**This blog post was written by Kimmel Cancer Center development specialist Allison Rich.

Michael Iati

With August just around the corner, it is crucial that we pause and take stock of our progress towards the goals we hope to reach before the starting line on September 13th. For Michael Iati, the Senior Director of Architecture and Planning for the Johns Hopkins Health System, watching several close family members battle cancer – and witnessing the amazing work that happens each day at the Kimmel Cancer Center – provided the impetus he needed to not just reach, but remarkably exceed, his own fundraising goals.

Currently the top individual fundraiser for this year’s inaugural Ride to Conquer Cancer, Michael has raised over $18,600 towards his current $20,000 goal. Having initially set a goal of $5,000, which is double the required individual fundraising minimum, Michael equates his fundraising success to starting a machine that, once running, is nearly impossible to stop. For Michael and his wife Dominique, who is also riding, this machine took the form of email requests sent out to friends and colleagues explaining what they were hoping to accomplish and requesting donations of whatever amount may be feasible. Using this fundraising approach familiar to many of us, Michael shared his top advice for fellow riders who hope to reach – and exceed – their fundraising goals before September:

  • The rate of response for each email blast will only be about 30%. Don’t be disappointed if not everyone comes through – find another 10 people to send it to, and cast as wide a net as you can.
  • Don’t forget about people like your mechanic or your accountant. Cancer touches everyone, and they may have a compelling reason to want to give.
  • Always send out thank you notes right away, regardless of how much the person gave.
  • Don’t be afraid to send a second follow up email – especially to family!
  • Send an email update once a month to keep donors posted. The email can include fun facts such as training milestones and the number of flat tires that month, which will help keep donors engaged and spreading the word about your goals.
  • Don’t forget about the opportunity for friends and family to double their impact through matching corporate contributions, should their employer provide such a program.
  • Remember to personalize your fundraising page! Telling your story, or even making your own personal contribution, can make a huge difference to people who might be on the fence about giving.
  • Set your initial goal at an amount that is low and attainable – and when you meet it, raise it. Never let people see your goal at 100% or more!
  • Set your own deadlines for fundraising, letting email recipients know that you are hoping to raise X amount by a certain date. This small change can make all the difference to those people who might otherwise forget or put off giving.

Most importantly, for those who have already met their goals, consider helping to pay it forward by directing donors to the pages of riders who have not yet achieved their fundraising minimum. After exceeding his own goals, Michael read the stories of other riders, selected 13 people whose stories inspired him, and included a link to each of their pages on his own. By beseeching friends to help these riders, five of them have been able to reach their minimum goals in time for this epic event.

To learn more about Michael’s story, please visit his fundraising page. If you have any fundraising tips and tricks of your own, please share them in the comments section below.

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Te(5A)m shirt design**This blog post was written by Kimmel Cancer Center development specialist Allison Rich.

There are as many reasons to gear up and join the Ride to Conquer Cancer as there are riders. Whether you are riding for the physical challenge, or are a cancer survivor yourself, each reason for riding paints a compelling picture of the unique journeys that will coalesce into one epic impact this September 13th and 14th. However, while our motivations may differ, we all share in common some challenges that stand between us and ultimately conquering this disease. From physical training to fundraising, these challenges begin to seem far less imposing when we take them on together.

For Te(5A)m, supporting each other during the Ride – and on the unit – is what makes the journey to September so feasible. Aptly named after its founding members, the Kimmel Cancer Center oncology nurses from the 5A unit of Weinberg, Te(5A)m is 17 riders strong – and even includes one very dedicated rider from Australia! Sharing an infectious enthusiasm for the impact that the Ride can make in the lives of their patients, families, and friends, the team has overcome the challenges of fundraising by working together long before the starting line.

