Study shows Retzius-sparing robotic prostatectomy at MedStar Georgetown University Hospital improves patient quality of life without compromising cancer control

Washington, D.C. — Retzius-sparing robotic prostatectomy, an innovative surgical approach to treat men with prostate cancer, has shown to significantly reduce the risk of urinary incontinence, or urine leakage, and also improve patient’s quality of life without compromising oncological outcomes, according to a new study led by Keith Kowalczyk, M.D., director, Urologic Oncology at Medstar Georgetown University Hospital. Only the 3rd of its kind in the United States, this study examined data gathered from 140 radical prostatectomies performed by Dr. Kowalczyk over a 4-year period at MedStar Georgetown University Hospital.

 Keith Kowalczyk, MD with DaVinci Xi Dual Console RobotThe findings show that, in comparison to standard robotic prostatectomy, men undergoing Retzius-sparing robotic prostatectomy had higher rates of continence (98% vs. 81%), achieved continence earlier (49 vs. 64 days), and demonstrated 80% lower risk of suffering from incontinence one year following surgery.  Additionally, men undergoing Retzius-sparing prostatectomy had significantly better overall quality of life one year following surgery.

Urinary incontinence and compromised quality of life following a radical prostatectomy has been a barrier to seeking appropriate care for some prostate cancer patients. “We tend to underestimate the effect that even mild urine leakage may have on patient’s quality of life and well-being following prostatectomy. That is why I decided to learn this new technique, even though it is technically very challenging.  I am glad that I did because I have seen a remarkable improvement in outcomes for my patients as seen in this study,” Dr. Kowalczyk said.

Following robotic prostatectomy, most patients were able to leave the hospital less than 24 hours after surgery and resume routine activities in 1–2 weeks. Additionally, patients undergoing Robotic surgery tend to have less pain and discomfort following the surgery, translating to a minimal need for pain medications during hospitalization and no need for narcotic pain medications at home. Sean Hawkins, a patient who underwent the surgery said, “After about 3 weeks I regained all of my functions and ended up going back to work earlier than I expected, I got my life back totally.”

 “Robotic surgery allows for a much more precise surgery with much easier recovery and less blood loss for the patient,” said Dr. Kowalczyk. “With Retzius-sparing robotic prostatectomy, the whole surgery is done in a very small space in the pelvis which is not accessible during traditional open surgery.  This allows us to leave as much as the normal pelvic anatomy intact as possible without causing surrounding damage, which is most likely what leads to these improved outcomes.”

Medstar Georgetown University Hospital acquired the DaVinci Xi Dual Console robot in February 2020, and Dr. Kowalczyk has started performing the surgeries on this platform. The state-of-the-art surgical system offers a minimally-invasive option for patients who require a prostatectomy. The new technology uses fine instrumentation, 3-D visuals, increased magnification, and only requires a less than ½ inch incision.  In addition, the DaVanci Xi platform allows improved visualization and improved movement of instrumentation. “Using the Xi platform has made this surgery much easier for me, for sure.” said Dr. Kowalczyk.

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100th Patient Treated with Proton Therapy at MedStar Georgetown University Hospital

WASHINGTON, D.C. – Physicians and hospital staff are celebrating the first 100 patients treated at the MedStar Georgetown University Hospital Proton Therapy Center, the first and only center of its kind in the Washington D.C. metropolitan area. Proton therapy is the latest cancer-fighting technology designed to shrink some previously untreatable tumors.

MedStar Georgetown providers with Proton therapy some patientsThe proton therapy system used by radiation oncologists at MedStar Georgetown is the most advanced cancer treatment technology currently available. Using pencil beam scanning (PBS) and HYPERSCAN™ technology, physicians can precisely target tumors anywhere in the body with minimal exposure to healthy tissues. This is especially beneficial for younger patients, who have a higher likelihood of living many years after their cancer has been cured.

“With conventional radiation, when we aim at a target, there’s full dose radiation in front of the target and full dose radiation beyond the target. With the protons, they can stop in the center of the tumor,” says Brian Collins, MD, clinical director of the Proton Therapy Center.

“There are certain types of cancer where you have to deliver a very high dose of radiation right next to a critical structure like the spinal cord or brainstem,” says Radiation Oncologist Sonali Rudra, MD, “So, for some patients, proton therapy might be their only radiation treatment option.”

