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

  • U.S. officials considering quarantines for returning healthcare workers

    By Laila Kearney and Sebastien Malo

    NEW YORK (Reuters) - The Obama administration is considering quarantines for healthcare workers returning from Ebola-ravaged West African countries, an official said on Friday, as authorities in New York retraced the steps of a doctor with the disease.

    In Washington, President Barack Obama hugged a Dallas nurse who survived Ebola after catching it from a patient.

    Quarantining healthcare workers returning to the United States from the Ebola "hot zone" was one of a number of options being discussed by officials from across the administration, Tom Skinner, a spokesman for the Centers for Disease Control and Prevention (CDC), told Reuters.

    The CDC-led discussions began on Thursday after Dr. Craig Spencer tested positive for the disease that day after returning to New York from West Africa.

    Spencer, 33, a New Yorker who spent a month with the humanitarian group Doctors Without Borders working with Ebola patients in Guinea, was the fourth person diagnosed with the virus in the United States and the first in its largest city.

    He was awake and talking to family and friends on a cellphone and was listed in stable condition in Bellevue Hospital's isolation unit, said Dr. Mary Travis Bassett, New York's health commissioner. The CDC confirmed the diagnosis on Friday.

    Officials urged New Yorkers not to worry. Obama's embrace in the White House Oval Office with nurse Nina Pham, who was declared Ebola-free on Friday, seemed to underscore the message that the disease's threat was limited.

    Pham, one of two nurses from a Dallas hospital infected with Ebola after treating the first patient diagnosed with the disease in the United States, walked out smiling and unassisted from the Bethesda, Maryland hospital where she had been treated.

    Emory University Hospital in Atlanta and the CDC also confirmed that the other nurse, Amber Vinson, no longer had detectable levels of virus but did not set a date for her to leave that facility.

    Spencer finished his work in Guinea on Oct. 12 and arrived at John F. Kennedy International Airport in New York on Oct. 17.

    Six days later, he was quarantined at Bellevue Hospital with Ebola, unnerving financial markets amid concern the virus may spread in the city. The three previous cases diagnosed in the United States were in Dallas.

    New York City Mayor Bill de Blasio said city health department detectives were retracing all the steps taken by Spencer, but said the doctor poses no threat to others and urged New Yorkers to stick with their daily routines.

    "We are, as always, looking at each individual contact," he said.

    Health officials emphasized that the virus is not airborne but is spread through direct contact with bodily fluids from an infected person who is showing symptoms.

    Three people who had close contact with Spencer were quarantined for observation. The doctor's fiancée was among them and was isolated at the same hospital, and all three were still healthy, officials said.

    U.S. stock markets shook off Ebola fears on Friday after paring gains late on Thursday following initial reports about Spencer's case.

    The worst Ebola outbreak on record has killed at least 4,877 people and perhaps as many as 15,000, predominantly in Liberia, Sierra Leone and Guinea, according to the World Health Organization (WHO).

    Spencer's case brought to nine the total number of people treated for Ebola in U.S. hospitals since August. Just two, the nurses who treated Liberian national Thomas Eric Duncan, contracted the virus in the United States. Duncan died on Oct. 8 at Texas Health Presbyterian Hospital in Dallas, where Pham and Vinson were infected.

    Officials told New Yorkers they were safe even though Spencer had ridden subways, taken a cab and visited a bowling alley in Brooklyn between his return from Guinea and the onset of symptoms. Authorities on Friday declared the bowling alley safe.

    New York state Governor Andrew Cuomo said that unlike in Dallas, where the two hospital nurses treating Duncan contracted the disease, New York officials had time to thoroughly prepare and drill for the possibility of a case emerging in the city.

    "From a public health point of view, I feel confident that we're doing everything that we should be doing, and we have the situation under control," Cuomo said.

    LEAVING THE HOSPITAL

    Pham, who was transferred to the U.S. National Institutes of Health Clinical Center in Bethesda, Maryland, from the Dallas hospital on Oct. 16, appeared at a news briefing and thanked her doctors.

    Looking fit in a dark blazer and a turquoise blouse, Pham said that even though she no longer is infected, "I know that it may be a while before I have my strength back." She said she looked forward to seeing her family and her dog.

