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Message from the Executive Director of Comprehensive Cancer Centers of Nevada

James KiblerComprehensive Cancer Centers of Nevada has provided oncology services to Southern Nevada residents and visitors for more than 40 years. James Kilber, Comprehensive Cancer Center’s Executive Director, is proud to lead the award-winning oncology practice in its commitment to providing patients with the “highest standards of care, newest technologies available and access to the latest clinical research in cancer treatment.”

Our oncology services and business practices have earned us many awards and accolades over the years, but what we are most proud of providing the best care possible and putting our patient’s needs above all else.

The physicians and our nursing staff at Comprehensive Cancer Centers of Nevada believes in the foundation of research to further advance patient care and to help develop new cancer fighting therapies. We are dedicated to our patients and committed to advancing the treatment of cancer for our patients.

We have contributed to the development of more than 55 FDA-approved cancer treatments and therapies and participate in more than 170 Phase I, Phase II and Phase III trials every year.

Comprehensive Cancer Centers of Nevada, an affiliate of The US Oncology Network and USC Norris Comprehensive Cancer Center, provides medical oncology, hematology, radiation oncology, breast surgery and pulmonary medicine services to those in need. From local Nevadans to patients traveling from other states, the physicians at Comprehensive are committed to providing the highest quality patient care. As James Kilber states, “[Comprehensive Cancer Centers’] main priority is saving lives through intelligent, thorough and compassionate patient care.”

We are here to save lives—one patient at a time—and we couldn’t do it without the support of our staff, physicians, affiliates and community partners. From our entire practice to you, thank you for allowing us to be part of your cancer-fighting journey.

 

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Clinical Trial Research Q&A – Part 1

Clinical research is a critical component in expanding treatment options for people with all types of cancer. All new cancer therapies in the last 50 years have come by way of doing research. Comprehensive Cancer Centers of Nevada has built an extensive clinical research program offering groundbreaking treatments to patients in Southern Nevada and from out-of-state. We participate in 170 Phase I, Phase II and Phase III clinical trials each year, and through our research efforts, we have helped develop more than 60 FDA approved cancer therapies.

The physicians at CCCN are dedicated to developing clinical research that will help save lives. We recently interviewed three of our physicians who actively enroll patients in clinical research to provide information about the latest in clinical research. Dr. Oscar Goodman is the medical director of CCCN’s research program and specializes in treating genitourinary malignancies. Dr. Fadi Braiteh focuses his treatment and research on gastrointestinal malignancies, lung cancer, breast cancer, and Immunotherapy. And Dr. Nicholas Vogelzang has a particular interest in genitourinary malignancies, Mesothelioma, and clinical research.

Dr. Oscar B Goodman, Jr.

Dr.-Goodman-2015

Dr. Nicholas Vogelzang

Dr.-Vogelzang-2015

Dr. Fadi Braiteh

Dr_Fadi_Braiteh_MD_CPI-670x500

 

  • What is a clinical trial and how does it work?

Dr. Oscar B Goodman, Jr. (OBG): Clinical trials allow new therapies (or medical devices) to be evaluated prior to Food and Drug Administration (FDA) approval.  These options have generally been tested and evaluated in laboratory models with promising results.  For patients, they allow access to treatments otherwise unavailable, and they provide hope by offering new forms of therapies to combat human disease.

Dr. Nicholas Vogelzang (NV):  The advances that we’ve made in cancer treatment and the medicines that we have today have been developed from clinical trials. In a clinical trial, we will ask a patient to take a new drug, compare a new drug to an old drug, or take an old drug and add a new drug to that. Clinical trials also compare two standard drugs. However, clinical trial research is changing rapidly. There are two new types of clinical research being conducted. One new way is through Bayesian, or adaptive clinical trials, where you pick the best drug over time. The second way is through diagnostics, where patients are only able to get the drug if they have a certain genetic characteristic.  

Dr. Fadi Braiteh (FB): A clinical trial, also referred to as a clinical study, is a type of scientific research study that tests how well new medical approaches, or new drugs, will work in humans. These studies test new methods of prevention, diagnosis, or treatment of a disease, such as cancer.

 

  • What are the different phases of clinical trials?

OBG: Phase I is typically a first in human study to assess whether a drug is safe and to identify its appropriate dose moving forward. Phase II- uses the phase I dose to assess whether a drug is effective and worthy of further evaluation.  These trials may be randomized against another treatment option in a blinded (unknown what is being administered) or unblinded (open label, with knowledge of what treatment is being administered). Phase III assesses whether the drug is better than the pre-existing standard of care, typically using criteria such as survival benefit or prevention of disease progression, are always randomized against the standard of care. Phase IV asses the drug for ongoing safety concerns after FDA approval.