MedStar Georgtown's 100th Proton Therapy PatientThe center’s 100th patient, Kathleen Norris of Lexington Park, Maryland, began receiving proton therapy treatments in April for her inoperable lung cancer. Proton therapy helps Norris’ care team avoid targeting critical nearby organs, like the heart, that may be damaged by conventional x-ray radiation. Norris says she’s thankful for the opportunity to fight her cancer battle with cutting-edge tools never-before available in her area.

“This proton is so advanced.  It was able to hit my cancer without damaging my other tissues and it could avoid my heart.  I’m so glad.  The tumor has already shrunk by forty percent,” Norris said. “I’ve done really well. I’ve been very lucky.”

In March 2018, Martha Ramos, a mother of two from Germantown, Maryland, became the first patient treated by doctors at the MedStar Georgetown University Hospital Proton Therapy Center. Before treatment, Ramos underwent multiple operations to remove a non-cancerous recurring brain tumor. Some cells deep in the brain could not be removed in surgery. Proton therapy eradicated those remaining cells and preserved her quality of life.

“I want to have more time to be a mom to my children. I want to be very healthy so I can be there for them and help them in life,” Ramos said after treatment. “I am very, very grateful that my medical team at MedStar Georgetown told me about proton therapy. I now look forward to a long and happy life.”

Since proton therapy was approved by the Food and Drug Administration in 1988, over 75,000 patients have been treated at only about 30 centers across the United States. Now, patients have access to this state-of-the-art technology in Washington D.C.

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National Cancer Institute Renews Prestigious Designation of Georgetown Lombardi Comprehensive Cancer Center

(Washington, D.C) - MedStar Georgetown University Hospital is proud to announce that the National Cancer Institute (NCI) has once again designated its research partner, Georgetown Lombardi Comprehensive Cancer Center, with its coveted distinction, "comprehensive cancer center."

First awarded to Georgetown Lombardi in 1974, MedStar Georgetown University Hospital serves as one of the cancer center’s primary hospital affiliates in Washington D.C.  Additionally, for the first time, MedStar Washington Hospital Center was also named as a Georgetown Lombardi primary hospital affiliate. 

"As the only NCI-designated comprehensive cancer center in the District of Columbia, we’re able to offer a comprehensive suite of services to our patients, providing them with research-inspired cancer care that they simply can't get anywhere else," says Dr. Louis M. Weiner, director of Georgetown Lombardi and the MedStar Georgetown Cancer Institute.

The MedStar Georgetown Cancer Institute combines medical expertise, the latest therapies, and research across the region. "What makes us special is the concept of cura personalis, or the care of the whole person. We don't treat diseases – we use evidence-based medicine to treat people in the context of their own lives, families, and communities. Having cancer is very frightening. Being a cancer patient can be a lonely journey.  At our hospital, you're going to be treated like a person, not like a disease," says Dr. Weiner. 

Of the 1,500 cancer programs in the United States, only 50 have this prestigious designation and Georgetown Lombardi is the only such center in the Washington, D.C. area.  

In order to renew its NCI designation, the cancer program in 2018 went through a rigorous, peer-reviewed grant renewal process conducted by cancer center experts from across the country. The renewal occurs every three to five years.

M. Joy Drass, MD, Executive Vice President and Chief Operating Officer of MedStar Health, says, "As the clinical partner for Georgetown Lombardi, our patients receive personalized care from physicians who are also, through innovative clinical trial research, offering breakthrough advancements in diagnostics, new technologies, and novel therapeutics. Our long-standing partnership provides patients with unparalleled access to a multidisciplinary team of experts, clinicians, and researchers who are leading the way in how cancer is detected and treated."

The NCI approved Georgetown Lombardi as a "consortium center" reflecting an integrated cancer research program with John Theurer Cancer Center, part of Hackensack Meridian Health in New Jersey. MedStar Georgetown, Georgetown Lombardi, and John Theurer began their clinical and research relationship in 2013 through which the world-class Bone Marrow and Blood Stem Cell Transplant Program at MedStar Georgetown was established. Because of this program MedStar Georgetown has been able to offer patients with blood cancers the latest in bone marrow transplantation, CAR T cell therapy and other new immunotherapies that require the infusion of cells into people to attack cancer.

Cancer-fighting technologies like proton therapy, which opened at MedStar Georgetown in 2018, and CyberKnife that has been used to treat cancers at the hospital since 2002 are also examples of the cutting-edge care available to treat patients in the region. 

