As news of our NCI Cancer Center designation was making headlines this year, you may have heard about Markey Cancer Center's track record and progress fighting cancer in Appalachia.
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LEXINGTON, Ky. (July 23, 2014) — Good nutrition is critical during cancer treatment, but side effects of chemotherapy and radiation can often cause patients to lose their appetites at a time when they need sustenance the most.
As a registered dietitian at the University of Kentucky Markey Cancer Center, Rachel Miller does all she can to help patients get the nutrition and calories they need.
"A lot of patients have trouble with weight loss and decreased appetite while they're going through various treatments," Miller said. "One of the things that's hardest to do when you don't feel like eating is getting that nutrition you need."
Much of Miller's time at Markey involves one-on-one counseling. She sees patients throughout the process of their treatment, provides them with nutrition education, and in some cases, assists patients with setting up their tube feeding.
In addition to the individual consults, Miller also tries to provide a more tangible example of healthy eating during cancer treatment. On the fourth Wednesday of each month, she hosts a smoothie demonstration in the Whitney-Hendrickson Building. The demonstrations are open to everyone at Markey, including patients, families and medical providers.
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Smoothies are an ideal way to boost nutritional value in a small volume of food, Miller said. Adding in healthy fats (for example, coconut milk) serves to improve the taste of the drink as well as pack in much-needed extra calories.
"Sometimes it's difficult to eat a full meal," Miller said. "So trying to fortify what you're eating, although it's a small amount, is one of the things I think is helpful to teach patients to do at home."
During the monthly demonstration, Miller tries to incorporate a variety of foods into the smoothies, testing out different tastes and textures. A common side effect of chemotherapy is a change in taste — many patients report a "metallic" taste in the mouth — so using strong flavors can be helpful in making the meal more appealing. As she prepares the drink, Miller talks her audience through the process, explaining the health and taste benefits of each ingredient.
Though she has regular medical staff who attend, her audience is often filled with families and friends of patients who are waiting for their loved one to complete an appointment or treatment. In addition to giving them information that will help them provide for their loved ones at home, Miller hopes the demonstrations also add a little levity to their day.
"I think the demonstrations have been very helpful," Miller said. "People have a lot of questions. It's easier to see and watch someone else do it, and then be able to implement that in your own home. I think it's also convenient, because a lot of patients have long days here so it can be a fun little break while you're waiting."
Smoothie demonstrations are offered on the fourth Wednesday of every month at 1 p.m. in the Psych-Oncology Services office, third floor, Whitney-Hendrickson Building. Miller also periodically partners with local chefs to host food demonstrations for patients and families.
For more information on good nutrition during cancer treatment, visit Miller's blog: the Markey Menu.
MEDIA CONTACT: Allison Perry, (859) 323-2399 or firstname.lastname@example.org
LEXINGTON, Ky. (July 15, 2014) — A new study by University of Kentucky researchers shows how a genetic defect in a specific hormonal pathway may make people more susceptible to developing melanoma, the deadliest type of skin cancer.
Fair-skinned people who tend to burn (rather than tan) from sun exposure have a much higher risk for melanoma than darker-skinned people. On the surface, it appears that the amount of melanin, the natural substance in the skin that determines pigment and acts as the skin's "natural sunscreen," would be the only determinant of melanoma risk. However, the truth is more complicated.
Published in Molecular Cell, the study looked at the role of the melanocortin1 receptor (MC1R), the receptor on melanocytes in the skin that gets called into action following ultraviolet exposure to help the skin lay down more UV-blocking melanin to protect itself. Fair-skinned people are more likely to inherit a defect in this receptor, and as a result, cannot make enough melanin to fully protect themselves from UV damage.
Since UV from sunlight or tanning beds is a major cause of melanoma, inherited problems in the MC1R means that the skin lacks natural protection by melanin, which acts as a biologic sunblock. This leads to more UV light chronically getting through to the sensitive layers of the epidermis, where it can contribute to cancer.
However, the UK study showed that MC1R defects contribute to melanoma development in ways other than melanin production. Besides regulating the amount of melanin that gets made in the skin, MC1R also controls how well melanocytes can repair their DNA from UV damage. Having defects in MC1R signaling delays the body's ability to clear out existing DNA damage in the skin – leading to an increased potential for cancerous mutations.
