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OneThousandOne represents the amount of time, verbally, that it takes to count to one second. In this one second of time, a great thing happened at Nebraska Medicine. In fact, several great things probably happened. A patient was cured, a researcher found the missing link, a nurse treated an injury, a doctor comforted a family or maybe a child just smiled.
MOMENTS IN MEDICINE
Winter | 2014

Leading the Revolution

Imagine a day when doctors can identify the exact gene mutation that is causing a cancer to grow. With this information, they are able create a unique drug designed to target the abnormality. This drug is customized for each individual and has the capability to attack the molecular alterations that are fueling the cancer and ultimately halt its deadly course.

That day is on our doorstep. Health care is entering a new and transformational era in cancer treatment when therapies based on a person’s unique genetic makeup are paving a new path in how we diagnose and treat cancer. Often referred to as “precision or personalized medicine,” The Nebraska Medical Center and the University of Nebraska Medical Center (UNMC) are laying the groundwork to ensure it will be in the forefront of this medical revolution.

Fred and Pamela Buffett

In July of 2013, The Nebraska Medical Center and UNMC broke ground for the Fred & Pamela Buffett Cancer Center, the largest project ever in its history. The new cancer facility will ensure Nebraskans and patients throughout the region will have convenient access to the latest breakthroughs in cancer therapy. A joint project of The Nebraska Medical Center and UNMC, it is expected to open in 2017. The Fred & Pamela Buffett Cancer Center will include three areas dedicated to cancer: a 10-story, 98-laboratory research tower named the Suzanne and Walter Scott Cancer Research Tower; a 108-bed inpatient treatment center named the C.L. Werner Cancer Hospital; and a multidisciplinary outpatient center.

Ken Cowan, MD, Phd

The $323 million Fred & Pamela Buffett Cancer Center was named in recognition of a gift to The University of Nebraska Foundation from Pamela Buffett, through her foundation, the Rebecca Susan Buffett Foundation. Pamela’s husband, Fred “Fritz” Buffett, died in 1997 after fighting kidney cancer.

“What makes the Fred & Pamela Buffett Cancer Center truly revolutionary is the fact that it will integrate clinical medicine and research in the same building,” says Ken Cowan, MD, PhD, director of the Fred & Pamela Buffett Cancer Center. “While many medical centers are attempting this, no one has achieved it on this same level. This will be a model for other centers.”

The proximity of researchers and clinicians will promote more collaboration and casual conversations between the two professions that will ultimately result in more focused research and hasten the transfer of scientific discoveries from the lab into new treatments that will benefit patients, says Dr. Cowan.

“The most important insights and ideas that come from thinking outside of the box almost always come over water cooler discussions,” says Dr. Cowan. “And in this new era of personalized medicine, this type of daily exchange of information will be more important than ever.”

Dr. Cowan predicts that today’s practice of treating cancers based on the tissue where they originated — such as the breast, colon or other part of the body — will eventually be a thing of the past. This will be replaced by the new age of genome sequencing in which cancers will be identified according to the names of mutated genes within the tumor. These mutations alter the cells and drive the malignancy. “In the future, an increasing number of cancers will be treated by targeting the molecular changes in tumors, resulting in treatment regimens that are individualized for each patient,” says Dr. Cowan.

“What makes the Fred & Pamela Buffett Cancer Center truly revolutionary is the fact that it will integrate clinical medicine and research in the same building.”
Ken Cowan, MD, PhD

Gene sequencing is a revolutionary technology that became available in 2003 with the completion of the Human Genome Project. This was a 13-year, international effort to sequence and map all 3 billion letters or base pairs in the human genome, which is the complete set of DNA in every cell of the human body. For the first time, this amazing feat gave scientists the complete genetic blueprint for building a human being. It is also providing researchers with powerful tools to understand the genetic factors in human disease, and paving the way for new strategies for their diagnosis, treatment and prevention. Accessibility of these tests has been very limited and they have been difficult to interpret. Cost also has been a major obstacle, but all of these things are finally starting to change. The medical center now has its own gene sequencing machine that can sequence a person’s entire genome in less than a couple days for approximately $5,000. That’s compared to three to four months for $30,000 to $40,000 just four years ago.

The complexity of these genes, combined with the task of trying to develop the therapies intended to fight the mutated genes, opens up a whole new generation of medicine. “If we have the right drug with the right dose that is used on the right patient, we can have a significant impact on a patient’s outcome,” says Dr. Cowan. “Right now, however, we don’t know what mutations are driving the cancer in the majority of cases.”

Many of these genetic changes are new to medical terminology and there may be hundreds and even thousands of them in every tumor. “Our hope is that with our researchers and clinicians working closely together, we will be able to shorten the timeline for discoveries to be tested and available to treat patients,” says Dr. Cowan.