The NCI designation as a comprehensive cancer center indicates that Georgetown Lombardi excels in laboratory science, clinical research and population-based programs, along with robust translational research that bridges these areas. It also demonstrates expansive public education and outreach capabilities, which focus on the community.

The populations in Washington, D.C., and in Bergen County, New Jersey, where the John Theurer Cancer Center is located have some of the highest cancer incidence and death rates in the country. Georgetown Lombardi researchers are working on new ways to address the underlying causes so that strategies to address these health disparities can be implemented and refined.

Edward B. Healton, MD, MPH, Executive Vice President for Health Sciences and Executive Dean of the medical school at Georgetown University Medical Center underscores the critical role of Georgetown Lombardi in the communities it serves.

"An important aspect of the research, outreach and education activities carried out at Georgetown Lombardi focuses on eliminating disparities in minority and medically underserved populations," Healton says. "This is especially important in the communities served by both Georgetown and Hackensack, as our special collaboration has the potential to be deeply impactful."

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Large Study Reveals Long-Term Outcomes for Prostate Cancer Patients Treated with High Dose, Short Term Radiation like CyberKnife Radiotherapy

WASHINGTON –– A large, national study examining a radiation treatment for prostate cancer––popular because it delivers a high dose of therapy in a very short time frame––supports its routine use. 

The study, conducted at cancer centers around the United States including at Georgetown Lombardi Comprehensive Cancer Center, looks at long term follow up data for stereotactic body radiotherapy (SBRT) used to treat more than 2,100 men with prostate cancer that had a low or intermediate risk of recurring.

The results were published Feb. 8 in the journal JAMA Network Open.

At MedStar Georgetown University Hospital, the therapy is delivered by a system called CyberKnife, which delivers high doses of radiation precisely aimed to minimize the involvement of healthy surrounding tissue.

Radiation oncologist Sean P. Collins, MD, PhD, says curative treatment is a shared goal along with maintaining a person’s quality of life.  Side effects, including impotence, can occur with all treatments for prostate cancer and can happen years after treatment.

“While it is necessary to observe these men for decades, our interim seven-year data show that survival and side effects are comparable to other forms of radiotherapy,” says Collins, director of the CyberKnife Prostate Program at MedStar Georgetown University Hospital and an associate professor of radiation medicine at Georgetown University. 

The National Comprehensive Cancer Network, which establishes cancer treatment guidelines, classified SBRT as an alternative to conventional therapy, but had noted a lack of long term follow up data. There is much more experience with conventionally fractionated radiation therapy, delivered five times a week for up to nine weeks, and brachytherapy, in which radioactive seeds are implanted in the prostate.

“Our findings give us great confidence that CyberKnife should become a standard option for some men who want to avoid the hassle and inconvenience of standard therapy,” Collins says.



Collins reports receiving grants from and being a paid consultant for Accuray Inc., the maker of CyberKnife.


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MedStar Georgetown’s First Proton Therapy Patient Grateful for Highly Precise Treatment with Fewer Side Effects

Martha Ramos of Germantown, Maryland is back to enjoying her active life with her two children thanks to treatment she received for a recurrent brain tumor that included proton therapy now being offered at MedStar Georgetown University Hospital.

In fact, Ramos, 54, was the first patient to receive proton therapy when the MedStar Georgetown University Hospital Proton Therapy Center opened its doors in March 2018.

“I was a little bit nervous to be the first patient at MedStar Georgetown to get proton therapy,” says Ramos though a Spanish interpreter. “But I trust my medical team wholeheartedly and after the first treatment I knew what to expect and was very happy.”

Ramos was first diagnosed with a brain tumor called oligodendroglioma in 2006.  She had surgery to remove the tumor.

But in the fall of 2017 routine follow-up imaging revealed that her tumor had returned.

Martha-Ramos-with-Her-ChildrenIn January 2018 MedStar Georgetown Neurosurgeon Vikram Nayar, MD removed the second tumor, about the size of a golf ball, in a very complex operation. But there were some cells deep within her brain that couldn’t be completely removed with surgery.

“She has a long life expectancy so we wanted to eradicate the remaining cells from this second tumor while still preserving her excellent quality of life,” says Brian Collins, MD, Ramos’s radiation oncologist and director of the MedStar Georgetown Proton Therapy Center.

“There was a little bit of tumor that was left after her surgery,” says Ramos’s neuro-oncologist, Deepa Subramaniam, MD, director of the Brain Tumor Center at MedStar Georgetown.  “That’s why she needed radiation after the surgery to get rid of what was left.”

