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The Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine is a cancer treatment, research and education institution with three locations in the St. Louis area. Siteman is the only cancer center in Missouri and within 240 miles of St. Louis to be designated a Comprehensive Cancer Center by the National Cancer Institute (NCI). Siteman is also the only area member of the National Comprehensive Cancer Network, a nonprofit alliance of 21 cancer centers dedicated to improving the quality and effectiveness of cancer care.

Each year, Siteman treats more than 8,000 newly diagnosed cancer patients and provides continuing care to more than 40,000 people, making it one of the largest cancer centers in the United States.

Siteman’s parent institutions, Barnes-Jewish Hospital and Washington University School of Medicine, also are nationally recognized, with U.S. News & World Report magazine consistently ranking both among the best in the country.

Locations
Siteman’s main facility is located on the campus of Washington University Medical Center in St. Louis’ Central West End neighborhood. Two other St. Louis-area sites offer specialized cancer care in community hospital locations:


 * Barnes-Jewish West County Hospital in Creve Coeur, Missouri (map).
 * Barnes-Jewish St. Peters Hospital in St. Peters, Missouri (map).

A third satellite location, the Siteman Cancer Center-South County (map), is slated for completion in early 2013.

History and leadership
In 1999, Alvin J. and Ruth Siteman committed $35 million to the development of the Siteman Cancer Center at Washington University School of Medicine and Barnes-Jewish Hospital. The commitment was the largest gift ever received by Barnes-Jewish and Washington University in support of cancer research, patient care and services, education and community outreach.

Timothy Eberlein, M.D., has been director of the center since its inception. John DiPersio, M.D., Ph.D., is deputy director.

In 2001, the NCI designated Siteman as a Cancer Center, which signaled that the institution had demonstrated significant scope and quality in its cancer research programs. The designation came with $850,000 per year in federal research grants. The NCI named Siteman a Comprehensive Cancer Center in 2005, recognizing its broad-based research, outreach and education activities, and awarded the center a five-year, $21 million support grant. The NCI renewed the designation in 2010 and awarded another five-year grant, totaling $23 million. The grants fund programs and specialized services that promote multidisciplinary research, as well as shared scientific resources and seed awards that enable investigators to develop and pursue new research opportunities.

Alvin J. Siteman announced in 2010 that he would donate at least $1 million annually to an endowment at the center to advance pioneering investigations into cancer prevention, diagnosis and treatment. The newly established Siteman Cancer Research Fund is intended for both short-term projects and significant major initiatives. It will be targeted particularly for innovative programs that might not receive funding from federal agencies. The fund will be a resource to catalyze fruitful research progress that will attract additional foundation, corporate or federal research support.

Patient care and services
More than 350 Washington University research scientists and physicians provide inpatient and outpatient care at Siteman. The center also offers patient and family support services, including discussion and education groups.

Rare and more common tumor types treated at Siteman include:


 * Bladder cancer
 * Bone tumor
 * Joint cancer
 * Brain tumor
 * Spinal tumor
 * Breast cancer
 * Cervical cancer
 * Childhood cancers
 * Colorectal cancer
 * Endometrial cancer
 * Esophageal cancer
 * Eye neoplasm
 * Head and neck cancer
 * Kidney cancer
 * Leukemia
 * Liver cancer
 * Lung cancer
 * Lymphoma
 * Multiple myeloma
 * Ovarian cancer
 * Pancreatic cancer
 * Prostate cancer
 * Skin cancer
 * Soft-tissue sarcoma
 * Testicular cancer
 * Thyroid cancer

Research
Scientists and physicians affiliated with Siteman hold more than $160 million in cancer research and related training grants. The results of basic laboratory research are rapidly incorporated into treatment advances. This process is enhanced by patient access to more than 240 therapeutic clinical studies, including many collaborative efforts with other leading cancer centers throughout the country.

Research at Siteman is organized into eight formal programs and two developing programs.

Formal programs

 * Breast Cancer Research
 * Cancer and Developmental Biology
 * Cellular Proliferation
 * Hematopoietic Development and Malignancy
 * Oncologic Imaging
 * Prevention and Control
 * Translational and Clinical Research
 * Tumor Immunology

Developing programs

 * Neuro-Oncology
 * DNA Metabolism and Repair

Research advances
Researchers affiliated with Siteman and/or Washington University School of Medicine have pioneered important advances in cancer research, prevention, education and treatment. Highlights and ongoing studies include these projects:

2012 — Prevention
 * Building on his research for the Nurses Health Study and Growing Up Today Study, Graham Colditz, M.D., Dr.P.H., continues to examine links between cancer and alcohol use, diet, exercise and other factors, and what individuals and communities can do to reduce disease risk. In a 2012 paper, Colditz argues that half of all cancer cases can be prevented, thereby saving more than 280,000 people in 2011, and that individuals, medical and health experts, government officials and others must start taking already known steps to reduce cancer’s impact.

2011 — Breast and blood-related cancers


 * Scientists led by Matthew Ellis, M.B., Ph.D., use whole genome sequencing to compare differences between the DNA of breast cancer tumors and healthy cells in 50 patients. While revealing the complexity of the disease, the analysis flags therapies that may have a greater probability of healing patients.


 * Siteman completes its 5,000th hematopoietic stem cell transplantation, a common therapy for patients with blood-related cancers such as leukemia, lymphoma, and multiple myeloma or another blood-related cancer.

2010 — Pediatric cancers


 * Washington University School of Medicine and St. Jude Children’s Research Hospital announce their joint Pediatric Cancer Genome Project to identify the genetic changes that give rise to some of the world’s deadliest childhood cancers. The team plans to decode the genomes of more than 600 childhood cancer patients who have contributed tumor samples.

