Treating the rise of colorectal cancer with personalized care

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Sukeshi Patel Arora, MD, speaks with a woman in blue shirt in a clinical space.
Sukeshi Patel Arora, MD, medical oncologist and leader ofthe gastrointestinal malignancies. program at Mays Cancer Center

Colorectal cancer is now the primary cause of cancer-related deaths among young men under 50 and the second leading cause among women in the same age group, according to the American Cancer Society.

The rise in younger men and women developing colon cancer is a trend Alicia Logue, MD, has observed over the last 10 years. Logue is a fellowship-trained colorectal surgeon at the Mays Cancer Center at UT Health San Antonio.

“If I were asked the average age of a patient when I finished residency 16 years ago, my answer would be different,” she said. “Now, at least 1/3 of my patients are under 50.”

Colon and rectal cancers are tumors of the large intestine. Risk factors for developing the disease, according to the Centers for Disease Control and Prevention, include inflammatory bowel disease, family history and in rare cases an inherited trait.

Certain lifestyle choices can also increase the risk of developing the disease. These include a lack of regular exercise and a diet lacking in fruits and vegetables, as well as one low in fiber and high in fat and processed meats. Being overweight or obese, along with the use of alcohol and tobacco, can also elevate the risk for developing the disease.

Colorectal cancer symptoms

Colorectal cancer can start as a polyp or small, abnormal grouping of cells in the colon’s lining. Logue said polyps can develop and mutate into cancer slowly, and symptoms are common enough that patients ignore them.

“The symptoms are oftentimes subtle and attributed to common life circumstances, such as fatigue, stress or difficulty maintaining a healthy lifestyle,” Logue said. “It’s not unusual for most of us to have symptoms such as occasional stomach discomfort, fatigue, constipation or seeing small amounts of blood in the stool. They are symptoms that can easily be dismissed or attributed to less serious conditions.”

Logue said the following symptoms should prompt a visit to the doctor: change in bowel habits, rectal bleeding, persistent fatigue and unexplained anemia.

Regular screenings are the best way to prevent developing the disease and the gold standard for screening is a colonoscopy. If polyps are found during the screening, they can be removed before they progress into cancer.

Alternate screenings, such as stool sample tests, can be up to 95% effective in detecting cancer.

The Mays Cancer Center offers a specialized chemotherapy delivery system called hepatic artery infusion, also known as HAI pump therapy, for colorectal cancer patients who have tumors that are inoperable and have spread to the liver.

The latest treatment options for personalized care

Treatment plans for patients are as individual as the patient. Following a patient’s diagnosis and tumor removal surgery, a multidisciplinary team of doctors convenes to devise a personalized treatment strategy that could include surgery, chemotherapy, radiation and other therapies.

In some cases, colorectal cancer patients have tumors that are inoperable and spread to the liver. For these patients, the Mays Cancer Center offers a specialized chemotherapy delivery system called hepatic artery infusion, also known as HAI pump therapy.

Approved by the Food and Drug Administration, the hepatic artery infusion pump is a palm-sized device implanted below the skin in the abdomen while the patient is under anesthesia. It is designed to deliver high doses of chemotherapy safely to patients living with colorectal cancer and bile duct cancer (intrahepatic cholangiocarcinoma) that have spread to the liver.

“Having HAI therapy available at the Mays Cancer Center to treat patients whose cancer cannot be removed completely

Colin Court, MD, director of regional therapies at Mays Cancer Center and assistant professor at The University of Texas Health Science Center at San Antonio, speaks to a patient.
Colin Court, MD, PhD, director of regional therapies at Mays Cancer Center and assistant professor at The University of Texas Health Science Center at San Antonio, speaks to a patient.

through surgery is pivotal,” said Colin Court, MD, PhD, director of regional therapies at Mays Cancer Center and assistant professor at UT Health San Antonio.

Court, a surgical oncologist, said the HAI pump is powered by the patient’s body heat to continuously administer chemotherapy directly through the hepatic artery, a vessel that provides blood to the liver. Once implanted, a medical oncologist oversees the patient for the duration of the treatment or the lifetime of the therapy.

