A final goodbye: Remembering William L. Henrich, MD, MACP
IN MEMORIAM
William L. Henrich, MD, MACP, who served as university president from 2009 to 2024, died March 14, 2024. He was 77.
In his 15 years as president, Henrich transformed UT Health San Antonio into a top-ranked academic health center.
He presided over the greatest period of expansion in the institution’s 65-year history, punctuated by $1 billion in ongoing construction projects that will change the city’s health care and life sciences research landscape. A board-certified and fellowship-trained nephrologist, Henrich served as dean of the health science center’s Joe R. and Teresa Lozano Long School of Medicine from 2006 until 2009, when The University of Texas System Board of Regents appointed him president.
Dedicated to preserving the core missions of health care education and biomedical research during uncertain economic climates such as the COVID-19 pandemic, Henrich consistently led the charge to augment the institution’s clinical practices. The number of patient visits to all the institution’s clinical practices, which includes UT Health Physicians and UT Dentistry, exceeds 2.6 million annually.
Meanwhile, he worked to increase the institution’s research footprint and impact. UT Health San Antonio is the largest academic research institution in South Texas and is a primary driver of San Antonio’s $44.1 billion health care and biosciences sector.
The academic mission, so vital in training tomorrow’s health care providers and researchers, was especially important to Henrich. He steered the creation of The University of Texas School of Public Health San Antonio, the institution’s sixth school, initiated in collaboration with The University of Texas at San Antonio.
Speaking in April 2023, Henrich described the uniqueness and mission of the health science center.
“Our mission is to make lives better. That mission compels us to not allow ourselves to get fatigued, because what’s at stake is a human life. Many human lives. That’s why what we do comes from our hearts. That’s why we can’t allow ourselves to quit. If not us, then who will do it? People are depending on us.”
Henrich is survived by his wife, Mary, their two children and their five grandchildren.
And caring donned a thousand faces
In ways, 2020 and the first half of 2021 were normal times for UT Health San Antonio. Tomorrow’s health care professionals were educated and graduated, and new, highly qualified students were recruited. Research labs were abuzz with the widest range of scientific inquiry and discovery. Thousands of patients were seen, treated, healed.
But those darkest days of COVID-19, of course, were normal for no one. The novel coronavirus killed millions of people worldwide, devastated economies, shattered dreams and broke hearts.
And yet, said William L. Henrich, MD, MACP, president of UT Health San Antonio, COVID-19 also magnified the courage, the heroics, the inclination to run toward the fire, to go beyond, that marks the healing professions and the mission of UT Health San Antonio.
“What I’m most proud of is we’ve saved thousands of lives by virtue of what our health care providers have done, and we’ll save thousands more by what we’ll continue to do,” Henrich said. “That ‘north star’ of saving lives is our vocation, our vision.”
And it’s a story that continues to this day, three years after the first known cases that forever changed the world of health care and of the entire health care workforce.
The perfect storm
As her daughter lay in the emergency room on the brink of a diabetic coma, Becky Salazar thought, “It should be me.”
Her daughter, Liz, was only 17. But her sugar level was sky high, three times higher than it should be. Her face was pale, eyes sunken. She was gasping for air. Her body was critically ill from too much sugar and too much acid in the blood.
They hadn’t even known she was diabetic.
“It’s a parent’s worst nightmare to see your child lying there so sick,” Becky Salazar said.
They had seen the signs. Tired all the time. Always thirsty. She couldn’t seem to lose weight. Then, all of a sudden, there was a dramatic weight drop. But the signs were just as easily dismissible. Teens are always tired. And it wasn’t like Liz was terribly overweight. She was tall and big-boned for her age. And she had recently begun exercising, so a drop in weight was to be expected.
Although Type 2 diabetes runs in their family, Becky and her husband, Gabriel Salazar, himself a diabetic, thought the chances of their teenage daughter being diabetic were slim to none.
A little more than 20 years ago, they would have been right.
Type 2 diabetes used to be known as adult-onset diabetes because, most frequently, it manifests gradually when people are in their 40s or 50s, after years of struggling with being overweight or obese, poor diet and a lack of exercise. But increasingly, physicians are seeing much younger patients affected by the disease.
