Medical center has lung cancer in crosshairs

For decades, the medical field has been searching tirelessly for answers to the callously fatal efficiency of lung cancer, a disease that kills more than 150,000 people in the U.S. every year, making it the nation’s deadliest cancer.

Despite the considerable efforts put forth by dedicated lung cancer specialists, progress in the fight against the disease has been measured in frustratingly tiny increments — until now.

Spearheaded by a research team at the University of Colorado Cancer Center, miraculous new results are being discovered, giving patients a previously absent asset in their ordeal: hope.

A multidisciplinary institution that features radiation treatment, surgical procedures and extensive scientific research, the center has made some of the biggest strides in the clinical testing of lung cancer drug treatments.

Unlike in previous practices, when doctors and researchers sought a single pill or protocol of drugs to be a panacea for all lung cancer patients, the University of Colorado team has focused on identifying specific genetic forms of the disease that can be more efficiently targeted.

The first series of breakthroughs began three years ago following the licensing of Tarceva, a drug used to treat lung cancer patients. The pill had a marginal effect in most cases, but it’s proved to be incredibly effective with a specific group of people, whom researchers realized had a specific gene mutation.

Armed with that knowledge, specialists at the Cancer Center began performing a battery of molecular tests on lung cancer patients, eager to see which clinical trial could work effectively with specific forms of the disease.

Following that work, center researchers made another advancement, this time with patients who had a gene rearrangement that’s found in about 3 to 4 percent of all lung cancer cases. Called the ALK inhibitor (named after the gene rearrangement it suppresses), the drug has recorded previously unheard of results, in some cases completely eliminating advanced stages of lung cancer within three months.

“I think we can go two ways with this type of research,” said Dr. David Ross Camidge, who’s leading the center’s clinical efforts. “We can identify a group of people that have one dominant molecular identity and find the right drug for that, which is like finding the right key to the right lock to turn the cancer off. Or, we might need a combination of drugs to combat the various forms of resistance that lung cancer cells are sure to possess.”

Camidge heads the successful clinical research results, but he emphasizes that the strength of the Cancer Center research is its excellence in all fields of oncology, including advanced chemotherapy practices and state-of-the-art surgical work. World-class leaders from each field frequently meet with each other to discuss manners of combating lung cancer using a holistic approach.

The results at the center are telling. Patients diagnosed with advanced forms of cancers usually have a 25 percent chance of survival past one year, but at the center that rate is 56 percent.

“There is a relatively short list of world-class lung centers, and I don’t think any center can say, ‘Oh, we’re the best,’” Camidge said. “But we’re up there, and I think that’s because we have a perfect storm of things going on.”

Doctor leads disease hunt with a down-to-earth style

He holds degrees from two of the most prestigious universities in the world, has an encyclopedic knowledge of the most esoteric and obscure medical data, helms some of the nation’s most exciting research on lung cancer, and has an English accent that only adds a further sense of refinement to his impeccable résumé.

With those notable achievements, Dr. David Ross Camidge could be the epitome of the haughty, detached academic, but the chief medical oncologist at the University of Colorado’s lung cancer research center in Aurora, Colo., matches his boundless intelligence with an equal match of compassion, approachability and good-natured humor.

“There is a great balance with Dr. Camidge between a very sharp mind and the soothing bedside manner,” said Ellen Pulhamus, a patient of Camidge’s for the past year. “We’ve really bonded.”

The 43-year-old London native describes himself as the “quarterback of sorts,” leading efforts to coordinate new studies into radiation treatment, surgical practices and clinical trials at the center, an institution that has helped pioneer lung cancer research since it was founded in 1986.

And despite attending both Oxford University and Cambridge University, and possessing institutional knowledge few in the world can match, Camidge has no problem sitting down to a lunch of deli sandwiches with nursing assistants in the center’s team room.

“It doesn’t work like the movies, where there is just one person toiling away to find the cure,” Camidge said. “It takes a lot of very smart, very dedicated people who are really invested in trying to find the right treatments for the right people.”….