“Hepatic artery infusion is a treatment option available for patients to shrink liver metastases to get to surgery, to prevent recurrence in the liver after a liver resection, or to offer another line of treatment when traditional systemic chemotherapy is no longer working,” said Sukeshi Patel Arora, MD, medical oncologist and leader of the gastrointestinal malignancies program at Mays Cancer Center. “The procedure is considered another line of treatment and offers not only control of the cancer, but also allows patients to live longer and gives a chance for a cure.”

A National Cancer Institute (NCI)-designated Cancer Center, Mays Cancer Center is currently one of only two facilities in Texas offering HAI therapy. Prior to the advent of HAI therapy, patients received traditional chemotherapy, administered through a vein and into the bloodstream to reach the liver. HAI therapy is localized and precisely targets tumors. It delivers up to 400 times higher drug concentration than standard chemotherapy, with minimal side effects.

“This therapy gives our patients hope, limiting toxicity elsewhere in the body, and allowing them to continue their daily activities without disruptions,” Court said.

The Mays Cancer Center at UT Health San Antonio is one of only four National Cancer Institute-designated Cancer Centers in Texas. The Mays Cancer Center provides leading-edge cancer care, propels innovative cancer research and educates the next generation of leaders to end cancer in South Texas. To learn more, visit cancer.uthscsa.edu.

Stay connected with the Mays Cancer Center on Facebook, Twitter, LinkedIn, Instagram and YouTube.

The University of Texas Health Science Center at San Antonio (UT Health San Antonio), a primary driver of San Antonio’s $44.1 billion health care and biosciences sector, is the largest academic research institution in South Texas with an annual research portfolio of $413 million. Driving substantial economic impact with its six professional schools, a diverse workforce of more than 8,500, an annual expense budget of $1.46 billion and clinical practices that provide 2.6 million patient visits each year, UT Health San Antonio plans to add more than 1,500 higher-wage jobs over the next five years to serve San Antonio, Bexar County and South Texas. To learn about the many ways “We make lives better®,” visit UTHealthSA.org.

Lot 35 to close permanently due to construction starting May 6

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Remaining employees parking in Lot 35 will be relocated

On Monday, May 6, the construction project currently underway to run chilled water lines from the new chilled water plant on Charles Katz Drive to the existing plant on the Greehey Academic and Research Campus, will expand to the grounds of the Sam and Ann Barshop Institute for Longevity and Aging Studies.

On May 6, construction fencing will be placed in Lot 35 and in the landscaped area next to the Barshop Institute, located on the corner of Floyd Curl Drive and Charles Katz Drive. The construction will require the permanent closure of Lot 35. The remaining employees parking in Lot 35 will be relocated. Options for relocation include Garage G and lots 17 and 30. Barshop Institute lot permit holders can contact the parking office for further information.

Once the construction fence is placed, the entrance to the stairwell door of the Barshop Institute Building on the corner of Charles Katz Drive and Floyd Curl Drive, will not be directly accessible. Employees will need to walk around to the front of the Barshop Institute building towards Garage G and enter through the building’s front door or continue around the building to the stairwell. This phase of the project is scheduled to end on August 16.

Below, please find a map of the area where construction will take place beginning May 6.

A separate area adjacent to the north side of the Barshop Institute Building will have a later start date of  June 6. This phase of the construction at the Barshop Institute is scheduled to end on Sept. 30.

For more information about the road closures or parking during this project, please email the parking office at parking@uthscsa.edu or call 210-567-2800.

 

STRONG STAR Consortium secures $17 million in DOD research funding for brain injuries, PTSD and more

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UT Health San Antonio-led studies will involve national collaboration

Contact: Steven Lee, (210) 450-3823, lees22@uthscsa.edu

SAN ANTONIO, April 29, 2024 – In a recent round of grant awards, the U.S. Department of Defense selected the STRONG STAR Consortium based at The University of Texas Health Science Center at San Antonio (UT Health San Antonio) for a total of $17 million in funding to launch eight new research projects focused on traumatic brain injury and psychological health.

The combined projects will enable the consortium to take a big step forward in its mission to advance the care of military personnel and veterans recovering from war-related trauma and the psychological wounds it inflicts.

STRONG STAR, or the South Texas Research Organizational Network Guiding Studies on Trauma and Resilience, is a national research group led by UT Health San Antonio that brings together the expertise of military, civilian and VA institutions and investigators from across the country. Its network of clinical trials, funded by the DOD, Department of Veterans Affairs and other agencies, takes a synergistic approach to better propel advances in military psychological health.

