“The thing that is most indicative of advances in cancer care is the FDA’s approval of more drugs for cancer than any other area in medicine,” says Dr. Thomas Froehlich, oncologist and professor of internal medicine at UT Southwestern Medical Center’s Harold C. Simmons Comprehensive Cancer Center. “We have treatments curing some cancers for people who, just a few years ago, were destined to die from it. Some medicines are putting people in long-term remission when previously, they would have only survived one to three years. People with early-stage cancer have a much higher chance of being cured of the disease and going on to live normal lives.”
The well-known fact that the single best way to survive cancer is to catch in its earliest stages is finally catching on. More people are talking to their doctors about getting life-saving tests and genetic screenings and are making healthy lifestyle changes that can reduce their risk of cancer. If you hear the word ‘cancer’ in a diagnosis from your doctor, Dallas is a good place to be. “We understand cancer is a scary term, but if we intercept it in its earliest stages through improved screening programs, and if more people aren’t afraid to go to the doctor with concerning symptoms, there’s a greater chance of surviving it,” says Dr. Ronan J. Kelly, chief of oncology at Baylor Scott & White Health – North Texas and director of Baylor Charles A. Sammons Cancer Center at Baylor University Medical Center. “If you do get cancer, there are world-class treatments available.”
Researchers are constantly working to find new or improved cancer treatments that are not only prolonging, but saving, the lives of people with cancer. Targeted therapies, advanced robotic surgery, genetic testing, clinical trials, and groundbreaking research are well within reach for cancer patients in Dallas and beyond. Fighting cancer can seem like an impenetrable maze without guidance. Therefore, more hospitals are incorporating comprehensive cancer treatment programs that address a patient’s needs both clinically and holistically. In a single day, a patient could receive the latest medication from a clinical trial, followed by music or art therapy and a lesson from a chef on how to prepare nourishing meals at home during recovery.
“Being told the words ‘you have cancer’ is a life-changing event for every patient,” Dr. Kelly says. “You inevitably start questioning your own mortality, and everything else is placed on hold. Patients who develop cancer today should have hope. There is a much greater understanding about how to fight cancer at the molecular level, and immunotherapy now allows us to turn on a patient’s own immune system to wage a war between a patient’s new immune cells and their tumor cells. For example, utilizing our GMP facility, we are creating next-generation personalized immunotherapies in an attempt to overwhelm a patient’s tumor. We try to focus on improving the emotional, psychological, and spiritual well-being of the patient and try to take away the fear as much as we can.”
Baylor Scott & White Health
Baylor University Medical Center’s Baylor Charles A. Sammons Cancer Center-Dallas and Baylor T. Boone Pickens Cancer Hospital represent one of the largest cancer treatment centers in Texas. Baylor University Medical Center, a leading infrastructure for cancer care in North Texas, has long been a source of hope to many cancer patients through the years, and the reasons for this continue to climb in number. Many patients with cancer throughout the region and the country choose Baylor Scott & White as their destination for cancer care because of its innovative blend of the latest in research, treatment, and holistic care.
Always on the forefront of research, Baylor University Medical Center has become a sought-after resource for one of the newest, most effective treatments for many types of cancer—immunotherapy. Researchers have learned that patients, with the right treatment, can inherently fight cancer through their own genetic makeup. Immunotherapy is a type of cancer treatment that harbors your own unique immune system to fight the cancer within your body. Baylor University Medical Center is a destination center for immune therapy in cancer care, offering patients clinical trials and advanced treatment options that utilize these living drugs to treat the most complex forms of cancer. The goal of these drugs is to take away the ability of a tumor to defend itself by targeting what is called the PD-(L)1 pathway.
“We now have the ability to create living drugs, where we take a patient’s strongest immune fighting cells, genetically alter them, grow them outside a patient’s body by billions, and give them back to the patient as an infusion of genetically altered tumor fighting cells,” Dr. Kelly says. “Cellular therapy is unmatched—no one can create something as amazing as our immune cells. They were given to us by our moms when we were born. We have known for decades that if we can just turn on immune cells, we can wage war against cancer.”
Baylor University Medical Center is the first approved site in North Texas for adult commercial use of CAR-T treatment to treat large B-cell lymphoma, a genetically personalized therapy. In addition, Baylor Scott & White Research Institute focuses on innovative clinical trials, including novel cellular therapies and evaluates promising treatment options in many first in-human studies that span across varying tumor-types. “The immunotherapy work we do at Baylor Scott & White can teach us a lot about how to combat complex and advanced stages of cancer,” Dr. Kelly says. “Through our research, we hope to understand how to personalize immunotherapy treatment so every patient can benefit—despite the diagnosis they receive.”
