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Dayton Physicians Network

COVID-19 And Cancer: Implications For Patients

Dayton Physicians NetworkFacing a cancer diagnosis is an enormous challenge under the best of circumstances. When you add in a global pandemic, the physical and mental stressors compound.

Medical oncologist Mark Marinella, MD, FACP, from Dayton Physicians Network, provided insights to Premier Health Now about how people with cancer can best take care of themselves during the COVID-19 (coronavirus) outbreak.

Immune System Challenges

“For people with cancer, there are both disease-related and treatment-related risks of getting the virus or having more serious complications from the virus,” Dr. Marinella explains.

He treats all types of cancer and says people with blood cancers – leukemias, lymphomas, and multiple myeloma – are at the greatest risk concerning coronavirus because these cancers carry an immune system defect with them, and the drugs used to treat them can cause immune suppression. Even in remission, people with blood cancers may have a higher risk of contracting the virus or having serious complications.

People actively receiving cancer treatment also need to consider the effects of a weakened immune system, potentially worsening the effects of COVID-19.

For people who have recovered from solid tumors like breast or colon cancer years ago, Dr. Marinella says their immune systems should be intact, and they probably are not at greater risk of experiencing the virus and its complications.

Taking Extra Precautions

Both Dr. Marinella and the National Cancer Institute recommend steps people with cancer can take to avoid getting COVID-19 and possible serious complications of the virus. The guidelines are similar to suggestions for the general population, but even more critical to follow.

Avoid:

  • Crowds
  • Smoking
  • Excessive alcohol
  • Touching your mouth, nose, and especially eyes (a gateway for coronavirus infection)
  • Handshaking
  • Having visitors if you are in active treatment
  • Non-essential travel

Choose to:

  • Wash hands frequently
  • Wipe down hard surfaces often, especially door handles, faucet handles, and any stainless steel or plastic surfaces
  • Keep several weeks of medication and supplies on hand in case you need to stay home for prolonged periods of time
  • Eat a healthy, plant-based diet
  • Exercise
  • Consider wearing a mask if you have to go out in public places

He recommends that family members and friends stay away if they have a cough, respiratory symptoms, or unusual symptoms like loss of taste or smell.

How Medical Offices Are Adapting Care

To keep people with cancer at home as much as possible, Dr. Marinella says he and other physicians are changing cancer treatment regimens from IV to oral doses whenever appropriate.

“We are minimizing trips in and out of the house for people,” he explains. “When we can, we’re lengthening the amount of time between treatments, for example, treating every four weeks instead of every three weeks.”

Other measures include avoiding steroids, which can deplete the immune system, and using telehealth visits when possible.

For those who do come in for their cancer treatments, he says, “Don’t panic if you have to come in for treatment.”

Medical facilities are taking lots of precautions. Miami Valley Hospital South, where he sees patients, is screening people for fever at the hospital entrance. Nurses, doctors, and phlebotomists are wearing masks to minimize spread of infection. Reduced schedules have eliminated crowds.

Staying Mentally Strong

“Cancer is stressful enough on its own, plus now we have the pandemic,” Dr. Marinella says. “I would suggest that people avoid watching too much news on television and radio.”

He recommends staying connected with friends, family, a faith group, or other groups through Zoom or similar video platforms. Dr. Marinella encourages getting outside when it’s sunny and walking around your yard or neighborhood. Watch funny shows, read a book, or pursue a hobby.

Family members can help by supporting their loved one emotionally, bringing meals, and keeping a positive attitude.

“I’ve seen a lot of toughness in my patients,” Dr. Marinella comments. “I haven’t seen people shrinking back from their treatment. They’ve been pretty positive. I’ve been amazed.”

New Drug Shows Promising Results For Metastatic Breast Cancer

Dayton Physicians NetworkA new cancer drug called tucatinib (Tukysa) recently was approved by the Food and Drug Administration (FDA) to slow tumor progression and prolong life in women with metastatic HER2-positive breast cancer

Oncologist Shamim Jilani, MD, from Dayton Physicians Network describes to Premier Health Now the potential impact of this new drug, saying, “We previously had an unmet need for the group of patients with HER2-positive breast cancer who have brain metastatic disease (cancer that spreads to the brain). There is a substantial population who will benefit from this drug. If I have a patient who is appropriate, I won’t hesitate to use it.”

Dr. Jilani applauds cancer research efforts that continue even as the world battles the COVID-19 pandemic. “The lives of people with advanced cancer may well depend on receiving new treatments without delay,” she says.

The FDA approved tucatinib four months ahead of schedule, based on positive results from clinical trials.

The trial included patients who had already tried one or more other cancer treatments. They received either tucatinib (Tukysa) or a placebo, in combination with chemotherapies trastuzumab (Herceptin) and capecitabine (Xeloda).