Approaching fundraising as a steady climb, much like the 150-mile ride itself, Te(5A)m has spent the past several months raising funds through a variety of approaches which run the gamut from events at restaurants like The Green Turtle and Slainte’s Pub, where a portion of the proceeds are donated to the team, to simply cycling around Baltimore with donation buckets at the ready. Overall, the team has successfully raised over $17,000, and a series of upcoming efforts are sure to bring them even closer to their final goal.

Te(5A)m’s latest fundraising approaches involve a specially designed t-shirt, available for sale until July 21st, and a raffle for a huge gift basket featuring gift cards and gear from an assortment of local businesses such as Looney’s Pub, Dog Watch Tavern, Pitango Gelato, and Ten Thousand Villages. The t-shirt is available in several colors with either long or short sleeves (priced at $10 and $15, respectively), and features a white ribbon, indicative of the hope to conquer all cancers. The raffle tickets are priced at $1 each, or six for $5, and a winner will be drawn on August 1st.

Te(5A)m blog photoTo show your support for Te(5A)m by purchasing a shirt or a raffle ticket, please email Kathie Garben at kgarben1@jhmi.edu. As September swiftly approaches, we can all draw inspiration from the work of Te(5A)m, realizing that the difference we can make when we come together is far more powerful than that which we can achieve on our own.

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In this month's cancer news review podcast, Dr. William Nelson, director of the Johns Hopkins Kimmel Cancer Center, discusses top cancer stories on a new bladder cancer center announced at Johns Hopkins, liver cancer on the rise, cancer cells in tumors and more.

First, Dr. Nelson speaks on the announcement of a new bladder cancer institute at Johns Hopkins Kimmel Cancer Center.  He explains the significance of bladder cancer and the need to bring together experts in different disciplines to collaborate on patient care and research.

Next, Nelson discusses a few cancers that seem to be on the rise. One of those being liver cancer. He believes liver cancer is one of the more common cancers and the common causes of cancer death throughout the world. Some of the liver cancer causes is due to diet, obesity and fatty liver.

Finally, based on a study published in the scientific journal, Science, Nelson reviews the idea of harvesting T cells in someone's tumor in the laboratory to control metastatic disease. Scientists are able to research what the T cells are recognizing in the cancer and why  some treatments work in some people's cancer and not in others.

Listen to the full podcast to hear all of the latest cancer news this month.

Program notes:

0:19 New bladder cancer center at Johns Hopkins
1:20 Cancer data worldwide
2:20 Liver cancer on the rise
3:20 Fatty liver
4:10 Modified measles vaccine to treat cancer
5:11 Can also change cell processes
6:09 Harvesting T cells
7:10 Cells in tumor
8:10 Disease stabilization
9:10 Scale up techniques
10:15 End

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Healthy living was the theme of June 18th’s Day at the Market event held at Northeast Market on Monument Street in East Baltimore.

Cooking presentation by Chef Gayle Owens

The bimonthly event brings together Johns Hopkins nurses and other clinicians, safety experts, and others to interact and to share information with Baltimore citizens on simple things they can do to prevent cancer and other diseases.  Today’s event featured a cooking presentation by Chef Gayle Owens, who showed visitors to the market how to make a healthy meal (see the recipe) for under $3!  The event also featured the unveiling of a new video screen that provides easy-to-follow tips for living a healthy lifestyle.

Johns Hopkins Kimmel Cancer Center Director, Dr. Bill Nelson, attended the event and praised Maryland and Baltimore City elected officials for their dedication to the health of its citizens.  He reminded visitors of a dark day in 1990, when Maryland made national news as the state with the highest cancer death rates in the nation.  The dismal report led to the Maryland Council on Cancer Control and the Maryland Cigarette Restitution Fund, which helps fund the Day at the Market Program.  As a result of these dedicated efforts, which includes funding for Johns Hopkins Kimmel Cancer Center and Bloomberg School of Public Health cancer researchers, Maryland now ranks 30th in the nation for cancer deaths, and these rates continue to go down.   Dr. Nelson said this Maryland success story is the model for managing—and one day eradicating—cancer.

Baltimore City Council President Jack Young and Councilman Carl Stokes also attended the event.