    White House spokesman Josh Earnest said Obama brought Pham in for a meeting to recognize her for doing her job at the Dallas hospital. Earnest said, "I think this also should be a pretty apt reminder that we do have the best medical infrastructure in the world."

    Photographs of the meeting showed Obama hugging Pham. Reporters and television cameras were not allowed in for the meeting.

    Dr. Anthony Fauci, director of the NIH's National Institute of Allergy and Infectious Diseases, said he could not pinpoint any one factor that contributed to Pham's speedy recovery. He said it could be any of a number of factors, including the fact that "she's young and very healthy" and was able to get intensive care very quickly.

    Pham received donated blood plasma from Dr. Kent Brantly, who contracted Ebola working in Liberia for a Christian relief group and survived after being treated with an experimental drug. Brantly was released from a hospital in August.

    It is believed that antibodies that fight the virus in the blood of Ebola survivors can help other patients fight it, too. Pham made a point of thanking Brantly upon her release.

    Cuomo said Spencer checked into the hospital when he realized he had a temperature of 100.3 degrees Fahrenheit, suggesting he may have caught the onset of symptoms early.

  • Two doctor visits a year linked to better blood pressure control

    By Shereen Lehman

    NEW YORK (Reuters Health) - People who went to their doctor's office at least twice a year were more likely to keep their blood pressure under control compared to those who went once a year or not at all, says a new study.

    Having health insurance and following treatment for high cholesterol were also linked to better blood pressure control.

    "Folks that go to the doctor at least twice a year are more likely to be aware of their blood pressure, more likely to be treated, more likely to be controlled when treated and have significantly better control rates," Dr. Brent Egan, who led the study, told Reuters Health.

    "People with uncontrolled high blood pressure have a greater risk for having a stroke, having a heart attack, having heart failure and even memory loss without having a stroke," said Egan, of University of South Carolina School of Medicine in Greenville.

    He added that most people may not be aware of the fact that memory loss with aging is greater in people who have high blood pressure that's uncontrolled.

    "So there are number of reasons why it's a good thing to get the blood pressure control," said Egan, who is also medical director of the non-profit Care Coordination Institute.

    About one of every three Americans has high blood pressure, which is defined as having a reading above 140/90 mmHg. Only about half of adults with high blood pressure have it under control, the study team writes in the journal Circulation.

    A national health promotion and disease prevention initiative called Healthy Living 2020 established goals to reduce the rate of high blood pressure in the U.S. from 30 percent of all adults to 27 percent, and to increase the rate of blood pressure control to greater than 60 percent of people with high blood pressure.

    Egan and his colleagues designed the study to see how those goals are coming along. They looked at data on participants in the annual National Health and Nutrition Examination Survey who had their blood pressure checked during the period from 1999 to 2012.

    The researchers found that people who were obese, didn't have insurance and didn't see their doctors were more likely to have untreated high blood pressure.

    Egan and his team also examined what factors were associated with good blood pressure control.

    "One of the things we were looking at in this analysis was some of the modifiable variables that might, if we paid more attention to them, might help move us towards the goal," Egan said.

    The study team discovered that people who saw their doctors at least two times a year were more than three times more likely to get their blood pressure under control as those who saw a doctor less often.

    People with health insurance were about 70 percent more likely than those without it to have their blood pressure controlled.

    In addition, people who had high blood pressure and were being treated for high cholesterol were almost twice as likely to have their blood pressure under control.

    "Many people, in fact the majority of people with high blood pressure, also have a cholesterol problem," Egan said. "What our data shows is that if they're also being treated for the cholesterol they're more likely to get their blood pressure under control."

    Egan said that when doctors control both high blood pressure and cholesterol, "we reduce heart disease and stroke by about 60 percent; if we treat only one we reduce it by about 30 percent, so it's a really good idea to get both treated."

    Egan also said he thinks the Healthy Americans 2020 target of 61.2 percent, or a little over three out of every five people, with high blood pressure being controlled is an excellent goal.

    "Right now we're 10 percent below the goal and it looks like we've pretty much stabilized for the last six to seven years, and so it's clearly going to require some new efforts to get another round of progress," Egan said

    "It's sort of what we've known for years, that about a third of Americans are hypertensive and hypertension correlates with obesity," Dr. Ronald Wharton told Reuters Health.

    "Patients who tend to go to the doctor more are going to be in tune with their health and be more likely to take their health seriously," said Wharton, a cardiologist with Montefiore Medical Center in New York who wasn't involved in the study.

