|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
General Information
TreatmentStem Cell Transplant Program The Bone and Marrow Transplant program at The James is accredited by the Foundation for the Accreditation of Cellular Therapy (FACT) and the following are treated using autologous or allogeneic stem cell transplants:
Cancer Prevention and ScreeningThe James offers a number of cancer-prevention strategies and cancer-screening opportunities. JamesCare for Life is a program within The James that offers multiple services to address the emotional, social and spiritual needs of cancer patients, families and friends. Services include: community outreach; educational classes for patients and families about a broad array of quality-of-life issues during and after cancer treatment; cancer support groups for patients and families; education and training for healthcare professionals; grief and bereavement support for families; creative arts and expressive therapies; resource referral and information; and cancer-specific survivorship initiatives. Information about this program can be obtained by calling The James Line at 800.293.5066. The James periodically provides free public screenings for breast and prostate cancer, as well as melanoma. In addition, The James’ Mobile Mammography Services Program extends affordable mammography to the community in mobile units equipped with state-of-the-art technology. The James also maintains conveniently located mammography suites at : The Babe Zaharias Center at The James; JamesCare at Macy’s in Easton Town Center on the near east side of Columbus; The James at University Hospital East, 1492 E. Broad St.; and at JamesCare in Dublin, a comprehensive breast health center that offers breast cancer detection, diagnosis, counseling, continuity of care and a multidisciplinary team of healthcare professionals collaborating to provide a full range of patient needs. Periodic educational sessions are available through The James regarding prostate cancer, breast cancer and living with lymphedema. Further, JamesCare for Life offers free monthly integrative-care classes that are open to the public and presented by clinical experts on topics of health/wellness, complementary care, symptom management, and quality-of-life issues. Support ServicesWith the aim of rehabilitating cancer patients and families into as normal a life as possible, JamesCare for Life offers a number of support groups and classes. Most groups are cancer-specific (e.g., brain, breast, gynecologic, prostate, head and neck, etc.), but some focus on physical and functional aspects of cancer, such as lymphedema, cosmetic concerns and self-appearance. Adult coping and bereavement groups are also available. Supported by donations and grants, the MusicCare initiative offers live performances from volunteer musicians to hospital inpatients and also provides hundreds of CDs and audiotapes for patients. In addition, JamesCare offers massage therapy at Hope’s Boutique, a James specialty shop catering to women with cancer. Also available to patients and families is referral to support services such as social work, pastoral care, patient-education packets, psychology clinical nurse specialists/mental health specialists, home care agencies that provide a myriad of services, a clinical nutritionist who works with patients and families, programs specific to survivorship issues, and a multidisciplinary recovery/rehabilitation team. Questions regarding any of these services, or about physician referral or cancer in general, can be answered by calling The James Line at 800.293.5066. Supportive CarePain Service The James has a multidisciplinary pain team that meets daily. It provides inpatient visits and consultations five days a week, but its physicians are on call around-the-clock. The team can be reached by calling 614.293.2957. Palliative/Supportive Service The James has a Cancer Pain and Palliative Medicine Program directed by Robert Taylor, MD. He can be reached at 614.293.2957. The program also services Ohio State University Hospital and Ohio State’s Richard M. Ross Heart Hospital. Cooperative Group Membership
Clinical and Research EffortsInterdisciplinary collaboration among researchers and clinicians at Ohio State’s Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute allows for the translation of scientific discoveries to innovative clinical care that contributes to global efforts to control cancer in its many forms. Adult Oncology Program *
*This data is for fiscal year 2005–06, or July 1, 2005 through June 30, 2006 Arthur G. James Cancer Hospital & Richard J. Solove Research Institute at The Ohio State University
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
In collaboration with the OSU Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute (OSUCCC-James) unique capabilities exist in:
|
|
Pediatric Referral and Information |
General Hematology Oncology Blood and Marrow Transplantation Weekends, Holidays, and Weekdays after 5PM Phone: 614.722.2000 |
General Information |
Nationwide Children’s Hospital Operator |
Referring Physician |
General Hematology Oncology |
Location |
Columbus, Ohio Pediatric Oncology services at the OSU Comprehensive Cancer Center-James Cancer Hospital and Solove Research (OSUCCC-James) reside at Nationwide Children’s Hospital. |
Physical Plant |