“I want to have more time to be a mom to my children,” explains Ramos. “I want to be very healthy so I can be there for them and help them in life.”

“We chose proton therapy for Ms. Ramos because we could irradiate a significantly smaller area of the brain than we could have with conventional radiation,” says Dr. Collins.

Dr. Collins explains that with conventional radiation the photons or x-rays travel through the entire brain without stopping; with proton therapy, the radiation is unleashed just inside the target, then stops.  That means there is no exit dose to harm healthy brain tissue.

“This results in fewer side effects like dementia or memory loss.  For Ms. Ramos this was an advantage because we could deliver radiation just to the tumor without affecting other areas,” says Dr. Collins.

The proton therapy system at MedStar Georgetown is the first and only in the Washington, D.C. metropolitan area and is the first in the world to offer proton therapy with HYPERSCAN™ technology. HYPERSCAN produces beams that are sharper than other proton systems and treats patients faster.

“I feel that I responded very well to the proton therapy treatment,” says Ramos.  “My recovery from the proton therapy was surprisingly fast.”

 “I’m very excited for Ms. Ramos,” says Dr. Collins.  “After a short time, she’s back to living her normal life and we expect her to make a full recovery. Proton therapy was an excellent option and it was a pleasure helping her get through this.”

“I am very, very grateful that my medical team at MedStar Georgetown told me about proton therapy,” says Ramos. “I now look forward to a long and happy life.”

MedStar Georgetown First and Only Center in the Washington, D.C. Metropolitan Region to Offer Proton Therapy for Cancer Patients

Dr. Brain Collins with MedStar Georgetown’s first patient to receive proton therapy.(Washington, D.C) April 17, 2018- For the first time, cancer patients in the Washington, D.C. metropolitan region have access to the latest cancer-fighting technology, proton radiation therapy, now available at the MedStar Georgetown University Hospital Proton Therapy Center.

Martha Ramos, 53 of Maryland became MedStar Georgetown’s first patient to receive proton therapy.  Ramos is being treated for recurrence of a brain tumor.  

“It’s encouraging to know that this kind of radiation will result in less damage to the healthy area of my brain,” says Ramos. 

Proton therapy is more precise and targeted than conventional radiation. It works by using pencil beam scanning, similar to a 3D printer, to match the tumor’s exact shape and size with superior accuracy that eliminates the exit dose of traditional radiation, and spares healthy tissue.

MedStar Georgetown is the first and only proton center in the world to offer the Mevion S250i with HYPERSCAN™ technology, producing beams that are sharper than previous proton systems. Proton therapy with HYPERSCAN is also faster than other proton systems, benefiting patients whose treatment includes holding their breath.

“I am extremely excited to be able to offer this latest advancement, proton therapy, to my patients,” says Brian Collins, MD, a radiation oncologist and clinical director of the new proton therapy center.  “It’s clear that this treatment will help to improve the clinical outcomes for our cancer patients and decrease their side effects when radiation is needed.”

 “In certain cases, proton therapy can be a game changer,” says Keith Unger, MD, radiation oncologist at MedStar Georgetown.  “It allows us to treat cancers where traditional radiation might not even be possible."

How Protons Destroy Cancer

“Proton therapy is an advanced form of radiation that can destroy cancer cells,” says Peter Ahn, MD, a radiation oncologist at MedStar Georgetown.  “A machine called a cyclotron speeds up protons to two thirds the speed of light and they become highly charged.  These high energy protons are then delivered to the tumor as an invisible beam that eradicates the cancer.  Because we can more tightly control the protons than we are able with traditional radiation, proton therapy can be given without damaging critical tissues and structures near the tumor because the beam conforms  precisely to the tumor’s size and shape, sparing healthy tissue.”

Advantages of HYPERSCAN™

HYPERSCAN is an FDA-approved proprietary technology that has advantages over existing proton therapy systems. In addition to producing a micro beam that is sharper than many current proton systems and reducing damage to nearby healthy tissue, HYPERSCAN is also faster than other pencil beam scanning systems which can reduce the margin of error in treating tumors that are affected by breathing or organ motion.  This improves both treatment accuracy and patient comfort as patients need to spend less time lying still.

“HYPERSCAN is currently the most precise type of proton therapy in the world,” says Dr. Ahn. 

“Proton therapy with HYPERSCAN can be given from head to toe,” says Dr. Collins.

