UNTIL EVERY CANCER IS CURED - WINTER 2021 - Thomas ...
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UN T I L E V ERY C A NCER IS CU RED WINTER 2021 Photo credit: Katie Scherwitzky
FROM THE DIRECTOR
On the Front Lines of Cancer and COVID
safety protocols to protect patients and The pandemic is still with us and we
staff. I am so proud of the entire SKCC remain diligent; however, as we emerge
team, who worked around the clock to from many of the restrictions put in place
ensure that our patients continued to to mitigate the spread of the virus, we are
receive comprehensive cancer care. also focusing on the long-term effects of
It has been truly inspiring to see the pandemic. A large study led by SKCC
SKCC staff come together in this mo- researchers found patient encounters re-
ment. Our clinical teams rapidly adapted lated to cancer dramatically declined na-
operations to move non-treatment visits tionwide, including mammograms, which
to telehealth, and to deploy rigorous declined by nearly 90%, and colorectal
safety standards. These critical mea- cancer screenings, which declined by
sures were impactful for our cancer nearly 85%. It is now critical that we en-
patient volume–we heard an outpouring courage people to not put off their can-
of appreciation to SKCC for ensuring cer screenings and routine appointments.
uninterrupted access to the very latest The pandemic has also highlighted
treatment options. These accomplish- racial disparities in health care, further re-
ments are all the more remarkable given inforcing our commitment to addressing
Karen E. Knudsen, MBA, PhD
Executive Vice President that SKCC continues to serve an influx disparities and promoting health equity.
Oncology Services of new patients over the course of the This issue of Discovery highlights our
Enterprise Director pandemic, now seeing more patients
Sidney Kimmel Cancer Center challenges and successes during this
than ever before at our expert center. unprecedented moment in history. Even
Scientific research remained on in times of uncertainty, we are undeterred
W hen COVID-19 began to spread
throughout the world last year,
nearly everything changed for all of us.
track. Although many laboratories
closed during the stay-at-home orders,
in our mission to improve the lives of
cancer patients and their families through
our scientists found ways to remain compassion, innovation, and break-
Cancer, however, never stops, and the
engaged from home, and others re- through discoveries. I am confident going
Sidney Kimmel Cancer Center quickly
focused their research toward coro- forward that SKCC will overcome any ob-
jumped into action to establish strict
navirus treatments and vaccines. stacle in order to care for our patients.
STAY CONNECTED TO THE SIDNEY KIMMEL CANCER CENTER BY
VISITING OUR WEBSITE AND FOLLOWING US ON SOCIAL MEDIA!
sidneykimmelcancercenter.jeffersonhealth.org facebook.com/sidneykimmelcancercenter
@KimmelCancerCtr @sidneykimmelcancercenter
linkedin.com/company/skccatjeffersonhealth sidneykimmel.cancercenter@jefferson.edu
2
CONT ENT S
FEATURE ARTICLE
16
TELEHEALTH
Telehealth Keeps Patients Connected from a Safer Distance
5 BREAKTHROUGHS
COVID-19 Treatment 4
Cancer Care at Home 5
Oncology Navigation 6
COVID-19 Vaccine 7
Cancer Informatics 9
Laboratories During Lockdown 20
8 CLINICAL TRIALS
10 HEALTHCARE HEROES
12 NEW DEVELOPMENT HIGHLIGHTS
15 ACCOL ADES
19 SURVIVOR STORIES
Arnaldo Santos 19
Amy Schimanski 22
21 SUPPORT SERVICES
Care During COVID 21
Welcome Center 23
Neu Center 24
25 NEW LEADERSHIP
28 ADVANCED CARE HUBS
Asplundh Cancer Pavilion 28
Washington Township 29
30 PHIL ANTHROPIC SPOTLIGHT
3
BREAKTHROUGH
COVID-19 TREATMENT
A Novel Drug Target in Prostate Cancer Emerges
as Potential Target for Coronavirus Treatment
A t the beginning of last year – and
just a few months before the
novel coronavirus was reported in
how new viruses emerge as a result of
interspecies infections,” he explained.
In mid-March last year, Kim came
the United States – Felix Kim, PhD, across a preprint report from a group
was awarded an R01 research grant of researchers at the University of
from the National Cancer Institute California, San Francisco, in which they
(NCI) for his project, “Multifunctional identified 69 existing drugs and exper-
regulation of prostate cancer me- imental compounds that could poten-
tabolism by Sigma1 modulators.” tially be repurposed to treat COVID-19.
Kim, an Associate Professor of “This was based on a protein inter-
Cancer Biology at the Sidney Kimmel action screen wherein they identified
Cancer Center (SKCC), aims to define a number of cellular proteins that
how Sigma1 (also known as sigma-1 re- physically bind to key SARS-CoV-2/
ceptor) – a unique, pharmacologically COVID-19 viral proteins. They ser-
controllable scaffolding protein that is
aberrantly expressed in prostate cancer
and required for tumor growth – reg-
“Targeting Sigma1 might
prevent the virus from co- Felix Kim, PhD
ulates metabolic processes essential opting the cellular machinery, Associate Professor, Department
for prostate cancer proliferation and thus blocking COVID-19 of Cancer Biology
disease progression, and to discover replication and dissemination.” Associate Director of Training
& Education, SKCC
and develop a novel class of therapeu-
tic agents that target Sigma1 in order endipitously found Sigma1 among
to treat advanced prostate cancer. them, and this piqued my interest,” lar machinery, thus blocking COVID-19
“By targeting Sigma1, we propose a Kim said. “So, I took a closer look replication and dissemination.
new approach to restricting metabolic at whether I could make sense of Kim, in collaboration with Holly
processes that drive the proliferation how Sigma1 might be involved in Ramage, PhD, Assistant Professor of
of lethal prostate cancer,” Kim said. SARS-CoV-2/COVID-19 infection.” Microbiology and Immunology at
“This approach simultaneously targets Coronaviruses replicate by co-opt- Thomas Jefferson University, plans
multiple growth pathways in prostate ing the machinery inside the cells to establish whether Sigma1 is a valid
cancer and may circumvent resistance of the infected host. When the virus therapeutic target for SARS-CoV-2 and
mechanisms that invariably emerge infects a host, it remains completely related viruses and to evaluate whether
with the sequential use of current dependent on this cellular machinery a series of novel compounds originally
standard of care therapeutic agents.” in order to replicate and spread. Sigma1 proposed as anti-cancer therapeutic
Kim has been studying Sigma1 in is an important part of the cellular agents can be used to target Sigma1 in
cancer biology and Sigma1 pharma- machinery, helping to regulate the pro- a range of viral infections. Additionally,
cology for over 10 years; however, duction, processing, and quality control Kim and Ramage are looking to identify
he had previously worked on human of essential proteins and lipids, particu- established drugs that bind Sigma1 that
viruses for more than a decade. “My larly under conditions of stress, such as can potentially be repurposed as antivi-
PhD thesis was focused on dissecting viral infection. This led Kim to hypoth- ral therapies for COVID-19 infection.
