26
Jeremy G Perkins, MD
Chief, Hematology/
Oncology
COL
|
MC
|
USA
WRB
Brian P Monahan, MD
Director, Hematology/
Oncology, USU;
Attending Physician of the
United States Congress
and Supreme Court
RDML
|
MC
|
USN
Under the leadership of Jeremy Perkins, the
Hematology/Oncology Service at Walter Reed
Bethesda continues to serve as the heart of
the Murtha Cancer Center (MCC). The MCC
has been designated by the Defense Health
Agency as the official DoD Center of Excellence
for Cancer, and as the MCC’s premier service,
Hematology/Oncology treats adult patients
with all forms of malignancy, bleeding
disorders and clotting disorders.
The Heart of the Murtha Cancer Center and
the DoD’s Center of Excellence for Cancer
As a referral center for high-complexity
patients, we provide inpatient and outpatient
chemotherapy,
hormonal
therapy,
immunotherapy, and autologous stem cell
transplantation using the most current
treatments and procedures. In addition to
standard therapies, the Service provides
nutritional services, integrative health and
wellness services, case management and
nurse navigation, survivorship programs, and
many cutting-edge therapies in the context of
clinical trials to advance care for all patients
with cancer. Its faculty provides clinical
rotations
and
training
and
research
opportunities for fellows, residents and
medical students.
The medical staff consists of eight active duty
military physicians, two full-time civilian
physicians and three nurse practitioners. In
addition, our patients benefit from the care
provided by experts from the National Cancer
Institute (NCI), the National Heart Lung and
Blood Institute (NHLBI) and the Food and Drug
Administration (FDA).
The nursing specialists consist of 11 nationally-
accredited chemotherapy/biotherapy-certified
nurses, four case managers paired with four
social work-case managers, two research
nurses, a stem cell coordinator, a licensed
professional nurse and a certified nursing
assistant.
The Hematology/Oncology Service hosts an
ACGME-accredited fellowship program, led by
the program director, Dr. David Van Echo. This
program—one of two fellowship programs in
the Army and the only fellowship program in
the Navy—was reaccredited in 2016 and has
produced highly skilled military hematologists/
oncologists to serve throughout the MHS. It
has boasted a 100% board certification pass
rate for our graduates for more than a decade.
Each physician serves as a key clinical faculty
member and holds a faculty appointment at
Uniformed Services University. The fellowship
is accredited to train up to 12 fellows and is
currently comprised of eight fellows from the
Army and Navy with 2 third-year fellows, 2
second-year fellows, and 4 first-year fellows.
A Robust Clinical and Translational
Research Portfolio Provides Access to New,
Encouraging Opportunities for Patients
Through a tri-federal cancer initiative among
WRB, USU and the National Cancer Institute,
Hematology/Oncology has a robust clinical
and translational research program. The
Service maintains collaborative research
relationships and active protocols with the
ALLIANCE cooperative group, the Oncology
Research Information Exchange Network, and
the Applied Proteogenomics Organizational
Hema
tolo
gy
/Onc
olo
gy
27
Learning and Outcomes (APOLLO) network,
and is supported with research grants
through the MCC. It has also partnered
closely with the NCI to share opportunities
for clinical trials for our patients. Our nursing
staff is similarly engaged in research.
Playing a Key Role in Creating the First US
System to Screen for Genomic Abnormalities
to Match Tumor Types to Therapies
The APOLLO network will look at a patient’s
genes (genomic analysis) and the expression
of those genes in the form of proteins
(proteomic analysis) in order to create the
nation’s first system in which cancer patients
are
routinely
screened
for
genomic
abnormalities and proteomic information to
match their tumor types to targeted
therapies. Initially, we are focusing on a
combined cohort of 8,000 cancer patients
within the nation’s two largest healthcare
systems—the VA and DoD—with the aim of
expanding the program to additional cancer
types and making findings available to
physicians across the country.
We are starting with lung cancer to address
the pressing need of treating a form of cancer
that is pervasive and prevalent among
veterans
and
service
members.
Approximately 8,000 veterans are diagnosed
with lung cancer each year in the VA’s
healthcare system alone.
Cancer Moonshot Summit Marshalls Federal
Resources to Speed Up Search for the Cure
Walter Reed Bethesda participated in June in
a White House-sponsored national Cancer
Moonshot Summit—organized to boost
support for speeding up efforts for cancer
research, treatment and cures. President
Barack
Obama
launched
the
Cancer
Moonshot in his 2016 State of the Union
Address, appointing Vice President Joe Biden
to lead the effort. During his remarks at the
summit, the Vice President praised, among
others, the Walter Reed Bethesda staff for
increasing his knowledge of cancer during his
son’s illness and hospitalization at WRB.
WRB attendees at the summit participated in
workgroups, brainstorming ideas for tackling
challenges posed by cancer, such as
prevention,
detection,
diagnosis,
data
sharing, enhancing care and access, as well as
advancing research, discovery and scientific
breakthroughs.
The
results
of
those
workgroups were later shared with the White
House.
Standing Up a Phase 1 Clinical Trials Clinic
Will Provide Novel Cancer Treatments
In conjunction with the National Cancer
Institute and under the leadership of Dr.
Michelle Ojemuyiwa, Hematology/Oncology
is standing up a Phase I clinical trials clinic.
We are excited to offer our patients
additional clinical trial opportunities that
provide novel cancer treatments. Patients no
longer responding to standard therapy will be
able to meet with members of the NCI
research team and the WRB Hematology/
Oncology staff in our clinic on Mondays. This
innovation will significantly reduce the time it
takes to enroll in a clinical trial and receive
treatment.
Opposite page:
Cancer treatments
historically were almost
exclusively provided
intravenously, which
required administration
by nurses in a clinic or
hospital setting.
However, advances in
understanding of tumor
biology, molecular
targets and drug design
have led to the
development of an
increasing array of oral
oncology medications.
While these medications
can be taken by patients
at home, they still
require monitoring for
side effect and have the
potential to interact
with other medications.
Dr. Frank Grollman, an
experienced, board-
certified oncology
pharmacist, carefully
reviews an oral
oncology medication
from the Hematology/
Oncology pharmacy
prior to dispensing
to a patient.
Hematology/Oncology
patients have complex
needs that often require
multidisciplinary care and
resources. Nurse case
managers assist with the
coordination of care by
helping patients navigate
the hospital system to
ensure expeditious
evaluation and planning
of treatments. They also
help schedule radiology
imaging, clinical
trial/second-opinion
referrals, in-home durable
medical equipment,
applications for medical
leave/disability, and
engagement with
community resources. At
left, Fatu Fofana, RN,
reviews records and
communicates with the
physician on behalf of a
patient.