For information on clinical trials at this NCCN Member Institution click here.

Established in 1972 as one of the original cancer centers designated by the National Cancer Institute, Duke Comprehensive Cancer Center in Durham, North Carolina, has outstanding multidisciplinary programs for all types of cancer. In these programs, physicians, scientists, nurses, and other health care professionals representing various clinical specialties provide comprehensive, individualized treatment for patients. In 2006, Duke had nearly 9,000 inpatients and 175,000 outpatient encounters including 100-120 patients who receive chemotherapy each day. The number of outpatient encounters has grown nine percent from 2005. Drawn by the Cancer Center’s national and international reputation, 30 percent of these patients come from outside of North Carolina.

U.S. News & World Report has consistently ranked Duke among the nation's top ten centers for cancer care and the top cancer center in the South. Particular strengths of the Duke Comprehensive Cancer Center include the Preston Robert Tisch Brain Tumor Center at Duke, breast and ovarian oncology, adult and pediatric stem cell transplantation (including bone marrow and cord blood transplantation), thoracic oncology (esophageal and lung cancer), melanoma, and experimental therapeutics including hyperthermia and cancer vaccines. The Duke Comprehensive Cancer Center also has an outstanding Cancer Patient Support Program and Oncology Recreation Therapy Program.

Duke Comprehensive Cancer Center reaches out to the larger community through programs such as the Duke Oncology Network, a consortium of affiliated practices throughout the southeast.

The Division of Pediatric Hematology-Oncology at Duke University Medical Center offers a comprehensive range of medical services for children, adolescents, and young adults. Coordinated teams of physicians, nurses, nurse practitioners, physician assistants, psychologists, social workers, and others care for each patient in modern facilities, offering the latest advances in clinical care. Patients also can participate in both national and Duke-led clinical research studies testing new treatments. Special expertise is available in stem cell (bone marrow and cord blood) transplantation, sickle cell disease, auto-immune blood disorders, myelodysplastic syndromes, inherited blood diseases, hemangiomas and vascular malformations, and long-term follow-up for survivors of childhood cancer.

The Hereditary Cancer Clinic at Duke Comprehensive Cancer Center, a member of the National Cancer Institute's Cancer Genetics Network, offers cancer risk assessment and education to cancer patients and people with a family history of cancer or other cancer risk factors. Duke’s board-certified genetic counselor teams with medical oncologists to inform interested patients about their cancer risk, early detection, risk-reduction, and genetic testing. Through the Hereditary Cancer Clinic, individuals may be able to participate in research projects aimed at understanding and identifying the inherited genes that are important in cancer. 

Duke Comprehensive Cancer Center
Adult Oncology Services

Introduction

Since its inception in 1972 as one of the nation’s first comprehensive cancer centers, the Duke Comprehensive Cancer Center has been at the forefront of efforts to understand, prevent, diagnose, and treat cancer through patient care, clinical research, laboratory investigation, and education. Every activity the Cancer Center undertakes—from basic research to clinical trials to educational programs—is aimed at improving the care of cancer patients.

The Duke Comprehensive Cancer Center is a matrix center—one that draws upon the depth of basic scientific research and clinical expertise of the Duke University Medical Center. The formal structure of the Cancer Center consists of:

• 11 established research programs (divided into basic, translational, and clinical research programs)
• 16 Shared Resources
• 22 member Executive Committee
• Protocol Review and Monitoring System

The "comprehensive" status recognizes the center for its excellence in research and for other contributions in the areas of clinical trials, prevention and control efforts, information and educational offerings, and outreach and service activities. The Center’s more than 350 physicians and scientists research all aspects of cancer biology and treatment.

General Information

Treatment

Multidisciplinary Clinics

Stem Cell Transplant Program

Duke has earned national and global recognition for its leadership in bone marrow/stem cell transplantation. The adult program is renowned for its pioneering efforts in the treatment of breast cancer with autologous bone marrow/stem cell transplantation and innovative approaches to the treatment of leukemia, lymphoma, and myeloma. Duke is also recognized for its extensive research into a variety of treatment modalities that can be combined with transplantation. These include immunotherapy, anti-angiogenesis therapy, and the latest chemotherapy and pharmacologic therapies.

