Case Comprehensive Cancer Center

Cleveland, OH, United States

Case Comprehensive Cancer Center

Cleveland, OH, United States

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"NCCN Foundation is proud to support this important resource which indeed will empower patients with thyroid cancer and their caregivers to make informed choices about their care," said Marcie R. Reeder, MPH, Executive Director, NCCN Foundation. "We are incredibly grateful for the generous support from our sponsors, ThyCa and Rockin' for the Cure, as their sponsorship for these resources gives patients access to the same treatment information that their doctors use." "Thyroid Cancer is challenging because it affects people of all ages from young children through seniors, is especially life-disrupting and stressful when diagnosed in younger patients, and needs lifelong monitoring and management even in low-risk patients," said Gary Bloom, ThyCa Executive Director, and Thyroid Cancer survivor of 21 years. "ThyCa is very pleased to support these important guidelines, which will be helpful resources for both patients and their caregivers." NCCN Guidelines for Patients are easy-to-understand adaptations based on the same clinical practice guidelines used by health care professionals around the world to determine the best way to treat a person with cancer. Each resource features unbiased expert guidance from the nation's leading cancer centers designed to help people living with cancer understand and discuss their treatment options with their providers. NCCN Guidelines for Patients and NCCN Quick Guide™ sheets—one-page summaries of key points in the patient guidelines—are written in plain language and include patient-friendly tools, such as questions to ask your doctor, a glossary of terms, and medical illustrations of anatomy, tests, and treatment.  NCCN Guidelines for Patients and NCCN Quick Guide™ sheets DO NOT replace the expertise and clinical judgment of the clinician. NCCN currently offers NCCN Guidelines for Patients for the following: Brain, Breast, Colon Distress, Esophageal, Kidney, Non-Small Cell Lung, Ovarian, Pancreatic, Prostate, Stomach, and Thyroid Cancers; Acute Lymphoblastic Leukemia; Adolescents and Young Adults with Cancer; Chronic Lymphocytic Leukemia; Chronic Myelogenous Leukemia; Hodgkin Lymphoma; Lung Cancer Screening; Malignant Pleural Mesothelioma; Melanoma; Multiple Myeloma; Myelodysplastic Syndromes; Nausea and Vomiting; Non-Hodgkin's Lymphomas; Soft Tissue Sarcoma; and Waldenström's Macroglobulinemia. The NCCN Guidelines for Patients and NCCN Quick Guide™ sheet for Thyroid Cancer are available to download for free at NCCN.org/patients and on the NCCN Patient Guides for Cancer mobile app. NCCN Foundation® was founded by the National Comprehensive Cancer Network® (NCCN®) to empower people with cancer and advance oncology innovation. NCCN Foundation supports people with cancer and their caregivers at every step of their treatment journey by delivering unbiased expert guidance from the world's leading cancer experts through the library of NCCN Guidelines for Patients® and other patient education resources. NCCN Foundation is also committed to advancing cancer treatment by funding the nation's promising young investigators at the forefront of cancer research, initiating momentum in their careers and furthering the betterment of patients through their groundbreaking innovations. For more information about NCCN Foundation, visit NCCNFoundation.org. ThyCa: Thyroid Cancer Survivors' Association, Inc., an international nonprofit organization founded in 1995 and advised by thyroid cancer specialists, educates and supports patients and families through its website, online and face-to-face support groups, one-to-one support, over 50 videos with experts on its YouTube Channel, handbooks on all thyroid cancer types, downloadable low-iodine cookbook, online newsletter, and materials in 10 languages. ThyCa sponsors seminars, workshops, and the annual International Thyroid Cancer Survivors' Conference, as well as Thyroid Cancer Awareness Month, year-round awareness programs for early detection, and thyroid cancer research funds and research grants. For more information visit http://www.thyca.org. About the National Comprehensive Cancer Network The National Comprehensive Cancer Network® (NCCN®), a not-for-profit alliance of 27 leading cancer centers devoted to patient care, research, and education, is dedicated to improving the quality, effectiveness, and efficiency of cancer care so that patients can live better lives. Through the leadership and expertise of clinical professionals at NCCN Member Institutions, NCCN develops resources that present valuable information to the numerous stakeholders in the health care delivery system. As the arbiter of high-quality cancer care, NCCN