At the Children’s Center at Texas Diabetes Institute, a partnership between UT Health San Antonio and University Health System, more than 1,000 children have been diagnosed with Type 2 diabetes since 2005. More than 20 were under the age of 10 when they were diagnosed, and the youngest was just 5. In Texas, it is estimated that 30,000 youth under age 20 will be diagnosed with Type 2 diabetes by 2025.
“We have the perfect storm in San Antonio,” said Jane Lynch, M.D., FAAP, professor of pediatrics and the Greehey Family Foundation Chair in Pediatric Endocrinology. “We are seeing so much more Type 2 diabetes in San Antonio, and we are seeing it in young ages. We’re the epicenter.”
As one of two U.S.-based members of the Global Expert Committee on Type 2 Diabetes in Youth, Dr. Lynch is well-located—on the logistical frontlines of what she calls an urgent public health threat. Because, while San Antonio bears the burden of being the epicenter for diabetes, it is also a hotbed for breakthrough research.
The epicenter for disease
Diabetes is a chronic disease that affects the way the body uses carbohydrates, protein and fat. People with diabetes have abnormally high levels of sugar in the blood.
In the two most common types of diabetes, Type 1 and Type 2, the sugar builds up in the blood, starving the cells of energy. Over time, this can damage the eyes, kidneys, nerves or heart. It can also be fatal.
Type 2 diabetes occurs when the body can’t properly use insulin, a hormone that the pancreas creates to use sugar for energy or store it for future use. It also can occur if the pancreas cannot keep up with the need to produce higher amounts of insulin. It typically develops slowly, and often is linked with obesity. Until the 1990s, it was almost always diagnosed near middle age.
So what makes San Antonio an epicenter for Type 2 diabetes? The Alamo City claims most of the risk factors. Type 2 diabetes disproportionately affects minorities, especially American Indians, blacks and Hispanics. And San Antonio is a majority-minority city, with Hispanics making up more than 63 percent of the population, while 6.9 percent are black.
The dramatic rise in pediatric Type 2 diabetes also corresponds with the rise in obesity. In the San Antonio region, obesity rates have been steadily ticking upward, hitting between 34.8 and 39 percent of all adults in 2016, according to the Texas Department of State Health Services.
While obesity is the biggest risk factor for the disease, the role of genetics is profound. If a woman has diabetes or gestational diabetes at the time she gives birth, her child likely is predisposed to the disease. Environmental factors, such as a family’s diet and lifestyle, may trigger its onset.
And women with diabetes are giving birth at higher rates because of improved medical treatments, Dr. Lynch said.
“We’re seeing a pretty steady trickle of new diabetics,” she said.
While it’s not a bragging point for San Antonio, the high rate of diabetes makes the city the perfect site for research to better understand how the disease behaves in children and discover new treatment options. One such landmark study, called Treatment Options for Type 2 Diabetes in Adolescents and Youth, or TODAY, began in 2005. The ongoing results, while grim, provide valuable insight that researchers are using to shape treatment plans.
The TODAY study was designed as a randomized trial to try treatment options in children of different ethnicities, ages 10 to 17, from around the United States. It followed 699 youth from 16 sites—including San Antonio—for seven years with medical intervention followed by ongoing observation. Dr. Lynch co-led the San Antonio site for the study, treating 44 children from the area.
The study evaluated the effectiveness of metformin, a drug that helps lower sugar levels and one of only two drugs approved by the Food and Drug Administration for pediatric use. It also studied the success of metformin paired with rosiglitazone, a drug that also reduces the amount of sugar in the blood, and metformin taken in combination with diet and exercise.
The results were disturbing. Lifestyle intervention had minimal effect on diabetes health outcomes. And although the children on the combined drugs did the best of the three study groups, all did poorly.
“Half of our enrolled youth failed metformin therapy rapidly,” Dr. Lynch said. “It lost its effect.”
Children with Type 2 diabetes experienced a very different, much more aggressive form of the disease than their adult counterparts.
“Deterioration in diabetes control was reported, and these youth with Type 2 diabetes were different from adult Type 2 diabetes patients for their very concerning rapid loss of the ability of the pancreas to continue to produce adequate insulin,” she said. “These youth could no longer be treated with the two oral study medications alone and required the addition of insulin therapy to control their blood sugars.”
