Category Archives: Swedish Today

A collection of stories marking the 100th anniversary of Swedish Medical Center.

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When to consider home care

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When to consider home care

As people age, changes in their abilities are often gradual and subtle. That’s why it is often difficult for families and care providers to know when a loved one may need help with daily activities.

Portrait of an elderly Asian woman

You’re never too young or old to stay on top of your health.

You’re never too young or old to stay on top of your health.

Frequently, there are certain signs that may indicate a person is having trouble caring for him- or herself. If you answer “yes” to one or more of the following questions, it might be time to ask your doctor or your loved one’s doctor if a referral for home care services is appropriate:

  • Has the person experienced any falls?
  • Has the person lost weight? Is he or she experiencing a loss of appetite?
  • Is the person becoming increasingly forgetful? Do new situations cause confusion and/or anxiety?
  • Has there been a change in the person’s personal hygiene? Does he or she appear to be bathing less often and/or appear unkempt?
  • Does it appear that the person is experiencing difficulties getting to appointments and/or running errands?
  • Does the person forget to take his or her medications?
  • Does the person live alone with no local family or friends? Does he or she need to be in a skilled nursing home but want to stay at home?

While these are not the only signs that may suggest a person may need help caring for him- or herself, they are a good starting point when considering home care.

“Home care is a great option for patients who are struggling with the aging process or recovering from a surgery or illness,” says Jon Younger, M.D., medical director of Swedish Visiting Nurse Services. “It is an ideal alternative for patients who are ready to leave the hospital and return home, but who still require specialized services from a nurse, physical therapist, occupational therapist or other home-care clinician. It serves as a way for patients who cannot get to an outpatient clinic to receive the care they need.”

Home care is always provided under the supervision of a patient’s doctor, and the home-care staff can assist the doctor by being the eyes and ears in the home.

“Being in a health care facility — such as a hospital or nursing facility — is sometimes necessary and unavoidable, but the availability of home care can often shorten the stay and sometimes even prevent the patient from having to leave home at all,” says Dr. Younger.

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E-Health records: greater Seattle ahead of curve

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By Rod Hochman, M.D.

Despite differing opinions on health-care reform, there is general consensus on at least one critical issue: most everyone agrees it’s time for the country to get serious about electronic health records.

The economic stimulus package approved last year includes $19 billion in federal funding to help hospitals and doctors go digital. That’s a good thing because electronic health records can dramatically improve health care in our country by promoting higher quality, greater safety and lower costs.

While other industries have embraced information technology and have used it to streamline operations and better serve customers, health care has been slow to break free of its archaic paper-based filing system. Of the 6,000 hospitals in the United States, only 1.5 percent have made the leap to electronic health records.

Here in the Puget Sound region, however, we are fortunate to be ahead of the curve. Most of the major local health institutions, including Swedish, have already made the transition into the digital age.

A secure, information super highway for our region

One of the most innovative things about the Puget Sound region is that many of the major local providers have chosen to use the same software system for their electronic records. That’s not the case in other parts of the country where many hospitals have selected different systems, only to find out they’re not able to “talk” to each other.

Swedish, Multicare, Group Health and the University of Washington are all using a system developed by Epic, which is widely considered a national leader among the health IT software vendors. And recently, Swedish began extending its Epic system to independent physician practices. The Polyclinic – one of the largest multi-specialty groups in Greater Seattle – went live on Swedish’s Epic system last year.

A shared system allows local providers to exchange information over a secure network, and that’s an important benefit for patients. It means eventually wherever patients go within the region’s Epic network, from their neighborhood primary-care office to an emergency room across town, clinicians will be able to access vital information about patients’ health history, which helps ensure they’ll receive higher quality, safer health care.

Within a couple of years, if you travel outside of our region, your medical records can be made available to you on the Epic system. If you’re in Los Angeles, for example, and are not feeling well, you’ll be able to check your smart phone to find a provider who uses Epic. With your permission, they’ll be able to instantly access the information they need to diagnose and treat you.

What we’re doing at Swedish

Swedish staff working at computers

Electronic health records are fully implemented at Swedish.

Swedish began implementing an electronic health record system in 2007, and it is now in use at all of our locations. And we’re already seeing the benefits. By prescribing medications online, for example, physicians can quickly cross-reference drug interactions, thereby thwarting possible medication errors. By having vital information about a patient’s health history at their finger tips, our clinicians can be ever more effective at treating and caring for the patient.