The new Hematology/Oncology Unit at Nationwide Children’s Hospital opened in 2002. The 31-bed, HEPA-filtered unit has eight rooms dedicated for Blood and Marrow Transplant patients. The unit contains a four-bed apheresis facility, a Day Hospital, an outpatient clinic for Blood and Marrow Transplant patients, and a dedicated hospice room. It is served by a dedicated pharmacy staffed from The outpatient clinic is in the Outpatient Care Center and includes an infusion area for chemotherapy, fluids, and blood products, and a dedicated pharmacy. Radiation oncology services are provided at the OSUCCC-James Cancer Hospital and Solove Research Institute. |
Travel Assistance |
Nationwide Children’s Hospital social workers coordinate transportation for patients as needed. |
Lodging |
A new Ronald McDonald House opened in place of the former one in 2005 on the hospital campus. There are four dedicated suites for immune-compromised patients and their families. The Clinical Services and Care Coordination department assists with lodging and can be reached at 614.722.6300. |
Social Support |
Psychology, Nutrition, Dental, Child Life, Physical Therapy, Occupational Therapy, and Recreational Therapy specialists work as members of the interdisciplinary team to support the psychosocial, developmental, and emotional needs of patients and their families. An educational specialist is available as a liaison to the child’s school. Tutoring and a school re-entry program are available. There is a sibling support group and a “Clubhouse” for siblings of children in the hospital. Nationwide Children’s Hospital runs an annual weekend camp for children with hematologic and cancer diagnoses. Visitation for parents is 24 hours a day. |
Home Health Care/Hospice |
Nationwide Children’s Hospital offers many services to meet the needs of children at home throughout central Ohio either through Children’s Homecare or working through other community-based agencies. To contact Children’s Homecare, call Children’s also offers hospice services for pediatric oncology patients. This service is JCAHO-accredited and certified by Medicare/Medicaid. It is the only pediatric hospice program in central Ohio. It provides homecare services to meet the physical, emotional, and spiritual needs of terminally ill children and their families. To contact Nationwide Children’s Hospice program, call 614.722.3556. |
Ages Treated |
Children of all ages, from birth to age 20, are treated at Nationwide Children’s Hospital, including young adults with pediatric disease diagnoses. |
Pediatric Oncology Director |
Thomas G. Gross, MD, PhD |
Director, Pediatric Bone Marrow Transplant Program |
Amanda M. Termuhlen, MD |
Multidisciplinary Teams |
All children and adolescents diagnosed with cancer are treated by a multidisciplinary team consisting of a pediatric oncologist, nurse practitioner, nurses, psychologists, social workers, child life specialists, education specialists, pharmacists, and therapists. There are formal teams that care for patients with brain or bone tumors, long-term survivors, and those undergoing blood or marrow transplantation. |
Cooperative Group Membership |
|
Cooperative Group Activities |
The Pediatric Blood and Cancer Program at Children’s Hospital is one of the largest and most active members of the Children’s Oncology Group. The Division Chief, Tom Gross, MD, PhD, is the chair of the Non-Hodgkin’s Lymphoma Strategy Group and chairs a protocol for the treatment of post-transplant lymphoproliferative disease. The associate chief, Amanda Termuhlen, MD, is chair of a Rare and Cutaneous Non-Hodgkin Lymphoma Registry, vice-chair of the treatment protocol for all newly diagnosed lymphoblastic lymphomas, and a member of the protocol committee running a trial for relapsed B-cell lymphomas. She is on the Voting Body, Adolescent and Young Adult Committee, and is a member of both the Hematology/Oncology and the Stem Cell Transplant discipline. Fred Ruymann, MD, former principal investigator in the Children’s Cancer Oncology Group and active in the Intergroup Rhabdomyosarcoma committees, chairs the Children’s Oncology Group Membership Committee. Several advanced practice nurses and clinical research associates serve on Children’s Oncology Group committees, including late effects and the treatment of neuroblastoma, nasopharyngeal carcinomas, and Hodgkin’s disease. Clinical research is supported by a staff of Clinical Research Associates and managed by Barb Pugh, RN, MS, CCRP. The clinical research office can be contacted at 614.722.3568. |
Average Number of Trials |
100 |
In 2004, the Center for Childhood Cancer was established as a new Center of Emphasis in The Research Institute at Nationwide Children’s Hospital. The Center for Childhood Cancer strives to expand understanding of the pathogenesis of childhood cancer through basic and translational research. The goal is to improve diagnosis, refine prognosis, and advance treatment, with the ultimate goal of increasing cure rates and decreasing side effects and outcomes of therapy. Specific research programs focus on mechanisms of cellular growth and proliferation, the tumor microenvironment, and the role of the immune system in cancer control and treatment. Studies on the pathogenesis of childhood sarcomas are also an emphasis and a distinguishing strength of the Center.