Although streaks of gray hair are evidence of a medical career that has stretched nearly 20 years, Camidge’s hands still flutter while discussing his craft, exhibiting the vitality more commonly associated with a wide-eyed rookie doc. And while he can cite by memory the names of anachronistic-sounding gene mutations, he also makes every effort to relate the details of his work in the easiest, most digestible ways possible.

“With lung cancer, it’s difficult to talk to patients about the future,” said Tiffany Caudill, a patient coordinator at the center. “But Dr. Camidge has a way of really instilling the right kind of hope in his patients.”

After harboring brief aspirations of being an Olympic oarsman, Camidge — who split time growing up in Edinburgh, Scotland and London — focused his attention on a career in medicine while attending Oxford. After a series of residencies in Britain, he was recruited by the University of Colorado’s Division of Medical Oncology and joined the team in 2005.

“I came to the University of Colorado for two reasons: It was strong on drug development and very strong on lung cancer,” Camidge said.

Originally, he was planning a two-year stint at the center, but in 2006, he met his future wife, Windy, and opted to stay in the States indefinitely. The couple married in 2008, and in November they welcomed their first child, Sophie Grace.

Whether it’s with his craft or his family, Camidge has a way of taking his boundless enthusiasm and energy and applying it to what he loves. He’s also getting fresh inspiration from the city he lives in — Denver — a place far from Britain, both historically and philosophically.

“It’s funny because I always liked the old cities such as Oxford and Cambridge,” Camidge said. “While Denver has some history, it’s not that old. And one of the refreshing things about that is you don’t have people saying, ‘We don’t do it like that here.’ So you can actually do new things, and you develop an appreciation for being able to make changes in the right direction.”

Dr. David Ross Camidge

Age: 43
Family: Wife Windy, daughter Sophie Grace
Favorite movie: “Life is Beautiful” — because “the title says it all”
Favorite book: “Nine Stories” by J.D. Salinger
Favorite television show: “Doctor Who”
Hidden talent that someone would be surprised to know: In the late 1990s and early 2000s, published a series of short stories under a pseudonym in several literary magazines
Living person he most admires: Nelson Mandela — “To step into a major position of power after so many years in prison and then seek out unity rather than revenge, to put the greater good ahead of yourself so completely, goes beyond any superlatives I can think of.”
Biggest fear: Being pointless
Greatest achievement: “It might be my 3-month-old daughter, Sophie Grace.”

Slow, but steady, progress

The numbers are staggering.

Each year, 200,000 people are diagnosed with lung cancer in America. That’s more than breast, bowel, prostate and pancreas cancers combined.

In two-thirds of the lung cancer cases, the disease has reached an advanced stage, a rate significantly higher than the aforementioned cancers.

By the time lung cancer patients reach a Stage 4 diagnosis — the most advanced phase — they have only a 25 percent chance to live longer than a year.

Even with that shocking data accompanying the disease, lung cancer remains relatively unknown. Advocacy efforts for the disease are muted when compared to other cancers, and there’s little effort to increase education about the disease.

Much of this has to do with the stigma related to cigarette smoking, which is a leading cause of lung cancer. The skeptical approach often directed at lung cancer patients is hurtful and misguided, according to Dr. David Ross Camidge, a lung cancer specialist at the University of Colorado Cancer Center.

“It is difficult for people who have never smoked having others wag their finger at them unjustly,” Camidge said. “But I get equally annoyed when people say, ‘Well, you’re a smoker, so it’s your fault that you have lung cancer.’ It doesn’t matter how the cancer arose — you have to deal with the condition at hand, and people who smoke are no less deserving of our respect and treatment.”

Lung cancer is dangerous for a number of reasons, primarily because the cells originate in a thin lining between a person’s airway and bloodstream, according to Dr. Paul Bunn, a leading oncologist at the Cancer Center. Because the disease has such direct access to a person’s blood, it spreads quickly throughout the body. Also, early detection methods to forecast the illness do not exist.

Despite the uphill odds of defeating the disease, progress is being made in the fight against lung cancer.

Thoracic surgeons — doctors who specialize in removing cancerous lung tissues — are becoming much more exact in their efforts, with the latest breakthroughs allowing them to remove small, precise pieces of the vital organs, affording patients a better quality of life.