promotes the importance of continuous quality improvement and recognizes the significance of creating clinical practice guidelines appropriate for use by patients, clinicians, and other health care decision-makers. The NCCN Member Institutions are: Fred & Pamela Buffett Cancer Center, Omaha, NE; Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; City of Hope Comprehensive Cancer Center, Los Angeles, CA; Dana-Farber/Brigham and Women's Cancer Center | Massachusetts General Hospital Cancer Center, Boston, MA; Duke Cancer Institute, Durham, NC; Fox Chase Cancer Center, Philadelphia, PA; Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT; Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, WA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL; Mayo Clinic Cancer Center, Phoenix/Scottsdale, AZ, Jacksonville, FL, and Rochester, MN; Memorial Sloan Kettering Cancer Center, New York, NY; Moffitt Cancer Center, Tampa, FL; The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute, Columbus, OH; Roswell Park Cancer Institute, Buffalo, NY; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center, Memphis, TN; Stanford Cancer Institute, Stanford, CA; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL; UC San Diego Moores Cancer Center, La Jolla, CA; UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; University of Colorado Cancer Center, Aurora, CO; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; The University of Texas MD Anderson Cancer Center, Houston, TX; University of Wisconsin Carbone Cancer Center, Madison, WI; Vanderbilt-Ingram Cancer Center, Nashville, TN; and Yale Cancer Center/Smilow Cancer Hospital, New Haven, CT. [1] Robert I. Haddad, MD, et. al., NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Thyroid Carcinoma, Version 1.2017. © 2017 National Comprehensive Cancer Network, Inc.  Available at NCCN.org. Accessed: May 8, 2017 [2] "Cancer Stat Facts: Thyroid Cancer." Surveillance, Epidemiology, and End Results Program. National Cancer Institute, n.d. Web. 08 May 2017. To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/nccn-publishes-new-patient-education-resources-for-thyroid-cancer----one-of-the-most-commonly-diagnosed-cancers-in-women-in-the-united-states-300456776.html


The study, "Are We on the Same Page? Patient and Provider Perceptions about Exercise in Cancer Care: A Focus Group Study," published in the May 2017 issue of JNCCN – Journal of the National Comprehensive Cancer Network is available free of charge on JNCCN.org until July 30, 2017. "Our results indicate that exercise is perceived as important to patients with cancer, both from a patient and physician perspective; however, physicians are reluctant to consistently include PA recommendations in their patient discussions. Our findings highlight the value of examining both patient and provider attitudes and behavioral intentions," said Dr. Smaradottir. "While we uncovered barriers to exercise recommendations, questions remain on how to bridge the gap between patient and provider preferences." Where they exercise is important to patients. More than 80% of those surveyed noted that they would prefer a home-based exercise regimen that could be performed in alignment with their personal schedules and symptoms. Patients also noted a preference that exercise recommendations come from their oncologists, as they have an established relationship and feel that their oncologists best understand the complexities of their personalized treatment plans. Although patients prefer PA at home, Dr. Smaradottir found that practitioners wish to refer patients to specialist care for exercise recommendations. The practitioners surveyed noted not only mounting clinic schedules, but also a lack of education about appropriate PA recommendations for patients. Furthermore, they expressed concern about asking patients to be more physically active during chemotherapy and radiation, and also expressed trepidation about prescribing PA to frail patients with limited mobility. "We were surprised by the gap in expectations regarding exercise recommendation between patients and providers. Many providers, ourselves included, thought patients would prefer to be referred to an exercise center, but they clearly preferred to have a home based program recommended by their oncologist," Dr. Smaradottir said. Exercise was felt to be an equally important part of treatment and well-being for patients with early stage cancer treated with curative intent as well as patients receiving palliative therapy. For the focus groups, the investigators interviewed 20 patients aged 45 and older – 10 with stage I-III non-metastatic cancer after adjuvant therapy and 10 with stage IV metastatic disease undergoing palliative treatment, both across multiple tumor types. Additionally, the researchers interviewed nine practitioners.  