Mark Sides, MD, PhD, joined Tulane's faculty in July and is building a comprehensive Thoracic Oncology Program here that offers the full spectrum of multidisciplinary care for lung cancer patients, from early detection to innovative research to genetic testing and targeted therapies.
A Highly-Skilled, Excellently Trained Clinical Team
"Caring for cancer patients is a team sport," said Dr. Sides. "This is especially true with lung cancer. And here at Tulane, we've assembled an extremely strong and focused thoracic oncology team. From radiology to interventional pulmonology to radiation oncology, we have highly skilled and excellently trained people in place, all within the Tulane network."
As a medical oncologist who exclusively treats lung cancer patients, Dr. Sides is a unique and pivotal member of this team. Prior to his arrival -- a homecoming, as Dr. Sides completed his PhD, postdoctoral training and received his MD here at Tulane -- our lung cancer patients were treated by one of our general medical oncologists.
"They offered excellent care; they just weren't exclusively focused on lung cancer," said Sides. "The benefit of our new program is that I am dedicated ONLY to thoracic oncology patients. And because I'm an academic physician, I have a limited patient panel. I see fewer patients and so I spend more time with them and they have better access to me than a clinical practice physician in the community who might see four or five times as many patients a week. Hopefully that translates into more personalized, focused and higher-quality care."
The Benefits of Academic Lung Cancer Care
As an academic cancer center, Tulane offers other benefits as well, according to Dr. Sides. "Typically, academic centers are considered 'first choice, last resort' options for patients. First choice because you get the benefit of cutting-edge care from professionals on the front lines in terms of research and treatment. Patients come here because we ARE Tulane. We have ongoing research and access to knowledge and treatment options other community practices may not be aware of yet. Last resort because let's say a patient who has been treated by a community oncologist has progression of their disease. Now they need to come to Tulane because we offer access to clinical trials or the latest in targeted or immunotherapies -- options often not offered elsewhere."
Tulane's Low-Dose CT Lung Screening Saves Lives
According to the American Cancer Society, lung cancer (both small cell and non-small cell) is the second most common cancer in both men and women, and is by far the leading cause of cancer death, accounting for almost 25% of all cancer deaths. Each year, more people die of lung cancer than of colon, breast, and prostate cancers combined.
On a positive note, lung cancer incidence and mortality continue to decrease, partly because more people have given up smoking, but also because of advances in early detection and treatment.
Low-dose CT lung cancer screenings -- now offered at Tulane Lakeside -- can help detect lung cancers at their earliest stages, when they are most treatable.
"The earlier you find the cancer, the better the prognosis," said Dr. Sides. "This screening can save your life. Five-year survival rates go down dramatically with each stage of the disease. If we can catch stage 1 -- when lung cancer is typically asymptomatic -- then it's a surgical issue. The surgeon goes in, removes the tumor and the patient is cured."
Patients at high risk for lung cancer who may benefit from CT screening:
Radiation exposure from low-dose CT is slightly more than an x-ray but less than 10% of the radiation from a standard CT scan. "Anything actionable will be picked up with much less radiation," said Dr. Sides. "If a detected lesion is below a certain size, we simply watch it, do serial screenings, and if it doesn't change, it doesn't change. It's very unlikely it's cancer."
But if it is, it's the location more than the size of the mass that matters, according to Dr. Sides. "You can have a lot of cancer in an area that doesn't cause a problem or a little bit of cancer in an area that causes a big problem and it will get picked up easily with low-dose CT, before it has a chance to move out of the lung."
Research Into Adverse Outcomes From Immunotherapy
As a physician scientist, Dr. Sides is also very involved in lung cancer research. One of his major interests is to better understand adverse outcomes from lung cancer immunotherapies. He is currently working with Tulane's Hayward Genetics Center to identify patients who may be more genetically susceptible to these complications.
"Chemotherapy targets and attacks all rapidly dividing cells, including immune system cells," said Dr. Sides. "Therefore, chemo actually reduces our immune response. Immunotherapies, on the other hand, sensitize our bodies to cancer and ramp up our immune response, allowing it to identify and attack tumor cells. These are great treatments and the vast majority of patients receiving immunotherapies have terrific benefit for several years."
The problem is that when you ramp up the immune system, it can overwork and cause adverse reactions in some patients, and these can be severe. The complication that most concerns Dr. Sides is autoimmune pneumonitis. "Less than 5% of immunotherapy patients will experience this complication, but the mortality rate can be as high as 50%," he said.
It starts out as a little shortness of breath and a cough that develops between 12 and 15 weeks after immunotherapy treatment begins, when patients are on cruise control and don't think the symptoms are related to their therapy. "We're often unaware it's even happening until the patient ends up in the ER unable to breathe," said Dr. Sides.
Because of this, he wants to find biomarkers that will help to identify which patients are more at risk for autoimmune pneumonitis so that physicians can monitor them much more closely. "If we catch it early, steroids can be given to turn down the immune system for a short time until everything resolves and then the patient can resume therapy again."
