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Cancer Center Sets Interdisciplinary Standard

"We are truly integrated," says Mark Israel, director of the Norris Cotton Cancer Center. "We've got an outstanding balance of research, clinical care, and physician education. The best patient care involves all three."

Cancer Center Director Mark Israel, PhD candidate Paula Knittle, and postdoctoral fellow John Nguyen confer in Israel's lab.
Cancer Center Director Mark Israel, PhD candidate Paula Knittle, and postdoctoral fellow John Nguyen confer in Israel's lab. (photo by Joe Mehling '69)

Israel says this mixture comes together so well partly because of the connections with Dartmouth and Dartmouth Medical School (DMS). That's why the impact of the cancer center reaches far beyond its physical location. Just a few miles from Hanover, the center is hosted in the Barbara E. Rubin building at Dartmouth-Hitchcock Medical Center in Lebanon. The strong, upbeat energy of the people who work there can be felt in the engineering and chemistry labs at Dartmouth, in classrooms at DMS, in the halls of the Children's Hospital at Dartmouth (CHaD), throughout the Upper Valley region of Vermont and New Hampshire, and among researchers around the world.

The fields of bioinformatics and computational biology span many departments and divisions in the Dartmouth family, including connections to the cancer center. These fields combine biological studies with engineering and information technology to interpret, analyze, and archive huge amounts of data, like genetic sequences. Many diseases, such as cancer, are rooted in genetic processes, and research at Dartmouth involves faculty and physicians from such disparate areas as computer science, chemistry, molecular biology, and genetics.

"Thanks to research at the genomic level, cancer diagnoses are becoming more specific and treatments are more targeted," says Israel. "We are quickly converting our new knowledge in biotechnology into strategies for treatment, and our interdisciplinary team contributes meaningfully to this effort."

For example, Bruce Donald, the Joan P. and Edward J. Foley Jr. 1933 Professor of Computer Science and adjunct professor of chemistry and biological sciences, and Hany Farid, associate professor of computer science, have teamed up with Bernard Cole, associate director of clinical research in biostatistics at the cancer center, to further develop an algorithm that helps analyze blood samples to find cancer. The algorithm, called Q5, uses data from a mass spectrometer, a device that generates a molecular fingerprint of biological samples. "Q5 works on the assumption that the molecular composition of the blood changes between healthy and disease states," says Donald. Already, Q5 has proved accurate in detecting ovarian and prostate cancer. The Dartmouth team is working to further test Q5 with more samples and among other types of cancer.

Researchers at the Thayer School of Engineering are also involved with a cancer center initiative to develop and test new imaging techniques. One group, headed by Professor of Engineering Keith Paulsen, is using microwaves, electricity, and infrared light to learn more about the structure of breast tissue. These different methods produce images that offer detail not seen with X-rays or MRIs, and they can reveal tumors and other abnormalities. Paulsen works with Steven Poplack, associate professor of radiology and of obstetrics and gynecology at DMS and co-director for breast imaging/mammography at the cancer center, on this project. The close relationship between engineers and clinicians has been invaluable in building and testing these imaging techniques.

Paulsen also works with Professor of Surgery David Roberts, a neurosurgeon who specializes in brain tumors. Through this collaboration, the doctors hope to improve the accuracy of image-guided surgery. They're using models to predict changes that occur in the brain during surgery to update the images neurosurgeons see as they operate.

"We're developing mathematical models to predict the movement of brain tissue during surgery," says Paulsen. "This helps the surgeons with precision and accuracy."

Dartmouth embraces this brand of integration and interdisciplinary teamwork. "It reflects deeply held beliefs that give value to collegiality and collaboration," says Israel. The relationships between people at the cancer center and colleagues at the College and throughout the community flourish. This recipe for success has caught the attention of leaders in the science community. Earlier this year, Andrew von Eschenbach, director of the National Cancer Institute, and Elias Zerhouni, director of the National Institutes of Health, visited the Norris Cotton Cancer Center and participated in a panel discussion on getting research advances utilized in patient care, a process sometimes referred to as "bench to bedside" or "translational research."

"We're totally committed to understanding the many facets of cancer and improving treatment for our patients," says Israel. "We have built an environment where the patients are the center of focus and where they have confidence in their care. We're committed to training physicians and researchers and enabling them to work together to find solutions for cancer prevention and treatment. We're proud to be a model for other cancer centers around the world."

By Susan Knapp

The Norris Cotton Cancer Center

  • ...was established in 1972 through the initiative of U.S. Senator Norris Cotton of N.H.
  • ...is a National Cancer Institute designated Comprehensive Cancer Center, one of only 38 in the United States. Comprehensive Cancer Centers conduct programs in all three areas of research-basic, clinical, and prevention and control-and have a strong body of interactive research that bridges these areas. In addition, Comprehensive Cancer Centers provide information, outreach, and education to both healthcare professionals and the community.
  • ...unveiled a new addition in 2003 that doubled the size of its facilities at the Dartmouth-Hitchcock Medical Center, providing four floors of new space for clinical care, basic and translational research, and cancer prevention and control.
  • ...welcomes each year approximately 2,400 new patients and handles more than 31,000 appointments at its Dartmouth-Hitchcock Medical Center location.
  • ...is on the web at www.cancer.dartmouth.edu.

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Last Updated: 5/30/08