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

  • Heeding musicians, New Orleans moves to ban smoking in bars

    By Jonathan Kaminsky

    NEW ORLEANS (Reuters) - The New Orleans City Council voted on Thursday to ban smoking in the city's bars, a move supported by several prominent local musicians who said the issue was for them a matter of workplace health.

    Most large U.S. cities already have such restrictions in place, anti-smoking advocates said, though smoking is still permitted in bars in cities including Las Vegas, Atlanta and Miami, and across much of the southeastern United States.

    The measure initially proposed in New Orleans included a ban on smoking in many outdoor areas, including parks and at city-sponsored festivals, but council members removed those restrictions before their unanimous vote to bar people from lighting up in bars and casinos.

    Smoking has been banned in Louisiana restaurants since 2007.

    The measure, which has the support of New Orleans Mayor Mitch Landrieu, is expected to take effect in April.

    "In the same way that government is responsible to make sure that there are guards on dangerous machinery, we are responsible to protect the workers in our city, including the workers in bars and casinos," said Councilwoman Susan Guidry before casting her vote.

    The ban received backing from prominent local musicians, including Kermit Ruffins, Irvin Mayfield and Deacon John Moore. Some bar owners and the casino industry opposed it, warning that it will harm business.

    The ban also covers the use of e-cigarettes, angering those who view the metal tubes that heat liquid into an inhalable vapor as less harmful than traditional cigarettes, both to their users and to those inhaling their contents secondhand.

    It exempts existing hookah bars, cigar bars, and businesses catering specifically to e-cigarettes, known as vape shops.

  • California lawmakers introduce Oregon-style assisted suicide bill

    By Alex Dobuzinskis

    (Reuters) - California lawmakers introduced a bill on Wednesday to legalize assisted suicide in the most populous U.S. state, an effort tearfully welcomed by a woman whose daughter moved to Oregon last year to avail herself of a death-with-dignity law there.

    The bill proposed by two Democratic state senators is similar to the physician-assisted suicide statute approved by Oregon voters in 1994. As in Oregon, it would require a determination from two doctors that a patient has six months or less to live before a drug to hasten death could be prescribed.

    The California bill also would emulate Oregon's law by requiring a patient seeking life-ending medical assistance to present two separate requests to an attending physician and for two witnesses to attest to the patient's wish to die.

    Sponsors of the legislation were joined at a news conference in Sacramento by Debbie Ziegler, whose daughter, Brittany Maynard, moved from the San Francisco Bay Area to Portland, Oregon, after she was diagnosed with terminal brain cancer.

    Maynard, 29, became the face of the right-to-die movement as she shared her feelings about her impending death on the Internet and was featured on the cover of People magazine before she ended her life on Nov. 1.

    Maynard's death gave increased momentum to legalizing assisted suicide, which is opposed by some advocates for the elderly and the disabled. They say making that option available could lead vulnerable people to end their lives prematurely.

    Critics cite concerns that some patients might end up being "steered" toward assisted suicide if insurers deny or even delay coverage for costly life-sustaining medical treatments.

    Since Maynard went public with her diagnosis in October, lawmakers have pledged to introduce assisted suicide legislation in 13 states, according to the office of California Senator Bill Monning, who co-authored the bill in Sacramento. In addition to Oregon, such laws are on the books in Washington state, Vermont and Montana.

    "Stand up and make your voice heard, even if it shakes like mine. Please help me carry out my daughter's legacy," Ziegler said, adding that her daughter gained a measure of peace from knowing she could end her life on her own terms.

    She recalled taking an Alaska cruise with her daughter and gazing into tide pools.

    "For those minutes of time, she forgot that she was dying and she just lived," Ziegler said.

  • The smoke around e-cig science

    By Sara Ledwith

    LONDON (Reuters) - From Apple Pie to Bubbly Bubble Gum, Irish Car Bomb or Martian bar - from Mars!, the flavors of electronic cigarette offer something for every taste.

    Researchers have counted 7,764 varieties of "vape." That adds up to one of many challenges - from practical constraints to conflicts of interest - in working out how safe e-cigs are, and whether they help smokers quit.

    Most scientists agree e-cigs have potential as a stop-smoking aid. They can be used with or without nicotine and are free of the thousands of toxins in conventional cigarettes. But e-cigs also throw up some unusual obstacles.

    Drug firms usually test one treatment against another. With e-cigarettes, the huge variety of constantly evolving products means it would be prohibitively expensive to test every flavor and vaporizer.

