UNTIL EVERY CANCER IS CURED - WINTER 2021 - Thomas ... (2024)

UN T I L E V ERY C A NCER IS CU RED WINTER 2021Photo credit: Katie Scherwitzky

FROM THE DIRECTOR On the Front Lines of Cancer and COVID safety protocols to protect patients and The pandemic is still with us and we staff. I am so proud of the entire SKCC remain diligent; however, as we emerge team, who worked around the clock to from many of the restrictions put in place ensure that our patients continued to to mitigate the spread of the virus, we are receive comprehensive cancer care. also focusing on the long-term effects of It has been truly inspiring to see the pandemic. A large study led by SKCC SKCC staff come together in this mo- researchers found patient encounters re- ment. Our clinical teams rapidly adapted lated to cancer dramatically declined na- operations to move non-treatment visits tionwide, including mammograms, which to telehealth, and to deploy rigorous declined by nearly 90%, and colorectal safety standards. These critical mea- cancer screenings, which declined by sures were impactful for our cancer nearly 85%. It is now critical that we en- patient volume–we heard an outpouring courage people to not put off their can- of appreciation to SKCC for ensuring cer screenings and routine appointments. uninterrupted access to the very latest The pandemic has also highlighted treatment options. These accomplish- racial disparities in health care, further re- ments are all the more remarkable given inforcing our commitment to addressing Karen E. Knudsen, MBA, PhD Executive Vice President that SKCC continues to serve an influx disparities and promoting health equity. Oncology Services of new patients over the course of the This issue of Discovery highlights our Enterprise Director pandemic, now seeing more patients Sidney Kimmel Cancer Center challenges and successes during this than ever before at our expert center. unprecedented moment in history. Even Scientific research remained on in times of uncertainty, we are undeterred W hen COVID-19 began to spread throughout the world last year, nearly everything changed for all of us. track. Although many laboratories closed during the stay-at-home orders, in our mission to improve the lives of cancer patients and their families through our scientists found ways to remain compassion, innovation, and break- Cancer, however, never stops, and the engaged from home, and others re- through discoveries. I am confident going Sidney Kimmel Cancer Center quickly focused their research toward coro- forward that SKCC will overcome any ob- jumped into action to establish strict navirus treatments and vaccines. stacle in order to care for our patients.  STAY CONNECTED TO THE SIDNEY KIMMEL CANCER CENTER BY VISITING OUR WEBSITE AND FOLLOWING US ON SOCIAL MEDIA! sidneykimmelcancercenter.jeffersonhealth.org facebook.com/sidneykimmelcancercenter @KimmelCancerCtr @sidneykimmelcancercenter linkedin.com/company/skccatjeffersonhealth sidneykimmel.cancercenter@jefferson.edu2

CONT ENT SFEATURE ARTICLE 16 TELEHEALTH Telehealth Keeps Patients Connected from a Safer Distance5 BREAKTHROUGHS COVID-19 Treatment 4 Cancer Care at Home 5 Oncology Navigation 6 COVID-19 Vaccine 7 Cancer Informatics 9 Laboratories During Lockdown 208 CLINICAL TRIALS10 HEALTHCARE HEROES12 NEW DEVELOPMENT HIGHLIGHTS15 ACCOL ADES19 SURVIVOR STORIES Arnaldo Santos 19 Amy Schimanski 2221 SUPPORT SERVICES Care During COVID 21 Welcome Center 23 Neu Center 2425 NEW LEADERSHIP28 ADVANCED CARE HUBS Asplundh Cancer Pavilion 28 Washington Township 2930 PHIL ANTHROPIC SPOTLIGHT 3

BREAKTHROUGH COVID-19 TREATMENT A Novel Drug Target in Prostate Cancer Emerges as Potential Target for Coronavirus Treatment A t the beginning of last year – and just a few months before the novel coronavirus was reported in how new viruses emerge as a result of interspecies infections,” he explained. In mid-March last year, Kim came the United States – Felix Kim, PhD, across a preprint report from a group was awarded an R01 research grant of researchers at the University of from the National Cancer Institute California, San Francisco, in which they (NCI) for his project, “Multifunctional identified 69 existing drugs and exper- regulation of prostate cancer me- imental compounds that could poten- tabolism by Sigma1 modulators.” tially be repurposed to treat COVID-19. Kim, an Associate Professor of “This was based on a protein inter- Cancer Biology at the Sidney Kimmel action screen wherein they identified Cancer Center (SKCC), aims to define a number of cellular proteins that how Sigma1 (also known as sigma-1 re- physically bind to key SARS-CoV-2/ ceptor) – a unique, pharmacologically COVID-19 viral proteins. They ser- controllable scaffolding protein that is aberrantly expressed in prostate cancer and required for tumor growth – reg- “Targeting Sigma1 might prevent the virus from co- Felix Kim, PhD ulates metabolic processes essential opting the cellular machinery, Associate Professor, Department for prostate cancer proliferation and thus blocking COVID-19 of Cancer Biology disease progression, and to discover replication and dissemination.” Associate Director of Training & Education, SKCC and develop a novel class of therapeu- tic agents that target Sigma1 in order endipitously found Sigma1 among to treat advanced prostate cancer. them, and this piqued my interest,” lar machinery, thus blocking COVID-19 “By targeting Sigma1, we propose a Kim said. “So, I took a closer look replication and dissemination. new approach to restricting metabolic at whether I could make sense of Kim, in collaboration with Holly processes that drive the proliferation how Sigma1 might be involved in Ramage, PhD, Assistant Professor of of lethal prostate cancer,” Kim said. SARS-CoV-2/COVID-19 infection.” Microbiology and Immunology at “This approach simultaneously targets Coronaviruses replicate by co-opt- Thomas Jefferson University, plans multiple growth pathways in prostate ing the machinery inside the cells to establish whether Sigma1 is a valid cancer and may circumvent resistance of the infected host. When the virus therapeutic target for SARS-CoV-2 and mechanisms that invariably emerge infects a host, it remains completely related viruses and to evaluate whether with the sequential use of current dependent on this cellular machinery a series of novel compounds originally standard of care therapeutic agents.” in order to replicate and spread. Sigma1 proposed as anti-cancer therapeutic Kim has been studying Sigma1 in is an important part of the cellular agents can be used to target Sigma1 in cancer biology and Sigma1 pharma- machinery, helping to regulate the pro- a range of viral infections. Additionally, cology for over 10 years; however, duction, processing, and quality control Kim and Ramage are looking to identify he had previously worked on human of essential proteins and lipids, particu- established drugs that bind Sigma1 that viruses for more than a decade. “My larly under conditions of stress, such as can potentially be repurposed as antivi- PhD thesis was focused on dissecting viral infection. This led Kim to hypoth- ral therapies for COVID-19 infection.  key determinants of viral entry into esize that targeting Sigma1 might pre- host cells and also on understanding vent the virus from co-opting the cellu-4

