Better understanding of head and neck tumor causes and progression could help doctors improve personalized treatment for cancer patients.

“How it started and how it evaded the immune system and got into the blood stream provides a wealth of information we can utilize, and gives us more treatment options,” says James Rocco, MD, PhD, a head and neck cancer specialist and chair of the head and neck surgery department at The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute.

Rocco and his collaborators have developed a computational data analytics program called PhylogicNDT, which will evaluate the progression of head and neck cancer tumors caused by the human papillomavirus (HPV), and they believe “the approach can be applied to other types of cancers,” according to Rocco.

Episode 152: Understanding Head and Neck Cancer Progression, with James Rocco, MD

With advances in care and research, along with the opening of new, state-of-the-art facilities, 2023 was another big year in Ohio State’s work to create a cancer-free world.

“These are really exciting times for our cancer program, as we continue to broaden our facilities and access, and further the innovation of treatments, technologies and expertise that offer tomorrow’s treatments today,” says David Cohn, MD, MBA, interim CEO and chief medical officer of The James Cancer Hospital and Solove Research Institute.

Listen for some of the many cancer care and research highlights from The Ohio State University over the past year.

Episode 153: The Best of Our 2023 Podcasts

The number of younger patients diagnosed with colorectal cancer is on the rise. “We always used to say at age 50 get your first colorectal screening, and now we’ve dropped that to 45,” said Samuel Akinyeye, MD, an Ohio State gastroenterologist. “And the reason is we’re seeing younger people being diagnosed with colorectal cancer … I’m seeing younger patients in my clinic.” In this episode, Akinyeye discusses several of the reasons for the increase, including the impact of unhealthy diets and sedentary lifestyles, and the role of family history and inherited genetic mutations that increase the risk of colorectal cancer. “We’re eating more processed foods and greasy, fatty foods that are pro-inflammatory,” he said, adding obesity and inflammation increase the risk of cancer. He also talks about the importance of screenings, such as colonoscopies, and how they can reduce the number of colorectal cancer diagnoses and deaths. “Colonoscopies are the gold standard of screening,” Akinyeye said, adding they detect and pre-cancerous polyps that are then removed before they actually become cancerour and spread to other parts of the body. “Screenings save lives,” he said. Knowing your family history and discussing it with your primary care physician is vital. “We have a saying, that family secrets kill families,” Akinyeye said, adding people with a family history of colorectal cancer or even high-risk polyps should start screenings even earlier than 45. “People aren’t getting screened as early as necessary because they’re not aware of their family history.” Inherited genetic mutation, such as Lynch Syndrome, “greatly increase the chances of developing colorectal cancer and other types of cancer,” Akinyeye said.

Episode 159: Understanding the Increase in Colorectal Cancer Diagnoses, with Samuel Akinyeye, MD

Clinical trials are “the foundation of cancer research and lead to better treatment options and outcomes for patients,” said John Hays, MD, PhD, a James medical oncologist who treat patients with peritoneal cancers. He is also one of the leaders of the James clinical trials office and “at any given time we have between 500 to 600 clinical trial open and we put 1,000 patients a year on clinical trials, which is one of the largest numbers in the country.” In this episode, Hays explained the process of how an idea that begins in the lab (usually a new drug) goes through several different phases before it becomes approved for treatment. “Less than one percent of the Phase 1 clinical trials are ever approved,” he said, adding this is done to ensure patient safety and ensure the new treatment is an advancement over current options. “But, even if they’re not successful, we can learn something we can apply to the next trial.” He also said there is a common misconception that clinical trials are the “last resort” for patients. “It can be at any phase during treatment, from a front-line treatment setting or a later stage,” he said. “In most cases it’s adding something to the standard of care to make the standard of care work better … And, I never present to a patient that you have to do this trial. It’s always their decision and my goal is to help them understand everything, answer their questions and allow them to make the best-informed decision for them.” A new national trend in clinical trials the James is helping to lead is decentralizing the location of the trials in order to reach more patients. “We’re developing clinical trials by James people for patients all over the state and beyond,” Hays said. “We utilize tele-med and work with the patient’s local oncologist. COVID opened our eyes about what we can do from a distance.” Advancing cancer science and bringing new treatment options to patients is what motivates Hays. “We want to be there for our patients and bring them the newest and best options,” he said. “The real joy for me is talking to a patient and giving them the option to participate in a clinical trial and maybe bring them a drug [or treatment option] that isn’t available anywhere else.”