“With immunotherapy, we are doing everything possible to turn on a patient’s inherent cancer fighting ability and engage immune cells to wage a microscopic war–good cells against bad cancer cells.”Ronan Kelly, M.D., Baylor Scott & White Health
Dr. Kelly says one patient-centered advancement that Baylor University Medical Center is looking forward to is the creation of databases that store each cancer patient’s biological samples as a resource library for years to come. A primary goal in Baylor Scott & White Research Institute’s cancer research efforts is to learn from every patient, Dr. Kelly says. Because Baylor University Medical Center is a major academic hospital, it has the capabilities of not only treating patients but taking what is discovered throughout treatment and putting it to work in the lab. “The better we understand personalized medicine and each patient’s make-up, the more efficiently we can turn on the patient’s immune system,” Dr. Kelly says.
Cancer doesn’t stay dormant, Dr. Kelly says. It changes and mutates over the years and can be different if it comes back. “That’s why it is critical to keep up in real time what is happening with the immune system,” he says. “Chemotherapy is not going to result in long-term control of cancer. For some cancers it is effective, but for a majority—even with radiation and surgery—the cancer comes back. The real ability for us to control cancer is to engage our immune cells to wage a microscopic war between good and bad cells, and the good immune cells will continue to fight the cancer when going about our lives—sleeping, driving, and watching TV. The hope is that immunotherapy treatment turns cancer into a chronic disease.”
According to Dr. Kelly, immunotherapy is now the fourth pillar of therapy, along with chemotherapy, radiation, and surgery. For example, in patients with melanoma who received immunotherapy, 50 percent of these patients are alive five years after treatment with no signs of cancer. “This shows us how far we have come in a small time period,” he says.
In addition to the latest therapies to treat cancer, one of the primary draws of Baylor University Medical Center’s cancer care programs is its collaborative, multidisciplinary team approach to treating the whole patient—mind, body, and spirit. As a major academic medical center, the medical staff at Baylor University Medical Center offers patients personalized cancer care through multidisciplinary teams of researchers and specialists in cancer care. In addition to its cutting-edge cancer treatments, Baylor Sammons Cancer Center – Dallas takes care a step further by providing psychological support, dedicated patient navigators, personalized rehabilitation programs to recover from cancer treatments, dietary counseling and healthy eating/food preparation classes, caregiver consultations, and arts and music therapy.”
Baylor University Medical Center’s physicians have seen how their patients’ mental health and outlook can make an impact on the progress of their treatment. Peace of mind, access to information, and convenience all play a role in this. “We are proud to also offer a softer side of medicine with a variety of programs and services designed to support patients and their families both during and after cancer treatment,” Dr. Kelly says. “Everything is designed to ease their anxiety and worry and help them get stronger as they heal. We never forget there’s a patient behind the medical record number and place a focus on our patients’ emotional health as well.”
Some of Baylor University Medical Center’s comprehensive holistic offerings to address these needs include:
The American Cancer Society’s Hope Lodge, a free, short-term housing option opening in 2021 on the Baylor University Medical Center campus that is designed for cancer patients and their families to utilize during cancer treatment.
North Texas’ only urgent care facility offering after-hours emergency care for cancer patients.
Nutrition counseling, wellness classes, art and music therapy, cooking classes, behavioral health, support groups, and fitness classes and education through the Baylor Charles A. Sammons Cancer Center – Dallas’ Patient Resource Center.
A comprehensive revitalization program for patients to receive speech therapy, occupational therapy, and physical therapy in a single location during recovery.
The ability to provide patients with access to a broad portfolio of cancer research studies through Baylor Scott & White Research Institute.
UT Southwestern Medical Center
In the Dallas area and beyond, when the diagnosis is cancer, treatment at UT Southwestern Medical Center is often the next step. UT Southwestern’s cancer care earned High Performing recognition from U.S. News & World Report this year, placing it among the country’s leading cancer treatment facilities. A team of hundreds of leading cancer physicians and oncology-trained support staff are trusted partners in returning patients with cancer to good health. UT Southwestern’s Harold C. Simmons Comprehensive Cancer Center is known for its innovative therapies, broad array of treatment options, leading-edge clinical trials, advanced technology, modern hospital and clinics, and innovative, caring support services for patients and their loved ones.
