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Since 1898, Roswell Park Cancer Institute (RPCI), America's first cancer center, has forged an exemplary reputation based on the combined strength of its basic/translational research, multidisciplinary oncology teams, educational programs and compassionate staff. A seamless interface of scientific inquiry and clinical application, and an aggressive clinical trials program, afford patients access to promising breakthroughs in cancer diagnostics, technology and therapies. RPCI is the only facility in Upstate New York to hold the National Cancer Institute designation of "comprehensive cancer center."

RPCI has been credited with initiating the world's first chemotherapy studies, and pioneering the prostate-specific antigen (PSA) test and photodynamic therapy. Specialized treatments include high-priority protocols and new therapeutic regimens based on the most recent advances in biochemical pharmacology, genetics, immunology, and biological response modifiers. Specialized programs have been established for blood and marrow transplantation, neuro-oncology, pigmented tumors, genetic counseling and testing, long-term survivors of childhood cancer, pain management, photodynamic therapy, robotics, and minimally invasive surgery (Gamma Knife, brachytherapy, RFA, VATS, etc).

In addition:

• The Institute’s Center for Pharmacology & Therapeutics is one of only a few centers in the nation capable of taking drug development from conception stage through clinical trials and FDA approval within the confines of a single institution.
• Roswell Park has become a significant contributor to basic, translational and clinical prostate cancer research in the United States. RPCI investigators have taken a national leadership role in laboratory and clinical studies of vitamin D and prostate cancer.
• RPCI’s Blood and Marrow Transplant Program is certified by the National Marrow Donor Program as a Transplant, Collection and Apheresis Center.
• RPCI is one of only a handful of centers in the nation to offer Interleukin-2 therapy for metastatic kidney cancer.
• RPCI geneticists created the first gene library that was used to map and sequence the human genome. An RPCI geneticist was one of a handful of researchers who led teams involved in the international effort to map the human genome.
• RPCI immunologists are exploring new therapies—such as cytokines, monoclonal antibodies, and vaccines—that boost, direct, or restore the body’s normal defenses against cancer. Recent “translational” investigations include:
• Clinical studies on Rituxan, the first FDA-approved monoclonal antibody for treating non-Hodgkin lymphoma.
• Studies on hyperthermia—a process by which the whole body temperature is raised two to three degrees above normal. By raising a person’s temperature, the immune system may be stimulated against tumors in much the same way that natural fevers help fight off infections.
• Studies on how tumors avoid the immune system by confining themselves to a limited number of tissues and organs. By delivering drugs that stimulate the immune response directly into these “compartments,” physicians can gain the advantage in this cellular game of hide-and-seek.
• RPCI is poised to become a leader in phase I/phase II evaluation of new drugs.
• RPCI maintains registries for individuals with a genetic predisposition to certain cancers.
• RPCI epidemiologists, behavioral scientists, cancer prevention experts, biostatisticians, and other applied researchers conduct important cancer studies on tobacco control, chemoprevention, high-risk populations, long-term effects of treatment, screening and early detection strategies, nutrition and lifestyle, environmental exposures, and stress and coping, among others.
• RPCI’s comprehensive health disparities program aggressively advances community-based research to reduce, eliminate and prevent health disparities in underserved populations.
• In conjunction with the National Comprehensive Cancer Network, RPCI physicians and administrators have taken a national leadership role in crafting and implementing national measurement/benchmarking tools to define quality.

Over the last decade, RPCI has undergone major renovation and expansion, adding nearly 200 faculty, opening a new hospital facility and a $74 million Center for Genetics & Pharmacology, and forming strategic partnerships with research and clinical investigators and medical centers throughout the state and nation.

Committing the infrastructure, intellectual capital, and necessary resources to convert its scientific discoveries into real-world products/applications, RPCI has recently established three biotech spin-off companies with the potential to change the future of cancer medicine.
 
RPCI ranks among the nation¹s top 1% of cancer centers and teaching hospitals for patient satisfaction with physician services and overall care; and among the top research centers funded by the NCI/NIH.