The authors note that while the sample size is limited, because the subjects of the study all hailed from the same institution, the study provides an understanding of how the group as a whole has the potential to influence the practice of PA recommendations. Smaradottir et al note that physician education is paramount and suggest that successful implementation of an education protocol should begin with a multidisciplinary collaboration between treating providers and physical therapy specialists, exercise physiologists, and other sub specialties. They add that the emphasis of such a program should be on a patient-centered approach, making the recommendations specific for each patient. "Indeed, physicians, fellows, and residents who collaborate with a PA specialist through a shared-care clinic visit will gain valuable education about how to discuss exercise recommendations with their patients," said Dr. Smaradottir. Currently, the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Survivorship recommend exercise for cancer survivors. "Physical activity is emerging as an important adjunct therapy in the treatment of multiple cancers, and there is consensus that physical activity is helpful to patients with cancer and survivors in terms of augmenting symptom burden and maintaining overall health. This study highlights the discord between what we think is important and what we do in actual practice as providers. It also highlights patients' desire to remain physically active and to receive guidance from their oncologists regarding what they can and should be doing. Based on the results of this and other studies, further work on both defining what the optimal physical activity recommendation for patients should be and determining how best to train our oncologic workforce to implement recommendations is needed," said Crystal Denlinger, MD, Chief of Gastrointestinal Medical Oncology and Associate Professor, Department of Hematology/Oncology at Fox Chase Cancer Center, and Chair of the NCCN Guidelines® Panel for Survivorship. Free access to this article is available until July 30, 2017, on JNCCN.org. About JNCCN – Journal of the National Comprehensive Cancer Network More than 24,000 oncologists and other cancer care professionals across the United States read JNCCN–Journal of the National Comprehensive Cancer Network. This peer-reviewed, indexed medical journal provides the latest information about best clinical practices, health services research, and translational medicine. JNCCN features updates on the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), review articles elaborating on guidelines recommendations, health services research, and case reports highlighting molecular insights in patient care. JNCCN is published by Harborside Press. Visit JNCCN.org. To inquire if you are eligible for a FREE subscription to JNCCN, visit http://www.nccn.org/jnccn/subscribe.asp JNCCN 360 is a new online resource for oncology professionals featuring up-to-date news, literature, trials, clinical perspectives on current therapies, and much more. Visit JNCCN360.org About the National Comprehensive Cancer Network The National Comprehensive Cancer Network® (NCCN®), a not-for-profit alliance of 27 leading cancer centers devoted to patient care, research, and education, is dedicated to improving the quality, effectiveness, and efficiency of cancer care so that patients can live better lives. Through the leadership and expertise of clinical professionals at NCCN Member Institutions, NCCN develops resources that present valuable information to the numerous stakeholders in the health care delivery system. As the arbiter of high-quality cancer care, NCCN promotes the importance of continuous quality improvement and recognizes the significance of creating clinical practice guidelines appropriate for use by patients, clinicians, and other health care decision-makers. The NCCN Member Institutions are: Fred & Pamela Buffett Cancer Center, Omaha, NE; Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; City of Hope Comprehensive Cancer Center, Los Angeles, CA; Dana-Farber/Brigham and Women's Cancer Center | Massachusetts General Hospital Cancer Center, Boston, MA; Duke Cancer Institute, Durham, NC; Fox Chase Cancer Center, Philadelphia, PA; Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT; Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, WA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL; Mayo Clinic Cancer Center, Phoenix/Scottsdale, AZ, Jacksonville, FL, and Rochester, MN; Memorial Sloan Kettering Cancer Center, New York, NY; Moffitt Cancer Center, Tampa, FL; The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute, Columbus, OH; Roswell Park Cancer Institute, Buffalo, NY; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center, Memphis, TN; Stanford Cancer Institute, Stanford, CA; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL; UC San Diego Moores Cancer Center, La Jolla, CA; UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; University of Colorado Cancer Center, Aurora, CO; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; The University of Texas MD Anderson Cancer Center, Houston, TX; University of Wisconsin Carbone Cancer Center, Madison, WI; Vanderbilt-Ingram Cancer Center, Nashville, TN; and Yale Cancer Center/Smilow Cancer Hospital, New Haven, CT. To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/despite-evidence-that-it-benefits-patients-with-cancer-study-finds-most-oncologists-dont-discuss-exercise-with-patients-300456186.html


