University of Pennsylvania Health System

Focus on Cancer

We are happy to announce the launch of our new Abramson Cancer Center website.

Please stay connected to our Focus On Cancer blog by visiting us there.

Tuesday, April 30, 2013

People Magazine refers to Basser Experts in Kara DioGuardi’s Cancer Gene and Surrogacy Story

The Basser Research Center for BRCA, directed by Susan Domchek, MD, is mentioned in a People Magazine article detailing former American Idol judge Kara DioGuardi's quest to become a mother after learning she was a carrier of the BRCA2 mutation:

Kara DioGuardi: How My Cancer Gene Led Me to Surrogacy

"There was all this synchronicity... when the time came that I needed experts — The Basser Research Center for BRCA at the University of Pennsylvania is also great — I could ask them for information and resources. I was very lucky."

Save the Date: Free Melanoma Conference

Penn’s Abramson Cancer Center invites patients, family members and anyone interested in learning about melanoma risk, prevention, diagnosis and treatment to attend Focus On Melanoma.

melanoma-conference-at-PennFocus On Melanoma is a free educational conference featuring a keynote address by Paul B. Chapman, MD, and Marisa Weiss, MD.

Penn’s Focus On Melanoma Conference addresses the personal and medical issues facing people with melanoma including those in treatment, survivors, their loved ones, relatives and caregivers.

The conference provides patient-focused information on the latest advances in melanoma risk, prevention, diagnosis, treatment, symptom management and psychosocial issues. It is also an opportunity to network and gain support from other melanoma patients and survivors.

Who Should Attend

  • People newly diagnosed with melanoma
  • Those at risk for melanoma
  • Melanoma survivors
  • Family members, caregivers or health care providers of melanoma patients/survivors
  • Those diagnosed with a pigmented lesion and their family members/caregivers

Join Us

Time: 7:30 am to 3 pm
Date: Friday May 18, 2012
Location: Hilton Hotel located at 4200 City Avenue, Philadelphia, PA
Registration: Register here or call 800-789-PENN (7366)
Cost: FREE

Unable to Attend?

If you are unable to attend in person, follow Penn Medicine on Twitter for event information before the conference date, and live tweeting throughout the conference with the hashtag #MelanomaACC.

FREE Skin Cancer Screening

Have your skin checked by a Penn dermatologist to determine your risk for developing skin cancer.

Date: Saturday, May 18, 2013

Appointments are necessary and space is limited.

Call 215- 662- 2737 to make your reservation.

Monday, April 29, 2013

Save the Date: Free Skin Cancer Prevention Conference

Penn’s Abramson Cancer Center invites you and your loved ones to attend CANPrevent Skin Cancer, a free educational conference for anyone interested in learning about preventing skin cancer.

CANPrevent Skin Cancer is designed to address the personal and medical issues facing those at risk for skin cancer. The conference provides patient-focused information about the latest advances in skin cancer risk, screening and prevention.

Who Should Attend

Anyone interested in learning about skin cancer and its prevention - especially those with:
  • Natural blond or red hair color
  • Presence of atypical or numerous moles
  • Sun sensitivity (easily burns, difficulty tanning)
  • History of excessive sun exposure, including sunburns
  • History of using tanning booths
  • History of diseases that suppress the immune system
  • Personal or family history of melanoma, basal cell or squamous cell skin cancers

Join Us

Time: 8 to 11:30 am
Date: Friday, May 17, 2013
Location: Hilton Hotel located at 4200 City Avenue, Philadelphia, PA
Registration: Register here call 800-789-PENN (7366)
Cost: FREE

Get the facts on skin cancer and melanoma risk, prevention and screening – they could save your life or the life of someone you know.

Unable to Attend?

Follow Penn Medicine on Twitter for event information before the conference date, and live tweeting throughout the conference with the hashtag #SkinCancerACC. 

Please “re-tweet” and share Penn Medicine's messages about skin cancer prevention and awareness with your followers.

FREE Skin Cancer Screening

Have your skin checked by a Penn dermatologist to determine your risk for developing skin cancer.

Date: Saturday, May 18, 2013

Appointments are necessary and space is limited.

Call 215- 662- 2737 to make your reservation.

Friday, April 26, 2013

Why I Chose to be an Oncology Nurse

Carolyn Vachani
Carolyn Vachani, RN, MSN, AOCN, is a nurse educator for OncoLink®, an award-winning cancer information website sponsored by Penn’s Abramson Cancer Center. She is an oncology advanced practice nurse and has worked in the areas of medical hematology and oncology, bone marrow transplant, clinical research, radiation therapy and staff development.

In this blog post, she discusses her choice to become an oncology nurse.

From her blog:
Talk to an oncology nurse and they will tell you the rewards of this specialty; the fact that you never leave work thinking did I really make a difference in someone’s life today? You don’t have to ask, you did. They might tell you about the honor you feel holding a dying person’s hand, the way you live your life differently because of the people you’ve met in this profession or the joy you share in when a person finishes treatment. But it’s not for everyone. I started my career on the oncology unit with 13 newly minted nurses and more than half have moved on to other specialty areas. But if it is a right fit for you, you will know.
Read more of Carolyn's blog post at Oncolink. 

Thursday, April 25, 2013

5 Things to Know about Head and Neck Cancer Treatment

head neck cancer treatment surgery proton therapy

Head and neck cancer is cancer that originates in the head and neck areas with a few exceptions, such as cancer that originates in the brain.

Head and neck cancers can originate in the following sites:
  • Nasopharynx
  • Cancer of the oral cavity including lips, gums, inside of cheeks, part of the tongue, floor of the mouth under the tongue, palate and area behind wisdom teeth
  • Salivary glands
  • Paranasal sinuses and nasal cavity
  • Oropharynx (Base of tongue, tonsils)
  • Larynx, or voicebox
  • Hypophyarnx
  • Lymph nodes of the neck

Because head and neck cancer is often located in difficult to reach areas, it’s important to ask a lot of questions from your head and neck cancer treatment team.

About Head and Neck Cancer

There are approximately 42,000 new cases of head and neck cancer in the United States every year. And, while the biggest risk factor for head and neck cancer is smoking and tobacco use, the fastest growing population of people affected by head and neck cancer is young, otherwise healthy adults. This is due to the rise in cases of HPV.

