Pioneering Progress: New Mexico’s Path to Better Cancer Outcomes
New Mexico Statewide Cancer Clinical Trials Network reviewed state’s cancer clinical trials and celebrated advances in cancer care at June Scientific Retreat
Credit: Robin M. Johnston, UNM Comprehensive Cancer Center Chandylen Nightingale, PhD, MPH, Wake Forest University, was the keynote speaker at the NMCRA Scientific Retreat « Stronger Together
For nearly 20 years, the New Mexico Cancer Care Alliance (NMCCA) ensured that New Mexicans in all parts of the state had access to cancer clinical trials. That network of health care organizations has modernized its processes. It also strengthened its focus and mission on delivering clinical trials and clinical research to prevent, detect, and treat cancer and to improve patient outcomes, experiences and access to cancer care using culturally sensitive approaches.
The rebranded organization, now called the New Mexico Cancer Research Alliance (NMCRA), held its first in-person scientific retreat on June 21. Attendees at the event represented The University of New Mexico Comprehensive Cancer Center, Presbyterian Healthcare Services, Lovelace Health System and Memorial Medical Center and the Veteran’s Administration Hospital System.
Summary
The New Mexico Cancer Care Alliance (NMCCA) has rebranded as the New Mexico Cancer Research Alliance (NMCRA) to strengthen its focus on delivering cancer clinical trials to New Mexicans.
Through the NMCRA’s unique collaboration, every New Mexican has access to cancer clinical trials.
Cancer clinical trials test new treatments and new methods of delivering and improving cancer care
A “Gem” to Improve Cancer Care
The NMCRA is an incredible gem for the people of New Mexico,” says Carolyn Muller, MD, FACOG, NMCRA Director. “Clinical research improves the lives of cancer patients by focusing on better ways to prevent, detect and treat cancer and to optimally deliver cancer care.”
Cancer Clinical research is conducted through clinical trials, which test new treatments and new methods of delivering and improving cancer care. Some trials test whether new drugs are more efficacious than the currently used “standard” drugs. Some test new drug combinations.
Other cancer clinical trials test better ways to screen for cancer or lessen symptoms from cancer or cancer treatments. Still other trials test different methods of delivering care to different people, such as individuals from different racial or ethnic communities or those who live in rural or underserved communities.
The FDA enforces a four-phase process of testing through which new treatments are approved for use. Each phase has its own set of requirements that treatments must meet in order to progress to the next phase.
Professional medical organizations, such as the American Society for Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN) create guidelines for cancer related clinical practice based on the strength of scientific evidence that results from clinical trials. These standards reflect the latest scientific research and best-known practices for delivering care.
The current standard treatments and care practices in effect today went through scientifically rigorous clinical trials to become the standards. When new clinical trials show a drug, treatment or method to be more effective than the current standard, the practice of cancer care changes.
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Muller says that the results of several practice-changing clinical trials were presented at the most recent American Society for Clinical Oncology (ASCO) national conference. Some New Mexico patients took part in those clinical trials.
“Our patients had an opportunity to benefit from the clinical trial treatments, and they also helped future patients receive better care,” says Muller. “They are true heros!”
“Cancer research is the key to progress in our battle against cancer,” says Dr. Heyoung McBride, MD from Lovelace Cancer Center, Radiation Oncology. “It is only through high quality research that we can advance our understanding of biological processes involved in cancer and improve outcomes for patients and loved ones suffering from cancer,” she says.
Daunting Challenges
New Mexico’s small population is spread over a large area: the state ranks fifth in land mass but 36th in population. Offering clinical trials to people throughout the state thus presents a daunting challenge.
Because of their scientific nature, clinical trials demand more than strict adherence to a detailed plan, called a protocol, that every person on the trial must follow. Trials also require evidence that each person has followed that protocol. Should anyone deviate from the protocol – for example, if someone must come off the protocol because of a new health issue or a serious side effect – a note of that situation must also be recorded and reported, especially for safety purposes.
