National Comprehensive Cancer Network

NCCN Research & Business Resources

Roswell Park Cancer Institute
Buffalo, New York
877.275.7724 (877.ASK.RPCI)
www.roswellpark.org

Adult Oncology Services

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, Soft Tissue Melanoma, Thoracic Center

Lower Gastrointestinal Center

Upper Gastrointestinal Center

Genito-Urology Center

Gynecology Center

Head & Neck Center

Hematology/Neurology/Pain Center

Pediatric Center

Hematopoietic Stem Cell Transplant Program

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

Amyloidosis

Aplastic Anemia

Acute Lymphoblastic and Myelogenous Leukemias

Chronic Lymphocytic and Myelogenous Leukemias

Ewing Sarcoma

Hodgkin Lymphoma and Non-Hodgkin Lymphoma

Multiple Myeloma

Myelodysplastic Syndromes

Neuroblastoma

Testicular Cancer/Germ Cell Tumors

Immunodeficiency Disorders

Alternative/Complementary Medicine

RPCI's Community Cancer Resource Center offers patients and their families weekly yoga and meditation classes; affirmation tapes; journals; teleconferences; public computers with internet access; wig, hat and scarf boutique; lending library of books, movies CDs (CD players); and laptop computers on loan for in-patients. The Center is open 9:00 AM - 5:00 PM EST. For more information call Roswell Park's Cancer Information Program at 877.ASK.RPCI (877.275.7724),.

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 Population Sciences

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 and/or receive adequate screening for early detection. 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 the Department of Cancer Prevention and Control, Christine Ambrosone, PhD, is an internationally recognized leader in molecular epidemiology of cancer, emphasizing the roles of genetic variation in modifying cancer risk and treatment outcomes, The epidemiology program focuses on studies of cancer risk and prognosis, with an emphasis on 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, and in melanoma and leukemia. The importance of lifestyle factors, such as diet and supplement use in treatment outcomes, including toxicity during cancer therapy and long-term outcomes, are also key areas of research. Molecular epidemiological studies of cancer prognosis include research on pharmacogenetics, and genetic variability in a number of other biological and genetic pathways.

Dietary studies continue to examine compounds that may reduce the risk of cancer. An important goal of these dietary studies has been to identify dietary and other compounds that, as chemopreventive agents, might decrease cancer risk. Selenium has been a focus. 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. Yuesheng Zhang, MD, PhD leads a well-developed program of isothiocyanate research. Isothiocyanates are potent

anti-carcinogens found in cruciferous vegetables.

This research is linked to epidemiologic studies that have considered risk of bladder, breast, prostate and lung cancer. Susan McCann, PhD, RD, leads research on flaxseed and an important component of flaxseed, lignan, in prevention of breast cancer among high risk women. Researchers are also conducting studies on calcium, aspirin, selenium, and vitamin D for preventing breast, lung and colorectal cancers. An important emerging arena of research is use of chemotherapeutic drugs as chemopreventive agents among people who are at elevated risk of cancer. Mary Reid, PhD, leads a critical study in this area, exploring the use of erlotinib among lung cancer patients, who, after definitive treatment, have formed additional premalignant lesions.

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. Led by K. Michael Cummings, PhD, MPH, chair of the Department of Health Behavior and an internationally recognized expert in the use of government tobacco policy, the tobacco control program at RPCI has been recognized as an NIH-supported Transdisciplinary Tobacco Use Research Center of Excellence; the program is focused on how policy in the developing and industrialized societies can lessen tobacco dependence. 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.

Highlights of 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 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, as well as research in other cancers. 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, who can serve as control groups for research on cancer etiology, matched with patients in the DBBR. 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.

An emerging focus of the prevention program is health disparities. As a society, we must make the benefits of cancer research available to all segments of our population. Deborah Erwin, PhD, who leads our health disparities research effort, is nationally recognized as the founder of the Witness Program, which uses narrative rather than more standard didactive methods to encourage cancer screening and appropriate treatment. Dr. Erwin has convened a community advisory board as part of her community participatory research approach.

Support Services

Department of Psychology

The Department of Psychology has active clinical, research and educational programs in PsychosocialOncology. Clinical services include individual, couplesand family medical psychotherapyand address the emotionalimpact of the diagnosis and treatment of cancer as well asthe side effects of cancer therapies.Treatment is individualized, empirically based, and tailored to the patient's and family presenting situation. Group and psycho-educational interventions are also available. An active caregiver support program addresses caregiver needs for both adult and pediatric patients across the treatment spectrum.

Researchprograms areinterdisciplinary and include investigations of cancer outcomes, coping in response to illness related stressors, survivorship, andhealth related quality of life.Psychology faculty participate in a range of national groups to include COG, CALG-B, and GOG.Graduate and post-graduate educational opportunities are offered in general psycho-oncology and more specific clinical programs such as Pediatrics, Palliative Care, Pain Management, and Survivorship.

Department of Social Work

The Department of Social Work provides psychosocial assessment, consultation, counseling, and support to patients and families seeking care at Roswell Park. The department consists of licensed masters and licensed clinical social workers, a child life specialist, and bachelor level social workers. These staff address a variety of care concerns, from the need to get transportation and lodging arrangements and lodging arranged to coping with disease and disability, intimacy concerns, communicating with the care team and family members, finding rehabilitation facilities, coping and emotional support, and locating community resources. Individual and group counseling are offered on a broad spectrum of concerns, including caregivers, pediatric parents, bone marrow transplant, and head and neck cancers.

Case Management Department

Case Management is a collaborative process that assesses, plans, implements and evaluates the options and services required to meet an individuals health care needs for the post hospital phase when being discharged to the home setting. RN Case Managers help to educate and assist patients, their families, and the health care team members to understand what services, equipment (walkers, wheelchairs) medications and home care options are covered by the insurance plan the patient is enrolled in.

Pastoral Care Department

The Pastoral Care Department is an interfaith department supporting the concept of holistic medicine. This concept recognizes the integration of spiritual, emotional, social, psychological and physical care as necessary for the health of the whole person. Working collaboratively with other health care professionals, chaplains provide spiritual care to all persons in the Institute regardless of religious affiliation.

Supportive Care

RPCI offers patient navigation, psychosocial support (patients and families), pastoral care, cancer resource center, interpreters, childlife specialists, occupational therapy, hospitality services, genetics assessment/counseling, palliative care, patient/family education, international patient access coordinator, lodging and transportation coordination, Tai Chi, pet therapy, art therapy, WiFi, support groups and long-term cancer survivorship clinic. For additional information call 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 research studies 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*

*Figures reflect RPCI activity from April 1, 2008 through March 31, 2009.
**Number of beds in service as of 3/31/09.

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