    Wharton said that obesity, cholesterol problems, hypertension and diabetes are not "independent parameters" - they're all interrelated.

    "When people take care of one problem, they're really taking care of multiple problems at the same time," Wharton said.

    But, "the data says we've come a long way and we've got a long way to go," Wharton added.

    "What we're facing in healthcare with obesity and hypertension, diabetes and all the ramifications is going to put an expense on the healthcare system that's going to make smoking-related illnesses look like a drop of sand on the beach," Wharton said.

    Egan said that cardiovascular disease is projected to increase healthcare costs tremendously over the next 15 years or so, roughly doubling the current cost.

    "Treating hypertension certainly is one of the ways to reduce that health burden," he said.

    SOURCE: http://bit.ly/1t48i9Y Circulation, online October 20, 2014.

  • REFILE-Giving pricey hepatitis drug to prisoners may be financially wise

    (Revises para 23 to clarify quote.)

    By Andrew M. Seaman

    NEW YORK (Reuters Health) - When prisoners have hepatitis C, treating them with expensive new antiviral drugs makes fiscal sense despite the hefty pricetag, according to a new study.

    Based on computer models, new pricey drug combinations that treat hepatitis C infections were more cost-effective than older drug combinations and no treatment at all, researchers found.

    "Essentially what our model does is follow a hypothetical cohort of prisoners that looks like a prison population in the U.S.," Jeremy Goldhaber-Fiebert told Reuters Health.

    "It allows us to ask a variety of 'what-if' questions and probe how sensitive our findings are to various factors," said Goldhaber-Fiebert, the study's senior author from Stanford University in California.

    Hepatitis C is a viral infection of the liver that is typically transmitted when the blood of an infected person enters the body of a healthy person. (Most commonly, this happens when people share needles, syringes, or other equipment to inject drugs - but before 1992 hepatitis C was also transmitted by blood transfusions.)

    When people are first infected, the symptoms can include fever, nausea, stomach and joint pain, dark urine, vomiting and a yellowing of the skin and eyes.

    If left untreated, hepatitis C can slowly, over years or decades, lead to liver damage, liver failure, liver cancer, and a need for liver transplant, according to the Centers for Disease Control and Prevention (CDC). It may also lead to death.

    The CDC says about 3.2 million people in the U.S. are infected with the chronic disease. Goldhaber-Fiebert and his colleagues write in Annals of Internal Medicine that about 500,000 incarcerated people have hepatitis C.

    Until recently, the virus was treated with a combination of drugs that had to be taken for about a year and caused people to have flu-like symptoms. The treatment was only effective in a minority of patients.

    The U.S. Food and Drug Administration (FDA) approved Merck's Victrelis, which is known generically as boceprevir, in 2011 to be added to the existing combination of drugs. The new combination made the treatment more effective - and more expensive (see Reuters story of May 13, 2011 here: http://reut.rs/1yg9GGm).

    Then, the FDA approved Gilead's Sovaldi, which is known generically as sofosbuvir, in 2013. The drug is taken for 12 weeks and cures a majority of patients but comes with a price tag of $84,000 (see Reuters story of December 6, 2013 here: http://reut.rs/1ygcAuT).

    Insurers have pushed back against the price of the new medication (see Reuters story of May 20, 2014 here: http://reut.rs/1ygfGPx).

    To examine benefits and costs associated with hepatitis C treatment among the U.S. prison population, the researchers used a computer model. They compared prisoners who received 12 weeks of Sovaldi plus the original drug combination, prisoners who received 28 weeks of Victrelis plus the original drug combination and prisoners who did not receive treatment.

    They examined costs of treatment in terms of quality-adjusted life years (QALY), which is the amount of time in good health that inmates could gain from the treatment.

    Overall, they found the combination of Sovaldi and the original drugs added 2.1 QALYs at a cost of about $54,000, compared to no treatment.

    The combination including Sovaldi cost about $25,700 per QALY gained among prisoners serving short sentences and about $28,800 per QALY gained among those serving long sentences. The difference in cost can be partially attributed to various factors, including the increased risk of reinfection among people still in prison, Goldhaber-Fiebert said.

    In either case, he and his colleagues found Sovaldi combination of drugs to be less expensive per QALY than the Victrelis combination.