Because diabetes is a progressive disease that damages the cells in the pancreas that make insulin, many people with Type 2 eventually need insulin therapy. Insulin therapy uses a syringe, insulin pen or insulin pump to inject insulin into the fat under the skin to help maintain blood sugar levels.
But with the youth, the rate of deterioration of the insulin-producing pancreatic cells, called beta cells, was almost four times higher than in adults. And the kids kept getting sicker. By the time the treatment phase of the study was complete in 2011, many of the children had developed early kidney disease, and teenage boys were 81 percent more likely to develop hypertension. They also developed fatty liver disease, which can lead to liver failure.
“This is devastating,” Dr. Lynch said.
Nearly a decade after the study began, participants were transitioned to routine medical care with their own physicians, with researchers continuing to monitor their progress. This second phase of the TODAY study, funded by the National Institutes of Health, began in 2011 and allows the researchers to record the long-term effects of Type 2 diabetes and the timing and prevalence of complications to the kidneys, heart, eyes and nerves, and overall health issues. The study has been extended twice, with the current funding slated to end in spring 2020.
Dr. Lynch has been following the same children for 15 years. Study participants are now in their mid-20s. While some have done well, others have struggled to maintain control of their diabetes.
“It was pretty scary and it keeps getting more worrisome as results become available,” Dr. Lynch said. “This is the first generation that will not live to be as old as their parents—in history.”
Still, she said, there’s hope.
“I feel like we missed a generation or two and now we’re trying to catch up,” Dr. Lynch said. “And we’re trying to figure out what is going to be most effective approach to turn the tide.”
While there are 34 drugs available to treat Type 2 diabetes in adults, there are only two approved by the FDA for use in children—metformin and insulin.
This is where Dr. Lynch and other researchers see a gaping window of opportunity. They have joined more than 55 other leading diabetes centers from around the country to form the Pediatric Diabetes Consortium. The group is helping redesign clinical drug studies to make them more accessible to pediatric participants. Whereas trials of the past required children to meet strict criteria in order to participate, the consortium is working to modify the trials to meet the children where they are in their disease. Already, the group has helped oversee and guide pharmaceutical and investigator-initiated clinical trials in nearly 50 sites throughout the U.S. Three of them are being led at UT Health San Antonio.
“In the past year we have seen significant changes in study designs, which continue to improve,” Dr. Lynch said. “Each protocol has gotten a little better. We have now reached a point where these companies are willing to work with us to do these very kid-friendly studies, which is important to be successful.”
And while there are no new treatments yet, she believes new medications are on the horizon. Until then, she said, education and outreach are important tools to correctly diagnose and fight back against both Type 1 and Type 2 diabetes. Just one example, Camp Independence of San Antonio, provides a summer camp for children with diabetes and offers physical education, arts and crafts and diabetes-related educational games. UT Health San Antonio staff and endocrinology fellows volunteer each year to provide medical counseling and gain experience in the management of diabetes in children of all ages.
“I think we need to accept that Type 2 diabetes is a real threat to our youth and that we need to aggressively treat it, and we need to aggressively attempt to prevent it,” Dr. Lynch said.
Fighting for health
Before Liz Salazar was rushed to the emergency room on the brink of a diabetic coma Nov. 4, 2018, the Salazar family approached their health lackadaisically.
“As young parents, our priority was to always accomplish as much as we could and not worry about the consequences of what we ate or how we ate,” said Gabriel Salazar, who was diagnosed with Type 2 diabetes at age 29. “It took a crisis like this to really change how we eat as a family.”
Now, instead of eating out every day, they make their meals at home. “We’re disgusted by eating out now,” Becky Salazar said.
Trips to the grocery store can take hours as they read nutrition labels to make sure they keep track of all the carbohydrates and sugars in each item. It takes a lot of work, time and money.
“It’s insane how much education you really need to have in order to maintain your healthy lifestyle,” Gabriel Salazar said. “You have to be aggressive and you have to really want to be healthy to maintain it. It takes a lot of work.”
But it’s worth it, they said. Not just for Liz, but also for her 7-year-old sister Leiya, who already struggles with weight and doesn’t much like eating healthy foods. They want to permanently change their lifestyle before it’s too late and affects her too.
“I think about my little sister and I try to play with her outside. Take more walks. Make sure she’s as healthy as we can get her,” Liz said. “I try to encourage her to do more so she doesn’t end up where I’m at now.”