“The drug produced a very impressive, amazing result,” Dr. Jilani says.

“Tucatinib, in combination with trastuzumab and capecitabine, versus placebo, reduced the risk of death by one third; reduced the risk of progression or death by half in all patients, including patients with brain metastases; and almost doubled the response rate.”

Dr. Jilani adds, “In patients with brain metastases, there was a 52 percent lower risk of disease progression or death. For this subset of patients, this is very impressive data.

“I am really excited when I look at this. The greatest news is we are prolonging people’s lives,” she says with enthusiasm. “Previously, we had nothing to offer as a standard of care for brain metastatic HER2-positive breast cancer.”

Tucatinib Has Potential To Be First-Line Treatment

Twenty percent of women with breast cancer have HER2-positive breast cancer, an aggressive disease fueling cancer growth through excess HER2 protein on tumor cells. If the cancer is not detected while still confined to the breast, up to 50 percent of these women develop cancer in their brains (metastases).

Since the late 1990s, drugs targeted to stop or slow the progression of HER2-positive breast cancer have continued to emerge. Tucatinib, which is taken by mouth, works in concert with two of these therapies by binding to the HER2 protein inside a cancer cell and prevents it from sending signals that promote cancer cell growth.

Dr. Jilani explains that the new drug regimen with tucatinib is designed to slow cancer progression and prolong a person’s life, but not to cure the cancer. A patient continues to take the treatment as long as it is providing beneficial results.

“Patients are living longer with metastatic breast cancer,” she says. “I am very hopeful this will be the new standard of care, the first-line treatment, in the near future for breast cancer patients with brain metastases.”

New Study Shows COVID-19 Plus Cancer Equals Higher Death Risk

Dayton Physicians NetworkFor people with cancer that is getting worse or spreading, getting COVID-19 makes the chance of dying within a month five times higher, according to data recently presented at a national cancer conference.

In addition, the study found that the virus nearly doubled the risk of dying (as compared to the general public), even if the person’s cancer was not spreading.

To shed light on these findings for cancer patients, Premier Health Now spoke with medical oncologist/hematologist Satheesh Kathula, MD, with Dayton Physicians Network® and certified physician with MD Anderson Cancer Network at Premier Health.

Dr. Kathula says the implications of the study on receiving cancer treatment depend on an individual’s circumstances. “We can’t put all cancer patients into one basket. Talk to your oncologist to make an informed decision. Weigh the benefits and the risks. If you have curable cancer — for example, early stage breast cancer, leukemia, lymphoma — don’t delay the treatment. Also, if you have good performance status [functioning well in everyday life] with a meaningful chance to recover or prolong life, don’t put off the treatment.”

Why Cancer Patients Are At Increased Risk With COVID-19

Dr. Kathula explains that several factors contribute to an increased risk of death for cancer patients. “Many cancer patients are elderly. Many have poor performance status, [bedridden or partially bedridden] with compromised immunity, especially if cancer is spreading. They often have poor nutrition and weight loss due to loss of appetite.”

“I expected this,” Dr. Kathula says of the study results.

The type of cancer a person has also influences the impact of COVID. “Patients with lung cancer tend to have increased mortality. Their lung capacity is compromised because of the disease itself. They tend to be smokers and have COPD [chronic obstructive pulmonary disease]. Patients with blood-related cancers have more risk from COVID, as well.”

He continues, “The type of treatment also matters. Patients on heavy-duty chemotherapy have increased risk because immunity goes down.”

Other types of cancer treatment, such as immunotherapy or targeted therapy with tyrosine kinase inhibitors, did not present a greater risk of death from COVID-19 among people with cancer.

Dr. Kathula also commented on the study’s report that cancer patients who received corticosteroids to reduce inflammation were 1.5 times more likely to die. He explains, “Patients on chronic immunosuppression [from cancer-fighting medications] have a higher chance of infection. If the use of corticosteroids is just short term, however, it can help inflammation.”

He notes that the corticosteroid dexamethasone is actually helping some patients on ventilators who are critically ill with COVID-19.

Preventing COVID-19 In Cancer Patients

One of the best ways to lessen COVID’s impact on cancer patients is to prevent them from getting the virus, Dr. Kathula says.

“We have to educate our patients. Most stay at home and are careful. They wash hands and wear masks. They are disciplined and follow instructions.”

He encourages friends and family members to be extra careful and limit visits, especially if they have been in public gatherings. “We have a responsibility to save vulnerable people. Avoid close contact and take precautions,” he says.

Evaluate When To Get Cancer Screenings

Those who don’t have cancer may be questioning when to resume their cancer screenings.

Dr. Kathula notes, “Everything is open again for cancer screenings – colonoscopy, mammogram, Pap smear.”