At our new Issaquah hospital, which opens in 2012, patients will have a wireless computer station at their bedside, with direct access to their own medical records. They’ll be able to review their records at any time during their hospital stay, making it possible for them to stay well-informed about their health care and participate in the clinical decision-making.

The electronic health record also plays a key role in our new medical home in Ballard, which provides access to primary care and serves the full range of patients, including those with insurance and those without. Information technology makes it possible for us to communicate with patients and coordinate care to better manage chronic conditions and encourage wellness and prevention.

Security and privacy

With the move to online medical records comes a great responsibility to protect personal health information. At Swedish, we are vigilant about security and privacy. We’ve enacted an internal auditing program to ensure that patient records are only being viewed by those who are directly involved in that patient’s care.

The Federal government is also keeping a close eye on privacy and security. As part of the stimulus funding for health information technology, patients now have the right to request an audit trail, showing all disclosures of their personal health information. There are also now tougher penalties for health-care workers who violate the Health Information Portability and Privacy Act.

Sharing technology and expertise

Now that most of the major local health institutions have implemented an electronic health record, what’s the next step for our community? At Swedish, we believe it’s about sharing our technology and expertise with community hospitals, independent clinics and rural providers that have not yet made the leap.

By bringing more local providers into an integrated, secure information network, it can measurably improve the health of our community and truly reform the way health care is delivered. Compared to other parts of the country, the Greater Seattle region is closer than most to making that a reality, and that’s good news for everyone who lives here.

Rod Hochman, M.D., is the CEO of Swedish Health Services.

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Picture of Swedish pain specialist Dr. Gordon Irving

Learn to control pain instead of letting pain control you

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Physical therapist helps man stretch leg

Physical therapy is a component of pain management at Swedish.

Chronic pain is common and becomes more so as we grow older. In fact, after the age of 60, one in three people lives with chronic pain.

But how such pain affects one’s life can vary greatly, said Dr. Gordon Irving, medical director of the Swedish Pain & Headache Center. For some, chronic pain is a nuisance but for others, it can be debilitating.

Why this is so is unknown, said Dr. Irving, but the differences suggest that there are strategies that can help people overcome chronic pain and live happier, more fulfilling lives. This is the goal of the Swedish Pain & Headache Center.

Chronic pain and changes in the brain

Acute pain is the normal response to injury. Nerve fibers send signals from injured tissues to the brain where they are perceived as pain. Normally when the injury heals, the signals diminish and the pain fades.

In some cases, there is a chronic, pain-generating injury, such as damage due to arthritis, cancer and neuropathies. But in other cases, the perception of pain can persist even after the injured tissue has healed.

It is now known that the perception of pain can persist in part due to changes in the brain that occur in response to pain. In fact, such changes can be so profound, that brain scans of some patients with chronic pain show that areas of their brains have measurably diminished in size. “These and other findings have significantly changed how we think about pain,” said Dr. Irving.

Picture of Swedish pain specialist Dr. Gordon Irving

Through the STOMP program, Dr. Gordon Irving helps patients get chronic pain under control.

The approach at Swedish is to help patients “to get outside of their pain, so they control their pain, instead of having their pain control them,” said Dr. Irving.

To help patients gain that control Swedish has put together a team with a broad array expertise, including pain-medicine specialists, anesthesiologists, physical and occupational therapists, psychologists and practitioners of complementary treatments, such as acupuncture.

“The center is unique in that it has a wide variety of practitioners all working on the same floor, all working together,” said Dr. Irving.

The team takes a step-by-step conservative approach to each patient, said Dr. Irving. After a detailed history and physical exam, patients may have an imaging study, such as a bone scan or MRI, if a serious structural problem is suspected. But in most cases, says Dr. Irving, such studies are not necessary and, instead, patients typically begin working on a plan to gain control their pain with physical therapy and a program developed at Swedish called STOMP, for Structuring your Own Management of Pain.

This program provides information about pain and pain treatments, but its primary focus is helping patients engage in a series of activities that have been shown to help people overcome pain. These activities include, improving sleep habits, engaging in regular exercises, addressing psychological problems, learning relaxation and “mindfulness” techniques and enrolling in an online “mind-strengthening” program that aims at reversing some of the brain changes seen with chronic pain.

The program is designed so that it can be tailored to each individual’s needs, said Dr. Irving, and allows the patient to decide on what goals he or she wants to pursue.

