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

  • Florida jury awards record $23 billion against RJ Reynolds

    By Barbara Liston

    ORLANDO, Fla. (Reuters) - A Florida jury has awarded the widow of a chain smoker who died of lung cancer 18 years ago record punitive damages of more than $23 billion in her lawsuit against the R.J. Reynolds Tobacco Company, the nation's second-biggest cigarette maker.

    The judgment, returned on Friday night, was the largest in Florida history in a wrongful death lawsuit filed by a single plaintiff, according to Ryan Julison, a spokesman for the woman's lawyer, Chris Chestnut.

    Cynthia Robinson of the Florida Panhandle city of Pensacola sued the cigarette maker in 2008 over the death of her husband, Michael Johnson, claiming the company conspired to conceal the health dangers and addictive nature of its products.

    Johnson, a hotel shuttle bus driver who died of lung cancer in 1996 at age 36, smoked one to three packs a day for more than 20 years, starting at age 13, Chestnut said.

    "He couldn't quit. He was smoking the day he died," the lawyer told Reuters on Saturday.

    After a four-week trial and 11 hours of deliberations, the jury returned a verdict granting compensatory damages of $7.3 million to the widow and the couple's child, and $9.6 million to Johnson's son from a previous relationship.

    The same jury deliberated for another seven hours before awarding Robinson the additional sum of $23.6 billion in punitive damages, according to the verdict forms.

    Lawyers for the tobacco company, a unit of Reynolds American Inc whose brands include Camel, Kool, Winston and Pall Mall cigarettes, could not immediately be reached for comment.

    But J. Jeffery Raborn, vice president and assistant general counsel for R.J. Reynolds, said in a statement quoted by the New York Times that the company planned to challenge "this runaway verdict." Such industry appeals are often successful.

    Chestnut countered, "This wasn't a runaway jury, it was a courageous one."

    He said jurors appeared to have been swayed by evidence of the company's aggressive marketing of tobacco products, particularly promotions aimed at young people, and by its claims that it was Johnson's choice to smoke.

    "They lied to Congress, they lied to the public, they lied to smokers and tried to blamed the smoker," he said.

    Robinson's lawsuit originally was part of a large class-action litigation known as the "Engle case," filed in 1994 against tobacco companies.

    A jury in that case returned a verdict in 2000 in favor of the plaintiffs awarding $145 billion in punitive damages, which at the time was the largest such judgment in U.S. history.

    That award, however, was tossed out in 2006 by the Florida Supreme Court, which decertified the class, agreeing with a lower court that the group was too disparate and that each consumer had smoked for different reasons.

    But the court said the plaintiffs could file lawsuits individually. Robinson was one of them.

    The Florida high court also let stand the jury's findings that cigarettes are defective and cause disease, and that Big Tobacco was negligent, meaning those issues did not have to be re-litigated in future lawsuits.

    The U.S. Supreme Court last month declined to hear a series of tobacco company appeals, mainly from R.J. Reynolds, seeking to overturn Florida court judgments totaling more than $70 million.

  • Musicians On Call' bring music for the soul to patients' beds

    By Daniel Gaitan

    NEW YORK (Reuters Health) - Musicians On Call, a nonprofit providing live music to the seriously ill, hopes to aggressively expand to other major cities across the U.S. next year.

    For more than a decade, volunteer artists with Musicians On Call have given bedside performances to patients undergoing treatment or unable to leave their hospital beds.

    "It's a very tangible way to give back," Pete Griffin, president of Musicians On Call, told Reuters Health. "We are not music therapy, because that is its own medical profession. What we do is bring live music, and what a lot of research shows is that that does decrease patients' stress levels and lowers blood pressure." Family members may also benefit from seeing their loved ones enjoy a "moment of normalcy."

    Since 1999, Musician On Call volunteers have performed for more than 415,000 patients in hospitals, nursing homes and hospices - but only in a handful of states.

    Griffin said the organization hopes to aggressively grow throughout 2015 and expand beyond its seven "hubs" where most Music On Call programs are located: New York, Philadelphia, Baltimore, Washington, D.C., Miami, Nashville and Los Angeles.

    For hospitals without the bedside concert program, Musicians On Call provides a collection of albums.

    "We create 'music pharmacies.' We have supporters and record labels who donate CDs, and then hospitals go on our website and request a 'music pharmacy,' a box of 200 CDs and CD players for their patients to listen to," Griffin said. Nearly 800 hospitals have requested them.

    Dr. Melinda R. Ring, an assistant professor of clinical medicine at Northwestern University's Feinberg School of Medicine in Chicago, said she believes music helps provide the seriously ill a sense of peace.