News Article | May 17, 2017
Site: www.eurekalert.org

CLEVELAND - Results from the DAWN stroke trial presented at the European Stroke Organization Conference (ESOC) provide compelling evidence that selected patients suffering a major ischemic stroke recovered significantly better with mechanical retrieval of the blood clot with medical therapy compared with medical therapy alone when initiated past the current guidelines of within 6 hours and up to 24 hours of the stroke. University Hospitals Cleveland Medical Center was one of the top seven recruiting sites in the multi-site study that enrolled a total of 206 patients in the nation. The results showed that patients treated with the retrieval system, known as mechanical thrombectomy, had significantly decreased post-stroke disability and improved functional independence at 90 days compared to medical management alone. "This is incredible," said Cathy Sila, MD, Director of UH's Comprehensive Stroke Center, and principal investigator of the study at the UH site. "Almost half of the patients (48.6 percent) receiving the thrombectomy therapy had a good outcome at 90 days after treatment--defined as the patients being independent in activities of daily living--as opposed to only 13.1 percent of the patients treated medically or with clot-busting drugs alone. This 35 percent difference may be higher than any level of benefit from any stroke trial." "Not only did the patients treated with mechanical thrombectomy dramatically improve during hospitalization, sometimes being able to walk and be discharged to home, but there was also a much lower risk of subsequent neurological worsening because of the poor blood flow to the brain," said Dr. Sila. "The number of patients needed to treat to achieve a good outcome was 2.8. This is a much greater chance of response than what was seen in trials that did not routinely use advanced brain imaging to guide treatment," she said. "We have long believed in the usefulness of MRI scans to define appropriateness of treatment. UH had been using a similar MRI protocol since 2010, five years before the DAWN trial began in 2015." Anthony Furlan, MD, Chairman of the Department of Neurology at UH and Case Western Reserve University School of Medicine, was on the DAWN study's steering committee and helped write the study protocol. "These results provide physicians who treat stroke with evidence of the benefits of thrombectomy even when administered out as far as 24 hours, and should help to make decisions clearer as to which patients to treat," said Dr. Furlan. "These positive outcomes of the DAWN trial represent a major change in patient selection for endovascular therapy for stroke," he said. In the study, researchers used neuroimaging to determine which patients would likely benefit from the procedure. According to Dr. Sila, they would examine how much brain tissue had suffered irreversible damage and how much might be able to be saved. If the amount of damaged tissue were no bigger than the size of a small apricot, researchers believed the patient could benefit from the therapy. Neuro-interventionists would then use a mechanical stent retriever called the Trevo Retriever to remove the blood clot, followed by treatment with the clot-busting medication. The study had been stopped earlier this year after an FDA-approved planned interim review by the independent Data Safety Monitoring Board (DSMB) of data from the first 200 patients enrolled nationally because there was such a dramatic difference between the two arms of the study. The study had been designed to enroll up to a maximum of 500 patients. Dr. Sila said that in Northeast Ohio, we have about 18,000 strokes per year. Stroke survivors commonly experience devastating disabilities and loss of independence due to impaired movement, paralysis, loss of speech and memory. Randomized clinical data has proven the benefit of mechanical thrombectomy with stent retrievers in helping patients with large vessel occlusion strokes, but these devices have only been indicated to reduce disability if used within six hours of stroke