Whether to schedule your screening now or wait a few months depends on your individual circumstances and the recommendation of your physician(s), based on factors such as age and other health conditions.

“You have to weigh the benefits and risks,” Dr. Kathula says. “If you’re at high risk for breast cancer, colon cancer, or another type of cancer, but you are otherwise fairly young and healthy, you should get screenings on your regular schedule.”

Get the Facts On Prostate Cancer: Screening, Diagnosis, Treatment

Dayton Physicians NetworkWhat do you know about cancer? For starters, it’s the most common cancer among men, except for skin cancer. An estimated 191,930 American men will be newly diagnosed with prostate cancer this year.

On the positive side, “the outlook for men who have prostate cancer is fantastic,” says David Key, urologist with Dayton Physicians Network and Premier Health. “We have so many things we can offer patients, especially men with advanced cancer.”

Prostate cancer rarely occurs before age 40. The majority of prostate cancers grow slowly, reducing the number of deaths from the disease. Dr. Key explains that often, “you are more likely to die with the disease than die of the disease.”

How To Know If You Have Prostate Cancer

The prostate is a gland in men, about the size of a walnut, located below the bladder and in front of the rectum. As part of the male reproductive system, it makes fluid that mixes with sperm to become semen.

“The majority of men who have prostate cancer have no symptoms or complaints,” Dr. Key says.

Your risk of getting this cancer is higher if you have a father or brother who has prostate cancer. If you are an African-American man, you also have a higher risk of developing prostate cancer. It also may be a more aggressive form and occur at a younger age.

If symptoms are absent, screening becomes important to identify the disease. Dr. Key notes two screening tools that are the “gold standard” for prostate cancer detection: prostate-specific antigen test (PSA) and a digital rectal exam.

The PSA test measures the level in your bloodstream of the PSA protein made by the prostate gland. A high level could be a sign of prostate cancer. It also can be a sign that you have an enlarged prostate, infection, or inflammation of the prostate. So, further testing may be needed.

Dr. Key recommends that men follow the American Urologic Association guidelines for PSA screening,by age:

  • Under 40. No screening needed
  • 40 to 54. Get a PSA if you are at risk due to being African-American, having a family history of prostate cancer, or a family history of BRCA1 or BRCA2 gene defects, which are linked to increased occurrence of breast, ovarian, and prostate cancer
  • 55-69. Get a baseline PSA level, after which you and your doctor will discuss whether you should have a follow-up test in a year or two, based on your overall risk and preferences
  • 70+. No routine screening is recommended. However, some men age 70+ who are in excellent health may benefit from prostate cancer screening. “We don’t want to over-diagnose insignificant cancer or put people through diagnostic procedures (like biopsies) that have risks in themselves and don’t lead to better overall medical care,” Dr. Key says.

See Your Doctor For These Symptoms

Sometimes, prostate cancer does cause symptoms. If you experience any of the following issues, see your primary care physician or urologist to evaluate whether it is a sign of cancer or another condition:

  • Problems with starting to urinate
  • Urine flow that is weak or that stops and starts
  • Frequent urination, especially at night
  • Problems with emptying your bladder completely
  • Pain or burning sensation when you urinate
  • Blood in your urine or semen
  • Pain in your back, hips, or pelvis that doesn’t go away
  • Painful ejaculation

Diagnosis For Prostate Cancer

If you have an elevated PSA level or abnormal digital rectal exam, your doctor is likely to recommend a biopsy – removal of a small tissue sample from the prostate for study. Most commonly, the physician uses a transrectal ultrasound to guide the biopsy removal. 

If greater precision is needed to locate a tumor or area of concern, the urologist may use magnetic resonance imaging (MRI). A combination of MRI and transrectal prostate ultrasound can be used to biopsy the abnormal area on the MRI.

Genomic testing also can be performed on a tissue biopsy. This test can help predict how cancer cells will grow and behave. Identifying genomic markers is important in early stage prostate cancers to decide whether to take action to treat the cancer or carefully monitor the cancer to see if it grows. Monitoring is called active surveillance.

Treatment For Prostate Cancer

There are several options for managing or treating prostate cancer:

Active surveillance. If your cancer is confined to your prostate and slow-growing, your doctor may recommend carefully monitoring it and not actively treating it. Dr. Key says genetic markers help determine if you are a candidate for active surveillance. You will need regular checkups to make sure nothing changes.

“Up to 40 percent of men with prostate cancer can be managed this way initially without any treatment,” Dr. Key says. “If something changes, we can move into potentially curative options.”