Episode 158: The Importance of Clinical Trials, with Dr. John Hays

The foods we eat can reduce or increase the risk of developing cancer over the course of a lifetime, according to Fred Tabung, PhD, an assistant professor in the Department of Internal Medicine. “Think of food as medicine,” he said, adding that “what you eat should be enjoyable, but we should also eat in a healthy way to reduce the risk of cancer.” In this episode, Tabung joined with Candice Schreiber, RDN, LS, CSO, a James dietician, to discuss the importance of a healthy diet, including what it entails, how and why what we eat impacts the risk of cancer, and tasty ways to eat healthier. “A plant-focused diet is what I encourage people to eat,” Schreiber said. “It doesn’t have to be vegan or vegetarian, the goal is to fill the majority of your plate with fruits and vegetables and whole grains.” In his James lab, Tabung studies “combinations of food and beverages that effect the metabolism, specifically inflammation and the insulin response,” he said, adding that too much inflammation and insulin can increase the risk of cancer. “High levels of insulin [from consuming too much sugar] can tell the cells to divide when they’re not supposed to divide, and this can lead to cells becoming cancerous.” Red meat, processed meats, such as sausage and hot dogs, as well are highly processed foods chock full of preservatives and sugar increase the risk of cancer. “In these highly processed foods, the nutritious parts are removed … the cancer-fighting parts of the foods have been stripped away,” Tabung said. His lab is involved in a new clinical trial in which women with a high risk of developing breast cancer are placed on a diet designed to reduce the risk. “We’re really excited about this,” he said. Tabung and Schreiber provided numerous tips and suggestions on how to eat healthier. For example, when it comes to beverages, unsweetened coffee and tea are metabolically active and provide healthy nutrients, while diet soda “is metabolically active, but not in a good way,” Tabung said. “My pet peeve is that people often think that healthy food doesn’t taste good, but it absolutely does,” Schreiber said.

Episode 157: How Diet Impacts the Risk of Cancer, with Fred Tabung, PhD, and Candice Schreiber, RDN

To kick off Pelotonia 2024 Launch Week, this is a special re-release of episode 155, “The Next Leaps Forward in Cancer Treatment, with Guest Co-Host Raph Pollock.” The new version of this episode now includes an introduction and conclusion from Joe Apgar, Pelotonia CEO. Each of the James scientists and physicians featured in this episode has been funded by Pelotonia. Hearing directly from these individuals about the continued progress, groundbreaking research, and treatment advancements is inspiring as the Pelotonia movement kicks off its 16th year. Pelotonia's cycling events for 2024 are Ride Weekend on August 3-4 and Gravel Day on September 28, 2024. Riders, Volunteers, and Challengers can sign up and commit to continue funding the work of James scientists and physicians like those you will hear from in this episode. Registration for Pelotonia 2024 opens on February 29 at Pelotonia.org/register.

Special Pelotonia Episode: The Future of Cancer Treatment, with Pelotonia CEO Joe Apgar

A breast cancer diagnosis in 2011 changed the life and career path of Jessica Winter. “It was a really defining moment in my career,” said Winter, PhD, an Ohio State professor of engineering, and a member of the Ohio State Cancer Engineering Center. “I could have kept doing research and publishing papers … but now I really wanted to do translational work and take something from the lab to patients.” Winter is a leader in the growing field of utilizing nanotechnology for cancer science and treatment. “There are three areas where it can be applied – imaging, biosensing and drug delivery,” she said. Winter and her lab, and her collaborators at the James and the Ohio State Cancer Engineering Center are involved in all three of these areas. Nanotechnology has been used since the 1990s to deliver chemotherapy drugs. “Nanotechnology is defined as something between the size of one and 100 nanometers,” Winter said. “You can fit five million nanoparticles that are five nanometers in diameter inside a cell.” In her lab, Winter has developed what she calls “quantum dots” to improve the delivery of drugs to cancer patients. Another area of her research involves biosensing. “The COVID test is a biosensor and some of the earliest biosensors were home-pregnancy tests,” Winter explained. Winter and collaborators at the James are also working on a nanotechnology biosensing method to analyze solid tumors. “We came up with a method of erasable labelling,” she said of the method in which several different colors, or layers, of can be used to create a series of images. “We need better diagnostic tests to match the patient with the best therapy, this is personalized medicine,” Winter said. Her cancer diagnosis (she is in remission and doing well) continues to motivate Winter. “I love my job and what I do,” she said. “The idea that I can help people … and make real things for real people is very exciting.”

Episode 161: How Nanotechnology is Improving Cancer Treatment, with Jessica Winter, PhD

Pelotonia has changed Joe Apgar’s life. “I’ll never forget how I felt in the moment someone told me I had cancer,” the CEO of Pelotonia said in this episode. “You feel completely lost and by yourself and you don’t have answers to the questions running around through your head.” Apgar was diagnosed with testicular cancer while a student at Penn State. Pelotonia is the fundraising cycling event that has raised more than $285 million for cancer research at the James. Apgar first rode in 2011, soon after he moved to Columbus to work for Rockbridge Capital, a private equity firm that sponsors a Pelotonia team Apgar helped create. “I remember standing at my first opening ceremony [of Pelotonia] and how uplifted and excited and supported I felt … that’s when I could flip the switch on it and feel empowered by my own story and experience,” Apgar said of the start of his first ride and crossing the finish line. Apgar talked about his cancer journey, how he connected with a James physician for his follow-up cancer care, his Pelotonia experiences as a rider and leader, and the future of the event. Apgar also talked about the importance of the Pelotonia “community” and how it has helped connect members of the James team with riders, volunteers and donors. “I think [the Pelotonia founders] hoped that some of this sense of community would happen, but I don’t think anyone could have dreamed it would happen at the scale it has,” he said.

