Alabama’s Role in the Local War on Cancer
The UAB Comprehensive Cancer Center is the end result of what began as the Lurleen B. Wallace Memorial Hospital and Tumor Institute. Wallace, Alabama’s first female governor, died at 40-years-old from gynecological cancer in 1968. Her death galvanized the state to raise millions of dollars to start a cancer hospital. By 1970 supporters in the state had raised $5 million dollars. So in 1971 when Richard Nixon declared war on cancer Alabama was poised to become
Her death galvanized the state to raise millions of dollars to start a cancer hospital. By 1970, supporters in the state had raised $5 million. So in 1971, when Richard Nixon declared war on cancer and Alabama was poised to become one of the original comprehensive cancer centers in the nation, which it did in 1973.
The milestones reached in cancer research since President Richard Nixon first declared war on the “dread disease” can be measured in the cancer survival rates for then versus now. In 1971, for some people a cancer diagnosis meant a fifty-fifty chance of living beyond 5 years. In 2017, according to the National Institutes of Health, five-year survival rates after a cancer diagnosis improved for all of the most common cancers combined. These include breast, lung, prostate, colon and bladder cancers.
This year the NIH National Cancer Institute (https://seer.cancer.gov/report_to_nation/survival.html) “Annual Report to the Nation 2017” included a special section on cancer survival rates. They compared data from 1975 to 2012. In 1975 the
They compared data from 1975 to 2012. In 1975 the five-year survival rate for the most common cancers was 50 percent. In 2012 the rate improved to 66 percent. The institute's findings show survival rates improving even when patients were diagnosed with later stages of the disease.
While this is not the case for cancers that have spread to other parts of the body, recent therapy trends like immunotherapy and precision medicine may even improve survival rates for those cancers. According to the report, melanoma and lung cancer patients may benefit in particular.
In 2016, when President Barack Obama signed the 21st Century Cures Act, its goal was to get many of the drugs in trials to people faster as part of the Beau Biden Moonshot Initiative. Congress agreed to put $1.8 billion dollars over the next eight years into the nation’s renewed efforts to win the war on cancer.
In 1971 a similar bi-partisan effort led to $100 million and the creation of many of the institutions doing much of the groundbreaking research in cancer treatments today.
UAB Comprehensive Cancer Center Executive Director Dr. Ed Partridge was in medical school when President Nixon signed the National Cancer Act.
“It was only a couple of years after that, because that act established the concept of the National Cancer Institute nationally designated cancer centers," Partridge said. "That is, that the research needed to be done in academic institutions across the country. That's where most of the work and the discoveries would be made.”
Those discoveries included many of the screenings we benefit from today for early detection of cancer.
By the 1980’s, it became clear that some segments of the U.S. population were benefitting from early detection and screenings, but others were not. Education level, income, and insurance became factors in who got screened for early cancer detection and who did not.
Often, people in poor and minority communities were coming up short on benefitting from the advances in cancer even back then. Dr. Partridge said by 1992 it became statistically evident that there was a disparity,
“So we said we have a moral and ethical obligation, and an opportunity to actually begin to change the world around disparate cancers," Partridge said. "And so we said let’s make cancer disparities our over-arching theme, and it has been our over-arching theme since 1992."
UAB has established itself as a leader in eliminating cancer disparities. The Deep South Network for Cancer Control is one way they are making a difference, by educating communities in Alabama's Black Belt region about cancer and providing screenings to help with early detection of cancers.
The NCI recently awarded UAB another 16 million grant to address cancer disparities in partnership with Morehouse School of Medicine and Tuskegee University.
It is not uncommon to hear of people traveling to nationally well-known cancer centers like Mayo Clinic or MD Anderson for specialized cancer treatment. In our Local War on Cancer, we came across people who travel here to Birmingham for groundbreaking cancer treatment in the UAB Phase One Unit where, according to Dr. Mansoor Saleh who leads the unit, one-third of their patients come from outside the state of Alabama.
Their Phase One Unit (https://www.uab.edu/ccts/research-commons/clinical-services/phase-i-clinical-trials-unit) is where patients can participate in early phase clinical trials some that are first in human. Meaning they have worked well in test tubes and animals, yet have never been used in humans.
Doctor Saleh is also Medical Director of the Clinical Trials Unit.
"The first in human is a phase one, the patient gets low doses to test for toxicity, then you get higher dose, until you get the maximum doses and can say this is the right dose for this patient, based upon toxicity," Saleh said.
Dr. Saleh said most of the phase one trials in his unit are combination trials.
“So we have famously called the Jimmy Carter Drug, the drug given to Jimmy Carter for melanoma," Saleh said. "That drug works well for other cancers, but it has not been approved for other cancers. So we have the Jimmy Carter drug which is a checkpoint inhibitor, plus another blocker. We've got muds where drugs mix together."
This unit can mean a lot to patients who have been told there are no other conventional therapies for their cancer.
"We provide not just hope, but really the benefit of new drug development for the benefit of our patients," Saleh said.
Phase I: First in human which evaluates if a drug is safe, how should it be given, does it work?
Phase II: For which cancers does it work, what's the effect on the body?
Phase III: How does it compare to other treatments?
For more information on clinical trials, visit: https://www.cancer.gov/research/areas/clinical-trials
We are Ora and the New Frontier
Dr. Hadiyah-Nicole Green and the Ora Lee Smith Cancer Research Foundation are working to do something out of the traditional realm for cancer treatment by using lasers.
"[We basically] use the nanoparticles as a heat sink for the laser, and target the tumor like you would an enemy," Green said. "You take out just that enemy without affecting anything else around it."
Green is already the recipient of a $1.1 million dollar grant to advance her development of that treatment which she pioneered killing cancer cells in mice.
This physicist, who has several disciplines in the field, would especially like to see cancer treatment without side effects in the arsenal of cancer treatment options available today. Her specialty is targeted cancer therapeutics.
"[It includes] the field of immunotherapy to target the nanoparticles through the system," Green said. "It's guided by the receptors on the surface of the cell in the same way that precision medicine helps personalize medicine."
In April 2017, she said she is in the process of completing FDA applications to move her research to humans.
Green is on a mission to raise $30 million to advance her research. She started the Ora Lee Smith Cancer Research Foundation to help with that mission. The foundation is named for the late aunt who died of cancer the same year Green graduated from Alabama A&M University.
In addition to the search for treatment itself, her mission also includes speaking where she can to raise awareness and money for what she wants to be an affordable treatment for people with cancer.
"When people are sending me messages on my website or they're sending me emails about what they are going through, I cry," Green said. "This is personal for me, this is not business. It’s personal."
In addition to being the founder of the Ora Lee Smith Cancer Research Foundation, Dr. Green is Director of Research in the Nanobiophotonics and Targeted Therapeutics Laboratory and Assistant Professor of Surgery at Morehouse School of Medicine.
Learn more about here research at https://weareoralee.org/