onset. "For patients presenting with stroke symptoms beyond six hours, the benefit of clot retrieval using a stent retriever was unknown," said Dr. Furlan. "Now we have evidence that for patients who present to the hospital outside of the six hour time window could have a better chance for an independent life with improved clinical outcomes. Although this is great news, earlier treatment is always better because with stroke 'time is brain.'" The study was supported by Stryker, which produces the Trevo Retriever, a tiny stent-shaped medical device that is attached to a thin wire. The retriever is designed to ensnare the blood clot to remove it from a blood vessel. UH is working with Case Western Reserve University to develop the Cleveland Brain Health Initiative, linking this kind of leading edge neuroscience work from CWRU, UH, Cleveland Clinic, MetroHealth Medical Center and the Louis Stokes Cleveland VA Medical Center to advance progress therapy and treatment of devastating neurological diseases. A video of a UH patient who was in the DAWN trial at: http://www. The DAWN trial is an international, multi-center, blinded endpoint assessment, randomized study. The purpose of the study is to demonstrate superior clinical outcomes at 90 days with Stryker's Trevo Retriever plus medical management compared to medical management alone in appropriately selected patients treated six to 24 hours after last seen well. The Trevo Retriever indication within the DAWN Trial is currently approved for investigational use only by the U.S. Food and Drug Administration in the United States under an Investigational Device Exemption (IDE) study approval. Founded in 1866, University Hospitals serves the needs of patients through an integrated network of 18 hospitals, more than 40 outpatient health centers and 200 physician offices in 15 counties throughout northern Ohio. The system's flagship academic medical center, University Hospitals Cleveland Medical Center, located on a 35-acre campus in Cleveland's University Circle, is affiliated with Case Western Reserve University School of Medicine. The main campus also includes University Hospitals Rainbow Babies & Children's Hospital, ranked among the top children's hospitals in the nation; University Hospitals MacDonald Women's Hospital, Ohio's only hospital for women; and University Hospitals Seidman Cancer Center, part of the NCI-designated Case Comprehensive Cancer Center. UH is home to some of the most prestigious clinical and research programs in the nation, including cancer, pediatrics, women's health, orthopedics, radiology, neuroscience, cardiology and cardiovascular surgery, digestive health, transplantation and urology. UH Cleveland Medical Center is perennially among the highest performers in national ranking surveys, including "America's Best Hospitals" from U.S. News & World Report. UH is also home to Harrington Discovery Institute at University Hospitals - part of The Harrington Project for Discovery & Development. UH is the second largest employer in northern Ohio with 26,000 employees. For more information, go to UHhospitals.org. The Trevo Retriever is a tiny stent-shaped medical device that is attached to a thin wire. In a minimally invasive procedure that utilizes X-ray, the physician navigates the retriever from the femoral artery (located in the upper leg) to the blocked blood artery in the brain. The retriever is designed to ensnare the blood clot and remove it from the body. Originally cleared by the FDA in 2012 for the revascularization of patients experiencing ischemic stroke, the Trevo Retriever has been used in thousands of patients worldwide. Stryker's Trevo Retriever was the only mechanical thrombectomy device used in this trial. An animation of Stryker's Trevo Retriever is available here: https:/ An ischemic stroke occurs when an artery in the brain becomes blocked by a blood clot or other substance such as plaque, a fatty material. Blood vessels carry blood, oxygen and nutrients throughout the body and to the brain. When the brain is deprived of blood and oxygen, it fails to work properly. Depending on the severity of the stroke and the area of the brain affected, loss of brain function or death may occur. According to the World Heart Federation, ischemic stroke contributes to nearly six million deaths around the globe. Stryker is one of the world's leading medical technology companies and, together with our customers, we are driven to make healthcare better. The Company offers a diverse array of innovative products and services in Orthopedics, Medical and Surgical, and Neurotechnology and Spine that help improve patient and hospital outcomes. Stryker is active in over 100 countries around the world. Please contact us for more information at http://www.

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