    "E-cigs are really the first product I'm aware of that have challenged pharma in this way," said Chris Bullen, an associate professor at the University of Auckland and author of one of two randomized trials of e-cigs in a recent major review of the science. "I guess many alternative 'natural' products raise similar issues when they start to make health claims."

    E-cigarettes can look like ordinary smokes but are metal and plastic battery-powered gadgets that heat flavored liquids into a cloud which users suck in, then exhale as dense white plumes. Invented in their present form in China about a decade ago, e-cigarettes generated $4 billion to $5 billion in sales in 2014, according to Euromonitor, a market research firm.

    The gadgets themselves come in hundreds of brands and are constantly morphing, at the hands of both users and the small-scale distributors who sell them online.

    Because they are a strange hybrid between smoking - which kills nearly 6 million people a year - and stop-smoking medications, e-cigs rival both tobacco and pharma. Tobacco companies have responded to that threat by buying up e-cig businesses, and are now funding research. Pharma firms have kept their distance.

    The products have also opened a rift between researchers who see their goal as eliminating nicotine in all its forms, and others who believe it makes more sense to reduce the harm of smoking.

    "You've got people who've taken a position and they're looking at the evidence only in relation to the position they've got," David Sweanor, an e-cig enthusiast and law professor at the University of Ottawa, told an e-cigarette symposium in London in November.

    PHARMA BOWS OUT

    There are more than 2,000 papers on e-cigarettes in the scholarly journals covered by the Web of Science, a database. Of those in the highest impact journals, most have been funded by public bodies. Only a few contain original research; methodological problems or potential bias are common, scientists have found.

    Last month, in an attempt to clear matters up, Bullen and other scientists in Britain and New Zealand published their assessment of the most impartial studies. Known as a Cochrane Review - a study of the best science on a subject - it aimed to see if e-cigs can help people stop smoking.

    The review concluded that e-cigs may help smokers quit, and that there is little sign that they hurt users.

    But it found the evidence thin and data poor. Of almost 600 studies analyzed, only 13 published papers were up to the Cochrane standard. Just two were randomized controlled trials, the most rigorous test.

    Big Pharma is not helping. The pharmaceutical industry has backed efforts to restrict e-cigarettes and is not sponsoring a single current e-cigarette trial in the U.S. National Institutes of Health database.

    For drugs firms, smoking cessation is a small business, generating $2.4 billion in sales in 2013, according to Euromonitor. That's just a fraction of the $206 billion the industry generated in global consumer health products.

    "We've decided we're not going to play (in e-cigs)," GlaxoSmithKline Chief Executive Andrew Witty told Reuters. "We've consciously had a think about it but we're not going to play."

    VESTED INTEREST

    This leaves e-cigarette companies to fund their own research, giving rise to concerns over conflicts of interest.

    In 2010 one European e-cig distributor, Italian firm Arbi Group Srl, sponsored a significant body of work by a team at Catania University in Sicily. Catania researchers are among the most prolific, records in the Web of Science show; they conducted the second of the two randomized trials included in the Cochrane Review and are working on nine of the 48 trials on e-cigarettes logged with the U.S. National Institutes of Health (NIH).

    The Catania randomized trial took 300 smokers who did not intend to quit and found that, with or without nicotine, e-cigarettes cut cigarette consumption and helped some people stop completely, without significant adverse effects. That supported claims e-cigarettes had a role reducing the harm of smoking.

    "At the end of the day we were stuck accepting money from e-cigarette owners because there was no other way to carry out research," said Catania professor Riccardo Polosa, who designed the trial. He said he had also received funding from pharma.

    That, says Charlotta Pisinger, a Danish doctor who runs stop-smoking clinics, is a problem. Last October she published a review which found one in three e-cigarette studies had a conflict of interest because they were funded by e-cig manufacturers, pharma or tobacco, or a combination. She saw evidence of bias: "We must exercise the utmost caution in trusting their conclusions," she wrote.

    Experienced medical researchers say industry funding to test new products is the norm.

    "The majority of clinical research is sponsored by the manufacturers," said David Tovey, editor in chief of the Cochrane Library, which vets Cochrane Reviews. Another Cochrane study has found that scientific studies sponsored by private industry generally reported greater benefits and fewer harmful side effects than studies industry did not sponsor.

    "MORAL STANCE"

    E-cigarette opponents are also being scrutinized for bias.

    A 2014 U.S. review of the literature, carried out for the World Health Organization at the University of California, San Francisco (UCSF), said that the two randomized trials had shown e-cigarettes were no better than other nicotine replacement therapies at helping people quit.