    However, there are other challenges when choosing a hepatitis C treatment for prisoners, the researchers write.

    For example, treating U.S. prisoners infected with hepatitis C with the Sovaldi combination may come at an upfront cost exceeding $30 billion to the prison systems. The cost benefits may not be realized until the prisoners are released on another healthcare system like Medicaid, which is government-run insurance for the poor.

    "Most people in will be out," said Dr. Anne Spaulding. "We're looking at a disease that will take 30 years to progress. A lot of hepatitis C that we're not treating in the prison will end up being very costly not just for patients who are on Medicaid, but patients who do not have Medicaid who present to emergency rooms. Someone will have to pay."

    Spaulding, who wasn't involved with the new study, is an expert on hepatitis C infections among U.S. prisoners. She's an assistant professor at Emory University's Rollins School of Public Health in Atlanta.

    The U.S. Federal Bureau of Prisons currently recommends Sovaldi for many prisoners with hepatitis C infections.

    "I think the key message would be to those who control state budgets," said Spaulding. "There are benefits to considering the health of people returning to the community. There are benefits to treating hepatitis C while they're incarcerated."

    "The group that can have the most affect on increasing the new infections of hepatitis C is actually the injection drug users," she said. "If you can get rid of the hepatitis C while they're in prison, they can't spread hepatitis C when they're in the community."

    "It's a message that needs to go to the decision makers who control the purse strings," she said, adding that this is especially true for people who control state budgets.

    Goldhaber-Fiebert said prisons and jails in the U.S. should give careful consideration to the hepatitis C treatment for the population that they provide services to.

    "High-cost treatments can also be high-value if they deliver substantial enough value," he said.

    SOURCE: http://bit.ly/1zjAkCK Annals of Internal Medicine, online October 20, 2014.

  • REFILE-Giving pricey hepatitis drug to prisoners may be financially wise

    (Revises para 23 to clarify quote.)

    By Andrew M. Seaman

    NEW YORK (Reuters Health) - When prisoners have hepatitis C, treating them with expensive new antiviral drugs makes fiscal sense despite the hefty pricetag, according to a new study.

    Based on computer models, new pricey drug combinations that treat hepatitis C infections were more cost-effective than older drug combinations and no treatment at all, researchers found.

    "Essentially what our model does is follow a hypothetical cohort of prisoners that looks like a prison population in the U.S.," Jeremy Goldhaber-Fiebert told Reuters Health.

    "It allows us to ask a variety of 'what-if' questions and probe how sensitive our findings are to various factors," said Goldhaber-Fiebert, the study's senior author from Stanford University in California.

    Hepatitis C is a viral infection of the liver that is typically transmitted when the blood of an infected person enters the body of a healthy person. (Most commonly, this happens when people share needles, syringes, or other equipment to inject drugs - but before 1992 hepatitis C was also transmitted by blood transfusions.)

    When people are first infected, the symptoms can include fever, nausea, stomach and joint pain, dark urine, vomiting and a yellowing of the skin and eyes.

    If left untreated, hepatitis C can slowly, over years or decades, lead to liver damage, liver failure, liver cancer, and a need for liver transplant, according to the Centers for Disease Control and Prevention (CDC). It may also lead to death.

    The CDC says about 3.2 million people in the U.S. are infected with the chronic disease. Goldhaber-Fiebert and his colleagues write in Annals of Internal Medicine that about 500,000 incarcerated people have hepatitis C.

    Until recently, the virus was treated with a combination of drugs that had to be taken for about a year and caused people to have flu-like symptoms. The treatment was only effective in a minority of patients.

    The U.S. Food and Drug Administration (FDA) approved Merck's Victrelis, which is known generically as boceprevir, in 2011 to be added to the existing combination of drugs. The new combination made the treatment more effective - and more expensive (see Reuters story of May 13, 2011 here: http://reut.rs/1yg9GGm).

    Then, the FDA approved Gilead's Sovaldi, which is known generically as sofosbuvir, in 2013. The drug is taken for 12 weeks and cures a majority of patients but comes with a price tag of $84,000 (see Reuters story of December 6, 2013 here: http://reut.rs/1ygcAuT).

    Insurers have pushed back against the price of the new medication (see Reuters story of May 20, 2014 here: http://reut.rs/1ygfGPx).

