Researchers from Vanderbilt-Ingram Cancer Center will present findings from clinical trials, laboratory discoveries and innovations in caring for patients with hematologic cancers and other blood diseases at ASH 2025 in Orlando, Florida, Dec. 6-9.
ASH 2025 is the American Society of Hematology Annual Meeting and Exposition. Established in 1958, ASH is the world’s largest professional organization for clinicians and scientists who study blood diseases.
Three of the presentations from Vanderbilt-Ingram researchers will focus on chimeric antigen receptor T-cell (CAR-T) therapies, a form of immunotherapy that involves treating cancer with white blood cells that have been reengineered to attack cancer cells. Vanderbilt-Ingram is an international leader in advancing the efficacy of and expanding access to CAR-T therapies.
Olalekan Oluwole, MBBS, MPH, associate professor of Medicine, who leads the cellular therapy research program at Vanderbilt-Ingram, will present data on health care resource utilizations of the therapies in U.S. patients treated at newly authorized treatment centers. He will also provide an overview of outcomes for inpatient and outpatient CAR-T treatment. Grace Mercadante, MD, will present data on the impact of clonal hematopoiesis on CAR-T therapy.
Michael DeBaun, MD, MPH, the J.C. Peterson, MD, Professor of Pediatrics and founder and director of the Vanderbilt-Meharry Sickle Cell Disease Center of Excellence, will speak at a special session focusing on ASH’s sickle cell disease initiative. He will present findings from “Sickle Cell Trait Does Not Cause ‘Sickle Cell Crisis’ Leading to Exertion Related Death: A Systematic Review.”
Other topics researchers will address include acute myeloid leukemia, myelodysplastic syndrome, drug resistance, potential adverse reactions and risk comparisons of treatments, pediatric blood disorders, multiple myeloma, bispecific antibody treatment, and graft-versus-host disease.
A complete list of presentations from Vanderbilt researchers follows:
Sally Momoh, MD – Sex-related differences in silent cerebral infarction burden among adults with sickle cell disease
Jamila Mammadova, MD – Behind the blood-brain barrier: Contemporary screening practice patterns and trends of central nervous system involvement in acute myeloid leukemia treated with intensive regimens and hypomethylating agent/venetoclax
Alyssa Jarabek – Impact of innate immune memory on myelodysplastic syndrome progression by TET2-driven inflammation
Raymond Zhang – VISTA contributes to disease progression in high-risk myelodysplastic syndrome
Mattew Villaume, MD, PhD – EB2023 primes mitochondria for BCL2 dependence and induces pyroptotic cell death via AMPK signaling and the unfolding protein response
Grace Mercadante, MD – The impact of clonal hematopoiesis on CAR-T cell therapy outcomes: a single-center analysis
Ghadeer Dawwas, PhD, MSc, MBA – Risk of serious bleeding with concomitant use of apixaban or rivaroxaban with amiodarone compared to flecainide or sotalol in patients with atrial fibrillation
Olalekan Oluwole, MBBS, MPH – Real-world health care utilization following CAR-T cell therapy in U.S. patients treated in newly authorized treatment centers
Erin Christensen, MS, DO – A case series of pediatric patients with congenital thrombotic thrombocytopenia purpura treated with recombinant ADAMTS13
Andrew Jallouk, MD, PhD – Real-world outcomes of mosunetuzumab use in indolent and aggressive lymphomas
Bhagirathbhai Dholaria, MBBS – Characterization of a population with newly diagnosed standard risk multiple myeloma by 2025 ims/IMWG definition with exceptional long-term outcomes after fixed duration therapy
Y. Emily Chu – The acute myeloid leukemia microenvironment is defined by ineffective immune surveillance despite the presence of activated, clonally-expanded CD8 T cells with preserved effector function
Michael DeBaun, MD, MPH – Findings from “Sickle cell trait does not cause ‘sickle cell crisis’ leading to exertion related death: a systematic review ”
Mattew Villaume, MD, PhD – F1 subunit-specific ATP synthase inhibition disrupts AML mitochondrial metabolism distinctly from other electron transport chain inhibitors
Lauren Klein, MD, – Early weight gain predicts nutritional recovery in children with sickle cell anemia and severe acute malnutrition in Nigeria
Olalekan Oluwole, MBBS, MPH – U.S. cost consequence and time toxicity model for advanced therapies in the treatment for relapsed/refractory third-line or later diffuse large B-cell lymphoma: a comparison of axicabtagene ciloleucel with bispecific antibodies
Olalekan Oluwole, MBBS, MPH – Outcomes of inpatient and outpatient CAR-T in newly authorized treatment centers in the United States
Elizabeth Pollard, MD – Leukapheresis for acute leukemia with hyperleukocytosis: line complications, resource utilization, and early mortality outcomes
Carrie Kitko, MD – Long-term treatment duration and safety of axatilimab among patients with chronic graft-versus-host disease in AGAVE-201
While most women over age 50 schedule mammograms for breast cancer, only a minority who are also eligible for low-dose CT scans for lung cancer undergo those potentially lifesaving screenings. A new study shows that targeted outreach can close the gap.
The study results, published Dec. 1 in the Journal of theAmerican College of Radiology, showed that the improvement in lung cancer screenings exceeded the target enrollment set by the researchers. The study also demonstrated that two different types of outreach initiatives were effective in increasing uptake. Called CALM, an acronym for Coordinate A Lung screening with Mammography, the study was funded by the American Cancer Society.
At one academic medical center, a research team from pulmonary medicine determined eligibility by manual review of smoking history in electronic health records and then contacted patients directly to inform them of eligibility. The team also conducted surveys at mammography locations about smoking history. They had a target enrollment of 200 new patients for lung cancer screening and exceeded it by enrolling 214 patients.