BRE AKTHROUGH CANCER CARE AT HOME Pandemic Underscores Feasibility of Home-based Cancer CareF or many cancer patients, treat- ment means frequent trips tothe clinic. When the novel corona- patients experienced challenges with IV access and pump malfunc- tions – but nothing insurmountable.virus emerged in the United States, Binder and colleague NathanAmericans were told to begin prac- Handley, MD, MBA, Assistant Profes-ticing social distancing and to try sor of Medical Oncology, hope to seeto stay home when possible. an expansion of home-based cancer The Sidney Kimmel Cancer Center care at SKCC and beyond, even afterquickly took steps in order to minimize the emergency of COVID-19 abates.risks to patients and staff, including “COVID is providing us with cleartransitioning appointments to tele- evidence that managing patientshealth whenever possible. But what virtually is feasible, and in many casesabout patients who come in regular- may be better for patients,” Hand-ly for treatment? Many people were ley said. “We know that patients withunderstandably concerned about cancer are at higher risk for infectionsvisiting a hospital, and some even and complications associated withconsidered postponing appointments. interacting with healthcare settings health emergency of the pandemic, For some patients at SKCC, home this is changing. New waivers by thecare might be an option, such as infu- “COVID is serving as a catalyst Centers for Medicare and Medicaid for change in many areas ofsions for supportive therapy, which are Services (CMS) are further enhancing medicine, and cancer carenon-chemotherapeutic agents. Phar- is no exception. It is forcing the feasibility of home-based treat-macists, working with the Infusion Cen- us to rethink what it means ments by making the reimbursem*ntter, were able to move many of these to deliver high-quality care more streamlined, he explained.patients to home infusions, according and what it means to be Binder hopes to improve infrastruc-to Adam Binder, MD, Assistant Profes- engaged with patients.” ture to create a more robust homesor of Medical Oncology. Additionally, chemotherapy program for the future.some patients are eligible for at-home even in the best of times, so think- “I think this will require some restruc-chemotherapy with the assistance ing of ways to move more care into turing of the current home infusionof home infusion nurses. For these the home setting is something that is model or the creation of a separatepatients, physicians need to confirm going to continue to be important.” home infusion model that will allowcertain requirements including stable IV One barrier to home-based therapy for the same safety checks at homeaccess, normal lab values, and mini- is insurance coverage. “We know from that occur in the infusion center.”mal risk for infusion-related reactions. a variety of studies that delivery of che- “COVID is serving as a catalyst Overall, Binder reports minimal motherapy in the home setting is safe for change in many areas of medi-concerns regarding home chemo- and can often be done at a lower cost cine, and cancer care is no excep-therapy infusions. The home infusion than in the hospital or infusion center,” tion,” Handley said. “It is forcing usservice uses a different medical re- Handley said. However, Medicare and to rethink what it means to delivercord system, so he found it can be other insurers do not usually reimburse high-quality care and what it meanschallenging coordinating two differ- treatment given outside of the usual to be engaged with patients.” ent electronic records. Also, some medical settings, although due to the 5

BREAKTHROUGH ONCOLOGY NAVIGATION Oncology Navigation Team Helps Guide Patients Through Uncertainty W hen faced with a cancer diagno- sis, some patients may be unsure about who to turn to for guidance and community to accommo- date referrals,” support. However, patients receiving said Lisa Dun- care at the Sidney Kimmel Cancer bar, a patient Center – Jefferson Health (SKCC) in navigator Center City Philadelphia have access who works to an Oncology Navigation Team with people that is available to assist them from diagnosed the moment they are diagnosed. with malig- The Oncology Navigation Pro- nant brain gram, which started in the summer tumors and of 2018, provides patients with a cutaneous lymphoma. The SKCC Oncology Navigation Team. Back row, from left: Joanne direct point of contact and an advo- Anderson, Will Sabb, Brian Ward, Christine Weiner, Tracie Williamson- cate with whom they establish trust “Navigators Burrell, Kimberly Brennan, Jaki Mitchell, Renee Zalinsky throughout their cancer journey. play a huge Front row, from left: Allison Bell-Dean, Aliya role in en- Rogers, Casey fa*gan, Jackie Smith Studies have shown that navigation suring pa- programs can improve outcomes and tients receive in-person appointments and transi- satisfaction among patients, as well continuity of care.” tion care to telehealth, rescheduling as reduce costs. Navigators provide Nurse navigators, who are reg- 524 appointments from mid-March patients with personalized care and istered nurses, typically contact a through May. They also helped fill an added layer of support, serving patient after a cancer treatment plan a void for patients who have been as an extension of the care team. is created and help to address clini- feeling isolated during the pandemic, SKCC employs a hybrid approach and many navigators have heard deep cal concerns. As a resource for care that includes both patient navigators appreciation in their voices on the management, they can address is- and nurse navigators. Patient navi- other end of the phone. “I miss your sues such as treatment side effects gators are trained professionals who smile, which brightens any room, but I and help patients avoid unnecessary connect with new patients before their can still imagine it through the phone visits to the emergency department first visit with an oncologist. During an because I can hear it,” patient naviga- and potential hospital admissions. initial phone call, the patient navigator tor Tracie Williamson-Burrell heard. gathers background information on the “I work with incredible profession- als who dedicate pretty much 120% The Oncology Navigation Team patient’s medical history. The navigator of themselves to the patient popu- continues to make sure that ev- can also help identify psychosocial, lation,” said nurse navigator Renee ery SKCC patient feels that their economic, or other personal barriers Zalinsky, RN, OCN, who works with cancer care remains a top pri- the patient may face when starting or patients who have metastatic uveal ority during the pandemic. continuing treatment and can refer them to the nurse navigator or appro- melanoma. “It takes teamwork.” For more information on the priate supportive care team member. Teamwork has been especially SKCC Oncology Navigation Team important to support patients during or to connect directly with a nav- “Patient navigators make things hap- COVID-19. Navigators have played igator, call 215-955-8014.  pen. We build relationships with care teams across campus and out in the a critical role in strategies to reduce6

