Top Doctors 2013: Inside The Helen F. Graham Cancer Center and Research Institute
From researching less invasive procedures to growing artificial body parts, the doctors at the Graham Center are well ahead of the cancer research curve.
Two years after cancer surpassed heart disease as the No. 1 killer in the country, the Helen F. Graham Cancer Center was established on the campus of Christiana Hospital in Newark. Today, 10 years later, it is now the Helen F. Graham Cancer Center and Research Institute, and amazing things are happening here.
Dr. Bruce Boman, for example, studies colon cancer. He believes understanding cancer stem cells, which drive the growth of all malignant tumors, is the key to a cure. In his lab, he is marking the cells to track their reproduction and growth in an effort to develop new diagnostic markers and treatments for advanced forms of colon cancer.
Molecular biologist Jennifer Sims-Mourtada is also interested in stem cells. She is working to understand why some breast cancers respond well to radiation or chemotherapy and others don’t. If she succeeds, doctors may find less invasive preventative measures than mastectomies for the most aggressive hereditary breast cancers.
From patients’ own cells, molecular biologist Swati Pradhan-Bhatt, a post-doctoral fellow at the University of Delaware, with Dr. Robert Witt, chief of the Multidisciplinary Head and Neck Oncology Center at the Graham Center, have grown small structures that are part of the salivary gland. In 10 years, Witt estimates, doctors will be able to implant artificial salivary glands in cancer patients who suffer the effects of dry mouths—tooth decay, oral ulcers and debilitating sore throats—due to destruction of their natural salivary glands by radiation treatments. That’s not a cure for cancer, but it is a major advance in the treatment of cancer patients.
The salivary gland project is supported by a major grant from the National Cancer Institute—a major indicator of how far the center has come in so short a time. It’s the kind of research that happens mostly at major universities. That’s it’s happening at a community healthcare center is highly unusual, especially in a state without a medical school. That the grant was made for a project headed by a physician in private practice—a first for Christiana Care—is extraordinary.
Welcome to the Center for Translational Research, 7,000 square feet of lab space on the fourth floor of the Graham Center, where physicians and scientists work side by side to find better ways of diagnosing and treating cancer. “To me, this is the heartbeat of the place,” says Dr. Nicholas Petrelli, founding medical director of the Graham Center. The center is where problems encountered at the bedsides of cancer patients are solved in the lab, then translated to better treatment back at the bedside. It’s just one of the factors that earned the Graham Center a place in the National Cancer Institute Community Cancer Center Program.
Since it began, the Graham Center has strengthened basic programs and services, and it has added some critical new ones. In one visit, patients can see a surgeon, medical and radiation oncologist, geneticist, psychologist, other support staff and subspecialists. The center’s rate of enrollment in NCI clinical research trials is seven times higher than the national average, making it No. 3 in the nation last year. (Participation in clinical trials correlates directly to better outcomes for patients.) And what Petrelli calls a “robust” program of genetic testing and counseling has helped thousands of people identify the genetic mutations that can cause cancer and determine courses of prevention. Three thousand families—150,000 individuals—have been registered. “This is a real legacy for future Delawareans,” Petrelli says. “That’s why we’re doing this.”
With so many resources in one place, the Graham Center has become every bit as good as the major cancer centers in the biggest cities. “Ninety-five percent of the patients who leave here for a second opinion in Philadelphia or New York or at Johns Hopkins come back here for treatment,” Petrelli says. Even after consulting professional friends at Memorial Sloan-Kettering Cancer Center in New York, Petrelli, one of the most esteemed cancer professionals in the country, chose his own center for treatment of his thyroid cancer. (Three years after surgery, he remains free of cancer.)
With its great success in treating patients, the Graham Center became the first to develop a survivorship program. It has reached out to 1,000 patients over the past five years. Add to the center’s accomplishments strong community outreach and minority screening programs, its involvement with Early Lung Cancer Action Project and other efforts. It’s easy to see why the National Cancer Institute has made the Graham Center a model for cancer research, detection, treatment and care. It is considered one of the five best of 220 cancer centers in the country.
Through the Delaware Cancer Prevention and Control Program, the Graham Center and Center for Translational Research are aligned with the Kimmel Cancer Center and Thomas Jefferson University in Philadelphia, the University of Delaware and Delaware State University, The Wistar Institute and the Nemours Research Institute. The people at the center, Petrelli says, are the reason for its success. “The people who care about cancer care really care about it,” he says. “This isn’t just a job to them.”
As the number of patient visits has grown over the years, so have the center’s successes. Delaware is on track to drop to No. 14 in the country for cancer mortality this year, down from No. 11 in 2012. And the rate of mortality is dropping at twice the national rate.
That’s not to mention other efforts to help patients, who are often impaired in other ways by their treatment, such as those who lose the ability to salivate.
“We have 70 percent, 80 percent survival rates today, but quality of life is diminished,” Witt says. “When a patient asks the doctor what we can do, the answer is usually nothing. Now with the Center for Translational Research, I can learn from and work with the scientists. I’m learning their language, and that allows me to make a more positive contribution.”
“Knowing the science,” Petrelli says, “makes them better doctors.”
And vice versa. “Scientists get the real deal of what’s happening in the clinical,” Sims-Mourtada says. “I can see the reality of what’s going on.”
Petrelli now looks forward to establishment of the Delaware Center for Cancer Biology, a “medical school without walls” where physicians, geneticists, biologists, immunologists, pharmacologists and others can work together closely in the same facility. That’s the future, a dream, but as the Graham Center and the Center for Translation Research clearly demonstrate, “The days of the scientist sitting in the lab are over,” says Sims-Mourtada.