Potentially curative options. If found early, before it has spread, prostate cancer is often curable. You will likely have one of these treatment options:

  • Surgery. A robotic-assisted prostatectomy removes the prostate entirely. This requires a brief hospital stay.
  • Radiation therapy. Radiation beams of intense energy are aimed precisely at the tumor from outside the body. The beams travel to the tumor site with minimal or no harm to the skin and surrounding tissue. Often, a hydrogel substance can be injected between your prostate and rectum to spare your rectal area from the radiation beams.

Medical treatment for advanced cancer. A number of options are now available to treat prostate cancer that has spread:

  • Androgen deprivation to stop the production of the male hormone testosterone
  • Oral oncolytics, which is chemotherapy in pill form
  • PARP inhibitors, a targeted cancer therapy that is taken by mouth
  • Provenge immunotherapy, which is a cancer infusion treatment that activates your immune system to fight the cancer cells
  • IV chemotherapy
  • Access to national research study protocols, such as those offered through Premier Health’s affiliation with the MD Anderson Cancer Network®

“We can use these medications to delay the onset of metastases [cancer spread] and provide a longer quality of life,” Dr. Key says.

The Dude’ Has Lymphoma. What That Means

Dayton Physicians NetworkWhen Oscar-winner Jeff Bridges announced this week that he has lymphoma, his multitude of fans were understandably shocked. “Cancer” doesn’t jibe with the actor they affectionately call “The Dude.”

But Bridges’ tweet confirmed the news and treatment has begun for the blood cancer, which attacks the lymphatic system, your body’s army of germ fighters.

Premier Health Now spoke with hematologist/oncologist Satheesh Kathula, MD, to learn more about lymphoma and what the diagnosis may mean for Bridges.

Dr. Kathula explains that lymphoma is not just one disease. It’s a group of diseases that starts in the cells of your lymphatic system. The main types of lymphoma are Hodgkin and Non-Hodgkin, Dr. Kathula explains. Both may produce swollen lymph nodes in your neck, arm pits, and groin. Non-Hodgkin is also sometimes found in the brain, the skin, and other areas throughout the body.

“All lymphomas are not created equal,” says Dr. Kathula. “Your treatment and recovery depend largely on the type that you have, and how advanced it is. Because Jeff Bridges didn’t reveal that information, we can’t predict how he’ll fare.” 

In addition to swollen lymph nodes, symptoms of most lymphomas include fever, night sweats, fatigue, loss of appetite, and unexplained weight loss. “But you may not have any symptoms at all,” says Dr. Kathula. “We might find it during a routine physical or notice it on a CT scan.”

Your likelihood of getting lymphoma increases as you age. Bridges is 70. “You’re more prone to get any cancer as you age, because your cells start to degenerate,” Dr. Kathula adds. Smoking and exposure to chemicals and radiation also increase your chances.

Charlie’s Story: ‘Listen To Your Body And Act On It’

Dayton Physicians NetworkFewer than 1 percent of breast cancer patients are men – a statistic that often causes symptoms to go unnoticed for far too long.

Thanks to his observant wife, Patti, that didn’t happen to Charlie Smith of Clayton. One evening, when Charlie took his shirt off, Patti noticed that his nipple was inverted.

“That doesn’t look right,” she said.

They immediately scheduled an appointment with their family physician, David Mesker, MD, of Englewood Family Practice. He detected a lump in Smith’s breast and referred him to breast surgeon Thomas Heck, MD, of Gem City Surgeons. Dr. Heck is a certified physician with MD Anderson Cancer Network®, a program of MD Anderson Cancer Center, at Premier Health.

A biopsy came back positive for invasive ductile carcinoma. Dr. Heck performed a right-sided mastectomy, which revealed that the cancer was close to Stage 2. “Dr. Heck was an awesome surgeon,” Charlie says. “He felt he got it very early.”

During the initial consultation with Dr. Heck, Patti promised she wasn’t going to cry. “He gave me a box of Kleenex anyway, and of course I needed it,” she recalls.

Early detection may be the reason that Charlie, 65, has been in remission for nine years.

“It’s very important to have increased awareness that men can get breast cancer, because there isn’t an equivalent test to a mammogram,” says Charlie’s medical oncologist, Charles Bane, MD, of Dayton Physician Network also a certified physician with MD Anderson Cancer Network.

Dr. Bane also recommended genetic testing for Charlie. “Every patient diagnosed with breast cancer, whether male or female, should discuss the option of genetic testing with their care team to determine if genetic testing is indicated in their case,” Dr. Bane says.

“In my case, it was not genetic, which was a huge relief,” Charlie says. “Our children are not at risk.”

Dr. Bane ordered six initial rounds of chemotherapy over the course of three months. “It wasn’t that uncomfortable,” Charlie recalls.

Dr. Bane notes that the ability to manage the side effects of treatment is much greater than in the past: “The advancements in anti-nausea medication have been really effective in the majority of people, and those continue to improve.”