Cancer Treatment for Patients with Fewer Side Effects

Proton therapy is beneficial for pediatric cancer patients because it lowers their exposure to radiation avoiding unnecessary exposure to healthy tissue and resulting in less growth impairment as they grow up.  Children are less likely to develop a secondary cancer later in life when treated with proton therapy as it treats tumors while keeping health surrounding tissues unharmed.

proton therapy patient with doctorProton therapy is also effective in treating re-current tumors.

 “There are also certain types of cancer where you have to deliver a very high dose of radiation right next to a critical structure like the spinal cord or brainstem,” says Sonali Rudra, MD, radiation oncologist at MedStar Georgetown. “With proton therapy we can deliver a high dose to the area we are trying to target and minimize the radiation beyond the tumor.  So for some patients, proton therapy might be their only radiation treatment option.”

“Proton therapy can also be a good option for patients with left-sided breast cancer, which is close to the heart,” says Dr. Rudra. “When indicated for breast cancer, using proton therapy instead of traditional radiation means more control over the radiation itself and less potential damage to the heart and lungs.”

Proton Therapy Closer to Home and Under One Roof

“The addition of proton therapy is a logical next step for a center like MedStar Georgetown as part of the Lombardi Comprehensive Cancer Center, dedicated to and recognized for providing the latest cancer treatments and access to clinical research trials,” says Dr. Collins.

Lombardi Comprehensive Cancer Center is one of only 49 sites in the nation and the only center in Washington, D.C. to earn the prestigious Comprehensive Cancer Center designation by the National Cancer Institute.

“All the multiple specialties and disciplines involved in cancer care are here helping to support patients through their treatment, in one location, under one roof,” says Dr. Unger. “They no longer have to travel outside of our area to receive this advanced treatment.”

 “The addition of proton therapy means MedStar Georgetown offers the full range of radiation treatments for cancer that are available,” says Dr. Collins.  “For patients that means we take an individual approach when considering radiation therapy. Whether it’s CyberKnife, proton therapy or conventional radiation, we will choose the optimal treatment to achieve the best outcomes with the fewest side effects.”


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The Day of Dance at MedStar Georgetown

2017 MGUH Day of DanceMedStar Georgetown recently hosted the “Day of Dance” which brought healing music and movement to patients, visitors and associates alike.

2017 MGUH Day of Dance ViolinistBeginning in the Lombardi atrium, passersby heard and saw something unusual: violin music reverberated through the lobby as dancers moved to the rhythm of the music. Dressed in soft grey and white tones, 12 dancers moved in sync with the goal of infusing open spaces in the Hospital with lightness and joy. Anthony Hyatt, the violinist, kept a peaceful, yet playful tempo and engaged everyone as the dancers (or movement choir) slowly and gracefully made their way from the atrium to other parts of the Hospital, including hematology/oncology infusion centers.

The movement choir and musical accompaniment are a part of an ongoing initiative to bring the healing arts to MedStar Georgetown. “We believe movement is a part of health,” says Julia Langley, faculty director of the Arts and Humanities Program for the Lombardi Comprehensive Cancer Center. “Integrating arts into the Hospital helps patients and their loved ones see that beauty is around them and they can take part in it.”

Qualitative studies show that music is beneficial to the practice of medicine. “The arts are a way to help patients heal from the inside out,” Langley says. “It’s a creative and constructive response to illness. If we can study arts like science studies medicine, we’ll be doing good in the name of cura personalis.” The Day of Dance at MedStar Georgetown is just one way that the Arts and Humanities Program aims to care for the whole person.

2017 MGUH day of Dance

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Combined Technology improve Breast Reconstruction Outcomes in Breast Cancer Patients

dsc_1156“My surgeon told me he would decide during surgery whether or not I could undergo breast reconstruction immediately, but I’m so glad he decided to wait before proceeding with implants. It gave me a chance to heal, and the results of my reconstruction are just remarkable,” said Sarah Bessin, a 47-year-old breast cancer survivor.  

Bessin was diagnosed with breast cancer in July 2015. After she opted to begin breast reconstruction at the same time of her mastectomy in October 2015, Bessin reaped the benefits of undergoing breast reconstruction that combines two tissue-saving technologies to diagnose and avoid serious complications.

The unique combination of SPY Elite and Hyperbaric Oxygen Therapy at MedStar Georgetown saved Bessin’s breast tissue and improved her breast reconstruction outcome. To date, MedStar Georgetown University Hospital is the only center in the Greater Washington, D.C. region offering the combination of SPY Elite and hyperbaric oxygen therapy for patients with breast cancer.