At the other academic center, researchers from radiology identified patients eligible for lung screenings one month prior to their mammography appointments through a review of electronic health records. The patients were offered the opportunity to have both cancer screenings on the same day at the same location. They also exceeded their target enrollment of 322 patients by enrolling 445 patients.
“For years, we have recognized that many women screened for breast cancer are in fact dying from lung cancer. This study allowed us the opportunity to inform women and their referring providers of lung screening eligibility and to facilitate lung screening exams. We are incredibly grateful for the American Cancer Society and for the National Lung Cancer Roundtable as they supported this multicenter initiative. We plan to continue these efforts at VUMC and with institutions across the country to save more lives,” said Kim Sandler, MD, professor of Radiology and Radiological Sciences at Vanderbilt University Medical Center, director of the Vanderbilt Lung Screening Program, and the study’s corresponding author and co-principal investigator.
A previous study revealed that 58% of women who were eligible for lung cancer screening had reported having a mammogram within two years compared to only 7.9% who underwent lung cancer screening. Overall, participation in lung cancer screening by both men and women is low, with less than 20% of those eligible for low-dose CT scans receiving the screenings.
“It has been more than 10 years since annual screening for lung cancer was recommended, and screening rates still are disappointingly low. There are many reasons for these low rates, but mostly identifying eligible individuals is challenging in the primary care setting, and there is evidence showing a surprising lack of awareness about lung cancer screening among eligible individuals. The CALM model demonstrates we can successfully recruit eligible women through mammography screening. Perhaps we also will be able to enlist them to encourage eligible family members to have a conversation about lung cancer screening with their health care providers. There is enormous potential here, and the ACS is thrilled with the outcome of this study,” said Robert Smith, PhD, senior vice president and director of the American Cancer Society Center for Early Cancer Detection and the study’s other co-principal investigator.
The researchers hypothesized that mammography screening could be a “teachable moment” for women who are also eligible for lung cancer screening. The study period was from November 2019 to December 2021, but data from 2020 was excluded because of the disruptions in health care screenings due to the onset of the COVID-19 pandemic. Initially, women were considered eligible for lung cancer screening from ages 55 to 80 with a 30 pack-year history of smoking; guidelines expanded in 2021, and women were eligible beginning at age 50 with a 20 pack-year history. One pack year is equal to smoking an average of 20 cigarettes, or one pack, every day for a year. A person who has smoked half a pack per day for 30 years has a 15 pack-year history.
Other VUMC authors on the study are Caroline Godfrey, MD, MPH, Valerie Welty, PhD, Stephen Deppen, PhD, MA, Alexis Paulson, MS, Shanna Joyner, Hannah Marmor, MD, MPH, Grace Wallace, CCRC, Lauren Hatcher, MD, MBA, Landon Fike, MD, and Arulita Gupta, MD.
Researchers at Vanderbilt University Medical Center and the University of Calgary have established an analytical framework that integrates genomic, proteomic and electronic health record data to identify cancer risk proteins and therapeutics for cancer prevention.
Their study, reported Dec. 2 in the American Journal of Human Genetics, identifies previously unreported protein biomarkers and candidate drug targets across six major cancer types and highlights approved drugs with potential cancer preventive effects.
To date, genome-wide association studies (GWAS) have identified several hundred genetic variants associated with increased risk for breast, colorectal and prostate cancer, and several dozen risk variants for other cancers, including lung, pancreatic and ovarian cancer.
Xingyi Guo, PhD
“Previous research, including our work, has identified hundreds of putative cancer susceptibility genes that could be regulated by these risk variants; however, most dysregulated gene expression has not been thoroughly investigated at the protein level,” said Xingyi Guo, PhD, associated professor of Medicine in the Division of Epidemiology at VUMC.
Guo is a co-senior author of the current study with Zhijun Yin, PhD, MS, associate professor of Biomedical Informatics at VUMC, and Quan Long, PhD, associate professor of Biochemistry and Molecular Biology at the University of Calgary.
Zhijun Yin, PhD
“To deepen the understanding of causal mechanisms and enhance drug discovery efforts, it is imperative to explore data from transcriptomic to proteomic studies,” Yin said.
In the current study, the investigators integrated large GWAS data for breast, colorectal, lung, ovarian, pancreatic and prostate cancers and population-scale proteomics data from over 75,000 participants (combined from the Atherosclerosis Risk in Communities study, deCODE genetics, and UK Biobank Pharma Proteomics Project) to identify risk proteins associated with each cancer.
They identified 365 proteins associated with cancer risk, and through further analysis narrowed the list to 101 proteins, including 74 not reported in previous studies. Using a variety of pharmaceutical databases, the researchers comprehensively annotated the risk proteins as therapeutic targets of approved drugs or drugs in clinical testing. The idea, they said, is to find drugs that can potentially be repurposed for cancer prevention.
“Traditional drug discovery faces challenges of escalating costs, lengthy timelines, and high failure rates. Drug repurposing is a promising strategy to identify new applications for existing drugs with well-documented characteristics,” Guo said.
Among the 101 risk proteins, the researchers identified 36 druggable proteins potentially targeted by 404 drugs already approved or in clinical trials. Nineteen of the druggable proteins were targeted by drugs approved or in trials to treat cancer. The researchers compared drug effects using data from more than 3.5 million electronic health records (EHRs) from VUMC. They demonstrated in simulated trials with EHR data that several approved drugs, for example the diuretic medication acetazolamide, were associated with reduced colorectal cancer risk.
“Our findings offer additional insights into therapeutic drugs targeting risk proteins for cancer prevention and intervention. It is essential to evaluate the effects of the reported candidate drugs through both in vitro and in vivo assays in future research,” Yin said.