BRE AKTHROUGH COVID-19 VACCINE Building Upon Rabies Vaccine, Jefferson Researchers Develop Novel Coronavirus VaccineA ny new coronavirus vaccine found to be safe and effectivewill still have the daunting challenge efficiency and safety record.” CORAVAX is made from a portion of SARS-CoV-2, theof being quickly produced to scale virus that causes COVID-19and safely delivered to the world’s disease. Rather than use thepopulation. The more complex and entire virus, Schnell usesuntested the vaccine approach, the part of it – the spike pro-more difficult these tasks will be. tein, a component most By building upon an existing safe likely to generate a protec-and effective vaccine, which has tive immune response.well-established and active manu- Many vaccines arefacturing hubs and can be stored prepared by using anoth-on the shelf until it is reconstituted er vaccine as a “carrier.”with water, Matthias Schnell, PhD, In CORAVAX, that carrierhas a COVID-19 vaccine candidate is a killed rabies vaccinethat could cover a global need. that has the spike portion Matthias Schnell, PhD Director, Jefferson Vaccine Center “Our vaccine candidate, CORA- of the SARS-CoV-2 virus Associate Director, SKCC Shared ResourcesVAX, is made from part of the current as an added component, Chair, Department of Microbiology & Immunologycoronavirus that is combined with essentially one vaccineanother proven vaccine,” said Schnell, piggybacked onto anoth- “We’ve already begun safety test-Jefferson Vaccine Center Director and er. A vaccinated person would de- ing in animals. And we know that theAssociate Director for Shared Re- velop antibodies against both rabies rabies vaccine has an excellent safetysources at SKCC. “The benefit is that and the coronavirus spike protein. profile,” Schnell said. “That vaccinethe ‘carrier’ vaccine has already been The benefit of using rabies as a is safe in children, pregnant women,rigorously tested and shown to be safe “carrier” vaccine is speed. “There are across diverse populations, and of-and effective. There are manufactur- already at least 20 manufacturing ten generates life-long protection.”ing plants around the world already facilities around the world churning outrunning and with the technological In another encouraging sign, some 100 million doses a year of theknow-how to produce large quantities Schnell’s group previously demonstrat- rabies vaccine. They have the meansof that vaccine. We can leverage that ed safety with a rabies vaccine for oth- and know-how to produce this vaccine er coronaviruses that are highly similar already. We’re adding one small to SARS-CoV-2. The group’s vaccines component,” Schnell said. It’s also for the coronaviruses that caused the relatively low-cost production, 2003 SARS and the 2012 MERS epi- which is important for a vaccine demics were proven safe and effective that may need to be available to in animal models of those diseases. billions. In addition, some vaccines require freezer storage that limits Jefferson signed a deal with Bharat their use in remote areas. By con- Biotech to develop the vaccine, which trast, the rabies vaccine can be pro- showed a strong antibody response in duced in a shelf-stable, dehydrated mice. The next steps are to complete form that is easy to reconstitute. animal tests and move into phase I clinical trials for safety in people.  7

CLINICAL TRIALS CLINICAL RESEARCH ORGANIZATION Clinical Research Organization Keeps Clinical Trials on Track Amidst COVID A s the COVID-19 pandemic reached the United States, ac- ademic health centers across the tained a no in-person requirement. The next step was to review pro- tocols on a case-by-case basis as country began to adjust – and often requested by the principal investigator. suspend – certain research and clini- “This allowed us to keep the investi- cal activities, including clinical trials. gators engaged and reminded them However, clinical trials are essen- that clinical trials remained an op- tial to provide comprehensive care, tion for their patients,” O’Neill said. and for many people, they can offer To ensure patient and staff safety, the best, or only, treatment option. clinical research coordinators facili- SKCC decided that keeping trials open tated care remotely. Guidance from for patients remained a top priority regulatory bodies allowed for mod- and quickly worked to ensure thera- ification of some of the strict stan- peutic trials could safely continue. dards of clinical trial conduct, such “We have a large and broad port- as shipping the drugs to patients and folio of clinical trials and felt that it permitting them to undergo physical was still in the best interest of patients exams at their local physicians’ offices. Sylvia Salazar O’Neill, MD to have these options,” explained Executive Director “We have a large and broad Sylvia Salazar O’Neill, MD, Executive portfolio of clinical trials SKCC Clinical Research Organization Director of SKCC’s Clinical Research and felt that it was still in Organization (CRO). “Very early on, the best interest of patients to have these options.” the main challenge remains a “balancing the core directive from SKCC lead- act,” O’Neill said, “between wanting to ership was patient and staff safety.” At any time, communication is move forward with important research To determine whether a clinical important. During an evolving crisis that was going on pre-COVID and trial could be conducted safely, two like a pandemic, it becomes abso- ensuring patient and staff safety while questions were asked: Does the pa- lutely essential, especially as much of living in a future that is unknown.” tient’s cancer put them more at risk the staff began working from home. The CRO’s deft response to an than COVID, and can the trial be “Since things were moving so quickly, unprecedented challenge and ability to conducted while following social/ we knew that daily communications forge forward has been a silver lining physical distancing protocols? had to be initiated as early as possible,” along the way, O’Neill noted. “We have The CRO defined essential trials said O’Neill, who established morning been able to push initiatives that were as all phase I, I/II, and II trials, which meetings with the entire CRO staff as a on the back burner through faster. Now, were allowed to move forward. Addi- forum to address questions and deliver we have ways to remotely consent tionally, 16 new trials opened between information as quickly as possible. and monitor our studies. Our staff has March and early June. Non-interven- The CRO is cautiously beginning flexible work from home schedules, and tional and phase III trials comprised of to lift the suspension of interventional communication has actually increased a standard-of-care arm were placed trials that were put on hold in a cautious by becoming familiar with the different on hold unless the protocol con- step-by-step process. Looking ahead, electronic communication platforms.”  For more information on clinical trials, contact the Sidney Kimmel Cancer Center Clinical Research Organization at 215-955-1661.8