key determinants of viral entry into esize that targeting Sigma1 might pre-
host cells and also on understanding vent the virus from co-opting the cellu-
4
BRE AKTHROUGH
CANCER CARE AT HOME
Pandemic Underscores Feasibility
of Home-based Cancer Care
F or many cancer patients, treat-
ment means frequent trips to
the clinic. When the novel corona-
patients experienced challenges
with IV access and pump malfunc-
tions – but nothing insurmountable.
virus emerged in the United States, Binder and colleague Nathan
Americans were told to begin prac- Handley, MD, MBA, Assistant Profes-
ticing social distancing and to try sor of Medical Oncology, hope to see
to stay home when possible. an expansion of home-based cancer
The Sidney Kimmel Cancer Center care at SKCC and beyond, even after
quickly took steps in order to minimize the emergency of COVID-19 abates.
risks to patients and staff, including “COVID is providing us with clear
transitioning appointments to tele- evidence that managing patients
health whenever possible. But what virtually is feasible, and in many cases
about patients who come in regular- may be better for patients,” Hand-
ly for treatment? Many people were ley said. “We know that patients with
understandably concerned about cancer are at higher risk for infections
visiting a hospital, and some even and complications associated with
considered postponing appointments. interacting with healthcare settings health emergency of the pandemic,
For some patients at SKCC, home this is changing. New waivers by the
care might be an option, such as infu- “COVID is serving as a catalyst Centers for Medicare and Medicaid
for change in many areas of
sions for supportive therapy, which are Services (CMS) are further enhancing
medicine, and cancer care
non-chemotherapeutic agents. Phar- is no exception. It is forcing the feasibility of home-based treat-
macists, working with the Infusion Cen- us to rethink what it means ments by making the reimbursement
ter, were able to move many of these to deliver high-quality care more streamlined, he explained.
patients to home infusions, according and what it means to be
Binder hopes to improve infrastruc-
to Adam Binder, MD, Assistant Profes- engaged with patients.”
ture to create a more robust home
sor of Medical Oncology. Additionally, chemotherapy program for the future.
some patients are eligible for at-home even in the best of times, so think- “I think this will require some restruc-
chemotherapy with the assistance ing of ways to move more care into turing of the current home infusion
of home infusion nurses. For these the home setting is something that is model or the creation of a separate
patients, physicians need to confirm going to continue to be important.” home infusion model that will allow
certain requirements including stable IV One barrier to home-based therapy for the same safety checks at home
access, normal lab values, and mini- is insurance coverage. “We know from that occur in the infusion center.”
mal risk for infusion-related reactions. a variety of studies that delivery of che- “COVID is serving as a catalyst
Overall, Binder reports minimal motherapy in the home setting is safe for change in many areas of medi-
concerns regarding home chemo- and can often be done at a lower cost cine, and cancer care is no excep-
therapy infusions. The home infusion than in the hospital or infusion center,” tion,” Handley said. “It is forcing us
service uses a different medical re- Handley said. However, Medicare and to rethink what it means to deliver
cord system, so he found it can be other insurers do not usually reimburse high-quality care and what it means
challenging coordinating two differ- treatment given outside of the usual to be engaged with patients.”
ent electronic records. Also, some medical settings, although due to the
5
BREAKTHROUGH
ONCOLOGY NAVIGATION
Oncology Navigation Team Helps
Guide Patients Through Uncertainty
W hen faced with a cancer diagno-
sis, some patients may be unsure
about who to turn to for guidance and
community
to accommo-
date referrals,”
support. However, patients receiving said Lisa Dun-
care at the Sidney Kimmel Cancer bar, a patient
Center – Jefferson Health (SKCC) in navigator
Center City Philadelphia have access who works
to an Oncology Navigation Team with people
that is available to assist them from diagnosed
the moment they are diagnosed. with malig-
The Oncology Navigation Pro- nant brain
gram, which started in the summer tumors and
of 2018, provides patients with a cutaneous
lymphoma. The SKCC Oncology Navigation Team. Back row, from left: Joanne
direct point of contact and an advo- Anderson, Will Sabb, Brian Ward, Christine Weiner, Tracie Williamson-
cate with whom they establish trust “Navigators
Burrell, Kimberly Brennan, Jaki Mitchell, Renee Zalinsky
throughout their cancer journey. play a huge Front row, from left: Allison Bell-Dean, Aliya
role in en- Rogers, Casey Fagan, Jackie Smith
Studies have shown that navigation suring pa-
programs can improve outcomes and tients receive in-person appointments and transi-
satisfaction among patients, as well continuity of care.” tion care to telehealth, rescheduling
as reduce costs. Navigators provide
Nurse navigators, who are reg- 524 appointments from mid-March
patients with personalized care and
istered nurses, typically contact a through May. They also helped fill
an added layer of support, serving
patient after a cancer treatment plan a void for patients who have been
as an extension of the care team.
is created and help to address clini- feeling isolated during the pandemic,
SKCC employs a hybrid approach and many navigators have heard deep
cal concerns. As a resource for care
that includes both patient navigators appreciation in their voices on the
management, they can address is-
and nurse navigators. Patient navi- other end of the phone. “I miss your
sues such as treatment side effects
gators are trained professionals who smile, which brightens any room, but I
and help patients avoid unnecessary
connect with new patients before their can still imagine it through the phone
visits to the emergency department
first visit with an oncologist. During an because I can hear it,” patient naviga-
and potential hospital admissions.
initial phone call, the patient navigator tor Tracie Williamson-Burrell heard.
gathers background information on the “I work with incredible profession-
als who dedicate pretty much 120% The Oncology Navigation Team
patient’s medical history. The navigator
of themselves to the patient popu- continues to make sure that ev-
can also help identify psychosocial,
lation,” said nurse navigator Renee ery SKCC patient feels that their
economic, or other personal barriers
Zalinsky, RN, OCN, who works with cancer care remains a top pri-
the patient may face when starting or
patients who have metastatic uveal ority during the pandemic.
continuing treatment and can refer
them to the nurse navigator or appro- melanoma. “It takes teamwork.” For more information on the
priate supportive care team member. Teamwork has been especially SKCC Oncology Navigation Team
important to support patients during or to connect directly with a nav-
“Patient navigators make things hap-
COVID-19. Navigators have played igator, call 215-955-8014.
pen. We build relationships with care
teams across campus and out in the a critical role in strategies to reduce
6
BRE AKTHROUGH
COVID-19 VACCINE
Building Upon Rabies Vaccine, Jefferson
Researchers Develop Novel Coronavirus Vaccine
A ny new coronavirus vaccine
found to be safe and effective
will still have the daunting challenge
efficiency and safety record.”