Co-first authors of the AJHG paper are Qing Li, PhD; Qingyuan Song; and Zhishan Chen, PhD. The research was supported by the National Institutes of Health (grants R37CA227130, R01CA269589, R01CA297582).
Vanderbilt University Medical Center is one of two facilities in Tennessee recognized by Becker’s Hospital Review as “hospitals and health systems with great oncology programs” for 2025.
“Vanderbilt-Ingram Cancer Center, part of Vanderbilt University Medical Center, is the only NCI-designated comprehensive cancer center in Tennessee that provides care for both adults and children,” Becker’s Hospital Review noted. “Recognized by U.S. News & World Report as a top-performing cancer hospital, Vanderbilt-Ingram serves more than 49,000 distinct patients and manages over 250,000 outpatient visits annually. With a team of more than 200 cancer specialists and over 300 physician-scientists, the center leads in precision medicine and translational research, supported by more than $150 million in total research funding, including $69 million in competitive NCI grants.
“Vanderbilt-Ingram offers access to more than 350 clinical trials and is the developer of MyCancerGenome.org, a globally recognized resource for genetically informed cancer care. As a member of the National Comprehensive Cancer Network, Vanderbilt-Ingram helps shape national standards in cancer prevention, treatment and survivorship care.”
The other Tennessee hospital that made the list is Memphis-based St. Jude Children’s Research Hospital.
A few days ago, I found out the results of a biopsy. If you have ever waited for test results to show up, you know the mixture of anticipation and dread that the little “you have a new message” icon on the My Health at Vanderbilt portal can bring. This is the way most people now find out medical information, including biopsy results, even before your doctor has had a chance to see them.
Some people prefer to wait for a phone conversation or meeting with their doctor, but I couldn’t wait another minute. I knew these results would have a great bearing on the next few months, and maybe the rest of my life.
I clicked on the report and read the words. Not to put too fine a point on it, I have cancer. Specifically, prostate cancer: adenocarcinoma, grade group 1, Gleason score 3+3=6.
I’m not a medical person; I’m a writer, but I’ve written about medical subjects and medical people for a long time, and as I read the report I thought that it was relatively good news, at least for someone like me who had gotten to the point of needing a biopsy.
I did something which I freely admit is a terrible idea, which I had been sternly warned against, and which I certainly don’t recommend that anyone else do.
And then I did something which I freely admit is a terrible idea, which I had been sternly warned against, and which I certainly don’t recommend that anyone else do: I googled my results.
Relief.
I ran downstairs to tell my wife, Sharon. It’s almost surreal even remembering this, but I told her everything with a smile on my face.
My relief was real because my fear had been real.
A little later, Sharon summed it up: “You’re the happiest person I ever heard of who just found out he has cancer.”
It hit me then. My reaction was unexpected, to me, and probably would be to anyone else. It was weird.
Hear me out, though. Here’s what I was thinking when I opened that report: I was considering that there was a range of outcomes, from “no cancer” at the good end to “life-threatening metastatic disease” at the other (very, very few people get this result, but still it was a fear, however far-fetched).
This result was much closer to the good end.
Time for a referral
Steven Allon, MD
This gland-oriented escapade began about 10 weeks earlier when routine blood work came back from a visit to my primary care physician, Steven Allon, MD, assistant professor of Medicine. I had an elevated prostate specific antigen (PSA), which can indicate cancer, but other things can also make it go up; it’s an imperfect test.
Allon is a low-key guy, which I appreciate, and he said the thing to do about a high PSA was to wait a few weeks and retest. I wasn’t having any symptoms; this was not a crisis; so, let’s just be sure the elevated PSA was real.
It was. Three weeks later, my PSA levels had risen.
Allon said it was time for a referral to Urology, where I met with Taylor Brewer, MSM, physician assistant in Urology, who, and I cannot emphasize enough how much I appreciate this, was low-key and professional. She looked over my lab work and quickly sketched out what needed to happen next: first, a multiparametric MRI (which shows more detailed images of the prostate and is now recommended by the American Urological Association for evaluation of an elevated PSA in some patients), and following the MRI, a prostate biopsy.
It’s quite an experience hearing Warren Zevon’s classic song “Werewolves of London” in an MRI tube.
Taylor Brewer, PA
So, first stop: MRI. I had never had one before, but I’m not claustrophobic and the Saturday morning I was there, the techs at Vanderbilt Imaging Services Midtown (who were friendly and, yes, low-key) played, at my request, songs by Warren Zevon into my earphones. It’s quite an experience hearing his classic song “Werewolves of London” in an MRI tube.
The report was, to me, scarier than a werewolf. The MRI indicated several lesions on my prostate, which were characterized as “at least mildly suspicious.” That “at least” is doing a lot of work in that sentence, and “prostate lesions” is not a phrase designed to cheer anybody up.
So: I had an elevated PSA and lesions. As you might imagine, this made me very apprehensive about what was going on.
I was about to find out.
A visiting dignitary at the surgical center
My biopsy was scheduled for a Monday morning at the Vanderbilt Surgery Center Belle Meade. The procedure just takes a few minutes, under IV anesthesia similar to that used for a colonoscopy. A couple of weeks before the biopsy, Lori King, FNP, a nurse from the Vanderbilt Preoperative Evaluation Center, phoned for some pre-op information, and she told me the urologist performing the biopsy would be Kristen Scarpato, MD, MPH, associate professor of Urology and the director of the Urology Residency Program.
I knew Scarpato a little bit by reputation because the News and Communications office where I work had featured her in some news stories and interviews with news media, but I did not know her personally.
