the enclosed postage-
positions as a nurse at Boone Hospital            Fischel Cancer Center.                              paid envelope.
Center, a research coordinator for cystic fi-

                                                                         A Friend for Life        Ellis   Summer 2007    13
Komen Foundation funds community
breast health programs
                                                                                                         Informatics Research Training Program.”
                                                                                                              Sue Deutscher, Ph.D., associate
                                                                                                         professor of biochemistry, U.S. Department
                                                                                                         of Defense, “Prostate Cancer Imaging and
                                                                                                         Therapeutics from In Vivo Tumor-targeting
                                                                                                         Phage Display.”
                                                                                                              Deutscher, U.S. Department of Veterans
                                                                                                         Affairs, “Combinatorial Chemistry and
                                                                                                         Genetics to Develop Tumor-avid Peptides,”
                                                                                                         and “Phage Display-selected Peptides for
                                                                                                         Tumor Imaging and Growth Modulation.”
                                                                                                              Kevin Everett, Ph.D., assistant
                                                                                                         professor of family and community
                                                                                                         medicine, American Cancer Society, “Efficacy
                                                                                                         of Smoking Cessation Intervention for
Charles Caldwell, M.D., Ph.D., acknowledges the community support from the mid-Missouri affiliate
of Susan G. Komen for the Cure. Members of the affiliate’s Board of Directors include Elizabeth           Expectant Fathers.”
Mendenhall, Pam Newman, Dawn McGhee, Kay Lindner and Alicia Weaver.                                           Everett, Missouri Foundation for Health
                                                                                                         (MFH), “Mobilizing Tomorrow’s Leaders
     Representatives from the mid-Missouri                   To learn more about the mid-Missouri        for a Smoke-Free Missouri.”
affiliate of Susan G. Komen for the Cure                 affiliate of Susan G. Komen for the Cure
presented Ellis Fischel Cancer Center with              and the grants awarded, please visit                  William Folk, Ph.D., senior
five community grants totaling $60,714 on                                 associate dean for research and professor
Tuesday, March 20, at Ellis Fischel.                                                                     of biochemistry, National Center for
                                                                                                         Complementary and Alternative Medicine
     The grants will be used by Ellis Fischel
to fund breast health education and breast
                                                        Grants                                           (NCCAM), “The International Center for
cancer screening and treatment programs.                      Grants for cancer research at the          Indigenous Phytotherapy Studies.”
     Programs funded by the mid-Missouri                University of Missouri-Columbia total                 Frederick Hawthorne, Ph.D., co-
affiliate include:                                       nearly $40 million. The following is a           director of the International Institute
     • Breast cancer educational videos provided        partial listing of grants with the principal     for Nano and Molecular Medicine and
       at public libraries in Boone County and          investigators, funding sources and grant         professor of radiology, NIH, “Targetable
       at Ellis Fischel Cancer Center through           titles listed. More than 60 investigators as     Exploratory Multinuclear MRI Contrast
       the Margaret Proctor Mulligan Breast             well as 90 research fellows and laboratory       Agents,” and “Liposome Delivery of Boron
       Health and Research Program                      personnel are involved in cancer research        for Boron Neutron Capture Therapy.”
                                                        at MU. The scientists are from a variety              Kattesh Katti, Ph.D., co-director
     • A lymphedema outreach project that               of disciplines and are housed in at least 20
       provides educational information to                                                               of the International Institute for Nano
                                                        different colleges and departments across the    and Molecular Medicine and professor
       women about risk factors and preventive          MU campus.
       measures related to the condition                                                                 of radiology, NCI, “Hybrid Gold Nano-
                                                            Linda Bullock, Ph.D., R.N., associate        particles for Imaging and Therapy of
     • A study by MU’s Center for Health                professor of nursing, National Institutes        Prostate Cancer.”
       Care Quality to explore rural breast             of Health (NIH) and National Institute
       cancer survivors’ and primary care                                                                     Dennis Lubahn, Ph.D., professor
                                                        of Nursing Research, “Nursing Smoking            of biochemistry, NCCAM and NIH,
       physicians’ understanding and                    Cessation Intervention During Pregnancy.”
       management of late treatment effects                                                              “Phytoestrogen and Antioxidant Regulation
                                                            Charles Caldwell, M.D., Ph.D.,               – Prostate Cancer.”
     • Funding for the Women’s Cancer                   medical director of Ellis Fischel Cancer              Lubahn, Missouri Soybean Institute,
       Control Project fund, an internal                Center and CRC Missouri Chair in                 “Prostate Cancer Signal Transduction
       philanthropic initiative at Ellis Fischel        Cancer Research, National Cancer Institute       Pathways and Estrogens.”
       Cancer Center that financially supports           (NCI) and NIH, “Epigenetic Signatures                 Lubahn, NCI, “Genistein and
       screenings for women younger than 65             of Non-Hodgkins Lymphomas,” and                  Hedgehog-Signaling in Prostate Cancer.”
       who are unable to afford it                      “DNA Methylation in Non-Hodgkin’s                    Michael Perry, M.D., professor of
     • Individual assessments, breast health            Lymphomas.”                                      hematology and oncology, Nellie B. Smith
       education and referrals for screening                Caldwell, National Library of Medicine and   Chair of Oncology, NCI, “Cancer and
       targeted to minority women                       NIH, “Biomedical and Health                      Leukemia Group B Clinical Trials.”