    "Music touches us. Music has the ability to transform the mood that we're in, the way we're perceiving things," Ring told Reuters Health. "For somebody who has fears about death, pain or other end-of-life issues, listening to something that can bring them joy in the hospital doesn't necessarily change the outcome of what will happen, but it changes their experience."

    Loretta Downs, past president of the Chicago End-of-Life Care Coalition and a hospice volunteer, said she would like to see more medical centers supporting Musicians On Call.

    "Music is a form of reminiscence, and if a family member or a patient can request a song that brings back positive memories, it's a great thing," Downs told Reuters Health. "We want to remember the things that made us happy."

    Downs founded Chrysalis End-of-Life Inspirations, an effort aiming to equip hospitals and nursing homes with "Chrysalis Rooms," private spaces where seriously ill patients can gather with family and friends and listen to music, among other things.

    Many artists visiting hospitals through Musicians On Call find themselves playing requests for upbeat pop songs. Currently, the most popular request from young people is "Let It Go," the Oscar-winning anthem from the animated film "Frozen."

    "When we go into the children's hospitals, a lot of them know the Disney songs," Griffin added. "With the older populations, blues and classic rock are popular. Country music is popular around Nashville, rock in the Northeast."

    Singer and songwriter Kenli Mattus was one of the first artists to work with Musicians On Call.

    "I really enjoy giving patients what I think they want. For kids, I play nursery rhyme songs or make up songs on the spot, which they really like. When I play for adults, I play Frank Sinatra, soul or gospel." Mattus told Reuters Health. "When you go room-to-room and play for a handful of people, it's an incredible personal connection. It really inspires me and makes me feel like I'm doing something good for the world."

    Other notable artists who have performed with Musicians On Call include Pharrell Williams, Kelly Clarkson and Paulina Rubio.

  • HPV test better than Pap for assessing cervical cancer risk: study

    By Andrew M. Seaman

    NEW YORK (Reuters Health) - Testing for human papillomavirus (HPV) may be the best way to know whether a woman is at risk of developing cervical cancer in the near future, according to a new study.

    Negative HPV tests provided women with more reliable assurance that they wouldn't develop cancer or other abnormal cervical changes in the next three years, compared to traditional Pap tests, researchers report.

    "Primary HPV screening might be a viable alternative to Pap screening alone," said Julia Gage, the study's lead author from the National Institutes of Health's National Cancer Institute in Bethesda, Maryland.

    About 12,000 U.S. women were diagnosed with cervical cancer in 2010 and about 4,000 died from the disease, according to the Centers for Disease Control and Prevention. Roughly 91 percent of cervical cancers are thought to be caused by HPV.

    Pap smears, which require doctors to collect cells from the cervix to look for abnormalities, have traditionally been used to determine whether a woman is at risk of developing cancer in the near future.

    In 2012, the government-backed U.S. Preventive Services Task Force recommended women between ages 21 and 65 years be screened using a Pap test every three years and said those ages 30 to 65 years could instead opt for cotesting, which is a Pap test in combination with a HPV test, every five years.

    HPV is the most common sexually transmitted infection and affects both men and women. About 79 million people have the infection but most people don't know they're infected because symptoms are uncommon.

    HPV testing also requires doctors to collect cells like they would during a Pap test but the end result is whether the woman has the virus - not abnormal cells.

    "What we wanted to see is whether primary HPV screening could be a good alternative to Pap and compare it to cotesting," Gage said.

    For the new study, the researchers used data from over one million women who were between ages 30 and 64 years and screened for cervical cancer at Kaiser Permanente Northern California since 2003.

    The researchers followed women who had a negative Pap or HPV test to see whether they developed cervical cancer during the next three years. They also looked at how many women developed cervical cancer in the five years following cotesting.

    Overall, about 20 women out of 100,000 developed cervical cancer in the three years following a negative Pap test. That compared to 11 women out of 100,000 who developed the cancer during the three years after receiving a negative HPV test.

    About 14 women out of 100,000 developed cervical cancer in the five years following negative cotests, according to results published in the Journal of the National Cancer Institute.

    Gage said the findings were not surprising, since HPV is the cause of most cervical cancers.

    She cautioned that the results do not foreshadow the death of Pap smears. The tests may still have a role in monitoring whether women with HPV, who are at an increased risk of cancer, go on to develop abnormal cervical cells.

    "We always have to reconsider how we're screening patients and focus on the best way to screen for certain cancer," said Dr. Mario Leitao Jr., a gynecological surgeon at Memorial Sloan Kettering Cancer Center in New York City.

    "I think this is very interesting because instead of doing (Pap tests) every three years you could do HPV (tests) every three years," said Leitao, who was not involved with the new study.

    He said there will be a lot of variables in deciding which test is best for women.

    "The best way to do it is still to be determined but it's important they have some form of cervical cancer screening at least every three years," Leitao said.