Kristen Scarpato, MD, MPH (photo by Erin O. Smith)
King volunteered something that was very reassuring to hear: “Dr. Scarpato is great,” she told me. “She does most of the prostate biopsies at Vanderbilt. If my father needed a prostate biopsy, I would want her to be the one doing it.”
I met Scarpato the morning of my biopsy, and I liked her right away. She was — you probably saw this coming — low-key. In our brief pre-op discussion, she was calming and matter of fact and went over how the biopsy would be done (transperineally, guided by ultrasound). A little later, she went into more detail: “I make two needle sticks in your skin. Through those two needle sticks, I take 20 biopsies of your prostate.” She also met Sharon, who was waiting with me, and made sure to let Sharon know that she would phone her in the waiting room with a report on how I was doing as soon as I was out of surgery.
Scarpato was one of the last people I met before being taken to the OR, but she was far from the first.
Jami Webb, RN (photo by Erin O. Smith)
Jami Webb, RN, was the nurse who looked after me before and after the procedure, and she was efficient and friendly. We had some time to talk while I waited, and it would have just been fun to hang out with her if I hadn’t been about to have a biopsy.
Eric Briggs, MD
The anesthesiologist who would be working on my surgery, Eric Briggs, MD, introduced himself and went over the anesthesia procedure, and was a friendly and affable companion for a few minutes.
In fact, while I waited for my turn, it’s like I was a visiting dignitary or something, so many people came by. Each introduced themselves (I don’t remember most of their names; I’m terrible at names under the best circumstances, and when I’m wearing a hospital gown with an IV in my arm, I’m REALLY terrible at it).
There was the nurse who started my IV, a urology resident who would be assisting on my procedure, possibly a urology fellow (I’m a little hazy on this point), a certified nurse anesthetist, and at least two other nurses who wheeled the bed to the OR and helped me shift to the operating table.
Before this whole thing was over, my prostate was going to have a higher viewership than many late-night cable TV shows.
I thought about how many people were involved in my care. The front desk people who checked me in at each appointment and continuing through the clinicians in many VUMC departments, including internal medicine, pathology, radiology, anesthesiology and urology; the phlebotomists who drew my blood for tests; the techs at the imaging center; the nurses in the clinical offices and at the surgery center; and the people in Vanderbilt Medical Laboratories.
Before this whole thing was over, my prostate was going to have a higher viewership than many late-night cable TV shows. I think this is a very good thing. I’m happy to know that at VUMC, people work as a health care team, and that second, third, fourth and fifth opinions are built into the system.
The biopsy was very easy, from the point of view of a person who was technically there but, in the words preferred by leading anesthesiology texts, “out like a light.” I never had any pain, and I was deeply impressed with the efficiency and care at the surgical center.
My surgery was scheduled for 11:15 a.m., and the clock in the OR read 11:12 when I was rolled in. There was music playing: Belinda Carlisle’s “Heaven is a Place on Earth.” One of the nurses was softly singing along.
I awoke in recovery and asked for a cup of coffee (I had had to skip anything to eat or drink that morning). Sharon was there at my bedside, and soon we were in the car headed home.
The results came a week later.
Words of realistic reassurance
When Scarpato and I spoke the day after the pathology report had landed in the portal, she was thorough in explaining the results, willing to answer all my questions, and (you know how much I like this), low-key.
I liked her when I met her the day of my biopsy, and I liked her even more when we spoke, both because of what she said and the way she said it.
“You have low-risk prostate cancer,” she said. She explained that the recommended course is active surveillance, which, in my case, means another PSA test in three months and another biopsy in six months, just to be sure everything is stable and the first tests didn’t miss anything important. (Will I be nervous to check those results? Oh, yes.)
Here’s what the doctor did not say: “Hey, Wayne, everything looks great! Have a nice life!”
If I had received this same diagnosis 30 years ago, my options would have been much more limited.
This is going to require watching, and as Scarpato put it in a follow-up message, “The benefit (of active surveillance) is to avoid the harms of treatment for a cancer that is unlikely to spread or progress. Should your PSA or your repeat biopsy indicate higher risk, we would intervene at that time.”
Kristen Scarpato on the uses of the PSA test and when a prostate biopsy is indicated.(video by Erin O. Smith)
Because I’m an old guy, I know lots of old guys. I know several people who have had prostate surgery or radiation treatments, and they are all doing fine. When I was waiting for my results, I kept all of these guys in mind. Knowing that even in my circle of family and friends, I was not alone in this experience was a great comfort to me. I don’t know anyone personally whose disease has been fatal, and most cases of prostate cancer do not shorten the patient’s life.
If I had received this same diagnosis 30 years ago, my options would have been much more limited, and it’s possible that a prostatectomy would have been recommended. Thanks to advances driven by scientists and clinicians, including those at VUMC, the understanding of what prostate cancer is, how it spreads, and how it should be diagnosed and treated has advanced tremendously. This has meant a better life and a better survival rate for those of us with this diagnosis.
Right now, more than 40% of men with new diagnoses go the rest of their lives with no harm to health, and according to the American Cancer Society (ACS), even though prostate cancer is the second-leading cause of cancer death in American men (behind lung cancer), the prostate cancer death rate declined by about half from 1993 to 2022. The ACS, somewhat reassuringly, says: “Prostate cancer can be a serious disease, but most men diagnosed with prostate cancer will not die from it.”
I hope my active surveillance goes on and on and on — but if it turns out I do need treatment later, I know I’m in good hands and at a good place.
These two things are both true: I have cancer. I am so very lucky.
Bonus video: Kristen Scarpato on why Vanderbilt Urology is a special place.(video by Erin O. Smith)
Eating, speaking clearly and breathing easily are essential functions we often take for granted, and Nick Schrock of Macon County, Tennessee, admits he did, too. Then, he noticed a small bump inside his mouth that changed everything.
