Dear Medical College of Georgia Friends,

MCG takes a leadership role in avoiding a collision between the nation’s top killers

There is common ground between our state and nation’s two biggest killers: cardiovascular disease and cancer. Obesity, ongoing inflammation, smoking and increasing age are just some of the common risks for these too common killers. That can mean if you have cardiovascular disease, you likely are at increased risk for some cancers and vice versa. The increased number of individuals who are surviving their cancer, because of the great work of physicians and scientists at places like our Georgia Cancer Center, also are at increased risk of cardiovascular disease because some cancer treatment can inadvertently impact the heart, including some of the old mainstays like chemotherapy and radiation therapy as well as newer approaches like CAR T treatment that better arm our immune system to attack cancer but can have unintended impact on the heart. These bidirectional relationships, particularly the one that puts cancer patients at increased risk of cardiovascular problems, are the focus of the not brand new but still emerging field of cardio-oncology. It’s also the focus of an exciting new leadership role for our medical school to better understand, prevent when possible, and treat those most at risk, with a particular emphasis on Black Americans, who are at even higher risk for these conditions and treatment complications.

MCG is one of four centers in the American Heart Association’s new Strategically Focused Research Network

I am happy to share that we are among four centers in the nation, comprising the American Heart Association’s newest $11 million Strategically Focused Research Network on disparities in cardio-oncology. The other centers in this important initiative are Boston University School of Medicine, the Medical College of Wisconsin and the University of Pennsylvania. Much closer to home, our essential colleagues also include our neighbors at Paine College. At home, the stellar team that will be leading the many fronts include Dr. Neal Weintraub, chief of cardiology and co-director of our Vascular Biology Center, who is the enthusiastic director of the new center. “Patients are surviving because our therapies are so much better in many different ways, so it becomes even more important now to prevent the cardiovascular disease and to be able to recognize it and treat it,” Dr. Weintraub told us. “Once we understand the causes, and especially the disparities, that might lead to individualized approaches. Personalized medicine is kind of a buzzword but in essence that is what we are talking about,” says the physician-scientist, who after seeing patients with cardiovascular disease following radiation therapy years ago became an early advocate for working to make a difference for these individuals. Dr. Ryan Harris, clinical exercise and vascular physiologist at the Georgia Prevention Institute, is PI on the clinical science project that already is looking at newly diagnosed patients with breast or prostate cancer in collaboration with his colleagues Dr. Zach Klaassen, urologic oncologist, and Dr. Priyanka Raval, hematologist-oncologist specializing in breast cancer. They are doing a lot of complex testing and follow-up to look at the cardiovascular impact of their cancer treatment and the stress of a diagnosis of cancer. Dr. Avirup Guha, who completed his medicine residency with us and is now a cardio-oncologist at University Hospitals Seidman Cancer Center in Cleveland and Case Western Reserve University School of Medicine, and Dr. Xiaoling Wang, genetic epidemiologist at the GPI, are co-PIs on the population science project, which is approaching this issue from a different angle: looking at large national databases like the NHANES-Medicare merged cohort to explore how obesity and socioeconomic disparities along with loss of a well-functioning Duffy antigen receptor for chemokines, or DARC, — which can dampen inflammation — predisposes Black people with cardiovascular disease to cancer. DARC was first recognized as a portal for malaria parasites to gain access to red blood cells, and mutations in DARC can actually help protect from malaria. The majority of Blacks have this mutation but evidence also indicates that people and mice deficient in DARC have increased problems with obesity related disease, including cardiovascular disease and cancer.