A cadre of expertly-trained research teams are needed to manage clinical trials. Some of these people are trained to ensure that participants in each clinical trial meet all the criteria for joining that trial. Others explain the protocols to potential participants. And many others enter clinical trial data, manage databases, report results to oversight entities, and track patient responses and side effects.
Few, if any, independent doctor’s offices could manage clinical trials on their own. Even some larger health care organizations in the state would struggle under the vast administrative burden. UNM, as the only NCI designated Comprehensive Cancer Center in NM, serves as the academic hub for the NMCRA. And the NMCRA brings cutting edge clinical trials and clinical research from the National Cancer Institute, lead investigators and other stakeholders to the NMCRA member health systems.
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Through the NMCRA’s unique collaboration, UNM’s clinical research expertise is shared with all affiliated cancer treatment providers in the state. The UNM Cancer Center’s Clinical Research Office supports many of the core functions of the NMCRA.
This collaborative effort between the academic and community health systems partners has led to sustained funding support from the National Cancer Institute’s National Community Oncology Research Program (NCORP).
“The NCORP Program delivers state-of-the-art national cooperative group clinical treatment, prevention and screening trials to New Mexico,” Muller says. She also notes that many clinical research leaders in New Mexico across the NMCRA not only serve on the national committees that help to shape the future of these trials but also make sure that New Mexicans can access these trials.
“Health systems in New Mexico value cancer clinical trials,” says Muller.
William Adler, MD, at Memorial Medical Center in Las Cruces, sees the benefits of clinical trials for New Mexicans, He says, “Memorial Cancer Center has made clinical research trials a priority for nearly 15 years. The availability of these national and international studies allows patients to stay at home with their families and still have access to the leading edge of cancer care. The cancer program at Memorial Medical Center has received national recognition for its clinical trial research activities. As the umbrella organization, NMCRA has made cancer clinical research possible in southern New Mexico.”
Malcom Purdy, MD, at Lovelace Cancer Center Medical Oncology agrees. He says, “The Lovelace Cancer Center has participated in clinical trials with the University of New Mexico for close to 40 years. These have included groundbreaking studies which have advanced patient care and cancer treatment, especially in breast cancer. Unlike clinical trials for other conditions, clinical trials for cancer patients take the best of what we know now and add to that care, so all participants receive excellent care. I always tell my patients that participation in a clinical trial gives the best care.
Access for All
As the many affiliates of the NMCRA know, offering the best cancer care isn’t good enough; that care must reach the people who need it.
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In addition to the large cancer care providers, smaller oncology practices throughout the state are also NMCRA affiliates. They provide cancer clinical trials to people in some of the most underserved and remote areas in New Mexico.
And the National Cancer Institute (NCI) also recognizes the need to bring cancer care and cancer research to people who have not taken part in clinical trials in the past or who may face significant barriers to joining then now.
The NCI is also focusing on cancer care delivery. Cancer care delivery research studies how different processes, models, concepts and approaches can improve the quality of cancer care, patient outcomes, and access to care.
Chandylen Nightingale, PhD, MPH, Assistant Professor in the Department of Social Sciences and Health Policy, Division of Public Health Sciences, at Wake Forest University School of Medicine spoke at the recent NMCRA scientific retreat and shared her research and insights and the importance of cancer care delivery research.
“It is imperative for New Mexico’s cancer patients to have access to innovative treatments that will hopefully move cancer care forward,” says Ethan Binder, MD, at Presbyterian Healthcare Services Hematology/Oncology. “The NMRCA is a wonderful collaborative effort that truly tailors cancer research for New Mexicans.”