2008 — Genetic sequencing


 * For the first time, scientists decode all the genes of a person with cancer and find a set of mutations that might have caused the disease or aided its progression. Timothy Ley, M.D., Elaine Mardis, Ph.D., Richard K. Wilson, Ph.D., and their colleagues at The Genome Institute say the finding could lead to new therapies and could help doctors make better choices among existing treatments, based on a more detailed genetic picture of each patient's cancer. Though the research involved acute myelogenous leukemia (AML), the same techniques can also be used to study other cancers.

2007 — Nanotechnology and radiation therapy


 * Gregory Lanza, M.D., Ph.D., Samuel Wickline, M.D., and researchers in their labs announce the development of nanoparticles, significantly smaller than the width of a human hair, aimed at attacking cancer by locating and “latching on” to tumors. The nanoparticles then could help physicians monitor cancerous tissue and deliver medicine directly to the tumor, not to the rest of the body.


 * Researchers led by Parag Parikh, M.D., develop a machine called the 4D Phantom that follows a patient’s complex breathing pattern to deliver radiation therapy to tumors that move, such as those in the lung.

2006 — Photoacoustic imaging


 * Lihong Wang, Ph.D., announces his work on photoacoustic imaging, a new technique that uses light and sound to create detailed, color pictures of tumors and organs. The noninvasive imaging method may eventually help doctors diagnose cancer earlier than is now possible and to more precisely monitor the effects of cancer treatment — all without the radiation involved in X-rays and CT scans or the expense of MRIs.

2001 — Imaging and the immune system’s role in controlling cancer


 * Research led by Joanne Mortimer, M.D., shows that positron emission tomography (PET) scans can often identify within two weeks which women with advanced breast cancer are likely to respond to hormone therapy, a gentler alternative to chemotherapy that is usually just as effective.


 * Robert D. Schreiber, Ph.D., and colleagues publish the first evidence that the immune system plays a role in controlling cancer, a process called immunosurveillance. Later, in a paper published in 2007, they describe a revised version of this idea, called immunoediting, which they say could result in one of three outcomes: the immune system destroying the cancer; the immune system checking cancer’s growth but not being able to eradicate it; or cancer cells evading the immune system’s defenses and, in the process, often becoming more malignant. The researchers suggest that immunotherapy may one day help convert cancer into a chronic but controllable disease.

1998 — Biopsies


 * Ralph G. Dacey Jr., M.D., performs the world's first magnetic stereotactic surgery to biopsy a human brain tumor using an indirect route to the tumor. The route is designed to avoid regions that would normally be entered when a surgeon manually inserts a surgical tool straight at a site. The investigational computerized system allows surgeons to carefully manipulate surgical tools inside the brain through the use of a catheter driven by precisely controlled magnetic fields.

1994 — Genetic screening test for thyroid cancer


 * Led in part by Helen Donis-Keller, Ph.D., researchers for the first time develop genetic screening tests that detect a rare, lethal form of thyroid cancer in the preclinical state, permitting early treatment in children predisposed to the disease. It was the first surgical prevention of cancer based on genetic test results.

Mid-1970s — Imaging


 * Michel Ter-Pogossian, Ph.D., leads the research that will turn the PET scanner from an intriguing concept to a medical imaging technique used by hospitals and laboratories everywhere to scan the working brain.

1946 — Radiocarbon in cancer research


 * For the first time, the United States Department of War releases carbon-14 isotopes to a civilian entity, Siteman’s predecessor institutions, Barnard Free Skin and Cancer Hospital (founded in 1905) and the Mallinckrodt Institute of Radiology (founded in 1923), where they are used in cancer studies.

1941 — Cyclotron


 * At the Mallinckrodt Institute of Radiology, construction begins on the first cyclotron devoted to medical and biological research.

1933 — Lung cancer surgery and the disease’s link to smoking


 * Evarts Ambrose Graham, M.D., becomes the first surgeon to cure a human case of lung cancer by removing an entire lung. In 1950, he and Ernst Wynder, M.D., will publish the results of the first large-scale research on smoking, linking prolonged cigarette use to lung cancer.

Cancer prevention and control
Siteman and Washington University School of Medicine are actively engaged in many projects to prevent cancer in the St. Louis region and across the United States. These efforts include:
 * The Your Disease Risk website, an interactive tool that helps people estimate their risk of cancer, diabetes, heart disease, osteoporosis and stroke, and suggests preventative measures that help lower the likelihood of developing each disease.
 * Zuum, a free mobile app for iPad that estimates a person’s risk of cancer, heart disease, diabetes and other diseases, and offers customized tips for prevention and boosting one’s overall health.
 * Leading-edge research, including studies examining breast cancer disparities, cancer communication and tobacco use.
 * Community partnerships to assure cancer center research is responsive to local needs, conducted in real world settings and accountable for timely translation of research into practice.
 * Coordinating seminars, workshops and training sessions that help shape the research ideas and skills of cancer prevention and control researchers.

Education and community outreach
In addition to treatment and research programs, Siteman is committed to community outreach, education and screening. Through a wide variety of programs, the center works to increase public awareness of cancer; to educate about warning signs, prevention, treatment and well-being; and to make early screening widely available.

Efforts include:


 * The Program for the Elimination of Cancer Disparities (PECaD), which develops cancer prevention and awareness messages, reports research findings to the community, hosts continuing medical education events and engages in other activities.
 * Placing information about breast cancer and mammograms in Laundromats, where a study has shown it’s more likely to be seen than in other community settings by women who lack access to adequate health care.
 * A mobile mammography van that offers screenings by appointment in St. Louis and surrounding communities.