He was just 30 when he felt a solid bump on the roof of his mouth where the hard and soft palates meet. It didn’t hurt and wasn’t irritated, so Schrock dismissed it as a random nodule of bone he just hadn’t noticed before. Nine months later, however, it began to grow and was soon the size of a quarter and felt “rubbery” rather than hard.
“It started to hurt when I yawned or took a bite of food,” he said. “It got bothersome, and I told my wife I needed to have it looked at.”
Today, after recovering from surgery at Vanderbilt University Hospital to remove what turned out to be a cancerous tumor and radiation therapy to target any remaining cancer cells, Schrock is grateful for all the care he’s received, but especially to have his voice back. Because of this, he feels he can be a better parent to his young daughter, Magnolia Mae, and can enjoy life with his wife, Brittany, and other family and friends.
After the tumor removal left a sizable hole inside his mouth, he initially could only speak in a muffled, lispy whisper. This was due to velopharyngeal insufficiency, a condition where the seal between the oral and nasal cavities does not close completely.
Schrock credits Vanderbilt University Medical Center providers for not only quickly addressing his cancer but also for restoring his voice. A key player on that collaborative team is Tyler Ames, DMD, chief of the Division of Dentistry at VUMC.
A custom obturator designed by VUMC’s Tyler Ames, DMD, sealed the hole left after removal of an oral cancer and restored Nick Schrock’s voice. It fits along the roof of the mouth, and the ball seals the cavity. (photo by Susan Urmy)
A rare cancer and arduous treatment
In January 2024, a biopsy revealed adenoid cystic carcinoma (ACC), a rare cancer typically originating in the salivary glands that makes up about 1% of all head and neck cancers. This type of cancer doesn’t run in families, and there are no known risk factors. While ACC is slow growing, it is aggressive. Surgery is the primary treatment, often followed by radiation. Reconstruction or prosthetics are often needed following treatment.
Because of the intricate anatomy of these areas of the body and often delayed detection, treatment for head and neck cancers can be arduous and impact critical functions like speaking, breathing and swallowing.
Within a week, the Schrocks were consulting with Alexander Langerman, MD, SM, a head and neck cancer and reconstructive surgeon at VUMC with fellowship training in microvascular reconstruction. Surgery was quickly scheduled.
Langerman worked for five hours to remove a golf-ball sized growth that was extensively invading the soft tissue and muscle, especially muscles involved with chewing. It required removal of part of Schrock’s upper jawbone and a few teeth. Langerman then performed a local flap surgery using part of Schrock’s inner cheek to help patch the hole inside his mouth.
Schrock then underwent radiation therapy under the care of D. Nathan Kim, MD, PhD, a Vanderbilt Health radiation oncologist at Vanderbilt-Ingram Cancer Center at Wilson County, which was much closer to his home.
Making it through 33 sessions of radiation treatment was one of the hardest things he’s ever done in his life, Schrock said. His mouth and throat were raw and dry. His stomach was continually upset. His hair, including his beard, fell out. And he lost 60 pounds.
And there were other setbacks. He lost hearing in his right ear because of a fluid buildup due to the radiation. That was resolved quickly through a minor procedure by otolaryngology-head and neck surgeon Matthew O’Malley, MD. Schrock also began having difficulty breathing through his nose. Another otolaryngology-head and neck surgeon, Naweed Chowdhury, MD, MPH, cleared swollen tissue caused by the radiation from a maxillary sinus, which improved his ability to breathe.
But the biggest thing he wanted resolved was his voice. Ames was ready. He had been in consultation with Langerman from the start of Schrock’s journey, viewing imaging and following his progress closely.
“Nick expressed that he was afraid of his daughter being embarrassed by his speech,” Ames said. “I took this to heart as I also have a young daughter. Putting myself in his shoes, I knew that I had to do everything I could to help him.
“With these cases you really are not sure what is possible until you try. Nick is an amazing patient who is very motivated. His drive helped to keep the treatment on track and helped motivate me to do the best I could for him.”
Prosthetics to seal oral cavity holes
When individuals are left with holes or deficits in their oral cavity due to congenital defects like cleft palate, cancer surgeries or trauma, prosthetics known as obturators are often custom designed to restore function. This is what Schrock needed.
“An obturator is a prosthetic device used to close and seal a defect or opening in the hard or soft palate to assist in speech and eating and drinking,” Ames said. “This can prove challenging because you are not always sure if the patient is going to tolerate having the obturator in the back of their throat.”
Because of the precision diagnoses and effective treatments provided by Vanderbilt-Ingram clinicians, patients come not just from Tennessee but also from parts of seven contiguous states and beyond. That means the center sees a higher volume and higher complexity of patients with head and neck cancers. Ames was increasingly being referred individuals who needed restoration after surgery.
Obturators are usually created by specialized dentists known as prosthodontists or maxillofacial prosthodontists, but many private practices instead focus on dental implants and other higher volume, profitable procedures. Finding a dentist who can create a custom obturator isn’t easy. With the growing number of cancer patients he was seeing with unique needs, Ames decided a few years ago he would research and teach himself the precision craft of creating obturators.
“Since Tyler joined VUMC, we have worked together in tougher and tougher cases and grown together as partners,” Langerman said. “Nick’s case was indeed a tough one, and his success is the product of the years of work Tyler has put in to restore patients to a greater quality of life after surgeries such as this.”
Ames works with Vanderbilt Health surgical oncologists to review imaging, even running over to the surgical clinics so he can see the space he needs to seal. He works with an area dental lab to produce obturator prototypes and in the early days, he even tried varied materials to achieve the best seals and most comfortable devices. Now, though every case is different, he has become adept at problem-solving and creating obturators for even highly complex cases.
