Monday, April 29, 2013

Numerous Benefits of Robotic Surgery to Treat Gallbladder Disease

 

By: Jeffrey Albright, MD


It is estimated that over 20 million Americans have cholelithiasis, or the presence of gallstones. In addition, individuals with biliary dyskinesia, a condition that results in chronic cholecystitis unrelated to gallstones, accounts for a small but significant proportion of gallbladder disease. Over 500,000 cholecystectomies are performed annually in the US.

People with gallbladder disease often present with characteristic descriptions of their attacks. Most commonly, pain is experienced in the right upper quadrant and epigastrium and may radiate to the back or shoulder. Pain is often associated with nausea and vomiting, and generally occurs after eating a fatty meal.  Those with symptomatic cholelithiasis experience self-limited episodes of colicky pain resulting from transient cystic duct obstruction.

When acute cholecystitis develops from persistent cystic duct obstruction, the presentation is often more dramatic and prolonged, sometimes for days at a time. Such patients often visit their primary care physician or seek urgent/emergency care. At this point, gallbladder disease must be differentiated from other common conditions like peptic ulcer disease, gastritis, pancreatitis and dyspepsia.

The number of cholecystectomies has increased significantly, since the advent of laparoscopy in the early 1990’s. Prior to the laparoscopic approach, gallbladder surgery required a large incision, several days of inpatient recovery and painful convalescence. Since the laparoscopic era, gallbladder surgery has changed to an outpatient procedure with significantly less pain and recovery time. Further, patients generally have only a few incisions, with the largest being about an inch long. The era of laparoscopy has been transformative from the perspective of decreasing patient suffering and hospital length of stay.

Recently, surgeons have begun to adopt a new tool in their armamentarium for treating gallbladder disease. Through advances in the technology of surgical robots, such as the da Vinci system, the multi-incision approach to cholecystectomy is being challenged. Using a single, one inch incision within the umbilicus, the same procedure can be performed with better cosmetic results. The high definition three-dimensional visualization available on robotic systems (not in traditional laparoscopy), allows surgeons to see a patient’s anatomy in unprecedented detail. This advancement has the potential to improve patient safety through enhanced visualization, not to mention the cosmetic benefits of hidden scar tissue.
Dr. Jeffrey Albright is a board-certified general and colorectal surgeon with Brookwood Medical Center.

Thursday, April 25, 2013

A new laser therapy treatment of onychomycosis


By: Dr. Falls
 
Onychomycosis of the toenail is a chronic infection of the nail plate and nail bed by dermatophytes, yeasts, and opportunistic fungi. It is believed that over 35 million American’s alone suffer from this disease. It is found to be much more prevalent in Southern states due to environmental factors and comorbidity disease states.  Until recently treatments were limited to topical OTC and prescription nail liquids and oral anti-fungal therapies. Topical therapies both OTC and prescription such as topical ciclopirox have few side effects however they require sustained use by the patient for 6-9 months for toenail therapy. Unfortunately the cure rate is below 50% in most all studies even with correct sustained application. Oral anti-fungal therapies such as itraconazole and terbinafine have a much higher mycological cure rate approaching 80-90% in most studies however there are hepatic function contraindications for many patients.

 

With so much of the population affected by this disease there have been many attempts to find better therapies both with regard to reduced contraindications as well as providing higher cure rates.  Recently, the emergence of new technology has brought about another option for the treatment of onychomycosis. Laser treatment to the toenail is now a better option for almost all patients regardless of age or other medical conditions. Utilizing very specific wavelengths, the newer lasers are able to cause photo damage and/or ablation of the fungus within the toenail. This new therapy is now available at Alabama Foot Institute on Montclair Road. In the office setting the patient’s nails are treated utilizing specific wavelengths of laser light without the need for local anesthesia. There is very limited thermal effect and the treatment of 10 toenails takes only 10-15 minutes. As the nail plate grows normally it will grow proximally increasingly clear.  It takes 4-9 months typically for full toenail growth and full clearing. In most cases no further laser treatments are needed.  This therapy option is excellent for those patients who either cannot or do not wish to take oral therapy. 
 
Todd Falls, DPM
Alabama Foot Institute

Monday, April 22, 2013

Alabama Pain Management Act Why I Support It


Prescription drug diversion, abuse, and misuse is a serious threat to the health, safety, and welfare of the citizens of the State of Alabama.  It is a problem.  There is no singular medical specialty board which governs pain management.  This makes pain management as a specialty unique from others.   When there is a problem and there is no governing board, the state medical board is the entity to do this. 