CORAVAX is made from a
portion of SARS-CoV-2, the
of being quickly produced to scale virus that causes COVID-19
and safely delivered to the world’s disease. Rather than use the
population. The more complex and entire virus, Schnell uses
untested the vaccine approach, the part of it – the spike pro-
more difficult these tasks will be. tein, a component most
By building upon an existing safe likely to generate a protec-
and effective vaccine, which has tive immune response.
well-established and active manu- Many vaccines are
facturing hubs and can be stored prepared by using anoth-
on the shelf until it is reconstituted er vaccine as a “carrier.”
with water, Matthias Schnell, PhD, In CORAVAX, that carrier
has a COVID-19 vaccine candidate is a killed rabies vaccine
that could cover a global need. that has the spike portion Matthias Schnell, PhD
Director, Jefferson Vaccine Center
“Our vaccine candidate, CORA- of the SARS-CoV-2 virus
Associate Director, SKCC Shared Resources
VAX, is made from part of the current as an added component, Chair, Department of Microbiology & Immunology
coronavirus that is combined with essentially one vaccine
another proven vaccine,” said Schnell, piggybacked onto anoth-
“We’ve already begun safety test-
Jefferson Vaccine Center Director and er. A vaccinated person would de-
ing in animals. And we know that the
Associate Director for Shared Re- velop antibodies against both rabies
rabies vaccine has an excellent safety
sources at SKCC. “The benefit is that and the coronavirus spike protein.
profile,” Schnell said. “That vaccine
the ‘carrier’ vaccine has already been The benefit of using rabies as a is safe in children, pregnant women,
rigorously tested and shown to be safe “carrier” vaccine is speed. “There are across diverse populations, and of-
and effective. There are manufactur- already at least 20 manufacturing ten generates life-long protection.”
ing plants around the world already facilities around the world churning out
running and with the technological In another encouraging sign,
some 100 million doses a year of the
know-how to produce large quantities Schnell’s group previously demonstrat-
rabies vaccine. They have the means
of that vaccine. We can leverage that ed safety with a rabies vaccine for oth-
and know-how to produce this vaccine
er coronaviruses that are highly similar
already. We’re adding one small
to SARS-CoV-2. The group’s vaccines
component,” Schnell said. It’s also
for the coronaviruses that caused the
relatively low-cost production,
2003 SARS and the 2012 MERS epi-
which is important for a vaccine
demics were proven safe and effective
that may need to be available to
in animal models of those diseases.
billions. In addition, some vaccines
require freezer storage that limits Jefferson signed a deal with Bharat
their use in remote areas. By con- Biotech to develop the vaccine, which
trast, the rabies vaccine can be pro- showed a strong antibody response in
duced in a shelf-stable, dehydrated mice. The next steps are to complete
form that is easy to reconstitute. animal tests and move into phase I
clinical trials for safety in people.
7
CLINICAL TRIALS
CLINICAL RESEARCH ORGANIZATION
Clinical Research Organization Keeps
Clinical Trials on Track Amidst COVID
A s the COVID-19 pandemic
reached the United States, ac-
ademic health centers across the
tained a no in-person requirement.
The next step was to review pro-
tocols on a case-by-case basis as
country began to adjust – and often requested by the principal investigator.
suspend – certain research and clini- “This allowed us to keep the investi-
cal activities, including clinical trials. gators engaged and reminded them
However, clinical trials are essen- that clinical trials remained an op-
tial to provide comprehensive care, tion for their patients,” O’Neill said.
and for many people, they can offer To ensure patient and staff safety,
the best, or only, treatment option. clinical research coordinators facili-
SKCC decided that keeping trials open tated care remotely. Guidance from
for patients remained a top priority regulatory bodies allowed for mod-
and quickly worked to ensure thera- ification of some of the strict stan-
peutic trials could safely continue. dards of clinical trial conduct, such
“We have a large and broad port- as shipping the drugs to patients and
folio of clinical trials and felt that it permitting them to undergo physical
was still in the best interest of patients exams at their local physicians’ offices.
Sylvia Salazar O’Neill, MD
to have these options,” explained Executive Director
“We have a large and broad
Sylvia Salazar O’Neill, MD, Executive portfolio of clinical trials SKCC Clinical Research Organization
Director of SKCC’s Clinical Research and felt that it was still in
Organization (CRO). “Very early on, the best interest of patients
to have these options.” the main challenge remains a “balancing
the core directive from SKCC lead-
act,” O’Neill said, “between wanting to
ership was patient and staff safety.” At any time, communication is move forward with important research
To determine whether a clinical important. During an evolving crisis that was going on pre-COVID and
trial could be conducted safely, two like a pandemic, it becomes abso- ensuring patient and staff safety while
questions were asked: Does the pa- lutely essential, especially as much of living in a future that is unknown.”
tient’s cancer put them more at risk the staff began working from home.
The CRO’s deft response to an
than COVID, and can the trial be “Since things were moving so quickly,
unprecedented challenge and ability to
conducted while following social/ we knew that daily communications
forge forward has been a silver lining
physical distancing protocols? had to be initiated as early as possible,”
along the way, O’Neill noted. “We have
The CRO defined essential trials said O’Neill, who established morning
been able to push initiatives that were
as all phase I, I/II, and II trials, which meetings with the entire CRO staff as a
on the back burner through faster. Now,
were allowed to move forward. Addi- forum to address questions and deliver
we have ways to remotely consent
tionally, 16 new trials opened between information as quickly as possible.
and monitor our studies. Our staff has
March and early June. Non-interven- The CRO is cautiously beginning flexible work from home schedules, and
tional and phase III trials comprised of to lift the suspension of interventional communication has actually increased
a standard-of-care arm were placed trials that were put on hold in a cautious by becoming familiar with the different
on hold unless the protocol con- step-by-step process. Looking ahead, electronic communication platforms.”
For more information on clinical trials, contact the Sidney Kimmel Cancer Center Clinical Research Organization at 215-955-1661.
8
BRE AKTHROUGH
CANCER INFORMATICS
Nationwide Trends Show Fewer Cancer
Patients Seeking Care Since Start of Pandemic
R esearch from SKCC found significant
decreases nationwide in the number
of patients being seen for cancer-re-
in January through April of 2020.
The team identified a significant
decline in patients with encounters
lated care as the COVID-19 pandemic associated with any neoplasm, including
progressed during the few first months malignant, benign, and in situ diseases
of 2020. The most significant decline (-56.9%); new incidence neoplasms
was seen in encounters related to new (-74%); malignant disease (-50%); and
cancer incidences, including screening, new incidence malignant disease
initial diagnosis, second opinion, and (-65.2%). The researchers also looked at
treatment initiation appointments. data from University Hospitals Plymouth
Anecdotal reports and physician NHS Trust in the U.K., which showed
surveys have suggested dramatic similar trends. However, the researchers
declines; however, this study, pub- cautioned that more data are needed
lished in JCO Clinical Cancer In- to compare trends outside the U.S.
formatics, is the largest to date to The researchers also looked at these
measure the effects of the pandemic encounters by cancer type. Patient
on normal cancer care activities. encounters decreased across all types, Christopher McNair, PhD
“While it is not surprising that the although they observed a greater de- Director, Cancer Informatics
Associate Director, Data Science
pandemic has had a significant impact crease related to melanoma (-51.8%), Sidney Kimmel Cancer Center
on patients seeking care, it was import-
“This report is a nationwide
ant to test and quantify these trends
call to arms, underscoring the and mitigation efforts – even in regions
using a large, institutionally agnostic urgent need to resume cancer that had not seen a significant impact
dataset, as the results have important screening and early detection.”