Charlie continues to follow up with Dr. Bane every six months and to take a hormone-blocker pill to reduce the likelihood of a recurrence.

The couple made it through their ordeal with the strong support of their children, Joshua Smith of Dayton and Dawn Selby of Kettering. “And I can’t say enough about our physicians and our medical team,” Patti says. “They were all very caring and professional and took an interest in you as an individual.”

For his part, Charlie gives the bulk of the credit to his wife of 47 years. “She is my savior,” he says. “It was very important that she knew something wasn’t right and that it should be checked out.”

Charlie is a very private person, but he says he decided to share his story “in order to give back and to make people aware that men can get breast cancer, too.”

Adds Patti, “The key is early detection. If you see something that isn’t right, don’t wait a week or even a day. Listen to your body and act on it.”

Breast Cancer Symptoms In Men

Dr. Bane, chairman of Premier Health Cancer Institute, says that men often delay seeking treatment for breast cancer because they are unaware of the symptoms. He advises men and their families to be alert to the following warning signs:

  • Asymmetry in the breasts
  • Swelling
  • Pain or discomfort
  • A lump
  • Discharge from the breasts
  • A change of appearance in breasts or skin

Keeping You Safe During COVID-19

You will find new safety measures in place when you schedule appointments and come to our facilities — all with the goal of keeping you safe as we care for you.

Contact Us

Our cancer team is here for you. Our cancer specialists have access to nationally recognized cancer care protocols and best practices, since Premier Health is a certified member of MD Anderson Cancer Network®, a program of MD Anderson Cancer Center. Our patients benefit from advanced local care backed by the world-renowned expertise of the nation’s leading cancer center.

Call the Dayton Physicians Network hotline at (844) 316-HOPE (4673), Monday through Friday, 8 a.m. to 5 p.m., to connect with a Premier Health cancer navigator.

Get the Facts On Prostate Cancer: Screening, Diagnosis, Treatment

Dayton Physicians NetworkWhat do you know about cancer? For starters, it’s the most common cancer among men, except for skin cancer. An estimated 191,930 American men will be newly diagnosed with prostate cancer this year.

On the positive side, “the outlook for men who have prostate cancer is fantastic,” says David Key, urologist with Dayton Physicians Network and Premier Health. “We have so many things we can offer patients, especially men with advanced cancer.”

Prostate cancer rarely occurs before age 40. The majority of prostate cancers grow slowly, reducing the number of deaths from the disease. Dr. Key explains that often, “you are more likely to die with the disease than die of the disease.”

How To Know If You Have Prostate Cancer

The prostate is a gland in men, about the size of a walnut, located below the bladder and in front of the rectum. As part of the male reproductive system, it makes fluid that mixes with sperm to become semen.

“The majority of men who have prostate cancer have no symptoms or complaints,” Dr. Key says.

Your risk of getting this cancer is higher if you have a father or brother who has prostate cancer. If you are an African-American man, you also have a higher risk of developing prostate cancer. It also may be a more aggressive form and occur at a younger age.

If symptoms are absent, screening becomes important to identify the disease. Dr. Key notes two screening tools that are the “gold standard” for prostate cancer detection: prostate-specific antigen test (PSA) and a digital rectal exam.

The PSA test measures the level in your bloodstream of the PSA protein made by the prostate gland. A high level could be a sign of prostate cancer. It also can be a sign that you have an enlarged prostate, infection, or inflammation of the prostate. So, further testing may be needed.

Dr. Key recommends that men follow the American Urologic Association guidelines for PSA screening, by age:

  • Under 40. No screening needed
  • 40 to 54. Get a PSA if you are at risk due to being African-American, having a family history of prostate cancer, or a family history of BRCA1 or BRCA2 gene defects, which are linked to increased occurrence of breast, ovarian, and prostate cancer
  • 55-69. Get a baseline PSA level, after which you and your doctor will discuss whether you should have a follow-up test in a year or two, based on your overall risk and preferences
  • 70+. No routine screening is recommended. However, some men age 70+ who are in excellent health may benefit from prostate cancer screening. “We don’t want to over-diagnose insignificant cancer or put people through diagnostic procedures (like biopsies) that have risks in themselves and don’t lead to better overall medical care,” Dr. Key says.

See Your Doctor For These Symptoms

Sometimes, prostate cancer does cause symptoms. If you experience any of the following issues, see your primary care physician or urologist to evaluate whether it is a sign of cancer or another condition:

  • Problems with starting to urinate
  • Urine flow that is weak or that stops and starts
  • Frequent urination, especially at night
  • Problems with emptying your bladder completely
  • Pain or burning sensation when you urinate
  • Blood in your urine or semen
  • Pain in your back, hips, or pelvis that doesn’t go away
  • Painful ejaculation

Diagnosis For Prostate Cancer

If you have an elevated PSA level or abnormal digital rectal exam, your doctor is likely to recommend a biopsy – removal of a small tissue sample from the prostate for study. Most commonly, the physician uses a transrectal ultrasound to guide the biopsy removal.