The University of New Mexico Comprehensive Cancer Center is the Official Cancer Center of New Mexico and the only National Cancer Institute-designated Cancer Center in a 500-mile radius. Its more than 120 board-certified oncology specialty physicians include cancer surgeons in every specialty (abdominal, thoracic, bone and soft tissue, neurosurgery, genitourinary, gynecology, and head and neck cancers), adult and pediatric hematologists/medical oncologists, gynecologic oncologists, and radiation oncologists. They, along with more than 600 other cancer healthcare professionals (nurses, pharmacists, nutritionists, navigators, psychologists and social workers), provide treatment to 65% of New Mexico’s cancer patients from all across the state and partner with community health systems statewide to provide cancer care closer to home. They treated approximately 14,000 patients in about 100,000 ambulatory clinic visits in addition to in-patient hospitalizations at UNM Hospital. A total of nearly 400 patients participated in cancer clinical trials testing new cancer treatments that include tests of novel cancer prevention strategies and cancer genome sequencing. The more than 100 cancer research scientists affiliated with the UNMCCC were awarded $35.7 million in federal and private grants and contracts for cancer research projects. Since 2015, they have published nearly 1000 manuscripts, and promoting economic development, they filed 136 new patents and launched 10 new biotechnology start-up companies. Finally, the physicians, scientists and staff have provided education and training experiences to more than 500 high school, undergraduate, graduate, and postdoctoral fellowship students in cancer research and cancer health care delivery. Visit www.UNMHealth.org/cancer.
Presbyterian Healthcare Services exists to improve the health of patients, members and the communities we serve. Presbyterian is a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, it is the state’s largest private employer with more than 13,000 employees.
Lovelace Health System (Lovelace) recently celebrated its 100th anniversary, marking a century of caring, change and progress while continuously improving the practice of medicine.
Lovelace is comprised of Lovelace Medical Group/New Mexico Heart Institute, Lovelace Women’s Hospital, Lovelace Medical Center, Heart Hospital of New Mexico at Lovelace Medical Center, Lovelace Westside Hospital, Lovelace Regional Hospital and Lovelace UNM Rehabilitation Hospital. Across its six hospitals, 33 health care clinics and seven outpatient therapy clinics, Lovelace has 619 inpatient beds and employs a team of more than 3,450, including over 280 health care providers. Lovelace continues to invest in our community, providing more than $81 million in unfunded care and supporting local nonprofit and community organizations with more than $357,000 in charitable contributions and community support in 2022. From the first and only hospital in New Mexico dedicated to women’s health to the state’s only hospital devoted exclusively to cardiovascular care, Lovelace is a leader in meeting the healthcare needs of this region. To learn more about our state-of-the-art treatment options, innovative health care providers and award-winning quality initiatives, visit lovelace.com.
Memorial Medical Center is a 199-bed full-service acute care hospital located in Las Cruces, New Mexico and serving a five-county region of Southern New Mexico. Our mission is simple: Making Communities Healthier. We are a part of the LifePoint Health family of hospitals, which means we aim to create a place where people choose to come for healthcare, physicians and providers want to practice, and employees want to work. Learn more at mmclc.org.
The science section of our news blog STM Daily News provides readers with captivating and up-to-date information on the latest scientific discoveries, breakthroughs, and innovations across various fields. We offer engaging and accessible content, ensuring that readers with different levels of scientific knowledge can stay informed. Whether it’s exploring advancements in medicine, astronomy, technology, or environmental sciences, our science section strives to shed light on the intriguing world of scientific exploration and its profound impact on our daily lives. From thought-provoking articles to informative interviews with experts in the field, STM Daily News Science offers a harmonious blend of factual reporting, analysis, and exploration, making it a go-to source for science enthusiasts and curious minds alike. https://stmdailynews.com/category/science/
(Family Features) Many people don’t think much about whether their blood is clotting properly. However, when you have a bleeding disorder, a condition that affects the way your body controls clots, it’s no small matter.
According to the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health, abnormal clotting can lead to a host of problems, including excessive bleeding after an injury or during surgery.