from the virus at the time,” McNair said.
implications for future cancer patients
and the potential burden on hospitals breast (-47.7%), and prostate (-49.1%) The researchers will continue to look
moving forward,” said senior author than lung (-39.1%), colorectal (-39.9%), at trends, especially as states are more
Christopher McNair, PhD, Director and hematological cancers (-39.1%). drastically affected. It will be important
of Cancer Informatics at SKCC. to understand these trends to determine
Additionally, McNair and colleagues
if delays in screening are resulting in an
McNair and colleagues leveraged found that mammograms declined
increased number of patients presenting
the TriNetX platform to create a COVID 89.2% and colorectal cancer screenings
with later-stage disease, McNair said.
and Cancer Research Network (CCRN). by 84.5% in April 2020 compared with
The CCRN is comprised of data from April 2019. They plan to track screenings “These findings are truly striking, as
20 healthcare organizations represent- in the coming months as virus mitiga- modeling from the NCI has predicted
ing over 28 million patients through- tion efforts are eased to help predict thousands of expected increases in
out the U.S. and includes aggregate how many patients are continuing to cancer death as a result of deferred
data from electronic medical records delay screenings due to the pandemic. breast and colorectal screening alone,”
such as diagnoses, procedures, and said SKCC Enterprise Director Karen
“The most significant finding in our
demographics. Using CCRN, the team E. Knudsen, MBA, PhD. “This report is
study was the considerable drop in can-
compared the number of patients with a nationwide call to arms, underscor-
cer screenings. The fact that this trend
cancer-related encounters in Janu- ing the urgent need to resume cancer
was so drastic nationwide is telling of
ary through April of 2019 with those screening and early detection.”
the widespread effect of the pandemic
9
HEALTHCARE HEROES
BETTER TOGETHER
Keeping Cancer Care Safe During COVID-19
T he Sidney Kimmel Cancer Center understands that cancer never stops, even during a
pandemic. Additionally, cancer patients and others with weakened immune systems
face an increased risk for severe illness due to COVID-19. To ensure patient safety, SKCC,
in alignment with the overall efforts of Jefferson Health, quickly made adjustments to
the way cancer care is delivered in order to limit exposure across all care sites through-
out Pennsylvania and New Jersey while still providing comprehensive cancer care.
Extra safety precautions designed to keep patients and staff safe and minimize the
risk of COVID-19 included expanded appointment hours in the mornings and evenings
to ensure optimal social distancing, waiting rooms were reconfigured to maintain social
distancing, additional cleanings in all care areas were scheduled throughout the day,
and masks were provided for all employees and patients. Telehealth appointments have
expanded, allowing patients and caregivers to meet with their care teams without hav- Ashley Peck (left) and
ing to make an unnecessary visit to the clinic. A no-touch registration option via mobile Stephanie Robinson,
phone was instituted to reduce unnecessary contact during on-site appointments. Department of Medical
Oncology front desk staff
These safety measures are also in place during cancer screening appointments,
which have now resumed. To date, Jefferson has treated more COVID-19 patients in the Philadelphia area than any
other health system and no Jefferson patients have been infected by those who were admitted with COVID-19.
Clockwise, from top left: SKCC – Washington Township Medical Oncology team; Dr. Joanne Filicko-
O’Hara & her patient Brian Burns; Jefferson – Northeast Radiation Oncology team; Asplundh Radiation
Oncology team; Dr. Margaret Kasner; and the Center City Radiation Oncology team
10COMMUN IT Y
BETTER TOGETHER
Legacy of Hope Provides Groceries
to Homebound Patients
T he nonprofit Legacy of Hope provides resources to cancer pa-
tients and their families facing financial distress, including assistance
with bills and essentials. The organization has worked closely with the
Sidney Kimmel Cancer Center for years to provide support to can-
cer patients experiencing difficulties while undergoing treatment.
In December 2019, Legacy of Hope teamed up with Brown’s Chef’s
Market, the parent company of local ShopRites and the Fresh Gro-
cer, and the Philadelphia Police Department to put together grocer-
ies for patients in need and deliver them right to their homes.
When the pandemic reached the Philadelphia area, Legacy of Hope Legacy of Hope volunteers and the
acted quickly to scale up efforts. The team works with the oncology so- SKCC supportive care team pick up
groceries (above), which PPD officers
cial workers at SKCC who identify pa-
deliver to patients at home (left)
tients and families in need and who are
facing hunger, and a nutritionist customizes orders based on each patient’s needs.
The groceries are managed by Brown’s Chef’s Market and picked up by Philadel-
phia Police officers, who then deliver each set of groceries to patients across the re-
gion several times each week, allowing patients the ability to safely shelter in place
without having to worry about whether they will have enough food at home.
“It’s inspiring to see how passionate Legacy of Hope’s partners have been in addressing this
critical need head on and watch grocery stores, cancer centers, and a police department mo-
bilize to create an entirely new support system for cancer patients that previously would have
been considered impossible,” said Michael Rowe, Legacy of Hope Founder and President.
Message Offers Support to Workers and Patients
S oon after the novel coronavirus reached the Philadelphia
region, Jamie Wiegand, a nurse at Jefferson, decided she
wanted to do something that could help brighten someone’s day.
Wiegand called her cousin, Katie Scherwitzky, with an idea
for the skywalk over South 10th Street that connects the Gibbon
Building at Thomas Jefferson University Hospital with the parking
garage across the street. Wiegand noted that many patients go
past the walkway, and the two quickly got to work brainstorming
ideas, then Scherwitzky printed everything for Wiegand to hang.
“Hopefully it brought a little sunshine to the
staff and patients,” Scherwitzky said.