NV: Currently, clinical research trials are organized into four phases – Phase I, Phase II, Phase III, and Phase IV. Each phase tests for different things; however, the research landscape is changing so rapidly that these numbers are going to go away. In a Bayesian trial or a randomized trial, they are not the traditional Phase I, II or III anymore. For example, we are doing Phase I trials for specific patient populations, when before, Phase I was available for everyone.

FB: A new drug or device is evaluated in the laboratory, often over years; in what is referred to as “pre-clinical trials.” This type of research does not include human subjects. After the pre-clinical phase, there are four different phases of a clinical research process that aim to answer specific questions about whether a new treatment will work well and if it’s safe. Phase I trials test the newest concept drugs in humans to find the best way to give the new treatment as well as the best dose. This phase tests the early evidence of efficacy. Phase II trials tests what effect the new treatment has on the disease. Phase III trials, typically much larger than I and II; compare the results of people taking a new treatment versus the results of people taking the standard of care. Phase IV trials are given after a drug is approved by the FDA and made commercially available. This phase checks for the occurrence of certain side effects, and detects the adverse events that are very rare and not witnessed in the phase III trial. Typically, a drug is made commercially available after a phase III trial. But in certain diseases, such as certain cancers, they can be made available after phase II if the trials show great results.

 

  • Why are clinical trials important to cancer treatment?

OBG: Clinical trials are critical to providing treatment options, particular for incurable diseases. Our future cancer cures will come exclusively through clinical trials.

NV: Conducting clinical trials is the only way the FDA will grant new drug approval in the United States or in the world, so it’s very important. Some people might fear clinical trials because they don’t know enough about it. It’s important to note that new drugs being developed through clinical research have far fewer side effects than older drugs.  

FB: Clinical trials are important for any treatment. It is the only way to test new drugs and to demonstrate that they are helpful. This is the only scientific research method that will prove such efficacy. Clinical trials are heavily regulated and supervised by ethics, scientific and governmental agencies. They are delivered by specifically trained investigators to ensure patients safety.

 

  • Who can participate in clinical trials?

OBG: Any individual who can provide informed consent (i.e. understand the potential risks, benefits, and alternative treatment options) and meets eligibility requirements (e.g. has the appropriate diagnosis and intact organ function) can participate.

NV: Anyone who has cancer, but also has good kidney function, good liver function and good blood function. We have to do a checklist of eligibility criteria before we can conduct a clinical trial.  

FB: Any patient with a specific condition can participate in a clinical trial, when available. These trials are designed so a patient will receive nothing less than the best standard of care that is available. In a trial, there is no compromise on medical care a patient receives.

 

  • What are the risks associated with clinical trials?

OBG: Risk depends on the trial phase (typically higher for phase I since there is less extensive experience with the drug or device) and the emergence of any unknown side effects.

NV: There are always new drugs being developed. They claim there are no side effects, but they do have some. However, through clinical research, we are able to identify those side effects and make modifications to the drugs. Sometimes the drug might not be the right dose, or it might affect humans differently. There’s a fair bit of science that doesn’t translate into the human experience, which may expose them to side effects.  

FB: Participation in a clinical trial itself has no risks, and in fact, studies show the quality of care given to a patient on a trial is often better. The risk is related to the new drug being studied, however, patients are well aware of the risks. Part of the enrollment process is to review, understand and accept the risks associated.

 

  • Will my clinical trial treatment be given by qualified physicians and staff?

OBG: Yes, this is mandated by the FDA. Since trials involve non-approved therapies, there is very extensive FDA-mandated oversight to assure patient safety. A full team of medical professionals including physicians, nurses, and research staff will monitor the patient and care for them through the duration of treatment.

NV: Yes. All doctors who participate in clinical trials have to sign an agreement with the company developing the trail that they will follow the letter of the law, in this case, the trial protocol. Clinical trials call for experienced doctors who are willing to communicate with the company on a regular basis which means agreeing to follow the protocol, joining regular calls, monitoring the patient and doing a very careful job. At CCCN, we have an entire team dedicated to research which includes the physician, clinical research coordinators, data managers, regulatory specialists and financial specialists.  

(FB): Yes, the provider administering the study must be licensed to practice medicine in her/his subspecialty. Additionally, the research staff and the physician must have  extensive training, must pass evaluation for conducting clinical trials, and have specific training for each trial individually.

