Building a Leading Cancer Program
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We have to be smarter and find more effective, less toxic therapies.
- Frank Smith, MD |
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We now cure most children with cancer, but our goal is to cure them all.
- Frank Smith, MD |
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Our mission at Cincinnati Children's Hospital Medical Center is to provide superb, uncompromising care to our patients, to do clinically meaningful research and to train new leaders in research and clinical medicine.
I tell people that I have the world's best job. I get to take care of amazingly wonderful children, and I get the intellectual stimulation of working with the most brilliant scientists, whose research is giving us better, more effective treatments for kids.
Children with cancer and serious diseases become more mature and wiser than children who aren't facing those challenges. They have tremendous insights into their own mortality — insights way beyond their years. They make it absolutely clear that they are not the cancer. They do every-thing possible to make their lives as normal as possible.
Their families also amaze me. I constantly ask how they muster the strength and energy and optimism and courage to face this problem and go forward. Somehow parents find the strength — from their own internal fortitude, their friends and families, their spouses, their religious background. It really speaks to the strength of the human spirit.
We've made huge strides in cancer care over the last 30 to 40 years. We now cure most children with cancer, but our goal is to cure all of them, with as little damage to the child as possible. We have some major challenges:
- Brain tumors
- Acute myeloid leukemia (AML)
- Relapsed acute lymphoblastic leukemia
- Advanced stage neuroblastoma
Back when we started treating children with cancer, we were just trying to keep kids alive. We've become really good at intensive, "sledgehammer" approaches. If you think in war terms, we come in with our big fighter jets and drop huge bombs that destroy everything. We may get the tumor, but we're also going to harm the child's brain, lungs, kidneys, liver, growth and fertility in the process.
We have to be smarter and find more effective, less toxic therapies. The focus today is on understanding the biology of tumors and designing drugs that will be specific to the tumor and minimize the impact on normal tissues.
We've talked about targeted therapy for a decade. In the last five years we've had some concrete successes. I think everyone in the field of cancer would agree that this is the future. And this is the focus of our research at Cincinnati Children's. We've implemented several studies where we're taking targeted therapies out of the laboratory to the patients — for example, our gene therapy trials for Fanconi anemia and for brain tumors.
If you want to be a leader and innovator and develop new therapies, you have to have experts in each disease — leukemia experts, brain tumor experts, neuroblastoma experts. The experts are important because they understand the disease best. So in the last four years our department has evolved from a generalist model to a disease-specific, research-based model. We've recruited spectacular clinical and research faculty to join us. Our faculty and staff are the best in the country. We've also built an amazing infrastructure so we can care for our patients and perform very complex studies.
There's sometimes a misunderstanding that research and clinical care are two separate and distinct things. You're either interested in research or you're interested in patients and not in research. Pediatric cancer is probably the example of how research and clinical care are one and the same thing. The clinical trial framework dictates superb clinical care. We deliver the best care to children by treating them as part of research studies.
