San Antonio (May 27, 2004) – Like many Americans, Edgar Smith loathes the words “prostate cancer.” His father had it, he had it, and his two brothers had it. That’s why he strongly encourages men to have themselves checked and to understand their options.
“My youngest brother, Harry, passed away March 6 and he died very sadly,” Smith said. “He was in hospice care. I remember it was bad, and it was so sad. I have that picture in my mind. I told myself, this doesn’t have to happen with early detection.”
Early detection of prostate cancer includes a digital rectal exam (during which the physician feels for prostate abnormalities), the prostate-specific antigen or PSA test, and prostate biopsy. The PSA test measures the level of one protein in the blood. Physicians often consider that if a man has a PSA of 4.0 nanograms per milliliter (ng/ml) or lower, he does not need a prostate biopsy, during which tissue is taken from the prostate to be examined for cancer by a pathologist.
Smith said he benefited from “out of the 4.0 box thinking” on the part of his physician, Dr. Javier Hernandez, and his surgeon, Dr. Ian M. Thompson, professor and deputy chair of the department of surgery and chief of urology at The University of Texas Health Science Center at San Antonio. Smith had a 0.9 ng/ml reading for two years, but because of his family history Dr. Hernandez suggested a biopsy, which was positive for prostate cancer. “It looked like I was doing really well, but I wasn’t,” Smith said.
His cancer was of the aggressive variety but had not spread. Dr. Thompson performed a prostatectomy on Smith at University Hospital, the Health Science Center’s teaching hospital. “If I had not seen the docs, I would not be in as great a shape,” Smith said.
Smith, 69, is retired from the Texas Workforce Commission and lives in Floresville near San Antonio. He said he has already told his two sons about the importance of checkups for prostate cancer.
Ian M. Thompson Jr., M.D., professor of surgery and chief of urology at The University of Texas Health Science Center at San Antonio, discusses the results of the Prostate Cancer Prevention Trial with reporters. Dr. Thompson was interviewed by local and national media regarding the trial’s results, which were published in the May 27 issue of “The New England Journal of Medicine.”
San Antonio (June 8, 2004) – Some men who have received good marks on the prostate-specific antigen (PSA) test from their physicians may be getting a false sense of confidence about not having prostate cancer, according to a study released May 27 in The New England Journal of Medicine.
The results of the Prostate Cancer Prevention Trial (PCPT) were announced last June in Washington, D.C. Additional information gleaned from this study has enabled researchers to study the risk of prostate cancer in men who had what physicians consider “normal” PSA scores – under 4.0 nanograms per milliliter (ng/ml). Of 2,950 men who throughout the trial always had PSA scores below 4.0, a surprising 15 percent (449 men) had prostate cancer. Not only that, 67 of the men had high-grade cancers, the type of cancer that poses the greatest risk.
“There are many men who have been told that, based on their PSA score, they don’t have prostate cancer,” said lead author Ian M. Thompson Jr., M.D., professor of surgery and chief of urology at The University of Texas Health Science Center at San Antonio, one of the institutions that participated in the PCPT. “Based on this study, we now know they have a substantial risk of cancer and some can have high-grade disease. Waiting for a PSA level to go above 4.0 may be too late in some men.”
The number of U.S. men who have been told they have “normal” PSA readings is estimated at 25 million to 35 million, researchers said.
“There is no PSA value below which a man can be assured that he has no risk of prostate cancer,” wrote the authors, who include Leslie G. Ford, M.D., of the National Cancer Institute (NCI) and Charles A. Coltman Jr., M.D., chairman of the Southwest Oncology Group, one of the largest NCI-supported cancer clinical trials cooperative groups in the United States.
The results suggest that men as young as 40 with a strong family history of prostate cancer and a PSA level even lower than 2.0 should seek consultation with their physicians. “I am familiar with a family in which every man had prostate cancer in his 40s,” Dr. Thompson said at a briefing at the Cancer Therapy and Research Center, the clinical partner with the Health Science Center in the San Antonio Cancer Institute, an NCI Clinical Cancer Center.
“The bad prostate cancers in the men with normal PSA scores may be more numerous than all the prostate cancers we are currently detecting,” Dr. Thompson added. “It calls into question whether our definition of prostate cancer risk is correct.”