Alternative/Complementary Medicine

The Duke Center for Integrative Medicine (DCIM) offers individual patient consultation services, both public and professional education, and dedicated research in the field of Integrative Medicine.

Integrative Medicine is based on a partnership between patient and practitioner, within which the best of conventional, complementary, and alternative medicine practices can be explored in a whole-person approach to health care and healing.

For over two decades, Duke Health System has been committed to doing whatever lies within our knowledge and power to care for, cure, and facilitate healing in our patients. As new knowledge has emerged in the investigation of healing approaches, Duke has sought to make the full scope of safe and effective healing resources available to all who seek our care.

The primary goal of Integrative Medicine is to maximize each individual’s ability to experience optimal vitality and wellness, whatever their current state of health. Duke believes that there is a powerful interrelationship between the mind, body, spirit, and community in the interplay of both health and disease, and that a dynamic, constantly shifting balance exists as each of us moves through the daily stressors of our lives.

Integrative Oncology, a partnership between the Duke Comprehensive Cancer Center and DCIM, provides a conduit to bring Integrative Medicine services to patients at Duke and is developing a robust research engine to practically evaluate various Integrative Medicine interventions offered to our patients—establishing benefit, minimizing harm, and generating evidence-based advice.

Long-Term Cancers Survivors Program

Long-term survivors of childhood and young adult cancer represent a special, growing population of individuals who have lived through, and conquered, a unique set of medical and psychosocial challenges. With greater than 70 percent of all children and young adults being cured of their primary tumors, Duke now has the opportunity and responsibility to study the long-term effects of treatment on these patients. While a great deal of effort continues to be expended to reduce the potential short-term and long-term toxicity of multi-modality cancer therapy without sacrificing efficacy, there is ample evidence to suggest that many current approaches will also continue to produce late effects. Moreover, since cancer treatment is a constantly evolving process, patients who received older and perhaps outdated therapies must continue to be evaluated. Finally, since the ability to cure most children and young adults with a wide variety of tumors is still in its infancy, it is not known, nor fully appreciated, what effects multi-agent chemotherapy and/or radiotherapy will have in an aging population of patients. For these many reasons, it is vitally important to establish combined multi-disciplinary clinical and research programs that have the capability to collect data retrospectively and prospectively on a large cohort of patients, analyze that data, and deliver medical care both reactively and perhaps preventively, based upon this information.

Cancer Prevention and Screening

Established in 1991, Duke's Cancer Prevention, Detection, and Control Research Program explores genetic and environmental factors that increase risk for cancer, and evaluates interventions to promote behaviors that can prevent cancer, lead to its early detection, and help patients cope with cancer treatment. Program goals are to develop, evaluate, and disseminate interventions to improve the early detection of cancer and promote behaviors that can prevent cancer and to identify genetic and environmental risk factors for cancer. Program activities include:

• Innovative interventions that are customized to individual characteristics are being evaluated to increase breast and colorectal cancer screening, as well as smoking cessation among family members of recently diagnosed lung cancer patients.
• A number of studies are ongoing to understand the role of gene-gene and gene-environment interactions in breast and ovarian cancer susceptibility that can inform primary and secondary prevention strategies.
• Research to improve the care and quality of life of cancer patients and their families is also ongoing. These studies include trials of interventions for pain management, coping among caregivers, and patient-oncologist communication. 

Support Services

The new Duke Center for Survivorship encompasses the services of Duke’s Cancer Patient Support Program, Duke’s Oncology Recreation Therapy, and Duke’s Cancer Education Program. Therapy, support, and education resources are offered to patients by professionally trained counselors and hundreds of volunteers.

The Center provides support groups and individual counseling as well as image enhancement services to cancer patients and their families. Music, games, crafts, and laughter are used to optimize functioning, coping, and quality of life during treatment. Through the center, popular hobbies such as genealogy research, painting, woodworking, tiling, flower arranging, and more are provided to survivors as both an emotional outlet and recreation. Multimedia information is provided to help survivors and their families understand their treatment options, make decisions, manage the effects of cancer and treatments, and find meaning in the experience. Books, audiotapes, videotapes, and online computer resources are available in the Patient and Family Resource Center.