“Knowing whether people have a specific genetic predisposition for melanoma could potentially save many lives”, says Dr. John D'Orazio, Associate Professor and the Drury Pediatric Research Endowed Chair at UK’s Markey Cancer Center. “If you happen to be born with a problem in this MC1R hormonal pathway, then you need to be extra careful with respect to UV safety.”
A good indication of a person’s MC1R status is what happens to the skin after sun exposure.
“If you tan well, then your MC1R probably works well,” D'Orazio said. “If you tend to burn, then you may have inherited a problem with your MC1R, and you probably should avoid purposeful UV exposure like tanning bed use or unprotected sun exposure."
D’Orazio and his research team found an important molecular link between MC1R signaling and DNA repair in their study. The team hopes to use this information to develop new melanoma-preventive treatments, like additives that can be included in sunblocks to ramp up the skin’s ability to deal with UV damage.
Melanoma incidence has increased steadily over the past few decades – in the 1930s, an estimated one in every 1,500 Americans developed the diseases. Today, the odds are about one in every 60. Having a problem with the MC1R pathway raises a person’s lifetime risk of melanoma about four-fold.
LEXINGTON, Ky. (July 11, 2014) — A year ago, a crowd of hundreds gathered in Pavilion A of the University of Kentucky Chandler Hospital to celebrate a long-awaited special announcement – the unveiling of the UK Markey Cancer Center as the state's first and only National Cancer Institute-designated cancer center.
The designation was the culmination of years of tireless work by the faculty and staff of Markey and its supporting service lines and colleges – all guided by Director Dr. Mark Evers, who came to UK in 2009 with the vision of propelling Markey to NCI designation.
"Even before earning the NCI designation, we'd already taken extraordinary steps in the past few years in terms of combating cancer incidence and mortality through preventative measures, treatments and research," Evers said. "But having the support and approval of the NCI has already made a huge impact in terms of both research and our clinical care."
Patient Care at Markey
As the word spread about Markey's NCI designation, clinicians and staff experienced an increase in the patient population in almost every clinical area. In 2014, Markey saw nearly 150 more new patients over the previous year, with total patient visits increasing from roughly 75,000 last year to more than 85,000 this year – which also marks a 29 percent increase in patient visits compared to just five years ago.
In particular, Markey's outpatient clinics are growing -- the Comprehensive Breast Care Center, the Multi-Disciplinary Clinic, and the Gynecology-Oncology Clinic saw unique patient growth of 29 percent, 10 percent, and 5 percent, respectively, over the past year.
With such an increase in patient volume – and variety – Evers and his team have also stepped up recruitment, seeking out the best cancer specialists in their fields to join the Markey Cancer Center. Markey's already vast team of specialists now includes a bevy of new team members added in the past year, including four medical oncologists; three hematology and blood and marrow transplantation specialists; three surgical oncologists; two genitourinary cancer surgeons; two oral and maxillofacial surgeons; and a specialist in oncofertility, a new program starting up at the cancer center.
Recruiting strong researchers is a major aspect of earning and maintaining an NCI designation, and this year Markey landed a major established research team in metabolomics. Rick Higashi, Hunter Moseley, Teresa Fan, and Andrew Lane joined Markey last fall, bringing with them more than $18 million dollars in funding. One of the major focuses of the team's work is to develop early diagnostic approaches for lung cancer based on metabolism markers, which is especially important in Kentucky, where we own the distinction of having the worst rates of lung cancer incidence and death in the country.
Over the past two years, Markey has increased its funding from the NCI by 27 percent and from other National Institutes of Health divisions by 16 percent. Overall, since the end of calendar year 2012, Markey's total research funding from both peer-reviewed and non-peer-reviewed sources has increased by $7.3 million.
Additionally, Markey researchers continue to push major findings out to their peers in academia – in 2014, Markey authors published 528 scientific articles, 49 more than the previous year.