Here are 5 things to know, or ask your cancer center before having head and neck cancer treatment.

What type of surgery is offered for head and neck cancer?

Penn physicians Drs. Gregory Weinstein and Bert O’Malley invented and developed the TransOral Robotic Surgery procedure, or TORS.

TORS, for the first time, has allowed surgeons to gain greater access to the areas of the throat for the removal of cancers and benign lesions via a minimally invasive robotic approach. The surgeon benefits by having improved access to the tight confines of the throat and the patient benefits in the short-term by faster and easier recovery and, in the long-term, by outstanding cancer results and improved swallowing results compared to alternative treatments.

Benefits of TORS can include:
  • Quicker return to normal activity
  • Shorter hospitalization
  • Reduced risk of long-term swallowing problems that are more commonly seen when chemoradiation or traditional open surgery is used for definitive treatment instead of robotic surgery
  • Fewer complications compared to traditional open surgery
  • Less scarring than traditional open surgery
  • Less risk of infection
  • Less risk of blood transfusion when compared to open surgery
  • No routine use of tracheostomy during surgery compared to routine use for open surgery

The medical literature confirms that TransOral Robotic Surgery's revolutionary technique contributes to improved outcomes for cancers and benign lesions of the mouth, voice box, tonsil, tongue and other parts of the throat.

"Thank you for saving my life."- A patient from Penn writes about her experience with TORS and Penn Medicine. Read her story here.

How will my radiation oncologist, surgeon and medical oncologist all know what each other is doing?

One of the benefits of getting your cancer care at the Abramson Cancer Center is getting multi-disciplinary care in a comprehensive cancer center.

To you, the patient, this means seamless care from a center designated as “exceptional” from the National Cancer Institute. It means never having to worry one physician won’t know what the other is doing. It also means getting access to all specialists under one roof.

To us, it means collaboration. It means that we know and trust each discipline to offer you the best, world-class cancer care.

Does your cancer center offer proton therapy?

Proton therapy for head and neck cancer offers more cancer-focused radiation extreme precision. This means that radiation can be delivered to difficult-to-reach areas of the head and neck with less exposure of surrounding tissues and organs, translating to potentially significant reductions in patient-experienced side effects

The Roberts Proton Therapy Center at Penn Medicine is the largest and most advanced proton therapy facility in the world. It’s also the only proton therapy center housed within an academic medical institution.

Will I be able to get pencil-beam proton therapy for head and neck cancer?

Pencil beam proton therapy allows for precise radiation delivery to the areas at risk for cancer involvement, while minimizing dose to normal tissues. We currently offer pencil beam proton therapy primarily to patients with cancers of the oropharynx, whether after surgery, or for patients who cannot receive surgery, in place of surgery. Only a few proton centers in the United States offer pencil beam proton therapy, and Penn Medicine is one of them.

What support services will I have access to?

As a comprehensive cancer center, the Abramson Cancer Center is proud to offer patients access to many support services.

From patient navigators who can walk patients through each step of care, to social workers who can help patients get outside support, the Abramson Cancer Center wants to ensure all patients get world-class care.

The Abramson Cancer Center also offers patients:

Learn More About Head and Neck Cancer Treatment At Penn

To learn more about head and neck cancer, and to learn if you are a candidate for TORS or proton therapy for head and neck cancer, please make an appointment with a Penn specialist by calling 1-800-789-PENN (7366).

Learn more about head and neck cancer treatment at Penn Medicine from the Focus on Head and Neck Cancers Conference.

Wednesday, April 24, 2013

Foundation Supports Families at the Abramson Cancer Center

It all started with an air mattress.

When Paul Nardoni was diagnosed with Hodgkin lymphoma at the age of 27, he and his family saw a unique need.

During his stays at Penn’s Abramson Cancer Center, Paul witnessed first hand the unparalleled care and attention that is given to a cancer patient. He noticed that their families, including his own, often spent the night sleeping in an uncomfortable chair or a makeshift bed. He discovered that there were no diversions for patients, or their families, during the long and sometimes arduous chemotherapy sessions. Paul longed to remedy those circumstances - for his own family and for the families of all patients. This became the basis of the Paul R. Nardoni Foundation’s mission.

“At the time there were no couches that turned into beds, or room for family members to sleep comfortably in the room,” remembers his mother, Roseann.

About Paul Nardoni

Paul was an executive chef for Holland America Cruise Lines and was working on the Wind Star cruise ship when he became ill and had to return home to New Jersey. Paul was diagnosed with Hodgkin lymphoma in the fall of 1996.

As his disease progressed, Paul was able to stay active with the help of chemotherapy and immunotherapy. Despite frequent hospitalizations, Paul never gave up. And he made sure his family didn’t either.

Paul passed away in 2001 after his 5-year-long battle. But today, his legacy lives on.

The Paul R. Nardoni Foundation

The Nardoni family was inspired to create a unique patient experience for patients and their families at the Abramson Cancer Center. They raised some money to purchase air mattresses for the patient floor so that family members could spend the night with their loved ones.

Then came the videos.

“We’d stop at Blockbuster on the way to the Abramson Cancer Center to pick up videos,” recalls his mother, Roseann. “We thought, ‘Wouldn’t it be great if there was a video library for patients right here on the patient floor?’ and that is really how our foundation began.“

“As time went on, and needs changes, we established a special needs fund for people who need assistance with things like groceries, utility bills and childcare,” says Roseann.

Today, the Paul R. Nardoni Foundation provides support for families’ needs and wants through a “Carpe Diem Find” that supports patients who need assistance with paying their bills, getting childcare, or even “fun” activities such as attending a Phillies baseball game, or getting family portraits.

The Foundation has no paid staff and all work is performed by volunteers. Almost all events are supported by generous donations enabling the Foundation to keep its cost down around 4 percent. Therefore, 96 percent of every dollar you contribute goes directly to cancer patients and their families.

Since the foundation was founded, it has provided funding to establish programs that provide comfort and aid to cancer patients and their families at Abramson Cancer Center of the University of Pennsylvania, and other area hospitals and cancer centers.

