One in three women in the United States will experience cancer in her lifetime, a frightening trend that Moffitt Cancer Center is helping to reverse, with outcomes that are better than the national average.
Ongoing outcomes research throughout Moffitt is used to identify which cancer treatments work best and determine survival rates. It confirms that survival rates at Moffitt are higher than the national average for brain, breast, colon, liver, lung, pancreas and prostate cancers and myeloma.
Moffitt’s focus on the prevention and cure of cancer is credited for its success. Each day, highly trained cancer specialists lead individualized treatment plans and recovery programs that enlist the best medical science has to offer. Multidisciplinary patient care teams, composed of physicians, surgeons, registered nurses and nurse practitioners, research scientists, genetic counselors, nutritionists and integrative medicine specialists are dedicated to screening, diagnosing and treating cancers.
Moffitt’s Center for Women’s Oncology is home to 26 physicians, all of whom are proven leaders in the field of cancer care. Each has completed a fellowship in her or his medical specialty. All have gone through the rigorous process of achieving board certification from their specialty and subspecialty organization.
Fifteen female physicians further enhance treatment at Moffitt’s Center for Women’s Oncology. Among them is gynecologic oncologist Patricia L. Judson, M.D. Gynecologic oncology is a unique specialty that combines surgery and medical oncology.
There are now approximately 1,000 board-certified gynecologic oncologists in the nation with the majority being male. There are only three female gynecologic oncologists practicing in Tampa, according to Judson. She and Moffitt colleague Hye Sook Chon, M.D., are among them.
“There are times when a female patient who has seen a male doctor will say to me, ‘Oh, my gosh, he never asked me about that.’ It’s a comment that follows quality-of-life questions like, ‘How are you doing emotionally with all of this?’” says Judson, who serves on the Gynecologic Oncology Group’s Quality of Life Committee. “It makes sense that women physicians are more in tune with personal issues that affect women.”
Judson’s clinical practice at Moffitt’s Center for Women’s Oncology specializes in minimally invasive radical surgeries – laparoscopies and robotic-assisted laparoscopies – and chemotherapeutic treatment of gynecological malignancies.
“Many gynecologic cancers can now be treated laparoscopically rather than with open surgery, which leaves large incisions,” she says. “This is particularly beneficial for women with endometrial cancer, many of whom tend to be overweight and obese, which increases the risk for complications with open surgery.”
Judson also has a special interest and advanced training in integrative medicine, which combines safe complementary therapies with conventional medical treatments to improve the quality of life for cancer patients during and after treatment.
Her expertise complements the inpatient and outpatient services provided through the Moffitt’s Integrative Medicine Program. They include: wellness consultations, nutrition consultations, acupuncture, inpatient and outpatient massage, inpatient and outpatient individual yoga and group classes in yoga, meditation, Qigong, tai chi and stress management.
“We know that exercise and weight management play a role (in cancer risk), but it’s difficult to subanalyize. Many cancers are estrogen driven such as colon, endometrial, breast and ovarian cancer. We make estrogen in our fat; therefore, being overweight or obese places one at risk for developing these cancers and also increases one’s risk of recurrence,” Judson says.
“When patients come in, they are in very different mindsets, which determine what we do in the initial appointment. I try to focus at some point either during or after their treatment on improving diet and exercise, and make sure they understand what they can do to enhance that,” she says.
Judson’s interest in integrative medicine led her to become one of only a few gynecologic oncologists to complete physician training in acupuncture, which she performs for patients during clinic visits. While effectiveness varies according to the individual, she says, acupuncture for some alleviates such side effects as pain following surgery, nausea and vomiting associated with chemotherapy, even hot flashes in women whose ovaries have been removed and who have had breast cancer and can no longer take estrogen-based supplements for hormonal relief.
“We won’t cure cancer with integrated medical technology,” Judson says. “It’s really about quality of life and making people more comfortable with the therapies they are receiving.”
Before coming to Moffitt, Judson was a tenured associate professor at the University of Minnesota, where she also served as director of the gynecological oncology fellowship program. She was a Sime research fellow at the Center for Spirituality and Healing, and there she completed a two-year research fellowship in alternative therapies for women with gynecologic cancers. She is now an associate professor at the University of South Florida College of Medicine.
Moffitt is one of 41 National Cancer Institute-designated comprehensive cancer centers in the country and the only one based in Florida. The designation is bestowed on institutions that have significant peer-reviewed research funding; high-quality programs in basic, translational and population research; and are dedicated to developing more effective approaches to cancer prevention, diagnosis and therapy; educating health care professionals and the public; and reaching out to underserved populations.
“Because there are numerous clinical trials open at Moffitt at any given time, patients have access to medical advances that are not otherwise available for treatment,” says Judson. She encourages her patients to participate when appropriate, though clinical trials may have requirements – such as cell type and treatment stage – that limit eligibility. “We try to have something open for every disease site and place in treatment.”
Moffitt’s research spans basic science, prevention and clinical research, with a focus on translating discoveries into better care. Development of early-stage translational research aims for rapid “translation” of scientific discoveries into better patient care.
Judson is recognized for her role as a principal investigator of several significant clinical trials and authoring more than 60 studies. She is a member of the national Gynecological Oncology Group, and her work has examined standards of cancer treatments, including radiation and chemotherapy, as well as complementary and alternative therapies and their effects on women and cancer outcomes.
Currently, Judson is chief investigator of a human-safety study of fermented wheat germ extract (FWGE). The study is set to start this fall. Invented in the early 1990s in Hungary, FWGE differs from ordinary wheat germ in that it is fermented with baker’s yeast to concentrate biologically-active benzoquinones.