It’s an uphill battle. The odds are statistically against Liz, but she doesn’t dwell on that. She has already lost nearly 30 pounds and has more energy. She feels better, overall.
“I don’t worry about my health down the road,” she said, but she does think about her future. “I want to get certified to do personal training so I can use this experience to help others. I see myself teaching others—kids—because it could happen to them. It could happen to my little sister. I want to help others so they don’t get to the point I was in.
“Diabetes changes your life completely. I hurt my body for so long. I don’t want to do that anymore.”
The essence of research
What does research look like to you? In the university’s first Image of Research Photography Competition, 21 students provided an intimate look into the depths of their research, from microscopic images of a rodent kidney to a 3D radiograph of a person’s nasal cavity. It was part of a competition that challenges students from colleges and universities from around the world to provide a creative, photographic view into the sometimes-nebulous world of research.
“When I first heard about the Image of Research, I knew it would be the perfect way to allow students from all five of our schools to be able to showcase their research in a creative, visual way that they aren’t necessarily always able to do,” said Kirsten Lorenzen, outreach and community engagement librarian in the Briscoe Library, which sponsored the competition.
Jaclyn Merlo, from the Graduate School of Biomedical Sciences, earned first place and $400 for her photo titled “Rodent Kidney Extracellular Scaffold” (see photo and description, page 3). Second place was awarded to Fabio Vigil from the Long School of Medicine, who received $300 for his image “The Universe Within.” Camila Pereira, from the Graduate School, won third place and $200 for “Airway Space Tour–A 3D Ride.” The Interprofessional Education Award of $600 was given to Sarah Khoury and Daryl Gaspar, from the Graduate School, for “Treatment in the Stars.”
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First place: Jaclyn Merlo, Graduate School of Biomedical Sciences “Rodent Kidney Extracellular Scaffold” Artist’s description: High-quality extracellular scaffolds are indispensable for research in regenerative medicine, gene transfer, cancer and tissue transplantation. The extracellular scaffolds of specific animal tissues can provide templates for the differentiation of human stem cells for the study of diseases in more relevant models, thus facilitating translation to human medicine. The technology is scalable and can prepare large animal and human tissue extracellular scaffolds. See story, page 34.
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Second place: Fabio Vigil, Long School of Medicine “The Universe Within” Artist’s description: The image is the merging of two photos. The first is a fluorescent microscope photo of a brain slice with the nucleus of all brain cells shining in blue (DAPI) and occasional immune cells shining in green (Iba1). Similar photos are taken everyday in neuroscience laboratories. The second image is a photo of the Cat’s Eye nebula taken by NASA’s Hubble Space Telescope. Looking simultaneously through the microscope and the telescope, this image invites you to think of your brain as a universe within you. The resemblance of the fluorescent cells to stars in the sky is astounding. The image also alludes to a fractal repetition of the same shapes and structures in different scales.
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“Airway Space Tour-A 3D Ride” Artist’s description: The airway should be free of obstacles so that air can flow from the nasal cavity into the lungs. Our research investigates the airway space imbalance that affects children who breathe through their mouths while sleeping. Dental 3D radiograph should be used as an opportunistic screening tool for sleep-related breathing disorders such as snoring and sleep apnea. Ultimately, three dimensions of life are affected: craniofacial growth, intellectual development and quality of life. When the dysfunction is detected early enough, the consequences can be reduced or even eliminated. Sleep disordered breathing is a public health issue and surveillance is essential. Let’s take this ride! |
Operating in the new normal
By Lety Laurel
Photo courtesy of Rachel Denny Clow/Corpus Christi Caller-Times
It wasn’t the first time they had seen the ravaging effects of high-velocity gunshot wounds on a body, or the first time they had to rush to prepare multiple operating rooms at once, bracing for a group of trauma patients to arrive.
It wasn’t the first time trauma surgeons Ronald Stewart, M.D., and Lillian Liao, M.D., M.P.H., had lost a patient in the operating room.
But this time was different. It was a mass shooting in a church. On a Sunday, during a worship service. There were kids. So many kids.
The rampage in the quiet town of Sutherland Springs on Nov. 5, 2017, the one that made Texas history for being the deadliest mass-shooting event in the state and ranks as one of the largest mass-shooting events in modern U.S. history, threw the trauma surgeons, both alumni of UT Health San Antonio, on the frontline of what they call a national public health crisis.