“We want to help the patient, and the whole family,” says Roseann. “And I am sure that if Paul was here to see what we are doing today, he’d be thrilled.”

Roseann adds: “Nothing can take away the feeling of loss when you lose a child, but knowing we are helping others with this foundation helps.”

Learn more about the Paul R. Nardoni Foundation

To learn more about the Paul Nardoni Foundation, and to find out how you can make a donation to help others undergoing cancer treatment, visit

Help Families at the Abramson Cancer Center

The Abramson Cancer Center is grateful to the Paul R. Nardoni Foundation and other foundations who directly support our patients in need including Bringing Hope Home, Stomp the Monster, The Mary Anne Mazanec Ovarian Cancer Foundation, Sandy Rollman Foundation, Starr Foundation, Fox’s Fight, and Peggy Spiegler Melanoma Research Foundation, just to name just a few.

The Abramson Cancer Center also has a Patient Special Needs Fund to help provide support to patients and families facing financial hardship as a result of diagnosis. We are grateful to the many individual friends and organizations that directly support this fund. Please consider making a gift and easing the burden of cancer for our patients and families with a donation.

Tuesday, April 23, 2013

Camp for Kids who Have Parents with Cancer

Playing, creating, exploring and smiling: These are activities every child should focus on. But for children of parents who have cancer, or who have had cancer their days can be filled with worry about the health of their loved ones.

Camp Kesem Chapter at the University of Pennsylvania provides kids whose parents have or have had cancer with an overnight summer camp experience that gives them a chance to be kids. To us, this means doing everything in our power to provide as much fun for the kids as humanly possible in the span of one week.

Camp Kesem be welcoming campers for Summer 2013, our second session of camp.
  • Camp is for children ages 6-16 and free of charge to all families
  • A five night sleep away camp that provides transportation to and from our facilities in Oxford, PA
  • A 3:1 camper-to-counselor ratio
  • Fully planned and staffed by UPenn students, all of whom are thoroughly trained before camp
  • Professional staff includes a nurse and mental health professional who stay on-site all week
  • Camp Kesem is open to all families, regardless of race, religion, nationality.

How to Apply for Camp Kesem

If you are interested in Camp Kesem for your child, please contact the Camp Kesem
Camper Care Coordinators, Alex Smith and Molly Blais, at
or find the application link on our website at

Learn more about Camp Kesem, and ways to get involved with its mission.

Help provide this meaningful experience to even more kids by making donation to Camp Kesem today.

Monday, April 22, 2013

Minimally Invasive Surgery for Head and Neck Cancer with TORS

Penn Medicine's TransOral Robotic Surgery (TORS) program is a world-class surgical program comprised of the leading surgeons, anesthesiologists, nurses, and operating personnel dedicated to providing superior patient outcomes through the use of robotic-assisted technology. The program benefits not only patients seeking state-of-the-art care, but also physicians who come from around the world to observe and learn about this groundbreaking procedure.

TransOral Robotic Surgery may either allow the patient to avoid radiation altogether or decreases the intensity thereby avoiding side effects of treatment.

TORS is the world's first group of minimally invasive robotic surgery techniques enabling surgeons to remove benign and malignant tumors of the mouth and throat. This revolutionary breakthrough results in shorter, virtually scarless head and neck surgery. Designed to avoid incisions for primary site resection, TORS is performed through the patient's mouth and provides unprecedented access to the small and often difficult-to-reach areas of the mouth and throat.

Transoral robotic surgery (TORS) was invented and developed by the pioneering team of Bert W. O'Malley, Jr., MD and Gregory S. Weinstein, MD at Penn Medicine

TORS uses the state-of-the-art da Vinci® Surgical System, which allows surgeons better access to the areas of the throat for the removal of cancers and benign lesions via a minimally invasive robotic approach.

Surgeons benefit by having improved access to the tight confines of the throat and patients benefit in the short term with a faster and easier recovery and, in the long term, by outstanding cancer results and improved swallowing results compared to alternative treatments.

Benefits of TORS can include:
  • Quicker return to normal activity
  • Shorter hospitalization
  • Reduced risk of long-term swallowing problems (most commonly seen with chemoradiation or traditional open surgery)
  • Fewer complications compared to traditional open surgery
  • Less scarring than traditional open surgery
  • Less risk of infection
  • Less risk of blood transfusion when compared to open surgery

In this video, Drs. O'Malley and Weinstein explain the TORS procedure, and how Penn Medicine is revolutionizing care for patients with head and neck cancer.

TORS patient, Cynthia Miller along with other Penn patients discuss how the TORS procedure changed their lives.

Friday, April 19, 2013

What It’s Like to Work in Oncology Care

Carolyn Vachani
Carolyn Vachani, RN, MSN, AOCN, is a nurse educator for OncoLink®, an award-winning cancer information website sponsored by Penn’s Abramson Cancer Center. She is an oncology advanced practice nurse and has worked in the areas of medical hematology and oncology, bone marrow transplant, clinical research, radiation therapy and staff development.

Have you ever wondered what it is like to work with cancer patients for a living?

Working with cancer patients at a comprehensive cancer center like the Abramson Cancer Center can be a rewarding experience for the men and women who have dedictated their lives’ work to caring for cancer patients and working to find a cure for cancer through research.

In this blog series, Oncolink highlights cancer care professionals to show patients, their families, friends and caregivers what it’s like to work with people who have cancer, cancer treatment and cancer research.

Check out these articles from those working in cancer care and research:

Tools and Inspiration for Mindful Living from Penn Medicine

2nd Annual Living from the Heart Award: An Evening Honoring Sharon Salzberg

The Penn Program for Mindfulness will proudly honor Sharon Salzberg with its 2nd Annual Living from the Heart award.

Sharon Salzberg is co-founder of the Insight Meditation Society (IMS) in Barre, Massachusetts. She has been a student of meditation since 1971, guiding meditation retreats worldwide since 1974. Sharon’s newest book, Real Happiness, The Power of Meditation, was published by Workman Publishing in January 2011.