    To examine benefits and costs associated with hepatitis C treatment among the U.S. prison population, the researchers used a computer model. They compared prisoners who received 12 weeks of Sovaldi plus the original drug combination, prisoners who received 28 weeks of Victrelis plus the original drug combination and prisoners who did not receive treatment.

    They examined costs of treatment in terms of quality-adjusted life years (QALY), which is the amount of time in good health that inmates could gain from the treatment.

    Overall, they found the combination of Sovaldi and the original drugs added 2.1 QALYs at a cost of about $54,000, compared to no treatment.

    The combination including Sovaldi cost about $25,700 per QALY gained among prisoners serving short sentences and about $28,800 per QALY gained among those serving long sentences. The difference in cost can be partially attributed to various factors, including the increased risk of reinfection among people still in prison, Goldhaber-Fiebert said.

    In either case, he and his colleagues found Sovaldi combination of drugs to be less expensive per QALY than the Victrelis combination.

    However, there are other challenges when choosing a hepatitis C treatment for prisoners, the researchers write.

    For example, treating U.S. prisoners infected with hepatitis C with the Sovaldi combination may come at an upfront cost exceeding $30 billion to the prison systems. The cost benefits may not be realized until the prisoners are released on another healthcare system like Medicaid, which is government-run insurance for the poor.

    "Most people in will be out," said Dr. Anne Spaulding. "We're looking at a disease that will take 30 years to progress. A lot of hepatitis C that we're not treating in the prison will end up being very costly not just for patients who are on Medicaid, but patients who do not have Medicaid who present to emergency rooms. Someone will have to pay."

    Spaulding, who wasn't involved with the new study, is an expert on hepatitis C infections among U.S. prisoners. She's an assistant professor at Emory University's Rollins School of Public Health in Atlanta.

    The U.S. Federal Bureau of Prisons currently recommends Sovaldi for many prisoners with hepatitis C infections.

    "I think the key message would be to those who control state budgets," said Spaulding. "There are benefits to considering the health of people returning to the community. There are benefits to treating hepatitis C while they're incarcerated."

    "The group that can have the most affect on increasing the new infections of hepatitis C is actually the injection drug users," she said. "If you can get rid of the hepatitis C while they're in prison, they can't spread hepatitis C when they're in the community."

    "It's a message that needs to go to the decision makers who control the purse strings," she said, adding that this is especially true for people who control state budgets.

    Goldhaber-Fiebert said prisons and jails in the U.S. should give careful consideration to the hepatitis C treatment for the population that they provide services to.

    "High-cost treatments can also be high-value if they deliver substantial enough value," he said.

    SOURCE: http://bit.ly/1zjAkCK Annals of Internal Medicine, online October 20, 2014.

  • Petition calls on Roche to cut breast cancer drug price

    By Reuters Staff

    LONDON (Reuters) - A British-led petition signed by 29,000 people has demanded that Switzerland's Roche, the world's biggest maker of cancer medicines, cut the price of its expensive new breast cancer drug Kadcyla.

    The campaign shows the growing pressure on drug companies as a raft of promising new cancer treatments reach the market. U.S. insurers also say they are alarmed by a coming flood of cancer medicines with "astronomical price tags," while pricing rows have flared in France and Italy.

    Kadcyla can add about half a year to the lives of some women with inoperable breast cancer but Britain's cost watchdog NICE estimates it costs about 90,000 pounds ($145,000) per patient and is too pricey for the state-run health service.

    Roche argues the cost reflects the benefits offered by its innovative treatment. It also disputes the headline price cited by the National Institute for Health and Care Excellence (NICE).

    NICE bases its calculation on a mean treatment course of 14.5 months, whereas the median length of treatment in clinical trials -- the measure Roche believes is more relevant -- was 9.6 months, reducing the cost per patient significantly.

    The Care2 petition, calling on Roche Chief Executive Severin Schwan to reduce the price of Kadcyla to a level public health services can afford, was started by British breast cancer survivor Margaret Connolly.

    Kadcyla combines the antibody used in Roche's established Herceptin drug and a tumor-killing payload that is delivered directly into cancer cells, causing fewer chemotherapy-related side effects such as hair loss.

    It is one of a number of targeted therapies that are revolutionizing cancer care. Other promising new approaches include a range of drugs to help the immune system fight cancer, which also carry a high price.