“Everything that we do in plastic surgery involves blood flow. If blood flow is disrupted, skin above it can flake off and even die. This is the reason we need to be able to anticipate those problems intraoperatively so we can act quickly,” says Troy Pittman, MD, Bessin’s breast reconstruction surgeon.  

A New Valuable Player in the Operating Room

After a mastectomy, the plastic surgery team enters the operating room with a fluorescent imaging system, SPY Elite. SPY Elite has a long arm that connects to an infrared lamp device, which is used for scanning over a patient’s body. A special contrast is injected through the patient’s IV line, and a TV monitor shows the scans of breast tissue and blood vessels in real time. A breast reconstruction surgeon will move the SPY Elite lamp over different areas of the breast to detect the quality of blood flow in breast tissue before proceeding with the surgery. The system’s monitoring of the blood flow helps surgeons determine if the patient’s tissue is in a safe state to move forward with surgery and place an implant. If blood flow is limited, surgeons will add hyperbaric oxygen therapy after surgery to promote healing in the tissue.

 “SPY Elite lets me look at the blood supply of the breast tissue and the nipple in real time. This helps us diagnose a problem early on and initiate hyperbaric oxygen within 24 hours, if we need to,” says Dr. Pittman.

SPYing a Problem

During Bessin’s procedure, the SPY Elite imaging system informed Dr. Pittman’s team that there were worrisome vascular changes in her breast skin following the mastectomy. To avoid compromising the vascular health of the skin, Dr. Pittman decided on a different plan. The new breast reconstruction approach for Bessin meant waiting on the implants and placing tissue expanders, a type of deflated temporary implant, in the surgery site. This plan allows for healing time in the hyperbaric oxygen therapy chamber. dr-pittman-working-in-surgery

“Our goal is to get patients in for treatment as soon as possible. We are aggressively treating the patient to save their breast tissue and augment their healing,” said Kelly Johnson-Arbor, MD, medical director of Hyperbaric Medicine in the Department of Plastic Surgery. “Our dedicated team of physicians, nurses and technicians works to ensure that patients remain safe and comfortable during their treatment regimen.”

Healing Tissue within Days

Hyperbaric oxygen therapy exposes patients to pure oxygen in a pressurized space. Sending patients to the hyperbaric oxygen chamber treats the initial blood flow issue and can help the patient avoid future healing problems. Although treatment begins within 24 hours after surgery, patients do not have to stay at the hospital. Patients will only visit the hyperbaric oxygen therapy chamber once or twice a day for about an hour. 

Bessin’s tissue healed in only 13 hyperbaric oxygen therapy treatments. Her hyperbaric oxygen therapy schedule started with two visits to the hospital per day, which later decreased to one visit per day near the end of her treatment.  

“I bounced back quite quickly. I’m already working my normal schedule, and my energy level is back to normal,” said Bessin. “I’m so grateful to my doctors for providing this therapy!”

Treatment Affords Rest and Relaxation Time

Bessin said she spent most of her time relaxing in the hyperbaric oxygen therapy chamber, which is a large glass tube. In the chamber, patients are required to leave most items outside of the chamber to minimize any chance of creating a spark in the oxygen chamber.  Patients cannot wear makeup, lotion, nail polish or outside clothing, nor can they bring in cell phones, books or paper. A glass of water and a cotton gown are permitted inside the chamber. During treatment, a nurse or technician stays in the room the whole time to administer the hyperbaric oxygen therapy, answer questions or assist with movie selections.

“Georgetown has a great movie selection!” said Bessin.

Access for Every Breast Reconstruction Patient at MedStar Georgetown

Dr. Pittman has used SPY Elite with hyperbaric oxygen therapy at MedStar Georgetown for five years. For breast reconstruction, Dr. Pittman’s team uses SPY Elite on almost every patient, but particularly in those who want to begin breast reconstruction with an implant immediately after a mastectomy.

“SPY Elite and hyperbaric oxygen therapy allow us to aggressively treat patients safely and predictably,” said. Dr. Pittman. “This approach gives our patients the best chance for success.”


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Colon Cancer Survivor Encourages Screening for Colon Cancer, Donates to Patient Care Fund

“It was like someone had hit me in the chest and knocked me over,” said colon cancer survivor Cheryl “Cee” Alston, after finding out she had cancer. “It was so devastating to find out that my symptoms turned out to be colon cancer!”cee-1

Alston was diagnosed with stage 2 colon cancer at age 56, after a physician initially attributed her symptoms to gastroesophageal reflux disease (GERD).