Simmons Cancer Center is the only National Cancer Institute-designated comprehensive cancer center in North Texas and one of just 51 so designated in the nation. In addition, it is among only 32 U.S. cancer research centers to be designated by the NCI as a National Clinical Trials Network Lead Academic Participating Site, an honor signifying scientific leadership in the design and conduct of clinical trials.
At UT Southwestern, more than 200 dedicated professionals, from more than 20 different departments, participate in over a dozen cancer research and clinical care programs that advance the treatment and prevention of cancer through basic discovery, translational research, innovative clinical trials, exceptional cancer care, community education, and the latest technologies.
One of the latest discoveries at UT Southwestern is giving justifiable hope to cancer patients. A drug used to treat breast cancer patients is showing promise in the treatment of other cancers, and the study continues to expand, potentially reaching and helping even more patients who are looking for another line of defense. A new molecular mechanism discovered by UT Southwestern researchers indicates that drugs currently used to treat less than 10% of breast cancer patients could have broader effectiveness in treating all cancers where the drugs are used, including often difficult-to-treat ovarian and prostate cancers. The new study also revealed a potential biomarker indicating when these drugs, called PARP inhibitors, can be unleashed in the fight against cancer.
“These findings could increase the patient population benefiting from these drugs by two-, three-, or four-fold. Up to 70% of breast cancer patients could now be good candidates,” says W. Lee Kraus, Ph.D., director of the Green Center for Reproductive Biology Sciences at UT Southwestern and a member of the Simmons Cancer Center. “We have found that PARP inhibitors can act by a mechanism that is different from those previously identified, which rely on BRCA-dependent DNA repair pathways.”
“Our capacity to diagnose and treat cancer has increased dramatically.”Thomas Froehlich, M.D., UT Southwestern Harold C. Simmons Comprehensive Cancer Center
The way this molecular mechanism was discovered starts with the innovative and collaborative research environment for which UT Southwestern is known, Dr. Kraus says. It was a situation where research on one project naturally led to an unexpected discovery that prompted another research project. Dr. Kraus and his team began their research by trying to identify new molecular mechanisms, but they didn’t know where the study would lead.
“We started as pure basic scientists, but as the study progressed the clinical relevance became more evident,” Dr. Kraus says. “In a sense, the floodgates have opened. There is a chance for efficacy in other types of cancer.”
This research helps explain why breast cancer patients can be responsive to PARP inhibitors even if they don’t have BRCA gene mutations, which are rare anomalies that disable a DNA repair pathway in cancer cells. The Kraus team’s findings were recently published in the journal Molecular Cell.
PARP inhibitors were approved by the FDA in 2014 for the treatment of ovarian cancers containing BRCA mutations and in 2018 for breast cancer treatment. In their current use, doctors prescribe PARP inhibitors to disable a second DNA repair pathway, making it difficult for cancer cells to survive.
Dr. Kraus’ lab discovered that while this war on DNA repair is being waged, PARP inhibitors are also battling for dominance elsewhere in the cancer cell, attacking the machinery that makes proteins, called ribosomes. It is an important, effective fight previously unknown to science.
“Cancer cells are addicted to ribosomes,” Dr. Kraus says. “Cancer cells grow fast and must make proteins to support cell division and other essential processes going on in the cell. If you can slow down or inhibit the production of ribosomes, then you can slow down the growth of the cancer cell.”
The historical view is that cancers need the mutated BRCA gene to be sensitive to PARP inhibitors. “That’s what most scientists and clinicians thought,” Dr. Kraus says. “But what the field is now coming to realize is that’s just not true.”
This new understanding changes the way scientists and oncologists think about PARP inhibitors and their clinical applications. New treatments with PARP inhibitors based on Dr. Kraus’ discovery could help a much wider group of patients. Dr. Kraus has already started clinical trials with UT Southwestern oncologists, including Barbara Haley, M.D., a breast cancer specialist.
“Cancer care is advancing in the clinic because of advances in the lab. New findings in basic science drive new treatments,” says Dr. Haley, a professor of internal medicine who holds the Charles Cameron Sprague, M.D. chair in clinical oncology. “Dr. Kraus’ discovery is the latest example of fighting cancer at the molecular level. Turning the latest scientific discoveries into new treatments can only happen at places like Simmons Cancer Center with advanced lab research and extensive patient care.”
Visit Baylor University Medical Center to learn more about the cancer programs. Visit UT Southwestern Harold C. Simmons Comprehensive Cancer Center to learn more about the cancer programs.