As surgeons in University Hospital’s Level 1 trauma center, the only Level 1 pediatric trauma center in South Texas, they had drilled for mass-shooting events dozens of times with their partners from San Antonio Military Medical Center, the city’s other Level 1 trauma center. They knew what to do.
But this was real. This was close. This was theirs.
If there is a first time for everything, those firsts come with a sobering reality—they’re typically not the last.
This, the surgeons fear, could be the new normal.
7:00 a.m.
If there is anything fortuitous about the day of the Sutherland Springs shooting, perhaps it is that the entire trauma leadership team was already gathered in a conference room in University Hospital on an otherwise quiet Sunday morning, reviewing the results of a site visit with members of the American College of Surgeons.
“Sutherland Springs happened in a rural area in South Texas that has an outstanding trauma system,” Dr. Stewart said. “That trauma system is essentially the backbone, or the framework, for disaster response in South Texas.”
And that morning, nearly every one of its trauma surgeons was already in the building at 11:20 a.m. when a lone gunman began
firing on worshippers inside First Baptist Church, using a variant of an AR-15 rifle.
“Normally we have two attending trauma surgeons on call on weekends in addition to our very large team of residents and physician extenders—our physician assistants and nurse practitioners—who are here taking care of the trauma that comes in.,” Dr. Liao said. “But we were all already here. So in a way we were kind of lucky.”
When the first emergency alert sounded, nearly every phone in the conference room lit up.
12:05 p.m. | Emergency alert
“Wilson County is responding to a mass shooting, the possibility of 30 patients. Update yourselves.”
As soon as they heard it was a church shooting, they knew there would be kids. The trauma surgeons immediately left the conference room and ran upstairs to prepare. They didn’t know how long they’d have before the first patients began arriving, but they knew they would be ready.
“We paged everyone and said this is real. Trauma surgeons started coming in. Anesthesia. By the time we received our first patient, we were prepared to run 15 rooms,” Dr. Stewart said.
But they wouldn’t need them. Of the 46 people shot, 26 died before ever making it to a hospital.
It takes time before the first emergency medical service responders can get to the injured at a mass-shooting event. Police have to make sure it is safe for anyone to enter. As the minutes tick away, people die from blood loss.
“There were more people who died on the scene than who made it,” Dr. Stewart said.
12:45 p.m.
After the rooms had been prepared and the blood bank notified, the surgeons and their teams waited.
“We were just like ‘Where are they? Where are they?’ Then we started getting the children first,” Dr. Liao said. “You don’t know the number of injured that are going to come in because it could be zero. We got a total of nine patients. Four of them were children.”
It took nearly an hour for all the patients to arrive, many of them with multiple gunshot wounds.
Among them was 5-year-old Ryland Ward, who was shot five times. His 7-year-old stepsister arrived later with severe abdominal injuries.
“You have nine patients with gunshot wounds with a high-velocity firearm at close range and a mix of children and adults. That’s not common. That’s different. Almost all of them needed an operation. That’s not true in ‘normal’ situations,” Dr. Stewart said. “You’re trying to find family members. And you have in the back of your mind that they’re not here because they’re dead.”
12:50 p.m.
Ryland’s body was riddled with bullet wounds to his leg, arm, bladder and kidney. While Dr. Liao worked on controlling the hemorrhage in his arm and leg, another surgical team worked to close the holes in his intestines.
“AR-15 type weapons are high-velocity firearms, so at close range, it creates a big blast. It’s a lot on a small body,” Dr. Liao said.
It wasn’t the first time she had seen traumatic wounds from high-velocity rifles. But it was the first time she’d ever seen so many at once. She’s never served in a war zone, and that used to worry her about her preparation for mass-casualty events, she said.
“I never thought it would happen here,” she said. “We drill two or three times a year, and you always think you’ll be ready for it. The real test comes when it happens.”
When it did, her eight years as a UT Health San Antonio trauma surgeon kicked in.
“In this day and age, in this country, you get to see all that as a trauma surgeon,” she said. “Mass shootings are becoming more common. And I think we’ll see it again.”
2:20 p.m.
While the patients came in, Dr. Stewart took on the role of triage officer, assigning the most critical patients to surgical teams. After the last patient was assigned, he went into the operating room of the 7-year-old girl.