 “My mistake was not asking questions, which might have prompted me to get a colonoscopy sooner,” said Alston. “We need to ask more questions and we have to choose life.”

Alston, who also has been cancer-free since November 2013, pledges to learn as much as she can about colon cancer, while educating and engaging the community. In October 2015, Alston and her friend, Sheila Whitehead, directed the Colon Cancer Coalition’s 5K walk and run, “Get Your Rear In Gear.”

 The Colon Cancer Coalition (CCC) is an advocacy group dedicated to spreading awareness about colon cancer and empowering patients. Alston and Whitehead contributed to the CCC’s efforts by surpassing the team’s $2,000 fundraising goal. Despite the rainy, cold day, 130 participants, including a man who brought his oxygen pack on the walk, joined “Get your Rear in Gear” at Rock Creek Park. Together the team raised a total of $8,580, which will help patients with colon cancer at MedStar Georgetown.

“When I found out about the patient care fund at MedStar Georgetown, I knew that I wanted to donate the money there. This was the best hospital experience of my life, beginning with my consultation for surgery with Dr. Mohammed Bayasi!” said Alston. “I know there is someone somewhere who might need help getting to their doctor’s appointments or need a place to stay after surgery. We want to help!”

cee-2The donation will go to the Lombardi Patient Assistance Fund to financially help patients with colon cancer maintain continued care, safety and quality life.  Research shows that cancer costs can interfere with a patient’s focus on recovery.  Alston’s donation will be a valuable resource for families in need of financial assistance with taxi rides, nearby hotel stays, purchasing medicine, buying food and more.

 “We recognize that cancer can touch so many other parts of a patient’s life that insurance might not cover,” said Joanne Assarasan, LICSW OSW-C. “If we can help for a little bit, we can bridge a gap and lessen the financial burden with this donation.”

Alston and Whitehead’s foundation, “Cee’s Cause 4 a Cure,” focuses on funding support for colon cancer patients and survivors in need of financial assistance. The foundation focuses on fundraising goals and engaging adults, especially African Americans, on colon cancer screening.

“This is one donation to MedStar Georgetown, but our goal is to get more sponsors and keep the funds growing so we can continue to support patients in this way,” said Alston. “I want them to know that there is hope!”

Marianne Worley
Director of Media Relations
Office: 703-558-1287
Pager: 202-405-2824
[email protected]

Yvette Rattray
Media & Communications Specialist
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[email protected]

Study: Cancer Drug Restores Important Brain Dopamine in Parkinson’s Patients

WASHINGTON — A small phase I study provides molecular evidence that an FDA-approved drug for leukemia significantly increased brain dopamine and reduced toxic proteins linked to disease progression in patients with Parkinson’s disease or dementia with Lewy bodies. Dopamine is the brain chemical (neurotransmitter) lost as a result of death of dopamine-producing neurons in these neurodegenerative diseases. 

Researchers from Georgetown University Medical Center (GUMC), say the findings, described in the Journal of Parkinson’s Disease, support improved clinical outcomes observed and first reported at the Society for Neuroscience annual meeting in October 2015.

The study tested nilotinib taken daily for six months. A much smaller dose of nilotinib (150 or 300 mg once daily) was used compared to the dose for chronic myelogenous leukemia (300-400 mg twice daily). Twelve patients were enrolled in the clinical trial — one patient withdrew due to an adverse event. Researchers say the drug appears to be safe and well tolerated in the remaining 11 participants who completed the study.

In addition to safety, the researchers also examined biological markers in the blood and cerebral spinal fluid as well as cognitive, motor and non-motor improvement. They found significant signs that nilotinib may provide benefit for patients with these neurodegenerative diseases.

“These results need to be viewed with caution and further validated in larger placebo controlled trials, because this study was small, the patients were very different from each other, and there was no placebo,” says the study’s senior investigator, Charbel Moussa, MD, PhD, scientific and clinical research director of the GUMC Translational Neurotherpeutics Program.

