Cancer Currents for November 2011

News and Notes from the Director
Photo: Mark Israel, Director of Norris Cotton Cancer Center

Greetings -

Last week when I introduced the 2nd Annual C. Everett Koop Distinguished Lecture and Dr. Koop, I said, "As the U.S. Surgeon General, Dr. Koop awakened a nation to the dangers of addiction inherent in tobacco use. Through his stunning leadership and bold ideas we were convinced that what many considered a social habit was in fact an addictive behavior with dreadful health consequences. From his earlier and groundbreaking work as a pediatric surgeon to his broad impact as Surgeon General, Dr. Koop has advanced the standard of care in ways that have touched lives here and worldwide." In fact, Dr. Koop is a hero in public health whose innovations and policy recommendations saved literally millions of lives.

Our speaker was Kenneth Warner, MD, who delivered an informative, hard-hitting talk. He asked some tough questions, too: for example, how should we define success? What tools will get us across the finish line? He pointed out that while tobacco-cessation legislation and media efforts have reduced the adult smoking rate in the U.S. down to about 20%, the remaining smokers largely belong to the lower socio-economic classes, and the anti-smoking tools and programs that have been effective for well-educated people aren't working with current smokers. Moreover, about 30% of smokers say they're not interested in quitting—and that figure may actually be higher. Finally, in a given year, just 2.6% of those who try to quit smoking are successful. That's a dismal rate. Clearly, the challenge before us as a society is to develop new anti-tobacco techniques to move the remaining smoking population toward permanent cessation. That won't be easy.

At our Cancer Center, we have a tremendous breadth of research and practice committed to cancer control and treatment. From Jim Sargent, MD, whose internationally renowned work on the influence of smoking in movies on teens' behavior was cited by Warner for its excellence, to Bill Black, MD's upcoming economic analysis of the potential for implementing spiral CT scans for screening smokers for lung cancer, to Telisa Stewart, MPH, DrPH's work with tobacco prevention education in work places, and many others, we have a tobacco cessation impact that is local, regional, national, and international. Given that lung cancer is the biggest cause of cancer mortality, our work is a high priority. Answers for the future are being discovered right here.

I am enormously proud of the cancer control work we do here. Thank you for your extraordinary efforts.

Mark Israel, Director

Tiny Steps, Big Results in Quality in Neuro Oncology

Photo: Camilo Fadul, MD

By implementing and studying small tests of changes, the Neuro Oncology Program's quality improvement team increased fulfillment of its 10 quality indicators from 66% to 91% from 2010 into 2011. Tiny steps brought significant results. To ensure that Neuro-Onc is notified of all incoming patients, brain tumor codes were added to scheduling sheets to trigger emails to the neuro team notifying them of a diagnosis of a brain mass. To improve compliance with social worker visits and follow-up appointments, nursing developed checklists for discharge and patient education. By involving patients and families in the process, the team learned that the primary concern of discharged patients—constipation—had to be added to the discharge packet.

The group continues to work towards improving performance by developing airtight processes to ensure that every patient, every time, receives care proven most effective by stringent clinical research. As they move forward with defining patient- and family-centered care, the quality improvement team plans next to work with patients and families to identify measurable indicators for patient-centered care.

Photo: Women celebrating with their hands in the air
$6.1M Grant for PROSPR Program

Congratulations to the Cancer Center's Anna Tosteson, ScD, and Tracy Onega, PhD, and their colleague Jennifer Haas, MD, at Brigham and Women's Hospital in Boston on a new five-year $6.1 million NCI grant supporting a PROSPR (Population-based Research Optimizing Screening through Personalized Regimens) Breast Cancer Screening Center.

The PROSPR Center is one of just three centers dedicated to breast cancer screening research in the United States funded by NCI. It will develop and evaluate systems-based approaches using the latest in health-information technology to improve the quality of care for women undergoing breast cancer screening. Working in partnership with health care providers in the Dartmouth-Hitchcock Regional Primary Care Center in New Hampshire and the Brigham & Women's Primary Care Practice-Based Research Network in Massachusetts, researchers will develop and test new informational tools designed to help each individual woman understand how she may benefit from breast cancer screening. The Center will also develop tracking systems that are integrated with a patient's electronic health record to assist primary care providers in improving breast cancer screening outcomes for women who are cared for in their practices.