“In Nick’s case, a nasal endoscopy performed by Dr. Langerman with the custom obturator in allowed me to have a ‘GPS’ to show exactly where I needed to add to the obturator to better seal the defect and aid his speech,” Ames said. “We could see the obturator in place from the viewpoint of the sinus, which helped tremendously.”
Recently, Ames met with Schrock again and checked in on his progress. His voice was strong and easily understandable. But Ames cocked his head, listened closely, and told Schrock he felt like he could make some minor adjustments to improve his voice even more. Schrock smiled.
“Dr. Ames has significantly changed my life,” Schrock said. “I still struggle, and I don’t like talking in front of a lot of people, but what he’s done for me is incredible.
“I don’t mind sharing my story if it gives someone else hope. It does get better. I didn’t feel that way for a while, but it does.”
Vanderbilt University Medical Center offers access to new resources that help relatives connect and join forces to protect their families from inherited diseases.
VUMC is one of the first cancer centers to partner with the ConnectMyVariant program, which offers resources for families with hereditary cancer risk. The resources make genetic medicine approachable, can help people discover distant relatives they didn’t know before, and can assist families in talking across dinner tables about a potentially sensitive topic. It’s akin to an ancestry game that allows people to amplify the family benefits of cancer prevention, and the person who starts it can be a superhero.
To launch a connection search, someone with a specific gene variant signs up to meet others who share that variant. When people have the same gene variant, there is more than 90% chance they are related, even if it is several generations back. This begins the process of sharing stories with others who are likely to be relatives, discovering new connections with unknown relatives, and encouraging family members to get tested. The program is designed around the perspective and experience of lay people — not clinicians. It is an innovative approach to encourage genetic testing, and it’s needed, said Tuya Pal, MD, professor of Medicine in the Division of Genetic Medicine and Clinical Pharmacology at VUMC.
Tuya Pal, MD
“Family communication, which is the basis of what we call cascade testing, is hugely important,” said Pal, who is also Ingram Professor of Cancer Research and an associate director at Vanderbilt-Ingram Cancer Center. “BRCA genes were identified 30 years ago, but we’ve found maybe 20% of adults who are at risk for cancer. There’s a lot of adults walking around with a BRCA mutation. They could get ongoing prevention, but they don’t know it. This is a challenging nut to crack, but it is of huge public health relevance. If we can get to these people, we can save lots of lives.”
BRCA1 and BRCA2 gene variants, which increase risk for breast, ovarian, pancreatic and prostate cancer, have received the most media attention. However, in recent years, several other gene mutations have been discovered that can also put people at risk for cancer. Pal stressed that people should seek genetic testing from reputable and accredited laboratories, which are different from many direct-to-consumer testing companies that offer testing for “recreational genetics.” While direct-to-consumer labs offer ancestry testing, sometimes they also delve into other genes; however, the quality of the data they provide is not always accurate for disease risk. For this reason, it is important to get tested through providers knowledgeable about genetic testing options, such as the Vanderbilt Hereditary Cancer Clinic. Insurance typically covers the cost for those at high risk, such as those with a personal history of specific cancers (and diagnosed at certain ages), family history of specific cancers, and those who already have a relative found to have a gene mutation. The tests, which can be done with either blood or saliva samples, cost about $250 for self-paying patients.
Pal likens a gene mutation to a spelling mistake.
“When we’re talking about an inherited predisposition, you can think of each gene as a big book, and a mutation is like a ‘spelling mistake’ in that book — leading to the gene not working quite right and thereby raising risk of certain cancers,” she said. “If you’ve got the same spelling mistake between two people, they are somehow related. People sometimes have trouble sharing broadly with family members, so this tool can make this experience of family communication and testing more enjoyable. You can connect with people you don’t know that are related from maybe eight generations ago.”
Brian Shirts, MD, PhD
ConnectMyVariant, which is operated as a nonprofit organization, was developed by Brian Shirts, MD, PhD, associate professor of Pathology, Microbiology and Immunology and of Biomedical Informatics, who was recruited to VUMC in December 2024. He is the service medical director of the Molecular Genetics Laboratories.
“Scientific modeling has shown that if we could reach out to second and third cousins effectively of people with known variants, we could identify everyone who has a hereditary cancer risk,” said Shirts, who is also President of ConnectMyVariant’s Board of Directors.
However, he stressed that ConnectMyVariant is not a research program or a direct clinical resource.
“It’s an educational program,” Shirts said, noting that people should schedule a visit with a genetic counselor affiliated with a medical provider if they discover they have relatives with mutations that put them at increased risk for cancer.
ConnectMyVariant offers educational resources for adult-onset hereditary diseases for which there are established preventive actions people can take. It is not intended for use by people younger than 18, so it does not offer resources for autosomal recessive pediatric diseases.
“The way I like to think about what we offer is ‘If I talk to my relatives, are they going to be able to do something?’ If the answer is yes, and they can get genetic testing and do something that will improve their health, then that’s included,” Shirts said.
The ConnectMyVariant program also offers participants access to resources for ancestry research, such as professional assistance from the Center for Family History and Genealogy at Brigham Young University.
For individuals with inherited cancer predisposition, Vanderbilt-Ingram has the Inherited Cancer Registry (ICARE), which Pal founded in 2010. It has grown into one of the largest registries for inherited cancers, with almost 8,000 participants enrolled to date. Through the registry, the latest care and research updates are shared with participants by newsletter, email and links to presentations, and it is a way for people to be part of the larger research mission.
Pal serves as vice chair of the National Comprehensive Cancer Network Genetics/Familial Guidelines Committee for Breast, Ovarian and Pancreatic Cancer. She leads a team of certified genetic counselors at the Vanderbilt Hereditary Cancer Clinic.