BRE AKTHROUGH CANCER INFORMATICS Nationwide Trends Show Fewer Cancer Patients Seeking Care Since Start of PandemicR esearch from SKCC found significant decreases nationwide in the numberof patients being seen for cancer-re- in January through April of 2020. The team identified a significant decline in patients with encounterslated care as the COVID-19 pandemic associated with any neoplasm, includingprogressed during the few first months malignant, benign, and in situ diseasesof 2020. The most significant decline (-56.9%); new incidence neoplasmswas seen in encounters related to new (-74%); malignant disease (-50%); andcancer incidences, including screening, new incidence malignant diseaseinitial diagnosis, second opinion, and (-65.2%). The researchers also looked attreatment initiation appointments. data from University Hospitals Plymouth Anecdotal reports and physician NHS Trust in the U.K., which showedsurveys have suggested dramatic similar trends. However, the researchersdeclines; however, this study, pub- cautioned that more data are neededlished in JCO Clinical Cancer In- to compare trends outside the U.S.formatics, is the largest to date to The researchers also looked at thesemeasure the effects of the pandemic encounters by cancer type. Patienton normal cancer care activities. encounters decreased across all types, Christopher McNair, PhD “While it is not surprising that the although they observed a greater de- Director, Cancer Informatics Associate Director, Data Sciencepandemic has had a significant impact crease related to melanoma (-51.8%), Sidney Kimmel Cancer Centeron patients seeking care, it was import- “This report is a nationwideant to test and quantify these trends call to arms, underscoring the and mitigation efforts – even in regionsusing a large, institutionally agnostic urgent need to resume cancer that had not seen a significant impactdataset, as the results have important screening and early detection.” from the virus at the time,” McNair said.implications for future cancer patientsand the potential burden on hospitals breast (-47.7%), and prostate (-49.1%) The researchers will continue to lookmoving forward,” said senior author than lung (-39.1%), colorectal (-39.9%), at trends, especially as states are moreChristopher McNair, PhD, Director and hematological cancers (-39.1%). drastically affected. It will be importantof Cancer Informatics at SKCC. to understand these trends to determine Additionally, McNair and colleagues if delays in screening are resulting in an McNair and colleagues leveraged found that mammograms declined increased number of patients presentingthe TriNetX platform to create a COVID 89.2% and colorectal cancer screenings with later-stage disease, McNair said.and Cancer Research Network (CCRN). by 84.5% in April 2020 compared withThe CCRN is comprised of data from April 2019. They plan to track screenings “These findings are truly striking, as20 healthcare organizations represent- in the coming months as virus mitiga- modeling from the NCI has predicteding over 28 million patients through- tion efforts are eased to help predict thousands of expected increases inout the U.S. and includes aggregate how many patients are continuing to cancer death as a result of deferreddata from electronic medical records delay screenings due to the pandemic. breast and colorectal screening alone,”such as diagnoses, procedures, and said SKCC Enterprise Director Karen “The most significant finding in ourdemographics. Using CCRN, the team E. Knudsen, MBA, PhD. “This report is study was the considerable drop in can-compared the number of patients with a nationwide call to arms, underscor- cer screenings. The fact that this trendcancer-related encounters in Janu- ing the urgent need to resume cancer was so drastic nationwide is telling ofary through April of 2019 with those screening and early detection.”  the widespread effect of the pandemic 9

HEALTHCARE HEROES BETTER TOGETHER Keeping Cancer Care Safe During COVID-19 T he Sidney Kimmel Cancer Center understands that cancer never stops, even during a pandemic. Additionally, cancer patients and others with weakened immune systems face an increased risk for severe illness due to COVID-19. To ensure patient safety, SKCC, in alignment with the overall efforts of Jefferson Health, quickly made adjustments to the way cancer care is delivered in order to limit exposure across all care sites through- out Pennsylvania and New Jersey while still providing comprehensive cancer care. Extra safety precautions designed to keep patients and staff safe and minimize the risk of COVID-19 included expanded appointment hours in the mornings and evenings to ensure optimal social distancing, waiting rooms were reconfigured to maintain social distancing, additional cleanings in all care areas were scheduled throughout the day, and masks were provided for all employees and patients. Telehealth appointments have expanded, allowing patients and caregivers to meet with their care teams without hav- Ashley Peck (left) and ing to make an unnecessary visit to the clinic. A no-touch registration option via mobile Stephanie Robinson, phone was instituted to reduce unnecessary contact during on-site appointments. Department of Medical Oncology front desk staff These safety measures are also in place during cancer screening appointments, which have now resumed. To date, Jefferson has treated more COVID-19 patients in the Philadelphia area than any other health system and no Jefferson patients have been infected by those who were admitted with COVID-19.  Clockwise, from top left: SKCC – Washington Township Medical Oncology team; Dr. Joanne Filicko- O’Hara & her patient Brian Burns; Jefferson – Northeast Radiation Oncology team; Asplundh Radiation Oncology team; Dr. Margaret Kasner; and the Center City Radiation Oncology team10

COMMUN IT Y BETTER TOGETHER Legacy of Hope Provides Groceries to Homebound PatientsT he nonprofit Legacy of Hope provides resources to cancer pa- tients and their families facing financial distress, including assistancewith bills and essentials. The organization has worked closely with theSidney Kimmel Cancer Center for years to provide support to can-cer patients experiencing difficulties while undergoing treatment. In December 2019, Legacy of Hope teamed up with Brown’s Chef’sMarket, the parent company of local ShopRites and the Fresh Gro-cer, and the Philadelphia Police Department to put together grocer-ies for patients in need and deliver them right to their homes. When the pandemic reached the Philadelphia area, Legacy of Hope Legacy of Hope volunteers and theacted quickly to scale up efforts. The team works with the oncology so- SKCC supportive care team pick up groceries (above), which PPD officers cial workers at SKCC who identify pa- deliver to patients at home (left) tients and families in need and who are facing hunger, and a nutritionist customizes orders based on each patient’s needs. The groceries are managed by Brown’s Chef’s Market and picked up by Philadel- phia Police officers, who then deliver each set of groceries to patients across the re- gion several times each week, allowing patients the ability to safely shelter in place without having to worry about whether they will have enough food at home. “It’s inspiring to see how passionate Legacy of Hope’s partners have been in addressing this critical need head on and watch grocery stores, cancer centers, and a police department mo- bilize to create an entirely new support system for cancer patients that previously would have been considered impossible,” said Michael Rowe, Legacy of Hope Founder and President.  Message Offers Support to Workers and PatientsS oon after the novel coronavirus reached the Philadelphia region, Jamie Wiegand, a nurse at Jefferson, decided shewanted to do something that could help brighten someone’s day. Wiegand called her cousin, Katie Scherwitzky, with an ideafor the skywalk over South 10th Street that connects the GibbonBuilding at Thomas Jefferson University Hospital with the parkinggarage across the street. Wiegand noted that many patients gopast the walkway, and the two quickly got to work brainstormingideas, then Scherwitzky printed everything for Wiegand to hang. “Hopefully it brought a little sunshine to thestaff and patients,” Scherwitzky said. Scherwitzky’s photograph of the walkway is fea-tured on the cover of this issue of Discovery.  Katie Scherwitzky poses under the skywalk on South 10th Street 11

