On March 8, Samuel Hellman, MD, A.N. Pritzker Distinguished Professor of Radiation & Cellular Oncology at the University of Chicago, presented a J. Walter Juckett Distinguished Lecture entitled “A New Paradigm for the Curative Treatment of Metastatic Cancer.” Outlining data collected from his and others' studies, Hellman asserted that in the current era of early diagnosis, accurate staging, and effective systemic therapies, the standard palliative approach to most individuals with metastatic cancer must be reconsidered.
Hellman cited several specific screening methods, including mammography and the test for elevated serum prostate specific antigen (PSA), which in recent years have lead to the diagnosis of many cancers, including metastatic cancers, earlier in the course of their progression—and potentially at a point where their biologic behavior and response to therapy will be more favorable than previously possible. Hellman also talked about newly introduced sensitive-staging methods such as positron emission tomography (PET), which may improve oncologists' ability to detect metastatic disease, again possibly at a point before it becomes uniformly fatal.
Hellman presented intriguing historical data compiled at the University of Chicago and published by Ruth Heimann, MD, PhD (now a VCC member) which revealed that in the pre-chemotherapy era, women diagnosed with breast cancer involving multiple lymph nodes survived and were effectively cured with local (surgery or radiation) alone, while today chemotherapy is favored in metastatic patients. Hellman believes that in today's medical environment at least some patients diagnosed with oligometastases should be offered potentially curative treatment, with aggressive local therapy to both the primary site of disease and a limited number of metastases, in addition to systemic chemotherapy.
Lecture attendee H. James Wallace III, MD, VCC member and medical director of radiation oncology at Fletcher Allen Health Care, said “It was great to see a turnout of 75 physicians, researchers, trainees, and staff at this lecture. Dr. Hellman's visit to VCC has energized our discussions about local therapy for metastatic cancers. His talk beautifully outlined a new paradigm for the treatment of such cancers that we will be sure to examine over the next few years."
Hellman, who was previously dean of the Division of Biological Sciences and the Pritzker School of Medicine at Chicago, physician-in-chief of the Memorial Sloan-Kettering Hospital for Cancer and Allied Diseases, and chair of the Department of Radiation Therapy at the Harvard Medical School, conducts research focused on breast cancer, prostate cancer, and lymphoma. His recent breast cancer studies emphasize the importance of understanding the clinical evolution of disease in order to develop effective therapy and his recent laboratory investigations center on the cell kinetics of the hematopoietic system.