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20142015RUNNING TOTAL: 608,678RUNNING TOTAL: 752,000 “I’m grateful for the support that the 5K givesto critical cancer research that might not haveother funding sources.”Suresh RamalingamWINSHIP LUNG CANCER DOCTOR/RESEARCHERWINNER’S CIRCLE TEAM“The people out heretoday are not exercising.These people are outfor a cause.”Tom ReynoldsPEACH STATEFREIGHTLINER TEAM10Winship Magazine winshipcancer.emory.edu

CHASING DOWNGENETIC RISKSBy MiriamFalcoFamily is important to Pete and Pauline Giannakopoulos and their fourgrown daughters. Golfo, Patty, Anna, and Kathie have stayed close to their parentsin order to share family joys and sorrows. “We are the typical big fat Greek family,” saysGolfo, the second daughter. “Except we roast the lamb in the backyard, not the front yard.”What the family might also share, though, is a genetic mutation that puts some of them at riskfor a certain type of cancer.Their lives changed in November 2014, when Kathie, the only sister to move away from Atlanta (to North Carolina), was diagnosed with medullary thyroid cancer (MTC).Winship Magazine fall 201511

feature genetic risksThe Giannakopoulos family met withWinship genetic counselors to investigatetheir risk for medullary thyroid cancer.PETE WINKELJust a few months after having her thyroid removed, geneticpositive for a BRCA1 gene mutation that increased her risk fortesting revealed Kathie carries a mutation in the RET gene associ-breast and ovarian cancers may have led to the belief that heredi-ated with a diagnosis of multiple endocrine neoplasia Type 2Atary cancers are prevalent, but the reality is that only about five to(MEN2A), a hereditary condition that greatly increases the riskten percent of all cancers are believed to be linked to an inheritedfor getting medullary thyroid cancer. Kathie urged her siblings togenetic change. So far, about 50 hereditary cancer syndromes haveget tested, and “I even called [Winship Cancer Institute’s] Geneticbeen identified, according to the National Cancer Institute, thatCounseling center myself,” she says. Speaking with Christinecan increase the risk of breast, ovarian, thyroid, pancreatic, colon,Stanislaw, director of the program, Kathie provided informationand other cancers.for the first branch of her medical family tree.The sisters were all screened for symptoms of thyroid cancer,Individuals who come to Winship and meet with Stanislawand the two genetic counselors on her team learn about the risks,including neck nodules and high calcitonin hormone levels. Then,benefits, and limitations of genetic testing in each person’s specificin mid-August of this year, Golfo, Patty, Anna, and their parentssituation.arrived together as a family to meet with Stanislaw for their genet-“Genetics can potentially help determine the cancer risk levelic counseling session. Together they learned what genetic testingfor an individual,” Stanislaw explains, “but unfortunately it doesn’tentails and what it could reveal. The outcome was important notgive you the ‘when, where, how and if ’ answers. No genetic testonly to them, but also to 17 first cousins on their father’s side andcan say with 100 percent certainty if a person will develop cancer.”four first cousins on their mother’s side. Depending on the results,the cousins and their children might need to be tested too.Actress Angelina Jolie’s very public revelations about testing12Winship Magazine winshipcancer.emory.eduCounselors explain how a genetic mutation gets passed down,what testing is available for which cancers, possible prognoses, andtreatment options. “In an ideal world, we want to be able to test

