Surgeons in this section provide the most up-to-date care for breast and endocrine system disease, melanoma and sarcoma, and other cancers at the Alvin J. Siteman Cancer Center, the only Comprehensive Cancer Center in Missouri. Faculty consists of nationally recognized leaders in research seeking to advance treatment and constantly improve the quality of care. With one of the largest endocrine surgery practices in the country, surgeons also offer expertise in thyroid cancer, adrenal tumors and hyperparathyroidism. This section offers clinical trials that evaluate new therapies, supports clinical and research opportunities for general surgery residents and offers a breast disease fellowship.
Our Year In Numbers
2,080
operating room cases
16,504
visits
10
faculty
188
office procedures
49
clinical research studies
$3,646,853
research funding
Section of Surgical Oncology | 2022 Annual Report
Mapping Pancreatic Cancer Development
A detailed analysis by Washington University researchers has uncovered a breakthrough in the understanding of pancreatic cancer development. A recent study, published in Nature Genetics, revealed two key transition points in cells–from normal to precancerous and precancerous to cancerous–and uncovered indications of how tumors adapt to survive chemotherapy and become resistant to treatment over time. The study is part of the Human Tumor Atlas Network, funded by the National Cancer Institute’s Cancer Moonshot program, all part of the National Institutes of Health (NIH).
Addressing Disparities in Our Communities
Comprehensive breast cancer treatment requires a collaborative, multidisciplinary approach. Washington University physicians work together across several disciplines to provide comprehensive quality care for their patients. The breast cancer surgery program at Siteman Cancer Center is a national leader in breast cancer research and treatment, offering individualized care plans to provide the best possible care to each patient. When a patient is diagnosed, they have the opportunity to develop a treatment plan in partnership with a team of physicians, including a cancer surgeon, a plastic and reconstructive surgeon if they desire reconstruction, a medical oncologist, and a radiation oncologist.
Highlights
CLINICAL
For patients with rare endocrine disorders, having an experienced surgeon is critical to ensuring a safe, effective, and positive treatment outcome. Washington University endocrine surgeons operate at a major regional referral center for these complex conditions. Endocrine surgeon T.K. Pandian, MD, MPH, is a leading figure in the Section of Surgical Oncology’s clinical programs, where he works with other experienced endocrine surgeons to amplify the reach of their specialized surgical techniques and expertise. “The history of endocrine surgery is engrained in our legacy at Washington University,” says Pandian. “We have comprehensive experience in our very focused surgical niche. We are going to do whatever is takes for the needs of our patients.”
RESEARCH
Washington University endocrine surgeon Taylor Brown, MD, MHS, was awarded the American Association of Endocrine Surgeons Foundation’s Paul LoGerfo Research Award for further investigation into understanding and developing new therapies for aggressive thyroid cancer. Brown’s project will investigate how DNA repair pathways can be targeted in thyroid cancer to reveal new therapeutic opportunities for patients. This work can also augment current thyroid cancer treatments to potentially make them more effective and durable. The support from the award helps Brown continue researching anaplastic thyroid carcinoma, the deadliest form of thyroid cancer, and work to determine new therapeutic pathways for treating this rare and extremely aggressive disease.
EDUCATION
Washington University was recently awarded an R38 NIH grant to fund the Stimulating Access to Research in Residency (StARR) program, which will help recruit and retain post-doctoral health professionals and provide them with research opportunities early in their career. This program seeks to address the growing need for clinician-researchers in the medical field. “By identifying, recruiting, training, retaining and advancing MD research during residency years, we can encourage new projects that cross department and program lines and may be innovative and impactful,” says Section Chief of Surgical Oncology Ryan Fields, MD, who is principal investigator of the StARR program.