Scherwitzky’s photograph of the walkway is fea-
tured on the cover of this issue of Discovery. Katie Scherwitzky poses under the
skywalk on South 10th Street
11NEW DEVELOPMENTS
AWARDS AND HONORS
ANDREW APLIN, PHD EDITH P MITCHELL, MD
Appointed member, Mechanisms of Cancer Therapeutics Study Elected Fellow, Royal Academy of Physicians of London
Section, National Institutes of Health, Center for Scientific Review Appointed member, President’s Cancer Panel
Melanoma Research Foundation Humanitarian Award PHL Life Sciences Ultimate Solutions Award
Geisinger Commonwealth School of Medicine Wellbeing Award
USMAN BAQAI GINAH NIGHTINGALE, PHARMD
Melanoma Research Foundation Medical Student Award to study Appointed member, Association of Community Cancer Centers’
BAP1 dependent kinome in uveal melanoma Board of Trustees
CLAUDIA CAPPARELLI, PHD ISIDORE RIGOUTSOS, PHD
Melanoma Research Foundation Career Development Award to Elected Fellow, American Association for the Advancement of
investigate the role of the protein SOX10 in BRAF melanoma Science
Legacy of Hope Merit Award to identify alterations that allow
cancer cells to metastasize and survive treatment
SIGNE CASKA ANURADHA SHASTRI, PHD
Melanoma Research Foundation Medical Student Award to study Radiation Research Society Scholars-in-Training Travel Award for
the role of SOX10 in metastatic melanoma drug resistance research on altering the gut microbiome with caloric restriction in
prostate cancer
ANDREW CHAPMAN, DO ALISON SHUPP
American Society of Clinical Oncology B.J. Kennedy Award for AACR-Woman in Cancer Research Scholar-in-Training Award for
Scientific Excellence in Geriatric Oncology research on osteoblasts’ role in breast cancer that has metastasized
to the bone
ANNA HAN, PHD ADAM SNOOK, PHD
AACR-Ocular Melanoma Foundation Fellowship to define unique American Society for Pharmacology and Experimental Therapeutics
metabolic features of uveal melanoma that can be targetable and Early Career Award
identify metabolic functions of BAP1 mutations in uveal melanoma
AMY HARRISON, PHD JOUNI UITTO, MD, PHD
Elected member, Residency Education Programs Review Commit- Knight of the White Rose, First Order, Republic of Finland
tee, Commission on Accreditation of Medical Physics Education
Programs
FELIX KIM, PHD SCOTT WALDMAN, MD, PHD
Appointed chair, Translational Clinical Pharmacology Division, Elected Fellow, American Society for Pharmacology and Experimen-
American Society for Pharmacology and Experimental tal Therapeutics
Therapeutics
KAREN E KNUDSEN, MBA, PHD CHARLES YEO, MD
National Liberty Museum Healthcare Hero Award Global Philadelphia Corporate Leadership Award
American Society of Clinical Oncology Advocacy Champion
12NEW DEVELOPMENTS
GRANTS
ANDREW APLIN, PHD ANJALI MISHRA, PHD
BRUNO CALABRETTA, MD, PHD ASH JUNIOR FACULTY SCHOLAR AWARD
NATIONAL INSTITUTES OF HEALTH Basic/Translational Research Grant to study oncogenic pathways
T21 grant to establish a training program in cancer biology to operation in blood cancers of T- and NK-cell origin
support multidisciplinary training to pre-doctoral candidates and
postdoctoral researchers
KAREN BUSSARD, PHD MANISH NEUPANE, DVM, PHD
U.S. DEPARTMENT OF DEFENSE KALEIDOSCOPE OF HOPE OVARIAN CANCER FOUNDATION
Breast Cancer Research Program award to study the role of Young Investigator Grant to study novel personalized MECP2-direct-
osteoblasts in the bone-tumor niche during bone metastatic ed epigenetic therapy in high-grade serous ovarian cancers
breast cancer
MEGHAN BUTRYN, PHD RAFFAELLA PIPPA, PHD
NATIONAL INSTITUTES OF HEALTH PROSTATE CANCER FOUNDATION
R21 grant to evaluate how text messages may change food Young Investigator Award in Honor of H. Ward Hamlin Jr. to investi-
purchasing habits and improve dietary intake. gate MITF as a therapeutic target in prostate cancer
CHRISTINE EISCHEN, PHD MAURICIO REGINATO, PHD
ST. BALDRICK’S FOUNDATION NATIONAL INSTITUTES OF HEALTH
Jack’s Pack - We Still Have His Back Research Grant to study an NCI - ALLIANCE OF GLYCOBIOLOGISTS FOR CANCER RESEARCH
innovative way to destroy Burkitt lymphoma cells that contain RU01 grant to elucidate mechanisms of how of O-GlcNAcome reg-
specific gene mutations that make them resistant to therapy ulates tumor-initiation pathways in breast cancer
VEDA N GIRI, MD VERONICA RODRIGUEZ-BRAVO, PHD
PROSTATE CANCER FOUNDATION NATIONAL INSTITUTES OF HEALTH
Valor Challenge Award to develop tools to educate physicians, R01 grant to identify novel actionable nuclear pore-regulated mech-
patients, and the public on prostate cancer genetics and identify anisms in lethal prostate cancer
patients who should undergo counseling and testing
VEDA N GIRI, MD YURI SYKULEV, MD, PHD
AMY LEADER, PHD, MPH NATIONAL INSTITUTES OF HEALTH
U.S. DEPARTMENT OF DEFENSE U01 grant to study novel strategies to improve NK cell-based immu-
Idea Award to study peer-based intervention for genetic notherapies to treat cancer, viruses, and autoimmune diseases
evaluation for prostate cancer among African American men
ETHAN HALPERN, MD MATHEW THAKUR, MD
FLEMMING FORSBERG, MD, PHD EDOUARD TRABULSI, MD
NATIONAL INSTITUTES OF HEALTH NATIONAL INSTITUTES OF HEALTH
MPI R01 grant to develop a cost-effective 3D multiparametric MPI R01 grant to develop a noninvasive urinary assay for prostate
ultrasound imaging for selectively guiding biopsies to detect cancer detection and management
prostate cancer
FELIX KIM, PHD ANNE M. VAN HARTEN, PHD
NATIONAL INSTITUTES OF HEALTH OVARIAN CANCER RESEARCH ALLIANCE
R01 grant to develop a novel class of therapeutic agents that Ann and Sol Schreiber Mentored Investigator Award to examine in-
target Sigma1 in advanced prostate cancer novative treatment approaches for high-grade serous ovarian cancer
ALEXANDER MAZIN, PHD YAN YU, PHD
NATIONAL INSTITUTES OF HEALTH LYDIA LIAO, MD, PHD
MPI R01 grant to identify patients with acute myeloid leukemia NATO
displaying specific preferences for repairing spontaneous and Multi-year Science for Peace and Security Programme grant to de-
drug-induced DNA damage based on gene expression analysis velop a wearable panel to assess radioactive contamination
13NEW DEVELOPMENTS
DISCOVERIES OF NOTE
Schilder RJ, et al. Sequential Ipilimumab After Chemotherapy in Sciences. 2020 March 02 [Epub ahead of print]
Curative-Intent Treatment of Patients With Node-Positive Cervical
Cancer. JAMA Oncology. 2019 Nov 27; 6(1):92-9 Lombardo J, et al., Care of Transgender Persons. New England
Journal of Medicine. 2020 Apr 09; 382(15):1481
Cai W, et al. PBRM1 acts as a p53 lysine-acetylation reader to sup-
press renal tumor growth. Nature Communications. 2019 Dec 20; Trabulsi EJ, et al. Optimum Imaging Strategies for Advanced Pros-
10(1):5800 tate Cancer. Journal of Clinical Oncology. 2020 Apr; 16(4):170-176
Porcu P, et al. Brentuximab vedotin in the treatment of CD30+ Kelly WK, et al. Clinical Outcomes in Men of Diverse Ethnic Back-
PRCL. Blood. 2019 Dec 26; 134(26):2339-2345 grounds with Metastatic Castration Resistant Prostate Cancer.