She was unstable. After hours, multiple units of blood and several resuscitation attempts, there was nothing more that they could do.
Dr. Stewart turned the operation over to his former student, Dr. Liao, so he could speak with family members and let them know that despite everything they tried, they couldn’t get her back.
She was the only victim from the Sutherland Springs shooting to die in the hospital.
“I think probably the one thing that I’ll remember the most from that day was just pronouncing her dead,” Dr. Liao said. “It’s always the one thing that you remember—the patient you couldn’t save.”
7:00 p.m.
It was finally quiet. After the controlled chaos of the last few hours, the exhausted surgical teams gathered together to decompress. They talked about their patients’ operations. They gave each other updates on their well-being. They sketched out a plan for the next day.
They did not talk about Sutherland Springs, or the shooter, or the fact that now they had joined an ever-growing number of surgeons to respond to yet another mass shooting.
“You don’t have time for the emotional aspect of what just happened,” Dr. Liao said. “Your mind is still running through ‘What do I need to do tomorrow to take care of the patients?’
“None of us asked how we felt. We were all glad we stabilized the patients and took care of their injuries. I didn’t think about the magnitude of this experience until weeks later.”
Today
It would take two months for Ryland to recover enough from his wounds to go home. He was the last survivor of the church shooting to leave the hospital. He returned to a new, harsh reality. While he survived, his stepmother and two stepsisters died in the massacre.
Dr. Liao watched him leave the hospital Jan. 12 in a bright red fire truck, driven by the first responder who found him wedged between the floor and the body of his stepmother, and carried him to safety.
“Him going home was great for Sutherland Springs and for us. It was symbolic. It was really emotional,” she said.
But the tragic event should never have happened.
There is no widely accepted definition of “mass shooting,” but it is loosely defined as an event in which four or more people are killed at random in a public place by one or two shooters. Over the last 10 years, they have become more frequent and more deadly, placing the U.S. at the top of the world in the number of mass-shooting events.
All horrific in their savagery, the worst of them have become known simply by their locations: Mandalay Bay in Las Vegas, the Pulse nightclub in Orlando, Sandy Hook Elementary School in Newtown and, frighteningly close to home, First Baptist Church in Sutherland Springs.
“I don’t think any of us [trauma surgeons] thought a mass shooting was going to be a routine day for us until recently,” Dr. Liao said.
In 2017, there were 346 mass shootings. In 2018, the numbers have continued to climb, reaching 134 by June, according to the Gun Violence Archive.
In the months since Sutherland Springs, both trauma surgeons have traveled around the country advocating for a “common-ground approach to make firearm ownership as safe as reasonably possible, and for training the general public on bleeding control,” Dr. Stewart said.
The way to address a public health crisis such as this, they said, is to approach it as any scientist would: by focusing on prevention strategies, while simultaneously working to improve treatment.
“We all own this epidemic of violence,” Dr. Stewart said. “And we all must take steps to address the crisis of mass violence. It’s unacceptable that nearly 50 people sitting in church on a Sunday morning were brutally attacked, assaulted and murdered. We can, and we must, work together to end this type of violence.”
Trauma is the leading cause of death of children, and bleeding is a major preventable cause. It can take as little as five minutes for a person to bleed to death. But simple steps can save lives, and these steps are being taught to emergency personnel and medical professionals so that they can, in turn, empower bystanders to become lifesavers. In 2015, the White House launched the “Stop the Bleed” campaign to better prepare the public to save lives by raising awareness of basic ways to stop life-threatening bleeding following everyday emergencies, and man-made and natural disasters. To learn more, read story here.
Changing the standard of cancer care
Bladder cancer patients who received the chemotherapy drug gemcitabine had significantly lower recurrence of their cancer, a clinical trial has revealed.
The multi-institution trial involved 406 patients with newly diagnosed bladder cancer or low-grade bladder cancer that had not invaded the muscle wall. Those who received gemcitabine-saline treatment directly into the bladder within three hours following surgery had an estimated recurrence rate of 36 percent within four years. There was a 48 percent recurrence rate in the same time frame for those receiving a saline-only treatment.
“This is a huge difference in recurrence rate and demonstrated that gemcitabine is a safe and well-tolerated drug,” said Robert Svatek, M.D., the university’s study leader and a genitourinary oncologist. “We expect this study to change the standard of care.”