Not only will the Fred & Pamela Buffett Cancer Center bring researchers and clinicians closer together, but it will expand the number of research labs now available on campus. Currently, there are 200 labs in the two Durham Research Towers. The Scott Research Tower will add 98 additional labs dedicated to cancer research. “Researchers in cancer and other diseases will be able to share equipment and ideas as the new cancer research tower will be linked to the Durham Research Tower,” says Dr. Cowan. “There will be ample opportunities for collaboration between researchers across diseases and between researchers and clinicians, which we think will fuel new discoveries and cures.”

“Expanding our research capabilities provides many advantages to our patients. The bigger our research program, the more trials we will have to offer our patients and that translates into more options for treatment.”
Julie Vose, MD, MBA

“The future of cancer care lies in research,” says Julie Vose, MD, MBA, chief of Hematology/Oncology at UNMC. “Expanding our research capabilities provides many advantages to our patients. The bigger our research program, the more trials we will have to offer our patients and that translates into more options for treatment.”

Experts expect the Fred & Pamela Buffett Cancer Center to elevate The Nebraska Medical Center’s reputation as one of the leading cancer research centers in the country.

Currently, the medical center is in the middle tier of research funding and has been on a rapid course of growth for the past 15 years. From 1999 to 2013, total grant funding increased from $19 million a year to nearly $70 million. The medical center also added 100 new researchers over that period. Space has been one of its biggest challenges for additional expansion.

“This new building will allow us to continue to expand and gives us the space we need to see more patients,” says Dr. Cowan. The medical center expects to recruit 15 to 30 new researchers with the opening of the new research facility and expand its grants by about $20 to $30 million.

Brian Hastings, president and CEO of the NU Foundation, says that the Fred & Pamela Buffett Cancer Center not only will house the best cancer physicians and researchers in the state, “it also will help us attract even more of them to Nebraska to find a cure.”

The medical center currently holds the title as the only National Cancer Institute (NCI)-designated cancer center in Nebraska. NCI-designated cancer centers are recognized nationally for their scientific excellence and commitment to cancer treatment and research that focuses on development of more effective approaches to cancer prevention, diagnosis and therapy. The medical center’s goal is to become an NCI “Comprehensive Cancer Center,” a top designation shared by only 41 centers in the country.

Julie Vose, MD, MBA

To achieve this designation, the medical center will be expanding its research to include more population-based research related to cancer causes and prevention, epidemiology as well as expanding the field of genome research, says Dr. Cowan.

An improved patient experience is also an important goal of this new facility. For patients needing cancer care, a multidisciplinary outpatient treatment center will make what is often a painful experience, a little easier. The Fred & Pamela Buffett Cancer Center is being designed as a single-use facility, which means patients only have to go to one place for their diagnosis, care and treatment. The outpatient center will include multidisciplinary clinics where patients will be able to see the entire team of doctors including surgical, medical and radiation oncologists, as well as supportive services such as social services, physical therapists and nutritionists. The outpatient center will also include an infusion center, radiation treatment, surgery suites, as well as radiology and collaborative treatment and diagnostics. The 108-bed C.L. Werner Cancer Hospital will be located adjacent to the cancer outpatient center, which will allow patients and family to walk from the clinic to the hospital and back.

Dr. Vose says patients will enjoy more amenities and comfortable surroundings in the new cancer hospital. “The environment will be much more conducive to patient care with more space for treatments, the convenience of easy access, new services, educational opportunities and additional dedicated family space,” she says.

“The Fred & Pamela Buffett Cancer Center places Nebraska firmly at the leading edge of cancer care, research and education,” University of Nebraska President J.B. Milliken says. “This will allow us to attract the best and brightest faculty and students and build on our significant strengths in cancer research to serve the people of Nebraska and the nation.”

“This is a very exciting time for cancer patients,” agrees Dr. Cowan. “The hope that this facility can provide is almost incalculable. When a patient is diagnosed with cancer, that ‘c’ word is transformational. It changes your life forever. I can imagine patients coming here and getting all of their care in one clinic. And when they look out their windows and see three research towers, with lights blazing 24 hours a day, this will give them hope knowing that there are so many people working night and day to find a cure for cancer.”

To learn more go to FredandPamelaBuffettCancerCenter.com

Benefactors of the Fred & Pamela Buffett Cancer Center:

Lead Benefactor
The Rebecca Susan Buffett Foundation (Pamela Buffett)
Principal Benefactors
Robert B. Daugherty Foundation
C.L. Werner Foundation
Clarkson Regional Health Services
Suzanne and Walter Scott Foundation
Peter Kiewit Foundation
Holland Foundation
Founding Benefactors
UNMC Physicians
Mutual of Omaha Foundation
The David Scott Foundation
Amy L. Scott Family Foundation
Parker Family Foundation
Dixon Family Foundation
Shirley & Jim Young
Acklie Charitable Foundation
Mammel Foundation
Patti & David Aresty
Iowa West Foundation
HDR, Inc.
Faculty and staff of UNMC, The Nebraska Medical Center, UNMC Physicians and
Bellevue Medical Center
Public Partners
State of Nebraska
City of Omaha
Douglas County
Next article in the Winter | 2014 issue of One Thousand And One:
A Standing Ovation