Moving forward, Evers notes that his team will continue to seek out new clinician-scientists who have experience in clinical trials and early phase drug development, with the goal of significantly increasing the number of patients who participate in trials. Another emerging field of research for Markey is molecular epidemiology, the study of potential genetic and environmental risk factors for disease identified at the molecular level, which has the potential for great impact in Appalachia.
Markey's Reach Across the State
Though based in Lexington, Markey also strives to provide access to top-notch cancer care across the state and beyond through the Markey Cancer Center Affiliate Network. The Affiliate Network is a group of healthcare facilities that provide high-quality cancer services and programs in their communities with the support and guidance of the UK Markey Cancer Center, allowing patients to receive their care closer to home.
Currently, the network comprises nine hospitals across the state of Kentucky:
Since Markey earned the NCI designation, demand for new affiliations has grown. Two new ARH hospitals will be added this summer, moving Markey further into Eastern Kentucky, an underserved area known for some of the worst rates of cancer incidence and death in the country. Additionally, evaluations are under way for seven other hospitals, including two outside the state of Kentucky, extending Markey's reach further and establishing it as the destination cancer center for the region.
The Future of Cancer Care in Kentucky
Following last year's announcement of Markey's NCI designation, Evers joked with his staff that they had one day to celebrate – and the next day, they'd be back in full swing, ready to propel Markey to the next level of designation: an NCI-designated Comprehensive Cancer Center. Currently, 41 of the 68 total NCI-designated cancer centers in the country hold a comprehensive cancer center status.
To earn this top level of designation, cancer centers must show a depth and breadth of research in each of three major areas: laboratory, clinical, and population-based research, as well as substantial transdisciplinary research that bridges these scientific areas. Additionally, outreach is especially important, and comprehensive cancer centers must demonstrate professional and public education and outreach capabilities, including the dissemination of clinical and public health advances in the communities it serves.
NCI designations are renewable every five years, and Evers hopes that Markey's next application will be for comprehensive status. To reach that level, Markey has a long to-do list, including increasing cancer-related funding, accruing more patients into clinical trials (including pushing these trials out into the state via the affiliate network), and maintaining and increasing focus on Appalachian Kentucky.
"Our progress in the past year has been spectacular, but we can – and should – do more," Evers said. "As the only NCI-designated cancer center in Kentucky, it's our responsibility to be the leader in cancer care and to always seek out new ways to improve rates of cancer incidence and death in the state, and to make sure that we can also offer the best possible care for our patients right here in Kentucky. Earning a comprehensive cancer center designation from the NCI will be another big step in that direction."
LEXINGTON, Ky. (July 1, 2014) – UK HealthCare has been recognized by America’s Essential Hospitals for a patient safety initiative that has resulted in a significant decrease in mortality at the hospital compared with the general population.
America's Essential Hospitals, a national organization representing hospitals committed to high-quality care for all people, including the vulnerable, awarded UK HealthCare a 2014 Gage Award honorable mention for improving quality. The association made the award June 26, at its annual conference, in San Antonio.
“UK HealthCare’s patient safety initiative stands out among the innovative approaches our hospitals take to avoid harm and improve the quality of care,” said America’s Essential Hospitals President and CEO Dr. Bruce Siegel.
The Gage Awards, named after association founder Larry Gage, honor and share successful and creative programs that improve patient care and meet community needs. The Gage Award for improving quality recognizes activities that improve the quality of care delivered, or reduce or eliminate harmful events to individual patients or groups of patients.
"UK HealthCare is continuously working to improve, driven by our high standards and our commitment to serve the people of the Commonwealth and beyond and the Gage Award represents national recognition of this work," said UK HealthCare Chief Medical Officer Dr. Bernard Boulanger. "It is recognition of our team’s relentless, rigorous approach to improving patient care, in a manner that directly benefits our patients"
UK HealthCare received the award for the development of an internal process called SWARMING to help the hospital improve overall patient safety. A SWARM is initiated shortly after the occurrence of an adverse incident or undesirable event, and the people directly involved are empowered to "stop the line" when they observe a problem. Since instituting SWARMs in 2009, the hospital has experienced an overall reduction in the observed to expected mortality ratio from 1.5 to 0.7, as reported in December 2013.