Among the biomarker findings were that:

  • The level of the dopamine metabolite homovanillic acid — an indicator that dopamine is being produced — steadily doubled, even with the loss of most dopamine neurons. Most study participants were able to stop using, or reduce their use of, dopamine replacement therapies;
  • The level of the Parkinson's related oxidative stress marker DJ-1 — an indicator that dopamine-producing neurons are dying — was reduced more than 50 percent after niltonib treatment; and
  • The levels of cell death markers (NSE, S100B and tau) were significantly reduced in cerebrospinal fluid (CSF) suggesting reduced neuronal cell death.

In addition, Moussa adds that it appears nilotinib attenuated the loss of CSF alpha-synuclein, a toxic protein that accumulates within neurons, resulting in reduced CSF levels in both Parkinson’s disease and dementia with Lewy bodies.

The researchers also said that all 11 patients who tolerated the drug reported meaningful clinical improvements. All patients were at mid-advanced stages of Parkinsonism and they all had mild to severe cognitive impairment.

“Patients progressively improved in motor and cognitive functions as long as they were on the drug — despite the decreased use of dopamine replacement therapies in those participants with Parkinson’s and dementia with Lewy bodies,” says the study’s lead author, Fernando Pagan, MD, medical director of the GUMC Translational Neurotherpeutics Program and director of the Movement Disorders Program at MedStar Georgetown University Hospital.

But three months after withdrawal of the drug, participants returned to the same reduced cognitive and motor state they had before the study began, Pagan adds.

Some serious side effects were reported including one patient who withdrew at week four of treatment due to heart attack and three incidents of urinary tract infection or pneumonia. The researchers say these incidents are not uncommon in this patient population, and additional studies are needed to determine if the adverse events are related to use of nilotinib.

“Long term safety of nilotinib is a priority, so it is important that further studies be conducted to determine the safest and most effective dose in Parkinson’s, says Pagan.

The researchers designed the clinical trial to translate several notable observations in the laboratory. The preclinical studies, led by Moussa, showed that nilotinib, a tyrosine kinase inhibitor, effectively penetrates the blood-brain barrier and destroys toxic proteins that build up in Parkinson’s disease and dementia by turning on the “garbage disposal machinery” inside neurons.

Their published studies also showed nilotinib increases the levels of the dopamine neurotransmitter — the chemical lost as a result of neuronal destruction due to toxic protein accumulation — and improves motor and cognitive outcomes in Parkinson’s and Alzheimer’s disease animal models.

“Our hope is to clarify the benefits of nilotinib to patients in a much larger and well controlled study. This was a very promising start,” Moussa says. “If these data hold out in further studies, nilotinib would be the most important treatment for Parkinsonism since the discovery of Levodopa almost 50 years ago.”  

He adds, “Additionally, if we can validate nilotinib effects on cognition in upcoming larger and placebo controlled trials, this drug could become one of the first treatments for dementia with Lewy bodies, which has no cure, and possibly other dementias.”

Two randomized, placebo-controlled phase II clinical trials are planned for summer/fall in Parkinson’s and Alzheimer’s diseases. The Translational Neurotherpeutics Program is also planning a small trial in ALS (Lou Gherig’s disease).

According to Novartis, the cost (as of Oct. 2015) of nilotinib for the treatment of CML was about $10,360 a month for 800 mg daily. The dose used in this study was lower —  150 and 300 mg daily.

The phase I study received philanthropic funding and was supported by the Georgetown-Howard Universities Center for Clinical and Translational Science.

Moussa is listed as an inventor on a patent application that Georgetown University filed related to the use of nilotinib and other tyrosine kinase inhibitors for the treatment of neurodegenerative diseases. 

Study co-authors include Ellen H. Valadez, MD; Yasar Tores-Yaghi, MD; Reversa R. Mills, MD; Barbara M., Wilmarth, NP; Hellen Howard, RN; Connell Dunn; Alexis Carlson; Sean L. Rogers, MD, PhD;  and Ramsey (Drew) Falconer, MD; from the National Parkinson’s Foundation Center for Excellence, the Translational Neurotherapeutics Program, and the Movement Disorders Program at the MedStar Georgetown University Hospital; Michaeline Hebron, and Xu Huang, and Jaeil Ahn, PhD, Georgetown University Medical Center.

The researchers represent the MedStar Georgetown Movement Disorders Program, GUMC’s Translational Neurotherapeutics Program, the Laboratory for Dementia and Parkinsonism, the Georgetown-Howard Universities Center for Clinical and Translational Science Clinical Research and the department of biostatistics.

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Charbel Moussa, MD, PhD and Fernando Pagan, MD
Charbel Moussa, MD, PhD and Fernando Pagan, MD

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