The genetics of a cancer center

With the infrastructure in place, UF prepares to take its place as a major player in the fight against cancer.

By: Melanie Fridl Ross
Like any doctor, John Wingard remembers his first patient as if the encounter were just yesterday. He was a young, ambitious medical student. The patient was a man dying of lung cancer.
Wingard spent days at the man’s side, witnessing the suffering he experienced struggling to get his breath and sharing his wife’s grief.”I felt so helpless, not being able to do something meaningful,” Wingard said. “It brought back to me the raw feelings of helplessness I experienced as a 14-year-old as my grandfather died of bladder cancer.

“I resolved then to try, in whatever way I could, to alleviate the suffering, to help find some way to beat back the fear and suffering that cancer brings to too many lives.”

"Buildings and money are important facilitators of progress, but shared vision and broad leadership are much more powerful agents of change." John Wingard, MD

Today, as the UF Shands Cancer Center’s deputy director for the Gainesville campus, he has made a career out of that calling, one of a cadre of UF scientists who have marshaled their forces in the fight against cancer.

The disease is a formidable foe, and progress has been slower than he’d like, he said. There is much work to be done. Yet progress is being made.

“When I started, there were only three-dozen cancer drugs. Today there are nearly 150 FDA-approved cancer drugs, more than one-third receiving FDA approval in just the past 5 years,” Wingard said. “There now are two licensed vaccines to prevent cancer.  In the last several years, the cancer death rate in the U.S. has finally stop rising and started to fall at last.”

But for true, lasting advances to occur, these treatments need to reach the people who most need them, Wingard said. And that is why the commitment UF and Shands have made to become leaders in cancer care and research is so important, he said.

“Florida has the second-highest rate of cancer in the U.S.,” he said. “To best serve the health needs of our citizens, we need to be developing and testing the drugs of tomorrow and offering the best and latest therapies to our patients today.”

That’s exactly the UFSCC’s strategy, one that is being propelled forward by plain old scientific skill, technology and sheer people power. New facilities, including the $85 million, 280,000-square-foot Cancer & Genetics Research Complex, are helping, too-as is a sizable infusion of money.

The overall institutional investment in cancer in the past decade has been simply astounding-in excess of $600 million. Consider, too, the cancer extramural research base, which has grown from $3.7 million to $24.6 million in just seven years. And for the first time in the institution’s history, administrators say, UF has in place fundamental bench research in cancer that will yield advances at the patient’s bedside. To further that effort, a critical mass of scientists has been assembled, bolstered by a flood of new faculty recruits: In the past year alone, 25 cancer researchers have come on board.

UF Proton Therapy Institute

The list goes on: Last month, UF’s Proton Therapy Institute-one of only five in the nation-treated its first patient. And by 2009, the Shands at UF Cancer Hospital will have sprung up along Southwest Archer Road.

“We expect to be major contributors to ending the long-fought war on cancer,” said W. Stratford May, MD, PhD, Cancer Center director. “We plan to grow our cancer operation through research and clinical trials. That’s what I envision the Cancer Center being able to do-to provide the infrastructure, the support, the colleagues and all of the backup needed to develop a new therapy and bring it into testing in the clinical arena for the potential benefit of patients. That’s our job.”

Doing their Job

Building up the research effort to support the overall cancer initiative has been a key thrust for UF scientists. Particularly, taking information gleaned in the lab to identify new targets for novel therapies that can be tested clinically. Researchers in pharmacology and therapeutics, for example, have done groundbreaking work on an enzyme that is active in stimulating cancer cell growth, May said, opening new avenues for drug development.

Other notable initiatives include the planned cancer hospital facility, which will provide the latest technology and high-quality care. Clinicians now scattered throughout the existing hospital system will be able to work in an interdisciplinary fashion more easily, Wingard said.

“The Shands at UF Cancer Hospital will allow us to blend the science of medicine with the art of healing in a specially designed space,” said Shands HealthCare CEO Tim Goldfarb.

And last month, a Cocoa Beach man with prostate cancer became the first patient to undergo treatment at the new 98,000-square-foot, $125 million UF Proton Therapy Institute, the first time this advanced form of radiation therapy has been offered in the Southeast. The therapy has a high rate of success in curing prostate cancer and malignancies of the brain, lung, head and neck, eye, cervix, gastrointestinal tract, bones and soft tissues, with minimal side effects.

“We are determined to offer patients in Florida and the Southeast the best possible treatment options, whether it be proton therapy, conventional radiation therapy, surgery or chemotherapy,” said Nancy Mendenhall, MD80, the institute’s medical director. “We do believe that protons will occupy a very important place among the armamentarium of cancer weapons. We are also poised to become a center for both clinical and basic research that will increase our understanding of basic disease processes and improve cancer treatments.”

A Shared Vision

So where to go from here? Cancer Center administrators say they will build on existing strengths, which include a world-class bone marrow transplant program, the surgical and radiation oncology programs and significantly enhanced capabilities in epigenetics.

Robert Nuss, senior associate dean and associate vice president for health affairs at the Health Science Center-Jacksonville, said the center’s structure as a joint campus initiative also is a plus. And because of Jacksonville’s huge patient base, it will be a key component in clinical trials development.

“I think the sum of the parts is greater than each one alone, clearly,” Nuss said. “I think that’s the key advantage of this opportunity, to allow us to be successful utilizing the strengths of both campuses.”

Wingard likes to think back to a year ago, when program leaders gave a presentation to the UFSCC internal advisory board, articulating their vision, their accomplishments, recruitment efforts and plans to strengthen programs and collaborative research.

“In the past, it seemed that only a couple of individuals had a vision of what was to be accomplished; it was then that I saw that the vision was embraced by a wider circle of leaders who over time will shape the future of the Cancer Center,” he said. “Buildings and money are important facilitators of progress, but shared vision and broad leadership are much more powerful agents of change. These changes are now happening and are perhaps the most notable accomplishments of the Cancer Center to date.”