cancer cancer guidelines clinical trials cancer patients oncology cancer physicians cancer hospitals oncology
NCCN - National Comprehensive Cancer Network National Comprehensive Cancer Network Homepage Patients with Cancer Cancer Clinicians Cancer Industry About National Comprehensive Cancer Network

 

Contact Us / Privacy Policy

Find an NCCN Member Institution


Arthur G. James Cancer Hospital Home Page

Profile


Find a Clinical Trial

Adult Oncology Services

Introduction

General Information

Treatment

Cancer Prevention and Screening

Support Services

Supportive Care

Clinical and Research Efforts


Pediatric Oncology Services

Introduction

General Information

Clinical and Research Information

Special Expertise

Statistics


Genetic Counseling and Testing Services

Introduction

Intake Process

Testing

Post-Test Counseling and Follow-Up

Research


Go back to previous page

 

 

     
  Arthur G. James Cancer Hospital and Richard J. Solove Research Institute

For information on clinical trials at this NCCN Member Institution click here.

Arthur G. James Cancer Hospital  BuildingThe Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (The James) is the patient-care component of the Ohio State University Comprehensive Cancer Center. A national and international leader in cancer research, The James provides high-quality patient care and educational programs for the citizens of Ohio and beyond. The James is a leader in breast cancer detection, treatment and research, and is known for its innovative programs in leukemia and lymphoma, bone marrow transplant, head and neck cancer, and AIDS-related malignancies, among others.

  • U.S. News & World Report, in addition to ranking The James as the best hospital in Ohio and 15th best in the nation for cancer care in 2007, specifically identified The James’ gynecologic and head and neck cancer programs as among the best in the country.
  • The James Cancer Hospital and Solove Research Institute was one of only 41 Hospitals in the country to be named a 2007 Top Hospital by The Leapfrog Group in their national survey on hospital quality and safety. 
  • The James community of researchers has earned an international reputation for cutting-edge discoveries in bone marrow transplantation, hairy cell leukemia, acute myeloid leukemia, chronic lymphocytic leukemia, post-transplant lymphoproliferative disorder, boron neutron capture therapy, chemopreventive agents, and radioimmunoguided surgical techniques.
  • In the areas of cancer prevention and detection, The James has conducted high-profile programs aimed at reducing the incidence of cancer. Its efforts to reach healthcare consumers range from cancer screenings and a toll-free telephone information service to seminars, lectures and nationally distributed video news programs.
  • Radiation oncologists at The James use the latest radiation oncology technology to provide disease-specific care for patients.  In addition to standard conformal imaging-based radiation therapy, The James also provides intensity-modulated radiation therapy (IMRT), image-guided radiation therapy (IGRT), stereotactic body radiation (SBRT), intracranial and extracranial stereotactic radiosurgery (SRS), fractionated stereotactic radiation therapy (FSRT), and intraoperative radiation therapy (IORT).  The brachytherapy program at The James also provides novel, imaging-based brachytherapy dose planning and delivery for HDR and LDR procedures.

Other special features found at The James include:

  • Private outpatient chemotherapy suites and cutaneous oncology and dermatology suites
  • A world renowned Human Cancer Genetics Program headed by geneticist Carlo Croce, MD, a member of the National Academy of Sciences.

The Ohio State University Comprehensive Cancer Center (OSUCCC) and The James have more than 265 researchers working in nearly 240 clinical trials in cancer prevention and treatment. Since 1990, total funding for cancer research at the OSUCCC-James has grown from $19 million to more than $100 million. The James has 160 licensed patient beds. In fiscal year 2005-06, the hospital had nearly 8,000 inpatient admissions and more than 173,000 to all outpatient sites combined. 


Arthur G. James Cancer Hospital & Richard J. Solove Research Institute at The Ohio State University
Adult Oncology Services

Introduction

The James opened in July 1990 as the adult patient-care component of The Ohio State University Comprehensive Cancer Center (OSUCCC), which was initially designated by the National Cancer Institute in 1976. Drawing upon the expertise of more than 265 scientists representing 14 colleges at Ohio State, the OSUCCC-James is devoted to translating cancer research into innovative patient care for people of central Ohio and beyond.