someone with cancer first, to see if the cause is ofresults of the sisters’ recent screenings to fill ingenetic origin,” says Stanislaw. “Then a determi-the medical family tree. Patty reported that hernation can be made about whether other familyscreening did not reveal anything of concern.members might benefit from genetic testing.”Golfo’s screening led to a diagnosis of thyroidDNA dilemmayoungest sister, Anna, does not have cancer, butWinship GeneticCounseling ProgramThat’s why Josh Ream met with Stanislaw. He’snodules were found and her calcitonin hormoneWHAT YOU CAN LEARN:a 36-year-old cancer survivor who had under-level was elevated.cancer and a thyroidectomy in late August. Thegone colon cancer surgery just months earlier.Ream, a diabetic, was suffering from increasedfamily met the crite-gastrointestinal symptoms. Reading about aria for genetic test-35-year old former Dallas Cowboys player whoing. Even the parents,died of colon cancer prompted Ream to get awho are in their 80scolonoscopy, even though it’s not usually rec-and never had anyommended for men and women until age 50.thyroid problems,The colonoscopy found Ream’s cancer andGenetic testingStanislaw says thelooks for changes in genes thatcould increasethe risk fordisease. Thistype of testingusually involveswere tested to deter-collecting athe surgery successfully removed it, so he’s notmine which side ofmeeting with Stanislaw to determine his ownthe family may havecancer risk. “It’s truly not about me,” he says.the mutation andReam wants to know if his 18-month-old son isin turn how many other family members in thenetic testing to determineat increased risk.United States and in Greece should be tested.if they have an increasedAfter reviewing his personal and family his-Winship genetic counselors Christine Tallo, Christine Stanislaw, andFabienne Ehivet.Kathie’s mutation in the RET gene is calledsample of blood or saliva.Individuals can have ge-risk of cancer and couldtory, including the fact that his mother survivedp.G553C. It’s one of several known mutations inhave passed this risk on tocolon cancer at age 54 and breast cancer tenthe RET gene that causes a diagnosis of MEN2A.their family members.years later, Stanislaw thought it worthwhile toThis mutation is what the other sisters’ and par-investigate whether Ream has Lynch syndrome,ents’ DNA tests zeroed in on.known to greatly increase the chance of gettingThe sisters worried—about their children,cancers in the digestive tract. Stanislaw recom-not about themselves—because if they have themended testing Ream’s DNA for the five knownsame mutation, there’s a 50 percent chance theirgenetic mutations linked to Lynch syndrome.children have it too, increasing the risk of gettingThe tests showed he does not carry those muta-medullary thyroid cancer by at least 60 percent.tions and were negative for 27 other cancerA few weeks after their blood samples wentsusceptibility genes. This significantly decreasesout for analysis, the family received results thatbut does not eliminate the possibility of a he-revealed which side of the family carries the ge-reditary cancer risk in the family.netic mutation. They have requested that specificWinship’s geneticcounselors can help youdetermine if you meet thecriteria for testing andalso answer questions youmight have about family dynamics, the medicalmanagement of at-riskfamily members, confidentiality, insurability, andinformation remain private until they have noti-family planning.Narrowing the targetfied all family members who could be affected, aFor more information:During their meeting, Pete, Pauline, and theirbig job but one that the sisters feel more confi-winshipcancer.emory.edu/daughters provided more information and thedent tackling now, armed with knowledge. Wgenetic-counselingWinship Magazine fall 201513

feature monica’s storyATLANTA TV ICON REVEALS ANFByJudy Fortin Photos by Bryan MeltzFormer WSB-TV anchor Monica KaufmanPearson is used to delivering bad news to atelevision audience but receiving it is another story. Pearson was diagnosed withliver cancer in January 2015. Her Emoryinternist, Rio Dickens, suspected something was wrong following a routinephysical exam. It was Winship surgicaloncologist David Kooby who confirmedthe diagnosis. Pearson recalls saying tohim, “What do you mean it’s liver cancer?How did I get this? Where did itcome from?”14Winship Magazine winshipcancer.emory.edu

Monica Pearson spent 37 years as an anchor and reporter for WSB-TV. When she retired in 2012,she never intended to slow down. A liver cancer diagnosis changed that. Photos above courtesy of WSB-TV.SECOND TIME AROUNDThis wasn’t the first time that Pearson, now 68, faced a cancer diagnosis. Eighteen years ago, Winship surgeon Grant Carlson treatedher for ductal carcinoma in situ (DCIS) which is considered apre-invasive type of breast cancer. She recovered and jumpedback into her busy career as a journalist. Ironically, her researchskills proved to be too good when it came to her latest medical situation. “Everything that I read about liver cancerpretty much said I was going to die. Dr. Kooby answered allof my questions and told me that ‘you can’t believe everything you read on the Internet, here’s where you are.’”“In Monica’s case, she had a fairly unusual situation inthat she had a primary liver cancer and she did not have oneof the hallmarks that other liver patients have, which is cirrhosisor underlying liver disease,” explains Kooby. Risk factors for livercancer include heavy alcohol use, substantial morbid obesity andsmoking. Pearson didn’t fit any of those categories.David Kooby operated on Monica Pearson in January2015 to remove a cancerous tumor from her liver.“I don’t know why I got liver cancer, but I was in the rightplace at the right time with the right physicians to get mehealthy again. That’s why I come to Emory.”Winship Magazine fall 201515

feature monica’s storyJohn Pearson, Sr. was by hiswife’s side for every step ofher cancer journey.16Winship Magazine winshipcancer.emory.edu