Dr. Neal Weintraub is director of the new center, Paine College is our partner

Just like our core here at MCG, a core of this center is educating and inspiring the next generation of physicians and scientists who will take up this fight for patients. That in particular is where our partners at Paine College come in with Dr. Anna-Gay Nelson, chemist and faculty chemistry advisor at Paine, taking a leadership role. She is working with our Dr. David Stepp, vascular biologist who is already helping lead another training program for graduate students in different aspects of cardiometabolic disease related to minority health, to now lead the undergraduate and postdoc training programs for the new center, respectively. Our partnership with Paine and Dr. Nelson will enable STEM undergrads from Paine to come learn with us and, I am certain, we too will learn from them. This new center and partnership will enable STEM students at Paine to be immersed in the clinical care and science of medical problems that disproportionately affect their families and friends, and to have a leadership role in putting the brakes on those disparities. Please let me share how proud I am of everyone already involved with this center and how I share with Dr. Weintraub his hope that the entire community of Augusta and our state will take its mission up along with us. Please let me also say that I am very proud of Dr. Weintraub for being an individual who sees a significant problem and does something about it. As with so many of you, that along with the smarts it takes to move things forward, is what enables our medical school, which is relatively small in faculty numbers compared to our peers, to punch well beyond our weight. Thank you all. Plenty more coming on this.

New technology enables precision lung biopsies, improved treatment

Back at the Georgia Cancer Center, Dr. Shaheen Islam, chief of the Division of Pulmonary, Critical Care and Sleep Medicine, is taking better aim at lung cancer as well thanks to some cool new technology. We’ve all heard about the precision that robotics affords a huge range of surgical procedures. Robotics was first used in a human in the mid-1980s with a CT guided neurosurgical biopsy, and the FDA started approving different systems for different surgical procedures in the 1990s, but the first robotic system in bronchoscopy was approved in early 2018. The cancer center and our health system recently obtained the second robotic system approved for bronchoscopy, the Ion Endoluminal System. Dr. Islam tells us that the endlessly steady, directed reach of this system can make its way through our smallest airways and to lesions (areas of concern) far in the periphery of the lung, which as you can imagine are the hardest to reach. But studies indicate that’s where about 80% of these lesions are found and that is where Dr. Islam and his team wanted to precisely reach. “The trachea of the windpipe, that is like the trunk of the tree, and as you go further out, it’s like the branches of the tree, it gets smaller and smaller,” Dr. Islam told us. This precision reach makes good common sense and medical sense since it enables the most direct, least-invasive path to a lesion. He tells us the next generation of these devices will enable them to use heat or cold to kill a lesion when they get there, or even provide direct application of chemotherapy drugs. He also tells us that, despite decreasing smoking rates, lung biopsies are actually increasing here and elsewhere, sometimes as patients, who quit smoking years ago, still face some of its consequences. He hopes the current trend toward not smoking will whittle the problem in the next few decades but in the meantime, I am glad they are ensuring our patients get the best care possible. The most common cancers are breast, lung and bronchus cancer, followed by prostate and colon and rectum cancer, according to the National Cancer Institute.

Dr. Amado Alejandro Báez appointed physician leader for the FBI’s Atlanta Field Office

As we wrap up today, I wanted to also share that our Dr. Amado Alejandro Báez, vice chair of operational medicine in the Department of Emergency Medicine, is working to protect another important frontline. He has been selected physician leader for the medical oversight program for the FBI’s Atlanta Field Office. Not only is he doing medical training with these brave individuals, he is supporting them on tactical missions which also qualifies him as a brave individual. Many of you may know that our Department of Emergency Medicine has long, strong ties to supporting law enforcement at the local, state and national level and one of the many neat things about that is it shows significant respect going in both directions. Dr. Báez helped found Harvard University’s Operational Medicine Institute. There he helped garner the trust of groups like the Massachusetts State Police and Boston FBI and SWAT Teams, and performed simulations of high risk, mass casualty events which seem all too common in our world. He also helped Haiti and the Dominican Republic build two field hospitals that would treat 5,000 people affected by the 2010 Haiti earthquake. Good work Dr. Báez. We are glad you are now here helping take care of Georgia, Georgians and our FBI.

Please get vaccinated so we can put this pandemic behind us.