Through its highly qualified faculty and staff and their interdisciplinary activities, the OSUCCC-James is positioned to reduce cancer morbidity and mortality by:

  • Conducting basic, clinical and prevention research
  • Translating results from scientific investigation into quality patient care
  • Providing cancer detection, treatment, and rehabilitation services
  • Contributing to the educational advancement of healthcare professionals
  • Increasing public awareness regarding cancer
  • Promoting public policy changes to improve cancer prevention, detection and treatment

Multidisciplinary Teams

The James has multidisciplinary teams that meet regularly:

  • Breast
  • Bone Marrow Transplant
  • Cancer Prevention and Wellness
  • Central Nervous System
  • Colorectal
  • Genitourinary
  • Gynecologic
  • Head and Neck
  • Hematology
  • Leukemia
  • Lower Gastrointestinal
  • Lymphoma
  • Melanoma
  • Pain
  • Primary Bone
  • Thoracic
  • Upper Gastrointestinal


General Information

General Information

800.293.5066

Referring Physician Line

800.293.5066

Location

Columbus, Ohio

Facility

The James’ main hospital building on The Ohio State University campus consists of 13 floors comprising 268,000 square feet. The hospital is licensed for 160 beds, including a 24-bed blood and marrow transplantation unit. The building also contains:

  • Outpatient examination/consultation rooms
  • Private chemotherapy suites
  • Specialized surgical suites
  • A large radiation oncology area
  • Basic research laboratories and support facilities

The James also has an Immediate Care Center for cancer outpatients on the 9th floor of adjoining Ohio State University Hospital, and a specialized outpatient clinical treatment unit on 2 James for patients participating in phase I clinical trials. In addition, The James offers quality cancer care at University Hospital East, an OSU facility serving the east side of Columbus. It also provides comprehensive outpatient breast health services at JamesCare in Dublin. In the same Dublin complex is Hope’s Boutique, a James-sponsored shop catering to women with cancer. The hospital also maintains JamesCare at Kenny Road, an outpatient facility on floors 10 and 11 in the Tower Building at the Martha Morehouse Medical Plaza, 2050 Kenny Road.

Travel Assistance

Although The James has no formal travel-assistance program, the hospital works on a case-by-case basis to help patients/families who come either from some distance or travel locally.

Lodging

Based on need, patients and families/other caregivers can be placed in local university-owned housing or local hotels for short-term stays. The James also has an agreement with a temporary living agency to place patients and families/others in apartments. Rent fees are based on a sliding scale. Housing needs are assessed by social workers.


Treatment

Stem Cell Transplant Program

The Bone and Marrow Transplant program at The James is accredited by the Foundation for the Accreditation of Cellular Therapy (FACT) and the following are treated using autologous or allogeneic stem cell transplants:

  • Acute Lymphocytic Leukemia
  • Acute Myelocytic Leukemia
  • Acute Nonlymphocytic Leukemia
  • Amyloidosis
  • Chronic Myelocytic Leukemia
  • Chronic Myelogenous Leukemia
  • Chronic Lymphocytic Leukemia
  • Non-Hodgkin Lymphoma
  • Hodgkin Disease
  • Multiple Myeloma
  • Myelodysplasia
  • Aplastic Anemia


Cancer Prevention and Screening

The James offers a number of cancer-prevention strategies and cancer-screening opportunities.

JamesCare for Life is a program within The James that offers multiple services to address the emotional, social and spiritual needs of cancer patients, families and friends. Services include: community outreach; educational classes for patients and families about a broad array of quality-of-life issues during and after cancer treatment; cancer support groups for patients and families; education and training for healthcare professionals; grief and bereavement support for families; creative arts and expressive therapies; resource referral and information; and cancer-specific survivorship initiatives. Information about this program can be obtained by calling The James Line at 800.293.5066.

The James periodically provides free public screenings for breast and prostate cancer, as well as melanoma. In addition, The James’ Mobile Mammography Services Program extends affordable mammography to the community in mobile units equipped with state-of-the-art technology. The James also maintains conveniently located mammography suites at : The Babe Zaharias Center at The James;  JamesCare at Macy’s in Easton Town Center on the near east side of Columbus; The James at University Hospital East, 1492 E. Broad St.; and at  JamesCare in Dublin, a comprehensive breast health center that offers breast cancer detection, diagnosis, counseling, continuity of care and a multidisciplinary team of healthcare professionals collaborating to provide a full range of patient needs.