 
The big picture problem is 2 fold: the drug seeker / diverter and the pill mill.  These are characteristics of the drug seeker / diverter:

 
n The patient is from out of state.

n The patient requests a specific drug.

n The patient states that an alternative drug does not work.

n The patient states that their previous physician closed their practice.

n Prior treatment records cannot be obtained.

n The patient cannot afford an MRI.

n The patient presents to the appointment with an MRI.

n The patient presents to the appointment with pharmacy profile in hand.

n The patient(s) carpool.

n The patient tests positive for illegal drugs.

n Drug screen reveals no prescribed medications in the patient’s system

n The patient recites textbook symptoms.

n The patient pays in cash only, no insurance.

n The patient calls for early refills.

n The patient’s pain level remains the same.

n The patient is non-compliant with the physician’s treatment plan.

n Prescriptions are routinely lost or stolen.

These are characteristics of the pill mill: 

n The physician has minimal to no training in pain management.

n Cursory or no patient exam given.

n Large volume of patients seen daily (100 +).

n Patients drive long distances, often from other states.

n In many cases patients carpool.

n Clinic owners are not health care providers and have no medical training-they are

typically from out of state (some clinic owners are unscrupulous and have shady

backgrounds).

n Clinic is run on a cash only basis.

n Same prescription “cocktail” for each patient.

n Drugs are dispensed onsite (patient pays for office visit then pays for the drugs).

n Security guards are employed by the clinic.

n Unscrupulous clinic owners convince the physician that the clinic is operating

legally.

This bill lays the groundwork for the Alabama Board of Medical Examiners to regulate chronic pain management with opiate medications.  Currently, any licensed physician can operate as a pain management clinic regardless of intent, training, and ownership.  Unless there is a specific complaint, a rogue pain clinic will go about its business unnoticed for quite some time.  This bill requires anyone operating as a pain clinic to register and meet minimum standards.  This bill also lays the groundwork for what those standards will be.  For example, a pain clinic will require a medical director with specific training in pain management. 

 
I think the bill is a good start.  Most of the meat of this bill will come from the Board where the rules will be established.  I actually welcome this because if this bill is to accomplish its goals, it needs more meat.  For example, requiring the use of the Prescription Drug Monitoring Program (PDMP) by the prescribing provider to make sure the patient is not doctor shopping does work and 43 states have this program in some form already.  Part of this legislation is to make Alabama's PDMP process more user friendly and documentable which is welcomed.  These are things we do already which could be specific rules adopted by the Board:

 

o    Review PDMP (prescription drug monitoring program) report.

o    Require controlled substance agreement to be signed by the patient.

o    Require health care professional face-to-face visits at least every 90 days.

o    Require urine drug testing.  In office screens should be confirmed with toxicology reporting at least 3-4 times per year based on patient risk stratification.

o    Require risk stratification strategies.

o    Require multimodal therapy for chronic nonmalignant pain.  Controlled substances alone are not ideal when treating chronic nonmalignant pain.  We view controlled substances as one of many tools available. Other modalities include physical therapy, bracing, injections, counseling, topical medication, other adjunctive medications. 

o    Make minimum documentation requirements as indicated by the American Pain Society guidelines.

 
One thing I don't want this bill to do, and I don't think it will, is limit doctors who are not pain specialists from prescribing opiates for pain they routinely prescribe.  The problem arises when   the pain becomes chronic and these medications are written on a chronic long term basis.  Therefore, I think it is important to define acute pain and chronic pain and limit this bill to chronic pain so as not to create any undue regulatory burden and hardship on other doctors such as primary care and surgery.  Other states have messed this one up. 

 
I think an area of concern for physicians with regards to this bill and the power granted to the Board is unannounced inspections and suspensions without hearings.  While this does sound quite intrusive, the intent is in the interest of public safety.  Any legitimate pain management clinic has nothing to worry about with this bill. 

Thursday, April 18, 2013

Omalizumab for the Treatment of Chronic Idiopathic Urticaria




By: Carol Smith, MD
 
Chronic Idiopathic Urticaria (CIU) was described in a 1995 article in the NEJM as itchy hives that last for at least 6 weeks, with or without angioedema, and that have no apparent external trigger. This definition still holds true today, and we know that these patients can have a prolonged course lasting years, that plays havoc on their emotional and physical quality of life. H1 antihistamines have been the mainstay of treatment, but a majority of patients don’t respond even at quadruple the licensed dose. As we’ve come to understand more of this complex disease, new treatment options are emerging.
 
