Oncology Services

Specializing Institutions

Oncology is a branch of medicine that deals with tumors (cancer), from screening, diagnosis, therapy and surgery. The most important diagnostic tools in oncology are biopsies, endoscopies, X-rays, MRI scanning and blood tests. Interventions depend on the nature of the tumor. Often, surgery is attempted to remove a tumor entirely. Chemotherapy and radiation therapy are used as first-line radical treatments. Since cancer can occur in so many of the body’s systems, many doctors choose to specialize in a particular branch of oncology, such as bone cancer or blood diseases. Oncology also involves the research into cancer, its causes and possible cures. Lung cancer is by far the most fatal cancer in men, followed by prostate and colon. In women, lung and breast cancer are the leading sites of cancer death.

The South Texas Medical Center is home to the only academic treatment and research center in the South Texas Region. Patients can benefit by gaining access to new drugs that are unavailable in other cancer centers. We are also home to an internationally recognized Phase I clinical drug program.

Oncology services at the South Texas Medical Center extend the sophistication of radiation therapy. Our oncologists and researchers practice and pioneer innovative techniques to treat patients using advanced radiation systems such as the TomoTherapy® Hi Art® unit. The unit, one of only three available in Texas, integrates optimized planning, image guidance, and continuous 360° delivery for precise radiation therapy from all angles around the patient. Other cancer therapies and services that patients can find at the South Texas Medical Center include Intensity Modulated Radiation Therapy (IMRT), High Dose Rate (HDR) brachytherapy and Novalis Tx Radiosurgery.

Patients and their families can receive non-medical oncology services at the South Texas Medical Center. These services include lectures, support groups, nutrition advice, psychological and emotional assistance, social services and more.

The National Cancer Institute has recognized one of our institutions for its excellence in cancer treatment and patient service, making the South Texas Medical Center a source of hope for many and a hub of oncology research and innovation.

Pediatric Oncology Services

Pediatric Oncology is a branch of medicine concerned with the diagnoses and treatment of cancer in children. It is considered one of the most challenging specialties because of its high mortality rate. Pediatric Oncologists take a slightly different course in their education compared to regular oncologists. Some of them, for instance, become pediatricians after completing medical school and later specialize further in oncology. Cancer affects about 14 of every 100,000 children in the United States each year. The most common cancers in children are leukemia, lymphoma and brain cancer. Typically, factors that trigger cancer in kids differ from those that cause cancer in adults, such as smoking or exposure to environmental toxins. Rarely, there may be an increased risk of cancer in kids who have a genetic condition, such as Down syndrome. Childhood cancers can occur suddenly, without early symptoms.

The South Texas Medical Center features one of the most specialized children’s cancer research centers in the nation. The research center is organized around our major programs and is comprised of an interdisciplinary group of faculty and field experts. The center’s mission is to advance scientific knowledge relevant to childhood cancer and to accelerate the translation of knowledge into novel therapies.

Oncology Articles

  • Celiac disease showing up in many forms and at all ages

    By Janice Neumann

    (Reuters Health) - A classical set of celiac disease symptoms no longer reflects the profile of most newly-diagnosed patients, according to a new study from Italy.

    Instead, doctors need to take other symptoms into account and consider the possibility of celiac disease, even when patients don't fit the old image of the condition, researchers say.

    "It's been a gradual phenomenon since the 1970s that fewer people are presenting with the classical diarrhea and more with non-classical or silent presentation, both in adults and children," said Dr. Peter Green, who wasn't involved in the study.

    "We don't actually know why one person has diarrhea and another presents with abdominal pain or osteoporosis," said Green, director of the Celiac Disease Center at Columbia University in New York.

    Dr. Umberto Volta and his coauthors write in the journal BMC Gastroenterology that just 15 years ago, celiac disease was still thought of mainly as a rare pediatric food intolerance, whose most common signs were diarrhea and intestinal damage that was diagnosed through a biopsy.

    The disease is now known to be an autoimmune disorder, caused by an inability to tolerate the gluten protein in wheat, barley and rye.

    Eating gluten typically causes inflammation of the intestinal lining in people with celiac disease and makes it hard to absorb nutrients.

    Research shows that more than 1 percent of people worldwide have the disease, but most may not know it, the authors of the study note. The diagnosis is based on a blood test for signs of the abnormal immune response, such as antibodies, as well as biopsy in some cases.

    With his colleagues, Volta, a professor of medicine at the University of Bologna in Italy and vice president of the Ethical Committee at St. Orsola-Malpighi University Hospital, looked at the celiac patients diagnosed over the course of 15 years at that hospital.

