A story of untreated mental illness and cancer

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Jennifer Lycette, M.D.

“My first thought, as I viewed the CT images, was a somewhat fantastic notion that the tumor on the monitor screen could not possibly be real,” recalled Jennifer Lycette, M.D., an oncologist with the OHSU Knight Cancer Institute practicing in Astoria.

“Then I wondered how it had come to be. Somehow a living, breathing woman had been bearing this tumor — for many months, if not years, judging by the size of it. All without medical care until now, according to my colleague who had called me to consult,” Lycette continued in a forceful essay in the New England Journal of Medicine. It’s a meditation on her patient’s death – and what it reveals about the provision of mental health services in rural America:

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For rare tumors, a far-reaching trial of immunotherapy

The first federally funded clinical trial of immunotherapy for rare cancers launched this week under the auspices of SWOG, the research consortium headquartered at the OHSU Knight Cancer Institute. Over 30 different types of rare cancers – defined as less than a 6 in 100,000 incidence per year – will be studied.

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The study team includes OHSU’s Christopher Ryan, M.D.

The DART trial is testing the combined use of ipilimumab, a monoclonal antibody targeting the T-cell antigen CTLA4, and nivolumab, a monoclonal targeting the PD-1 receptor. The combination proved to be strikingly effective against melanoma, fueling enthusiasm for testing it in a wide array of solid tumors.

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Enterprising cancer treatment ideas nurtured with pilot funds

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Finding new treatment targets for aggressive prostate cancer, lymphoma and leukemia. Visualizing how breast tumors grow resistant to drug therapy. Using mobile phone sensors to track symptoms in patients with pancreatic cancer. These are some of the new pilot projects funded by the OHSU Knight Cancer Institute.

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Knight Cancer signal achievements of 2016

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Lara Davis, M.D., and Payton Williams, a former patient, at Doernbecher Children’s Hospital in a ceremony awarding Davis a young investigator grant from Hyundai Hope on Wheels.

The staff and faculty of the OHSU Knight Cancer Institute accomplished much together during the past year. Here’s a sampling of achievements that reflect the mission of delivering compassionate care and scientific discoveries that will end cancer as we know it:

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The ‘Cancer translated’ blog top ten posts of 2016

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The OHSU Knight Cancer Institute’s “Cancer translated” blog explores new findings, ideas and debates in cancer medicine, from basic biology, to clinical trials, to prevention, survivorship and patient advocacy. We sorted a year’s worth of posts to find the most heavily trafficked reports. Here’s the top 10 in order of popularity:

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New insight into the anti-cancer effect of aspirin

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Acetylsalicylic acid, a.k.a. aspirin.

For reasons that remain uncertain, people who take aspirin on a regular basis have a reduced risk of colorectal cancer and certain other malignancies.

Now researchers have identified a previously unknown way that aspirin could achieve this result: “The benefit of aspirin may be due to its effect on blood cells called platelets rather than acting directly on tumor cells,” says Owen McCarty, Ph.D., a professor in the Department of Biomedical Engineering at Oregon Health & Science University.

When tumor cells break off and enter the blood stream, their interactions with platelets can promote tumor cell survival by turning on genes such as c-MYC, a master regulator that is implicated in driving tumor growth in colon, pancreas, breast, lung, prostate and other cancers. In a series of experiments with cells grown in lab dishes, McCarty and colleagues showed that inhibition of platelets with low doses of aspirin cuts the signaling link between platelets and cancer cells, which in turn knocks back cancer growth.

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Predicting colon polyp risk from microRNA

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Differences in microRNA in colon polyps may help identify high risk cases that require more frequent follow-up screening, according to a study with four OHSU co-authors that is featured on the cover of Cancer Prevention Research this month.

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Blood test for cancer early detection? A giant study is underway

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Grail Inc., a startup with investors including Microsoft’s Bill Gates and Amazon’s Jeff Bezos, made a splash earlier this year when it unveiled plans to develop a blood-based screening test for cancer. The first clinical trial is now underway, the company announced on Dec. 1.

OHSU Knight Cancer Institute Director Brian Druker, M.D., who is a member of Grail’s scientific advisory board, said the study represents a “critically important” step in establishing the foundational knowledge that will be needed to advance early detection.

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Making better decisions to prevent colon cancer

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Colorectal cancer mortality rates (per 100,000) are as much as six times higher in red counties than in those colored dark blue. (Source: NCI SEER data 2007-2011)

To prevent deaths from colon cancer, the U.S. Preventive Services Task Force now recommends no less than eight different screening approaches for average-risk individuals, beginning at age 50.

There is no definitive evidence that one program is superior to another, but they all depend on access to high-quality colonoscopy, which is far from guaranteed, says David Lieberman, M.D., a professor of medicine and head of the Division of Gastroenterology and Hepatology at Oregon Health & Science University. And some screening programs require adherence to multiple steps to be effective, says Lieberman, co-author of a new review of colon cancer screening in the Journal of the American Medical Association. The writers propose that quality should be monitored closely in any screening program recommended in a primary care setting.

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Instant message to cancer: time to die

Cancer researchers have uncovered a signaling link – like a Snapchat between cells – that could be used to make tumors more vulnerable to therapy.

Dr. Sudarshan Anand (left) and postdoctoral researcher Cristina Espinosa in their lab, November 16, 2016. The early evidence from research by Dr. Sudarshan Anand and his team at OHSU is promising, suggesting there may be a panel of microRNA that can be used as a biomarker for radiation therapy for many types of cancer in the future. (OHSU/Kristyna Wentz-Graff)

Sudarshan Anand, Ph.D., (left) and Cristina Espinosa, Ph.D., a post doctoral researcher in his lab. (OHSU/Kristyna Wentz-Graff)

It is a signaling mode that’s also active in severe autoimmune diseases. In the new study published online Friday in Nature Communications, researchers showed that boosting the signal in a mice with tumors made cancer cells suffer more DNA damage from cancer drugs. It also blocked the growth of new blood vessels needed to sustain tumors and it increased survival of study animals.

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“We’re seeing results we never thought imaginable”

“We’re seeing results we never thought imaginable”

For a taping of Live Wire Radio, OHSU Knight Cancer Institute Director Brian Druker, M.D., shared the stage with the indie rock band Blind Pilot, comedian Phoebe Robinson, and Bill Oakley, a writer for “The Simpsons.”.