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The University of California, San Francisco is an international leader in cancer research and patient care. The mission of the UCSF Helen Diller Family Comprehensive Cancer Center’s clinical program is to provide comprehensive care through multidisciplinary collaboration and integrated services, to advance cancer therapies through clinical research, and to train future leaders in the treatment of patients with cancer. The collaborative approach to research and treatment is a hallmark of this program, enlisting the participation of surgeons, medical oncologists, radiation oncologists, pediatric oncologists, radiologists, and pathologists. Together with renowned UCSF investigators in fields ranging from molecular biology and biochemistry to epidemiology, biostatistics, and public policy analysis, UCSF clinical specialists are committed to translating scientific insights into lifesaving realities for cancer patients everywhere.

Highlights of the Center’s comprehensive clinical program include:

• Translational research and innovative combined-modality trials for management of cancers of the prostate, breast, head and neck, colon, liver, lung, melanoma, and other solid tumors.
• Premier bone marrow transplantation.
• Highly advanced radiation therapy techniques including conformal radiotherapy, intraoperative radiotherapy, high-dose brachytherapy, intravascular brachytherapy, stereotactic radiotherapy, and radio-immunotherapy.
• World-renowned neuro-oncology program providing innovative therapy for brain and spinal cord cancers.
• Risk prevention/genetic screening.
• Specialized therapy for AIDS-related malignancies.
• Leaders in the treatment of pediatric malignancies.

UCSF’s basic research on cancer follows in the tradition of J. Michael Bishop, MD, and Harold E. Varmus, MD, Nobel Prize recipients in 1989 for their work at UCSF on oncogenes. The Cancer Center received comprehensive designation from the National Cancer Institute in 1999, making it the only NCI-designated comprehensive cancer center from Seattle to Los Angeles. In November 2007 the Center was renamed the Helen Diller Family Comprehensive Cancer Center.  Particular foci of multidisciplinary research have been recognized by an NCI Specialized Program of Research Excellence (SPORE) in breast cancer, first awarded in 1992; a SPORE in prostate cancer, awarded in 2000; and a SPORE in brain cancer, awarded in 2002. Also integral to the Center’s programs are activities related to tobacco control, with projects ranging from laboratory science to public policy.

Current grant funding to UCSF investigators for cancer research projects from all sources totals $181.5 million annually.  In 2006, UCSF ranked 8th among all 740 National Cancer Institute grantee institutions, with 162 grants totaling $64.8 million.

UCSF Helen Diller Family Comprehensive Cancer Center
Adult Oncology Services

The University of California, San Francisco is an international leader in cancer research and patient care. The mission of the UCSF Helen Diller Family Comprehensive Cancer Center’s clinical program is to provide comprehensive care through multidisciplinary collaboration and integrated services, to advance cancer therapies through clinical research, and to train future leaders in the treatment of patients with cancer. The collaborative approach to research and treatment is a hallmark of this program, enlisting the participation of surgeons, medical oncologists, radiation oncologists, pediatric oncologists, radiologists, and pathologists. Together with renowned UCSF investigators in fields ranging from molecular biology and biochemistry to epidemiology, biostatistics, and public policy analysis, UCSF clinical specialists are committed to translating scientific insights into lifesaving realities for cancer patients everywhere.

Highlights of the Center’s comprehensive clinical program include:

• Translational research and innovative combined-modality trials for management of cancers of the prostate, breast, head and neck, colon, liver, lung, melanoma, and other solid tumors.
• Premier bone marrow transplantation and care for hematologic malignancies.
• Highly advanced radiation therapy techniques including conformal radiotherapy, intraoperative radiotherapy, high-dose brachytherapy, intravascular brachytherapy, stereotactic radiotherapy, and radio-immunotherapy.
• World-renowned neuro-oncology program providing innovative therapy for brain and spinal cord cancers.
• Cancer prevention/genetic counseling and testing for hereditary cancer syndromes.
• Specialized therapy for AIDS-related malignancies.
• Leaders in the treatment of pediatric malignancies.
• Active symptom management team including psychosocial services, medicine, chaplaincy, nursing, pharmacy, and integrative medicine services.
• Referral services and support programs including a Cancer Resource Center, Art for Recovery, and smoking cessation programs.