About 3 million people in the U.S. have bleeding disorders. Some types, such as hemophilia, are inherited, meaning a person who has it is born with it. Inherited bleeding disorders are caused by certain genes passed down from parents to children. These genes contain instructions for how to make proteins in the blood called clotting factors, which help blood clot. If there is a problem with one of these genes, such as a mutation – a change in the gene’s instructions – the body may make a clotting factor incorrectly or not make it at all.
You can also have what’s called an acquired bleeding disorder, meaning you develop it during your lifetime. Acquired bleeding disorders can be caused by medical conditions, medicines or something unknown. Your risk of developing a bleeding disorder depends on your age, family history, genes, sex, or other medical conditions. If bleeding disorders run in your family, you may have a higher risk of developing or inheriting one.
Symptoms of a bleeding disorder may appear soon after birth or develop later in life and can include:
Excessive bleeding or bruising, such as frequent or long nose bleeds (longer than 15 minutes) or frequent or long menstrual periods
Petechiae, which are tiny purple, red, or brown spots caused by bleeding under the skin
Redness, swelling, stiffness, or pain from bleeding into muscles or joints
Blood in urine or stool
Excessive umbilical stump bleeding
Excessive bleeding during surgery or after trauma
If you believe you, or someone you care for, may have a bleeding disorder, talk to a health care provider. Your provider may make a diagnosis based on symptoms, risk factors, family history, a physical exam, and diagnostic tests. Health care providers typically screen for bleeding disorders only if you have known risk factors or before certain surgeries.
How your bleeding disorder is treated depends on its type. If your disorder causes few or no symptoms, you may not need treatment. If you have symptoms, you may need daily treatment to prevent bleeding episodes, or you may need it only on certain occasions, such as when you have an accident or before a planned surgery.
If you have been diagnosed with a bleeding disorder, it’s important to be proactive about your health and follow your treatment plan. To lower your risk of complications:
A Story of Bravery, Balance, and a Bleeding Disorder
There are lots of things that make Mikey White Jr. special. He’s a dedicated athlete. He’s determined, disciplined, and optimistic. He’s also living with hemophilia, a type of bleeding disorder.
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White was diagnosed with hemophilia at age 3 after experiencing several severe bleeding episodes. He had to give up baseball and basketball, his passions, because of the high risk of injuries, but he found competitive swimming – and he’s been breaking records ever since.
“Competitive swimming is a noncontact sport, so it complements my hemophilia while still being an intense and rigorous sport,” White said.
Being an athlete with hemophilia requires support, White admits. He works with his healthcare team and coaching staff to make sure he safely manages his condition and balances it with his training. He hopes his story encourages others living with bleeding disorders to accept and appreciate their bodies the way they are.
(Family Features) Most people don’t want to think about death – let alone talk about it. When the time comes, families often find themselves overwhelmed, not only by grief but by the many decisions that need to be made quickly.
Funeral directors witness this every day. They see the stress and confusion that can come when there is no plan in place and the peace of mind that comes with thoughtful preparation.
After consulting funeral directors nationwide, the National Funeral Directors Association (NFDA) uncovered five things they wish families knew before a death occurs.
It’s Never Too Early to Start Planning
While everyone knows death and taxes are inevitable, conversations about death are often avoided.
Simply documenting your wishes and discussing your preferences with your family can alleviate the difficult decisions your loved ones will have to make in the future. Speak with a funeral director to explore the many options for planning a meaningful funeral.
Legal and Financial Details Can Cause Unexpected Issues
Families often don’t realize power of attorney ends at death, meaning a designated person can no longer make decisions or access bank accounts once an individual dies.
To avoid complications, consider adding a trusted loved one to your bank account and ensure life insurance beneficiaries are up to date. Too often, deceased individuals leave minor children, deceased spouses or former partners as beneficiaries, leading to legal and financial challenges.