INTO THE ORfor advice on how to deal with their own diagnoses. She takes theKooby says it is unlikely Pearson’s two cancer diagnoses aretime to reply to everyone and she shares similar advice. “I alwaysrelated. Because she was relatively healthy at the time of diagnosis,say let your attitude be one of gratitude, because you have this for ahe thought she could tolerate aggressive treatment. Kooby quicklyreason. Maybe it’s to make you slow down, maybe it’s to get you inconsulted with a multidisciplinary team of Winship gastrointes-touch with your faith. It makes you sit down and ask what’s reallytinal specialists and everyone agreed that the next step would beimportant and to examine where you are in your life. Breast cancersurgery. Kooby performed a right hepatectomy, removing close todid that for me, but having liver cancer did it in a bigger way.” W60 percent of Pearson’s liver. “Even though the tumor was large, itcame out nicely, and under the microscope it looked like a lot ofthe tumor cells were dead.” In other words, the tumor had “burnedout” and the cancerous cells had not spread to surrounding lymphnodes or other sites. Pearson was lucky.No one knows that more than her husband, John Pearson, Sr.:“My wife is the ultimate researcher and she truly interrogated him(Kooby) about the process. He was very calm and wasn’t sugarcoating anything.”The surgery took longer than expected because the tumor wasclose to a major blood supply and what Kooby calls the “commandcenter” of the liver that keeps the organ alive. “We put her througha very big operation, which she tolerated beautifully and the prognosis is quite good,” Kooby says.SIX-MONTH CHECK UPPearson returns to Winship every six months to meet with Koobyfor an MRI scan and to check her blood work. Her liver is regenerating and performing well, but Pearson admits recovery hasn’tLIVER CANCER IN THE U.S. – 2015STATISTICS35,660 new cases will be diagnosed in the U.S.25,510* men will be diagnosed* this represents 3% of all new cancer cases diagnosedamong men10,150 women will be diagnosed24,550 deaths in the U.S.660 deaths in GeorgiaFrom 2007 to 2011, the U.S. death rate for livercancer increased by 2.5% per year.been easy. “I was really tired after the surgery so I had to learn tostop doing so much and sleep. I’m really watching what I eat andRISK FACTORS for liver cancer are obesity,more importantly, I’m not having stress in my life.”diabetes, alcoholic liver disease, chronic infectionPearson retired in 2012 after 37 years on the anchor desk. Shenever intended to slow down, but facing cancer a second timewith hepatitis B virus (HBV) and/or hepatitis C virus(HCV), and tobacco smoking.around has changed her outlook. “I think what this cancer diagnosis did for me was it made me realize that I really am in the lastthird of my life and it made me want to do the things I love insteadof the things I like.”These days, she concentrates on spending time with her family and on her charity work. In March, she will serve as emcee ofthe annual Friends of Winship fashion show. Fans who have readabout her cancer journey contact her via email and social mediaCOMMON SYMPTOMS, which do not usuallyappear until the cancer is advanced, include abdominal pain and/or swelling, weight loss, weakness, loss of appetite, jaundice (a yellowish discoloration of the skin and eyes), and fever.Source: American Cancer SocietyWinship Magazine fall 201517

feature heroes at homeFrom Vietnam to Desert Stormto Afghanistan, Winshipphysicians, nurses, and otherstaff have honorably servedour country. We saluteour colleagues and thank themfor their commitment,courage, and compassion.H H H HOUR MILITARY HEROESP h ot o e s s ay byJa c k Ke a r s eTo see a full list of Winship veterans go to winshipcancer.emory.edu/magazine18Winship Magazine winshipcancer.emory.edu