General Information

Treatment

Multidisciplinary Clinics

Hematopoietic Stem Cell Transplant Program

UCSF provides Hematopoietic Stem Cell Transplant Services for adult and pediatric patients. Our programs perform autologous, related and unrelated allogeneic, and cord blood transplants to patients with a wide range of malignant and non-malignant disorders of the bone marrow and immune system.  Diseases managed include leukemia, lymphoma, myeloma, myelodysplasia, bone marrow failure states such as aplastic anemia, and selected solid tumors such as testicular cancer. In addition, the pediatric program treats patients with inherited disorders of the bone marrow or immune system, such as Fanconi’s Anemia and Severe Combined Immune Deficiency Syndrome (SCIDS).

Integrative Oncology

Complementary and alternative medical services for individuals with cancer are a collaborative effort between the UCSF Helen Diller Family Comprehensive Cancer Center and UCSF's Osher Center for Integrative Medicine.  Integrative oncology refers to the combination of evidence-based complementary therapies into the conventional cancer treatment regimen or survivorship plan.  Two board-certified UCSF oncologists provide integrative oncology consultation to patients living with and beyond cancer at the Osher Center and refer them to the Osher practitioners, who offer integrative psychiatry, psychotherapy, guided imagery, biofeedback, physical therapy, physical fitness, massage, yoga, Tai Chi, mindfulness meditation, acupuncture, and Traditional Chinese Medicine.  Clinical trials, undertaken both within the Cancer Center and the Osher Center, currently include studies of acupuncture, biofeedback, massage, botanicals, and other interventions.  Appointments for consultations at the Osher Center can be arranged by phone or e-mail: 415.353.7720, integrate@ocim.ucsf.edu.

Late Effects Clinic

Currently, UCSF follows survivors of childhood cancer who have been treated at UCSF until age 21–30 for second malignancies and other side effects of cancer therapy. We have a Childhood Cancer Survivor Clinic, a formal Late Effects Clinic, which operates under the leadership of Robert Goldsby, MD.

Cancer Prevention and Screening

Cancer prevention topics figure prominently among lunchtime lectures that are presented regularly at two campus locations and geared to members of the lay community. Additional education events, often produced in coalition with community partners, include an annual day-long women's health forum on breast and gynecologic cancers, an annual symposium on fighting cancer in the African-American community (including free screening for PSA levels), and drop-in skin cancer screening in observance of Melanoma Awareness Month. Ongoing smoking-cessation programs are offered through the UCSF Cancer Resource Center (415.885.3693, crc@ucsfmedctr.org). The Cancer Resource Center also has a dedicated dietitian who provides individual nutrition counseling and conducts a variety of public education events on cancer and nutrition.  Additionally, patients at high risk for a hereditary cancer syndrome are referred to the Breast Cancer Prevention Program, the Ovarian Cancer Screening Clinic, and the Familial Melanoma Clinic, when appropriate.

A mobile mammography program, operated by UCSF and San Francisco General Hospital Medical Center, provides early breast cancer detection for thousands of underserved Bay Area women. The mammovan, which is the first in the world to be equipped with high-diagnostic–quality digital mammography, travels to community health clinics across the city, providing about 30 mammograms daily. Foundation support pays for exams when women cannot afford the service. The UCSF Cancer Risk Program offers free monthly cancer risk education sessions for families with high rates of breast and ovarian cancer who are interested in counseling for genetic risk.

Support Services

UCSF's Cancer Resource Center (415.885.3693) sponsors more than two dozen patient support groups and weekly classes. Support groups are targeted to patients on the basis of cancer diagnosis; age-specificity; and cultural or language groups, including Russian, Spanish, Cantonese, and Mandarin. In addition, the Cancer Resource Center offers a Peer Support Program, Benefits and Health Insurance Counseling and Information services, and community education programs. 