Mapping Pancreatic Cancer Development
A detailed analysis by Washington University researchers has uncovered a breakthrough in the understanding of pancreatic cancer development. A recent study, published in Nature Genetics, revealed two key transition points in cells–from normal to precancerous and precancerous to cancerous–and uncovered indications of how tumors adapt to survive chemotherapy and become resistant to treatment over time. The study is part of the Human Tumor Atlas Network, funded by the National Cancer Institute’s Cancer Moonshot program, all part of the National Institutes of Health (NIH).
Pancreatic cancer is notorious for becoming chemo-resistant. For this reason and others, the five-year survival rate is under ten percent, making this cancer particularly deadly and difficult to manage. The researchers in this study conducted a deep analysis of the genetics and protein manufacturing of 83 pancreatic tumor samples donated by 31 patients who participated in the study. They noted how the tumors differed across the volume of the tumor and at various times as the patients underwent treatment. Understanding the ways pancreas cells change and cancer cells adapt opens up possibilities for novel treatment methods and new research strategies.
“We have a lot of snapshots of these tumors, but what we really need is a movie,” said co-senior author Ryan Fields, MD, the Kim and Tim Eberlein Distinguished Professor. “It’s very hard to study these tumors in patients across the spectrum of treatment. The point of the Human Tumor Atlas Network is to document the tumors across space and time so we have more of a continuous movie rather than distinct snapshots.”
As part of an ongoing phase 1 immunotherapy clinical trial at Siteman Cancer Center—based at Barnes-Jewish Hospital and Washington University School of Medicine—the researchers are also conducting the same detailed analyses performed in the current study to see how tumors from patients respond to two investigational drugs that prime the immune system to attack the cancer.
Future studies will look into how tumors, once cancerous, shift into metastatic disease and spread to other parts of the body. Li Ding, PhD, a professor of genetics, and colleagues Fields, and professor of medicine David G. DeNardo, PhD, now shift their focus to preclinical animal models to determine which are most promising to investigate in future human clinical trials.
Addressing Disparities in Our Communities
Comprehensive breast cancer treatment requires a collaborative, multidisciplinary approach. Washington University physicians work together across several disciplines to provide comprehensive quality care for their patients. The breast cancer surgery program at Siteman Cancer Center is a national leader in breast cancer research and treatment, offering individualized care plans to provide the best possible care to each patient. When a patient is diagnosed, they have the opportunity to develop a treatment plan in partnership with a team of physicians, including a cancer surgeon, a plastic and reconstructive surgeon if they desire reconstruction, a medical oncologist, and a radiation oncologist.
Breast cancer specialists at Christian Hospital focus not only on providing the highest-quality cancer care, but also on expanding access to that care where patients need it the most. Washington University investigators, public health experts and surgeon-scientists join their expertise to address the health disparities in the north St. Louis County area, a community afflicted by the presentation of late-stage breast cancer in underserved populations. In collaboration with public health researchers and a multitude of multidisciplinary experts, the breast cancer program seeks to investigate and remedy the issues of health disparities within the St. Louis community.
Katherine Glover-Collins, MD, PhD, an assistant professor of surgery, is dedicated to delivering breast cancer care to those at greatest risk of late-stage presentation. She works diligently to eliminate these local health disparities by promoting mammography screening and providing comprehensive care to the community.
“We are addressing these disparities in the north county area on two fronts,” says Glover-Collins. “We are engaging the community in educational programs and partnering with local organizations to reach more people. By building a Siteman Cancer Center facility in north St. Louis, we can bring the access that is sorely needed.”
Through conducting community outreach efforts, organizing screening events and providing funding for underinsured patients, the breast cancer surgery program at Siteman Cancer Center and Christian Hospital has made great strides in developing trust and increasing health equity within the north St. Louis community. The program has seen significant growth in clinical volume over recent years, allowing for much-needed access to top-of-the-line cancer care. Washington University researchers continue to conduct specialized research to further the understanding of cancers among understudied and disproportionately affected populations.
The dedicated team of surgeons and researchers at Siteman Cancer Center and Christian Hospital, in collaboration with the community they serve, have taken vital steps toward serving more patients, detecting cancers sooner and providing care to the patients who need it most.