Final Wishes Shouldn’t Be In Your Will
Many people believe the best place to document their final wishes is in their will. However, wills are often not read until after funeral services take place, making them an unreliable way to communicate last requests. Instead, discuss and document your wishes with family members or a trusted funeral professional who can keep your wishes on file until there is a need.
There Are a Variety of Memorialization Options
End-of-life planning offers more choices than many realize. While burial remains a common preference, cremation is an increasingly popular choice and can even include a viewing and funeral service. Additionally, eco-friendly options, such as alkaline hydrolysis, natural burial and natural organic reduction are becoming more widely available for those seeking green memorialization. In fact, according to NFDA’s 2024 Consumer Awareness and Preferences Study, 68% of respondents expressed interest in green funeral options.
Exploring these possibilities with a funeral professional can help ensure your final arrangements reflect your values, traditions and personal wishes.
Funeral Directors Don’t Just Manage Funerals – They’re Trusted Guides In Honoring Life
Funeral directors play a vital role in helping families create meaningful services that reflect their loved one’s life, values and traditions. Whether planning ahead or facing a recent loss, funeral professionals provide expertise, compassionate care and personalized guidance during one of life’s most difficult moments.
Choosing the right funeral director is an important decision and finding someone who understands your needs can make all the difference in honoring your loved one in a personal and meaningful way.
Start the conversation today by talking about end-of-life planning. It isn’t easy, but it’s one of the most important conversations you can have with your loved ones. A little planning today can make a world of difference tomorrow.
Use comprehensive resources like RememberingALife.com, which is designed to guide families through every stage of the journey, including planning, funeral options and grief resources. The site offers valuable tools and support, such as the “Find a Funeral Home” tool to connect families with compassionate, local funeral directors and much more.
Photo courtesy of Shutterstock
SOURCE:National Funeral Directors Association
Workers who are in frequent contact with potentially sick animals are at high risk of bird flu infection.
Costfoto/NurPhoto via Getty ImagesRon Barrett, Macalester College
Disease forecasts are like weather forecasts: We cannot predict the finer details of a particular outbreak or a particular storm, but we can often identify when these threats are emerging and prepare accordingly.
The viruses that cause avian influenza are potential threats to global health. Recent animal outbreaks from a subtype called H5N1 have been especially troubling to scientists. Although human infections from H5N1 have been relatively rare, there have been a little more than 900 known cases globally since 2003 – nearly 50% of these cases have been fatal – a mortality rate about 20 times higher than that of the 1918 flu pandemic. If the worst of these rare infections ever became common among people, the results could be devastating.
Approaching potential disease threats from an anthropological perspective, my colleagues and I recently published a book called “Emerging Infections: Three Epidemiological Transitions from Prehistory to the Present” to examine the ways human behaviors have shaped the evolution of infectious diseases, beginning with their first major emergence in the Neolithic period and continuing for 10,000 years to the present day.
Viewed from this deep time perspective, it becomes evident that H5N1 is displaying a common pattern of stepwise invasion from animal to human populations. Like many emerging viruses, H5N1 is making incremental evolutionary changes that could allow it to transmit between people. The periods between these evolutionary steps present opportunities to slow this process and possibly avert a global disaster.
Spillover and viral chatter
When a disease-causing pathogen such as a flu virus is already adapted to infect a particular animal species, it may eventually evolve the ability to infect a new species, such as humans, through a process called spillover.
Spillover is a tricky enterprise. To be successful, the pathogen must have the right set of molecular “keys” compatible with the host’s molecular “locks” so it can break in and out of host cells and hijack their replication machinery. Because these locks often vary between species, the pathogen may have to try many different keys before it can infect an entirely new host species. For instance, the keys a virus successfully uses to infect chickens and ducks may not work on cattle and humans. And because new keys can be made only through random mutation, the odds of obtaining all the right ones are very slim.