A full-time nutritionist provides individual dietary counseling to cancer outpatients as well as to the interested public.  Nutritionists on staff with the UCSF Medical Center are available to inpatients with special needs.

Psychologists and social workers are available in all oncology areas for individual patient and family counseling. Other support services include:  Art for Recovery (415.885.7221), an expressive arts program offered to anyone dealing with cancer, which offers workshops, community projects, and a music series, and a Spiritual Care Program (415.885.7785), in which counseling and guidance assists patients and their families with questions about life and death.

Supportive Care

Pain Service

Pain services are provided through the UCSF Medical Center Pain Management Program, available at 415.885.7246. The program employs physicians and therapists with specialties in anesthesiology, neurology, psychiatry, nursing, pharmacy, psychology, internal medicine, and physical therapy.

Palliative/Supportive Service, Home Care/Hospice Service, and Rehabilitation Service

Available through the UCSF Medical Center

Cooperative Group Membership

Clinical and Research Efforts

Adult Oncology Program *

*Estimates are for UCSF/Parnassus and UCSF/Mount Zion Medical Centers. UCSF also provides house staff and oncology services at San Francisco General Hospital Medical Center and the San Francisco Veterans Affairs Medical Center, for which numbers are not included here.

**Medical oncology only; does not include surgery.

***Includes medical, surgical, and radiation oncology. NOT full-time equivalents.

UCSF Helen Diller Family Comprehensive Cancer Center
Pediatric Oncology Services

Introduction

The pediatric oncology program at UCSF is renowned for delivery of comprehensive multidisciplinary care to children and adolescents with cancer. Pediatric oncologists incorporate the expertise of multiple specialists such as pediatric surgeons, pediatric radiation therapists, pediatric rehabilitation, pediatric radiologists, child play therapists, school liaisons, and nurse practitioners. This multidisciplinary team is dedicated to providing comprehensive physical and psychosocial care to families learning about and living with the illness.

The pediatric oncology faculty members are highly trained in translational and laboratory research as well as state-of-the-art clinical care and are internationally renowned for helping to promote advances in the understanding and treatment of childhood cancer.

General Information

Clinical and Research Information

Special Expertise

Bone Marrow Transplantation

UCSF has a very active pediatric bone marrow transplantation program, with expertise in transplants for immuno-deficiency disorders as well as neuroblastoma and other solid tumors. The program provides transplants using a variety of stem cell sources including:

• Autologous
• Purged autologous with tumor cell removal
• Unpurged peripheral blood stem cells
• Autologous transplants including both bone marrow and peripheral blood stem cells from related and unrelated donors
• Matched unrelated donors
• Partial mismatches with stem cell manipulation
• Cord blood transplants

Bone Tumors

The UCSF pediatric oncology program has an established multidisciplinary program in bone tumors led by international experts in pediatric oncology, radiation oncology, orthopedic oncology, and pathology. There is a strong commitment to optimal individualized tumor management with preservation of maximum function. Particular strengths of the UCSF program include new techniques for limb salvage surgery, as well as its pediatric radiotherapy department, orthotics, and physical therapy. A multidisciplinary pediatric bone clinic is held four times per year.

Brain Tumors

UCSF is renowned for its basic research as well as its multidisciplinary pediatric brain tumor program. The Brain Tumor Research Institute is dedicated to developing new treatments as well as finding the causes of childhood brain tumors. In addition, world-renowned neurosurgeons and expert radiotherapists support the program. It also includes a gamma-knife facility for the treatment of brain tumors. A dedicated pediatric neuro-oncologist directs the multidisciplinary program for children. A National Cancer Institute Program Project Grant helps to support the multidisciplinary research involved in this program. In addition, UCSF has become part of the NCI Pediatric Brain Tumor Consortium for testing new treatments.

Late Effects

The pediatric group at UCSF is part of a national study of 25,000 survivors of childhood cancer and places special emphasis on the assessment of cardiac, pulmonary, and neurocognitive late effects. Our Childhood Cancer Survivor Clinic follows patients at regular intervals after therapy with appropriate patient education and systematic surveillance for possible organ toxicities, secondary malignancy, and quality of life.