Coupled with the help of physical therapy and other interventions, the STOMP program helps many patients get control of their pain, but not all. In those cases, more testing might be needed with MRIs, bone scans and other imaging techniques. In some cases, it can help to look for the exact source of the pain by injecting an anesthetic under X-ray guidance to see if numbing specific nerves, joints and spinal disks relieves the pain. “It’s like finding a sore tooth,” explained Dr. Irving.

Other high-tech techniques are available for treating intractable pain. These include the use of spinal cord stimulators, which emit a low-voltage current that block pain signals, and pain-medicine pumps that can be inserted under the skin, which administer low-doses of pain medicine directly into the fluid surrounding the spinal cord.

With these and other interventions, most patients will get significant pain relief, said Dr. Irving, but not always. “In some cases, a patient comes back to the center and says, ‘Doctor, I’m feeling better – I still have my pain – but I’m able to live my life.’, said Dr. Irving, “That can be a good outcome, too.”

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To learn more about Swedish read other articles from the supplement:


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Headaches often under-diagnosed and undertreated

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Almost everyone has a transient “nuisance” headache once in a while and most find relief with rest or by taking an over-the-counter pain reliever.

But many people who have headaches, especially those who have recurrent headaches severe enough to interfere with work and other activities, may in fact have migraines and not know it, said Dr. Sheena Aurora, a neurologist and director of the Swedish Headache Center.

“I see patients all the time who say ‘I don’t have migraines because I’ve never had an aura’— well only about 20 percent of people with migraine have an aura. Aura is very rare,” said Dr. Aurora.

Such headaches are much more common than classic full-blown migraines and while they may not have a typical aura they often come with other migraine symptoms such as nausea and hypersensitivity to light and noise.

Milder headaches that are not too bothersome and don’t interfere with your daily life are probably simply “tension headaches,” said Dr. Aurora. “But a lot of headaches that people call tension headaches are probably migraines.”

This is good news because many of these milder migraines are treatable, often more treatable than the classic migraines, Dr. Aurora said. “If you have headaches that come and go and interfere with your social and work activities, you should probably see somebody about them.”

Dr. Sheena Aurora

The approach at the Swedish Headache Center is to get to know the person in order to understand why they are getting headaches, Dr. Aurora said.

“We probably talk about their headache for about five to 10 minutes, and we spend the rest of the time trying to understand who you are and what sorts of stresses you may be experiencing in life that could be behind your headaches.”

In some cases, patients’ lives are so fraught with family, work and financial pressures that it seems overwhelming. In that case, to address their headaches, patients need a strategy to help them address those pressures, Dr. Aurora said.

In other cases, a combination of medical issues need to be tackled one by one in order to end the headaches. A patient, for example, might be overweight, which makes her back pain worse, which in turn makes her neck pain worse that triggers the headaches.

Without addressing the lifestyle and medical issues triggering headaches, it is difficult to address the headaches, Dr. Aurora said. “There’s a tendency in America to think there’s a pill for every problem, but there isn’t.”

In many cases, though, small changes in lifestyle can make a big difference. Consider, she says, the case of a hard-charging tech worker who works long hours in the office, comes home late, eats a rushed meal of preservative-laden processed food and then tries to relax by watching television.

Such a person, Dr. Aurora said, might be able to avoid or at least reduce their headaches simply by taking time in the evening to prepare a meal with fresh food without preservatives and then, instead of watching television, take time to get at least 30 minutes or more exercise.

Keeping a headache “diary” to keep track of activities and foods that seem to set off headaches can help identify headache “triggers” to avoid, Dr. Aurora said.

A headache diary can often explain weekend headaches, Dr. Aurora said. “Sometimes people drink coffee Monday through Friday, and then they won’t have it on Saturday, triggering what’s called a coffee-withdrawal headache.”

Headache diaries often reveal that a change in sleep pattern, such as sleeping in on a Saturday morning, is triggering headaches. “In that case, if you need to catch up on your sleep, you could get up at your regular time in the morning and take a nap later in the day,” Dr. Aurora said.

Although Dr. Aurora is not convinced that specific cheeses, wines and other foods are responsible for headaches as many believe, “if you find a consistent pattern linking your headaches to certain foods, definitely avoid them.”

But she’s definitely a skeptic when it comes to “headache diets” promoted by some popular health books. “The headache diets probably don’t work and, in any case, they’re so strict they’re impossible to stick to,” she said.

For headaches that don’t respond to simple lifestyle changes, there is a range of medications that have been shown to be effective for preventing headaches, Dr. Aurora said.