Periodic educational sessions are available through The James regarding prostate cancer, breast cancer and living with lymphedema. Further, JamesCare for Life offers free monthly integrative-care classes that are open to the public and presented by clinical experts on topics of health/wellness, complementary care, symptom management, and quality-of-life issues.


Support Services

With the aim of rehabilitating cancer patients and families into as normal a life as possible, JamesCare for Life offers a number of support groups and classes. Most groups are cancer-specific (e.g., brain, breast, gynecologic, prostate, head and neck, etc.), but some focus on physical and functional aspects of cancer, such as lymphedema, cosmetic concerns and self-appearance. Adult coping and bereavement groups are also available. Supported by donations and grants, the MusicCare initiative offers live performances from volunteer musicians to hospital inpatients and also provides hundreds of CDs and audiotapes for patients. In addition, JamesCare offers massage therapy at Hope’s Boutique, a James specialty shop catering to women with cancer.

Also available to patients and families is referral to support services such as social work, pastoral care, patient-education packets, psychology clinical nurse specialists/mental health specialists, home care agencies that provide a myriad of services, a clinical nutritionist who works with patients and families, programs specific to survivorship issues, and a multidisciplinary recovery/rehabilitation team. Questions regarding any of these services, or about physician referral or cancer in general, can be answered by calling The James Line at 800.293.5066.


Supportive Care

Pain Service

The James has a multidisciplinary pain team that meets daily. It provides inpatient visits and consultations five days a week, but its physicians are on call around-the-clock.  The team can be reached by calling 614.293.2957.

Palliative/Supportive Service

The James has a Cancer Pain and Palliative Medicine Program directed by Robert Taylor, MD. He can be reached at 614.293.2957. The program also services Ohio State University Hospital and Ohio State’s Richard M. Ross Heart Hospital.  

Cooperative Group Membership

Cooperative Group Membership List

  • Southwestern Oncology Group
  • Cancer and Acute Leukemia Group B
  • National Surgical Adjuvant Breast and Bowel Project
  • Eastern Cooperative Oncology Group
  • National Cancer Institute
  • Radiation Therapy Oncology Group
  • M. D. Anderson Oncology Network
  • Gynecologic Oncology Group
  • Children’s Oncology Group
  • Mid-Atlantic Oncology Group
  • University-related
  • Pharmaceutical Company-related

Average Number of Adult Clinical Trials

213


Clinical and Research Efforts

Interdisciplinary collaboration among researchers and clinicians at Ohio State’s Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute allows for the translation of scientific discoveries to innovative clinical care that contributes to global efforts to control cancer in its many forms.

Adult Oncology Program *

No. of Inpatient Beds (Medical/Surgical)

No. of Admissions

Average Length of Stay (days)

Total Visits to all Outpatient Areas

No. of Oncologists (Medical and Surgical)

160

7,968

6.53

173,607

64

 

*This data is for fiscal year 2005–06, or July 1, 2005 through June 30, 2006

 


Arthur G. James Cancer Hospital & Richard J. Solove Research Institute at The Ohio State University
Pediatric Oncology Services

 


Introduction

The Comprehensive Cancer Center at The Ohio State University provides pediatric oncology services at Nationwide Children’s Hospital and at the James Cancer Hospital and Solove Research Institute. Nationwide Children's Hospital is one of the nation's recognized pediatric leaders. The program conducts both basic and clinical investigations, and the leadership of the Comprehensive Cancer Center focuses primarily on developing and applying new knowledge by bringing groundbreaking laboratory research directly to the patient’s bedside. This focus translates solid tumor research into clinical studies that result in improved therapy and quality of life for children with cancer. The pediatric oncologists have expertise in the management of all childhood cancers and are world-renowned experts in the areas listed below.