If greater precision is needed to locate a tumor or area of concern, the urologist may use magnetic resonance imaging (MRI). A combination of MRI and transrectal prostate ultrasound can be used to biopsy the abnormal area on the MRI.

Genomic testing also can be performed on a tissue biopsy. This test can help predict how cancer cells will grow and behave. Identifying genomic markers is important in early stage prostate cancers to decide whether to take action to treat the cancer or carefully monitor the cancer to see if it grows. Monitoring is called active surveillance.

Treatment For Prostate Cancer

There are several options for managing or treating prostate cancer:

Active surveillance. If your cancer is confined to your prostate and slow-growing, your doctor may recommend carefully monitoring it and not actively treating it. Dr. Key says genetic markers help determine if you are a candidate for active surveillance. You will need regular checkups to make sure nothing changes.

“Up to 40 percent of men with prostate cancer can be managed this way initially without any treatment,” Dr. Key says. “If something changes, we can move into potentially curative options.”

Potentially curative options. If found early, before it has spread, prostate cancer is often curable. You will likely have one of these treatment options:

  • Surgery. A robotic-assisted prostatectomy removes the prostate entirely. This requires a brief hospital stay.
  • Radiation therapy. Radiation beams of intense energy are aimed precisely at the tumor from outside the body. The beams travel to the tumor site with minimal or no harm to the skin and surrounding tissue. Often, a hydrogel substance can be injected between your prostate and rectum to spare your rectal area from the radiation beams.

Medical treatment for advanced cancer. A number of options are now available to treat prostate cancer that has spread:

  • Androgen deprivation to stop the production of the male hormone testosterone
  • Oral oncolytics, which is chemotherapy in pill form
  • PARP inhibitors, a targeted cancer therapy that is taken by mouth
  • Provenge immunotherapy, which is a cancer infusion treatment that activates your immune system to fight the cancer cells
  • IV chemotherapy
  • Access to national research study protocols, such as those offered through Premier Health’s affiliation with the MD Anderson Cancer Network®

“We can use these medications to delay the onset of metastases [cancer spread] and provide a longer quality of life,” Dr. Key says.

‘First in the world’: New tech to help Premier Health advance medical care

Dayton Physicians NetworkThe system installed at Miami Valley Hospital South in Centerville hospital is the first to be delivered in the world.

SUBMITTED RENDERING

COMPANIES

IN THIS ARTICLE
Miami Valley Hospital South
Dayton, OH

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Dayton Physicians Network
Dayton, OH
Hospital & Health Care
350Employees

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Jacob Fisher

By Jacob Fisher – Staff Reporter, Dayton Business Journal a day ago

Dayton’s largest hospital campus has repeatedly ranked among the nation’s best sites for urology care.

A new investment in next-generation technology could push that designation even higher.

Premier Health, one of the region’s largest health systems; and Dayton Physicians Network (DPN), a medical group with more than 350 employees, have acquired a new system by Israeli medical device company Lumenis Ltd. that provides advances in treatment for kidney stones and enlarged prostate.

The equipment, called the MOSES 2.0 Pulse 120H hominem laser, is the next generation of a platform Lumenis released in 2017. Bench tests for the latest iteration indicate up to 85% greater stone ablation using laser lithotripsy — a procedure used to break apart kidney stones in the urinary tract.

Premier Health’s Miami Valley Hospital South is one of eight sites globally part of a limited launch for the new equipment. The system installed at the Centerville hospital is the first to be delivered in the world.

“Premier Health has always invested in health care technologies that truly and measurably improve the health of the communities we serve,” Mary Boosalis, president and CEO of Premier Health, said in a release. “With MOSES 2.0, we are continuing to fulfill that commitment to our patients.”

Mary Boosalis

Mary Boosalis, president and CEO of Premier Health.

The first iteration of MOSES has been available for years at both Miami Valley Hospital’s main campus in Dayton and Miami Valley Hospital South. Both of those units have been upgraded to include new prostate surgery capabilities, and they will be fully upgraded by the end of 2020, a Premier Health spokesperson told DBJ.

Related: The future of health care — and how Dayton fits in

Since installation in late July, DPN physicians have used the new platform’s kidney stone dissolving capabilities on nearly 100 patients, and DPN urologist Blake Anderson has performed 21 minimally invasive prostate surgeries.

“The laser allows even better control of bleeding, decreasing postoperative catheter time so patients may even be discharged the same day without a catheter,” Anderson said.