Among some of the newer treatments for chronic migraines are injections of headache trigger points in the muscles of the head and neck with Botox, the muscle relaxing drug made famous by cosmetic surgeons as a treatment for facial wrinkles but also used for a number of neurological conditions, such as dystonia.

In a study conducted at Swedish and due to appear soon in the medical journal Cephalgia, Dr. Aurora and her co-workers got good results with this approach. Other approaches available at the Swedish Headache Center include physical therapy, biofeedback, and, when necessary, psychological counseling.

Recently a number of genes have been linked to specific headache syndromes. These discoveries may help us to better understand the mechanisms behind headaches and lead to drugs that specifically target those mechanisms.

In the not too distant future, Dr. Aurora said, “instead of shooting in the dark” we may be able to use the patient’s genetic profile to design a treatment regimen that targets the specific mechanism behind his or her headache.

MRI scan of the brain

Headache Hygiene

Headache hygiene is the practice of taking care of yourself in a way that will reduce the likelihood, frequency, intensity and severity of headaches.

Lifestyle Changes

Migraine is not a predictable disorder for all people. Simple things like changes to a normal routine can lead to a severely disabling migraine attack.

Understanding how lifestyle affects the severity and frequency of attacks can be a large part of successful migraine prevention.

It is unrealistic to expect anyone to completely change a certain life style. However, certain things are relatively easy to do. For example:

Maintain regular sleep patterns.

Go to sleep and wake up at the same time each day.

Exercise regularly.

For example, aerobic exercise for at least 30 minutes three times a week will help reduce frequency or severity of migraine.

Exercise on a regular basis, even if your daily routine changes (such as when traveling, when you have house guests, or when your workload increases).

Eat regular meals.

Do not skip meals, and eat a good, healthy breakfast.

Reduce stress.

Limit stress by avoiding conflicts and resolving disputes calmly. Some people find it helpful to take a daily “stress break.”

Avoid known triggers.

Establishing daily routines that help reduce migraine attacks is important for long-term migraine prevention. For example:

Schedule a relaxation period that includes relaxation strategies such as:

Take slow, deep breaths

Focus the mind on a relaxing image or scene

Try soft relaxing lighting and sounds

Maintain your treatment plan:

Maintain the medication treatment plan designed by you and your physician. Early intervention may help prevent the migraine from progressing into a severe, disabling attack.

To learn more visit the Swedish Headache Center’s webpage.

To learn more about Swedish read other articles from the supplement:


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Medical Home: changing the rules of primary care

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It’s mid-afternoon in Caffe Fiore on Ballard’s Leary Avenue, and the soft autumn light adds its warmth to an already inviting setting. Behind the counter, baristas serve steaming coffee to a steady flow of customers who are pushing strollers, chatting with friends, or intensely focused on the laptop screens in front of them. The baristas are all in their 20s. They are cheerful, hardworking and – until recently – among the millions of Americans who might have insurance to cover a catastrophic illness, but can’t afford the primary health care it takes to stay well.

Dr. Miranda Lu counsels with a patient at Swedish’s Community Health Medical Home in Ballard.

Dr. Miranda Lu counsels with a patient at Swedish’s Community Health Medical Home in Ballard.

“Our business is too small to be able to provide health care for our staff; our first priority is making sure we can pay their wages,” said Katrine Callahan, Caffe Fiore’s general manager. “We are always looking for ways to help them out, to get them care. What we want for ourselves and our staff is a doctor who knows us when one of us walks in the door. I want someone who is actually concerned about helping me stay healthy instead of waiting for an issue to come up and then trying to fix it. But how could we afford that?”

Katrine was surprised to find the answer a few blocks away on Swedish Medical Center’s Ballard campus. The recently opened Swedish Community Health Medical Home was designed to provide the community with unprecedented access to primary health care.

The word is spreading as friends tell friends: The clinic space is beautiful – large, light-filled and calm – but the waiting room is small because, well, there’s really no waiting. You can request appointments online and get seen within a day. When you call the office, a real person answers, and if you have a medical question, the doctor calls you back.

For $45 a month, Katrine learned, she could:

  • Come in for an unlimited number of appointments
  • Expect each appointment to last as long as she needed
  • Schedule same-day or next-day visits
  • E-mail or talk to a physician outside clinic hours
  • Log onto a secure Web site to review her medical chart, e-mail her doctor or make an appointment
  • Have routine tests and lab work done in the clinic

Swedish Community Health is a pilot program, built on a model called the patient-centered medical home. While many clinics across the country are converting existing programs to this model, Swedish is one of the first to start with a vision for accessible, affordable primary care and then build the clinic from the ground up.