The new study reveals the need for a more specific test for prostate cancer, Dr. Thompson said. “Very clearly, we can’t tell for sure which prostate cancers are slow growing and which are aggressive and we need a screening test that doesn’t just find cancer – it finds only those cancers that will cause problems in an individual man. Certainly, a man who is at risk of prostate cancer should think about the use of finasteride, the agent we demonstrated last year that can reduce the risk of prostate cancer by 25 percent. If you don’t ever get prostate cancer, you don’t have to worry about whether it is aggressive or not. From a philosophical standpoint, what we need to do is a ‘Manhattan Project’ of prostate cancer, an intensive, large-scale study of men who are characterized by family history, medications, diet and genes, and follow them for 20 years. Then we would have a much clearer picture.”
Men should speak with their physicians about the possibility of a prostate biopsy, which can be done on an outpatient basis in the doctor’s office, Dr. Thompson said.
Dr. Coltman, in his role as director of the Southwest Oncology Group, served as principal investigator on the study and Dr. Thompson served as clinical coordinator. The Fred Hutchinson Cancer Research Center at The University of Washington, Seattle, provided statistical support. Other co-authors are from The University of Texas M.D. Anderson Cancer Center and The University of Colorado Health Sciences Center.
San Antonio (May 25, 2004) – Martha Medrano, M.D., M.P.H., assistant dean for continuing medical education and director of the School of Medicine’s Hispanic Center of Excellence at The University of Texas Health Science Center at San Antonio, has received the 2004 Medical School Distinguished Alumnus Award.
“We are honored to present this award to Dr. Medrano, who stands out among her peers,” said Wei-Ann Bay, M.D., president of the Health Science Center’s Medical School Alumni Association. “She has truly taken the opportunity to give back to the School of Medicine. She shares her enthusiasm and love of medicine with her students and has been an incredible force in promoting health and education in the Hispanic community.”
Dr. Medrano, who graduated from the Health Science Center’s School of Medicine in 1981, received her award at the school’s commencement on Saturday, May 22.
One outstanding alumnus is selected each year to receive the award by the school’s alumni association. Candidates are selected based on their impact on, and accomplishments in, the profession of medicine, and the extent to which they have impacted their community through leadership and activities. Nominees are also judged on their efforts to promote the school and its students and their actions or involvement in reflecting the mission of the alumni association and the School of Medicine.
Dr. Medrano is also a medical staff member at the Southwest Neuropsychiatric Institute and works in psychiatry services at the Audie L. Murphy Division, South Texas Veterans Health Care System. She is a medical staff member of the University Health System and an Advisory Council Member for the National Institutes of Health in the Office on Research on Women’s Health.
The recruitment, retention and promotion of Hispanic medical students and faculty is the focus of Dr. Medrano’s work at the Medical Hispanic Center of Excellence. She is working to include cultural competence in the medical school curriculum, increase Hispanic health information resources at the Dolph Briscoe Library and to expand the center’s medical student summer research program.
As a co-investigator of the major nationwide initiative, Redes En Acción, she is working to create a national and regional infrastructure for collaboration among grassroots leaders, local communities, researchers and public health professionals to stimulate cancer control research, training and awareness for Hispanics/Latinos. Redes En Acción recently released a report stating that inadequate access to cancer screening and care is the number one cancer issue for the nation’s 38 million Hispanics/Latinos. The report also includes a series of research recommendations for cancer prevention and control education, training and outreach.
She is also the principal investigator of the U.S. Mexico Border Center of Excellence Consortium that is developing a strategic plan for increasing the health care delivery and research workforce along the United States and Mexico border.
Some of her other projects include studying the relationship between childhood trauma and drug injection behaviors, and training health professionals and staff in appropriate techniques when providing medical interpretation. She is the principal investigator of the Eisenhower Professional Development Program that is implementing an educational intervention with middle and high school teachers to integrate simple medical equipment into science classes.
In 2003, Dr. Medrano received a Recognition Award from The United States Border Health Initiative and the Latina Women in Action Award from the La Prensa Foundation. She also received the National Advisory Board Recognition Award from the National Hispanic Medical Association and the United Latin American Medical Student Association Appreciation Award.
Although she has written and has been cited in many articles, she has most recently been included as a physician leader in the September 2003 issue of San Antonio Medicine and was cited in the April 2003 issue of Latina. In the September 2002 issue of San Antonio Medicine, she wrote an article titled, “Minority Women in Medicine.”
She is an active member of the Bexar County Medical Society, the Hispanic American Biomedical Association and the Hispanic Faculty Association. She is also an active member in the National Hispanic Medical Association, the National Hispanic Science Network on Drug Abuse and the National Hispanic Medical Association Board of Advisers. She was a founding member and former president of the Hispanic Faculty Association at the Health Science Center.