Judson’s previous study, “Characterizing the Efficacy of Fermented Wheat Germ Extract Against Ovarian Cancer and Defining Genomic Basis of Its Activity,” laid the foundation for ongoing research. Funded in part by a $10,000 Moffitt Merit Society® grant awarded to Judson in 2011, this early study confirmed that FWGE is effective in killing a wide range of ovarian cancer cells, while simultaneously enhancing the cancer-fighting qualities of certain chemotherapy treatments. The findings were published in the July 2012 issue of International Journal of Gynecological Cancer.
Prior to her FWGE studies, anecdotal observations by patients about their experiences with the natural product inspired Judson to investigate the scientific basis for effective and safe treatment. “It’s a good example of translational – bench to bedside – medicine,” she says.
Expedited Outpatient Care on New McKinley Campus
Today, patients with breast, ovarian, cervical, endometrial, vulvar, and vaginal cancers or gestational trophoblastic disease are provided state-of-the-art care in an elegant, warm and caring environment.
In the past four years, Moffitt has experienced tremendous growth, and Moffitt Cancer Center’s main campus at the University of South Florida is at full capacity. In the Center for Women’s Oncology, the number of breast cancer patients has increased 38 percent, and women’s cancers have risen 33 percent since 2010.
Construction of a new six-story facility on a nearly 30-acre campus on North McKinley Dr. will give Moffitt the needed space to grow and continue its mission to contribute to the prevention and cancer cure. “We needed to decompress the original campus. If we can’t grow, we can’t take on new patients; if we can’t grow we can’t do new research. If we can’t do new research we can’t find a cure,” says Vicki Caraway, R.N., B.S.N., M.B.A., administrative director of the new McKinley campus.
According to Caraway, the new McKinley campus will provide “expedited surgical services for outpatient cases, expanded clinics, radiology services, infusion and other support services.”
When it opens in the fall of 2015, the $88.8 million, 207,000-square-foot McKinley building will be home to Moffitt’s breast and cutaneous cancer programs and associated imaging. Four new outpatient surgery suites will serve patients with head and neck cancer and sarcoma, as well as breast and skin cancers.
“When conceptualizing McKinley, we focused on what cancer programs involve the most outpatient surgeries and procedures and what made sense to move offsite and keep together,” says Caraway. Ongoing patient input during the design phase was key.
“We’re keeping the same level and model of care and minimizing fragmented care to maintain the integrity of Moffitt’s multidisciplinary model,” Caraway says. “Less back-and-forth reduces the burden on one’s time and stress.”
The new facility also will include:
- Centralized registration for quick check in on the first floor
- An infusion center
- A clinical research center
- A pharmacy and retail space
- Administration and faculty offices
- Conference rooms with video-conferencing
- Dining areas
- Seven-story parking garage with 1,300 spaces.
To assure the integrity of Moffitt’s comprehensive treatment-to-trial model of care, a host of supportive services are destined for McKinley. “The staff at the McKinley site will number around 150 people,” says Caraway. “Some of them will be moving over from the original campus, but expanded services here mean new jobs for people in the community.”
The McKinley campus “is about a mile and a half from the main campus as the crow flies and a 10-to-15-minute drive door-to-door, depending on traffic,” says Caraway. “So if a patient needs to have a CAT (computerized axial tomography) scan, they can have it done at the main campus or at the McKinley campus, whatever is more convenient.”
Cancer Prevention and Early Detection
Moffitt Screening and Prevention plays a central role in Moffitt’s mission, offering a wide range of clinical cancer screening services and extensive community education outreach opportunities.
It is home to Moffitt’s more comprehensive and up-to-date breast imaging technologies, 3D mammography and automated breast ultrasound (ABUS).
Breast imaging radiologist, Jennifer Drukteinis, M.D., credits breast tomosynthesis, or 3D mammography, as the most exciting and promising new technology in breast imaging. It obtains multiple “slices” through the breast, creating a three-dimensional view of the breast tissue that helps radiologists identify and characterize individual breast structures without the confusion of overlapping tissue.
“This is particularly beneficial to patients with dense breast tissue. The images are much sharper and give us a better look at any suspicious masses or areas of architectural distortion. Tomosynthesis has been proven in multiple studies to detect 40 percent more invasive cancers than standard 2D digital mammography alone. It also reduces the number of patients we have to call back for additional imaging, eliminating much of the anxiety and inconvenience of additional imaging,” says Drukteinis
Automated breast ultrasound technology is another option for women with dense breast tissue. Using ABUS, radiologists can look through hundreds of breast tissue image “slices,” viewing layers of dense tissue to find breast cancers that may have been missed on a mammogram. Moffitt is the only hospital in Florida that uses the General Electric Invenia 3rd Generation ABUS technology.
“Three-dimensional mammography and ABUS scans offer a better chance at diagnosing breast cancer early, at a more treatable stage, in women with dense breasts,” adds Drukteinis.
In addition to breast cancer screening services, Moffitt Screening and Prevention offers comprehensive cancer screenings for all cancer sites, dual-energy X-ray absorptiometry bone density exams, genetic risk assessment services, smoking cessation tools and cancer survivorship services.
To schedule an appointment at Moffitt Screening and Prevention, call (813) 745-3980 or (888) 860-2778.
Refer2Moffitt.com is an online resource for referring physicians and their staff, developed to assist in accessing Moffitt’s resources and services. Moffitt Medical Group members are dedicated to Moffitt’s mission to contribute to the prevention and cure of cancer. For more information about Moffitt Cancer Center, visit MOFFITT.org.
By Heidi Ketler