Alan Peterson, PhD

“As a group, these new projects will help us better understand and better assess, treat and prevent chronic problems with the two signature wounds of post-9/11 wars – traumatic brain injury and post-traumatic stress disorder – along with a variety of related conditions that stem from them or that contribute to their complexity,” said Alan Peterson, PhD, professor of psychiatry and behavioral sciences at UT Health San Antonio and director of the STRONG STAR Consortium.

“Some of these related conditions are suicide risk, sleep disorders and chronic pain, including post-traumatic headache, or chronic headaches that develop from or worsen following a traumatic brain injury,” he said. “Another is tinnitus, which is a persistent ringing in the ears that can develop after a brain injury. Tinnitus is also commonly comorbid with PTSD, and it both contributes to and is impacted by psychological distress.”

The new studies will address these problems through a variety of approaches as part of six randomized clinical trials, one treatment development project and one longitudinal follow-up project with previous research participants. Some of these projects will be led by UT Health San Antonio investigators and others by STRONG STAR collaborators at other institutions, with research participants from a variety of military and VA study sites.

Following is an overview of the new research projects:

Combining PTSD treatment and suicide prevention therapies to improve outcomes. This clinical trial will examine whether PTSD symptoms and suicide risk can both be significantly reduced by combining two evidence-based treatments: one a leading PTSD therapy called Cognitive Processing Therapy and the other a suicide-prevention approach known as Crisis Response Planning. This trial will involve both active-duty military personnel and veterans.

Rapid-acting intervention for severe suicide risk. This clinical trial will involve patients treated in an emergency department setting prior to a psychiatric hospitalization for severe suicide risk. Investigators will look for two main outcomes they hope to achieve: (1) Does an intramuscular injection of ketamine result in the rapid reduction of suicidal ideation? (2) Does the addition of Crisis Response Planning, a brief intervention to reduce suicide risk following a crisis, help maintain that improvement long term?

Prevention program to decrease suicide risk after brain injury. Because a traumatic brain injury can elevate a person’s suicide risk, this clinical trial will evaluate Crisis Response Planning as a secondary suicide prevention intervention. Service members already receiving care related to a brain injury will be invited to enroll in this study, which will offer brief training in self-selected actions and activities they can use in times of crisis. At the end of the study, researchers will determine whether the intervention effectively decreased risk among those who received it compared to those who did not.

Adaptive PTSD treatment to personalize care and maximize effectiveness. This clinical trial will test tailored intervention strategies to optimize treatment response and reduce drop-out among veterans with PTSD. The project seeks to determine if outcomes can be improved by: (1) changing the therapy type early on for non-responders, (2) daily digital prompts to help improve homework completion, and (3) reducing therapy intensity for patients who respond well early in treatment.

Improving understanding and treatment of PTSD and tinnitus following a brain injury. Working with military and veterans who have PTSD and tinnitus after a brain injury, investigators will evaluate whether combining therapies for each disorder improves patient outcomes with both. The study will use Cognitive Processing Therapy, a leading PTSD treatment, and Progressive Tinnitus Management, a cognitive-behavioral approach to managing tinnitus and the distress it causes. Some participants also will undergo neuroimaging before and after the treatment program. This can illuminate the brain networks involved in PTSD and tinnitus and how they are impacted by treatment, which could guide future research and approaches to care.

Brain games and stimulation: Improving executive function after a concussion. This clinical trial with service members and veterans will evaluate the effectiveness of a computer game designed to improve cognitive functioning following a mild traumatic brain injury, or concussion. It also will look at whether adding brain stimulation through a technique called electrical transcranial magnetic stimulation leads to further improvements in post-concussive symptoms.

Expanding an effective headache treatment to an alternative approach to PTSD recovery. In a previous consortium trial, researchers discovered that a non-medication treatment they designed for post-traumatic headache not only significantly reduced headache-related disability; it also reduced co-occurring PTSD symptoms as effectively as a gold-standard PTSD therapy. Now they will update the therapy and its treatment manual to specifically focus on PTSD symptoms. They will then test the approach with service members who suffer from PTSD following a brain injury. The aim is to identify an alternative approach to PTSD care that patients may prefer to traditional therapies that focus on the person’s trauma.