An El Paso native, she earned a bachelor of science in biology degree from The University of Texas at El Paso in 1977. In 1997, she earned a master’s of public health from The University of Texas Health Science Center at Houston. She completed her residencies and a fellowship at the Health Science Center in the departments of psychiatry and pediatrics.
Aging Intervention Testing Center lead investigators Drs. Randy Strong (left) and Jim Nelson joined the Health Science Center in 1993 and 1990, respectively.
San Antonio (May 18, 2004) – The University of Texas Health Science Center at San Antonio has received a $2.5 million grant for a National Institute on Aging (NIA) Intervention Testing Center, one of three such U.S. centers established by the NIA to test potential therapeutic interventions to slow the aging process.
The new center, which is part of the Health Science Center’s Sam and Ann Barshop Center for Longevity and Aging Studies, will test compounds that may slow the aging process and extend life span or “health span” – the continuation of good health throughout life. The San Antonio Aging Intervention Testing Center will interact closely with the two other NIA-designated centers at the University of Michigan and Jackson Laboratories, Bar Harbor, Maine.
The San Antonio center is headed by Randy Strong, Ph.D., associate professor of pharmacology at the Health Science Center and research career scientist with the South Texas Veterans Health Care System, and Jim Nelson, Ph.D., professor of physiology at the Health Science Center.
“Ten years ago, the only intervention known to increase life span in mammals was caloric restriction,” Dr. Strong said. “Since that time, rapid advances in gene technology have led to the discovery of a number of genetic manipulations or mutations that extend life span in both invertebrates (flies and worms) and mammals (mice and rats).
“In addition, epidemiological and clinical studies point to anti-inflammatory medications as having positive effects in preventing cancer and in delaying the progression of neurodegenerative diseases, and these medications are under clinical trials in Alzheimer’s disease and chemoprevention studies of colorectal cancer. Thus, a number of therapeutic targets are now identified and that is why the NIA funded a program to test potential interventions in aging processes. We are honored to be part of this new program.”
Dr. Strong said the genetic alterations studied by scientists have included manipulations of the insulin-like growth factor 1 (IGF-1) and insulin receptor genes; mutations in a gene that governs growth hormone and targeted deletion of the growth hormone receptor gene; targeted deletion of signaling molecules in the IGF-1 and insulin signaling pathways; and engineering animals to make high levels of anti-oxidant enzyme.
The first four interventions to be tested starting this summer are anti-oxidant and anti-inflammatory compounds. Four to five studies will be added each year to study other interventions.
“Biomedical aging research is in an exciting phase of rapid growth,” Dr. Nelson said. “The growing number of genes that are being found to play a role in aging provides a growing number of targets for drug therapy and interventions suitable for our center to test. My own studies, which show that anti-inflammatory mechanisms are associated with the longevity effects of calorie restriction, support the anti-inflammatory interventions being undertaken in these trials.”
Barshop Center Director Arlan Richardson, Ph.D., said, “This Intervention Testing Center will contribute to the Barshop Center’s emp
The Meyer family has practiced family medicine in Hondo for nearly a century, and that won’t end any time soon. Emily Sullivan Meyer, the first woman in the family to attend medical school, will receive her M.D. from The University of Texas Health Science Center at San Antonio School of Medicine at 1 p.m. Saturday, May 22, at Laurie Auditorium, Trinity University. And, you guessed it, after residency she hopes to be the fourth generation of Meyers to practice family medicine in Hondo.
“I’m so lucky to be from Hondo,” Emily said. “The community has always been supportive and wonderful, and I hope I can give something back.”
Meyer is the daughter of Dr. John and Gail Meyer of Hondo. She was valedictorian of the Hondo High School Class of 1995 and received a bachelor of arts degree, with honors, in theater and dance from The University of Texas at Austin in 2000. She excelled in medical school and the Alamo Chapter of the Texas Association of Family Physicians awarded her the S. Perry Post, M.D., Medical Student Scholarship, which is for a graduating senior who plans a career in family practice. Emily also received the John S. Primomo, M.D., Award for Exemplary Family Practice and the Leonard Tow Humanism in Medicine Award in recognition of exemplary compassion, competence and respect in the delivery of care.
Although Emily is the first woman in her family to attend medical school, she is not the first doctor in her family. She comes from a long line of physicians, who have served as outstanding role models and mentors for her.
Emily’s great-grandfather, Henry J. Meyer, M.D., attended Tulane Medical School in New Orleans and moved to Hondo in 1906 to begin general practice. He served on the Hondo school board from 1928 to 1946 and was president of the board for 15 years. Meyer Elementary School in Hondo is named for him.