Annals of Oncology. 2020 Apr 11 [Epub ahead of print]
Dalva MB, et al. Positive surface charge of GluN1 N-terminus
mediates the direct interaction with EphB2 and NMDAR mobility. Languino LR, et al. The avB6 integrin in cancer cell-derived small
Nature Communications. 2020 Jan 29; 11(1):570 extracellular vesicles enhances angiogenesis. Journal of Extracellu-
lar Vesicles. 2020; 9(1):1763594
Lu-Yao G, et al. Mortality and Hospitalization Risk Following Oral
Androgen Signaling Inhibitors Among Men with Advanced Prostate Benovic JL, et al. Arresting Developments in Biased Signaling. Trends
Cancer by Pre-existing Cardiovascular Comorbidities. European in Pharmacological Sciences. 2020 Apr 30 [Epub ahead of print]
Urology. 2020 Feb; 77(2):158-166
Spiller KL, et al. Macrophages of diverse phenotypes drive vascu-
Calabretta B, et al. Selective inhibition of Ph-positive ALL cell larization of engineered tissues. Scientific Advances. 2020 May;
growth through kinase-dependent and independent effects by 6(18):eaay6391
CDK6-specific PROTACs. Blood. 2020 Feb 07 [Epub ahead of print]
Giri VN, et al. Implementation of Germline Testing for Prostate
Eischen CM, et al. Pan-cancer analysis reveals cooperativity of Cancer: Philadelphia Prostate Cancer Consensus Conference 2019.
both strands of microRNA that regulate tumorigenesis and patient Journal of Clinical Oncology. 2020 Jun 09 [Epub ahead of print]
survival. Nature Communications. 2020 Feb 20; 11(1):968
Dey S, et al. Peptide vaccination directed against IDO1-express-
Mandigo AC, et al. Double Trouble: Concomitant RB1 and BRCA2 ing immune cells elicits CD8 and CD4 T-cell-mediated antitumor
depletion evokes aggressive phenotypes. Clinical Cancer Re- immunity and enhanced anti-PD1 responses. Journal for Immuno-
search. 2020 Feb 04 [Epub ahead of print] Therapy of Cancer. 2020 July;8(2).
Erkes D, et al. Mutant BRAF and MEK inhibitors regulate the tumor Flemming JP, et al. miRNA- and cytokine-associated extracellular
immune microenvironment via pyroptosis. Cancer Discovery. vesicles mediate squamous cell carcinomas. Journal of Extracellu-
2020 Feb; 10(134):1999-2000 lar Vesicles. 2020 July 13;9(10):1790159.
Wen KY. Not Just Another App: Realizing the Potential of Mobile Flickinger JC, et al. Chimeric Ad5.F35 vector evades anti-ade-
Healthcare Applications to Promote Adherence to Oral Cancer novirus serotype 5 neutralization opposing GUCY2C-targeted
Therapy Medications. Journal of the National Comprehensive Can- antitumor immunity. Journal for ImmunoTherapy of Cancer. 2020
cer Network. 2020 Feb; 18(2):219-22 Aug;8(2).
Porcu P, et al. Improved outcomes for extranodal natural killer Magee, et al. On the expanding roles of tRNA fragments in mod-
T-cell lymphoma. Lancet Haematology. 2020 Feb 24 [Epub ahead ulating cell behavior. Nucleic Acids Research. 2020 Sep 05 [Epub
of print] ahead of print].
Grenda TR, et al. Transitioning a Surgery Practice to Telehealth Handley NR, et al. The Home is the New Cancer Center. Jour-
During COVID-19. Annals of Surgery. 2020 March 16 [Epub ahead nal of the National Comprehensive Cancer Network. 2020 Oct
of print] 01;18(10):1297-1299.
Domingo-Domenech J, et al. Cellular rewiring in lethal prostate Alnahhas I, et al. Management of gliomas in patients with Lynch
cancer: the architect of drug resistance. Nature Reviews Urology. Syndrome. Neuro-Oncology. 2020 Oct 16 [Epub ahead of print].
2020 March 16 [Epub ahead of print]
Rasouli J, et al. A distinct GM-CSF T helper cell subset requires
Fong LY, et al. Abrogation of esophageal carcinoma development T-bet to adopt a T1 phenotype and promote neuroinflammation.
in miR-31 knockout rats. Proceedings of the National Academy of Science Immunology. 2020 Oct 23;5(52).
14ACCOL ADES
LEADING BY EXAMPLE
ASCO Recognizes Outstanding Contributions
of Dr. Andrew Chapman in Geriatric Oncology
A ndrew Chapman, DO, was honored
with the 2020 B.J. Kennedy Award
for Scientific Excellence in Geriatric
status. In a single appointment ei-
ther in-person or through telehealth,
members of the medical oncology,
Oncology from the American Society navigation, social work, geriatrics, and
of Clinical Oncology (ASCO) for his pharmacy teams provide personalized
leadership and achievement in the field. comprehensive care recommen-
Chapman is co-director of the dations that will help patients and
Jefferson Senior Adult Oncology caregivers make an informed deci-
Center, Chief of Cancer Services at sion to meet their treatment goals.
the Sidney Kimmel Cancer Center The center also provides research-
– Jefferson Health (SKCC), and En- ers the opportunity to evaluate the
terprise SVP of Medical Oncology. impact of a comprehensive geriatric
The distinguished award was es- assessment regarding treatment rec-
tablished in 2007 in honor of the late ommendations, as well as the impact
B.J. Kennedy, MD, who is considered of the multidisciplinary evaluation
the father of medical oncology and a model on treatment decision devel-
pioneer in the field of geriatric on- opment in a shared decision making
Andrew Chapman, DO
cology. It recognizes members who Enterprise SVP of Medical Oncology
have made outstanding contributions “Dr. Chapman is a dedicated Chief of Cancer Services, SKCC
physician and researcher Co-director, Senior Adult Oncology Center
to the research, diagnosis, and treat-
who understands the unique
ment of cancer in the elderly, and in needs of senior adults with
bringing an understanding of geriatric cancer. Under his leadership, “On behalf of the Sidney Kimmel
oncology to fellow and junior faculty. the Senior Adult Oncology
Cancer Center, I’d like to congratulate
Center at SKCC remains
“I am humbled to receive this at the forefront providing Dr. Chapman on receiving this incredi-
prestigious award on behalf of the specialized care to this growing ble recognition from ASCO,” said Karen
incredible geriatric oncology team population of cancer patients.” E. Knudsen, MBA, PhD, Enterprise
at Jefferson,” Chapman said. Director of SKCC and EVP of Oncol-
Chapman helped establish the environment with the healthcare team ogy Services at Jefferson Health.
multidisciplinary Senior Adult On- alongside the patients and caregivers. “Dr. Chapman is a dedicated physi-
cology Center at SKCC more than Additionally, the center offers clinical cian and researcher who understands
10 years ago. One of the first of its trials to older adults, a population that the unique needs of senior adults
kind in the U.S., the center con- is often excluded in clinical research. with cancer. Under his leadership,
tinues to set the standard model the Senior Adult Oncology Center at
Chapman is currently planning to
for interprofessional care delivery SKCC remains at the forefront provid-
launch a tool throughout the Jef-
for older adults with cancer. ing specialized care to this growing
ferson Health enterprise that will
The Senior Adult Oncology Cen- educate the oncology nurse force population of cancer patients. He is
ter provides a unique opportunity for and help them to evaluate patients committed to providing the best care
these patients to undergo a geriatric and refer them to the center for possible to all of his patients and this
assessment that evaluates their med- a comprehensive assessment. is a truly well deserved honor.”