    The study involved 770 patients, 599 of them female, diagnosed between 1998 and 2007. Nearly half were diagnosed during the first 10 years of the study period and the rest in the last five years, indicating a steep rise in rates of diagnosis.

    Among all the patients, 610 people, or 79 percent, had symptoms when they were diagnosed. But most of their problems were not the typical diarrhea and weight loss, but rather "non-classical" issues like bloating, osteoporosis and anemia. Diarrhea was a symptom in just 27 percent of patients.

    Indeed, classical symptoms became less common over the years, decreasing from 47 percent of patients during the first 10 years to 13 percent in the last five. Meanwhile, other problems, as well as a lack of any significant related illness, increased by more than 86 percent.

    "The most striking change in clinical presentation of celiac disease over time has been the decrease of diarrhea as the leading symptom and the progressive increase of other non-classical gastrointestinal symptoms (such as constipation, bloating and alternate bowel habits as well as gastro-esophageal reflux, nausea, vomiting and dyspepsia)," Volta said in an e-mail to Reuters Health.

    "A high proportion of celiac disease patients did not show any gastrointestinal symptom, but they displayed extra-intestinal manifestations such as iron-deficiency anemia, unexplained osteoporosis, abnormalities of liver-function tests and recurrent miscarriages," he said.

    The most common illness associated with celiac was thyroid disease. Only half the patients had severe intestinal damage, and 25 percent had partial damage.

    In later years, more patients were diagnosed through blood tests. That may be one factor accounting for the changing pattern of typical symptoms, Volta said, because the patients were diagnosed earlier, before gluten had done its damage.

    "The effects of gluten weren't as severe yet," Volta said. "The story of celiac disease has been radically changed by the discovery celiac disease-related antibodies, which identify plenty of unsuspected cases."

    Green agreed that testing has vastly improved diagnosis of the disease. He said that in the United Kingdom, anyone with iron deficiency or migraine is tested for celiac disease.

    While most celiac specialists understand the varied symptoms, other physicians might not, he said. Green pointed out that in the United States, only 17 percent of people with the disease are actually diagnosed.

    "Anyone can have celiac disease, it's common and underdiagnosed," said Green. "The message we want to get out is if you think you've got celiac disease, don't just go on a gluten-free diet, test for it."

    Volta said he hoped the study reminded doctors about the many problems that can signal celiac disease.

    "I hope doctors keep in mind that celiac disease is a very frequent food intolerance, which should be investigated not only in patients with diarrhea and overt malabsorption, but also in people (with other symptoms)," Volta said.

    "The treatment by gluten-free diet improves the quality of life in symptomatic patients and prevents complications in all celiac disease patients including those without symptoms," he said.

    SOURCE: http://bit.ly/1ATNpT3 BMC Gastroenterology, Nov. 18, 2014.

  • Breast cancer recurrence risk down since 1980s

    By Andrew M. Seaman

    (Reuters Health) - Rates of breast cancer recurrence fell by half or more between the 1980s and the early 2000s - likely due to improved treatments and increased screenings, according to a new study from Canada.

    The analysis of data on Canadian breast cancer patients offers reassurance that breast cancer survival is improving and also provides updated data to researchers, said the study's lead author, Dr. Karen Gelmon from the BC Cancer Agency in Vancouver, British Columbia.

    "It gives some contemporary numbers to people designing trials testing adjuvant treatments," she said.

    An earlier study, published in the 1990s and based on data from 1978 to 1988, found that women whose breast cancers fed off the hormone estrogen (so-called estrogen-receptor positive breast cancers) had a consistent risk of the cancer recurring over time. For breast cancers not driven by estrogen, recurrence risk was high for five years after successful treatment, but then dropped below the risk of those with estrogen-receptor (ER)-positive cancers.

    In the new study, published in the Journal of Clinical Oncology, Gelmon's team compared data on 7,178 women treated for early to moderately-advanced breast cancer during two different periods: 1986 to 1992, and 2004 to 2008.

    The researchers matched the cancer characteristics of each patient from the first period to a patient from the second period, including estrogen-receptor status as well as the presence of another protein on cancer cells, HER2.

    The HER2 molecule helps drive cancer-cell growth. Tumors with HER2 tend to be more aggressive than HER2-negative ones, the researchers note.

    Starting in the 1990s, drugs targeting molecules on cancer cells like HER2 became available. Together with improved early detection of less-advanced cancers, which gives such drugs a better chance of working, the targeted therapies have been credited with improving overall cancer survival

    In the new study, the overall risk of breast cancer recurrence for women in the later group was about 50 percent lower than for women in the earlier group, for each year after being cancer-free.