H H H H H H H H H H H H H H HWinship’s radiation oncology department isfull of medical heroes, but three doctors standout for their service to our country. Arif Aliis a Major in the Georgia Air National Guardwith 14 years of service; Jonathan Beitler isa Colonel in the Connecticut National Guardwith 32 years of service; and Trevor Lim isa Lieutenant Colonel in the Air Force Reserveswith 17 years of service.GEORGIA AIR NATIONAL GUARDCONNECTICUT NATIONAL GUARDAIR FORCE RESERVES

feature heroes at homeH H H HThe word courage has special meaning for newlyretired military officers Michael Zwick (left) andCletus Arciero (right). Zwick, director of the EmoryIntegrated Genomics Core, served in the Navy for25 years and retired as a Commander and SurfaceWarfare Officer. Arciero, a Winship surgeon specializing in breast cancer and melanoma, served inthe Army for 25 years and retired as a Colonel andChief of General Surgery at the Eisenhower ArmyMedical Center at Fort Gordon, Georgia.NAVYARMY

NAVYMARINES CORPSARMYNAVY NURSE CORPSH H H HCommitment is second nature for Deatra Perkins,Lisa Anderson, and Andrew West. They’veserved oncology patients and their country foryears. Perkins, a Winship oncology nurse in theClifton campus infusion center, served in the Armyand then became a commissioned officer in theNavy Nurse Corps; Anderson, an oncology nurseat Emory Saint Joseph’s Hospital, retired from theNavy after 12 years; West, senior director for ACTSI(Atlanta Clinical & Translational Science Institute) isan active duty Gunnery Sergeant in the Marines.

feature heroes at homeARMYH H H HMilton Reaves earned a PurpleHeart while serving as an ArmySpecialist in Vietnam. He creditsWinship’s Wayne Harris withhelping him to win his latestbattle against prostate cancer.The two are pictured withHematology and OncologySection Chief Maria Ribeiro atthe Atlanta VA Medical Center,where Winship doctors seeabout 875 veterans every year.22Winship Magazine winshipcancer.emory.edu

feature breaking down barriersHelping and healing a communityBySy l v i a Wro b e lCharles Moore never expected to be apoverty, unemployment, lack of healthyback on the road to independence. Then,hero to the medically underserved. Hisfood, and transportation. Somebody has toin 2014, with more support from donors,specialty is complex head and neck surgerydo something, he said. So, after long clini-the HEALing Community Center movedinto its own 16,000-squarefoot building on Martin LutherKing, Jr. Drive in SouthwestAtlanta. With a small corestaff and dozens of physicianvolunteers from Emory, Morehouse School of Medicine,and Piedmont Hospital, HEALnow offers screenings, healtheducation, and a wide rangeof medical, dental, and mentalhealth services to more than6,000 Atlantans annually. Feesslide between no cost to 20.A partnership with Emory’sUrban Health Initiative (ofwhich Moore is co-director)provides transportation, community gardens, and otherneeded programs. Without thefor meningiomas, neuroblastomas, andcal days at Grady and Emory, he packedcenter, many patients would have ended upother brain tumors at the front of thetongue depressors, gloves, and disposablein emergency rooms. Others don’t knowskull and reconstructive surgery to repairdental mirrors in the back of his car andwhere they would have gone.trauma to facial bones and tissue. But as abegan offering free head and neck screen-Moore teaches his own students what heyoung Emory medical professor and sur-ings. For many who lined up, he was theirdidn’t learn in medical school: sickness andgeon, he met patients at Grady Memorialonly source of medical attention.health take place in patients’ environments.Hospital unlike any he saw while trainingMoore’s actions lit a fire. Residents, med-With little money and no insurance, peopleat Harvard and the University of Michigan.ical students, and fellow doctors donatedchoose food over medicine. Without trans-Patients with enormous, bulbous tumorstime. A nonprofit organization providedportation, they call an ambulance, or theyon their tongues and necks. Why hadn’ta mobile unit. Governmental and philan-just don’t go.they com

Winship at Emory University Hospital Midtown Winship at Emory Saint Joseph's Hospital Winship at Emory Johns Creek Hospital Georgia Cancer Center for Excellence at Grady Memorial Hospital Atlanta VA Medical Center Aflac Cancer Center of Children's Healthcare of Atlanta 1-888-WINSHIP (946-7447) winshipcancer.emory.edu