 


General Information

Special Expertise

  • Blood and Marrow Transplantation
  • Brain Tumors
  • Bone Tumors
  • Lymphomas
  • Soft Tissue Sarcoma
  • Neuroblastoma
  • Pediatric Solid Tumors
  • Long-term Follow-up of Childhood and Adolescent Cancer
  • Psychology/Neuropsychology for Children and Adolescents

In collaboration with the OSU Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute (OSUCCC-James) unique capabilities exist in:

  • Intra-operative radiotherapy (IORT)
  • High-dose–rate brachytherapy
  • Gamma knife
  • Intensity modulated radiation therapy (IMRT)

Pediatric Referral and Information

General Hematology Oncology
Phone: 614.722.3250
Fax: 614.722.3271

Blood and Marrow Transplantation
Phone: 614.722.3558
Fax: 614.722.3699

Weekends, Holidays, and Weekdays after 5PM

Phone: 614.722.2000

General Information

Nationwide Children’s Hospital Operator
Phone: 614.722.2000
www.nationwidechildrens.org

Referring Physician

General Hematology Oncology
Phone: 614.722.3250
Fax: 614.722.3271

Location

Columbus, Ohio

Pediatric Oncology services at the OSU Comprehensive Cancer Center-James Cancer Hospital and Solove Research (OSUCCC-James) reside at Nationwide Children’s Hospital.

Physical Plant

The new Hematology/Oncology Unit at Nationwide Children’s Hospital opened in 2002. The 31-bed, HEPA-filtered unit has eight rooms dedicated for Blood and Marrow Transplant patients. The unit contains a four-bed apheresis facility, a Day Hospital, an outpatient clinic for Blood and Marrow Transplant patients, and a dedicated hospice room. It is served by a dedicated pharmacy staffed from
7:30 AM–6:00 PM. There are laundry facilities, parent showers, a family kitchen, and family lounge areas on the inpatient unit.

The outpatient clinic is in the Outpatient Care Center and includes an infusion area for chemotherapy, fluids, and blood products, and a dedicated pharmacy. Radiation oncology services are provided at the OSUCCC-James Cancer Hospital and Solove Research Institute.

Travel Assistance

Nationwide Children’s Hospital social workers coordinate transportation for patients as needed.

Lodging

A new Ronald McDonald House opened in place of the former one in 2005 on the hospital campus. There are four dedicated suites for immune-compromised patients and their families. The Clinical Services and Care Coordination department assists with lodging and can be reached at 614.722.6300.

Social Support

Psychology, Nutrition, Dental, Child Life, Physical Therapy, Occupational Therapy, and Recreational Therapy specialists work as members of the interdisciplinary team to support the psychosocial, developmental, and emotional needs of patients and their families. An educational specialist is available as a liaison to the child’s school. Tutoring and a school re-entry program are available. There is a sibling support group and a “Clubhouse” for siblings of children in the hospital. Nationwide Children’s Hospital runs an annual weekend camp for children with hematologic and cancer diagnoses. Visitation for parents is 24 hours a day.

Home Health Care/Hospice

Nationwide Children’s Hospital offers many services to meet the needs of children at home throughout central Ohio either through Children’s Homecare or working through other community-based agencies. To contact Children’s Homecare, call
614.461.2727 or 800.466.2727.

Children’s also offers hospice services for pediatric oncology patients. This service is JCAHO-accredited and certified by Medicare/Medicaid. It is the only pediatric hospice program in central Ohio. It provides homecare services to meet the physical, emotional, and spiritual needs of terminally ill children and their families. To contact Nationwide Children’s Hospice program, call 614.722.3556.

Ages Treated

Children of all ages, from birth to age 20, are treated at Nationwide Children’s Hospital, including young adults with pediatric disease diagnoses.

 


Clinical and Research Information

Pediatric Oncology Director

Thomas G. Gross, MD, PhD
Phone: 614.722.3552
Fax: 614.722.3699

Director, Pediatric Bone Marrow Transplant Program

Amanda M. Termuhlen, MD
Phone: 614.722.3552
Fax: 614.722.3699
e-mail: amanda.termuhlen@nationwidechildrens.org 

Multidisciplinary Teams

All children and adolescents diagnosed with cancer are treated by a multidisciplinary team consisting of a pediatric oncologist, nurse practitioner, nurses, psychologists, social workers, child life specialists, education specialists, pharmacists, and therapists. There are formal teams that care for patients with brain or bone tumors, long-term survivors, and those undergoing blood or marrow transplantation.

Cooperative Group Membership

  • Children’s Oncology Group (COG)
  • Childhood Cancer Survivor Study (CCS)
  • Pediatric Blood and Marrow Transplant Consortium
  • International Bone Marrow Transplant Registry (research member)
  • National Bone Marrow Donor Program

Cooperative Group Activities

The Pediatric Blood and Cancer Program at Children’s Hospital is one of the largest and most active members of the Children’s Oncology Group. The Division Chief, Tom Gross, MD, PhD, is the chair of the Non-Hodgkin’s Lymphoma Strategy Group and chairs a protocol for the treatment of post-transplant lymphoproliferative disease.