An important component of the Center for Childhood Cancer is the Biopathology Center, led by Nilsa Ramirez, MD. The Biopathology Center serves as the only pediatric repository for pediatric solid tumor samples and is one of only two repositories for leukemia samples in the United States, Canada, and Australia. More than 80,000 samples have been characterized and distributed to 250 pediatric cancer researchers throughout the world in the past five years. Because of the Biopathology Center, The Research Institute at Nationwide Children’s Hospital receives more grant funds from COG than any other national program.
Scientists in the Center for Childhood Cancer are listed below:
Research Scientist |
Expertise |
Tom Gross, MD, PhD |
Immunosurveillance and cancer control |
Long-Sheng Chang, PhD |
Retinoblastoma, Neurofibromatosis |
Mary Beth Ross, MD, PhD |
Leukemia; Genome profiling |
Brett Hall, PhD |
Tumor-stroma interactions |
Dawn Chandler, PhD |
Pre-mRNA splicing; Rhabdomyosarcoma |
Julie Gastier-Foster, PhD |
Molecular genetic testing |
Jayah Lin, PhD |
Jak/Stat signaling and cancer |
Blood and Marrow Transplantation
The Nationwide Children’s Hospital Pediatric Blood and Marrow Transplantation (BMT) Program works in collaboration with the adult BMT Program at the OSUCCC-James Cancer Hospital and Solove Research Institute. Bone marrow processing, HLA typing, and cytogenetics are shared between the two institutions. The Pediatric Blood and Marrow Transplant program is accredited by the Federation for Accreditation of Cellular Therapies (FACT), is an independent National Marrow Donor Program Center, and is a Children’s Oncology Group BMT Center. Types of transplants offered include:
The Pediatric Blood and Marrow Transplant Program patients are cared for at Nationwide Children’s Hospital with a full complement of multidisciplinary team members and pediatric sub-specialists. Nationwide Children’s Hospital has a Pediatric Intensive Care Unit with four designated HEPA-filtered Bone Marrow Transplant beds that offer 24-hour in-house pediatric intensivist coverage. The BMT physician team is sub-specialized into those caring for patients with leukemia, solid tumors, non-malignant disorders, and genetic/metabolic or immune deficiency disorders. There are dedicated multidisciplinary clinics for chronic graft-vs.-host disease patients and long-term survivors of BMT. The BMT program works closely with two immunologists, and the program conducts clinical research in oncology as well as brain tumors, non-cancer conditions, and graft-vs.-host disease. The program is supported by four full-time nurse practitioners who provide outpatient clinic coverage and 24-hour house coverage of BMT patients Monday through Friday. There are two BMT coordinators to facilitate referral and pre-transplant evaluations of patients. For a BMT referral, call 614.722.3558.
Brain Tumors
Randal Olshefski, MD, directs the Pediatric Neuro-oncology Program and provides extensive expertise in the treatment of children and adolescents with all varieties of brain tumors. Edward Kosnik, MD, director of neurosurgery at Nationwide Children’s Hospital, utilizes a variety of new surgical techniques to completely resect brain tumors. The Neuro-oncology Care Team consists of Drs. Oshefski, Kosnik, or his pediatric neurosurgery colleagues; a dedicated pediatric nurse practitioner; RN staff; psychologists; an educational specialist; and a social worker. The Pediatric Neuro-oncology Program has a Long-Term Follow-Up Clinic dedicated to meeting the needs of brain tumor survivors.
Bone Tumors
Nick Yeager, MD, oncologist, and Joel Mayerson, MD, orthopedic oncologist, along with a dedicated bone tumor pediatric nurse practitioner, staff a comprehensive bone tumor clinic. They jointly meet with new patients and collaborate on medical and surgical management. Mayerson is a national expert on limb-salvage procedures using cutting-edge surgical techniques and innovative pediatric prosthetics.