We typically like to rule out underlying conditions that can trigger chronic hives, such as allergy, chronic infection, autoimmune disorders such as hypothyroidism, and treat these accordingly. Also, recently linked to CIU, is an autoantibody directed against the high affinity IgE Fc receptor (FceR1), which stimulates mast cells and basophils to produce histamine.
 
For the patients not responding to high dose antihistamines or treatment of underlying diseases, more aggressive therapies are an option. High dose or prolonged course of oral steroids may be efficacious, but the side effects can be dire. Steroid-sparing immunosuppressant therapies frequently used include cyclosporine, methotrexate, tacrolimus, dapsone, with variable results and their own potential side effects.
 
A new treatment option is being studied, and was recently reported in the March 2013 NEJM. Omalizumab is a recombinant monoclonal anti-IgE antibody currently approved as an add-on therapy for moderate-to-severe asthma.  It binds free IgE antibody and reduces the high-affinity IgE Fc receptor, both of which are essential for the activation of mast cells and basophils.  The summary of this phase 3 multi-center, randomized, double-blind study found that omalizumab administered at three doses of 150 mg or 300 mg at 4-week intervals significantly reduced symptoms, as compared to placebo, in patients who were unresponsive to H1 antihistamines.
 
More studies are underway, but I am cautiously optimistic for the potential use of omalizumab as a safer option for the treatment of recalcitrant chronic idiopathic urticaria.

 
 
Carol Smith, M.D. _ Birmingham Allergy and Asthma

Monday, April 15, 2013

Medical home at Pediatrics East provides health hub for children


 
 
By: Peily Soong, M.D.
Medical homes have made their way to the forefront of health care in recent years. No wonder. This emerging system for primary care addresses two of medicine’s most pressing concerns — cost and quality.

Pediatrics East, which is part of the Children’s of Alabama system and one of Birmingham’s oldest pediatric practices, is at the forefront of the medical home movement. This year, Pediatrics East was recognized by the National Committee for Quality Assurance as a Patient Centered Medical Home with the highest designation, Level 3. That means a lot to the staff at Pediatrics East, but we think it means much more to our patients.

Medical homes focus on patients instead of procedures, which is why this approach is sometimes referred to as patient-centered care. Also, medical homes often operate under the umbrella of an accountable care organization, or an ACO. In fact, some ACOs have been referred to as “medical neighborhoods,” encompassing several medical homes.

Pioneered by large pediatric practices, medical homes are more of a philosophy than actual places or locations. The idea is based upon
primary care providers coordinating all medical needs for patients. This reduces overlapping procedures, hospitalizations, and emergency room visits while substantially cutting costs, better targeting care, and improving communication.

Developed decades ago, the patient-centered medical home model began to experience a growth spurt nationwide in 2007 when it was recognized and defined by the American Academy of Pediatrics, the American Academy of Family Medicine, American College of Physicians and American Osteopathic Association.

At Pediatrics East, we view our medical home as a “whole child” approach to medicine requiring a care team, technology, access to services, evidence-based care, and a solid partnership with children and their families.

Our care teams incorporates everyone in our clinic from our pediatricians to the people answering our phone calls. The clinical staff of physicians, nurses, lab techs, and medical assistants help to deliver care while our front staff, business office, and referral staff help with coordinating care and making sure there is continuity with other referring physicians.

Part of being a medical home includes being readily available to meet the needs of our patients. Our office hours are 8 a.m. till 5 p.m., and we offer extended hours for urgent care and routine newborn follow-up Monday through Thursday evenings, Saturday mornings, and Sunday afternoons. Our nurses can be reached by phone and by electronic messages through our patient portal during regular office hours. Pediatric nurses from Children’s of Alabama as well as one of our physicians are on-call once our clinic closes.

We have quick and easy access to a child’s comprehensive health information through electronic medical records, and we communicate with all providers who care for a child. We have referral specialists — office assistants who work closely with outside providers to arrange appointments and keep up with developments in a patient’s care by ensuring that referring physicians send us their clinic notes on our patients. Our lab technicians work diligently to follow up on lab tests and diagnostic imaging tests done at other facilities.
Our care is based upon evidenced-based recommendations for prevention, diagnosis and treatment. As medical evidence changes, we change. We explain changes to families and support family self-management of general health and chronic illnesses. We strive to give all of our families the tools they need and to serve as a health hub for every child’s care.