Sharon is a regular contributor the Huffington Post, and was a contributing editor of Oprah’s O Magazine for several years. She has appeared in Time Magazine, Yoga Journal,, Tricycle, Real Simple, Body & Soul, Mirabella, Good Housekeeping, Self, Buddhadharma, More and Shambhala Sun, as well as on a variety of radio programs.

The Penn Program for Mindfulness bestows this prestigious award to individuals who have paved the way for mindfulness practices to take root in our culture. Please join us as we celebrate the many ways that Sharon has helped to make a difference in our world.

Sharon will give a brief talk about mindfulness and lead us in a guided meditation.

Join Penn Medicine for the 2nd Annual Living from the Heart Award: An Evening Honoring Sharon Salzberg

Date: Friday, May 10, 2013
Time: 7 to 8:30 pm
Cost: $20
Location: Benchmark School, Media, PA

Learn more about Sharon Salzberg.

Support the Penn Program for Mindfulness by making a gift today, and help ensure all people have access to important tools.

Meditation Workshop- Meditation: Tools for Awakening Courage, Faith and Compassion

This workshop focuses on the practical tools that help us go beyond our constricting habitual patterns, such as fear and denial. Awakening the inner capacities we all have, meditation allows us to transform our worldview from one of isolation and confusion to one of connection, clarity and compassion.

Especially in times of uncertainty, meditation opens us to the power of faith and courage based on seeing things just as they are.

This workshop is suitable for both new and experienced students. The workshop will consist of guided meditations, talks and time for questions and answers.

Join Penn Medicine for Meditation: Tools for Awakening Courage, Faith and Compassion

Date: Saturday, May 11, 2013
Time: 9:30 am to 12:30 pm
Cost: $49
Location: Benchmark School, Media, PA

To register for one or both of these events, or to support the program with a philanthropic gift, please visit

Call 215-615-2774 or email for questions or more information.

Proceeds from these programs enable the Penn Program for Mindfulness to develop and deliver new, innovative programs that help those in need.

Thursday, April 18, 2013

Preventing Head and Neck Cancer with the HPV Vaccine

There are over 100 types of HPV, and more than 40 strains that can infect the genital areas of men and women, as well as the mouth and throat. HPV is passed through genital contact through vaginal and anal sex, and can also be passed through oral sex.

HPV and Head and Neck Cancer

The connection you should know about

In recent years, the human papilloma virus (HPV) has been linked to cervical, anus and skin cancers.

“HPV is the most common sexually transmitted infection in the United States,” says Ann Honebrink, MD, associate professor of clinical obstetrics and gynecology at Penn. “Even without showing symptoms of HPV, people can transmit the virus and barrier methods like condoms don’t work as well to prevent HPV transmission as they do other infections like HIV.”

While HPV can cause symptoms, a person can go for years without ever knowing they have the virus. That, along with the ability of the HPV virus to remain present in a person for a long time, make this virus so prevalent — people continue to spread the virus through sexual contact without knowing they carry the virus. In most cases, the body fights off HPV naturally and eventually the virus is cleared. However, when the body cannot fight off HPV, the virus can persist and also can trigger cellular changes that may lead to cancer.

“Some types of HPV must be present in order for a women to develop squamous cell cancer of the cervix, the most common type of cervical cancer,” says Dr. Honebrink.

Oral cancer – HPV’s new connection

While HPV has most been linked to cervical, anus and skin cancers, recent studies suggest the same strain of HPV can also cause oropharyngeal (head and neck) cancer.

“We are seeing more cancer located at the base of the tongue and in the tonsils,” says Jason Newman, MD, assistant professor of otorhinolaryngology, and head and neck surgeon at Pennsylvania Hospital.

Oropharyngeal cancer develops in the part of the throat including the back of the tongue, back part of the roof of the mouth, the tonsils, and the side and back wall of the throat.

“Historically, people who get head and neck cancer are older – over 70 – and have been heavy smokers or drinkers,” says Dr. Newman. “But we are seeing an increase in young, otherwise healthy men and women who develop head and neck cancer related to the HPV virus.”

Treatment for head and neck cancer may include trans-oral robotic surgery (TORS). TORS is the world’s first group of minimally invasive robotic surgery techniques enabling surgeons to remove tumors of the mouth and throat. This revolutionary breakthrough results in shorter, virtually scarless head and neck surgery. TORS is performed through the patient’s mouth and provides unprecedented access to the small and often difficult-to-reach areas of the mouth and throat.

Surgeons at Penn Medicine created da Vinci TransOral Robotic Surgery (TORS) in 2005. The adoption of this highly advanced robotics technique demonstrates Penn Medicine’s commitment to providing world-class health care.

“It’s important to know the signs of head and neck cancer, and to not ignore symptoms that do not go away,” says Dr. Newman. “Treatment options and outcomes improve greatly when cancer is found early.”

Preventing HPV

The good news is that there is protection for both girls and boys who have not yet encountered the HPV virus. There are two FDA approved HPV vaccines on the market: Gardasil and Cervarix.

Gardasil protects against four major types of HPV; HPV 16 and 18, the two types that cause about 70 percent of cervical cancer and HPV 6 and 11,which cause 90 percent of genital warts.

Cervarix protects against HPV 16 and 18.

HPV vaccines are given as three shots to protect against HPV infection and HPV-related diseases, and they offer the greatest health benefits to individuals who receive all three doses before having any type of sexual activity. This is why the HPV vaccination is recommended for preteen girls and boys at age 11 or 12 years.

Facts about HPV

  • Nearly 20 million people in the United States are infected with HPV.
  • 6.2 million Americans become infected each year with more than 50 percent of sexually active men and women infected with HPV at some time in their lives.
  • Most HPV infections do not cause any symptoms and go away on their own.
  • HPV can cause genital warts and warts in the oral and upper respiratory tract in both men and women.
There is no treatment for an HPV infection, but many of the conditions it causes can be treated.

Learn more about the latest HPV vaccine recommendations, and treatment for head and neck cancer at Penn.

Wednesday, April 17, 2013

Chemotherapy and Radiation Therapy for Head and Neck Cancer: Keep Your Mouth Healthy

Elizabeta Evtimovska, DDS, MS, is a maxillofacial prosthodontist at Penn Medicine. In this article, she discusses chemotherapy and radiation therapy for head and neck cancer, their complications, and how patients can prevent long-term side effects of head and neck cancer treatment.

radiation therapy head and neck cancer
Chemotherapy and radiation therapy for head and neck cancer can cause a range of short and long-term oral complications.