Chemotherapy methods also are becoming more accurate, with the radiation treatment able to blast out small clusters of cancer cells in the lungs. And experimental clinical trials that focus on specific genetic mutations of lung cancer have returned outstanding results, with some cases reporting a complete — albeit temporary — elimination of the disease.

“If you want to have a career of longevity in oncology, you probably have to be oriented in the perspective of having a glass half-full,” said Dr. Brian Kavanagh, a chemotherapy specialist at the university center. “We’re certainly woefully short of perfection, but if you look at the bright side, there have been these bit-by-bit improvements all around that lend hope for more progress in the future.”

Experimental cancer drug gives woman second chance

It was during a trip to Scotland in 2009 — a vacation designed to offer her a brief respite from reality — that Ellen Pulhamus first succumbed to doubt and fear.

Diagnosed with lung cancer in April 2008, prior to the journey, Pulhamus began bleeding internally while on the trip — a development in the disease that usually bears grim consequences.

“It was at that point where I asked myself, ‘Am I ready to die?’” she said, tearing up while recalling the painful memory. “I was scared to death.”

However, just hours after that moment of utter despair, Pulhamus received a call with news that would restore her hope and give her a new reason to believe. On the phone was Pulhamus’ son, informing her that she was eligible for a clinical trial study being conducted at the University of Colorado Cancer Center.

“When my son called me and said I was a match for the study, I just broke down and wept,” Pulhamus said. “Because that was the first time I had some hope in quite some while.”

Two weeks earlier, after being upgraded to Stage 4 lung cancer — an advanced phase of the disease that has a 75 percent fatality rate within the first year — Pulhamus agreed to be tested as part of the study. It focused on patients with a specific type of lung cancer — called the ALK mutation — found in about 3 to 4 percent of all cases. Through a series of advanced molecular testing, doctors at the center discovered that lung cancer patients with the ALK mutation could be treated effectively with a pill called the ALK inhibitor.

Less than six weeks after being on the pill in 2009, the cancer cells in Pulhamus’ body were reduced by 62 percent. Six weeks later, the cancer had shrunk 50 percent more. And during her latest checkup, the disease had become dormant to the point of being undetectable. Less than 100 people in the world are taking the ALK inhibitor, which is available at seven institutions internationally. Pulhamus, a lifelong Denver native, grew up just miles from one of those centers.

“It is incredibly humbling. When I was first diagnosed, I never asked, ‘Why me?’” Pulhamus said. “But I did finally say, ‘Way me’ when we found this clinical trial because I feel so fortunate that I’m eligible, and this is right here in my backyard.”

Dr. David Ross Camidge, who is leading the clinical trial of the ALK inhibitor, acknowledged that the pill is not a miracle cure — lung cancer is an incredibly resilient disease that eventually adapts to evade treatments — but it allows patients to live with the affliction for an extended period of time, much like someone with diabetes.

“The majority of the people diagnosed with Stage 4 lung cancer die within a year,” Camidge said. “But right now, we have people potentially living with their diagnosis for a decade or more, and that’s a total sea change.”

With her new prognosis, Pulhamus — a soft-spoken, thoughtful woman with warm, motherly features — can now turn her attention to resuming a life she all but abandoned. Last summer, Pulhamus, her three children and five grandchildren gathered to celebrate her 60th birthday, a landmark once deemed unfathomable. On June 21, she will take part in an even bigger celebration: her second marriage, to fiance Ben Smith.

“Now, because I have a future, I have a second chance of life and a second chance at love,” she said. “There are so many hills and valleys with this disease, but right now, I feel like I’m on top.”

University of Colorado Cancer Center

Location: Aurora, Colo.
Founded: 1986
Budget: $101.4 million (projects funded by National Institute of Health)
Stimulus funding: $27.4 million
Square footage: 108,000
Staff: 443
Institutions involved in center: Nine (three universities and six medical institutions)
Patient visits in 2001: 51,094
Patient visits in 2009: 101,597

Source: UCCC