There were no significant side effects for patients in the study, and gemcitabine, which is already approved by the Food and Drug Administration to treat several types of cancer, is less expensive than many other therapies frequently used in the U.S.
A triple blow to cancer
By Rosanne Fohn
In 2018, an estimated 1.7 million cases of cancer will be diagnosed in the United States, and the number of new cancer cases per year worldwide is expected to rise to 23.6 million by 2030, according to the National Cancer Institute.
“Almost everyone is touched in some way by cancer, and our family is no different,” said Kathryn Mays Johnson, president of the Mays Family Foundation.
Johnson, both her parents—Peggy and Lowry Mays—and her brother are cancer survivors.
With this medical diagnosis so prevalent in their family and a commitment to help their community, the Mays Family Foundation has supported cancer research and treatment for decades. In January, the Mays family announced an increase in their legacy gift to $30 million to support UT Health San Antonio’s cancer center, which recently affiliated with MD Anderson Cancer Center. In recognition of the Mays’ gift, the UT System Board of Regents authorized calling it the Mays Cancer Center, the newly named home to UT Health San Antonio MD Anderson Cancer Center.
“My parents’ vision has always been to strengthen this community, the community in which they live, the community in which we live,” Johnson said. “It is our hope that this will be a place close to home where all of San Antonio and South Texas can come when they hear those words ‘You have cancer.’ And I can assure you, those words are life altering.”
The combined contributions from the Mays Family Foundation will provide an endowment to perpetually support the director of the cancer center and to establish up to 10 new permanent distinguished endowed chairs to support faculty recruitment and retention. The gift also establishes the Mays Cancer Center Excellence Endowment to support top priorities for future success and long-term sustainability, said UT Health San Antonio President William L. Henrich, M.D., MACP.
“Cancer has been aptly called the ‘emperor of all maladies,’ the disease which is the most difficult to diagnose accurately and treat with precision,” Dr. Henrich said. “Defeating its complexity requires leading-edge science, teamwork, perseverance and courage, each in equal measure.
“The overwhelming major beneficiaries of this gift are patients who will seek and receive life-saving care here.”
The vision for improved cancer care in South Texas was set when former UT System Chancellor Bill McRaven challenged UT System institutions to collaborate and build on their strengths. Then, in November 2016, UT Health
San Antonio and MD Anderson Cancer Center announced their affiliation to create a comprehensive and clinically integrated cancer care program in San Antonio. At the announcement, the board of the San Antonio Cancer Foundation, formerly the CTRC Foundation, pledged $17 million to support the new comprehensive and clinically integrated cancer care program in San Antonio by funding recruitment of new physicians and scientists, facility renovations and specialized equipment for the cancer center.
“Our cancer center brings a long history of testing cancer breakthrough therapies through our world-renowned, early-phase cancer treatment program, the Institute for Drug Development, and we are proud of having founded 40 years ago the San Antonio Breast Cancer Symposium that is now the premier international meeting for both researchers and clinicians focused on breast cancer,” said Ruben A. Mesa, M.D., FACP, director of the cancer center.
“We are thankful to the Mays family for their exemplary long-standing support, and we are deeply grateful that they have partnered with us to further develop the Mays Cancer Center for the future. We also owe enormous thanks to the board of the San Antonio Cancer Foundation for their enduring and generous contributions.”
Peggy and Lowry Mays and their family have been key supporters of the cancer center since the early years. Peggy Mays, a former member of the cancer center’s board of governors, founded the annual fund program—the Cabinet—in 1996. The Cabinet has raised nearly $8 million to date. Cabinet gifts provide support for innovative cancer research, equipment, cancer education and patient care programs.
In addition to serving as president of the Mays Family Foundation, Johnson is a member of the Mays Cancer Center Board of Governors and is a past president of the SA Cancer Council, formerly known as the Cancer Center Council. Over the past 33 years, the council has supported the cancer center through fundraising, volunteer services, community outreach, and patient education and assistance. The SA Cancer Council has contributed more than $4.7 million to support the mission of the cancer center.