Healthy Living was the theme of Northeast Market Day.







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**Note: This blog was written by Elissa Bantug of the Kimmel Cancer Center's Breast Cancer Program.

On March 7-8, 2013, over two hundred physicians, nurses, and other healthcare providers from around the region attended the Seventh Bi-Annual Johns Hopkins Breast Cancer Conference to discuss the latest trends in research and clinical care.  Due to improved therapies, better screening processes, and enhanced multi-modality approaches, breast cancer survivors have seen a reduction in morbidity and mortality.  Conference speakers are world-renowned experts in the fields of surgical oncology, reconstructive surgery, pathology, radiology, medical oncology, radiation oncology, genetics, immunology, palliative care, social media, healthcare quality, and survivorship.  This multidisciplinary approach highlighted some of the many ways breast cancer care is improving in the U.S.  Below is some of what was discussed:

1)     Neoadjuvant Care.  Medical oncologist Dr. Karen Smith presented research indicating that neoadjuvant chemotherapy (chemotherapy before surgery) may improve surgical outcomes in patients who have certain kinds of tumors, such as those that are locally advanced and/or poorly differentiated.  Factors that may determine whether a patient is a good candidate for neoadjuvant treatment include age, grade, stage, t-score, and tumor subtype (e.g. triple negative disease).  Although long-term outcomes seem to be similar whether chemotherapy is given before or after surgery, neoadjuvant treatment may also provide clues about how certain populations respond to specific drugs or drug combinations.

2)     Tomosynthesis. Dr. Susan Harvey, Johns Hopkins Director of Breast Imaging, discussed tomosynthesis (often referred to as 3D mammography), a technology that combines the use of traditional digital mammography with 3D capabilities. Benefits of 3D mammography include a reduction in unnecessary repeat imaging, a 20-40 percent decrease in false positives and a 40 percent increase in the detection of invasive cancers.

3)     Genetic testing. Medical oncologist Dr. Deborah Armstrong provided an overview of genetic testing for breast cancer.  Approximately 10-20 percent of breast cancers are familial (running in the family) and 5-10 percent of all breast cancers are hereditary (associated with a known gene mutation such as BRCA 1 and BRCA 2).  Gene mutations can be passed down from either the mother’s or father’s side of the family, and may put affected women at a 50-85 percent lifetime risk of breast cancer and a 10-45 percent risk of ovarian cancer.  Factors that increase the likelihood of carrying one of these mutations include:

  • Multiple cases of breast cancer in a family
  • Early age of diagnosis (<50)
  • A family history of ovarian cancer
  • Breast and ovarian cancer in the same patient
  • Bilateral breast cancer
  • Ashkenazi Jewish descent
  • Male breast cancer

With the complexities of genetic testing, it is strongly advised that patients seek genetic counseling to understand result implications.  Expanded genetic testing is now becoming available however testing may yield results for which clinical significance and recommendations are currently unclear.

4)     Chemoprevention-Dr. Kala Visvanathan, medical oncologist and director of the Clinical Cancer Genetics & Prevention Service at the Sidney Kimmel Comprehensive Cancer Center, discussed breast cancer chemoprevention.  She advocated the use of currently underutilized prevention modalities and advised that providers discuss options with all patients who may be at high risk, including patients with a strong family history, atypical ductal hyperplasia (ADH), and lobular carcinoma in-situ.  It has been reported that taking chemoprevention drugs classified as selective estrogen receptor modulators (SERMs), such as tamoxifen and raloxifene, can strongly reduce the chances of estrogen-positive breast cancer in very high risk individuals.  More evidence is needed to better predict those most at risk for developing breast cancer and which may be good candidates for chemoprevention drugs.  Currently, there are very limited prevention options for women who may be at risk for estrogen-receptor negative disease.

