"My goal is to see a patient in clinic within 48-72 hours of their initial call," said Pedro Barata, MD, Tulane Cancer Center's new medical oncologist specializing in genitourinary cancers. "We need to be available to our patients, especially those facing a cancer diagnosis. It's what they need. Access to care is key, and there's just so much more we can do to help improve their experience. That's my top priority."

Barata actually has a long list of priorities, all aimed at further developing the regional presence of Tulane's Genitourinary Cancers Program, and he has hit the ground running to implement them since his recent arrival.

"Patients from Louisiana should know that we can offer them options right here at home that are beyond the standard of care," said Barata.

With the approval of novel immunotherapies, there have been recent dramatic changes in the management of bladder cancer, according to Barata. He and his team have taken advantage of that momentum and have cherry-picked clinical trials to offer here at Tulane for every stage of the disease. These are currently in the internal approval process, and he hopes to be able to offer them as alternatives to standard of care to eligible patients in the near future.

"If you come with localized bladder cancer and need neo-adjuvant treatment, we will have a clinical trial for you as an alternative," said Barata. "If you've been treated with surgery, have metastatic disease, or fail immunotherapy, we will have clinical trials to offer you as alternatives as well."

Access to clinical trials is one of the benefits of getting your cancer care in an academic setting, like Tulane, according to Barata. "Clinical research allows us to study novel therapies or combinations of treatments that already exist and try to prove that these are better than the standard of care, and if they are, they get approved as the new standard of care. So patients enrolled in clinical trials have opportunities to receive novel therapies before they get approved. Not all community cancer centers do this. A top-notch research team who know how to navigate a complex infrastructure to support these efforts is paramount, and that's what we offer here."

Dr. Barata also implemented genetic testing for every bladder and kidney cancer patient he sees. "Genetic markers that are revealed through testing may have a significant impact on the way we treat the disease," he said. "It won't impact 100% of our cases, but if it impacts 10-15%, that makes a huge difference. We won't know if we don't test, and that's why it's important."

According to the American Cancer Society, bladder cancer is the fourth most common cancer in men; it is less common in women. Although incidence rates have been dropping in recent years, still about 80,500 new cases are expected to be diagnosed in the U.S. in 2019, and approximately 17,700 people will die from bladder cancer this year.

Barata says it's a disease where multidisciplinary care really matters. "You need strong urology, medical oncology and radiation oncology teams all working closely together," he said. "Drs. Raju Thomas, Jonathan Silberstein, Spencer Krane from Urology; Oliver Sartor from Medical Oncology, and Kendra Harris from Radiation Oncology are among the best in the business. This excellent team was definitely one of the reasons why I decided to join Tulane."

Dr. Barata is currently accepting new patients. Please call 504-988-7444 to schedule an appointment.

More than 17 percent of prostate cancer patients are born with genetic variants that can be associated with a higher risk for various cancers, according to a new study in  JAMA Oncology  by researchers from Tulane University School of Medicine and genetics firm Invitae.

The research, which is the largest study to date on the genetics of prostate cancer, also found that guidelines for genetic testing at the time of the study missed a substantial number of patients, suggesting broader testing is warranted. 

“This research shows the genetic risks associated with prostate cancer have been underestimated and provides support for expanding testing to include an increased number of prostate cancer patients,” said lead study author Dr. Oliver Sartor, Tulane Cancer Center medical director. “Expanding the use of genetic testing in prostate cancer patients can inform treatment strategies and potentially suggest treatment with targeted therapies or clinical trials. In addition, testing can provide valuable information for a patient’s family, allowing for increased screening among those at risk that can potentially help prevent additional cancer deaths.”

Previous research has shown that approximately 12 percent of men with certain genetic variants have an increased risk of developing prostate cancer and may also be at risk for more aggressive forms of the disease. Relatives of men with these variants, including female relatives who carry these variants, can also be at increased risk for other cancer types including breast, ovarian, pancreatic, uterine and/or colon cancers. 

The study reviewed medical records between 2013 and 2018 for 3,607 men with a personal history of prostate cancer. Unlike previous studies in hereditary prostate cancer, inclusion in the study was not dependent on Gleason score, ethnicity, family history or stage of disease. Gleason scores are based on tumor biopsies to determine how aggressively the cancer may spread. The study included both the largest number of prostate cancer patients and the largest sampling of non-Caucasian patients studied to date. 

Results showed that among men with a personal history of prostate cancer, pathological variants were identified in 620 of 3,607 patients (17.2 percent).  Almost 31 percent of those variants included the BRCA1/2 genes, which are associated with breast and ovarian cancers. Pathologic variants in HOXB13, a gene associated only with prostate cancer risk, were identified in 30 (4.5 percent) patients and this represents an important subset of patients not covered by current guidelines. 

Examination of provided family histories indicated that 37 percent of the individuals with pathologic variants in this cohort would not have been approved for testing using the family-based guidelines at the time of study. Guidelines since have been revised and expanded to rely more heavily on Gleason scores for identifying patients for genetic testing. However, Gleason scores were an imperfect predictor of pathogenic variants in this dataset. Furthermore, Gleason scores require biopsy and are not always readily available to practitioners or family members who want genetic testing.