The Center is an outgrowth of years of experience and insights obtained through the New Hampshire Mammography Network (NHMN). The Network's continuing collection of data helps gauge the impact of mammography on cancer detection, and the data gathered by the registry also helps with the evaluation of new mammography technologies. Since the late 1990s, NHMN has collected data on almost a million mammograms in New Hampshire.

Welcome, John Peterson, MD

Hematologist and oncologist John Peterson, MD, a new clinician at the Cancer Center, will be seeing patients at our New Hampshire regional affiliates in Plymouth (Speare Memorial Hospital) and Littleton (Littleton Regional Hospital), and will also be at our satellite location in St. Johnsbury, VT, one day a week. You'll see him in Lebanon, too. Welcome, John!

More Welcomes

The Cancer Center was joined by a wealth of new talent recently:

  • Jennifer Snide, MS, is the Quality Measurement Analyst for NCCC. She will develop quality and safety metrics to improve performance.
  • Kate Turgeon is the Quality Program Coordinator for NCCC. She will provide project management support for quality initiatives.
  • Paula Therrien is the new Conference and Events Coordinator. She helps organize Grand Rounds, and will be working with Linda Kennedy on events such as the Board of Advisors gatherings and our CME day planned for next May.
Photo: Ryan Dougher (left) and William Daugherty (right)
Successful Migration

The DMS computing group, with substantial help from our two ace IT guys, William Daugherty and Ryan Dougher, recently completed its 1,000th successful account migration, taking old accounts and moving them into the new Blitz system. This tremendous effort was not without a bump here and there, of course, but William's and Ryan's courteous efficiency really saved the day (and the data). Thanks, guys!

Dartmouth Scholars

Beginning in early October, a group of MD-PhD student candidates have been gathering every Monday afternoon to listen to Cancer Center researchers and clinicians talk about their work and its impact on our community and society, and the expansion of cancer knowledge. The aim is to inspire these bright students to pursue careers in both the clinical and research realms—to inspire the next generation of bench-to-bedside cancer experts, in other words.

To date, the students have heard fascinating presentations from Marc Ernstoff, MD; Yolanda Sanchez, PhD; and Samir Soneji, PhD. This tremendous program seeds the imaginations of the people who may very well one day be the ones who find the keys to curing cancer once and for all.

Photo: Mary Jo Turk, PhD, in her office
Our New ACS Research Scholar

Speaking of scholars, congratulations to Mary Jo Turk, PhD, on winning a four-year Research Scholar grant from the American Cancer Society. This significant grant will support Mary Jo's fascinating work studying how the immune system responds to progressive, poorly immunogenic cancers.

A Great Send-Off for a Great Researcher
Photo: Allen Dietrich, MD (left), and Jim Sargent, MD (right)

On October 3, the Cancer Center celebrated Allen Dietrich, MD, on the occasion of his retirement from the role of Associate Director for Population Science. Within NCCC and nationally, Allen's tremendous intellect, critical analysis skills, and innovative vision as an investigator in many different areas of cancer control have combined to make his career contributions to cancer research in particular and medicine more generally both broad-reaching and important.

More recently, in his leadership role at NCCC, he has shaped work done here and had an immense influence on what we have become through focused recruitment, outstanding mentorship, and exemplary leadership.

The luncheon event was highlighted by remarks from Mark Israel, MD; Jim Sargent, MD; Ethan Dmitrovsky, MD; and even Patricia Carney, PhD, Dr. Dietrich's long-time former assistant who flew all the way from the University of Washington in Seattle to join in the festivities. It was a great day for a truly great leader.

Upcoming Event: Manchester Monarchs vs. Scranton Penguins
Photo: A man with a mullet hairstyle, moustache, and reflective sunglasses

On Saturday, November 19, at 7 p.m., the Manchester Monarchs will play the Scranton Penguins in the Mullets in Movember game, "where hair and hockey come together for cancer awareness."

  • Location - Verizon Wireless Arena, Manchester, NH
  • Ticket prices - lower level, $19.50; upper level, $13.75; club level, $30.00

Go to or call (603) 626-7825, ext. 6115, to buy tickets.