A multidisciplinary team led by investigators at Vanderbilt University Medical Center has received a $4.2 million grant from the National Cancer Institute (NCI) to probe the genetics of colorectal adenomas — polyps that can develop into colon cancer — and to identify drug candidates that could reduce adenoma recurrence.
Xingyi Guo, PhD
Colorectal cancer is the second most common cause of cancer-related death in the United States, according to the NCI, part of the National Institutes of Health. Removing precancerous polyps during colonoscopy procedures significantly reduces the burden of colorectal cancer, but about 30% of patients who have a colorectal adenoma removed will develop recurrent adenomas.
“Patients who have recurrent adenomas are at higher risk for developing cancer,” said Xingyi Guo, PhD, associate professor of Medicine in the Division of Epidemiology and lead principal investigator for the project. “We will integrate cutting-edge genomic research with real-world patient data from electronic health records, with the goal of translating genetic discoveries into actionable strategies to prevent colorectal cancer.”
Zhijun Yin, PhD
Zhijun Yin, PhD, MS, associate professor of Biomedical Informatics, is co-principal investigator for the four-year project.
The team previously conducted genome-wide association studies (GWAS) of about 8,000 colorectal adenoma cases from European American and African American participants included in BioVU, VUMC’s de-identified DNA biobank and linked electronic health records. Using a large-scale analysis of electronic health records and pathology reports, the investigators also established the Vanderbilt Colonoscopy Cohort of colorectal adenoma cases after polyp removal, which includes 76,664 cases.
With the new funding support, the team will extend its efforts to establish the largest-ever genetic study of colorectal adenoma, drawing on BioVU, the Mass General Brigham Biobank, and the NIH All of Us Research Program to include over 25,000 cases in European Americans and 6,500 cases in African Americans, with thousands of recurrences. African Americans are about 20% more likely to have colorectal cancer and about 40% more likely to die from it compared to other racial groups, according to the American Cancer Society.
“Our approach will allow us to examine racial differences in adenoma recurrence and colorectal cancer risk,” Guo said.
In addition to GWAS, the team will conduct transcriptome-wide, methylome-wide, and proteome-wide association studies to identify genes and proteins associated with colorectal adenomas and their recurrence. The investigators will integrate findings from these “omics” studies with electronic health record data from the Vanderbilt Colonoscopy Cohort and the Mass General Brigham Colonoscopy Cohort and use machine learning frameworks to identify candidate drugs that could prevent colorectal adenoma recurrence. They will test the most promising drug candidates in colorectal adenoma and cancer cells, patient-derived organoids, and animal models.
“This project is an innovative integration of multiomics analyses with electronic health record-based real-world clinical evidence,” Yin said. “We anticipate that our findings will inform personalized colorectal polyp surveillance, guide therapeutic prevention strategies, and ultimately reduce the burden of colorectal cancer nationwide.”
Guo holds a secondary appointment in the Department of Biomedical Informatics at VUMC, and Yin holds secondary appointments in the Department of Computer Science and the Department of Electrical and Computer Engineering at Vanderbilt University. Guo and Yin have both received NCI R37 MERIT Awards, which provide long-term grant support to outstanding investigators.
Other collaborators for the new NCI grant (R01CA297582) include VUMC Department of Medicine investigators Wei Zheng, MD, PhD, MPH, Qiuyin Cai, MD, PhD, and Wanqing Wen, MD, MPH, Division of Epidemiology; Bhuminder Singh, PhD, Division of Gastroenterology, Hepatology and Nutrition; and Kristen Ciombor, MD, MSCI, Division of Hematology and Oncology; and Harvard T.H. Chan School of Public Health investigator Mingyang Song, ScD, Departments of Epidemiology and Nutrition.
Mark Kelley, MD, MMHC, medical director of the Williamson County General Surgery Division in the Department of Surgery at Vanderbilt University Medical Center, has retired, effective Oct. 1, after 28 years of exceptional service and leadership.
“Dr. Kelley transformed the Division of Surgical Oncology and Endocrine Surgery into one of the nation’s largest and most productive academic surgical oncology programs,” said Carmen Solórzano, MD, John L. Sawyers Chair in Surgical Sciences and chair of the Department of Surgery. “His remarkable contributions span clinical excellence, innovative research and impactful education.”
Kelley, an associate professor of Surgery in the Division of Surgical Oncology and Endocrine Surgery, is lauded by his colleagues and surgical leaders for his contributions both at VUMC and nationally.
“Dr. Kelley’s career reflects an unwavering commitment to excellence in clinical care, research, education and leadership,” said Seth Karp, MD, H. William Scott Jr. Chair in Surgery and chair of the Section of Surgical Sciences. “His legacy has profoundly shaped surgical oncology at Vanderbilt and beyond. We are grateful for his dedication and leadership.”
In 1997, Kelley joined the VUMC faculty as an assistant professor in the newly established Division of Surgical Oncology and Endocrine Surgery and served as clinical director of the Vanderbilt Breast Center until 2005. His leadership skills led to his appointment as chief of the Division of Surgical Oncology and Endocrine Surgery in 2002, a role he held until 2015.
“As clinical director of the Vanderbilt Breast Center, he led its development and transition from a small practice in the Village at Vanderbilt to a comprehensive breast center at One Hundred Oaks,” said Solórzano. “In 2005, he passed the clinical directorship to Dr. Ingrid Meszoely, whom he recruited back to Vanderbilt after her surgical oncology fellowship. Today, the Vanderbilt Breast Center is one of the largest and most comprehensive programs in the United States.”
Recognizing the importance of focused training in breast surgical oncology, Kelley developed the framework for a breast surgical oncology fellowship. Expansion of the curriculum under the leadership of Mary Hooks, MD, MBA, and Ingrid Meszoely, MD, led to accreditation of the program by the Society of Surgical Oncology in 2016.