The associate chief, Amanda Termuhlen, MD, is chair of a Rare and Cutaneous Non-Hodgkin Lymphoma Registry, vice-chair of the treatment protocol for all newly diagnosed lymphoblastic lymphomas, and a member of the protocol committee running a trial for relapsed B-cell lymphomas. She is on the Voting Body, Adolescent and Young Adult Committee, and is a member of both the Hematology/Oncology and the Stem Cell Transplant discipline.

Fred Ruymann, MD, former principal investigator in the Children’s Cancer Oncology Group and active in the Intergroup Rhabdomyosarcoma committees, chairs the Children’s Oncology Group Membership Committee. Several advanced practice nurses and clinical research associates serve on Children’s Oncology Group committees, including late effects and the treatment of neuroblastoma, nasopharyngeal carcinomas, and Hodgkin’s disease.

Clinical research is supported by a staff of Clinical Research Associates and managed by Barb Pugh, RN, MS, CCRP. The clinical research office can be contacted at 614.722.3568.

Average Number of Trials

100

 


Research Efforts

In 2004, the Center for Childhood Cancer was established as a new Center of Emphasis in The Research Institute at Nationwide Children’s Hospital. The Center for Childhood Cancer strives to expand understanding of the pathogenesis of childhood cancer through basic and translational research. The goal is to improve diagnosis, refine prognosis, and advance treatment, with the ultimate goal of increasing cure rates and decreasing side effects and outcomes of therapy. Specific research programs focus on mechanisms of cellular growth and proliferation, the tumor microenvironment, and the role of the immune system in cancer control and treatment. Studies on the pathogenesis of childhood sarcomas are also an emphasis and a distinguishing strength of the Center.

An important component of the Center for Childhood Cancer is the Biopathology Center, led by Nilsa Ramirez, MD.  The Biopathology Center serves as the only pediatric repository for pediatric solid tumor samples and is one of only two repositories for leukemia samples in the United States, Canada, and Australia. More than 80,000 samples have been characterized and distributed to 250 pediatric cancer researchers throughout the world in the past five years. Because of the Biopathology Center, The Research Institute at Nationwide Children’s Hospital receives more grant funds from COG than any other national program.

Scientists in the Center for Childhood Cancer are listed below:

Research Scientist

Expertise

Tom Gross, MD, PhD

Immunosurveillance and cancer control

Long-Sheng Chang, PhD

Retinoblastoma, Neurofibromatosis

Mary Beth Ross, MD, PhD

Leukemia; Genome profiling

Brett Hall, PhD

Tumor-stroma interactions

Dawn Chandler, PhD

Pre-mRNA splicing; Rhabdomyosarcoma

Julie Gastier-Foster, PhD

Molecular genetic testing

Jayah Lin, PhD

Jak/Stat signaling and cancer

 

 


Special Expertise Descriptions

Blood and Marrow Transplantation

The Nationwide Children’s Hospital Pediatric Blood and Marrow Transplantation (BMT) Program works in collaboration with the adult BMT Program at the OSUCCC-James Cancer Hospital and Solove Research Institute. Bone marrow processing, HLA typing, and cytogenetics are shared between the two institutions. The Pediatric Blood and Marrow Transplant program is accredited by the Federation for Accreditation of Cellular Therapies (FACT), is an independent National Marrow Donor Program Center, and is a Children’s Oncology Group BMT Center. Types of transplants offered include:

  • Autologous (one’s own bone marrow or peripheral blood stem cell)
  • Allogeneic (a donor’s marrow—related or unrelated)
  • Umbilical cord blood

The Pediatric Blood and Marrow Transplant Program patients are cared for at Nationwide Children’s Hospital with a full complement of multidisciplinary team members and pediatric sub-specialists. Nationwide Children’s Hospital has a Pediatric Intensive Care Unit with four designated HEPA-filtered Bone Marrow Transplant beds that offer 24-hour in-house pediatric intensivist coverage. The BMT physician team is sub-specialized into those caring for patients with leukemia, solid tumors, non-malignant disorders, and genetic/metabolic or immune deficiency disorders. There are dedicated multidisciplinary clinics for chronic graft-vs.-host disease patients and long-term survivors of BMT. The BMT program works closely with two immunologists, and the program conducts clinical research in oncology as well as brain tumors, non-cancer conditions, and graft-vs.-host disease. The program is supported by four full-time nurse practitioners who provide outpatient clinic coverage and 24-hour house coverage of BMT patients Monday through Friday. There are two BMT coordinators to facilitate referral and pre-transplant evaluations of patients. For a BMT referral, call 614.722.3558.