NEW DEVELOPMENTS AWARDS AND HONORS ANDREW APLIN, PHD EDITH P MITCHELL, MD Appointed member, Mechanisms of Cancer Therapeutics Study Elected Fellow, Royal Academy of Physicians of London Section, National Institutes of Health, Center for Scientific Review Appointed member, President’s Cancer Panel Melanoma Research Foundation Humanitarian Award PHL Life Sciences Ultimate Solutions Award Geisinger Commonwealth School of Medicine Wellbeing Award USMAN BAQAI GINAH NIGHTINGALE, PHARMD Melanoma Research Foundation Medical Student Award to study Appointed member, Association of Community Cancer Centers’ BAP1 dependent kinome in uveal melanoma Board of Trustees CLAUDIA CAPPARELLI, PHD ISIDORE RIGOUTSOS, PHD Melanoma Research Foundation Career Development Award to Elected Fellow, American Association for the Advancement of investigate the role of the protein SOX10 in BRAF melanoma Science Legacy of Hope Merit Award to identify alterations that allow cancer cells to metastasize and survive treatment SIGNE CASKA ANURADHA SHASTRI, PHD Melanoma Research Foundation Medical Student Award to study Radiation Research Society Scholars-in-Training Travel Award for the role of SOX10 in metastatic melanoma drug resistance research on altering the gut microbiome with caloric restriction in prostate cancer ANDREW CHAPMAN, DO ALISON SHUPP American Society of Clinical Oncology B.J. Kennedy Award for AACR-Woman in Cancer Research Scholar-in-Training Award for Scientific Excellence in Geriatric Oncology research on osteoblasts’ role in breast cancer that has metastasized to the bone ANNA HAN, PHD ADAM SNOOK, PHD AACR-Ocular Melanoma Foundation Fellowship to define unique American Society for Pharmacology and Experimental Therapeutics metabolic features of uveal melanoma that can be targetable and Early Career Award identify metabolic functions of BAP1 mutations in uveal melanoma AMY HARRISON, PHD JOUNI UITTO, MD, PHD Elected member, Residency Education Programs Review Commit- Knight of the White Rose, First Order, Republic of Finland tee, Commission on Accreditation of Medical Physics Education Programs FELIX KIM, PHD SCOTT WALDMAN, MD, PHD Appointed chair, Translational Clinical Pharmacology Division, Elected Fellow, American Society for Pharmacology and Experimen- American Society for Pharmacology and Experimental tal Therapeutics Therapeutics KAREN E KNUDSEN, MBA, PHD CHARLES YEO, MD National Liberty Museum Healthcare Hero Award Global Philadelphia Corporate Leadership Award American Society of Clinical Oncology Advocacy Champion12

NEW DEVELOPMENTSGRANTSANDREW APLIN, PHD ANJALI MISHRA, PHDBRUNO CALABRETTA, MD, PHD ASH JUNIOR FACULTY SCHOLAR AWARDNATIONAL INSTITUTES OF HEALTH Basic/Translational Research Grant to study oncogenic pathwaysT21 grant to establish a training program in cancer biology to operation in blood cancers of T- and NK-cell originsupport multidisciplinary training to pre-doctoral candidates andpostdoctoral researchersKAREN BUSSARD, PHD MANISH NEUPANE, DVM, PHDU.S. DEPARTMENT OF DEFENSE KALEIDOSCOPE OF HOPE OVARIAN CANCER FOUNDATIONBreast Cancer Research Program award to study the role of Young Investigator Grant to study novel personalized MECP2-direct-osteoblasts in the bone-tumor niche during bone metastatic ed epigenetic therapy in high-grade serous ovarian cancersbreast cancerMEGHAN BUTRYN, PHD RAFFAELLA PIPPA, PHDNATIONAL INSTITUTES OF HEALTH PROSTATE CANCER FOUNDATIONR21 grant to evaluate how text messages may change food Young Investigator Award in Honor of H. Ward Hamlin Jr. to investi-purchasing habits and improve dietary intake. gate MITF as a therapeutic target in prostate cancerCHRISTINE EISCHEN, PHD MAURICIO REGINATO, PHDST. BALDRICK’S FOUNDATION NATIONAL INSTITUTES OF HEALTHJack’s Pack - We Still Have His Back Research Grant to study an NCI - ALLIANCE OF GLYCOBIOLOGISTS FOR CANCER RESEARCHinnovative way to destroy Burkitt lymphoma cells that contain RU01 grant to elucidate mechanisms of how of O-GlcNAcome reg-specific gene mutations that make them resistant to therapy ulates tumor-initiation pathways in breast cancerVEDA N GIRI, MD VERONICA RODRIGUEZ-BRAVO, PHDPROSTATE CANCER FOUNDATION NATIONAL INSTITUTES OF HEALTHValor Challenge Award to develop tools to educate physicians, R01 grant to identify novel actionable nuclear pore-regulated mech-patients, and the public on prostate cancer genetics and identify anisms in lethal prostate cancerpatients who should undergo counseling and testingVEDA N GIRI, MD YURI SYKULEV, MD, PHDAMY LEADER, PHD, MPH NATIONAL INSTITUTES OF HEALTHU.S. DEPARTMENT OF DEFENSE U01 grant to study novel strategies to improve NK cell-based immu-Idea Award to study peer-based intervention for genetic notherapies to treat cancer, viruses, and autoimmune diseasesevaluation for prostate cancer among African American menETHAN HALPERN, MD MATHEW THAKUR, MDFLEMMING FORSBERG, MD, PHD EDOUARD TRABULSI, MDNATIONAL INSTITUTES OF HEALTH NATIONAL INSTITUTES OF HEALTHMPI R01 grant to develop a cost-effective 3D multiparametric MPI R01 grant to develop a noninvasive urinary assay for prostateultrasound imaging for selectively guiding biopsies to detect cancer detection and managementprostate cancerFELIX KIM, PHD ANNE M. VAN HARTEN, PHDNATIONAL INSTITUTES OF HEALTH OVARIAN CANCER RESEARCH ALLIANCER01 grant to develop a novel class of therapeutic agents that Ann and Sol Schreiber Mentored Investigator Award to examine in-target Sigma1 in advanced prostate cancer novative treatment approaches for high-grade serous ovarian cancerALEXANDER MAZIN, PHD YAN YU, PHDNATIONAL INSTITUTES OF HEALTH LYDIA LIAO, MD, PHDMPI R01 grant to identify patients with acute myeloid leukemia NATOdisplaying specific preferences for repairing spontaneous and Multi-year Science for Peace and Security Programme grant to de-drug-induced DNA damage based on gene expression analysis velop a wearable panel to assess radioactive contamination 13