The focus is on wellness, disease prevention and day-to-day management of chronic illnesses. It is an approach, Swedish believes, that will be more convenient and affordable for patients, improve health outcomes and help reduce out-of-control health-care costs.

New Concept, Old Fashioned Care

At the heart of Swedish Community Health is an old-fashioned concept Katrine’s generation is too young to remember: Doctors who have the time to pay close attention to their patients.

“At my first appointment, I was really surprised that my doctor spent a full hour with me,” Katrine said. “In other places, I’ve typically gotten 10 minutes, if that. I’m pretty healthy, but have minor recurring concerns, and have been having a difficult time getting any consistency with health care. I talked with Dr. Lu about that and other ongoing concerns. It’s clear that the goal is to prevent issues and keep me healthy. That’s the most natural concept I’ve ever heard, but for some reason, it’s a ‘new’ concept.”

Miranda Lu, M.D., said consistency, communication and tracking patient information are all keys to facilitating optimal patient heath. The clinic’s doctors build time into their daily schedules to make follow-up calls to patients, especially those who are medically complex. The physicians also take turns being on call outside regular clinic hours.

In addition – thanks to a seamless system of electronic health records throughout all of Swedish – the staff can keep close tabs on patients who are hospitalized at Swedish or referred for specialty care. Although much goes on behind the scenes, what patients seem to appreciate most is, simply: Time.

“I had one patient with a heart-pounding sensation who had been to the emergency room, multiple doctors and a cardiologist,” Dr. Lu said. “It turned out that an over-the-counter medication was causing the problem. She had been using a nasal spray for over 20 years, and had never thought to mention it as part of her medical history. We were 30 minutes into our conversation when this came up – and I know that if I had seen her in the typical clinical setting, we never would have gotten to it.”

One might think that such access to a physician would result in unnecessary calls or appointments, but so far, that’s just not the case. Because they know they can reach a physician when they need one, Dr. Lu noted, people are not clamoring for time or services they don’t really need.

Pioneering Payment Reform

Dr. Kendra Wiggins with one of her younger patients; the clinic sees patients of all ages

Dr. Kendra Wiggins with one of her younger patients; the clinic sees patients of all ages

Intuitively, it makes sense: If all primary care doctors had abundant time to listen to their patients, make follow-up calls, or see three little boys in one appointment, considerable time and money could be saved. Unfortunately, across the country, the opposite is true.

“We believe the prevailing fee-for-service model is part of the problem with primary health care today,” said Jay Fathi, M.D., a family physician and the medical director of Primary Care and Community Health at Swedish. “With this model, to make money, you have to see as many patients as you can, spend as little time with them as you can, and charge payers as much as you can. Even if it’s a two-minute question, the system creates the incentive to have patients drive in, pay for parking, wait for the doctor… The time has come to be innovative. We think the payment rules should change.”

The Swedish team realized early on that the pay-for-service model was at odds with its patient-centered vision. Instead, they created a new reimbursement system and started this medical home pilot with an option for patients without insurance coverage to pay a flat monthly fee for all medical services available in the clinic. Doctors are paid a monthly salary not connected to patient volume. Self-pay patients – like Katrine and many of the café’s young baristas – have the monthly fee automatically charged to their credit cards.

Swedish physicians and administrators had expected to find a demand for affordable primary care, but were still surprised to find that, at the six-month mark, 40 percent of all Swedish Community Health patients are self-paying. Another 15 percent are Medicare patients, and about 10 percent qualify for Swedish’s charity care program. Swedish is partnering with Molina Health care, a third-party administrator for Medicaid, to provide the care for the remaining 35 percent of the clinic’s current patients.

Thanks to a recently signed partnership agreement with Premera Blue Cross, another component is being added: patients with private-pay insurance. Under the agreement, Premera will pay a monthly fee for every member enrolled in the program, and Swedish will waive their co-payments.

The clinic expects to grow to a total patient population of 2,500. Of those, an estimated 800 to1,000 patients will be Premera members.

The agreement also includes additional financial incentives for meeting evidence-based standards, such as immunization and screening programs and lower blood pressure rates among patients with hypertension and optimal blood-sugar levels for patients with diabetes.

“This is an innovative way to reimburse for primary care, and will help prevent such things as renal failure, stroke and heart failure down the road,” Dr. Fathi said.