Long-term follow-up with previous study participants to inform the research field. A large longitudinal study will enable STRONG STAR to conduct long-term follow-ups with thousands of individuals who participated in the consortium’s previous research studies. Participants from clinical trials will be contacted to assess how well they are doing years later. Researchers are particularly interested to see if treatment responders have maintained their treatment gains over time, which would provide valuable information about the long-term efficacy of the therapies they received. They also are interested to learn if non-responders found subsequent, alternative treatments helpful or if their conditions have remained chronic, which also would inform the field. In another arm of the project, STRONG STAR will follow up with service members who participated in a longitudinal study that involved various assessments before and after a combat deployment to shed light on the deployment’s long-term consequences.

 

The University of Texas Health Science Center at San Antonio (UT Health San Antonio), a primary driver of San Antonio’s $44.1 billion health care and biosciences sector, is the largest academic research institution in South Texas with an annual research portfolio of $413 million. Driving substantial economic impact with its six professional schools, a diverse workforce of more than 8,500, an annual expense budget of $1.46 billion and clinical practices that provide 2.6 million patient visits each year, UT Health San Antonio plans to add more than 1,500 higher-wage jobs over the next five years to serve San Antonio, Bexar County and South Texas. To learn about the many ways “We make lives better®,” visit UTHealthSA.org.

Stay connected with The University of Texas Health Science Center at San Antonio on Facebook, Twitter, LinkedIn, Instagram and YouTube.

 

Photos: Employees, local businesses discuss opportunities

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More than 250 employees visited with more than 30 local business representatives at the recent HUB Vendor Fair at the Holly Auditorium foyer. The fair allows employees institution-wide who are involved in purchasing processes an opportunity to meet with Historically Underutilized Businesses program participants and other local, small businesses who may be able to meet their supply needs. View photos of employees and vendors at the event.

2024 Presidential Ambassador Scholars recognized

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The 2024 Presidential Ambassador Scholars received their scholarships, medals and certificates on April 23. (Left to right): Acting President Robert Hromas, MD, FACP; Shalad Abdulsahib, Graduate School of Biomedical Sciences; Stephen Maldonado, Long School of Medicine; Sean Jones, School of Nursing; Anna Ye, School of Dentistry; Grace McGuire, School of Health Professions

UT Health San Antonio’s 2024 Presidential Ambassador Scholars were officially recognized by Acting President Robert Hromas, MD, FACP, on April 23.

Hromas, with assistance from the deans and associate deans from the schools, presented each student with their medals and recognized their achievements at the Academic and Administration Building, Room 302, with each ambassador awarded a $5,000 scholarship. The ambassadors represent the student body and the university at numerous events throughout the year.

The five scholars, one from each school in the university, are: Shalad Abdulsahib, Graduate School of Biomedical Sciences; Sean Jones, School of Nursing; Stephen Maldonado, Joe R. and Teresa Lozano Long School of Medicine; Grace McGuire, School of Health Professions; and Anna Ye, School of Dentistry.

Shahad Abdulsahib is a third-year Ph.D. student in the field of Cell Biology at the Graduate School of Biomedical Sciences. Her journey from escaping the ravages of war is a testament to her resilience and determination. Arriving in the U.S. in 2010, she faced the challenge of acclimating to a new culture while leaving her family behind. Originally inspired by a family history of cancer to become a medical doctor, Shahad’s trajectory shifted towards research as she majored in biochemistry. As a Muslim female in science, technology, engineering and mathematics (STEM), Shahad is not only dedicated to her academic pursuits, but also actively seeks opportunities for personal development. Throughout her academic journey, Shahad has demonstrated a commitment to community and academic service. She exemplifies a dedication to service by engaging in community outreach events and actively contributes to building a professional network. Her passion lies in advancing scientific knowledge in pediatric cancer research, supported by the Greehey Family Foundation.