NEW DEVELOPMENTS DISCOVERIES OF NOTE Schilder RJ, et al. Sequential Ipilimumab After Chemotherapy in Sciences. 2020 March 02 [Epub ahead of print] Curative-Intent Treatment of Patients With Node-Positive Cervical Cancer. JAMA Oncology. 2019 Nov 27; 6(1):92-9 Lombardo J, et al., Care of Transgender Persons. New England Journal of Medicine. 2020 Apr 09; 382(15):1481 Cai W, et al. PBRM1 acts as a p53 lysine-acetylation reader to sup- press renal tumor growth. Nature Communications. 2019 Dec 20; Trabulsi EJ, et al. Optimum Imaging Strategies for Advanced Pros- 10(1):5800 tate Cancer. Journal of Clinical Oncology. 2020 Apr; 16(4):170-176 Porcu P, et al. Brentuximab vedotin in the treatment of CD30+ Kelly WK, et al. Clinical Outcomes in Men of Diverse Ethnic Back- PRCL. Blood. 2019 Dec 26; 134(26):2339-2345 grounds with Metastatic Castration Resistant Prostate Cancer. Annals of Oncology. 2020 Apr 11 [Epub ahead of print] Dalva MB, et al. Positive surface charge of GluN1 N-terminus mediates the direct interaction with EphB2 and NMDAR mobility. Languino LR, et al. The avB6 integrin in cancer cell-derived small Nature Communications. 2020 Jan 29; 11(1):570 extracellular vesicles enhances angiogenesis. Journal of Extracellu- lar Vesicles. 2020; 9(1):1763594 Lu-Yao G, et al. Mortality and Hospitalization Risk Following Oral Androgen Signaling Inhibitors Among Men with Advanced Prostate Benovic JL, et al. Arresting Developments in Biased Signaling. Trends Cancer by Pre-existing Cardiovascular Comorbidities. European in Pharmacological Sciences. 2020 Apr 30 [Epub ahead of print] Urology. 2020 Feb; 77(2):158-166 Spiller KL, et al. Macrophages of diverse phenotypes drive vascu- Calabretta B, et al. Selective inhibition of Ph-positive ALL cell larization of engineered tissues. Scientific Advances. 2020 May; growth through kinase-dependent and independent effects by 6(18):eaay6391 CDK6-specific PROTACs. Blood. 2020 Feb 07 [Epub ahead of print] Giri VN, et al. Implementation of Germline Testing for Prostate Eischen CM, et al. Pan-cancer analysis reveals cooperativity of Cancer: Philadelphia Prostate Cancer Consensus Conference 2019. both strands of microRNA that regulate tumorigenesis and patient Journal of Clinical Oncology. 2020 Jun 09 [Epub ahead of print] survival. Nature Communications. 2020 Feb 20; 11(1):968 Dey S, et al. Peptide vaccination directed against IDO1-express- Mandigo AC, et al. Double Trouble: Concomitant RB1 and BRCA2 ing immune cells elicits CD8 and CD4 T-cell-mediated antitumor depletion evokes aggressive phenotypes. Clinical Cancer Re- immunity and enhanced anti-PD1 responses. Journal for Immuno- search. 2020 Feb 04 [Epub ahead of print] Therapy of Cancer. 2020 July;8(2). Erkes D, et al. Mutant BRAF and MEK inhibitors regulate the tumor Flemming JP, et al. miRNA- and cytokine-associated extracellular immune microenvironment via pyroptosis. Cancer Discovery. vesicles mediate squamous cell carcinomas. Journal of Extracellu- 2020 Feb; 10(134):1999-2000 lar Vesicles. 2020 July 13;9(10):1790159. Wen KY. Not Just Another App: Realizing the Potential of Mobile Flickinger JC, et al. Chimeric Ad5.F35 vector evades anti-ade- Healthcare Applications to Promote Adherence to Oral Cancer novirus serotype 5 neutralization opposing GUCY2C-targeted Therapy Medications. Journal of the National Comprehensive Can- antitumor immunity. Journal for ImmunoTherapy of Cancer. 2020 cer Network. 2020 Feb; 18(2):219-22 Aug;8(2). Porcu P, et al. Improved outcomes for extranodal natural killer Magee, et al. On the expanding roles of tRNA fragments in mod- T-cell lymphoma. Lancet Haematology. 2020 Feb 24 [Epub ahead ulating cell behavior. Nucleic Acids Research. 2020 Sep 05 [Epub of print] ahead of print]. Grenda TR, et al. Transitioning a Surgery Practice to Telehealth Handley NR, et al. The Home is the New Cancer Center. Jour- During COVID-19. Annals of Surgery. 2020 March 16 [Epub ahead nal of the National Comprehensive Cancer Network. 2020 Oct of print] 01;18(10):1297-1299. Domingo-Domenech J, et al. Cellular rewiring in lethal prostate Alnahhas I, et al. Management of gliomas in patients with Lynch cancer: the architect of drug resistance. Nature Reviews Urology. Syndrome. Neuro-Oncology. 2020 Oct 16 [Epub ahead of print]. 2020 March 16 [Epub ahead of print] Rasouli J, et al. A distinct GM-CSF T helper cell subset requires Fong LY, et al. Abrogation of esophageal carcinoma development T-bet to adopt a T1 phenotype and promote neuroinflammation. in miR-31 knockout rats. Proceedings of the National Academy of Science Immunology. 2020 Oct 23;5(52).14

ACCOL ADES LEADING BY EXAMPLE ASCO Recognizes Outstanding Contributions of Dr. Andrew Chapman in Geriatric OncologyA ndrew Chapman, DO, was honored with the 2020 B.J. Kennedy Awardfor Scientific Excellence in Geriatric status. In a single appointment ei- ther in-person or through telehealth, members of the medical oncology,Oncology from the American Society navigation, social work, geriatrics, andof Clinical Oncology (ASCO) for his pharmacy teams provide personalizedleadership and achievement in the field. comprehensive care recommen- Chapman is co-director of the dations that will help patients andJefferson Senior Adult Oncology caregivers make an informed deci-Center, Chief of Cancer Services at sion to meet their treatment goals.the Sidney Kimmel Cancer Center The center also provides research-– Jefferson Health (SKCC), and En- ers the opportunity to evaluate theterprise SVP of Medical Oncology. impact of a comprehensive geriatric The distinguished award was es- assessment regarding treatment rec-tablished in 2007 in honor of the late ommendations, as well as the impactB.J. Kennedy, MD, who is considered of the multidisciplinary evaluationthe father of medical oncology and a model on treatment decision devel-pioneer in the field of geriatric on- opment in a shared decision making Andrew Chapman, DOcology. It recognizes members who Enterprise SVP of Medical Oncologyhave made outstanding contributions “Dr. Chapman is a dedicated Chief of Cancer Services, SKCC physician and researcher Co-director, Senior Adult Oncology Centerto the research, diagnosis, and treat- who understands the uniquement of cancer in the elderly, and in needs of senior adults withbringing an understanding of geriatric cancer. Under his leadership, “On behalf of the Sidney Kimmeloncology to fellow and junior faculty. the Senior Adult Oncology Cancer Center, I’d like to congratulate Center at SKCC remains “I am humbled to receive this at the forefront providing Dr. Chapman on receiving this incredi-prestigious award on behalf of the specialized care to this growing ble recognition from ASCO,” said Karenincredible geriatric oncology team population of cancer patients.” E. Knudsen, MBA, PhD, Enterpriseat Jefferson,” Chapman said. Director of SKCC and EVP of Oncol- Chapman helped establish the environment with the healthcare team ogy Services at Jefferson Health.multidisciplinary Senior Adult On- alongside the patients and caregivers. “Dr. Chapman is a dedicated physi-cology Center at SKCC more than Additionally, the center offers clinical cian and researcher who understands10 years ago. One of the first of its trials to older adults, a population that the unique needs of senior adultskind in the U.S., the center con- is often excluded in clinical research. with cancer. Under his leadership,tinues to set the standard model the Senior Adult Oncology Center at Chapman is currently planning tofor interprofessional care delivery SKCC remains at the forefront provid- launch a tool throughout the Jef-for older adults with cancer. ing specialized care to this growing ferson Health enterprise that will The Senior Adult Oncology Cen- educate the oncology nurse force population of cancer patients. He ister provides a unique opportunity for and help them to evaluate patients committed to providing the best carethese patients to undergo a geriatric and refer them to the center for possible to all of his patients and thisassessment that evaluates their med- a comprehensive assessment. is a truly well deserved honor.” ical, functional, and psychological 15