    In August, the World Health Organization recommended that smokers should be encouraged to try already approved treatments, rather than e-cigs.

    Stanton Glantz, a veteran campaigner in the war against Big Tobacco and professor at UCSF, was one author of the U.S. review. But some researchers say activists like Glantz may have been prejudiced against e-cigarettes by their past battles with the tobacco industry.

    Robert West, a professor at University College London, is an e-cigarette enthusiast who has been funded by pharma, but not by e-cig makers. He says some opponents present themselves as unbiased, but "their professional and moral stance represents a substantial vested interest."

    Glantz says he started his review "completely agnostic."

    IMAGE MAKEOVER

    To add to the controversy, Big Tobacco is getting more deeply involved. E-cigarettes are a threat to the $722 billion retail sales of conventional cigarettes globally in 2013, but they are also an opportunity. Fewer people are smoking in the rich world. Shane MacGuill, senior tobacco analyst at Euromonitor, calls tobacco a "terminally sick" industry. E-cigarettes may offset the decline.

    Firms including Reynolds American Inc. and Imperial Tobacco Group PLC have sponsored seven of the e-cig trials in the NIH trials database.

    Tobacco executives mingled with researchers and anti-smoking activists at the London symposium last November. The conference was held at the Royal Society, an association of scientists whose fellows include around 80 Nobel Laureates. Beneath portraits of such illustrious figures as Stephen Hawking, delegates puffed on vaporizers.

    Some delegates said they found being in the same room as tobacco firms discomfiting. The industry's history of suppressing the truth about tobacco's risks still prompts some universities and academic journals to shun tobacco, and the World Health Organization is forbidden from collaborating with it.

    E-cigs are helping tobacco companies transform their image. Firms that for years denied tobacco's harms now emphasize that nicotine itself is not harmful, we just need safer ways to administer it. Some are stepping into smoking cessation: British American Tobacco already has a medical license for a medicinal nicotine inhaler. A Reynolds subsidiary sells nicotine gum.

    Big Tobacco has some support among those in public health who think it won't be necessary to eliminate nicotine, so we should reduce the harm of smoking. But as universities ban association with tobacco firms, it will become even harder for independent researchers to study vaping.

  • Ramping up e-cigarette voltage produces more formaldehyde -study

    By Toni Clarke

    WASHINGTON (Reuters) - People who smoke high-voltage e-cigarettes have greater exposure to formaldehyde, a suspected carcinogen, than those who keep the voltage low, according to a study published in the New England Journal of Medicine on Wednesday.

    The study, which critics say is misleading and lacks context, is the latest contribution to a debate on the safety of e-cigarettes that has so far has yielded little long-term data, though most experts believe they are less toxic than combustible cigarettes.

    Researchers from Portland State University took flavored nicotine liquid made by Halo Cigs, a private company, and tested it in a personal vaporizer from Innokin. The vaporizer allows consumers to adjust the voltage from 3.3V to 5.0V. The higher the voltage the greater the nicotine kick, but also the greater the amount of formaldehyde.

    E-cigarette liquids typically contain propylene glycol, which when heated is known to release formaldehyde gas. "Vaping" at high voltage also produced formaldehyde-containing compounds known as hemiacetals, the researchers found.

    Formaldehyde inhaled as a gas has been associated with an increased risk of leukemia and nasopharyngeal cancer, which affects the upper part of the throat behind the nose.

    It is not known exactly where formaldehyde contained in hemiacetals gets deposited in the body or whether it is similarly toxic, said James Pankow, one of the study's authors.

    "There has never been a cancer study with hemiacetals," Pankow said in an interview.

    Absent such a study, the authors estimated the formaldehyde-related cancer risk associated with e-cigarettes by extrapolating from data on formaldehyde in cigarettes.

    They concluded that the life-time risk of developing formaldehyde-related cancer at roughly 1 in 200 for high-voltage e-cigarettes versus 1 in 1,000 for cigarettes - at least five times higher. They found no increased risk for people vaping at a low voltage.

    Dr. Neal Benowitz, a nicotine expert at the University of California, San Francisco, said the study could prove useful to the U.S. Food and Drug Administration as it prepares to regulate e-cigarettes, potentially including limits on formaldehyde.

    But he questioned the legitimacy of comparing the effect of formaldehyde delivered in a cigarette to that delivered via hemiacetal, in droplet form, in an e-cigarette. The effect on organs could be entirely different, he said.