In April of 2007, Donald L. Trump, MD, former Chairman of RPCI¹s Department of Medicine and Associate Institute Director, was appointed President and CEO. Dr. Trump oversees operations, philanthropic and operating budgets, capital improvements, research priorities and clinical and scientific strategic planning.

RPCI’s Vital Statistics

• One of the top 20 employers in Western New York
• Over 2,900 employees including 135 physicians, 107 senior scientists, 472 nurses
• Hospital Admissions: 4,215
• Outpatient Visits: 161,869
• Patients Under Active Care: 24,027
• Patient Origin: 36 States, 5 Foreign Countries
• Number of Beds: 101
• Average Length of Stay: 7.1 days
• Results of Patient Satisfaction Surveys: Over 95 percent of Roswell Park patients consistently rate the care at Roswell Park as excellent or very good and over 95 percent of patients say they would recommend Roswell Park to other cancer patients.

Research/Biotechnology

• Grants/Contracts: $87.4 million
• Research and development agreements: 173 collaborations
• 63 licenses
• 119 patents

Roswell Park Cancer Institute
Adult Oncology Services

Introduction

While Roswell Park Cancer Institute has made many contributions to the practice of cancer medicine, its strength lies in its multidisciplinary approach to cancer care and management. Decisions made at the time of diagnosis and with recurrent disease demand multidisciplinary input to assure the selection of a “best practice” treatment plan for the patient. RPCI’s cancer program is disease-specific, with teams that work in centers. Team specialists work in concert to develop a comprehensive, individualized care program for each patient—from diagnosis, through treatment and rehabilitation, to discharge and follow-up care.

In addition, the collaboration and regular contact between clinicians and scientists encourage translational research and the development of new investigator-driven clinical trials that afford patients a wider range of treatment options, and ultimately lead to better approaches and improved technologies to reduce the cancer burden.

General Information

Treatment

Multidisciplinary Centers

All Disease Centers listed below may be contacted by calling 800.767.9355 (800.ROSWELL):

• Breast Center
• Chemotherapy/Infusion Center
• Dermatology Center
• Sarcoma/Melanoma Center
• Thoracic Center
• Gastrointestinal Center
• Urology Center
• Gynecology Center
• Head & Neck/Dental Center
• Hematology Center
• Neuro-Oncology Center
• Pain Management Center
• Pediatric Center

Stem Cell Transplant Program

Selected malignant and non-malignant hematologic disorders and solid tumors, including those listed below, are treated with autologous, allogeneic, or cord blood transplants:

• Amyloidosis
• Aplastic Anemia
• Acute Lymphoid and Myeloid Leukemias
• Chronic Lymphoid and Myeloid Leukemias
• Ewing Sarcoma
• Hodgkin Lymphoma and non-Hodgkin Lymphoma
• Multiple Myeloma  
• Myelodysplastic Syndromes
• Neuroblastoma
• Testicular Cancer/Germ Cell Tumors
• Immunodeficiency Disorders
  

Alternative/Complementary Medicine

The Center for Enhancing Life, a division of RPCI’s Community Cancer Resource Center, offers patients and their families weekly yoga and meditation classes, affirmation tapes, journals, etc. For more information call Roswell Park’s Call Center at 877.ASK.RPCI (877.275.7724), 9 AM – 5:30 PM, EST, Monday – Friday.

Late Effects Clinic

In addition to its Clinic for Long-Term Survivors of Childhood Cancers (see Pediatric Oncology Services), RPCI also has a late effects clinic to track BMT survivors for secondary malignancies and long-term complications.

Cancer Prevention and Outreach

The goal of the Cancer Prevention and Population Science Program is to lessen the human cost of cancer by developing more effective prevention strategies. Its research examines behaviors, environmental exposures and genetics as they relate to cancer and treatment outcomes. A major challenge in prevention and control of cancer is to identify those persons who are at greatest risk of developing cancer to help them alter their risk or at least they are appropriately screened. Through screening, disease is identified at more treatable stages, thereby reducing mortality from cancer. RPCI also works to identify predictors of recurrence after diagnosis and treatment so as to enhance cancer survival and quality of life among those affected by cancer.