Targeted Therapies Most Exciting Developments on the Horizon in Lung Cancer Treatment
"If you equate the treatment of cancer as a war on that cancer, then the first and most important step is to know your enemy," said Dr. Sides. "That's where targeted therapies come in."
Over the last five months, there have been three drugs approved as targeted therapies for lung cancer - treatments aimed at the specific genetic mutations in an individual's tumor - and these are the most exciting developments on the lung cancer treatment horizon, according to Dr. Sides.
Tulane's Thoracic Oncology Program can offer these personalized treatment options. "Of course, genetic testing is essential," said Dr. Sides. "I can't give the proper therapy to my patients without it. I've got to use the right tools." Sides equates it as using a power drill rather than a butter knife or a screwdriver to turn a screw.
Once the genetic mutation is identified and the targeted therapy begins, the average patient can remain on maintenance treatment for two to two and a half years before disease progression. "Then we can switch to something else," said Dr. Sides.
"The question I've had more and more from fellow clinicians is 'what do we do after the two years.' I asked one 'where is the burden of disease' and he told me 'we can't find it.' This was a stage IV metastatic lung cancer termed incurable and now we have NED - no evidence of disease. This is the type of reaction we're getting with these new targeted therapies, and as we continue to identify mutations that cause lung cancer, we can come up with additional targeted therapies to address them."
Make An Appointment
Dr. Sides sees patients on Tuesdays and Thursdays at Tulane Comprehensive Cancer Clinic, 150 S. Liberty St., New Orleans. To make an appointment, please call 504-988-6300.
If you are interested in a low-dose CT screening, please call Tulane Lakeside Radiology scheduling at 504-988-1200 or have your doctor call with a referral.
Tony Hu is the Weatherhead Presidential Chair in Biotechnology Innovation at Tulane University School of Medicine. (Story by Carolyn Scofield; photo by Sally Asher)
Non-small cell lung cancer (NSCLC) is the most commonly diagnosed cancer, and the leading cause of cancer death worldwide. More than half of NSCLC patients die after developing metastases. There are no tests currently that would allow doctors to identify patients where more aggressive therapy could reduce mortality. Researchers at Tulane University have identified a protein on tumor-derived extracellular vesicles that indicates if a NSCLC tumor is likely to metastasize, according to a study in Science Advances.
The protein could be used as a biomarker to develop a rapid, minimally invasive test to catch these cancers early when they are more treatable, said study author Tony Hu, PhD, Weatherhead Presidential Chair in Biotechnology Innovation at Tulane University School of Medicine.
“The goal of any cancer diagnosis and treatment is to catch it early,” said Hu. “This information could help diagnose patients who are at high risk for having their cancer metastasize, and treatment could be tailored to account for that. Not all patients have the same type of tumor, and if you can target therapy to address a particular tumor, you can improve outcomes.”
Most patients with NCSLC aren’t diagnosed until their primary tumor has metastasized to other parts of the body. However, even patients diagnosed with non-metastatic NSCLC tumors of the same stage can often have very different treatment outcomes. A marker that could identify which patients are likely to develop metastatic NSCLC would aid in selecting those patients who should receive different treatment approaches to reduce their risk of metastasis and improve odds for long-term survival. However, no biomarkers identified to date have adequate sensitivity, specificity or reproducibility for this purpose, and most require tumor samples that require invasive procedures that are not suitable for repeated analyses.
All cells shed extracellular vesicles, small membrane particles that carry proteins, RNA and other molecules. These vesicles can bind to and transfer their contents to specific cell types to change the behavior of these cells. Extracellular vesicles shed by cancer cells can alter the environment of both adjacent and distant cells to establish metastatic niches that promote the invasion and growth of circulating tumor cells. Study researchers evaluated proteins carried by extracellular vesicles shed by NSCLC cells to determine which might serve as markers for metastatic NSCLC cells. Hu and his team identified a protein that was highly expressed on extracellular vesicles of metastatic but not nonmetastatic NSCLC cells. This could predict which NSCLC patients were at increased risk for metastasis when its expression was analyzed on extracellular vesicles isolated from their blood.
The next goal of Hu’s team is to incorporate the biomarker profiling with their well-developed nanoplasmonic detection assay for a rapid clinical translation.
Tulane University School of Medicine and the Association for Community Cancer Centers (ACCC) is hosting Optimizing Outcomes for Patients with Urothelial Carcinoma, a virtual workshop for healthcare providers, on Saturday, November 14, 8 AM - Noon CST.
The workshop will feature presentations by Tulane physicians Erik Castle, MD, professor of urology, and Pedro Barata, MD, MSc, assistant professor of medicine.
Medical oncologists, urologic oncologists, urologists, advanced practice providers (nurse practitioners, physician assistants, oncology pharmacists), oncology nurses, and other healthcare professionals involved in treating patients with urothelial carcinoma are encouraged to attend.