ical, functional, and psychological
15FEATURE ARTICLE
TELEHEALTH
Telehealth Keeps Patients Con
A Telehealth Task Force supports health equity a
I n early March, the threat of a novel
coronavirus reached the United States
and the Sidney Kimmel Cancer Center
Between Jan. 1 and March 15, 2020,
a total of 456 telehealth visits were
completed across SKCC, while 7,952
and available for medical, radiation,
and surgical oncologists, as well as
supportive staff. The appointments
– Jefferson Health (SKCC) and hospi- telehealth appointments were com- were most often for pre-visit consul-
tals nationwide began taking actions to pleted from March 16 to June 7. tations, follow-up visits, and visits with
mitigate the threat of a looming pan- SKCC has continued to see new the oncology social work team. Early
demic. Such steps included rearrang- and current patients since the start patient feedback has been positive.
ing clinics to follow social distancing of the coronavirus outbreak and has “By uncoupling the office visit and
guidelines, amping up already-robust maintained the highest quality of care the infusion appointment, patients and
cleaning routines, providing adequate while decreasing risk for patients and caregivers expressed appreciation for
masks and hand sanitizer for staff streamlining the treat-
and patients, and shifting ment process in efforts
appropriate staff to a work- to create maximum
from-home environment. safety and efficiency,”
Transitioning many outpa- Chapman said. “This
tient appointments to virtual has led to increased
ones was also a key aspect patient, caregiver, and
of increased safety measures. healthcare provider
Providing remote care can satisfaction during what
help reduce the risk of expo- has been an otherwise
sure for vulnerable cancer very stressful time for
patients by keeping them cancer patients.”
out of the clinic and lessen Ana María López,
the number of people in the MD, MPH, Professor
clinics throughout the day. From left: Onyi Okorji, DO, Jefferson Health – Northeast faculty
resident; Jill Lefkowitz, MSW, oncology social worker; Elizabeth
and Vice Chair of Med-
Telehealth was a Jefferson Thornton, MSN, CRNP, medical oncology nurse practitioner; ical Oncology at SKCC
enterprise initiative champi- and Andres Ferber, MD, Director of Hematology Outreach at and Chief of Cancer
SKCC at Torresdale, consult with a patient via telehealth
oned by President and CEO Services for SKCC –
Stephen Klasko, MD, MBA, New Jersey, has also
and led by Judd Holland- found that patients are
er, MD, Associate Dean for Strategic staff through telehealth, explained responding favorably to the experience.
Health Initiatives at the Sidney Kimmel Andrew Chapman, DO, Enterprise
“Patients often comment about
Medical College. All hospital depart- Chief of Cancer Services at SKCC.
how seamless the experience is, how
ments were encouraged to introduce Outpatient appointments are shifted nice it is to be able to include family
telehealth and SKCC leadership was to telehealth when medically appro- members in the visit, and how secure
enthusiastic about incorporating the priate, depending on the needs of the they feel in this time of COVID to
platform into clinical cancer care. patient. Those who require in-office meet with their doctor in a safe way.”
It was first implemented in 2017, services such as chemotherapy in-
Right at the start however,
which allowed SKCC to shift patients fusions, radiation therapy, and other
SKCC recognized that many pa-
over to virtual care rather quickly essential purposes are still seen in the
tients face barriers to engaging
while assuring continuity of care. clinic. The virtual visits are facilitat-
with their health providers virtually.
ed through a HIPAA-compliant tool
16nnected From a Safer Distance
and helps patients overcome barriers to access
They may lack routine internet ac- ment building from
cess or report low digital literacy. the front desk or other
In response, SKCC established residents until social
the Telehealth Task Force to support distancing precautions
health equity in telehealth care and left the lobby empty.
help patients overcome any issues Many are predicting
proactively. If a patient identifies any that the shift toward
type of barrier to telehealth – such as telehealth will remain
lacking a MyChart account, an active in place even when
email address, or a working device the emergency of
– the Task Force steps in to assist. the pandemic is over.
The SKCC Telehealth Task Force. Clockwise, from top left:
They can provide patients access to Going forward, it is
Jillian Van Sciver, Lauren Waldman, Melissa Klein, Ilise Posner
a device or set them up with data important to have an
minutes. Additionally, the Task Force accurate understand-
mote health equity, and they will also
can help patients download the Jeff- ing of telehealth’s impact on cancer
examine telehealth’s ability to alleviate
Connect app and walk them through care – and SKCC researchers have
anxiety during these stressful times –
the process, help them set up an already begun. The National Can-
not only among patients and caregiv-
email address, or connect them with a cer Institute (NCI) recently awarded
ers, but also among the clinical teams.
translator if they do not speak English.
SKCC will also be in regular dis-
Patients have been highly recep- “By uncoupling the office visit
cussions with the two other institutes
tive to the intervention, expressing and the infusion appointment,
patients and caregivers studying cancer patient management
gratitude for the outreach, attention,
and patience guiding them through
expressed appreciation for through telehealth during COVID-19 –
streamlining the treatment the Stephenson Cancer Center at the
the process, according to Task Force process to create maximum University of Oklahoma in Oklahoma
member Lauren Waldman. “Patients safety and efficiency.” City, and Dartmouth-Hitchcock Norris
who self-identify as having low digital
Cotton Cancer Center in Lebanon,
literacy are particularly grateful, as in
SKCC a grant to evaluate the impact N.H. The three NCI-designated cancer
pre-COVID times they might have had
of telehealth during the pandemic on centers each serve different patient
the support of neighbors, family, or
health outcomes, patient and clini- populations, thus providing an oppor-
other community members to assist
cian well-being, and health equity. tunity to analyze diverse patient popu-
with new technology,” Waldman said.
lations in different geographic settings.
For example, Waldman assisted an The researchers plan to track
and compare patient outcomes and The synergy and partnership with
older woman who lives on her own.
satisfaction pre-telehealth expan- the other cancer centers gives the proj-
Prior to COVID, she watched her
sion prior to the pandemic, during ects the potential to impact telehealth
granddaughter and frequently saw her
the pandemic telehealth expan- cancer care nationwide, according to
daughter, who would usually assist her
sion, and post-pandemic telehealth López, who will be leading the effort.
with technology. Since the pandemic,
they have been unable to visit. She expansion, López explained. To schedule a telehealth or
also recalled an older man who often The researchers plan to assess the in-person appointment at the
found help in the lobby of his apart- Telehealth Task Force’s ability to pro- Sidney Kimmel Cancer Cen-
ter, call 1-800-JEFF-NOW.