Brain Tumors

Randal Olshefski, MD, directs the Pediatric Neuro-oncology Program and provides extensive expertise in the treatment of children and adolescents with all varieties of brain tumors. Edward Kosnik, MD, director of neurosurgery at Nationwide Children’s Hospital, utilizes a variety of new surgical techniques to completely resect brain tumors. The Neuro-oncology Care Team consists of Drs. Oshefski, Kosnik, or his pediatric neurosurgery colleagues; a dedicated pediatric nurse practitioner; RN staff; psychologists; an educational specialist; and a social worker. The Pediatric Neuro-oncology Program has a Long-Term Follow-Up Clinic dedicated to meeting the needs of brain tumor survivors.

Bone Tumors

Nick Yeager, MD, oncologist, and Joel Mayerson, MD, orthopedic oncologist, along with a dedicated bone tumor pediatric nurse practitioner, staff a comprehensive bone tumor clinic. They jointly meet with new patients and collaborate on medical and surgical management. Mayerson is a national expert on limb-salvage procedures using cutting-edge surgical techniques and innovative pediatric prosthetics.

Behavioral Research

The Nationwide Children’s Hospital Blood and Cancer Program works very closely with two research psychologists who are studying pediatric cancer patients. Ongoing research includes:

  • A study of communication between parent and child about cancer diagnosis and prognosis
  • Grief in the family that has lost a child to pediatric cancer
  • Obesity/bone problems in children finishing chemotherapy for leukemia
  • The late neuropsychological effects of brain tumor therapy
  • The efficacy of massage and humor therapy during bone marrow transplantation

 


Statistics

Pediatric Oncology Program, Calendar Year 2006

No. of Researchers

No. of Clinicians

No. of Inpatient Days

Average Length of Stay (days)

Inpatient Discharges

Total Outpatient Visits

Inpatient ADC (average daily census)

No. of Bone Marrow Transplants

10

13

8,345

5.9

1,415

10,228

22.9

26

   


Arthur G. James Cancer Hospital & Richard J. Solove Research Institute at The Ohio State University
Genetic Counseling and Testing Services

Introduction

The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute has a Clinical Cancer Genetics Program (CCGP) dedicated solely to the study of human cancer genetics. The (CCGP) is part of the Division of Human Genetics in the Department of Internal Medicine and provides services through the Cancer Genetics Clinic and through participation in multidisciplinary programs such as the High Risk Breast Program and the Neuroendocrine Clinic. These programs provide comprehensive services, including genetics, for individuals with cancer and their families. The focus is on pre-symptomatic risk assessment, management options, education of patients and professionals, genetic testing, and access to appropriate research protocols. Multidisciplinary teams staff the clinics and include physicians who are board-certified in clinical genetics and surgery, as well as board-certified genetic counselors with extensive experience in cancer genetics.

Location

Columbus, Ohio

Director, Clinical Cancer Genetics Program

Albert de la Chapelle, MD, PhD

Director, Human Cancer Genetics Program

Albert de la Chapelle, MD, PhD

Schedule Appointment

614.293.6694

 

The James provides a full range of genetic counseling, testing, screening and research. The following sets out the components of the comprehensive genetic testing program:

 

Intake Process

 

Physician Awareness

CCGP staff offer continuing medical education for academic and community physicians, nurses and medical center staff. Each year, about 50 interactive programs and lectures are offered on topics such as family cancer syndromes, cancer risk, prevention, early detection, follow-up care, pre-symptomatic genetic testing and ethical issues. In addition, other medical genetics topics are offered by special request.

Patient Education

Patients receive individualized education from a genetic counselor, clinical cancer geneticist or geneticist with experience in cancer genetics. They discuss basic genetic concepts, the relationship between genes and cancer, risk assessment strategies for personal cancer risk and cancer susceptibility syndromes, and pre-symptomatic genetic testing.