Support Groups:

• Living with Breast Cancer as a Chronic Illness Support Group
• Breast Cancer Support Group
• Young Women’s Breast Cancer Support Group (under 40)
• Gastrointestinal & Pancreatic Cancer Support Group
• Gynecologic Cancer Support Group
• Leukemia, Lymphoma & Multiple Myeloma Support Group
• Prostate Cancer Support Group
• KidsCan! for children who have a parent diagnosed with cancer

Nutrition Service
The Duke Health and Fitness Center, part of the Duke Center for Living, offers a program specifically to support cancer patients upon diagnosis, during, and after treatment. The C.A.R.E. program—Cancer and Regular Exercise—includes access to the Health and Fitness Center facilities and classes, an exercise program tailored to your goals and limitations, mind-body classes, and wellness lectures. Individualized nutritional counseling is also available. Call 919.660.6660 for more information or online at www.dukefitness.org.

Supportive Care

Pain Service and Palliative/Supportive Service

The Center for Palliative Care at Duke University Medical Center addresses the management of pain among patients from several perspectives.

• Inpatient Pain Management
  In most situations, the management of pain in those individuals who are in the hospital is managed at the point of service by the primary medical team. Immediately following surgery, medications are most often delivered via IV patient-controlled analgesia (PCA). As patient oral intake progresses, these medications are generally converted to oral analgesia.

• The Acute Pain Service (APS)
  The Acute Pain Service coordinates and manages pain in patients who elect to have analgesia administered via an epidural or regional anesthesia route as well as in patients with complicated pain situations. The APS becomes involved with the latter patients via consultation from the primary medical providers. Both adult and pediatric patients are cared for and managed. The APS consists of three attending anesthesiologists who rotate on the service one to two weeks per month; two full-time and four part-time advanced practice registered nurses (clinical nurse specialists); and one full-time pharmacist. In addition to formal involvement with the patients noted, the APS affects the pain management of many patients via informal consultation and educational efforts among staff.

• Outpatient Pain Management
  Outpatient Pain Management is provided at the Duke Health Center @ Morreene Road Pain Clinic. This clinic is staffed with an interdisciplinary team that includes practitioners from Neurology, Neurosurgery, Anesthesiology, Psychology, Psychiatry, Nursing, and Physical Therapy. A variety of pain management techniques are offered, including but not limited to single and multiple level nerve blocks; the evaluation, insertion, and management of epidural pumps and/or spinal cord stimulators; medication regimens; physical therapy techniques; and strategies including relaxation, biofeedback, and stress management. Patients undergo an extensive initial evaluation and the treatment plan emphasizes an interdisciplinary approach. The Duke Health Center @ Morreene Road Pain Clinic evaluates and treats older adolescents and adults while pediatric patients are evaluated in a Pediatric Pain Clinic located in the Duke Children's Hospital.

• Non-Pharmacological Management of Pain
  Non-pharmacological management of pain is provided through several groups at Duke University Medical Center. The Stress Management Consult Team consists of one full-time and four part-time advanced practice registered nurses who work primarily with patients and their families during hospitalization. This team works with and educates patients to manage their pain through relaxation techniques and complementary modalities. They also work with and educate various health care providers to help them provide better care and support to the patients. The Medical Psychology staff consists of psychologists who are available on a consultation basis and provide various non-pharmacological interventions such as biofeedback and relaxation exercises to both inpatients and clinic patients.

Home Care/Hospice Services

Duke HomeCare & Hospice is a community focused home care agency drawing on over 25 years of experience in providing quality home care to those in need. Duke HomeCare & Hospice provides innovative, thoughtful care, using an interdisciplinary team approach, to achieve the best possible outcomes for the patients, families, and communities. Their staff is on-call 24 hours a day, seven days a week to serve your needs.

Duke Community Infusion Services provides compassionate, quality home infusion care using a multidisciplinary approach and the most effective and efficient utilization of resources to achieve the best patient outcomes. Home Infusion Therapy provides nutrition and IV therapy, such as chemotherapy, pain management, and antibiotic therapy in the patient's home.