We are not alone in creating medical homes. The Department of Veterans Affairs is using the medical home model for its outpatient clinics, as are numerous primary care practices nationwide. The American Academy of Pediatrics has been working with the concept since 1967.
The National Committee for Quality Assurance has now recognized almost 5,000 practices throughout the United States. This committee offers the most widely accepted medical home recognition program in the nation. It has three levels of recognition that reflect how extensively a practice meets requires. These gradations also allow different sizes and types of practices to meet standards.

The National Committee for Quality Assurance’s Level 3 designation means that Pediatrics East has met the highest set of standards for a medical home that organizes care around patients, works with care teams, and coordinates and tracks patient care.

With our medical home, we strive to provide evidenced-based, quality medical. Being a medical home helps us to empower families and strengthens clinician-patient relationships.

 

 
Peily Soong, M.D. is a pediatrician at Pediatrics East. He graduated from the University of Alabama School of Medicine in 2001 and completed his internship at the University of Alabama Hospital and residency at the University of Alabama at Birmingham (Children’s Hospital of Alabama). He is certified by the American Board of Pediatrics.

With offices in Trussville and on Deerfoot Parkway, Pediatrics East was started by Dr. Vincent Carnaggio in 1957 to serve the pediatric community in the eastern part of Birmingham. Dr. Carnaggio was joined by Dr. Andrew Charles Money in 1962 and together they made a positive impact on pediatric health care and in the eastern area. Today Pediatrics East continues to provide pediatric medical care to the communities of Jefferson County, St. Clair County, Blount County and other surrounding areas. In 1996, Pediatrics East became part of the Children's of Alabama. Pediatrics East celebrated its 50th anniversary of treating patients in 2007.

 


 
 

Thursday, April 11, 2013

Intrabeam




By: William A. Thompson, III, MD, FACS
For Stage I and II breast cancer, lumpectomy provides equivalent survival to a mastectomy, provided adjuvant radiation is employed.  According to the American College of Surgeons, greater than 25% of patients in the United States who need radiation following a lumpectomy did not undergo radiation. In Alabama, this number is greater than 40%. Traditionally, high energy radiation is delivered externally 5 days a week for up to 7 weeks.

Within the past 10 years, it has become apparent that select patients can forgo extended whole breast radiation in favor of partial breast irradiation delivered twice a day through a percutaneous catheter that the patient would wear for about one and a half weeks to 2 weeks. The optimal patients are older than 45, have a tumor less than 3cm, have negative margins of excision, and ideally would be node negative. This is certainly more convenient than 6-7 weeks, but does add the discomfort of additional surgical procedures with catheter insertion, keeping the area dry for greater than a week, and having a medical device protruding from the breast for 1 to 2 weeks.

The most recent advance is a single dose of radiation delivered in the operating room while the patient is under anesthesia. The INTRBEAM system is a small portable electronic X-ray source that delivers radiation via a spherical applicator immediately after the lumpectomy following pathologic margin assessment. The duration of therapy depends on the volume of the applicator used, typically between 25 and 50 minutes. The lifestyle advantages are obvious. Daily radiation therapy for an employed patient is inconvenient at best, and for a more infirmed or rural patient may be completely untenable.

This exciting new therapy is supported by a  greater than 2000 patient  multicenter trial presented at the American Society of Clinical Oncology meeting in Chicago 3 years ago and published in the prestigious journal, The Lancet in July 2010. A follow up presentation at the December 2012 San Antonio Breast Conference showed no breast cancer 5 year  survival benefit to receiving 6 weeks of therapy compared to a single dose intraoperatively. In fact, there was a trend for improved overall survival in the INTRABEAM arm due to fewer non-breast cancer deaths.

Currently, Trinity Hospital is the only hospital in the state and one of about 40 facilities nationwide to use the INTRABEAM.  These hospitals include Georgetown, NYH-Cornell, Florida-Gainesville, and USC-Los Angeles. A clear impediment to wider state wide use has been reimbursement. Despite a willingness to pay thousands of dollars for catheter based therapy which has far weaker data, Blue Cross/Blue Shield of Alabama has refused to pay the several hundred dollars for the INTRABEAM. That deterrent however has not prevented Trinity surgeons and radiation therapists from delivering this treatment to Alabamians many who would not have had radiation therapy otherwise.