The acute complications such as mucositis (sores) and infections, as well as others are managed by the oncology team during the treatment. Some of the long-term complication, such as xerostomia (dry mouth) and osteoradionecrosis (ORN), is a serious complication of radiation therapy for head and neck cancer that occurs in a small percentage of patients as result of head and neck radiation treatment.

Osteoradionecrosis is bone that has died. Because radiation works to destroy cancerous cells through the deprivation of oxygen and vital nutrients, it inevitably destroys normal cells as well, damaging small arteries and reducing circulation to the area of the mandible (jaw bone).

As there is no treatment for ORN, the focus is on prevention. This means, avoiding extractions of teeth from the radiated parts of the jaws and making sure that dentures fit properly and don’t cause any sores. It most often occurs in the setting of tooth extraction from the radiated parts of the jaws, but can also occur spontaneously. In both cases, there is exposed bone in the mouth which can be asymptomatic or it can be further complicated by infections, pain, and/or malodor.

Preparing for Chemotherapy and Radiation Therapy for Head and Neck Cancer

Patients who are planning to undergo chemotherapy or radiation therapy for head and neck cancer should be evaluated by a dentist prior to the start of treatment.

During this appointment, the patient’s oral condition is evaluated and it is determined if any teeth need to be extracted prior to the start of radiation therapy. This visit is also a perfect time to go over good oral health care.

In our practice, I advise patients to do the following during and after radiation:
  • Maintain excellent oral hygiene by flossing and brushing every morning and evening and after every meal. If dry mouth develops, it is especially crucial to brush teeth after every meal and only drink water between meals, as opposed to sugary drinks or snacks.
  • Use fluoride to prevent caries (when xerostomia, dry mouth, is present, the patient has increased risk of caries). Fluoride is especially important to prevent extracting teeth from the radiated parts of the jaws and therefore prevent osteoradionecrosis.
  • Visit a local dentist regularly for regularly scheduled maintenance visits (cleanings), as well as any other routine dental treatment.
The severity of oral complications from chemoradiation differs depending on the diagnosis, the type of treatment administered, the amount and location of the delivered radiation, etc. Therefore, it is best to consult with a dentist prior to and after radiation in terms of the above discussed needs and recommended treatment.

Learn about managing cancer treatment side effects.

Learn about the Abramson Cancer Center Center’s Center for Head and Neck Cancer.

Tuesday, April 16, 2013

Supportive Care for People with Cancer

Today is National Healthcare Decisions Day.

National Healthcare Decisions Day exists to inspire, educate and empower the public & providers about the importance of advance care planning. National Healthcare Decisions Day is an initiative to encourage patients to express their wishes regarding healthcare and for providers and facilities to respect those wishes, whatever they may be. To celebrate this important day or recognition, we are discussing supportive care at the Joan Karnell Cancer Center at Pennsylvania Hospital.

A cancer diagnosis, cancer treatment, and side effects from cancer treatment can prove to be an overwhelming ordeal for many people. It’s important health care providers are able to help patients through the medical system, while assuring their values are met, and the burden of physical symptoms and emotional stress is eased.

support services for people with cancerThe Supportive Oncology Clinic (SOC) at the Joan Karnell Cancer Center at Pennsylvania Hospital extends the reach of a patient’s oncologist to meet these needs by addressing the following issues:
  • Goals and coordination of care
  • Emotional and family issues
  • Financial and insurance concerns
  • Work-related concerns
  • Symptom management

Who Supports Patients?

The Supportive Oncology team consists of a palliative care physician, palliative care nurse practitioner and oncology social worker. Together, they work with patients to understand their values, priorities, and hopes for the future.

The team may also include a patient’s loved ones and/or support persons in these important discussions so that the patient’s needs are met to the fullest extent possible. Shared understanding of patient values, goals and preferences helps the team work effectively with the patient’s oncologist as well, so patient care can be tailored appropriately even in the event that a patient can no longer speak for him or herself.

How the Supportive Oncology Team Works

The Team conducts a thorough assessment of the patient, and recommends treatment for symptoms such as pain, shortness of breath, nausea and vomiting, diminished appetite, constipation and fatigue.

Because many patients who have cancer suffer non-physical hardships, the team provides emotional support for patients and families, and addresses practical concerns about finances, health insurance, and managing well in the home setting.

The team also discusses with patients their wishes for long-term care and arrangements including advanced directives and living wills.

Changing Care with Patients’ Needs

As a patient’s experiences, goals and needs evolve, the team helps with changes to the patient’s plan of care so that it best fits the patient’s desires and needs.

For more information, or to schedule an appointment at the Supportive Oncology Clinic at the Joan Karnell Cancer Center at Pennsylvania Hospital, call 215-829-6466.

Monday, April 15, 2013

Who is At Risk for Testicular Cancer?

Barbara Zoltick, RN
Barbara Zoltick, RN, is an onocolgy nurse practitioner at the Abramson Cancer Center. Barbara has more than 30 years experience caring for patients with urologic cancers including testicular cancer. She has authored peer-reviewed journal articles, book chapter and educational webinars. In this article, she discusses testicular cancer and self-exams for testicular cancer. 

Testicular cancer is the most common cancer in men between 15 and 35 years of age.

Though it can occur in older men, testicular cancer generally occurs in young men, at the time of life when they are completing their education, finding new jobs, and creating families.

The American Cancer Society estimates that in 2013, 7,920 men in the United States will be diagnosed with testicular cancer, and 370 of those diagnosed will die.

Who is at Risk for Testicular Cancer?

The incidence of testicular cancer has been increasing over the past 40 years for reasons which remain unclear. Testicular cancer is more prevalent in white men than in black, Asian, or other nonwhite ethnic groups. Historically, the incidence has been found to be greater in men of any ethnicity with higher socioeconomic status and more education, though more recent studies have found this difference has diminished.