Leukemia

Investigators at UCSF are known for the molecular investigation in the causes of myeloblastic leukemia and myelodysplasia. They have also established national studies of these disorders to improve the outcome for children with leukemia. We are leaders in the biology and therapy of all childhood leukemias.

Neuroblastoma

Investigators at UCSF are internationally renowned for their research in the molecular biology of neuroblastoma as well as for testing novel treatments including tumor-targeted I-131 MIBG therapy, purged bone marrow transplantation, and new chemotherapeutic agents. UCSF has become a center for consultation for this devastating childhood tumor, and leads a national consortium for testing new therapies.

Resistant Cancers and New Agents

UCSF has an NIH-funded pediatric clinical research center that is dedicated, in part, to testing new therapies for children with advanced refractory cancer. Novel anti-cancer agents including monoclonal antibodies or immunotoxins specifically directed against cancers, differentiating agents to induce tumor growth arrest, targeted radiotherapy, and other new cancer chemotherapeutic drugs are administered to children with refractory cancer. In addition, important laboratory/clinical efforts directed at elucidating and overcoming mechanisms of drug resistance  are an important part of the Pediatric Oncology program.

Retinoblastoma

UCSF is one of the premier centers in the country for treatment of this rare pediatric eye tumor. UCSF offers both basic research programs and a dedicated pediatric ophthalmologic oncologist who coordinates the specialized care of these children through a multidisciplinary retinoblastoma program with participation of geneticists, prosthetist, craniofacial surgery, radiotherapy, endocrinology, pediatric oncology, and a school liaison nurse. The expert multimodality approach taken to these eye tumors can frequently save vision in these children.

Soft Tissue Sarcoma

UCSF has helped to pilot intensive therapies for children with metastatic sarcomas including autologous bone marrow transplantation. In addition, investigators from UCSF are leaders in the development of new national Intergroup Ewing Sarcoma studies.

Statistics

Percent of children treated in each age range

Pediatric Oncology Program, 2004

UCSF Helen Diller Family Comprehensive Cancer Center
Genetic Counseling and Testing Service

The UCSF Helen Diller Family Comprehensive Cancer Center operates a Cancer Risk Assessment Program (CRP) that provides genetic counseling, risk assessment, and genetic testing for individuals from families with a high risk of heritable cancer. The Cancer Risk Program is composed of five individual clinics and a consult service to provide comprehensive care for hereditary cancers across all organ systems: 

• The Breast Cancer Prevention Clinic within the Carol Franc Buck Breast Care Center.
• The Familial Gynecologic Cancer Clinic within the Gynecologic Oncology Department.
• The Familial Gastrointestinal Genetics Clinic within the Department of Medicine.
• The Familial Melanoma Clinic within the Department of Dermatology.
• The Familial Prostate Cancer Clinic within the Department of Urology.

The CRP’s main focus is on breast/ovarian cancer syndromes, colorectal cancer (hereditary non-polyposis colorectal cancer, or HNPCC), and related malignancies. The multidisciplinary consultation service provides genetic counseling and risk assessment to cancer patients whose families exhibit the characteristics of hereditary cancer.  This includes recommendations for genetic counseling and risk assessment for individuals at high risk in these families.  The Cancer Risk Assessment team includes individuals trained in oncology, gastroenterology, genetics, epidemiology, urology, dermatology, genetic counseling, and nursing.

The components of the comprehensive services provided by the Cancer Risk Team include:

Intake Process

Testing

Post-Test Counseling and Follow-Up

Research

All patients in the Program are asked to read and sign an informed consent, approved by the UCSF Human Subjects Review Committee. In addition to routine surveillance recommendations, several research programs at the UCSF Helen Diller Family Comprehensive Cancer Center address issues for high-risk patients.  In addition to offering clinical genetic counseling/testing services, the Cancer Center includes a Familial Cancer Risk Core that provides researchers with access to a database of genotyped probands (hereditary breast/ovarian/colorectal cancer) and clinical specimens with correlative epidemiologic data.

Last updated: 2/20/2008