14     Ellis   Summer 2007          Ellis Fischel Cancer Center   A Friend for Life
ght   Edward Sauter, M.D., Ph.D.,
 professor of surgery and surgical oncologist,
 U.S. Department of Defense, “Proteome
 Analysis in Nipple Aspirate Fluid.”
      Sauter, NIH and NCI, “Protein
 Profiling in Nipple Aspirate Fluid” and
 “Altered Breast Methylation After Low/Hi
 Dose Isoflavones.”
      Sauter, NIH and NCCAM, “The Effect of
 Black Cohosh Extract on the Human Breast.”
                                                  ‘This is my family now’
                                                                                                             Crews learned about the opportunity
                                                                                                       to volunteer at Ellis Fischel from a friend.
                                                                                                       The day after she signed up, her husband
                                                                                                       Robert was diagnosed with inoperable
                                                                                                       cancer of the esophagus. He died six
                                                                                                       weeks later.
                                                                                                             “It was a blessing I had this to go
                                                                                                       to,” Crews said of her volunteer position.
                                                                                                       “This is my family now. I get more from
                                                                                                       Ellis Fischel patients and staff than they
                                                                                                       do from me.”
 New faces                                                                                                   Debra Deeken, R.N., supervisor of
                                                                                                       nursing at Ellis Fischel, has worked at the
                          Carl Freter, M.D.,                                                           cancer center for 15 years and feels that
                          Ph.D., has joined                                                            Lorraine’s impact is invaluable.
                          Ellis Fischel’s                                                                    “Lorraine is warm, dedicated and
                          medical staff and                                                            has lots of energy,” Deeken said. “She is
                          MU’s School of                                                               very determined to make sure patients
                          Medicine as a                                                                are cared for in the best way possible. She
                          professor of internal                                                        helps a lot with communication by talking