5)     HER2 Guidelines-Medical oncologist Dr. Antonio Wolff discussed expanding systemic therapy options for HER2‐positive breast cancer. It is estimated that 15-20 percent of all breast cancers overexpress HER2.  These tumors tend to behave more aggressively.  Dr. Wolff acknowledged that beginning in the late 1980’s HER-2 positivity use to be perceived as a poor predictive marker.  In 1998, the drug trastuzumab was shown to improve overall survival in the metastatic setting.  By 2005, adjuvant trials began reporting very positive results.  Today with the use of targeted therapies, HER-2 positivity is often viewed with good predictive outcomes.  Targeted therapies can be very effective in treating patients with HER2-positive disease; however, not all patients with this overexpression respond to targeted therapy.  Data suggests that it is more likely for a patient to have a late recurrence with ER positive HER2-postive disease than with ER negative HER positive disease.  Historically, there was vast variability in HER2 testing, making the test unreliable in some circumstances. Now that HER2 testing quality has improved, heterogeneity has become a big concern. Research is underway to determine which patients have resistant disease and might require more therapy; if models can improve HER2 targeting strategies; and which patients have sensitive disease and require less therapy.

6)     Hormonal Therapy-Medical oncologist and co-director of the Johns Hopkins Breast Cancer Program, Dr. Vered Stearns, reviewed the current guidelines for hormonal therapy for patients with estrogen or progesterone- receptive breast cancers (ER+/PR+).  For premenopausal women with hormone positive disease, a daily oral medication called tamoxifen is prescribed for 5-10 years after the completion of initial therapy.  Although extended benefit has been demonstrated for 10 years of tamoxifen by multiple clinical trials, quality of life factors and individual risk musk be factored into this decision.  Data from the Oxford Overview indicates that five years of tamoxifen can reduce the risk of a recurrence by 40 percent.  Some very young premenopausal women with ER+ disease may also be advised to undergo ovarian suppression.  Research is underway to determine if ovarian suppression alone is as effective as chemotherapy in these young patients.

Data suggests that five years of an aromatase inhibitor (AI) may be better for postmenopausal women with ER+/PR+ disease. Sometimes, postmenopausal women with ER+/PR+ disease may be prescribed tamoxifen for a few years and then switched to an aromatase inhibitor to extend the total number of years of endocrine therapy.  Patients on AI’s often complain of significant side effects, and one study presented showed that 30-40 percent of patients discontinued AI use prematurely due to side effects.  Dr. Stearns recommends  NSAIDs, Vitamin D, antidepressants, yoga, exercise, and acupuncture to cope with some of these issues.

7)     Special Needs of Young Breast Cancer Patients.  Beth Thompson, nurse navigator/educator for the Johns Hopkins LiveWell Center for Young Women with Breast Cancer discussed the unique needs of the young breast cancer patient.  It is estimated that 12 percent of all breast cancers occur in women under 45, accounting for over 2,500 deaths annually in the United States.  Ms. Thompson presented research showing that these women have more aggressive breast cancers, have an increased risk of recurrence, and tend to have worse outcomes. They also show higher levels of emotional distress and due to their age, often balance newer careers, school, body image issues, sexual side-effects, fertility, and dating.  Specific age-appropriate resources are needed to tackle some of these complexities.

8)     Social media and oncology care.  Dr. Robert Miller, medical oncologist and the Johns Hopkins Kimmel Cancer Center’s Chief Information Officer, presented data on the use of social media.  He stated, “social media is user-generated content that is shared over the internet via technologies that promotes engagement, sharing, and collaboration.”  Dr. Miller offered three uses of social media for medical providers: to treat, teach, and learn.  Treating includes engaging with patients about their care.  Teaching allows providers to gain up-to-date and credible education.  Learning encourages professionals to share medical information and knowledge.  Although teaching and learning are preferable methods of social media, it is not recommended that providers use this technology to treat patients.  Dr. Miller offers the following advice when clinicians use social media:

  • Don’t be anonymous
  • Make thoughtful choices about what you are creating for the world to see
  • Everyone is watching
  • Developing trust in your online community takes time
  • Maintain a healthy skepticism

He proposes that medical professionals start by watching first (often called lurking).  This includes reading blogs, watching twitter feeds, listening to podcasts, and subscribing to RSS feeds for journals and news sites.  When joining twitter, Dr. Miller suggests you pick a short but descriptive twitter handle.  “Follow” people who share your similar interests and pay attention to twitter suggestions.  Finally, patience is required.  Allow time for you to gain comfortable and watch your social media contacts grow.