Conducting clinical trials through our research program provides us with a unique opportunity to offer our community the latest and greatest in cancer treatment. Comprehensive Cancer Centers of Nevada, an affiliate of The US Oncology Network, is dedicated to providing high quality cancer care, and we can’t do that without the advancement of cancer clinical research.

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How Much Physical Activity is Beneficial for a Cancer Patient

In the past, doctors often told patients being treated for a chronic illness like cancer to rest and reduce physical activity. This is good advice if movement causes any pain, rapid heart rate or shortness of breath. However, new research has shown that exercise is not only safe and possible during cancer treatment, but it can also have a positive impact on their prognosis during treatment.

Inactivity can lead to loss of body function, muscle weakness and reduced range of motion in cancer patients. Nowadays, cancer centers like Comprehensive Cancer Centers of Nevada recommend to cancer patients to remain as physically active as possible during and after cancer treatment.

Take a look at some of the ways physical exercise during and after cancer treatment can help to keep you healthy:

  • Improves balance
  • Lowers risk of falls and broken bones
  • Reduces muscle weakness due to inactivity
  • Helps lower the risk of heart disease
  • Diminishes osteoporosis (weak bones that are more likely to break)
  • Improves blood flow to legs and reduces the risk of blood clots
  • Allows less dependency on others for help
  • Improves self-esteem and lowers anxiety and depression
  • Lessens nausea
  • Decreases fatigue
  • Helps control weight during and after treatment
  • Reduces the impact of side effects

In short, physical exercise can be helpful for  cancer patients, and can help improve quality of life during and after cancer treatment. Many  cancer patients have reported health benefits when they maintained regular physical exercise during and after cancer treatment.

For more information on how to optimize your health during and after cancer treatment, contact the cancer care team at Comprehensive Cancer Centers of Nevada, an affiliate of The US Oncology Network and USC Norris Comprehensive Cancer Center. Our team of oncologists, nursing staff and medical professionals can help. Visit www.cccnevada.com for more information and to schedule an appointment, call 702-952-3350.

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Tips to Help Teach Your Kids About Cancer

When someone in your family is diagnosed with cancer, it’s important to talk to your children about what to expect and the seriousness of the disease. It’s also important to be there for them and let them express their feelings. They might handle the news differently, so it’s necessary to keep an open line of communication.

CancerCare, a national nonprofit organization, provides valuable advice and tips for helping those diagnosed with cancer as well as their family members and loved ones. The organization provides counseling and family workshops that help bring families together during a cancer diagnosis. The organization also offers great tips for keeping your child informed when someone in the family receives a cancer diagnosis.

How to Teach Your Child about Cancer

Prepare what you will say.

Many parents find it extremely helpful to practice or list what they will say when they explain a cancer diagnosis to a child. Try to have these conversations together as a family, so the child feels supported by all their family members.

Set the tone.

Some parents recommend choosing a time of day in which their child is rested and calm. Starting the conversation during this time will lead to better results. Once you start the conversation, it is just as important to set the tone. Not only does it matter what you say, but also how you say it. During this time, it’s okay to show your emotions. This will let your child know that it is okay to express their emotions in a healthy way. Do not talk longer than they can listen, and let them know that they can ask any questions they need to at any time.

Consider your child’s age.

As you speak with a child, it is also essential to keep their age and maturity level in mind. Younger children have shorter attention spans and cannot sit still for long periods of time.

When speaking about a cancer diagnosis, use simple and concrete terms that they will understand. Be prepared to answer questions. Some children, depending on their age, will have more questions than others. This is okay, and it can be good for you to discover answers together.

Ask professionals for help.

If you need guidance before addressing your child with a discussion about cancer, don’t hesitate to reach out to someone for support. Organizations like CancerCare, can provide assistance to anyone who needs advice in this area. You can also join support groups in your area. Locally, The Caring Place, a program of Nevada Childhood Cancer Foundation, offers support groups for adults and children who have been touched by cancer.  Comprehensive Cancer Centers of Nevada is also available to provide support and resources for every cancer patient.

If you or a loved one has been diagnosed with cancer, contact Comprehensive Cancer Centers of Nevada, an affiliate of The US Oncology Network and USC Norris Comprehensive Cancer Center. We are here to provide treatment, support, advice and resources for every cancer patient, and their families. Together, we can fight and beat cancer, one family at a time.  

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Breast Cancer Diagnosis and Treatment: What to Expect

Breast cancer is a disease in which cancerous cells form in the tissue of the breast. About one in eight women will develop breast cancer during her lifetime, making it the most common type of cancer among women in the United States.