The chair of epidemiology, Christine Ambrosone, PhD, is an internationally recognized leader in studying the interaction of treatment and genetic predictors of response. The epidemiology program focuses on studies of cancer risk and a prognosis, with an emphasis on the role of nutrition and other factors, as well as genetics, in carcinogenesis, with case-control or cohort studies in cancers of the breast, prostate, lung and ovary, as well as melanoma and leukemia. The role that lifestyle factors, such as diet and supplement use, play in treatment outcomes, including toxicity during cancer therapy and long-term outcomes, is also a key area of research. Molecular epidemiological studies of cancer prognosis include research on pharmacogenetics, and genetic variability in a number of other biological and genetic pathways.

Since tobacco use accounts for one third of all cancer deaths, a major focus of our program is devoted to research on ways to promote prevention and cessation of tobacco use. RPCI has an NIH-supported Transdisciplinary Tobacco Use Research Center of Excellence which is focused on population strategies to reduce tobacco use. Researchers in the program are also investigating how the design of cigarettes influences how people smoke and testing new methods to help people break their addiction to nicotine. RPCI operates the New York State Smokers’ Quitline and runs local tobacco control initiatives sponsored by the New York State Department of Health.

Dietary studies continue to examine compounds that may reduce the risk of cancer. Advanced studies with selenium at RPCI are led by Clement Ip, PhD, one of the world’s foremost researchers in selenium biochemistry and molecular biology. The protective effect of selenium against cancer in humans is supported by epidemiological data as well as by intervention trials. This research is now at an exciting stage, with molecular biological approaches being used to suggest new population-based studies. Other chemoprevention research focuses on dietary substances that may inhibit bladder carcinogenesis. Researchers are also conducting studies on calcium, aspirin, selenium, and vitamin D for preventing breast and colorectal cancers.

Highlights of the Tobacco Control at RPCI

• As one of the NIH-designated Transdisciplinary Tobacco Use Research Centers, RPCI is examining how national tobacco control policies such as taxation, smoke-free laws, advertising restrictions, product warns, and product regulation influence tobacco use behaviors.
• RPCI also has established a tobacco product testing lab and maintains one of the largest repositories of tobacco products in the world. This lab is now assisting NIH and WHO in establishing standards for evaluating tobacco products.
• New York State was the first state in the nation to adopt a product standard to reduce the fire risk of cigarettes in 2004. RPCI researchers are currently evaluating how effective the low-ignition propensity (LIP) standard has been in lower fire risk and how smokers have responded to the new law.
• RPCI has led efforts around the globe to evaluate the hazards of exposure to secondhand smoke through its global air monitoring program. Scientists in 40 countries are participating in this initiative through a web-based network that can be seen at http://tobaccofreeaim.com.
• RPCI also operates a state-of-the-art communication laboratory with eye-tracking equipment to support studies evaluating consumer response product warnings, anti-tobacco advertising, and other types of health communications.
• RPCI physicians and scientists are conducting research testing new behavioral and pharmacologic approaches to help people quit smoking.
• RPCI runs the New York State Quitline and Quitsite to assist smokers in cessation efforts and to provide counseling and educational materials to healthcare providers and community organizations.
• RPCI researchers were instrumental in digitizing tobacco industry documents and video archives that can be accessed online at http://tobaccodocuments.org and tobaccovideos.com.
• RPCI also operates outreach programs in community and health care provider tobacco control in the Western New York region. These programs include mass media campaigns to promote quitting, efforts to encourage adoption of home and care smoke-free policies and assistance to health care institutions so that they identify and offer evidence based cessation services to all tobacco users.

A concentrated commitment to translational research by building prevention linkages to basic science distinguishes the prevention program at RPCI. Top tier basic scientists are recruited to the Institute specifically to collaborate with prevention scientists. To explore scientific leads and develop more effective strategies, prevention experts collaborate with researchers from genetics, biochemistry, pharmacology, toxicology, and immunology.

RPCI clinicians work with primary care doctors, nurses, and other health care professionals in the community to enhance cancer control and screening to track cancer patterns, and to develop clinical interventions for prevention. Current efforts include a program to increase colorectal screening and to understand the dynamics of physician practices to determine what factors distinguish those practices in which screening is most pervasive. Prevention and early detection initiatives are also evaluating new approaches for cancer education of women, minorities, and high-risk populations.