 

 William A. Thompson, III, MD, FACS

 

Thursday, April 4, 2013

Summer Running


 
By: Dr. Mark Ricketts
Summer is coming up on us, and the heat doesn't mean you should totally give up on running. You can keep running outside (with the proper attire and preparation) or find a treadmill or indoor track. But whether you are indoor or outdoor - running injuries can still occur.

 

10 Common Running Injuries:

 

1) Runner's Knee - a sore kneecap from overuse. 

2) Stress fractures - overuse causing tiny hairline fractures in feet or around ankles.

3) Shin splints - is a muscle and tendon issue, that if not treated, can lead to stress fractures.

4) Achilles tendonitis - overuse of the Achilles tendon

5) Muscle pulls - real common, you know what they are

6) Ankle sprains - torn/partially torn tendons and ligaments around the ankle

7) Plantar fasciitis - inflamed tissue on the sole of your foot

8) IT band syndrome - inflammation of a tissue that runs from your knee to your hip

9) Blisters - You know

10) Temperature-related injuries (dehydration)

 

Preventing these injuries:

 

1) Listen to your body. Don't assume that every ache and pain is "just part of it", because it's not. If an ache or pain goes beyond the first mile, then something's probably wrong, and your body is telling you that something is wrong. Don't try to run through it.

 

2) Warm up and stretch. The older you get, this is more and more important. As adults, we spend too much time behind desks, behind the wheel - and our muscles sit stagnant for hours. Stretch them out before exercise.

 

3) Cross-train. Don't just run - spend some time with light weights, pushups, and sit-ups. For one thing, it leads to a little more creativity in your workout routine so you won't become bored, but it also works out different muscle groups, giving you a balance, and not overworking one muscle group endlessly.

 

4) Wear the proper clothing. Light material and - importantly - wear reflective running shorts/shoes so that vehicles can see you.

 

5) Make sure you are wearing the proper shoes for your feet. This is a big deal. Not all feet are equal in their shape and this can cause us to distribute our body weight in our feet differently from person to person. When getting a pair of running/workout shoes - talk to someone that knows what they are talking about. The big box stores aren't specialized in this - go to the Trak Shak, the New Balance shoe store, etc.

 

6) Staying hydrated. I preach it over and over. Because it's important.

 

7) Running on the road versus softer grass or dirt - softer is usually better on your body, as the shock of impact is lessened. But overuse is still overuse. While it could delay the onset of an injury, if you keep pushing your body, an injury becomes more likely.

 

Sounds kind of funny, but be sure to do the healthy things while you are being healthy. Exercise smart. Don't overdo it to the point where the exercise becomes detrimental to your body. Not only could you hurt yourself, but you may end up having a negative attitude towards exercise, which could be a negative in the long run.

 

So be smart. If you are looking to start exercise, consult your doctor and make sure you are getting off on the right foot.

 

Be Well,

Dr. Ricketts

 

Dr. Mark Ricketts can be heard weekly as the "Doc On JOX" Wednesdays on WJOX 94.5 FM at 2:30p. For more information and insight on health and wellness, visit his website, www.MarkRickettsMD.com. He currently practices medicine in Hoover, and construction on his new facility at the Vestavia City Center is currently ongoing. The new office is expected to open in late May.

Tuesday, April 2, 2013

EXERCISING AND STRETCHING IN COLD WEATHER


By: Robert E. Agee M.D.

The CDC defines physical activity as anything that gets your body moving. According to the 2008 Physical Activity Guidelines for Americans, you need to do two types of physical activity each week to improve your health (aerobic) and muscles (Strengthening). Adults need at least 150 minutes of moderate aerobic exercise or 75minutes of vigorous exercise a week. With muscle strengthening, adults need to strength train all muscle groups two days per week. Children and adolescents need to do one hour of exercise per day. Before engaging in any exercise, you must first stretch. These guide lines are great during spring and summer, but when the weather changes and it gets cold, what should you do then? During the winter months, you must take extra precautions when you exercise. You should warm up for the first 5-10 minutes by jogging or walking and then stretching for five minutes.

After you have warmed up, it is safe to begin your exercise routine. Cold weather exposure can make outdoor activity uncomfortable and dangerous for those who are not prepared.

When temperatures are cold, you may need to warm up longer to get your blood flowing and stretch longer before you start exercising to prevent minor injuries like sprains and strains. Two dangerous medical conditions that can

occur during cold weather exercise are frostbite and hypothermia. To prevent these illnesses, you must be able to recognize the signs and symptoms.