Under Kelley’s leadership, the Division of Surgical Oncology and Endocrine Surgery expanded from four surgeons to a multidisciplinary team of more than 20 surgeons, advanced practice providers (APPs) and research scientists. He also played a pivotal role in recruiting and mentoring key faculty who now serve as VUMC surgical and Vanderbilt-Ingram Cancer Center leaders, including Rondi Kauffmann, MD, MPH; Christina Bailey, MD, MSCI; Kamran Idrees, MD, MSCI, MMHC; Meszoely, Solórzano and others.
Kelley was a sought-after mentor throughout his career, and assisted numerous medical students, surgical trainees and junior faculty as they participated in projects and developed their own research. Under his leadership, the Division of Surgical Oncology and Endocrine Surgery was highly ranked, year after year, as a favorite learning environment for general surgery trainees. More than 30 residents completed surgical oncology fellowships during Kelley’s tenure, and many are leaders in the field today, including five current VUMC faculty members.
He was an early advocate for the integration of APPs into clinical roles. In 1999, he established training and mentorship programs for APPs specializing in breast health and surgical oncology, and these programs served as models for integrating APPs into surgical practices throughout VUMC. Today, there are 10 APPs practicing in inpatient and outpatient roles in the Division of Surgical Oncology and Endocrine Surgery.
Kelley was a surgical innovator and the first surgeon in Tennessee to perform sentinel lymph node biopsy for breast cancer and melanoma in 1997. This procedure has transformed the care of these cancers. Kelley developed an Institutional Review Board (IRB)-approved protocol to train surgeons on this technique, leading to the rapid and safe application of the new surgical procedure at VUMC and in the community.
Kelly was also integrally involved in the development of multidisciplinary clinical and research programs at Vanderbilt-Ingram Cancer Center. From 2000-2012, he served as chair of the VUMC Cancer Committee. This group monitors and reports cancer volumes and outcomes, guides quality improvement, and ensures compliance with national cancer treatment standards. During his tenure as chair, VICC was continuously accredited by the American College of Surgeons Commission on Cancer. The program was also routinely recognized as one of the top National Cancer Institute-accredited comprehensive cancer centers nationwide during that time.
Early in his career, Kelley had an independent laboratory that focused on translational research in melanoma tumor biology and contributed to the early development of immunotherapy for melanoma. He established the melanoma and cutaneous malignancy tissue repository in 2003. This IRB-approved research repository has collected tumor tissue samples from patients undergoing surgical resection or biopsy with paired clinical data from more than two decades. This invaluable resource has supported high impact basic and translational studies that have led to novel combinations of immunotherapy and targeted therapy being investigated in clinical trials today.
“Dr. Kelley is highly committed to the advancement of cancer care through research, and we are grateful that he will remain active in clinical and translational research with VUMC and VICC as professor of Surgery, retired, to continue to improve care for patients with cancer,” said Karp.
Allison Young is easing the pain for people grieving the lost connections when a loved one dies by providing a place for words left unspoken and milestones that can no longer be shared.
It’s a small phone booth without utility wires or cellular connections nestled along her driveway in East Nashville. The messages are carried by love vibes. Since Young erected the booth two years ago, it has become a sanctuary of solace and garnered attention from local and international media.
She learned about a “wind phone” while she was working on the thesis for her master’s degree, researching alternative grieving methods, and delving into the continuing bonds theory — a concept that it’s okay for people in mourning to maintain connections to loved ones who have died instead of just having to let them go.
The first wind phone was erected in 2010 in northern Japan by Itaru Sasaki, who wanted to talk with his cousin who had died from gastric cancer.
“Since he couldn’t talk to him in person on a regular phone line, he wanted his words to be carried on the wind,” said Young, MS, BSN, RN, a research nurse specialist for clinical trials at Vanderbilt-Ingram Cancer Center. “He lived at the top of a hill right next to the ocean, so there was lots of wind. It was a perfect concept for him. Then unfortunately, four or five months later was when the tsunami hit Japan, the one that killed tens of thousands of people along the northern Japanese coast.”
The tsunami devastated Ōtsuchi, the town where Sasaki lived, with about 10% of its population of 16,000 perishing. Sasaki’s wind phone became the place where grieving survivors went to connect with lost loved ones.
“Now, thousands of people from around the world have made the trek to northern Japan to see the original wind phone,” Young said. “The idea has spread across the entire world. There are wind phones in other places in Asia, in Australia, all over North America, and a ton in Europe as well.”
The “wind phone” allows people a place for words left unspoken and milestones that can no longer be shared. (photo by Donn Jones)
Young put up her wind phone booth in September 2022, then unveiled it to the wider community in February 2023.
“It is dedicated to my paternal grandparents,” she said. “We opened it on the 24th anniversary of my grandfather’s death, and it is dedicated to my grandma who died in 2016. She is the only person I have ever called on it, and I called her the day I defended my thesis.”
Young has received notes from more than 200 people who have visited it. The structure is a circa 1940s actual phone booth. Her father, who is a contractor, helped her set it up by putting a slanted roof over its flat top and weatherproofing it with exterior paint. The booth is soundproof with a privacy curtain.
“There’s a light so that people can use it overnight as well,” she said. “Since I am a nurse, I know what health care hours are like, so I made it available 24 hours a day.”
The door has a sensor to help her keep records of visitors, but there are no cameras or privacy infringements. Visitors are encouraged to park in her driveway because Rosebank is a two-lane road with a narrow shoulder.
The wind phone has been featured in news stories and documentaries, including coverage by NHK, Japan’s public media organization, and by “This American Life,” a public radio program in the United States.