    Like the 1990s study, the new analysis found a high risk of recurrence within the first five years among women with cancers that were not driven by estrogen. Among women treated in the 2000s, that early increased risk was less dramatic, however.

    Specifically, the risk of recurrence after one year was about 11 percent among women from the earlier period with cancers not driven by estrogen, compared to about a 6 percent risk among women with the same type of cancer in the later period.

    "It showed we were doing better, but the peaks are still there," Gelmon said.

    The researchers also found that HER2-positive cancers saw some of the greatest reductions in recurrence risk.

    For example, the risk of recurrence in the second year of being cancer-free among women whose tumors were HER2-positive and ER-negative fell from about 23 percent in the earlier period to about 9 percent in the most recent period.

    The new study can't show why recurrence rates improved, but the researchers say it's most likely a result of screening leading to early detection and more "comprehensive and appropriate" treatments targeting specific cancer types.

    For example, they also saw large increases in the use of chemotherapy, and of drugs targeting estrogen-driven cancers, among the most recent patients.

    Drugs targeting HER2-positive cancers were not available in the earlier time period.

    "I think the most important thing is (the study) validates all these things we've been doing all these years," said Dr. Marleen Meyers, an oncologist and breast cancer expert at the NYU Langone Medical Center's Perlmutter Cancer Center in New York City.

    Meyers, who wasn't involved in the new study, also called the findings reassuring.

    "I think we continue to learn," she said. "I think this is very good, very positive information for women."

    SOURCE: http://bit.ly/1vOlzpm Journal of Clinical Oncology, online November 24, 2014.

  • U.S. Supreme Court Justice Ginsburg recovering after heart procedure

    By Lawrence Hurley

    WASHINGTON (Reuters) - U.S. Supreme Court Justice Ruth Bader Ginsburg underwent a heart procedure at a Washington hospital on Wednesday after reporting discomfort following routine exercise, a court statement said.

    Ginsburg, 81, was resting comfortably after having a stent placed in her right coronary artery and is expected to be discharged from MedStar Washington Hospital Center within 48 hours, the statement said. A stent is a mesh tube used to improve blood flow in clogged arteries.

    Ginsburg reported discomfort after routine exercise on Tuesday night, according to the court statement. She was at the Supreme Court on Tuesday and met with a Reuters reporter in her chambers just before she was to exercise. She appeared healthy and alert.

    The oldest member of the nine-justice court, Ginsburg has survived serious bouts with cancer in 1999 and 2009.

    Ginsburg is the most senior liberal justice on the conservative-leaning court. As such, she is often the lead dissenting voice when the court is split 5-4.

    In statements from the bench she has challenged the conservative majority's curtailing of federal voting rights law and, in June, its position that for-profit employers can opt out of birth-control coverage under federal healthcare law for religious reasons.

    Ginsburg, who was appointed by President Bill Clinton in 1993, has resisted calls from liberal activists that she should retire from the bench before President Barack Obama leaves office in early 2017.

    In a July interview with Reuters, Ginsburg said she did not intend to leave the bench in the near future unless her health changed. She said she underwent regular medical check-ups for cancer and worked out twice a week with a personal trainer.

    "Thank goodness I haven't slowed down," Ginsburg said at the time.

  • Mindfulness program may improve some rheumatoid arthritis symptoms

    By Shereen Lehman

    (Reuters Health) - A two-month program combining gentle yoga with meditation techniques, known as Mindfulness Based Stress Reduction, seemed to ease tenderness, pain and stiffness among patients with rheumatoid arthritis in a new study.

    "I think these findings are pretty consistent with other studies of mindfulness and chronic conditions," said Mary Jo Kreitzer, who was not involved in the research.

    Although it was small, and relatively brief, the study's findings were impressive, said Kreitzer, the founder and director of the University of Minnesota Center for Spirituality and Healing.

    "I would say more research is needed to really understand how the mechanisms work," Kreitzer told Reuters Health, "so this trial is incredibly encouraging, but it's not definitive."

    Mindfulness Based Stress Reduction (MBSR) is a program developed decades ago at the University of Massachusetts to help seriously ill patients cope with pain, such as from advanced cancer or AIDS. But in recent years that program has been adapted and offered more widely to people seeking relief from pain and stress of many kinds.

    "Mindfulness training involves the cultivation of nonjudgemental attention to unwanted thoughts, feelings and bodily experiences via meditation and may help ameliorate both psychological and physical symptoms of chronic disease," write the study authors in Annals of the Rheumatic Diseases.

    Previous research has found mixed success when MBSR is used by sufferers of various conditions. For instance, in one trial among patients with fibromyalgia - a widespread pain syndrome of unknown cause - MBSR had little effect (see Reuters Health story of December 28, 2010 here: http://reut.rs/1HG0Sja).