                          medicine. Freter                                                             to staff and patients and asking, ‘Is there
                          is board-certified              f you have visited Ellis Fischel Cancer
                                                                                                      anything I can do for you?’ She always
 in medical oncology. He earned a medical                Center, you have likely been greeted
                                                                                                      checks in with me and sees what she can
 degree at Washington University in St.                  with a smile by Lorraine Crews. A
                                                                                                      do to help the nurses.”
 Louis and completed residency training at               dedicated volunteer since 1980, the
                                                                                                            In addition to helping the patients
 Stanford University Hospital in Palo Alto,       84-year-old Crews is known for her quick
                                                                                                      who come to Ellis Fischel every day, Crews
 Calif. He also completed a fellowship in         walking pace, vivacious personality and
                                                                                                      has pledged an estate gift to the Ernest and
 hematology and oncology at the National          concern for patients.
                                                                                                      Eugenia Wyatt Guest House to benefit the
 Cancer Institute in Bethesda, Md. He                   “You meet interesting people here,”
                                                                                                      lives of future patients.
 previously served as director of clinical        Crews said. “Most patients are not here
                                                                                                            “Charitable bequests such as the one
 research and clinical laboratory director        just one time, they come back. You recog-
                                                                                                      Lorraine has planned are extremely impor-
 at Washington Hematology-Oncology                nize them; they joke around with you.”
                                                                                                      tant to the future of Ellis Fischel, the guest
 Specialists in Yakima, Wash.                           Crews’ empathy for patients inspires
                                                                                                      house and our work to end cancer,” said
                                                  the activities she performs as a volun-
                                                                                                      Charles Caldwell, M.D., Ph.D., medical
                            Kristi Gafford,       teer. Helping with auxiliary fund-raisers,
                                                                                                      director of Ellis Fischel Cancer Center and
                            M.P.H., M.B.A.,       creating items such as soap for radiation
                                                                                                      CRC Missouri Chair in Cancer Research.
                            began her duties as   patients’ dry skin, compiling educational
                                                                                                      “An estate gift, which can be created sim-
                            executive director    packets for doctors and nurses to give
                                                                                                      ply by adding a provision to a will or living
                            of Ellis Fischel      patients, playing bingo with guests at the
                                                                                                      trust, allows donors to continue their sup-
                            Cancer Center         Ernest and Eugenia Wyatt Guest House,
                                                                                                      port — and continue to make a difference
                            in November           escorting patients to various appointments
                                                                                                      — in perpetuity.”
                            2006. She is          and chatting with patients and families are
                                                                                                            Crews is rather modest about her role,
                            responsible for       some of the many ways she assists at the
                                                                                                      insisting that Ellis Fischel Cancer Center is
                           planning, financial     cancer center.
                                                                                                      the true gift to patients.
 performance, personnel management,                     It is her drive to help patients that
                                                                                                            “This is a special place,” Crews
 quality, regulatory compliance and service       keeps her returning, usually a few days
                                                                                                      said. “One man who had been to several
 excellence initiatives at the cancer center.     each week.
                                                                                                      hospitals said that Ellis Fischel is the first
 She previously served as director of                   “This place became my family,” she
                                                                                                      health care center he has been to where he
 oncology services for Suburban Hospital in       said. “They saw me through my cancer,
                                                                                                      walked in and heard laughter. The first day
 Bethesda, Md.                                    radiation and surgery.”
                                                                                                      patients are here they may not be used to
                                                        Crews fought her battle with uterine
                                                                                                      the relaxed atmosphere. We get to know
                                                  cancer in 1989. She has been cancer-free
                                                                                                      the patients and try to put them at ease.”
                                                  since completing treatment.

                                                                        A Friend for Life      Ellis   Summer 2007   15
        or 10 years, the Lodge of Four Seasons has hosted “A Summer Celebration,” an annual event
        which has raised almost three quarters of a million dollars for Ellis Fischel Cancer Center’s
        research initiatives. The Lodge of Four Seasons, located in Lake Ozark, Mo., celebrates its 43rd
        year of excellence in 2007, offering the hospitality of a family-owned, waterfront resort, unique
artwork and beautiful Japanese gardens, as well as the breathtaking views of the Lake of the Ozarks.
           Ellis Fischel Cancer Center thanks the Lodge of Four Seasons for sponsoring this issue.

University of Missouri
Ellis Fischel Cancer Center
115 Business Loop 70 West
Columbia, MO 65203-3244

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