Duke Home Health provides certified home health services for adult and pediatric patients needing nursing, rehabilitation (physical, occupational and/or speech language pathology therapies) and home health aides. When medically necessary, the services help patients adapt and recover from illness or injury in the comfort of their home.  

Duke Hospice cares for patients who are seeking palliative end of life care. They provide care designed to manage symptoms and provide emotional and spiritual support. Care can be provided in the home, at an assisted living facility or in nursing homes.  They also provide care in their six bed Inpatient Care Facility in Hillsborough, NC.

Duke Community Bereavement Services provides bereavement care to primary caregivers/family members of Hospice patients for up to 13 months following the death of a loved one. They also offer bereavement services to anyone in our community who has suffered a loss due to death or who requires critical incident debriefing.

Cooperative Group Membership

Clinical and Research Efforts

Duke is a member of the National Comprehensive Cancer Network (NCCN) and is the headquarters for the biostatistics group and data management group for The Cancer and Leukemia Group B (CALGB) and the overall headquarters for the American College of Surgeons Oncology Group (ACOSOG). At any one time, approximately 250 active protocols for new cancer treatments are open for patient enrollment at Duke. Over 1,000 patients are enrolled in cancer treatment research protocols, and another 1,500 to 3,000 individuals in companion and cancer control studies each year. Well-established teams of specialists in radiology, pathology, surgical, radiation, and medical oncology provide multidisciplinary care for individuals with breast cancer; lung cancer; and hematologic, gastrointestinal, and other malignancies.

Duke Comprehensive Cancer Center
Pediatric Oncology Services

Introduction

The Division of Pediatric Hematology-Oncology at Duke offers a comprehensive range of medical services for children, adolescents, and young adults with malignant diseases. Patients are cared for in modern inpatient and outpatient facilities in which the most up-to-date therapies are employed by a coordinated team consisting of physicians, nurses, nurse practitioners, physician assistants, psychologists, social workers, activities therapists, and pharmacists. Members of the Division are actively engaged in cutting-edge research at both the bedside and the laboratory, and are constantly searching for new and novel treatments for these serious and often life-threatening diseases. As a full institutional member of the Children’s Oncology Group (COG), members of the Division actively participate in national clinical trials.

General Information

Clinical and Research Information

Statistics

Percent of children treated in each age range

Pediatric Hematology-Oncology & Transplant Programs, 2005

Duke Comprehensive Cancer Center
Genetic Counseling and Testing Service

Introduction

The Hereditary Cancer Clinic at Duke Comprehensive Cancer Center offers cancer risk assessment and education to cancer patients and people with a family history of cancer or other cancer risk factors. The board-certified genetic counselors work with medical oncologists to provide each patient with information about their risk of inherited cancers, ways to reduce the chance of developing cancer, and ways to find cancer early, when it’s easiest to treat. Consultations may also include discussions about genetic testing for cancer, which is available through the Hereditary Cancer Clinic. Clinic staff works closely with other researchers from Duke and cancer centers nationwide to better understand inherited cancers and to develop new tools for estimating cancer risk. At the Hereditary Cancer Clinic, confidentiality and caring are part of everything we do.

Intake Process

Testing

Cancer Risk Counseling and Follow-Up

Research

The Hereditary Cancer Clinic is involved in many on-going cancer genetics research projects. Patients seen in the clinic will have the option to participate in research when it is appropriate. Current projects include:

GEMS (Genetic Modifers Study) is a research project designed to identify genetic modifiers of BRCA1-related and BRCA2-related cancer risk. Eligible women must have been diagnosed with breast cancer within three years of undergoing testing for BRCA1/2 mutations.

The Breast Wellness Clinic is for women at increased risk of breast cancer and is directed by Dr. Victoria Seewaldt in the Division of Medical Oncology. It collaborates with a multi-institutional program investigating cancer prevention strategies and also uses techniques like random fine needle aspiration of the breasts to assess breast cancer risks.

The Hereditary Cancer Clinic can also facilitate participation in several cancer gene discovery and screening studies at other institutions.

Last updated: 2/11/2008