CME, CNE, and MOS credits are available.
At the end of this educational initiative, participants should be able to:
Registration is FREE! To RSVP, please contact Greg Clouatre at 504-988-5839 or firstname.lastname@example.org.
For more information on the workshop, please visit: https://www.accc-cancer.org/projects/urothelial-carcinoma-in-the-community/live-workshop
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We are deeply thankful to our previous NOLA Bluedoo sponsors, as well as the donors listed above, who have chosen to continue their support of Tulane's Prostate Cancer Research Fund this year, despite the event's cancellation.
Research funds are still urgently needed to assist in the search for new treatment options. We ask that you join these generous donors by making a tax-deductible donation today! Every penny donated is immediately available to Dr. Oliver Sartor and his team as they work to continue their progress against this disease.
To make your gift via credit card, please visit www.nolabluedoo.org and click the link in the red box at the top of the page.
Prefer to donate via check? Please make check payable to “Tulane Cancer Center,” reference “NOLA Bluedoo” in the memo line and send to Tulane Cancer Center, ATTN: K. Green, 1430 Tulane Ave., #8668, New Orleans, LA 70112.
Thank you for your support!
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Bryan Subaru / LLS Distribute Blankets, Art Kits & Messages of Hope to Cancer Patients
Win a Truck & Help Cure Prostate Cancer
Researcher's Publication Honored as "Top 100" by Scientific Reports
New Multidisciplinary Prostate Cancer Clinic Enhances Care / Convenience
In the Pink: 4th Annual Pink Bra Run Raises Spirits/Funds for Breast Cancer Research
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Improving Access to Care Top Priority for New Genitourinary Cancers Expert
Study Finds Genetic Risks Associated With Prostate Cancer are Underestimated
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8th Annual Blue Ribbon Soiree Sets Record, Raising $130K for Prostate Cancer Research
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Researcher Examines Role of DNA-Damaging Elements in Aging/Age-Related Diseases
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Fifth NOLA Bluedoo a Record-Setting Success - Raises $193K for Prostate Cancer Research
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Tulane Doctor Elected to Elite Surgery College
Tulane Welcomes Kendra Harris, MD, MSc - New Interim Chair of Radiation Oncology
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Bryan Subaru & LLS Bring Comfort to Patients Through Subaru Loves to Care Initiative
Repurposed Drug Approach May Halt Spread of Cancer Cells
Tulane Head and Neck Experts Lead Call for HPV Vaccines
American Cancer Society Updates Colorectal Cancer Screening Guidelines
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Grant Supports Smoking Cessation Education for Outpatient Mental Health Facilities
It's All About the Pink - Third Annual Pink Bra Run Supports Breast Cancer Research
Cancer Crusaders Donate $169,000 to Tulane/LSU Cancer Research Programs
Grant Supports Smoking Cessation Program for Newly Diagnosed Cancer Patients
Med Student Takes Top Honors at Recent Meeting
State Rep. Julie Stokes to Lead 3rd Annual Pink Bra 5K Fun Run
7th Annual One Man Shoot Raises $130,000 for Prostate Cancer Research
Grant Supports Smoking Cessation Program For Newly Diagnosed Cancer Patients
Researcher Explores Unique Genetic Mutation Associated with Liver Cancer
Healing Hands Across the Divide: Evolving to Address Cancer Disparities
Gunning for a Cure Raises $192K for Prostate Cancer Research
Tulane Oncologist Outlines Prostate Cancer Treatment Advances in New England Journal of Medicine
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May 25, 2017
Prostate Cancer Immunotherapy Works Better for African-American Men
Cancer Crusaders Present Check for $210K
Free Skin Cancer Screenings Offered at Downtown Dermatology Clinic
National Cancer Survivor's Day
Second Annual Pink Bra Run -
Great Fun for a Great Cause
April 25, 2017
"Scarless Thyroid Surgery" on Agenda at Thyroid/Parathyroid & Skin Malignancies Symposia
Free Skin Cancer Screenings Offered at Covington Clinic
Second Annual Pink Bra Run Scheduled for Mother's Day Weekend
April 11, 2017
Tulane Researcher Shows Education Can Ease Fear in Cancer Patients
Thanks A Million!
March 10, 2017
Komen Grant Supports Study of Ductal Carcinoma In Situ
One Man Can Make a Difference: 6th Annual One Man Shoot Takes Aim at Prostate Cancer
2017 Gunning for a Cure Fundraiser Exceeds $500,000 Goal!
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Leading Study Backs Hormone Therapy With Radiation for Recurrent Prostate Cancer
Victory Bell: Donation Helps Cancer Patients Celebrate Survivorship
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Genetic Counselors Help Patients Better Understand Inherited Cancer Risk
Perez Family Targets Prostate Cancer Through Sporting Clays Event
January 26, 2017
Tulane Researchers Find Tumor-Suppressing Protein Actually Promotes Cancer
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