Sean Jones, a first-semester junior in the Bachelor of Science in Nursing (BSN) program in the School of Nursing, is driven by a calling to serve in the nursing profession. His ambition lies in critical care, particularly in renal care and dialysis, yet his heart remains open to the diverse avenues nursing presents. Coming from a lineage of nurses within a military family, his upbringing was steeped in the ethos of patient care. Witnessing the unwavering dedication of his parents — both critical care nurses — ignited a fire within him to emulate their compassion and commitment. Beyond his academic pursuits, he has exhibited leadership in various spheres, from guiding peers as a section leader in an orchestra to advocating for LGBTQIA+ rights and community outreach initiatives.

Stephen Maldonado, a first-year-medical student in the Long School of Medicine, and his sister, were raised with education as a main priority. A family friend’s illness set Maldonado on the path to medicine. As he witnessed his friend’s decline, his interest in the importance of the nervous system was piqued. At New Mexico State University, he majored in biology and gained a love for teaching as a supplemental instruction facilitatory. He participated in research, helping to conduct gene knockdown in mosquitoes using CRISPR-Cas13 gene editing. Following his undergraduate career, he worked as a medical assistant. Now as a medical student, he participates in several intramural sports and has several leadership positions, including co-president of the Latino Medical Student Association and the social chair of the Student National Medical Association.

Margaret Grace McGuire is a first-year Doctor of Occupational Therapy student in the School of Health Professions. Originally from Spring, Texas, she is a Texas A&M graduate with a Bachelor of Science in kinesiology. She fell in love with occupational therapy (OT) after watching its profound impact in pediatric and geriatric populations. McGuire was drawn to the university’s Doctor of Occupational Therapy program for its sense of community and emphasis on service. Involved within her cohort as the class president, the School of Health Professions’ Student President’s Council, Student Occupational Therapy Association, intramurals and interprofessional events, she has also been involved in service events with organizations like Kinetic Kids and the local Center for Refugee Services.

Anna Ye is a third-year student at the School of Dentistry. She attended Baylor University, where she was an Honors College student majoring in University Scholars with concentrations in biology and Chinese. Ye brings her passion for teaching into the clinic and loves to educate and empower her patients to take charge of their oral health. She currently also serves as the course liaison for the Advanced Studies of Human Disease Procedures and Oral Medicine courses and is the public information officer for the Academy of General Dentistry student organization. Outside of the classroom and clinic, she spends her free time experimenting with different recipes in the kitchen, exploring parks, and working with children in her church’s kid ministry. After graduation, Anna plans to work as a general dentist who prioritizes providing personalized care and oral health education for a diverse population of patients.

 

 

 

Community Engagement Small Project Grants program awardees announced

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The Institute for Integration of Medicine and Science (IIMS) and The University of Texas at San Antonio (UTSA) College of Health, Community and Policy, are happy to announce that five community-academic partnerships from South Texas have been awarded $5,000 grants as part of the Community Engagement Small Project Grants program.

This program enables partnerships to develop activities that lead to the translation of research for public health benefit. Grants are available to newly developed or current partnerships with projects focused on research/assessment; education/training; and/or dissemination/communication of research results, program features or policy implications.

The 2024 awardees are:

  • Adolph Delgado, PhD, UTSA College for Health, Community and Policy
    • Project: What R We Doing with our Data: A Community-Academic Approach to Assessing HIV Data using RStudio
  • Doshie Poper, PhD, University of the Incarnate Word, Department of Criminal Justice
    • ​​​​​​​Project: Encountering the Other, Conversations with the Least of Thee: A Reassessment of Faith-Based Reentry
  • Joyce Turner, FNP, CHW, Lela Pharmacy
    • Project: ​​​​​​​CHW/RN Collaboration for Skill Expansion on Geriatric Specialty Populations
  • Jason Rosenfeld, DrPH, UT Health San Antonio Center for Medical Humanities and Ethics
    • ​​​​​​​Project: Nurturing Young Minds: When Brain Health Meets Art
  • Vidya Sharma, MA, RD, UT Health SA Translational Science PhD Program and UTSA College for Health, Community and Policy
    • ​​​​​​​Project: Project ECHO Nutrition & Brain Health Training for Primary Care Providers: A Stakeholder-Engaged SOARNet Study

The IIMS would like to thank all applicants for submitting proposals. The institute would also like to thank its Community Health Advisory Board members — Ann Salamone  of Rochal Industries, Kate Martin and Rhonda BeLue, UTSA College of Health, Community and Policy Health — for serving on the Grants Review Committee.

Click here for more information about the awardees.