The risk factors associated with the development of testicular cancer are not well established. However, cryptorchidism, or an undescended testicle, is currently the most recognized risk factor. Cryptorchidism increases the risk of developing testicular cancer by ten-fold, though only about 5% of testicular cancers can be attributed to this condition. Additional risk factors include prenatal exposure to estrogen; other testicular abnormalities, such as underdeveloped testicles; and genetic disorders that affect sexual development, such as Kleinfelter’s Syndrome.

Fortunately, testicular cancer is one of the most curable cancers. Men diagnosed and treated when the disease is still in an early stage have a 97 to 100 percent chance of being cured. Therefore, early detection is critical.

What Testicular Cancer Looks Like

The most common sign of testicular cancer is a lump, or swelling or enlargement of a testicle. This may be accompanied by tenderness, pain or a feeling of heaviness. Unfortunately, after noticing a change in a testicle, men may wait several months before seeking a medical evaluation. The disease is then more advanced upon diagnosis, possibly requiring more intensive treatment and potentially decreasing the chance of a cure. Monthly testicular self-examinations can help a man become familiar with how his testicles normally feel. He can then recognize any changes and seek medical attention at an early, more curable stage.

It is also important to note that not every change or discomfort indicates cancer; seeking medical evaluation can provide reassurance that cancer is not the cause.

How to Perform a Testicular Self-Exam

  • Check for any swelling on the scrotum. You may need to do this in front of a mirror.
  • Examine one testicle at a time using both hands. Put your index and middle fingers under the testicle with thumbs on top. Roll the testicle gently between your fingers. It can be normal for one testicle to be slightly larger than the other.
  • You will notice a soft, tube-like area behind the testicles. This is the epididymis where sperm is stored.
  • Any testicular changes, pain, swelling, lump or tender area should be evaluated by a health care professional, preferably a urologist as soon as possible. It may not be cancer, but needs to be evaluated to be sure.

Friday, April 12, 2013

Free Head and Neck Screening in Philadelphia

The Joan Karnell Cancer Center at Pennsylvania Hospital is offering a free screening for oral, head and neck cancer from 11 am to 3 pm on Friday, April 19, 2013.

Oral, head and neck cancer refers to a variety of cancers that develop in the head and neck region, such as the oral cavity (mouth), the pharynx (throat), paranasal sinuses and nasal cavity, the larynx (voice box), thyroid and salivary glands, the skin of the face and neck, and the lymph nodes in the neck.

Common symptoms of oral, head and neck cancer

  • Red or white patch in the mouth that lasts more than two weeks
  • Change in voice or hoarseness that lasts more than two weeks
  • Sore throat that does not subside
  • Pain or swelling in the mouth or neck that does not subside
  • Lump in the neck

Later symptoms of oral, head and neck cancer

  • Ear pain
  • Difficulty speaking or swallowing
  • Difficulty breathing

The most effective prevention strategy continues to be the cessation of behaviors such as smoking, use of chewing tobacco and excessive alcohol consumption.  Eighty-five percent of head and neck cancers are related to tobacco use.  

Research has linked the increase of oral cancer incidence in young adults, a population traditionally at low risk, to the rise of human papillomavirus (HPV), a cancer-causing virus that can be transmitted through oral sex.

Date: Friday, April 19 2013
Time: 11 am to 3pm
Location: Pennsylvania Hospital, Otorhinolaryngology – Head and Neck Surgery (adjacent to the Spruce Building) 811 Spruce Street, Philadelphia, PA 19107

To register for this free event, call 800-789-PENN (7366).

For more information, call 215-829-6466

Thursday, April 11, 2013

BRCA Beat: Spring Issue

Read the most recent edition of the Basser Center for BRCA Reseach’s quarterly e-newsletter. 

This newsletter reports on donor Andy Cohen, provides an update on current BRCA related clinical research and promotes upcoming Basser events! 

Read the full newsletter coverage and sign up for the future editions here.

What is an NCI-Designated Comprehensive Cancer Center

The Abramson Cancer Center has been designated a Comprehensive Cancer Center by the National Cancer Institute (NCI) since 1973, one of only 40 such centers in the country.

But what does it mean to be an NCI-designated cancer center?

Comprehensive Care in a Comprehensive Cancer Center

The NCI recognizes cancer centers around the country that meet rigorous criteria for world-class, state-of-the-art programs in multidisciplinary cancer research.

The NCI supports cancer centers that have dedicated significant resources into developing research programs, faculty, and facilities that will lead to better approaches to prevention, diagnosis, and treatment of cancer.

Cancer Research at the Abramson Cancer Center

The Abramson Cancer Center supports 11 research programs that bring together investigators from 41 departments and 8 University schools with a shared interest in specific types of cancer (e.g., breast cancer) or scientific themes (e.g., tumor biology). Many programs span multiple research disciplines (e.g., fundamental and translational).

Areas of Research at the Abramson Cancer Center Include:
  • Translational research, in which scientists translate discoveries from research laboratories into new treatments that benefit cancer patients.
  • Breast cancer, spanning the identification of genetic risk and innovative diagnostic modalities that will lead to earlier diagnosis to basic science understanding of breast cancer development in order to create earlier interventions.
  • Melanoma, focusing on the identification of familial risk and epidemiologic factors to testing new treatment approaches.
  • Hematologic malignancies/bone marrow transplantation, in which we are seeking ways to improve patient outcomes and develop new techniques.
  • Innovative clinical trials (nearly 200 active trials ongoing).
  • Tobacco research, in which scientists are examining several genes that may play a role in predisposing people to nicotine addiction.
  • Developmental therapeutics, in which Penn researchers are identifying and testing the effectiveness of new drugs in preventing or treating cancer.
  • Immunobiology, in which we are learning about how proteins function in order to design to innovative therapeutics to control immune reactions.

The NCI provides grant funding that accompanies the designation supports shared resources for research, provides developmental funds to advance scientific goals, and fosters cancer programs that draw investigators from different disciplines together.

Learn more about research programs at the Abramson Cancer Center

Learn more about institutes and centers at the Abramson Cancer Center.