9)     Palliative Care-Dr. Tom Smith, medical oncologist and director of Palliative Care for Johns Hopkins Medicine discussed the importance of palliative care.  He presented research to indicate that palliative care has better patient satisfaction, higher quality of life, improved symptom control, and reduced depression and anxiety, all at a reduced cost when compared to usual care.  This is evidenced by more at-home hospice, fewer hospitalizations, fewer days in the intensive care unit, less chemotherapy/tests/imaging, and fewer treatment-related complications.  Dr. Smith advocated that almost all patients want honest information about prognosis, treatment options, and trajectory of disease progression.  Discussions about palliative care should be the standard of care and should occur before patients become too sick to make informed decisions.

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Amber Warrington has seen the first hand advancements that take place at Johns Hopkins, as she works as a Administrative Supervisor in Medical Oncology. Unfortunately cancer became personal, when her mother was diagnosed with lung cancer in 2009, but Warrington knew her mother was in the right hands and would receive the best care possible.

Three years earlier, Warrington’s mother had lost her sister to brain cancer, and was determined to do whatever she could to beat cancer and be around for her children and grandchildren. Her family and the care team at Johns Hopkins became her support system as she began treatment. Aggressive chemotherapy was tough on her body and there were points where the family was unsure if she would make it. “My mom never complained and always wanted to know the truth,” said Warrington. Unfortunately, news came that the cancer had spread to her brain and radiation began.

The family decided they needed their mother to live life to her fullest, taking her on a cruise and hosting a big birthday party for her. “My mom was so surprised by everything we did for her and was so grateful to be around her family and friends,” says Warrington. “We knew mom wasn’t going to be able to fight this awful disease much longer, so we enjoyed every day we had with her.”

Sadly on June 23, 2012, she lost her battle. In her memory, Warrington wanted to continue to stay active and do something to make her mom proud. She has registered for the Ride to Conquer Cancer and will cycle 150 miles in September with a friend of hers.

“I’ve already raised over $1,500 by reaching out to my family and friends and I am surprised how easy the fundraising has been." Warrington has made a flyer that she can hand out to her network to explain The Ride, why she has decided to participate this year and ask for a donation.

“The support you receive motivates you to know that you can do this. You don’t have to be an athlete and everyone is there to help you along the way. I’m really looking forward to riding with so many people and making new friends along the route."

Warrington is determined to do her part in conquering cancer, so that others don’t have to lose their loved ones. “I know my mom would be proud of me for doing this and that continues to give me motivation to push forward.”

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Last week's news announcement of a new drug target for asthma and cancer heralded an example of the type of out-of-the-box thinking that has now widened the scope of research in both diseases and has the potential for great impact.

This research starts with innovative scientists willing to cross disciplines to understand how biological processes impact disease across many levels. It also takes organizations, foundations and philanthropic individuals who recognize the potential in such research and their ability to propel ideas from the laboratory bench to clinical application.

That’s exactly what the American Asthma Foundation did when they funded Dr. Jonathan Powell’s research. Funding a cancer-immunology researcher to study drug targets for asthma is the type of cross-discipline support that leads to innovation and discovery.

My daily work supports cancer communications, highlighting the research, people and practices it takes to conquer this disease, but I’ve had asthma since childhood. I never thought I’d write about asthma and cancer within the same piece of research, but Dr. Powell surprised me. And that’s what we need for science.

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In this month's Cancer News Review podcast, Johns Hopkins Kimmel Cancer Center Director Bill Nelson discusses the nation's top stories on cancer.