17FEATURE ARTICLE
TELEHEALTH
Post-pandemic Opportunities for Telemedicine
I n response to the COVID-19 pan-
demic, cancer centers rapidly shifted
to telemedicine, offering immediate
is that of digital literacy, as patients
with lower health literacy are less
likely to participate in shared deci-
benefits such as reducing exposure sion-making in their medical care.
to the virus in the clinical setting Pre-pandemic data revealed dispar-
and overcoming transportation bar- ities in digital heath literacy across
riers for patients and caregivers. numerous demographics, including
Additionally, telemedicine expanded socioeconomic status, race, ethnicity,
the definition of patient-centered care and age. Challenges are further exac-
from “the right treatment, for the right erbated in older adults who have lower
Communications Commission (FCC),
patient, at the right time,” to include “in digital health literacy compared with
97% of Americans living in an urban area
the right place,” wrote Karen E. Knud- younger patients, are less likely to have
have access to high-speed internet,
sen, MBA, PhD, Enterprise Director of an email address, own a smartphone,
compared with only 64% of people in
SKCC; Cheryl L. Willman, MD, Direc- or use an online portal to communi-
rural areas and 60% of those living on
tor and CEO of the University of New cate with their oncology care team.
tribal lands having similar access. Emer-
Mexico Comprehensive Cancer Center “Telemedicine expanded gency funding to increase broadband
in Albuquerque; and Robert A. Winn, the definition of patient- access was part of the FCC’s COVID-19
MD, Director of the VCU Massey Cancer centered care from ‘the
Telehealth Program that was appropriat-
Center in Richmond, Va., in a recent right treatment, for the right
patient, at the right time,’ to ed as part of the Coronavirus Aid, Relief,
manuscript published in Clinical Can- and Economic Security Act; however,
include ‘in the right place.’”
cer Research that outlined the current long-term solutions will be key post-pan-
state of telemedicine at AACI member Studies have also shown signifi- demic, Knudsen and colleagues wrote.
centers and offered recommenda- cant variances in access across di-
Sustained telehealth utilization also
tions for enhancing post-pandemic verse and at-risk populations. Many
requires reimbursement parity with
cancer care through telemedicine. patients with smartphones lack the
in-person visits and coverage for both
Telehealth visits through phone or ability to download the necessary apps
in-state and out-of-state visits. While
video, home-based care, and remote required for a telehealth video visit.
the Centers for Medicare and Medicaid
patient monitoring were effective ways Overall though, patients demonstrate
Services and select commercial payors
to deliver care throughout a pandemic, a strong desire for telehealth services,
modified reimbursement policies in
but will also remain part of the can- particularly those for whom a lack of
response to the pandemic, it is unclear
cer care continuum post-pandemic. transportation is a barrier to care.
whether policies will remain or whether
However, it is essential to understand Many cancer centers in rural settings other commercial payors will follow suit.
the impact of telehealth on access to report challenges related to broadband
Telehealth undoubtedly represents
cancer care, quality of care delivery, availability. A recent study found patients
an innovative change to cancer care
health equity, outcomes, and reim- living in the Northeast, West, or Midwest
that will transform patient access to
bursement, and there is a long way to in the United States had about a 34% in-
treatment, Knudsen and colleagues
go to achieve equitable implementa- creased likelihood of having a telehealth
concluded. As such, it is critical that the
tion, according to Knudsen, Willman, visit compared with people living in the
cancer community works to mitigate
and Winn, who identified immediate South. Additionally, individuals living in
cancer health disparities and to optimize
needs that must be addressed. urban areas were 54.3% more likely to
telemedicine services to meet the spe-
have a telehealth encounter than those
One issue that is critical to address cialized needs of a diverse population.
in rural areas. According to the Federal
18SURVIVOR STORY
ARNALDO SANTOS
Nothing to Fear: Cancer Surgery
During COVID-19
W ith thyroid cancer surgery sched-
uled for April 10, Arnaldo San-
tos, 51, was enjoying time at home
waiting area, when someone was called
back, a member of the staff was there
right away to sanitize the chair. It made
in Hopewell Township, N.J., with his me feel very comfortable and secure.”
family when he received a call from “Surgery, at baseline, is one of the
his surgeon, David Cognetti, MD. safest places for patients in medicine be-
With the COVID-19 pandemic wors- cause of how rigid things are in terms of
ening, the decision had been made protecting against the transmission of in-
to postpone his surgery to May. fectious disease,” Cognetti said. Because
“He was being cautious; he of the pandemic, additional precautions
wanted to make sure that his pa- include pre-op COVID testing for all
tients didn’t get the coronavirus,” patients and the escalation of personal Arnaldo Santos and his wife, Maribel
Santos said. “That was smart.” protective equipment (PPE) to include
While Cognetti assured Santos N95 masks, combined with face shields,
diagnosis and recovery. The successful
that his overall prognosis was excel- “Surgery, at baseline, is surgery is allowing Santos to return to his
lent, with minimal significant risk for one of the safest places
family and to his calling to help others. A
disease progression, Santos’s anxiety, for patients in medicine
because of how rigid things retired police detective, he’s witnessed
understandably, became somewhat
heightened. “The bottom line is, you are in terms of protecting more turmoil than many, starting at age
against the transmission 9 when he fled with his mother and
can tell somebody they’re going to do
of infectious disease.” brother from an abusive father in Puerto
great, but when they hear the word
for staff. “Protecting our staff is important, Rico. He grew up in government-as-
‘cancer,’ that’s going to wear on their
not only for the sake of our staff but also sisted housing in Bridgeton, and at 19,
mind,” said Cognetti, who is Chair of
because it protects the next patient.” began a career in law enforcement.
the Department of Otolaryngology.
Patients should know that surger- As a detective, he was recognized
Many of Cognetti’s patients whose
ies, despite the ongoing pandemic, by the U.S. District Court for the Dis-
surgeries were rescheduled received
are extremely safe, Cognetti explained. trict of New Jersey as an expert wit-
a call from him from time to time,
“It’s important that the message of safe ness on East Coast street gangs. His
just to keep in touch and offer reas-
surgery be out there because what’s hap- experiences on the front lines of gang
surance. “I’ve never had that experi-
pened now, which could potentially hurt warfare are captured in his 2016 book,
ence,” Santos said, “where a doctor
patients, is that much of the news has “Street Gangs and God – The Battle in
will call me at, say, 9 o’clock at night
made people scared to come into the the Streets,” which he describes as part
just to find out how I was doing.”
hospital or to come in and get surgery. memoir and part spiritual encourage-
From the minute he walked into ment for parents and young people
In many cases, that could end up hurting
the reception area for his rescheduled struggling to find purpose in their lives.
the patient instead of helping them.”
surgery on May 8, Santos felt very safe –
While recovering at home, Santos As a deacon, he continues to guide
despite the uncertainty swirling around
has returned to his duties as business parents and their children to do good
the pandemic. “I could smell the alco-
manager at Parish of the Holy Cross things. As a patient, he encourages
hol and just how clean everything was.
in Bridgeton, N.J. An ordained deacon anyone who has been told they will
That was very important to me,” he said,
in the Catholic Church, his faith has require surgery to go through with it.
adding that hospital staff was practicing
strict social distancing measures. “In the played an important role throughout his “Do not fear and do not be afraid.”
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