Episode 163: The Incredible Impact of Pelotonia, with CEO Joe Apgar

The James Cancer and Aging Resiliency (CARE) clinic is a leader in treating older cancer patients. Patients have been treated with blood and bone marrow transplants (BMTs) for more than 40 years, but, initially, only younger patients were eligible. “There was a bar set as low as 40-years-old when this was a brand-new technology,” said Sarah Wall, MD, MPH, a James hematologist who specializes in treating patients with blood cancers. “Then it was 55 and 60 and 65 and now there is no official upper-age cutoff … it comes down to the individual patient.” In this episode, Wall explains the basics of BMTs. “There are two types, autologous, where a patient gets their own stem cells back, and allogeneic, in which we use donor cells,” she said. Improvements in the drugs used to treat graft-versus-host-disease (GVHD), which can occur in allogenic BMTs, have “really expanded the pool of donors for older adults who may only have siblings who are deceased or have had cancer themselves previously or some other disease that would make them ineligible,” Wall explained. “We have better drugs to prevent graft-versus-host-disease and to treat it when it does happen.” Several patients 70 and older have been treated with BMTs at the James. Wall said her oldest BMT patient is 80. “I have a [group] of the first three gentlemen 70 and older who I treated with a transplant all coming up to their five-year anniversary,” Wall said. “It’s a testament to them and to their families and caregiver support that they got through this. We’re the scaffolding they build this support on … and it’s very rewarding to be part of this and especially to open doors for people who thought they were closed.”

Episode 164:  - Treating Older Patients With Bone Marrow Transplants, with Dr. Sarah Wall

Because adrenal cancer is so rare, very few cancer hospitals have specialists equipped to treat patients and perform research and offer clinical trials for this type of cancer. “Very few physicians ever see a case in their lifetime and so there are a lot of physicians out there who don’t really understand the disease process,” said Barbra Miller, MD, the co-director of the James Multidisciplinary Adrenal Clinic. “I want to make sure patients get good, consistent and comprehensive and safe care and as a surgeon I want to make sure every patient gets the best surgery.” In this episode, Miller and Priya Dedhia, MD, PhD, a James expert in adrenal surgery and research, discussed this rare form of cancer and the wide range of screening and treatment options at the James, and their cutting-edge research. There are currently no screening procedures, such as mammograms for breast cancer or colonoscopies for colon cancer. This means adrenal cancer is often first diagnosed in the later stages when it has metastasized and spread. “We don’t know there’s a tumor until it’s quite large or has gone somewhere else, and another way we know is if [the cancerous adrenal gland] overproduces hormones,” Miller said. Some of the research at the James is focused on understanding how benign tumors in the adrenals can become cancerous. “We know colon cancer starts as a benign polyp,” Miller said. “We never thought this was true with adrenal cancer but now we’re at the stage where we think we can prove this is true.” Surgery is the primary modality for treating adrenal cancer, often followed by chemotherapy or, in recent years, immunotherapy. “We’re working to create new models for adrenal cancer treatment,” Dedhia said, adding that in her lab she has created “organoids” that “are like patient avatars and help us better understand and treat the cancer.” Organoids are masses of cells grown in the lab and can be used to test the effectiveness of new drug treatments, such as immunotherapy, prior to clinical trials in patients. “We’ve found two new pathways that kill these organoid cells and the next step we’re hoping for is a clinical trial,” Dedhia said. “We believe we’ve found a way to improve the immune response [of new immunotherapy drugs] and we’re very excited.”

Episode 162: New Research & Treatment for Adrenal Cancers, Drs. Dedhia and Miller

Join us on The James Cancer-Free World Podcast as we talk to the top scientists and doctors at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James). They’ll discuss – in easy-to-understand language – all the cutting-edge cancer research going on at Ohio State and how this is improving patient care and ultimately saving lives.

About the OSUCCC – James:
The OSUCCC – James strives to create a cancer-free world by integrating scientific research with excellence in education and patient-centered care, a strategy that leads to better methods of prevention, detection and treatment. Since 1976, the OSUCCC – James has been a National Cancer Institute-designated Comprehensive Cancer Centers and one of only a few centers funded by the NCI to conduct both phase I and phase II clinical trials on novel anticancer drugs. As the cancer program’s adult patient-care component, The James is one of the top cancer hospitals in the nation as ranked by U.S. News & World Report and has achieved Magnet ® designation, the highest honor an organization can receive for quality patient care and professional nursing practice.

New tracks tagged #james cancer hospital