First, Nelson discusses the issues surrounding whole genome sequencing to predict development of disease. Then, he explains how the HPV vaccine works and why it's important for young people to be vaccinated. Finally, the podcast concludes with a discussion on a study of women with uterine fibroids and concerns over a specific surgical procedure and the spread of cancer cells that could be contained in the fibroids.

Program notes:

0:29 23 and Me
1:32 Do use these tests clinically
2:31 May be misinterpreted or misused
3:31 Companion diagnostic to drugs
4:31 Worried well and genome assessment
5:25 HPV vaccine uptake
6:25 Concern over carte blanche for sexual activity
7:00 Morcellation of uterine fibroids
8:00 Dissemination of cancerous cells
9:00 Concern over any surgery of cancer
10:09 End

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Ride to Conquer Cancer

**This blog post was written by Kimmel Cancer Center development specialist Allison Rich.

With all of the training support that the Ride to Conquer Cancer makes available, cyclists of all skill levels have access to the tools they need to successfully participate in this epic event. But even with these tools in hand, conquering a two-day, 150 mile route is no small feat. In light of today’s Gear Up Day events on campus, and with springtime weather just around the corner, there is no better time to ask ourselves what motivates us to grab our bikes and ride.

The motivation of the patients and survivors, their bikes identified with yellow flags, who ride towards a cure alongside their families and friends is unquestionably powerful. Others ride to honor a loved one who has passed away, a stoic reminder of just how important the research funds this event will raise truly are. But while cancer has touched everyone in some way, the reality is that not all of us have this kind of highly personal narrative that compels us to ride. For you, maybe the physical challenge of riding farther than you ever have before will drive you through the toughest miles; or perhaps the satisfaction of successfully raising funds towards defeating this disease provides more inspiration than the miles ever could. For some, a fun weekend spent with friends is reason enough to get involved.

No matter what motivates you to ride, we hope that you will register to become a part of the movement to make a difference in the lives of our patients and families. By signing up today, you can also take advantage of the special Gear Up Day registration code, JHRIDE50, and register for only $50! While no two riders will share the same reasons for getting involved, we are united by the same goal – to conquer cancer, together.

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**This blog post was written by Kimmel Cancer Center development specialist Allison Rich.

Here at the Kimmel Cancer Center, we are committed to keeping our promise towards progress in finding a cure. This year, we have decided to take this commitment a step further byGear Up Day for Ride to Conquer Cancer teaming up for the history-making Ride to Conquer Cancer.

In our desire to do our part to defeat this disease, it is easy to overlook the physical challenges associated with a two day, 150 mile cycling event. Curing cancer is not just a two day commitment – and neither is an athletic event like the Ride. While many of us have been touched by cancer in some way and would love to get involved, the reality is that most of us aren’t ready to cycle 150 miles at a moment’s notice. What makes this Ride unique is that, in exchange for your support of our work here at the Kimmel Cancer Center, we commit to support you with the tools you need to have a successful and healthy Ride experience. And with the recent burst of warm weather, what better time to grab our bikes and start training?

With the support of the Ride staff behind you, you won’t have to train alone. By teaming up with athletic groups, the Ride to Conquer Cancer can help direct you to the resources you need to train safely, avoiding injuries and unnecessary setbacks. While physical therapy is often associated with rehabilitation from injuries once they have already occurred, it can also be a vehicle for preventing injuries from happening in the first place. By partnering with the Ride to Conquer Cancer, the physical therapists will provide riders with access to specialized resources that can help them ride to victory. By analyzing movement patterns for indicators of deconditioning, physical therapists can identify training exercises that will be the most effective at restoring proper movement and building strength in each individual.

With these tools and resources available, there is no reason not to start mobilizing our friends, families, and communities for action. With Gear Up Day (and springtime weather!) just around the corner, it’s time for us to focus on one goal: to register and prepare to conquer cancer, together.

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