    He added that women also have to be their own advocates and tell their doctors that they don't need Pap tests every year.

    "It shouldn't be done more frequently than every three years," he said.

    SOURCE: http://bit.ly/UckC33 Journal of the National Cancer Institute, online July 18, 2014.

  • Depression may keep some men from fighting prostate cancer

    By Shereen Lehman

    NEW YORK (Reuters Health) - Depression may be source of disparities in the treatment men get for prostate cancer, according to a new study.

    In the analysis, older men who were depressed before they got a prostate cancer diagnosis were more likely to have aggressive cancer, less likely to undergo the recommended treatment for their stage and type of disease and more likely to die.

    "We traditionally think of disparities in healthcare by race and socioeconomic status, but our research demonstrates that mental illness can also be a significant driver of treatment choice and outcomes in terms of prostate cancer," Dr. Jim Hu told Reuters Health in an email.

    Hu is director of robotic and minimally invasive surgery at the David Geffen School of Medicine at UCLA. He led the new study that was published in Journal of Clinical Oncology.

    According to the Centers for Disease Control and Prevention, almost 200,000 men were diagnosed with prostate cancer in the U.S. in 2010, and just under 30,000 men died from the disease that year.

    Past research has linked depression to a greater likelihood of getting less-aggressive treatment and to poorer survival in other cancers, including breast and liver cancers. But little is known about how depression might affect men's diagnosis and treatment for prostate cancer, Hu and his colleagues write.

    The researchers analyzed information from a large national database of Medicare patients, focusing on more than 40,000 men diagnosed with localized prostate cancer between 2004 and 2007 and observed through 2009.

    Of those, 1,894 men were also diagnosed with depression during the two years before their cancer was detected.

    "First, we found that men with prostate cancer who were older, lower income, with more medical (conditions), white or Hispanic (versus Black and Asian), unmarried, residing in nonmetropolitan areas were more likely to be depressed," Hu said.

    "In addition, depressed men were less likely to seek out definitive therapy (surgery or radiation) in contrast to non-depressed men," he said, which goes against the current guidelines for treating intermediate- and high-risk disease.

    After adjusting for differences in the men's tumor characteristics and the treatment they chose, the researchers found that depressed men had worse overall survival compared to men who were not depressed, Hu noted.

    Hu said he was surprised by the results because depressed men were more likely to see physicians in the two years before their prostate cancer diagnosis compared to non-depressed men - an average of 43 times versus 27 times, respectively.

    The team also found that depressed men were more likely to get so-called expectant management, which includes the use of hormones to decrease the aggressiveness of prostate cancer or no treatment at all, which is called "watchful waiting" or active surveillance.

    It's possible, Hu and his colleagues write, that depression makes men less interested in screening, leading to their cancers being diagnosed at a later stage, and makes them choose less aggressive treatment. The greater number of doctor visits might be focused on mental illness, leading to less attention toward cancer screening.

    These findings cannot prove there's a cause and effect at work, the authors caution. However, they suggest that physicians should take care to ensure prostate cancer patients are getting the mental health treatment they need so depression doesn't bias a patient's treatment choices and chances for survival.

    Dr. Behfar Ehdaie, a surgeon who specializes in prostate cancer at Memorial-Sloan Kettering Cancer Center in New York, said that mental health is an important aspect of prostate cancer care.

    Given the prevalence of depression in these men, survivorship in that light has been underreported in the literature, said Ehdaie, who was not involved in the study.

    "We know that men who are diagnosed with prostate cancer have an increased risk of suicide - this was shown in a Swedish study looking at men from Sweden," he told Reuters Health.

    "This adds more data from the United States, specifically looking at men age 67 and older, that also demonstrates that mental health should be assessed and be part of our prostate cancer care," he said.

    But Ehdaie emphasized that this study does not suggest the less aggressive approach of expectant management is associated with poor outcomes, or that depression increases the risk of dying from prostate cancer.

    "The endpoint evaluated is overall survival, and we do know that from previous studies, depression is associated with cardiovascular events, for example, which are also associated with increased risk of mortality," Ehdaie said.

    That distinction between deaths from prostate cancer or progression of the disease, and overall deaths from any cause is important, he added.

    Ehdaie said that future studies are needed to determine the impact of mental health issues on treatment decision making, especially in men with intermediate- or high-risk disease who appear not to be receiving the appropriate treatment.

    "As healthcare providers, we need to be aware of the greater risk for aggressive prostate cancer in depressed men," Hu said. "Additionally, depressed men may require special attention in light of the lower initiative to follow through with physician recommendations."

    Hu added that encouraging depressed men with prostate cancer to join prostate cancer support groups may help spur them to pursue recommended treatments.

    SOURCE: http://bit.ly/UdORwx Journal of Clinical Oncology, online July 7, 2014.