Emily’s grandfather, Walter B. Meyer, M.D., graduated from Tulane and practiced medicine in Hondo from 1937 to 1977. He served on the school board from 1947-1965 and was board president for 17 years.
Emily’s uncle, Parker H. Meyer, M.D., graduated from Tulane in 1965, practiced in Hondo until 1991 and now sees patients in the Dallas suburb of DeSoto. Another uncle, James R. Meyer, M.D., graduated from Tulane in 1975, specializes in obstetrics and gynecology in The Woodlands, and returns to Hondo once a month to perform gynecological surgery.
Emily’s father, John W. Meyer, M.D., graduated from Tulane in 1974 and has been practicing medicine in Hondo for 28 years. He served on the Hondo school board from 1983 to 1998 and was board president for nine years. He served on the Texas Medical Foundation Executive Board from 1987 to 2003 and was president from 1995 to 1999. He currently serves on the Texas Medical Association Rural Health Committee and other panels.
Emily spent two months of her fourth year rotating with her dad at his office in Hondo. While there, she met several people who have been patients of the Meyer family for many years.
One such patient is the town optometrist, 82-year-old Dr. John Jennings, who was delivered by Emily’s great-grandfather. In fact, Dr. Jennings has been a patient of Emily’s great-grandfather, grandfather, one of her uncles and now her dad. Dr. Jennings, who still sees patients, told Emily that he would wait for her to come to practice in Hondo so that he could be seen by four generations of the Meyer family.
“My dad has been my role model and hero, and I can’t wait to practice with him,” Emily said. “I know this wouldn’t be happening without the support of my family, friends and the people of Hondo. It’s such a special place.”
Emily will begin her family practice residency at CHRISTUS Santa Rosa Hospital July 1. And just like her father, uncles, grandfather and great-grandfather before her, Emily will no doubt leave her mark on Hondo – and may someday inspire a fifth generation of Meyer family physicians to serve their hometown.
Harlingen (May 4, 2004) – Internal medicine residents at the Regional Academic Health Center (RAHC) Medical Education Division have begun presenting clinical research at national and regional meetings in the internal medicine field – a positive development that is aided by a $1.5 million gift from The Robert J. and Helen C. Kleberg, Jr. Foundation.
The RAHC Medical Education Division is the Harlingen campus of The University of Texas Health Science Center at San Antonio.
The Kleberg Foundation last year donated the funding to establish the Kleberg Medical Scholars Program to attract the best and brightest medical residents to the RAHC. Seven RAHC residents are conducting clinical research projects supported by $10,000 stipends from the Kleberg Medical Scholars Program. Another portion of the Kleberg grant is coordinated by Valley Baptist Medical Center, the RAHC’s teaching hospital in Harlingen. VBMC receives $10,000 per Kleberg Scholar per year to support the Kleberg Scholars’ research programs.
Two Kleberg Scholars are among the five RAHC residents invited to make presentations at the American College of Physicians regional associates meeting in San Antonio, said James F. Hanley, M.D., clinical professor of medicine at the Health Science Center and director of the internal medicine residency program at the RAHC. Another Kleberg Scholar, James W. Castillo, M.D., was invited to present an abstract at the Society of Hospital Medicine’s Seventh Annual Meeting in New Orleans April 20-21. Dr. Castillo presented a clinically rare case of liver perforation in a patient with pancreatitis.
The Kleberg Scholars program, along with rock-solid academic relationships that exist between the RAHC, Valley Baptist Medical Center and Su Clinica Familiar, result in a greatly strengthened RAHC internal medicine residency program. Many of the projects utilize patients from Su Clinica. “When you have an environment that focuses on research, it becomes a more common practice to take clinical observations, write them up and present them at important meetings,” Dr. Hanley said. “We have a substantial change in the number of meeting presentations made by our residents in one year. We are still in the infancy of our program, but by and large we have moved away from the starting gate, and that is due to the working relationship of the entities to do these projects, as well as the fact that the Kleberg funds have allowed the residents to take on these projects.”
The Kleberg Medical Scholars will present their findings at an evening session June 2 at the RAHC Medical Education Division building, 2102 Treasure Hills Blvd. The meeting is open to RAHC faculty and interested health care professionals.
The internal medicine program was inaugurated in July 2002 with eight residents. The program now has 12 residents, including the seven Kleberg Scholars. Additional Kleberg Scholars will be selected in coming weeks.