    But Francesca Fogarty at the University of Auckland in New Zealand, who led the new study, and her coauthors note that past research has found MBSR improves the psychological wellbeing of rheumatoid arthritis patients.

    They wanted to see if mindfulness techniques had any impact on the disease process itself.

    Rheumatoid arthritis is a chronic disease caused by the immune system attacking tissue in the joints, especially in the hands and feet, and sometimes causes problems in other parts of the body, such as the eyes, skin, lungs and blood vessels.

    For their study, Fogarty's team enrolled 42 patients with rheumatoid arthritis who had no previous experience with meditation. Twenty one participants were put into a treatment group, and the other 21 served as a comparison group who were told they could go through the MBSR program after the study.

    The treatment group participated in an eight-week program of meditation, gentle stretching and light yoga. Right after the program ended, and again at two, four and six months later, the study team assessed participants' disease symptoms.

    These included the number of tender and swollen joints, levels of C-reactive protein (a marker of inflammation) and the patients' own assessments of their stiffness and pain based on a scale of 1 to 100.

    On average, and throughout the follow-up period, morning stiffness, tenderness and pain scores were lowered among those who had gone through MBSR, but not in the comparison group.

    There were no differences, however, in objective measures of disease activity like C-reactive protein levels and number of swollen joints between the MBSR and comparison groups.

    The authors conclude that MBSR likely helped participants by changing their "experience" of the disease.

    "This pattern of effects is also consistent with evidence linking mindfulness training to improved pain regulation and well-established links between reduced pain and greater wellbeing among people with rheumatoid arthritis," the authors write.

    "I think it follows the line of so many studies that have been coming out about mindfulness-based stress reduction over the last 15 years. Literally hundreds of studies have come out," Kreitzer said.

    "Mindfulness is a way to slow down and be in the present moment and that's what mindfulness training is, so in a mindfulness class people focus on breathing and relaxation and that's sort of how they ease into a practice of meditation," she said.

    Kreiter said she thinks the study also demonstrates how important self-care and self-management approaches are. There's so much that people can do on their own," she said, adding that for many a sense of empowerment comes from being able to do something about their symptoms.

    MBSR classes are widely available at hospitals and privately, as well as through online programs (http://bit.ly/1vjU4kG), Kreiter said.

    "People can just check with local healthcare facilities or even use Google to see if there are any mindfulness programs in their communities," she said.

    SOURCE: http://bmj.co/1HEG0J5 Annals of the Rheumatic Diseases, online November 18, 2104.

  • Fat to blame for half a million cancers a year, WHO agency says

    By Kate Kelland

    LONDON (Reuters) - Some half a million cases of cancer a year are due to people being overweight or obese, and the problem is particularly acute in North America, the World Health Organization's cancer research agency said on Wednesday.

    In a study published in the journal The Lancet Oncology, the WHO's International Agency for Research on Cancer (IARC) said high body mass index (BMI) has now become a major cancer risk factor, responsible for some 3.6 percent, or 481,000, of new cancer cases in 2012.

    "The number of cancers linked to obesity and overweight is expected to rise globally along with economic development," said Christopher Wild, IARC's director.

    He said the findings underlined the importance of helping people maintain a healthy weight to reduce their risk of developing a wide range of cancers, and of helping developing countries avoid the problems currently faced by wealthier ones.

    The IARC study found that, for now, North America has by far the worst cancer problem linked to weight, with some 111,000 obesity-related cancers diagnosed in 2012, accounting for 23 percent of global cancer cases linked to high BMI.

    In Europe, obesity is to blame for around 6.5 percent of all new cancers a year, or around 65,000 cases.

    While in most Asian countries the proportion of fat-related cancers is smaller, it still translates into tens of thousands of cases because populations are so large, IARC said.

    In China, for example, about 50,000 cancer cases are associated with being too fat, accounting for 1.6 percent of new cancer cases.

    In Africa, on the other hand, obesity is to blame for only 1.5 percent of cancers.

    Having a high BMI increases the risk of developing cancers of the oesophagus, colon, rectum, kidney, pancreas, gallbladder, postmenopausal breast, ovary and endometrium. A BMI score of 25 or more is classed as overweight, while 30 or more is obese.

    Melina Arnold, who co-led the IARC study, noted that women are disproportionately affected by obesity-related cancers.

    For postmenopausal breast cancer, for example - the most common women's cancer worldwide - the findings suggest that 10 percent of cases could be prevented by not being overweight.

    SOURCE: http://reut.rs/1pneklY The Lancet Oncology, online November 26, 2014.