Dr. Blake AndersonDr. Blake Anderson, a urologist with Dayton Physicians Network, stands next to the new MOSES 2.0 laser at Miami Valley Hospital South.

COURTESY OF PREMIER HEALTH

Acquiring new technology has been a major focus for Premier Health and DPN, which in 2019 partnered to upgrade radiation equipment at three Dayton-area hospitals to enhance treatment for cancer patients. That partnership was part of a $22 million investment in facility upgrades and equipment.

Miami Valley Hospital — the 900-bed flagship medical institution operated by Premier Health — is the largest hospital in the region, with more than $963 million in revenue and 41,114 admissions in 2018. The multi-site medical center includes the primary MVH campus in downtown Dayton and satellite campuses in Englewood and Centerville.

Cancer drug recycling program changing local lives

Dayton Physicians NetworkCancer treatments are evolving but the high costs coupled with high copays and coinsurance of new approaches has been a challenge, forcing many patients to choose less effective or less convenient treatment routes.

When most people hear the word “chemotherapy” they think of intravenous chemotherapy, which requires a cancer patient to visit a clinic or other medical office and receive drugs that are delivered with an IV inserted into a large vein.

Oral chemotherapy is a lesser known but rapidly growing treatment approach that allows patients to receive their therapy in the form of a tablet or capsule. Oral therapy not only offers patients a broader range of treatment options, but also allows patients to receive their treatment in the convenience of their own home.

While intravenous chemotherapy is largely covered by insurance programs, oral chemotherapy is costly and can be challenging to afford.

“One oral chemotherapy drug can cost as little as $200 a month or as much as $17,000 a month,” says Director of Pharmacy Services and Research at Dayton Physician Network Joshua Cox, Pharm.D., BCPS, R.Ph. “Beyond that, prescriptions typically have no out-of-pocket cap so patients have to pay for the drug every time they pick it up.”

The cost of oral chemotherapy drugs has prohibited some patients from taking them. As many as 10% of patients fail to pick up their prescription medication to begin treatment because they are unable to cover the cost.

Identifying opportunity

Cancer treatment is dynamic in that as a patient responds or doesn’t respond to certain drugs, their treatment protocol and prescriptions change. This can leave patients who are being treated through oral chemotherapy with leftover pills.

“For years, we’ve had patients bring in expensive oral chemotherapy medications they’re no longer using and ask if they can donate them to patients who are unable to afford them,” says Dr. Cox.

“However, legislation has historically prevented us from re-administering these drugs and the pills would end up in the trash.”

Changing legislation

Cox is currently serving his second term as a member of the State of Ohio Board of Pharmacy. In the third quarter of 2019 Cox and his fellow board members started reviewing statutes around drug repository programs that would enable pharmacies to accept unused cancer medications donated by patients and dispense them to other patients in need.

“The Board of Pharmacy reviewed the statutes that were passed by state legislators, and we were able to change the rules to allow for drug repository programs to now include cancer drugs,” says Cox. “These actions created the possibility for cancer drug recycling programs to exist in the state of Ohio.”

The revised code for operating a drug repository program went into effect on October 3, 2019 and Dayton Physician’s Network was the first network in the state of Ohio to adopt a cancer drug recycling program.

Dayton Physicians Network

Making a difference

The Dayton Physician Pharmacy Team started accepting oral chemotherapy drugs in October 2019 and was very quickly receiving tens of thousands of dollars of donated drugs into our inventory,” says Dr. Cox. “We have now re-dispensed tens of thousands of dollars of those drugs to patients in need.”

Dayton Physician’s Network is leading the way in innovating not only the way patients have access to medications but also the way to high quality and high value care through comprehensive cancer treatment programs that include an integrated hematology and oncology team, chemotherapy classes, and after hours cancer care.

“The cancer drug recycling program is providing treatment to cancer patients who otherwise would not have received these medications due to an inability to pay,” says Cox. “It is making a huge difference in our community.”

“I want people who are currently being treated for cancer or those who have a loved one who is being treated to know this program is out there so if they identify an opportunity to donate, they know where to take unused medications,” says Cox. Any patient with unused oral chemotherapy drugs can donate to a pharmacy with a cancer drug repository like the one at Dayton Physicians Network.

“I also want anyone who is receiving treatment for cancer and in a situation where they are struggling to pay for medications to know this program is available,” says Cox. “Cost should no longer be a reason a cancer patient does not get the treatment they need.”

Coronavirus: What You Should Know

At Dayton Physicians Network the safety and well-being of our patients, staff, visitors, and the community is our top priority. To help you learn more, here is some basic information about the disease. 

Dayton Physicians Network is committed to your safety and well-being.