A critical resource for the Cancer Prevention Program is the establishment of a sample and data bank to provide the basic material for continued research. The Western New York Data Bank and Biorepository (DBBR) enrolls patients newly diagnosed with cancer. Patients consent to banking a blood specimen, contact for participation in future studies, and linkage of medical record data and findings from tissue research with blood specimens and other information. This resource is serving as the basis for a growing program in breast cancer molecular epidemiologic research, galvanized around the recruitment of a breast surgeon studying women at high-risk for invasive breast cancer. The conduct of patient-based research and development of preventive clinical trials are currently underway at RPCI.

A second component of the DBBR, also containing blood specimens and exposure data, is focused on healthy members of the Western New York population: the Cancer Prevention Research and Evaluation Program (C-PREP). An important concomitant goal is to expand the laboratory basis and grounding of the prevention studies in the program. Not only is the program building a base of tissue for use in prevention, but also a number of excellent scientists with laboratory-based research programs have been recruited or trained to provide the basic technical and scientific expertise to advance this effort.

Support Services

RPCI offers counseling to patients/families/caregivers through the Department of Psychosocial Oncology. Social workers, psychologists, and pastoral care counselors are available for consultation. In addition to multiple disease-site–specific support groups (lung, leukemia and lymphoma, multiple myeloma, etc.), RPCI offers patients, family members, and caregivers other highly specialized types of group sessions, such as those for parents of pediatric patients, bone marrow transplant patients, and families dealing with grief and bereavement. A Child Life Specialist is on staff and a multidisciplinary School Outreach Program is available.

Supportive Care

RPCI has a multidisciplinary pain team, as well as a palliative/supportive care service. They can be reached through physician referral or by calling 716.845.2300 or 877.ASK.RPCI (877.275.7724).

Home Care/Hospice Service

Home care/hospice service can be arranged by the case manager or social worker based on patient choices, geographical area, insurance coverage, etc. 

Nutrition Service

Registered dieticians are available for inpatients and outpatients with special dietary needs.

Rehabilitation Service

Service includes physical therapy, occupational therapy, nausea and fatigue management, speech therapy, and lymphedema management.

Special Expertise

Cooperative Group Membership

Clinical and Research Efforts

The collaboration and regular contact between clinicians and scientists encourage translational research and the development of new investigator-driven clinical trials that will afford patients a wider range of treatment options, and ultimately lead to better approaches and improved technologies to reduce the cancer burden.

Adult Oncology Program*

*FY 06–07. FY = April 1, 2006 to March 31, 2007

Roswell Park Cancer Institute
Pediatric Oncology Services

Introduction

The major goals of Roswell Park Cancer Institute’s Department of Pediatrics are to provide state-of-the-art treatment to children with malignant disorders, to conduct basic and clinical research aimed at improving cure rates and decreasing long-term toxicities, to identify and manage the acute and long-term complications of therapy, and to establish new and effective coping interventions for patients and their families. Over the years, Roswell Park Cancer Institute has pioneered many treatment innovations and cancer-related discoveries.

The pediatric oncologists have expertise in the management of all childhood cancers and are world-renowned experts in the areas listed below.

General Information

Clinical and Research Information

Research Efforts

Researchers at Roswell Park are studying the late effects of therapy for childhood cancer. Late organ toxicities and psychosocial adjustments in long-term survivors are being investigated. COG studies of the neuro-cognitive effects of treatment of acute lymphocytic leukemia states and of babies with brain tumors will be coordinated in Buffalo, as well as the biology study in pediatric Hodgkin lymphoma.

Special Expertise

Brain Tumors

Treatment at the multidisciplinary brain tumor clinic includes investigational drug therapies, the use of stereotactic radiosurgery in selected cases, and long-term follow-up, including the management of late effects. Stereotactic radiation therapy enables a high dose of radiation to be delivered to a small, intracranial area without harming adjacent tissue.