Behavioral Research
The Nationwide Children’s Hospital Blood and Cancer Program works very closely with two research psychologists who are studying pediatric cancer patients. Ongoing research includes:
Pediatric Oncology Program, Calendar Year 2006
No. of Researchers |
No. of Clinicians |
No. of Inpatient Days |
Average Length of Stay (days) |
Inpatient Discharges |
Total Outpatient Visits |
Inpatient ADC (average daily census) |
No. of Bone Marrow Transplants |
10 |
13 |
8,345 |
5.9 |
1,415 |
10,228 |
22.9 |
26 |
The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute has a Clinical Cancer Genetics Program (CCGP) dedicated solely to the study of human cancer genetics. The (CCGP) is part of the Division of Human Genetics in the Department of Internal Medicine and provides services through the Cancer Genetics Clinic and through participation in multidisciplinary programs such as the High Risk Breast Program and the Neuroendocrine Clinic. These programs provide comprehensive services, including genetics, for individuals with cancer and their families. The focus is on pre-symptomatic risk assessment, management options, education of patients and professionals, genetic testing, and access to appropriate research protocols. Multidisciplinary teams staff the clinics and include physicians who are board-certified in clinical genetics and surgery, as well as board-certified genetic counselors with extensive experience in cancer genetics.
|
Location |
Columbus, Ohio |
|
Director, Clinical Cancer Genetics Program |
Albert de la Chapelle, MD, PhD |
|
Director, Human Cancer Genetics Program |
Albert de la Chapelle, MD, PhD |
|
Schedule Appointment |
614.293.6694 |
The James provides a full range of genetic counseling, testing, screening and research. The following sets out the components of the comprehensive genetic testing program:
|
Physician Awareness |
CCGP staff offer continuing medical education for academic and community physicians, nurses and medical center staff. Each year, about 50 interactive programs and lectures are offered on topics such as family cancer syndromes, cancer risk, prevention, early detection, follow-up care, pre-symptomatic genetic testing and ethical issues. In addition, other medical genetics topics are offered by special request. |
|
Patient Education |
Patients receive individualized education from a genetic counselor, clinical cancer geneticist or geneticist with experience in cancer genetics. They discuss basic genetic concepts, the relationship between genes and cancer, risk assessment strategies for personal cancer risk and cancer susceptibility syndromes, and pre-symptomatic genetic testing. |
|
Identify Eligible Subjects/Referral |
Individual and family member records are obtained to verify medical histories prior to counseling. Pedigrees are constructed using the Progeny® pedigree and database program. Individuals with family histories consistent with familial cancer syndromes such as hereditary breast-ovarian cancer syndrome, familial adenomatous polyposis, Lynch syndrome (HNPCC), familial colorectal cancer in Jewish individuals, multiple endocrine neoplasia types 1 and 2, neurofibromatosis types 1 and 2, von Hippel-Lindau syndrome, retinoblastoma, hereditary Wilms’ tumor, and others are initially evaluated with the assistance of the CCGP. Appropriate referrals are made to multidisciplinary clinics such as the High Risk Breast Program and Neuroendocrine Clinic for long-term follow-up and management. In-depth counseling is provided about confidentiality, psychosocial, legal, and financial issues at the same time the individual is informed of his or her susceptibility risks. Some at-risk individuals may be identified through direct referral to the multidisciplinary clinics. If appropriate, the individuals are seen subsequently in the CCGP Clinic for in-depth counseling. |
|
Pre-test Counseling and Risk Assessment |
Risk evaluation is accomplished using medical records received in the pre-counseling period and with information received from the patient at the time of the counseling session. Individuals are encouraged to consult family members and records while preparing for the session. The individual meets with a genetic counselor and a clinical cancer geneticist or clinical geneticist who provide basic genetic concepts, the relationship between genes and cancer, and risk-assessment strategies for personal cancer and cancer susceptibility syndromes. The person's readiness to participate in pre-symptomatic testing is assessed. A counselor prepares the person psychologically for test results; discusses the potential risks, benefits and limitations of the testing; and provides information about the medical and genetic ramifications of positive, negative and indeterminate test results. Eligibility for genetic testing research protocols is discussed. In-depth counseling is provided about confidentiality, psychosocial, legal and financial issues. Risk-reducing surgical options are discussed. Management options are discussed for other at-risk family members, including appropriate options for children and adolescents in the case of FAP or MEN syndromes. |