Identify Eligible Subjects/Referral

Individual and family member records are obtained to verify medical histories prior to counseling. Pedigrees are constructed using the Progeny® pedigree and database program.

Individuals with family histories consistent with familial cancer syndromes such as hereditary breast-ovarian cancer syndrome, familial adenomatous polyposis, Lynch syndrome (HNPCC), familial colorectal cancer in Jewish individuals, multiple endocrine neoplasia types 1 and 2, neurofibromatosis types 1 and 2, von Hippel-Lindau syndrome, retinoblastoma, hereditary Wilms’ tumor, and others are initially evaluated with the assistance of the CCGP.

Appropriate referrals are made to multidisciplinary clinics such as the High Risk Breast Program and Neuroendocrine Clinic for long-term follow-up and management. In-depth counseling is provided about confidentiality, psychosocial, legal, and financial issues at the same time the individual is informed of his or her susceptibility risks.

Some at-risk individuals may be identified through direct referral to the multidisciplinary clinics. If appropriate, the individuals are seen subsequently in the CCGP Clinic for in-depth counseling.

Pre-test Counseling and Risk Assessment

Risk evaluation is accomplished using medical records received in the pre-counseling period and with information received from the patient at the time of the counseling session. Individuals are encouraged to consult family members and records while preparing for the session.

The individual meets with a genetic counselor and a clinical cancer geneticist or clinical geneticist who provide basic genetic concepts, the relationship between genes and cancer, and risk-assessment strategies for personal cancer and cancer susceptibility syndromes. The person's readiness to participate in pre-symptomatic testing is assessed. A counselor prepares the person psychologically for test results; discusses the potential risks, benefits and limitations of the testing; and provides information about the medical and genetic ramifications of positive, negative and indeterminate test results. Eligibility for genetic testing research protocols is discussed. In-depth counseling is provided about confidentiality, psychosocial, legal and financial issues.

Risk-reducing surgical options are discussed. Management options are discussed for other at-risk family members, including appropriate options for children and adolescents in the case of FAP or MEN syndromes.

Informed Consent Procedures

Written informed consent is required prior to any specimen acquisition for any gene testing. Institutional Review Board informed consent procedures are followed for research protocols. An informed consent document for reference laboratory is used for commercially available tests.

All informed consent documents indicate that the individual is informed of the purpose and type of genetic test to be performed, potential risks, benefits and limitations of genetic testing, confidentiality issues and fees involved in testing.

 


Testing

Confidentiality Standards

Physical examination findings are recorded as part of the medical record. Notation is made that a genetic counseling session has occurred and that a secure chart is available in the Clinical Cancer Genetics office. Release of CCGP records requires a specific, current, signed consent from the individual.

A detailed letter documenting the patient's family history, counseling issues and genetic testing results are located in CCGP records. No results of genetic testing are posted on the computer-based medical record.

Testing

Genetic testing may be performed at Ohio State University Medical Center Molecular Pathology Laboratory or at a licensed commercial laboratory. These laboratories meet the College of American Pathology (CAP) and Clinical Laboratory Improvement Act (CLIA) of 1988 standards and are accredited.

Examples of Available Testing at or through The James

Cancer/Syndrome

Gene

Hereditary Breast/Ovarian

BRCA1 & BRCA2

Cowden syndrome/BRR

PTEN

FAP

APC

Gorlin syndrome

PTC

Familial Jewish Colon Cancer

APC I1307K mutation

Familial Melanoma

p16

Lynch syndrome (HNPCC)

MLH1, MSH2, MSH6, PMS2

Juvenile Polyposis

BMPR1A, SMAD4

Li Fraumeni syndrome

TP53

MEN1 & MEN2

MEN1, RET

Neurofibromatosis types 1&2

NF1, NF2

Peutz-Jeghers syndrome

STK11/LKB1

Retinoblastoma

RB1

von Hippel-Lindau

VHL

Laboratory Quality Assurance

CAP/CLIA accreditation is current at all Ohio State University laboratories. The director of the Molecular Pathology Laboratory is certified in molecular genetics by the American Board of Medical Genetics.

Test Result Interpretation

Laboratory personnel provide a written report to the physician, who interprets all genetic testing results in light of the individual's personal and family history, the published literature and database repositories of mutations. The risk conveyed by a specific mutation is estimated based on all available data for each individual.