Wednesday, April 10, 2013

Penn Medicine's New Center for Personalized Diagnostics

When cancer specialists look at a patient’s tumor or cancer, they are just looking at a small piece of that patient’s diagnosis. For people with cancer, genetics and DNA testing can provide a clearer picture of why cancer develops to guide new, individualized treatments to stop the cancer from spreading.

Penn Medicine’s new Center for Personalized Diagnostics, a joint initiative of the department of Pathology and Laboratory Medicine in the Perelman School of Medicine and the Abramson Cancer Center, is diving deeper into each cancer patient’s tumor with next generation DNA sequencing.

These specialized tests can refine patient diagnoses with greater precision than standard imaging tests and blood work, all with an aim to broaden treatment options and improve their efficacy.

The Center for Personalized Diagnostics unites top experts in genomic analysis, bioinformatics, and cancer genetics – who use the most sensitive data analysis tools available to identify the rarest of mutations – with oncologists who treat patients and design clinical trials to test new therapies. Together, their efforts will provide cancer patients with cutting-edge diagnostic and therapeutic options.

Read the full press release announcing the new Center for Personalized Diagnostics at Penn Medicine to learn more about how these test results stand to change and improve cancer care.

About the Center for Personalized Diagnostics

The Center for Personalized Diagnostics (CPD), a joint initiative by Penn Medicine's Department of Pathology and Laboratory Medicine and the Abramson Cancer Center, integrates Molecular Genetics, Pathology Informatics, and Genomic Pathology for individualized patient diagnoses and to elucidate cancer treatment options for physicians.

The focus of the CPD's initial efforts has been toward developing two cancer gene sequencing panels: a custom hematologic malignancy panel and a solid tumor panel. The primary targets will include leukemias, and solid tumors, beginning with brain, melanoma, and lung tumors. The goal is to identify genomic alterations that allow clinicians to design and implement optimal treatment plans.

Learn more about the Center for Personalized Diagnostics here.

Tuesday, April 9, 2013

Esophageal Cancer: Risk and Prevention

Esophageal Cancer Risk and Prevention

There are risk factors that can increase the chance of developing cancer. Having a risk factor, or even several, does not mean that someone will get cancer. There are different kinds of risk factors.

Some risk factors for cancer, like age and family history, cannot be prevented. Patients who feel they are at risk may benefit from consulting with a risk assessment specialist within Penn Medicine’s GI genetics program.

Esophageal Cancer Risk Factors

Researchers believe chronic irritation of the esophagus may affect esophageal tissue and put some people at higher risk for developing esophageal cancer.

Some other risk factors include:
  • Alcohol use
  • Tobacco use
  • Barrett’s esophagus
  • Gastroesophageal reflux disease (GERD)
  • Eating a diet low in fruits and vegetables
  • Obesity
  • African Americans (greater risk for developing squamous cell esophageal cancer)
  • Caucasians (greater risk for developing adenocarcinoma)

Overall, men are about three times more likely than women to develop esophageal cancer.
Barrett’s esophagus is a condition in which the lining of the esophagus is damaged by stomach acid. Barrett’s esophagus is the body’s way of repairing the damage and this may increase the risk for developing esophageal cancer.

People diagnosed with Barrett's should be monitored for precancerous cells in the lining of the esophagus. If precancerous cells are found, they can be treated endoscopically to help prevent cancer.

Esophageal Cancer Prevention

The risk of esophageal cancer may be lowered by making several lifestyle changes:
  • Limiting or eliminating alcohol use: Moderate or no consumption of alcohol can decrease the risk of developing cancer.
  • Eliminating tobacco use: Smoking or chewing tobacco can increase the risk of developing cancer. Patients can get help to stop smoking through Penn Medicine’s Lung Center or through a smoking cessation research program at the Abramson Cancer Center.
  • Eating a diet rich in fruits and vegetables: This includes fruits and vegetables that are green and yellow, and cruciferous vegetables such as cabbage, broccoli and cauliflower.
  • Maintaining a healthy weight: Research has shown that obesity is a risk factor for developing esophageal cancer. A physician can help patients learn strategies to lose weight.

Esophageal Cancer Risk Assessment

Penn Medicine offers programs for patients who want to determine their risk of developing gastrointestinal cancer through the Penn Gastrointestinal Cancer Risk Evaluation Program.

This program offers knowledge about the presence of genetic risk factors for cancer and provides patients with important, sometimes life-saving options.

Learn more about your risk for esophageal cancer.

Learn more about esophageal cancer, and esophageal cancer treatment at the Abramson Cancer Center.

Monday, April 8, 2013

Ovarian Cancer Vaccine Made From Tumors Yields Responses

We are preventing progression of already existing disease," Kandalaft said. "Most of the patients are now on a maintenance vaccine, just to keep the system going. We haven't seen them recur. We are seeing how long they can go. - Lana Kandalaft, PharmD, PhD, MTR

Press releases this week, from the Abramson Cancer Center, and Penn Medicine report media coverage surrounding the ACC's recent collaborative research efforts with the Ovarian Cancer Research Center.  

Lana Kandalaft, PharmD, PhD, MTR, a research assistant professor of Obstetrics and Gynecology and director of clinical development and operations in Penn Medicine's Ovarian Cancer Research Center reported Saturday, during the American Association for Cancer Research's annual meeting, that a new immunotherapy approach that uses patients' own tumor tissue and dendritic cells is helping make headway against a formidable foe -- late-stage ovarian cancer."

The ACC press release highlights the work of the trial's principle investigator Janos Tanyi, MD, PhD, an assistant professor of Obstetrics and Gynecology.

TV stories about the new research also aired on NBC and FOX news affiliates in 106 cities across the nation, including Boston, New Orleans, Philadelphia, and Washington, DC.
Read the releases in full at the 
Abramson Cancer Center website
and for more of the latest information on 
BRCA research, testing and more
visit the official Basser webpage.

New Chief of Thoracic Radiation Oncology at Penn

Dr. Charles ‘Chuck’ Simone has joined Penn Medicine as the Chief of the Thoracic Service of the Department of Radiation Oncology at Penn.

As chief, Dr. Simone will lead a team of four clinicians working in the thoracic service, which currently accounts for one of the largest patient volumes of any service within the department of radiation oncology at Penn. His responsibilities will span from the development and implementation of a standardized clinical treatment approach to thoracic malignancies at Penn Medicine, and all network facilities to improving the overall patient experience treated on this service.