Given these evolutionary challenges, it is not surprising that pathogens often get stuck partway into the spillover process. A new variant of the pathogen might be transmissible from an animal only to a person who is either more susceptible due to preexisting illness or more likely to be infected because of extended exposure to the pathogen.
Even then, the pathogen might not be able to break out of its human host and transmit to another person. This is the current situation with H5N1. For the past year, there have been many animal outbreaks in a variety of wild and domestic animals, especially among birds and cattle. But there have also been a small number of human cases, most of which have occurred among poultry and dairy workers who worked closely with large numbers of infected animals.
Pathogen transmission can be modeled in three stages. In Stage 1, the pathogen can be transmitted only between nonhuman animals. In stage 2, the pathogen can also be transmitted to humans, but it is not yet adapted for human-to-human transmission. In Stage 3, the pathogen is fully capable of human-to-human transmission.Ron Barrett, CC BY-SA
Epidemiologists call this situation viral chatter: when human infections occur only in small, sporadic outbreaks that appear like the chattering signals of coded radio communications – tiny bursts of unclear information that may add up to a very ominous message. In the case of viral chatter, the message would be a human pandemic.
Sporadic, individual cases of H5N1 among people suggest that human-to-human transmission may likely occur at some point. But even so, no one knows how long or how many steps it would take for this to happen.
Influenza viruses evolve rapidly. This is partly because two or more flu varieties can infect the same host simultaneously, allowing them to reshuffle their genetic material with one another to produce entirely new varieties.
Genetic reshuffling – aka antigenic shift – between a highly pathogenic strain of avian influenza and a strain of human influenza could create a new strain that’s even more infectious among people.Eunsun Yoo/Biomolecules & Therapeutics, CC BY-NC
These reshuffling events are more likely to occur when there is a diverse range of host species. So it is particularly concerning that H5N1 is known to have infected at least 450 different animal species. It may not be long before the viral chatter gives way to larger human epidemics.
Reshaping the trajectory
The good news is that people can take basic measures to slow down the evolution of H5N1 and potentially reduce the lethality of avian influenza should it ever become a common human infection. But governments and businesses will need to act.
People can start by taking better care of food animals. The total weight of the world’s poultry is greater than all wild bird species combined. So it is not surprising that the geography of most H5N1 outbreaks track more closely with large-scale housing and international transfers of live poultry than with the nesting and migration patterns of wild aquatic birds. Reducing these agricultural practices could help curb the evolution and spread of H5N1.
Large-scale commercial transport of domesticated animals is associated with the evolution and spread of new influenza varieties.ben/Flickr, CC BY-SA
People can also take better care of themselves. At the individual level, most people can vaccinate against the common, seasonal influenza viruses that circulate every year. At first glance this practice may not seem connected to the emergence of avian influenza. But in addition to preventing seasonal illness, vaccination against common human varieties of the virus will reduce the odds of it mixing with avian varieties and giving them the traits they need for human-to-human transmission.
At the population level, societies can work together to improve nutrition and sanitation in the world’s poorest populations. History has shown that better nutrition increases overall resistance to new infections, and better sanitation reduces how much and how often people are exposed to new pathogens. And in today’s interconnected world, the disease problems of any society will eventually spread to every society.
For more than 10,000 years, human behaviors have shaped the evolutionary trajectories of infectious diseases. Knowing this, people can reshape these trajectories for the better.Ron Barrett, Professor of Anthropology, Macalester College
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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(Family Features) Most people don’t want to think about death – let alone talk about it. When the time comes, families often find themselves overwhelmed, not only by grief but by the many decisions that need to be made quickly.
Funeral directors witness this every day. They see the stress and confusion that can come when there is no plan in place and the peace of mind that comes with thoughtful preparation.
After consulting funeral directors nationwide, the National Funeral Directors Association (NFDA) uncovered five things they wish families knew before a death occurs.
Ron Barrett, Professor of Anthropology, Macalester College
This article is republished from The Conversation under a Creative Commons license. Read the original article.