 


Post-Test Counseling and Follow-Up

The Clinical Cancer Genetics Program at The James Cancer Hospital and Solove Research Institute serves as a liaison between patients/families and basic researchers. The program is involved in genetic research and encourages individuals and families to participate in the following types of research:

Gene Studies

Papillary Thyroid Cancer
Families in which multiple individuals are affected with papillary thyroid cancer are eligible for a research study attempting to identify genes involved in the tumorigenesis of this cancer. Patients also diagnosed with precursor thyroid lesions at The James and the University of Pennsylvania are eligible.

Lynch syndrome (Hereditary Non-Polyposis Colon Cancer)
Studies of a consecutive series of colon and endometrial cancers are being performed to determine the proportion due to hereditary non-polyposis colorectal cancer syndrome.

Spielman Breast Cancer tumor bank
This is for storage of genetic material from a consecutive series of breast cancer patients and their tumors for future research studies. The first 1,500 patients also received PTEN gene testing to determine the proportion due to Cowden syndrome.

Modifier study
Individuals with BRCA1 or BRCA2 gene mutations causative of Hereditary Breast-Ovarian cancer syndrome are eligible for this study, which aims to identify genes that modify the risks for cancer among this high-risk cohort.

Other Cancer Gene-Related Studies

Amish Population Study
This population study looks at cancer incidence among the Holmes County, Ohio, Amish.

Prospective Cohort BRCA Study
This prospective questionnaire-based study is offered to all female patients who test positive for BRCA mutations to identify hormonal, reproductive and lifestyle factors that are associated with the risk of developing breast and ovarian cancer. A second study, to include male BRCA carriers, is in process.

Improving Counseling Methods

The CCGP has developed JamesLink, an online, personalized, cancer-risk assessment tool that estimates risk by reviewing patterns of cancer in a family. JamesLink is available on The James Web site at www.jamesline.com/go/familyhistory.  We will improve access to CCGP counseling services by informing the appropriate individuals of their risk for hereditary cancer predisposition syndromes and recommending genetic counseling.

Participating in Familial Registries or National Registries

The CCGP is also in the consortium of centers participating in the Prospective BRCA Study centered in Toronto and a member of CIMBA (Consortium of Investigators of Modifiers of BRCA1/2). The CCGP also works closely with the Colon Cancer Family Registry.

Studying Impact of Receiving Genetic Information on Health-Related Outcomes

A research study is ongoing to assess patient compliance with cancer surveillance and genetic counseling recommendations provided in a risk-notification letter sent to patients using JamesLink. The letter is tailored to the patient in an attempt to increase compliance.

 


Other Components of Genetic Services

Quality assurance

A weekly CCGP case conference reviews each individual's case. Each counseling letter is reviewed prior to release.

Training

The Clinical Cancer Genetics Program participates as a clinical site for the training of genetic counselors.

Other

The Ohio Cancer Genetics Network, founded in 2006 by the Ohio Department of Health, aims to improve statewide collaboration in cancer epidemiology, management and counseling of clinical cancer genetics patients as well as research. To this end, databases at collaborating institutions are being made compatible with each other. 

Last updated: 2/11/2008

 

Educational Opportunities

NCCN 1st Annual Forum: Innovative Diagnostics & Therapeutics in Cancer Care™

September 4, 2008
New York Marriott at the Brooklyn Bridge
New York, New York

NCCN 3rd Annual Congress: Hematologic Malignancies™

September 5 – 6, 2008
New York Marriott at the Brooklyn Bridge
New York, New York


Exhibitor Information


NCCN Regional Guidelines Symposia

NCCN Breast Cancer Guidelines Symposium
Washington, D.C. (Monday, May 12, 2008)

NCCN Colon, Rectal, & Anal Cancers Guidelines Symposia
Seattle, Washington (Wednesday, June 11, 2008)

NCCN Breast Cancer Guidelines Symposium
Palo Alto, California (Friday, June 20, 2008)

NCCN Kidney Cancer Guidelines Symposium
Birmingham, Michigan (Friday, June 20, 2008)

More Events ....


NCCN International

Chinese – 中文

Japanese –日本語

NCCN Privacy Policy NCCN Legal Disclaimer NCCN Site Map Contact NCCN Home National Comprehensive Cancer Network