"The SWARM process has been a remarkable and successful team effort throughout the UK HealthCare enterprise and everyone should be commended for their role in what has become one of our best tools in improving patient safety," said Dr. Michael Karpf, UK executive vice president for health affairs. "This award is another example of our commitment to excellence in patient care and patient safety and in keeping our promise to Kentuckians that they can get the very best care right here regardless of the complexity or care needed."
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Video by Allison Perry, UK Public Relations & Marketing. To view captions for this video, push play and click on the CC icon in the bottom right hand corner of the screen. If using a mobile device, click on the "thought bubble" in the same area.
LEXINGTON, Ky. (June 18, 2014) — Facing a cancer diagnosis is no easy feat. Patients at the University of Kentucky Markey Cancer Center have always inspired the community with their strength and courage, and Friday, June 6th was no exception, as Markey honored the experiences of those who have battled cancer with a day of recognition and celebration.
June is National Cancer Survivorship Month, and to mark the occasion, Markey held its inaugural Expressions of Courage event, an art exhibit showcasing original, artistic expressions connected in some way to an experience with a cancer diagnosis, or crafted by or in memory of a Markey patient whose battle has ended.
"We sent out over 6,000 letters," said Cindy Robinson, a nurse practitioner at Markey and one of the organizers behind the event. "And we asked people for any type of creative modality that they wanted to share with us, to share their cancer journey, whether it be positive or negative."
More than 30 artists responded. Entries of visual arts included paintings, drawings, photography, sculpture, and quilting. The performing arts involved vocal music, instrumental music, and dancing, and poetry and short stories encompassed the literary arts.
The creations were on display all day in the Combs Research Building at Markey, with readings and performances starting in the afternoon and continuing into the early evening.
"The artwork is very moving and inspiring, and actually will bring tears to your eyes if you read some of the pieces," Robinson said. " We have some pieces here from patients that are no longer with us, and we personally know those people."
Expressions of Courage was made possible by gifts from the Markey Cancer Foundation and Biological Systems Consulting, Inc. With the help of Carla Repass, the assistant director for administration at Markey, and fellow Markey staff members Christie Daniels, Valeria Moore and Mincha Parker, Robinson said she felt they planned and pulled off the cancer center's first-of-its-kind celebration with flair.
"I think for our inaugural event, it's gone beautifully," Robinson said. "We have a lot of survivors here. They've shared their joy."
Shawna Cassidy Quan of Richmond, Ky., was one of the survivors in attendance, having been diagnosed with four different primary cancers over the course of fifteen years. Her expression of courage was an essay about her struggles with her multiple diagnoses.
"You figure out the answers to a lot of your problems even while you're sitting down writing," Quan said. "It's just been a wonderful, therapeutic thing for me."
Norton Cancer Center and Markey patient Phillip Meeks traveled nearly two hours from Jeffersonville, Indiana, to attend the event. Meeks' art piece, a drawing by his daughter, was inspired by the unlikely good fortune of his treatment. In 2012, he was diagnosed with acute myeloid leukemia, requiring a bone marrow transplant to survive.
As an African-American — a population which only makes up roughly 7 percent of the bone marrow registry — and an adoptee without biological siblings or parents to get tested, the odds of finding a match were against him.
The day he was admitted to the hospital, Meeks said, they found a token underneath his hospital bed: one side said "Believe in Miracles" while the other side said "Faith."
"To me, that was God's way of saying that I'm there with you, you know, don't be scared," Meeks said.
A donor match was found for him, and he received his life-saving transplant in January 2013. He notes that Expressions of Courage was not only a day to showcase talent, but a day that survivors could show their appreciation to the staff of Markey.
"I just want to give back," Meeks said. "That's my big thing. How can you thank so many people that are involved in saving your life? There's not a gift that you can give that's big enough. Hopefully this is my one little piece to say thank you for everything that everybody has done for me."
Many survivors and their families expressed their appreciation of the love and support of the UK and Markey community.
"You live life just as fully as you can, because you're not promised even another hour," Quan said. "I think we've done that today… I hope Markey does this again and keeps on doing it."
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