One question lingered in the back of Steve Johnson’s mind — was he going to get cancer?
Given his family history, the question certainly was a logical one. His father died from the disease shortly after Johnson graduated from college. His father’s two sisters also died from cancer, and Johnson suspects his paternal grandparents did, too.
At the urging of his neighbor Dr. Larry Gluck, an oncologist and medical director of the Prisma Health Cancer Institute, Johnson decided to get genetically tested. That decision saved his daughter’s life. The test revealed Johnson carried the BRCA1 gene mutation that indicates a higher risk of developing breast cancer. Two of his three daughters tested positive, and subsequent tests showed that one had breast cancer at a barely detectable point.
“It would have been a very different situation if my dad hadn’t gotten tested,” said Sarah Johnson-Taylor, a dentist in Annapolis, Maryland who was unaware she was at high risk until her father was genetically tested and she was diagnosed with breast cancer at the age of 31.
The Center for Cancer Prevention and Wellness is the cancer institute’s new initiative that aims to help Upstate families identify and manage their risk factors for cancer, examining the links between lifestyle, genetics and cancer formation, with a goal of eventually preventing cancer at its earliest molecular formation.
The program is taking a two-fold approach to cancer prevention.
First, the program aims to reduce a participant’s risk of cancer by offering free wellness screenings and suggested lifestyle modifications to reduce cancer from preventable causes, Gluck said. Participants will return for free annual assessments to monitor health changes and progress towards wellness goals. The National Cancer Institute estimates that controllable factors such as smoking, diet and sedentary lifestyles account for up to 70 percent of cancers.
The second part of the program collects blood, urine and cheek swab samples from participants for bio banking, or long-term storage of molecular material, at the Institute for Translational Oncology Research, part of the cancer institute, Gluck said. Through a longitudinal study of a cross section of the Upstate’s population, he said researchers hope to analyze the way cells are genetically modified through daily behaviors.
Gluck said that a cancer the size of a fingernail contains a billion cancer cells. Because it grows by doubling, from one cell to two, from two cells to four, it takes years before it gets to an appreciable mass.
“The time the cancer is developing at a molecular level but undetectable by routine scans and testing is the critical time to enact interventions that may be able to stop further cancer development,” Gluck said. “As we collect and study this data from CCPW, we anticipate that we will eventually be able to identify a molecular alteration in its early stages and intercede before cancer truly appears.”
The project started in November on a pilot basis with hospital employees, Gluck said. In an overwhelming number of cases, participants received recommendations for behavior modification or screenings. “It’s an honest look at where you are and what you might do to actually prevent cancer,” Gluck said. Baby boomers may be told to get screened for Hepatitis C, which can increase chances of liver cancer if not treated, Gluck said. Other participants might be told to modify their diets or that the number of alcoholic drinks they have per day puts them more in a danger zone, he said.
The project, which is believed to the be first of its kind, is now open to Upstate residents 18 and older of all genders, race and health status. The assessments are free, thanks to a grant from the Daniel-Mickel Foundation, money raised through fundraisers and other donors.
Gluck said the project is inspired by the Framingham Heart Study, a longitudinal study in 1948 in Massachusetts to identify common factors that contribute to cardiovascular disease. Through 70 years of data collection from 14,000 participants, the results have informed much of todays knowledge about cardiovascular disease and stroke, including knowledge about the detrimental effects of high blood pressure, high cholesterol and smoking.
“We are taking a similar approach to cancer,” he said. “We want to help individuals people take steps to better their health and reduce their risk of cancer from preventable causes, but we also want to identify patterns over time that could demonstrate facts about cancer that we don’t even know yet. But to do that, we need participation from a broad swath of the community.”
Individuals interested in participating in CCPW can contact nurse navigator Julia Yates at firstname.lastname@example.org or 864-455-2279.
The doctor becomes the patient
Dr. Gary Spitzer knows what it’s like to be on the cutting edge of cancer research.
He was one of the early pioneers in bone marrow transplantation at M.D. Anderson Cancer Center, and he directed programs at St. Louis University and Georgetown.
He started a program at Bon Secours St. Francis Health System.
He is now a biotechnology consultant and chief medical officer of Cadex Genomics, a company that is studying a product that would help doctors determine whether stage four cancer patients are responding to therapy.
He’s also a stage four colon cancer patient.
He supports the Center for Cancer Prevention and Wellness’ new initiative to help people identify and manage their risk of cancer while analyzing the way cells are genetically modified through daily behaviors in an effort to prevent cancer at its earliest molecular development. But, he said, the program must have big enough numbers.
“The bottom line is the study is essential, but it must be large and the whole community must have access to it,” said Spitzer, who supports bringing a genome lab and technology to Greenville. “We need to be one of the big silos of data in this country.”
In addition, he said, more research needs to be done on people who are living with incurable cancers.
He said Prisma’s integrative oncology program is the only one in the state that addresses the complicated issues of balancing the need of productive individuals living with incurable cancer with the complexities of cancer treatment.
“The integrative oncology program is trying to address the unique needs of the survivor with cancer,” he said. “It’s a much more difficult problem to manage than a survivor.”