|
Informed Consent Procedures |
Written informed consent is required prior to any specimen acquisition for any gene testing. Institutional Review Board informed consent procedures are followed for research protocols. An informed consent document for reference laboratory is used for commercially available tests. All informed consent documents indicate that the individual is informed of the purpose and type of genetic test to be performed, potential risks, benefits and limitations of genetic testing, confidentiality issues and fees involved in testing. |
|
Confidentiality Standards |
Physical examination findings are recorded as part of the medical record. Notation is made that a genetic counseling session has occurred and that a secure chart is available in the Clinical Cancer Genetics office. Release of CCGP records requires a specific, current, signed consent from the individual. A detailed letter documenting the patient's family history, counseling issues and genetic testing results are located in CCGP records. No results of genetic testing are posted on the computer-based medical record. |
||||||||||||||||||||||||||||||
|
Testing |
Genetic testing may be performed at Ohio State University Medical Center Molecular Pathology Laboratory or at a licensed commercial laboratory. These laboratories meet the College of American Pathology (CAP) and Clinical Laboratory Improvement Act (CLIA) of 1988 standards and are accredited. |
||||||||||||||||||||||||||||||
|
Examples of Available Testing at or through The James |
|
||||||||||||||||||||||||||||||
|
Laboratory Quality Assurance |
CAP/CLIA accreditation is current at all Ohio State University laboratories. The director of the Molecular Pathology Laboratory is certified in molecular genetics by the American Board of Medical Genetics. |
||||||||||||||||||||||||||||||
|
Test Result Interpretation |
Laboratory personnel provide a written report to the physician, who interprets all genetic testing results in light of the individual's personal and family history, the published literature and database repositories of mutations. The risk conveyed by a specific mutation is estimated based on all available data for each individual. |
The Clinical Cancer Genetics Program at The James Cancer Hospital and Solove Research Institute serves as a liaison between patients/families and basic researchers. The program is involved in genetic research and encourages individuals and families to participate in the following types of research:
|
Gene Studies |
Papillary Thyroid Cancer Lynch syndrome (Hereditary Non-Polyposis Colon Cancer) Spielman Breast Cancer tumor bank Modifier study |
|
Other Cancer Gene-Related Studies |
Amish Population Study Prospective Cohort BRCA Study |
|
Improving Counseling Methods |
The CCGP has developed JamesLink, an online, personalized, cancer-risk assessment tool that estimates risk by reviewing patterns of cancer in a family. JamesLink is available on The James Web site at www.jamesline.com/go/familyhistory. We will improve access to CCGP counseling services by informing the appropriate individuals of their risk for hereditary cancer predisposition syndromes and recommending genetic counseling. |
|
Participating in Familial Registries or National Registries |
The CCGP is also in the consortium of centers participating in the Prospective BRCA Study centered in Toronto and a member of CIMBA (Consortium of Investigators of Modifiers of BRCA1/2). The CCGP also works closely with the Colon Cancer Family Registry. |
|
Studying Impact of Receiving Genetic Information on Health-Related Outcomes |
A research study is ongoing to assess patient compliance with cancer surveillance and genetic counseling recommendations provided in a risk-notification letter sent to patients using JamesLink. The letter is tailored to the patient in an attempt to increase compliance. |
|
Quality assurance |
A weekly CCGP case conference reviews each individual's case. Each counseling letter is reviewed prior to release. |
|
Training |
The Clinical Cancer Genetics Program participates as a clinical site for the training of genetic counselors. |
|
Other |
The Ohio Cancer Genetics Network, founded in 2006 by the Ohio Department of Health, aims to improve statewide collaboration in cancer epidemiology, management and counseling of clinical cancer genetics patients as well as research. To this end, databases at collaborating institutions are being made compatible with each other. |
Last updated: 2/11/2008
|
NCCN 1st Annual Forum: Innovative Diagnostics & Therapeutics in Cancer Care™ |
|
|