Long-Term Survivors

Roswell Park Cancer Institute operates a Long-Term Follow-Up Clinic, created to provide specialized medical care and counseling to former childhood cancer patients. It was one of the first of its kind in the nation. Dramatic success in the treatment of childhood cancers has resulted in a population of survivors who may have unique problems, such as difficulty in finding employment, questions concerning their reproductive capability because of cancer and its treatment, and the possibility of developing other malignancies later in life. This Clinic assists cancer survivors in building full, productive lives.

Lymphoma

Investigators at Roswell Park Cancer Institute sit on the Hodgkin lymphoma core committee for the Children’s Oncology Group (COG) and have chaired multiple institutional trials for Hodgkin lymphoma.

State-of-the-art diagnostic screening and cutting-edge therapies, including several immunotherapeutic trials (i.e., unlabeled and radiolabeled monoclonal antibody trials in the treatment of B-cell lymphomas), institutional and cooperative group (i.e., CALGB) trials, as well as standard and high-dose transplant therapies, are available.

Roswell Park Cancer Institute investigators piloted clinical trials in advanced small non-cleaved–cell lymphoma, which contributed to subsequent Children’s Oncology Group (COG) multi-institutional trials. Survival for patients with advanced stage disease has improved significantly, with more than 70 percent of patients cured.

Orthopedic Oncology

Roswell Park Cancer Institute introduced a new surgical technique that saves the limbs of over 90 percent of soft tissue sarcoma patients whose options were once limited to amputation. The multidisciplinary team emphasizes limb-sparing procedures, new drug therapies, and rehabilitation.

Stem Cell and Blood and Marrow Transplantation

The Roswell Park BMT team utilizes allogeneic and autologous blood and marrow transplantation, stem cell infusion, and umbilical cord transplantation in the treatment of pediatric malignancies and bone marrow failure stages.

Wilms Tumor

The National Wilms Tumor Study Group (NWTSG) was headquartered at Roswell Park Cancer Institute from 1990–2003, as a federally funded, multi-institutional cooperative group designed to study the biology and treatment of Wilms’ tumor in children. The group involved the collaboration of a large number of pediatric surgeons, pediatric oncologists, pediatric radiation oncologists, pediatric urologists, and allied health professionals with a goal of developing more effective treatments for children with Wilms’ tumor, as well as looking for the causes of this cancer. Due to therapeutic advances evaluated in NWTSG clinical trials, long-term survival rates for children with Wilms’ Tumor increased from about 65 percent for patients diagnosed in 1970 to 90 percent for patients diagnosed in 1990. Survival reaches 95 percent for patients who have localized, completely resected disease of “favorable histology.” The NWTSG has been incorporated into the Children’s Oncology Group.

Statistics

Percent of children treated in each age range

Pediatric Oncology Program

Roswell Park Cancer Institute
Genetic Counseling and Testing Service

The Clinical Genetics Service at Roswell Park Cancer Institute is committed to the provision of quality genetic services by professionals with expertise. The team includes the director, who is a licensed health care practitioner and board-certified genetic counselor, as well as board-certified genetic counselors who act as institutional and community resources for these services. The program offers clinical genetic testing for cancer-associated susceptibility genes that have been recognized by the New York State Department of Health Wadsworth (Genetics) Laboratory as having potential clinical value. Clinical testing for cancer-associated susceptibility genes is offered in conjunction with appropriate cancer and genetic risk assessment, comprehensive genetic consultation, assessment of criteria for eligibility for testing, and a thorough process of informed consent. Roswell Park Cancer Institute is also involved in both scientific and clinical research studies, some of which include elements of genetic testing and/or enhanced screening for persons at increased risk.

Roswell Park Cancer Institute provides a full range of genetic services, including risk assessment and counseling, testing, screening, risk management and prevention approaches, and research. The following sets out the components of the comprehensive genetic testing program.

Intake Process

Testing

Post-Test Counseling and Follow-Up

Research

The genetics professionals of the Roswell Park Clinical Genetics Service support genetics research studies and clinical trials both directly and indirectly. Individuals and their interested relatives are encouraged to consider participation in research studies to further understanding about genetics and cancer. Both clinical and basic science research areas are evolving as new information comes to light.

Other Components of Genetic Services

Last updated: 2/20/2008