Age and gender are the two most important risk factors for breast cancer. Females have a much higher risk of developing breast cancer and that risk increases with age. It’s also important to know your family history, as that is a high risk factor for developing breast cancer.  Not everyone with risk factors will be diagnosed with breast cancer. However, not having any risk factors does not mean that you will not get cancer.

Risk factors for breast cancer

  • Race
  • Gender
  • Personal history of cancer
  • Personal history of benign (noncancerous) breast disease
  • Immediate family history of breast cancer (grandmother, mother, daughter, sister)
  • Inherited changes in the BRCA1 or BRCA2 genes
  • Taking hormones such as estrogen combined with progestin
  • Menstrual periods before 12
  • Menopause after 55
  • Drinking alcohol
  • Obesity

Signs of breast cancer

  • A lump or bulge near the breast or underarm area
  • Change in the size of the breast
  • Change in location of the nipple
  • Nipple turned inward
  • Dimple or puckering of the skin
  • Fluid discharge from the nipple
  • Scaly or red and swollen skin on the breast, nipple or areola

How can breast cancer be detected?

There are several ways to determine if you have breast cancer. If you have one or more of the risk factors listed above, it’s important to regularly practice breast self exams. Regardless of risk factors, women should start administering monthly breast self exams in their 20s and seek immediate medical advice if any changes or lumps are found.  

Breast self exams are a four step process and can be done in front of a mirror and while lying down.

  1. Examine your breasts in the mirror. They should be their usual shape, size and color.
  2. Raise your arms above your head and check for any changes
  3. Feel your breasts lying down. Use your first few finger pads and feel for lumps. Move in a circular motion and cover the entire breast.
  4. Feel your breasts when you are standing in the shower. Cover the entire breast and notice any lumps.

Premenopausal women should administer breast self exams approximately one week after the start of their period due to fluctuations of the way the breast tissue feels at different times of the menstrual cycle.

Additional recommendations for screening include:  

  • Mammograms: every year starting at age 40, or sooner depending on family history.
  • Clinical breast exams: every three years starting at age 20 and every year starting at age 40. Clinical breast exams must be conducted by a health care provider or gynecologist.

If cancer is found, biopsy is needed to study the cancer cells and determine the type of breast cancer and its stage. This will provide a better understanding of what treatment options are best for you.

Breast cancer treatment options

With world renowned physicians and surgeons specializing in breast health and breast cancer, Comprehensive Cancer Centers of Nevada (CCCN) provides the most current and effective treatment options to patients locally, and from around the world. These options may include:

  • Chemotherapy
  • Radiation
  • Surgery
  • Clinical research

If you or a loved one was recently diagnosed with breast cancer and want to discuss your treatment options and prognosis, contact our cancer treatment facility at 702-952-3350. You can also visit our website at www.cccnevada.com

Comprehensive Cancer Centers of Nevada is an affiliate of The US Oncology Network and USC Norris Comprehensive Cancer Center. We work extensively to develop new and progressive cancer treatment and research for all cancer types, including breast cancer. We participate in more than 170 Phase I, Phase II and Phase III clinical research trials each year, and have helped develop 55 FDA-approved cancer treatments.  

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The Superhero Wall at Comprehensive Cancer Centers

It takes courage and strength to fight a cancer diagnosis. Some would even say it’s heroic to “take on cancer like a superhero.” And, what does every superhero need? A superhero mask, of course. At Comprehensive Cancer Centers of Nevada, we give our patients the extra courage needed for treatment by decorating  radiation treatment masks like a superhero.

superhero wall

Cancer patients who need radiation therapy to the head or neck area require a special mask to immobilize the area. The idea for turning the special treatment masks into superhero masks was inspired by a young cancer patient who jokingly asked if the radiation treatment would turn him into a superhero. The patient’s radiation therapist at Comprehensive Cancer Centers decided to surprise him with his very own painted superhero mask the next time he came in for treatment. This idea grew into what is now called the “Superhero Wall.”

maskThe Superhero Wall began with the collection of a few old cancer treatment masks. Instead of discarding them, we turned into superhero faces and the wall slowly emerged. To commend and honor the brave patients that seek treatment at our centers, we dedicate this Superhero Wall to them. After all, they are the real superheroes in our facilities. And any patient who completes radiation therapy cancer treatment to their head or neck can get their treatment mask turned into the superhero of their choosing.

Comprehensive Cancer Centers oncology physicians and staff are excited that the Superhero Wall can inspire positivity, hope and courage to patients and their loved ones.