Effective immediately we are implementing the following policies:

  • In order to safeguard the health and safety of all patients, we are allowing patients to be escorted or accompanied by one caregiver within our facilities. We will screen patients upon arrival and all patients and escorts are required to wear masks.
  • No one under the age of 18 will be permitted in the facility.
  • Please call us prior to your visit if you have any symptoms with the onset of fever, cough and shortness of breath.

 

COVID-19 Vaccine Information

COVID-19 vaccines are safe and recommended for cancer patients.

Dayton Physicians Network completely supports the COVID-19 vaccines for our cancer patients. At this time, we are not able to offer the COVID-19 vaccinations at our clinics. There are two vaccines currently available by either Pfizer or Moderna, both require a two dose process. Patients can contact their local Health Departments or Hospital for more information about vaccine availability. Patients should not call our office to schedule a vaccine appointment as our clinics do not have scheduling access.

As we receive more information about vaccine supply’s from the State of Ohio, we will update this site as phases to self-schedule an appointment become available to receive first of two COVID-19 vaccine.

Learn more about COVID-19 Vaccines | CDC and COVID-19 Vaccination Program (ohio.gov)

Education Support

Public Health- Dayton & Montgomery County: https://www.bizjournals.com/dayton/news/2020/12/14/business-mandatory-covid-vaccine.html

For updates on the vaccination process visit: https://www.phdmc.org/coronavirus-updates/439-covid-19-vaccination-information

Both COVID-19 vaccines are safe and recommended for cancer patients

Your safety is always our top priority. We understand that many of our patients have serious medical conditions, including weakened immune systems, and are at greater risk for severe illness from COVID-19.

According to the Food and Drug Administration (FDA), both COVID-19 vaccines are highly effective at preventing symptomatic infection and require two doses to achieve maximum effectiveness.

After careful review of all available scientific evidence, our clinical experts have determined that both COVID-19 vaccines authorized for emergency use by the FDA are safe and recommended for former and current cancer patients.

Continue safe practices

For your safety, it important to continue wearing a mask, maintaining social distancing and washing your hands frequently. These actions will be needed until public health experts advise otherwise.

Additional resources

To learn more about COVID-19 and vaccines, visit the U.S. Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) websites.

Questions about Coronavirus 2019 (COVID-19)?

If you have questions regarding COVID-19, please call the Ohio Department of Health (ODH) hotline at 833-427-5634.

What is coronavirus?

The novel coronavirus, or COVID-19, is a new virus and disease unknown before the outbreak began in December 2019.

What are the symptoms of COVID-19?

Symptoms of COVID-19 can range from mild to severe, with the majority being mild. The symptoms may appear two to 14 days after exposure and include:

  • Fever
  • Cough
  • Shortness of breath
  • Flu-like symptoms

 

What should I do if I have these symptoms?

If you are experiencing symptoms of COVID-19, call your primary care provider.  Please do not go directly to your doctor’s office or emergency department without calling first, since many can isolate at home without being evaluated in person.

What can I do to prepare?

There are some steps you can take to prepare your family for COVID-19. Here is a checklist from the Ohio Department of Health to help you prepare. 

How can I protect myself?

The best ways to protect yourself are by washing your hands with sanitizer or using soap and water for at least 20 seconds; not touching your eyes, nose, or mouth with unwashed hands; and avoiding contact with people who are sick.

If you are sick, stay at home, avoid contact with others, and cover your mouth and nose when you sneeze or cough.

Social Distancing

The CDC continues to advise that the best way to prevent illness is to avoid being exposed to this virus. “Social distancing” means remaining out of congregate settings, avoiding mass gatherings, and maintaining distance (approximately 6 feet or 2 meters) from others when possible. Social distancing is not the same as self-quarantine or isolation, two other practices being utilized to minimize the coronavirus spread. The key difference is that a quarantine or isolation restricts the movement of people within a certain area or zone to limit transferring and spreading an infection. Social distancing places no such locational constraints, rather it is a behavioral practice to lower the risk in most circumstances. Clearly, there are instances where it’s hard to keep a certain kind of distance from other people — when traveling via public transportation, for example, or using an elevator. Accessing public services like the post office, the bank or a grocery store can also be challenging, as can socializing in public settings. Social distancing in these cases means doing the best that you can — be that with regards to personal space or related personal safety strategies. Some things you can reasonably include the following:

  • Take everyday precautions to keep space between yourself and others; at work this includes replacing face-to-face communications with phone calls, conference calls, email and jabber whenever possible.
  • When you go out in public, keep away from others who are sick, limit close contact and wash your hands often.
  • Avoid crowds as much as possible.
  • Avoid cruise travel and non-essential air travel.
  • Stay home as much as possible to further reduce your risk of being exposed.
  • Consider ways of getting food brought to your house through family, social, or commercial networks.