    Other critics said that in the real world most "vapers" do not push the voltage to the levels seen in the study as the taste would become unpalatable. They also noted that the overall health risk of conventional cigarettes, which contain 70,000 toxins in addition to formaldehyde, is far greater than any formaldehyde risk associated with e-cigarettes.

    "Lifelong smokers face a greater than 1 in 2 chance of dying from smoking-related diseases, including a roughly 1 in 10 chance of dying from lung cancer," said Jed Rose, director of the Center for Smoking Cessation at Duke University Medical Center.

    Pankow conceded that the study could have contained more context about overall relative risk, but said the authors "just wanted to get it out."

    They submitted it to the NEJM in the form of a letter, which a spokeswoman for the journal said was peer-reviewed. Pankow said letters tend to be less detailed than other studies.

    David Abrams, executive director of the Schroeder Institute for Tobacco Research and Policy Studies at the anti-tobacco group Legacy, said he was concerned the study would be taken out of context "in the worst possible way."

    For most vapers who use e-cigarettes as intended, he said, the findings show "there are non-detectable levels of formaldehyde ... which means people can use them to help them quit smoking lethal cigarettes."

    SOURCE: http://bit.ly/1wpbMAR NEJM, online January 21, 2015.

  • LGBT health concerns need special attention: experts

    By Andrew M. Seaman

    (Reuters Health) - Lesbian, gay, bisexual and transgender (LGBT) communities have their own specific needs when it comes to health and medicine, according to experts.

    Yet LGBT people often avoid seeking medical care because they're afraid they might face discrimination or that doctors might not understand their special health needs, said Barbara Warren, an expert on LGBT health and health policy, speaking at a discussion on LGBT health sponsored by the Thomson Reuters Pride At Work chapter in New York City on January 15.

    Or they may seek medical care, but not "come out" to their healthcare providers.

    Does it matter if healthcare providers know whether a patient is lesbian, gay, bisexual or transgender? Yes, said Warren, who is director of LGBT Programs and Policies in the Office of Diversity and Inclusion at Mount Sinai Health System in New York City.

    Warren said LGBT health concerns should be discussed for several reasons.

    First, people will have better health outcomes if they feel comfortable with their providers. Additionally, the LGBT community suffers from the stress of being a minority, which can impact people's health. And certain clinical issues are different in the LGBT community.

    For example, she said, members of the LGBT communities - especially lesbian and bisexual women - may be at an increased risk for some cancers and conditions if they don't get regular healthcare.

    "We do know that a percentage of LGBT people avoid and delay screening and care because of fear about or experience of stigma, discrimination or simply lack of knowledge about LGBT people and their health amongst providers," said Warren. "If you avoid or delay screening and care and you have an issue that may be precancerous, by the time you get into screening and care you're there because it has become acute and you already have a progressed disease."

    "All of those are factors that go into why it's important both for your providers to be trained and sensitive and to get it, and why it's important for you to come out to your providers as who you are and be as open as you can be," Warren said.

    She said the National LGBT Cancer Network advocates training providers to be sensitive in helping a person come out and to do all the screenings that are necessary.

    While estimates vary, a 2014 report from the Centers for Disease Control and Prevention (CDC) says about 97 percent of U.S. adults identify as straight, about 2 percent as gay or lesbian and about 1 percent as bisexual.

    The LGBT community also faces an increased burden of mental health concerns, including depression, anxiety and substance abuse - but this doesn't mean LGBT people are inherently mentally ill, Warren said.

    Instead, she said, LGBT mental health issues are largely related to the stresses of belonging to a minority group. "We can change that by changing the way the world perceives, treats and includes LGBT people."

    Kellan Baker, also speaking at the Thomson Reuters event, said there has been a lot of progress on U.S. policy issues regarding LGBT health.

    "We have seen an incredible explosion of initiatives that are inclusive of or focusing on LGBT communities from the federal government over the last five years," said Baker, a senior fellow with the LGBT Research and Communications Project at the Center for American Progress in Washington, D.C.

    He highlighted Healthy People 2020, which lists the nation's objectives on health and includes a topic area specific to LGBT health.

    Also, Baker said, the 2010 Affordable Care Act - better known as Obamacare - "has a lot to offer LGBT community members. One of the biggest things is simply the expansion of health insurance coverage."

    Baker said access to coverage ties into many of the topics Warren mentioned, such as getting screened for certain conditions and seeing a healthcare provider on a regular basis.

    However, more work is needed to connect LGBT people with the information they need to get health insurance and access to healthcare, he said.