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What Not to Do with a Cancer Diagnosis

When diagnosed with cancer, it can be overwhelming to learn of all the different treatment options and procedures. Your medical team will inform you of the right steps to take and will present you with options to develop a treatment plan. It is important that patients participate in this process, so that they feel in control of the diagnosis, treatment.

The following is a list of helpful tips of what not to do when diagnosed with cancer.

1.       Don’t be uninformed.

When first diagnosed with cancer, it’s important to know the details of your diagnosis. You will want to know the type of cancer you have, the size, the location, where it began and if it has spread. As you and your doctor discover more details about your cancer, you will want to know if it is slow-growing or aggressive. Take the time to do research on your cancer and treatment options so you stay fully informed when beginning your treatment process. However, ask your doctor for recommendations on the websites to visit for more information about your cancer. Some websites out there are not factual and cause more alarm than good.

2.       Don’t procrastinate.

Stay on track with your treatment plan for your cancer diagnosis. Keep to the schedule for treatments and try not to reschedule or delay your treatments. You and your cancer-fighting doctors like the oncologists at Comprehensive Cancer Centers of Nevada, have designed a plan to give you the best opportunity to fight this disease. It is important to stay on track.

3.      Don’t isolate yourself.

Having a support system is important during difficult times. Bring someone with you to your doctor appointments, someone who can be your advocate. Seek out support groups and others who have been diagnosed with cancer or those who have completed cancer treatment.

4.       Don’t be passive.

Don’t sit back and be passive. Stay positive and be active in your cancer treatment. Communicate how your feel physically and emotionally with your medical team and caregivers.

When diagnosed with cancer, take the time to stay informed, be active and seek support. Look for all the medical and emotional support systems you need. This will help you feel more proactive and in control.   

If you seek cancer treatment in Las Vegas, the physicians at Comprehensive Cancer Centers are there to be your cancer-fighting team and support system. Each patient will be armed with a team of oncologists, nursing staff and medical professionals, helping you throughout the duration of your cancer treatment and beyond. For more information visit, www.cccnevada.com and to schedule an appointment, call 702-952-3350.

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Chemotherapy: What to Expect at a Cancer Treatment Practice

A cancer diagnosis may come with a lot of confusion. Not knowing what to expect during the course of the disease is a difficult challenge. What will cancer treatment be like? What are the side effects of cancer treatment? What is chemotherapy and will it hurt?

We want to answer some of these questions to help ease your mind about the treatment process and to let you know that the physicians and staff at Comprehensive Cancer Centers of Nevada will do everything we can to make you as comfortable as possible.

What is Chemotherapy?  

Chemotherapy is a common type of cancer treatment. It is one of the many cancer treatment services offered at Comprehensive Cancer Centers of Nevada. Specifically, chemotherapy is a treatment intended to eliminate cancer cells in the body. It works by slowing the growth of cancer cells or stopping cancer from spreading to other areas of the body. However, in this process, chemotherapy  can also harm healthy cells too, which is why many cancer patients might lose their hair during the course of treatment. These side effects will usually get better and go away after chemotherapy treatment has ended.

Depending on the stage of cancer, chemotherapy can cure, control or ease cancer symptoms. If chemotherapy completely destroys cancer cells, cancer will be in remission. If chemotherapy keeps cancer from spreading, it has effectively controlled its growth. If chemotherapy cannot cure or control cancer, it can still ease cancer symptoms by shrinking the tumor and relieving the pressure.

What to expect when you visit Comprehensive Cancer Centers

Depending on the type of cancer you have and its stage, a team of doctors, nurses and medical professionals will work with you to decide the best course of action. If chemotherapy is recommended, it’s because of the following reasons:

  • Chemotherapy can make the tumor smaller before surgery or radiation therapy.
  • Chemotherapy can destroy cancer cells that remain after surgery or radiation therapy.
  • Chemotherapy can work in conjunction with radiation and biological therapy, helping them to work better.
  • Chemotherapy can destroy cancer cells that came back or spread to other parts of the body.

If you and your doctor decide that chemotherapy is the right course of action for your cancer type, you will not have to go through it alone. The nurses and medical oncologists at Comprehensive will work closely with you to manage dosage and monitor side effects.

Comprehensive Cancer Centers, an affiliate of The US Oncology Network and USC Norris Comprehensive Cancer Center, is your number one cancer fighting facility in Nevada. Our knowledgeable and compassionate physicians, nurses and medical professionals will ensure you have a dedicated team fighting this disease with you every step of the way.

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