FEATURE ARTICLE TELEHEALTH Telehealth Keeps Patients Con A Telehealth Task Force supports health equity a I n early March, the threat of a novel coronavirus reached the United States and the Sidney Kimmel Cancer Center Between Jan. 1 and March 15, 2020, a total of 456 telehealth visits were completed across SKCC, while 7,952 and available for medical, radiation, and surgical oncologists, as well as supportive staff. The appointments – Jefferson Health (SKCC) and hospi- telehealth appointments were com- were most often for pre-visit consul- tals nationwide began taking actions to pleted from March 16 to June 7. tations, follow-up visits, and visits with mitigate the threat of a looming pan- SKCC has continued to see new the oncology social work team. Early demic. Such steps included rearrang- and current patients since the start patient feedback has been positive. ing clinics to follow social distancing of the coronavirus outbreak and has “By uncoupling the office visit and guidelines, amping up already-robust maintained the highest quality of care the infusion appointment, patients and cleaning routines, providing adequate while decreasing risk for patients and caregivers expressed appreciation for masks and hand sanitizer for staff streamlining the treat- and patients, and shifting ment process in efforts appropriate staff to a work- to create maximum from-home environment. safety and efficiency,” Transitioning many outpa- Chapman said. “This tient appointments to virtual has led to increased ones was also a key aspect patient, caregiver, and of increased safety measures. healthcare provider Providing remote care can satisfaction during what help reduce the risk of expo- has been an otherwise sure for vulnerable cancer very stressful time for patients by keeping them cancer patients.” out of the clinic and lessen Ana María López, the number of people in the MD, MPH, Professor clinics throughout the day. From left: Onyi Okorji, DO, Jefferson Health – Northeast faculty resident; Jill Lefkowitz, MSW, oncology social worker; Elizabeth and Vice Chair of Med- Telehealth was a Jefferson Thornton, MSN, CRNP, medical oncology nurse practitioner; ical Oncology at SKCC enterprise initiative champi- and Andres Ferber, MD, Director of Hematology Outreach at and Chief of Cancer SKCC at Torresdale, consult with a patient via telehealth oned by President and CEO Services for SKCC – Stephen Klasko, MD, MBA, New Jersey, has also and led by Judd Holland- found that patients are er, MD, Associate Dean for Strategic staff through telehealth, explained responding favorably to the experience. Health Initiatives at the Sidney Kimmel Andrew Chapman, DO, Enterprise “Patients often comment about Medical College. All hospital depart- Chief of Cancer Services at SKCC. how seamless the experience is, how ments were encouraged to introduce Outpatient appointments are shifted nice it is to be able to include family telehealth and SKCC leadership was to telehealth when medically appro- members in the visit, and how secure enthusiastic about incorporating the priate, depending on the needs of the they feel in this time of COVID to platform into clinical cancer care. patient. Those who require in-office meet with their doctor in a safe way.” It was first implemented in 2017, services such as chemotherapy in- Right at the start however, which allowed SKCC to shift patients fusions, radiation therapy, and other SKCC recognized that many pa- over to virtual care rather quickly essential purposes are still seen in the tients face barriers to engaging while assuring continuity of care. clinic. The virtual visits are facilitat- with their health providers virtually. ed through a HIPAA-compliant tool16

nnected From a Safer Distanceand helps patients overcome barriers to access They may lack routine internet ac- ment building from cess or report low digital literacy. the front desk or other In response, SKCC established residents until social the Telehealth Task Force to support distancing precautions health equity in telehealth care and left the lobby empty. help patients overcome any issues Many are predicting proactively. If a patient identifies any that the shift toward type of barrier to telehealth – such as telehealth will remain lacking a MyChart account, an active in place even when email address, or a working device the emergency of – the Task Force steps in to assist. the pandemic is over. The SKCC Telehealth Task Force. Clockwise, from top left: They can provide patients access to Going forward, it is Jillian Van Sciver, Lauren Waldman, Melissa Klein, Ilise Posner a device or set them up with data important to have an minutes. Additionally, the Task Force accurate understand- mote health equity, and they will also can help patients download the Jeff- ing of telehealth’s impact on cancer examine telehealth’s ability to alleviate Connect app and walk them through care – and SKCC researchers have anxiety during these stressful times – the process, help them set up an already begun. The National Can- not only among patients and caregiv- email address, or connect them with a cer Institute (NCI) recently awarded ers, but also among the clinical teams. translator if they do not speak English. SKCC will also be in regular dis- Patients have been highly recep- “By uncoupling the office visit cussions with the two other institutes tive to the intervention, expressing and the infusion appointment, patients and caregivers studying cancer patient management gratitude for the outreach, attention, and patience guiding them through expressed appreciation for through telehealth during COVID-19 – streamlining the treatment the Stephenson Cancer Center at the the process, according to Task Force process to create maximum University of Oklahoma in Oklahoma member Lauren Waldman. “Patients safety and efficiency.” City, and Dartmouth-Hitchco*ck Norris who self-identify as having low digital Cotton Cancer Center in Lebanon, literacy are particularly grateful, as in SKCC a grant to evaluate the impact N.H. The three NCI-designated cancer pre-COVID times they might have had of telehealth during the pandemic on centers each serve different patient the support of neighbors, family, or health outcomes, patient and clini- populations, thus providing an oppor- other community members to assist cian well-being, and health equity. tunity to analyze diverse patient popu- with new technology,” Waldman said. lations in different geographic settings. For example, Waldman assisted an The researchers plan to track and compare patient outcomes and The synergy and partnership with older woman who lives on her own. satisfaction pre-telehealth expan- the other cancer centers gives the proj- Prior to COVID, she watched her sion prior to the pandemic, during ects the potential to impact telehealth granddaughter and frequently saw her the pandemic telehealth expan- cancer care nationwide, according to daughter, who would usually assist her sion, and post-pandemic telehealth López, who will be leading the effort. with technology. Since the pandemic, they have been unable to visit. She expansion, López explained. To schedule a telehealth or also recalled an older man who often The researchers plan to assess the in-person appointment at the found help in the lobby of his apart- Telehealth Task Force’s ability to pro- Sidney Kimmel Cancer Cen- ter, call 1-800-JEFF-NOW.  17