Dr. Simone will continue working with photodynamic therapy (PDT) with his new responsibilities, as well as proton therapy for lung cancer, and proton therapy for mesothelioma.

Watch this video of Dr. Simone to learn more about proton therapy, and treatment for lung cancer at Penn Medicine.

Friday, April 5, 2013

Pennsylvania’s Refunds for Research Program Benefits Penn Medicine (VIDEO)

6ABC reports on Pennsylvania’s Refunds for Research Program benefiting Basser investigator Roger Greenberg, MD, PhD for work on BRCA1 and BRCA2-related cancers.


After the video, get more information on BRCA1 and BRCA2 at the official Basser Research Center for BRCA webpage.

Treating Pancreatic Cancer with Proton Therapy

For most people, protons are those positive sub-atomic particles they stopped thinking about almost immediately after middle school chemistry class. But, for some patients with pancreatic cancer, there is another positive aspect of protons worth considering—proton therapy for pancreatic cancer.

Proton therapy is a non-invasive medical treatment that uses a beam of high-speed protons to destroy the DNA of cancer cells. This kills the cell and therefore prevents it from multiplying.

For pancreatic cancer patients, the precision of proton therapy treatment adds to the positive results of killing cancer cells. Proton therapy for pancreatic cancer is effective because the beam of protons can be adjusted to target very specific areas, making it perhaps the most advanced treatment for cancer tumors of the pancreas. Proton therapy allows doctors to target radiation doses into the tumor while avoiding harming cells in the nearby liver, kidneys and spinal cord.

Conventional radiation treatment is limited by the amount and frequency of radiation doses it can safely deliver. But with proton therapy for pancreatic cancer, the protons release their energy directly into the pancreatic tumor, limiting the radiation dose beyond that tumor, which causes less damage to surrounding tissue and organs and causes fewer side effects.

Proton Therapy at Penn Medicine

The Roberts Proton Therapy Center is the only center in the Philadelphia region, and one of the few in the world that offers patients pencil beam scanning. Pencil beam scanning is the procedure of tuning a proton beam to a precise range and intensity. With proton therapy for pancreatic cancer, doctors can use this beam to paint the tumor with a powerful dose of extremely targeted radiation.

The Roberts Proton Therapy Center is also the only center in the world that offers multi-leaf collimator precision. The collimator is a device that shapes the proton beam to match a 3-D profile of a patient’s tumor, allowing for proton delivery in the exact shape of the tumor.

More effective treatment with fewer side effects and complications. Learn more about proton therapy for pancreatic cancer at the Roberts Proton Therapy Center.

Thursday, April 4, 2013

Run and Walk to Support Myeloma

Dan Vogl, MD, is assistant professor of medicine at the Abramson Cancer Center. Dr. Vogl works with patients in the hematologic malignancies and bone marrow transplant program. 

The Philadelphia Multiple Myeloma Networking Group (PMMNG) is holding its fifth annual Miles for Myeloma 5K Run/Walk Saturday, April 27 on Martin Luther King Drive in Philadelphia.

Together with patients and their families, I’ll be there to help raise money to cure multiple myeloma.
The PMMNG is a fantastic group of patients and caregivers that provides support to the local myeloma community. Funds raised from this annual event support:

I am proud to be serving again as honorary co-chair for the event.

What is multiple myeloma?

Myeloma is a cancer of bone marrow plasma cells, which manifests in patients as low blood counts, painful bone lesions and fractures, kidney injury, and increased risk of infections. With several new medicines approved over the past 15 years, we can now routinely hope for many years of good quality life with the disease. However, we still do not have a cure, and improvements in therapy are certainly needed.

I became interested in multiple myeloma during my oncology training, and the focus of my career has become treating this difficult disease and researching ways to improve therapies.

Treating multiple myeloma at Penn Medicine

Penn’s Abramson Cancer Center has a great myeloma team.

Dr. Edward Stadtmauer, Dr. Brendan Weiss, and I focus on this disease, and we have a talented and dedicated group of nurse practitioners, chemotherapy nurses, research nurses, data coordinators, and staff, who all work hard to improve the lives of our patients.

Our current research program includes clinical trials for myeloma of completely new medicines, exciting immunotherapy approaches using the body’s own immune cells to attack cancer cells, and improvements to bone marrow transplantation.

In addition, we have expanded our research efforts to cover conditions that precede myeloma, like MGUS (monoclonal gammopathy of undetermined significance) and smoldering myeloma , as well as related disorders, like amyloidosis.

Research at Penn is focused on improving our ability to target the unique biology of myeloma cells. This includes ongoing clinical trials looking at ways to overcome resistance that myeloma cells can develop to some of our most effective therapies, as well as clinical trials of new medications targeting genes that regulate myeloma growth. We are actively working to understand how our treatments work, why some patients respond to them better than others, and how to make them more effective for everyone.

Participating in Clinical Trials at Penn

Penn’s Abramson Cancer Center has many options for patients with myeloma to participate in clinical trials for cancer.

Participating in clinical trials is important, because these trials advance our knowledge of how to treat this disease. The only way that we can truly understand whether, how, and for whom a treatment works is by studying the treatment in the patients receiving it. And we can only do that in the context of a clinical trial. Clinical trials also give patients access to new treatments, each of which is based on an idea of how to treat myeloma better.

Support Miles for Myeloma

Events like Miles for Myeloma raise important funds to allow this important research to continue. Last year, more than 1,000 participants, volunteers, and sponsors raised more than $140,000 bringing the total raised by this event to over $400,000 since its inception in 2009.

My own research has been supported by the Leukemia & Lymphoma Society, so I have seen firsthand the effects of this kind of fundraising.

In addition, Miles for Myeloma is a lot of fun. The setting along the Schuylkill River is beautiful, the opportunity to be outside (hopefully in good weather) is wonderful, and the patients and families who participate are some of the most amazing people I have ever met. They also have snacks available and a raffle with some great prizes.

As is my tradition, I’ll be walking the 5K, since I have not run that far since college. I’ll look forward to seeing everyone there.

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