The first symptom of trouble in cold weather is shivering. Shivering is your body trying to generate heat to bring your core temperature back to normal, and should not be ignored because it could indicate cold illness.

 

Frostbite

Frostbite is the freezing of superficial tissues of the face, ears, fingers and toes. Treatment includes getting the person to a warm, dry place, and remove constrictive clothing. Elevate affected areas and apply a warm compresses to the area(s). Do not rub frostbitten areas or apply direct heat.

 

Hypothermia

Hypothermia is a more severe response to cold exposure that is defined as a significant drop in core body temperature. Treatment includes taking the person to a dry, warm place or warming the victim with blankets, extra dry clothing, or your own body heat.

To improve your comfort and safety while exercising in the cold, the American College of Sports Medicine recommends the following:

 

1. Layer clothing

2. Cover your head

3. Cover your mouth

4. Stay dry

5. Keep your feet dry

6. Stay hydrated

7. Avoid alcohol

 

Consult your physician or health care professional before beginning any exercise or diet program.

Priority Care For Athletes. Personalized Care for All

www.LemakSports.com + 855.252.3618

 

Monday, April 1, 2013

The Power of Knowledge: Using What We Know to Fight Cancer


By: Ed Partridge, M.D., Director of the UAB Comprehensive Cancer Center
155,930 - the estimated number of new cancer cases in 2012 in the southeastern states of Alabama, Arkansas, Georgia, Louisiana, Mississippi and South Carolina, according to the American Cancer Society. In that six-state region, the University of Alabama at Birmingham (UAB) Comprehensive Cancer Center is the only National Cancer Institute (NCI)-designated comprehensive cancer center. It provides care for more than 20,000 patients, with more than 5,000 new cancer cases evaluated each year.

We diagnose and treat patients from all areas of the United States, as well as from different countries around the world. However, many of our patients come from Alabama and the five surrounding states to seek the care and counsel of one of only 41 NCI-designated comprehensive cancer centers in the country. Because of the number of new cases each year in these states, the UAB cancer center strives to offer the best treatment to its patients, as well as advance the world's understanding of cancer.

Based on what we have already discovered – and what will be discovered in the next several decades, there is little doubt that cancer will be conquered in this century. It will not be eliminated like smallpox, as cancer is a much more complex disease, but its impact on society will be reduced such that it is no longer a major public health problem.

The only question that is still outstanding is how early in this century will this occur. If we accelerate the delivery of what we already know that prevents cancer deaths as well as our discovery process by devoting more resources to research, this will become a reality sooner rather than later. For example, we know that at least 70 percent of cancer cases in the United States can be prevented by lifestyle modifications, such as eating more fruits and vegetables, increasing physical activity, and reducing or, even better, eliminating tobacco use. This is especially important for those of us in Alabama, which ranks seventh in the nation for cancer mortality with 211.3 cancer deaths per 100,000 people.

Related to this is the importance of eliminating health disparities among minorities and underserved populations, including those between people of lower and higher socioeconomic statuses. Using education as a measuring stick, the study found that people with a high school education or less died at a rate of up to five times higher than those with at least four years of college education. Among men, those with less education died of cancer at rates more than two and a half times than those of men with college degrees. These numbers among women were almost identical.

Why is this the case? Studies have shown that people with less education - often those in lower socioeconomic situations - are more likely to engage in risky health behaviors, such as smoking, poor nutrition and lack of physical activity. Likewise, these populations are less likely to have access to the care they need and screenings for early detection.

It is our duty to continue to address these disparities, which has been a longstanding commitment of the UAB Comprehensive Cancer Center. While we launch new research and discover new treatments, we must also look for ways to deliver all of these discoveries to every single person, regardless of where they are in life.

Likewise, we must remember that the fight against cancer is a year-round activity, and the support of our community is critical in helping us achieve our mission of eliminating cancer as a public health problem. On behalf of the UAB Comprehensive Cancer Center, I encourage you to learn more and get involved. Thank you for your support.

-Ed Partridge, M.D., is the director of the UAB Comprehensive Cancer Center and holds the Evalina B. Spencer Chair in Oncology. A native of Demopolis, Ala., Dr. Partridge is a nationally renowned leader in the research and treatment of gynecologic cancers as well as cancer health disparities. He is a past president of the American Cancer Society (ACS) National Board of Directors.