FEATURE ARTICLE TELEHEALTH Post-pandemic Opportunities for Telemedicine I n response to the COVID-19 pan- demic, cancer centers rapidly shifted to telemedicine, offering immediate is that of digital literacy, as patients with lower health literacy are less likely to participate in shared deci- benefits such as reducing exposure sion-making in their medical care. to the virus in the clinical setting Pre-pandemic data revealed dispar- and overcoming transportation bar- ities in digital heath literacy across riers for patients and caregivers. numerous demographics, including Additionally, telemedicine expanded socioeconomic status, race, ethnicity, the definition of patient-centered care and age. Challenges are further exac- from “the right treatment, for the right erbated in older adults who have lower Communications Commission (FCC), patient, at the right time,” to include “in digital health literacy compared with 97% of Americans living in an urban area the right place,” wrote Karen E. Knud- younger patients, are less likely to have have access to high-speed internet, sen, MBA, PhD, Enterprise Director of an email address, own a smartphone, compared with only 64% of people in SKCC; Cheryl L. Willman, MD, Direc- or use an online portal to communi- rural areas and 60% of those living on tor and CEO of the University of New cate with their oncology care team. tribal lands having similar access. Emer- Mexico Comprehensive Cancer Center “Telemedicine expanded gency funding to increase broadband in Albuquerque; and Robert A. Winn, the definition of patient- access was part of the FCC’s COVID-19 MD, Director of the VCU Massey Cancer centered care from ‘the Telehealth Program that was appropriat- Center in Richmond, Va., in a recent right treatment, for the right patient, at the right time,’ to ed as part of the Coronavirus Aid, Relief, manuscript published in Clinical Can- and Economic Security Act; however, include ‘in the right place.’” cer Research that outlined the current long-term solutions will be key post-pan- state of telemedicine at AACI member Studies have also shown signifi- demic, Knudsen and colleagues wrote. centers and offered recommenda- cant variances in access across di- Sustained telehealth utilization also tions for enhancing post-pandemic verse and at-risk populations. Many requires reimbursem*nt parity with cancer care through telemedicine. patients with smartphones lack the in-person visits and coverage for both Telehealth visits through phone or ability to download the necessary apps in-state and out-of-state visits. While video, home-based care, and remote required for a telehealth video visit. the Centers for Medicare and Medicaid patient monitoring were effective ways Overall though, patients demonstrate Services and select commercial payors to deliver care throughout a pandemic, a strong desire for telehealth services, modified reimbursem*nt policies in but will also remain part of the can- particularly those for whom a lack of response to the pandemic, it is unclear cer care continuum post-pandemic. transportation is a barrier to care. whether policies will remain or whether However, it is essential to understand Many cancer centers in rural settings other commercial payors will follow suit. the impact of telehealth on access to report challenges related to broadband Telehealth undoubtedly represents cancer care, quality of care delivery, availability. A recent study found patients an innovative change to cancer care health equity, outcomes, and reim- living in the Northeast, West, or Midwest that will transform patient access to bursem*nt, and there is a long way to in the United States had about a 34% in- treatment, Knudsen and colleagues go to achieve equitable implementa- creased likelihood of having a telehealth concluded. As such, it is critical that the tion, according to Knudsen, Willman, visit compared with people living in the cancer community works to mitigate and Winn, who identified immediate South. Additionally, individuals living in cancer health disparities and to optimize needs that must be addressed. urban areas were 54.3% more likely to telemedicine services to meet the spe- have a telehealth encounter than those One issue that is critical to address cialized needs of a diverse population.  in rural areas. According to the Federal18

SURVIVOR STORY ARNALDO SANTOS Nothing to Fear: Cancer Surgery During COVID-19W ith thyroid cancer surgery sched- uled for April 10, Arnaldo San-tos, 51, was enjoying time at home waiting area, when someone was called back, a member of the staff was there right away to sanitize the chair. It madein Hopewell Township, N.J., with his me feel very comfortable and secure.”family when he received a call from “Surgery, at baseline, is one of thehis surgeon, David Cognetti, MD. safest places for patients in medicine be-With the COVID-19 pandemic wors- cause of how rigid things are in terms ofening, the decision had been made protecting against the transmission of in-to postpone his surgery to May. fectious disease,” Cognetti said. Because “He was being cautious; he of the pandemic, additional precautionswanted to make sure that his pa- include pre-op COVID testing for alltients didn’t get the coronavirus,” patients and the escalation of personal Arnaldo Santos and his wife, MaribelSantos said. “That was smart.” protective equipment (PPE) to include While Cognetti assured Santos N95 masks, combined with face shields, diagnosis and recovery. The successfulthat his overall prognosis was excel- “Surgery, at baseline, is surgery is allowing Santos to return to hislent, with minimal significant risk for one of the safest places family and to his calling to help others. Adisease progression, Santos’s anxiety, for patients in medicine because of how rigid things retired police detective, he’s witnessedunderstandably, became somewhatheightened. “The bottom line is, you are in terms of protecting more turmoil than many, starting at age against the transmission 9 when he fled with his mother andcan tell somebody they’re going to do of infectious disease.” brother from an abusive father in Puertogreat, but when they hear the word for staff. “Protecting our staff is important, Rico. He grew up in government-as-‘cancer,’ that’s going to wear on their not only for the sake of our staff but also sisted housing in Bridgeton, and at 19,mind,” said Cognetti, who is Chair of because it protects the next patient.” began a career in law enforcement.the Department of Otolaryngology. Patients should know that surger- As a detective, he was recognized Many of Cognetti’s patients whose ies, despite the ongoing pandemic, by the U.S. District Court for the Dis-surgeries were rescheduled received are extremely safe, Cognetti explained. trict of New Jersey as an expert wit-a call from him from time to time, “It’s important that the message of safe ness on East Coast street gangs. Hisjust to keep in touch and offer reas- surgery be out there because what’s hap- experiences on the front lines of gangsurance. “I’ve never had that experi- pened now, which could potentially hurt warfare are captured in his 2016 book,ence,” Santos said, “where a doctor patients, is that much of the news has “Street Gangs and God – The Battle inwill call me at, say, 9 o’clock at night made people scared to come into the the Streets,” which he describes as partjust to find out how I was doing.” hospital or to come in and get surgery. memoir and part spiritual encourage- From the minute he walked into ment for parents and young people In many cases, that could end up hurtingthe reception area for his rescheduled struggling to find purpose in their lives. the patient instead of helping them.”surgery on May 8, Santos felt very safe – While recovering at home, Santos As a deacon, he continues to guidedespite the uncertainty swirling around has returned to his duties as business parents and their children to do goodthe pandemic. “I could smell the alco- manager at Parish of the Holy Cross things. As a patient, he encourageshol and just how clean everything was. in Bridgeton, N.J. An ordained deacon anyone who has been told they willThat was very important to me,” he said, in the Catholic Church, his faith has require surgery to go through with it.adding that hospital staff was practicingstrict social distancing measures. “In the played an important role throughout his “Do not fear and do not be afraid.”  19