Close to Home - An Overview of the UCSD Cancer Center

UCSD Cancer Center Clinical Trials

The Breast Care Unit

Ductal Lavage

Close to Home - an Overview of the UCSD Cancer Center

The complex nature of cancer – a family of some 100 diseases – is testing the best minds at some of the best institutions in the nation. Harnessing the strength of many disciplines – either within an institution, with neighboring organizations or with centers across the nation – is the direction cancer research and care will take in the future, according to David Tarin, M.D., Ph.D, director of the UCSD Cancer Center.

David Tarin, M.D., Ph.D. 

Tarin, who is also Associate Dean for Cancer Affairs and Professor of Pathology at UCSD School of Medicine, knows about the powerful results these kinds of multidisciplinary alliances can generate. He pioneered just such an approach as chairman and coordinator of the Oxford Breast Diseases Group for 15 years before coming to UCSD in 1997. This consortium of surgeons, medical oncologists, radiotherapists, radiologists and pathologists meet weekly to decide the management and care for each patient seen by the group. He has transferred this idea to UCSD, bringing patients the benefits of a caring, coordinated and multidisciplinary team approach to cancer care.

The Cancer Center’s Breast Care Unit was the first breast health service in San Diego to offer women a comprehensive team approach to their care. Every week about 20 specialists from eight disciplines meet to discuss each woman’s case to determine the best options available. Using the advice from this group of experts, the patient then decides with her primary physician what she feels is best for her.

Similar teams are now in place for patients with many other forms of cancer, including those of the brain, head and neck, gastrointestinal system, genitourinary system and more. Research and clinical care at UCSD does not just focus on the disease. It also helps patients cope with it. The Cancer Center right now has several innovative programs designed to help patients deal with anxiety, depression and pain associated with cancer.

“Too often we concentrate on the tumors, but it is vital to concentrate on the complete conscious and sensory experience perceived by the cancer patient about their illness, which includes the relief of pain,” Tarin said. “Our job is not just to cure the disease, but to ameliorate the negative symptoms you get from the illness or the treatment. We’re trying to comfort people as well as treat them.”

To that end, the Cancer Center has established the Cancer Pain Relief Unit, a service dedicated to patient comfort. This service is also based on the team approach model.

“Whether we’re working in the clinical or research arenas, we must bring together, in a coordinated and focused way, an array of expertise if we are to continue making progress against cancer,” he said.

That approach is integral to several research projects based at UCSD, including a San Diego collaboration to develop new ideas for the molecular characterization of prostate cancer; and a national consortium to study chronic lymphocytic leukemia.

The collaborative research effort among four San Diego institutions – UCSD Cancer Center, Sidney Kimmel Cancer Center, the San Diego Veterans Affairs Medical Center and the Ludwig Institute for Cancer Research – was made possible through a $4.7 million grant from the NCI. These organizations are pooling their expertise in an effort to develop technology capable of applying sophisticated genetic analyses to the battle against prostate cancer.

Currently, the diagnosis and characterization of prostate cancer depends on viewing small samples of each tumor under a microscope. While the procedure can determine if the patient has prostate cancer, it can’t predict the course of the disease.

Knowing how a tumor will behave in the future would be invaluable in deciding the best treatment for each patient, and in fact, which patients can safely have no treatment at all.

“There is as much disadvantage in over treating the patient as in under treating them, so it’s a balancing act to use one form of therapy or another, such as radiation or hormones,” said Tarin.

The idea is to make a comprehensive molecular classification of prostate cancer using the most advanced genetic methods and correlate that with the outcome of the disease to find molecular markers that will tell what the tumor will do.

Not only does this work aim to predict the future course of the disease in individual patients, but if the marker is related to the cause, “we will have a handle on innovative methods of treatment,” Tarin said.

On a national scale, UCSD has led the effort to bring together the nation’s top scientists from different disciplines – genetics, cell biology, biochemistry, immunology and pharmacology – to conduct an integrated program of basic and clinical research focused on chronic lymphocytic leukemia. CLL is the most common adult leukemia, striking about 10,000 to 12,000 Americans a year, and is currently incurable.

Members of the CLL Research Consortium hold “virtual” meetings in which they post slides and other information on the consortium’s Web site. The consortium is also creating a sophisticated national tissue bank, which collects blood samples on many different CLL patients. This makes it possible for different member scientists to study the same tissue from different angles, leading to a multi-faceted analysis that has greater potential for unraveling the mysteries of CLL.

 


UCSD Cancer Center Clinical Trials

Clinical trials provide important options for patients with cancer while advancing the current state of medical knowledge. UCSD Cancer Center is one of several in the nation specifically designated by the National Cancer Institute to develop new treatment approaches based upon the latest knowledge about the biology and technology related to cancer.

The Cancer Center has approximately 200 clinical trials open at any given time designed to test new approaches in prevention, diagnosis and treatment for nearly every cancer type. There are also research studies that aim to determine the psychological impact of cancer, and those that examine ways to improve a person’s comfort and quality of life.

  • evaluate a type of stem-cell transplant for its effectiveness against advanced kidney cancer, known to be highly resistant to conventional therapy and usually fatal

  • train partners of men with prostate cancer in specific stress management, coping and problem-solving skills

  • administer a pain medication through the spinal cord in doses at a fraction of those required as an oral medication to determine whether this method will provide similar pain relief with fewer side effects
If you are interested in participating in clinical trials, contact the UCSD Cancer Center Clinical Trials Office at 858-657-7020 or log onto:
http://cancer.ucsd.edu/level2/clintri.htm

These focused efforts will translate into new clinical trials, and the consortium will make these early trials available to more patients for whom standard treatment has failed. Usually, clinical trials are not widely available until they reach the final phases of testing (Phase III), making it necessary for patients to travel long distances in order to participate in the earlier phases.

More rapid accrual into Phase I and II clinical trials speeds the entire process of bringing promising new therapies from the laboratory to patients everywhere, creating new standards of care.

“By drawing on the nation’s best expertise and cross-fertilizing ideas, we expect this effort will generate new insights and novel ways of attacking this relentless disease,” said Tarin, who added that the insights gained will likely shed new light on other types of cancers.

This five-year study is funded by a $16.5 million grant from the NCI. It is among the largest grants ever received at UCSD.

Founded in 1979, the UCSD Cancer Center is one of just 60 centers in the United States to hold a National Cancer Institute (NCI) designation. As such, it ranks among the top centers in the nation conducting basic and clinical cancer research, and providing advanced patient care. The Center's mission is to translate promising scientific discoveries into new and better options for the prevention, diagnosis and treatment of cancer, and the amelioration of pain.

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Close to Home - An Overview of the UCSD Cancer Center

UCSD Cancer Center Clinical Trials

The Breast Care Unit

Ductal Lavage