“These findings support broadening and simplifying current guidelines to ensure all patients with prostate cancer have access to genetic information to guide their care and inform their families of any elevated inherited cancer risks,” said Dr. Robert Nussbaum, chief medical officer of Invitae. “Medically actionable genetic information is invaluable for managing, treating and preventing cancer. As clinical understanding of genetics and its impact on disease broadens, there is a medical responsibility to ensure that everyone that may benefit from genetic testing has access to it.”

Prostate cancer is the second-leading cause of cancer death in men in the United States, with more than 174,000 new cases expected to be diagnosed this year according to the American Cancer Society.

Cancer has been particularly devastating for the Greenberg Family, who have lost many family members to this deadly disease. Mark Greenberg passed away from prostate cancer in 2014. His son, Mark S. Greenberg, Jr. was diagnosed with prostate cancer in 2015.

"Our intent is to support Dr. Oliver Sartor in his mission to find a cure for this disease. Dr. Sartor has led us in this fight and has provided guidance and support along the way," said Mark Greenberg, Jr.

As a result, Mark Greenberg's family - Barbara Greenberg, Jennifer and Mark Greenberg, Jr., Diana and Sean Greenberg, and Lauren and Devin Wakeman - have established the Mark S. Greenberg Endowment for the Cure of Prostate Cancer at Tulane University.

"Cancer does not discriminate, and unfortunately, has shown little mercy on the Greenberg/Wakeman family," said Barbara Greenberg. "Through the BRCA1 and CHEK2 genetic mutations, my children face a genetic war against cancer."

Lauren Wakeman said, "Thanks to research, however, we have gained the knowledge and guidance to take the needed preventative measures to protect ourselves. Still, more research and clinical studies are essential."

The 8th Annual One Man Shoot Sporting Clays Fundraiser , benefiting Tulane Cancer Center's Prostate Cancer Research Fund, will take place Saturday, March 30, at Riverside Sporting Clays, 52400 Hwy. 16, in Denham Springs, LA.

This event, which has raised over $1.13 million since 2011, was founded by the late Connie Mack Boykin - a former patient of Dr. Sartor's - and continues to be inspired by his memory.

When an unexpected diagnosis of prostate cancer changed his life, Connie Mack not only resolved to fight his disease, but he also wanted to raise awareness among as many men as possible to be proactive when it comes to their health and that early detection of prostate cancer is key. He, along with his brother, Michael, and lifelong friends, Randy Hays and Cyril Lejeune, thought the best way to do this was to wrap the message around an activity that men enjoy - sporting clays - and the One Man Shoot was born.

"Connie Mack wanted folks to know that one man can make a difference in the fight against prostate cancer," said Michael Boykin. "His courage inspired everyone involved in the Shoot, and through his inspiration we have become passionate about supporting the search for a cure."

The competitive sporting clays tournament will include a 100-target course. Some will suit the novice shooter and others will challenge the more experienced professional. Prizes will be awarded to the top three teams in each of three classes: Expert, Hunter and Novice. There will also be trophies for the Top Male Shooter, Top Female Shooter, and for the top two Youth Shooters (under 18 years of age). The event will also feature food and refreshments, live entertainment, live and silent auctions, raffles, a wine pull and more.

In keeping with Connie Mack's mission, free PSA (prostate specific antigen) blood testing will also be available onsite to men over 40. Samples will be collected by volunteer nurses and tested at Tulane. Results will be sent via certified mail, along with additional information on interpretation and follow-up options. There will also be a special prize drawing at the event for those who participate.

"Funds raised through the One Man Shoot are vitally important to advancing the research that could bring us closer to a cure," said Oliver Sartor, MD, head of Tulane's Prostate Cancer Research Program. "This event has also shined a spotlight on a disease that attacks one in seven of our men, vigorously raising awareness and promoting early detection. I am continuously amazed by the tenacity, spirit and drive of the Planning Committee members, the sponsors, in-kind donors, volunteers and participants. They are all a testament to what can be accomplished when good people unite around something that deeply inspires them. In this case, it's someONE - Connie Mack Boykin. It's clear his mission continues - stronger than ever - through the hard work and dedication of everyone involved in the Shoot, and I am deeply, deeply thankful."

For more information on the One Man Shoot, visit www.onemanshoot.com .

Featuring

Oliver Sartor, MD

Raju Thomas, MD, FACS, FRCS, MHA

Emmanuel Antonarakis, MD

 

 

Topics to include:

Intended for:

For more information, or to register, please visit https://medicine.tulane.edu/prostate-cancer-symposium-2019.

This activity has been approved for AMA PRA Category 1 Credit ^TM

Tulane offers free prostate screenings - a PSA blood test - on the second Tuesday of each month at Tulane Comprehensive Cancer Clinic, 150 S. Liberty St., New Orleans. To make an appointment, call 504-988-6300 or 1-800-588-5800.