Cancer Center fosters world-class research and clinical care

Dr. Charles E. Myers Jr.

By Nancy Hurrelbrinck

The National Cancer Institute recently named U.Va.'s Cancer Center one of 13 clinical centers in the U.S., doubling its support of the center to almost $9 million over the next five years.

That kind of increase "almost never happens," said Dr. Charles E. Myers Jr., director of the center. "The review process is an adversarial one, and the pie is only so big. You have to convince them that you have something of value."

U.Va. has several world leaders in cancer cell and molecular biology research, as well as an effective protocol for bringing the latest scientific research to bear on clinical care, he said.

Ranked 12th in U.S. News and World Report's 1999 hospital rankings, the Cancer Center includes 172 investigators supported by more than $62 million in outside funding, representing a 60 percent increase in funding over the past four years.

"In 1994, we made the judgment that U.Va.'s faculty was much better than grant figures at that time suggested" and that more grants were needed, said Myers, who came to U.Va. in that year after 21 years at the National Cancer Institute. "The Cancer Center leadership got $1.5 million in seed funds for young investigators with promising ideas that were dispensed in $30,000 grants." They subsequently received $20 million in federal grants.

The University also has a talented pool of more experienced researchers. For more than 20 years, U.Va. scientists have been researching cell signaling -- that is, how information passes from outside a cell to its nucleus, Myers said. (Cancer develops when a cell gets an abnormal signal to grow.)

"A commitment was made long before anyone knew how cells become cancerous. We now have world leaders on signal transduction," he said, noting that former U.Va. researchers Dr. Alfred G. Gillman won the Nobel Prize in 1994 and Dr. Ferid Murad won it in 1998 for their work in this area.

"It turns out that many cancer-causing genes cause this pathway to be activated inappropriately," Myers said. "A cell that shouldn't be growing grows and keeps growing."

Microbiology professor Michael J. Weber has identified the steps by which a growth signal enters a cell.

J. Thomas Parsons, chair of the microbiology department, is among those who discovered how cells attach to one another, how they move and how these activities change when a cell becomes cancerous.

The Cancer Center has been streamlining the process of translating basic science into cutting-edge clinical care, Myers said, citing two examples.

Dr. Craig L. Slingluff Jr., associate professor of surgery, and microbiology professor Victor H. Engelhard are developing cancer vaccines "based on outstanding laboratory investigation into how the immune system recognizes and destroys cancer cells," Myers said.

Dr. Lelund W.K. Chung, professor of urology and cell biology, has taken one of the common cold viruses and engineered it so it kills prostate cancer cells; his work is currently in the first of three phases of clinical trial, Myers said.

His own research has focused on dietary factors that may cause cancer.

"We knew that a diet high in meat, dairy fat and egg yolks brings a high risk of prostate cancer, but [not] why," he said. "I was able to find a fat called arachidonic acid in those foods that prostate cancer converts into a growth hormone called 5-hete that stimulates the growth of prostate cancer."

To facilitate the translation of scientific research into patient care, the Cancer Center has been "trying to build multi-disciplinary care teams with a social worker, a pathologist and a general practitioner, and to have more efficient, patient-friendly ways of handling new diagnoses," Myers said.

"It's important because the most anxiety-producing time is between when you find out there's a problem and when definitive treatment begins," he said. "It also means treatment is a product of many minds, not just one. And it makes it easier to develop protocols for treatments of disease."

Among U.Va.'s teams, the closest to getting a new cancer treatment to the public is Slingluff's melanoma program, followed by a prostate cancer team that includes Weber and Parsons. Both teams' clinical trials draw patients from around the country.

Next along is the breast cancer team. "We have a growing group of scientists working on breast cancer biology, but no clinical trials yet," he said.

The center has three more teams: a head/neck cancer team that is doing clinical research and giving excellent clinical care, and just starting to build a lab program; a gastro-intestinal tumor group organized within the past 18 months that is just starting to do clinical research; and, the newest, a lung cancer team that will be testing a lung cancer vaccine Slingluff developed.

In addition to cutting-edge research and excellent clinical care, the Cancer Center has a number of programs to offer patients and their families emotional support, Myers said.

"In training our staff, we emphasize the human side, and patients have given us high ratings for that," Myers said. "We've gone to great lengths to develop a psycho-social support system. Insurance companies don't pay for this, but we get funding through philanthropic organizations.

"Once someone's diagnosed with cancer, emotional support makes a big difference -- not just to make the patient feel good," he said. "It's a matter of human survival."

The American Heart Association and the American Cancer Society both recommend a diet low in fat, with limited consumption of animal products and an emphasis on whole grains, legumes, fruits and vegetables.

Dr. Charles E. Myers Jr.
Director, Cancer Center