Challenges Ahead

Swedish is charting new territory with the way it has created this patient-center medical home, and questions remain: What is the best way to ensure specialty care for services beyond the scope of the clinic? Will the percentage of charity care patients rise, straining the system? Will a growing shortage of primary care doctors make the clinic challenging to staff as the patient load increases? What changes will national health care reform bring?

Any bold innovation brings its share of challenges, and not all the answers are readily available. Granted, in the complex conundrum that is our national health-care crisis, Swedish Community Health may be just one small step in the right direction. But it is a step that is working for its patients, and for its staff.

“This is why I went into primary care – to be able to take care of the whole person,” said Dr. Lu. “It’s a challenging job. It keeps us on our toes. But we have a great team here, and we are making a difference in the lives of our patients every day.”

Links:

To learn more about Swedish read other articles from the supplement:

Link to additional Information about the Swedish Robotic Program: www.swedish.org/Robotics



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Swedish 100 Max

Brain cancer: an orphan disease no longer

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Last August, Senator Edward Kennedy of Massachusetts died just 15 months after he had been diagnosed with brain cancer. His death was not unexpected: brain cancer is one of the most aggressive forms of cancer known.

Dr. Marc Mayberg, a neurosurgeon at the Swedish Neuroscience Institute, reviews brain scans.

In fact, on average, the life expectancy of a patient with glioblastoma, the type of brain cancer that killed Sen. Kennedy, is only 12 to 14 months.

That’s roughly the same as it was a century ago, noted Dr. Greg Foltz, director of the Ben and Catherine Ivy Center for Advanced Brain Tumor Treatment at the Swedish Neuroscience Institute. The lack of progress is due in part to the aggressiveness of this disease, said Dr. Foltz, but also to the lack of funding for research.

“Over the past 25 years only three new drugs have been approved by the U.S. Food and Drug Administration for the treatment of brain cancer, and none of these treatments extend median survival by more than a few months,” Dr. Foltz said. “In many ways, brain cancer is a neglected ‘orphan disease’.”

Dr. Greg Foltz leads effort to find a cure for brain cancer.

To improve the care of patients with brain cancer in the Northwest, Swedish created the Ivy Center for Advanced Brain Tumor Treatment two years ago. Since then, it has become the hub of a network of doctors in the Northwest caring for patients with brain cancer and researchers and scientists using the latest technology to develop new ways to diagnose and treat these tumors.

Individualizing treatment

Over the past decade it has become increasingly clear that tumors of the same type actually vary considerably from person to person and over time.

This explains why one treatment may work well for one patient and have little effect in another. Tumors can also evolve over time, responding to one drug initially but not a second time.

These findings suggest that one treatment does not “fit all” tumors and that treatments need to be tailored to target specific tumors.

One of the goals of the research being conducted at the Ivy Center is to see if it is possible to create “individualized” treatments for patients that will be more effective than standard approaches.

As part of this effort, the Ivy Center is working with Seattle’s Allen Institute for Brain Science to create a three-dimensional map of brain tumors. It is hoped that these maps will allow researchers to better understand the biology of glioblastomas and to identify the genes that are driving these tumors.

In this project, called the Ivy Glioblastoma Atlas Project, tumor samples are being collected from 64 patients. Tissue from the tumors will be used to create a genetic profile – or fingerprint – of each tumor to identify any genetic alterations that may explain why the tissue became cancerous and to serve as a guide to treatment.

The tumors themselves will be sent to the Allen Institute, where they will be sliced into microscopically thin strips. Then, using a process call in situ hybridization, the researchers will map the activity of more than 1,000 genes on each strip.

The data from thousands of individual strips will then be assembled into three-dimension computer maps of the tumors showing which genes are active in which parts of the tumor.

Brain tumors vary from person to person. A goal of researchers at the Ivy Center is to find individualized treatments.

The maps will make it possible for researchers to in effect peer into a tumor and see which genes seem to be active in the most aggressive, fastest-growing areas. This information, in turn, could be used to select drugs that will target these fast-growing areas.

The technique can also be used to study tumors that recur after treatment to help researchers understand how the tumor resisted treatment and to identify new targets for drug therapy.

A cure may be a long way off, said Dr. Foltz, but even small advances will make a difference.

“With survival measured in just one to two years, the majority of these patients will tell you that their lives become focused on a simple equation of time and hope,” he said. “With each month they continue to live, there is renewed hope for a medical breakthrough, an effective treatment or perhaps even a potential cure.”

Links: www.swedish.org/BrainCancer


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