“As longtime supporters and advocates for our cancer center in San Antonio, we are pleased to provide significant financial support at this critical time,” said Lowry Mays. “We are inspired by the cancer center’s exceptional leadership, mission, vision and goals, and we are especially pleased that our investment will support the Mays Cancer Center as we continue to develop the affiliation with MD Anderson Cancer Center.
“We are very proud that our family name will forever be associated with this cancer center, which serves millions
of people in San Antonio and across South Texas.”
In honor, to helpPeggy and Lowry Mays will be honored for their support in the fight against cancer at the 2018 President’s Gala Sept. 29 at the Grand Hyatt San Antonio. The gala is an annual event that raises money for the university and to support the work of faculty and students. This year’s event also marks the 50th anniversary of the Joe R. & Teresa Lozano Long School of Medicine. Proceeds from the gala will establish the Peggy and Lowry Mays Patient Care Endowment. The endowment will support the Patient Supportive Care Program at the Mays Cancer Center, the newly named home to UT Health San Antonio MD Anderson Cancer Center. The program helps people diagnosed with cancer by providing critical support, from transportation for daily treatments to prescription drug assistance, nutritional supplements, temporary lodging for out-of-town patients and funds to meet patients’ other emergency needs. The endowment also will provide wellness and survivorship programs to cancer patients, helping individuals prepare for a healthier life after treatment. For more information, go to makelivesbetter.uthscsa.edu/gala or call 210-567-2508. Long School of Medicine celebrates golden anniversary Alumni are invited to attend a 50th anniversary celebration before the President’s Gala at 6 p.m. Sept. 29 |
Newsmakers
Thomas G. Boyer, Ph.D., professor of molecular medicine, received two related National Institutes of Health R01 grants to study uterine leiomyomas, also called uterine fibroids. The first grant was for $1.56 million; the most recent, a five-year award for $3.8 million, was a multi-PI grant.
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The foundation, based in New York, is an independent, nonprofit grant-making organization. Dr. Cigarroa joined the board in 2014 and serves as chair of the finance committee, while also serving on the executive committee, the investments committee, and the Democracy, Rights, and Justice program committee. Dr. Cigarroa is head of pediatric transplant surgery and division head of liver transplant surgery at UT Health San Antonio. |
Francisco G. Cigarroa, M.D., former chancellor of The University of Texas System and former president of UT Health San Antonio, has been elected chairman of the Ford Foundation’s board of trustees.Daniel J. Dire, M.D., clinical professor in the Department of Emergency Medicine, has been appointed as the Army Deputy Surgeon General for Mobilization and Reserve Affairs. Dr. Dire is a major general and is the senior ranking physician in the Army Reserve.
Robert Esterl Jr., M.D., associate dean for undergraduate medical education and transplant center surgical director, received the 2018 Regents’ Outstanding Teaching Award from The University of Texas System. The award includes $25,000 in recognition of his commitment to student success.
Xianlin Han, Ph.D., professor in the Department of Medicine and the Sam & Ann Barshop Institute for Longevity & Aging Studies, received a $300,000 STARs award from the UT System. Dr. Han’s laboratory focuses on lipidomics, a relatively new field of biomedical research that involves complex lipidome analysis. The Science and Technology Acquisition and Retention program supports enhancement of UT System institutions.
Kenneth M. Hargreaves, D.D.S., Ph.D., won the Outstanding Research Accomplishment (Individual/Academia) Award from the Military Health System Research Symposium. The award recognizes outstanding research contributions on the health and well-being of the military by an individual research scientist.
Jeffery Hicks, D.D.S., professor of comprehensive dentistry, was appointed commissioner for postdoctoral general dentistry on the Commission on Dental Accreditation for years 2017-2021. The commission develops and implements accreditation standards for dental education programs.
Michaell A. Huber, D.D.S., professor in the Department of Comprehensive Dentistry, received the Diamond Pin Award for 2018 from the American Academy of Oral Medicine.
Ellen Kraig, Ph.D., professor in the Department of Cell Systems and Anatomy, was awarded the 2018 Regents’ Outstanding Teaching Award from The University of Texas System. The recognition includes $25,000 for her commitment to student success.
George Kudolo, Ph.D., FAIC, FAACC, was appointed chair of the Department of Health Sciences. Dr. Kudolo previously served as interim chair of the department and is a professor with tenure.
Yui-Wing Francis Lam, Pharm.D., FCCP, professor of pharmacology, was named a 2018 Piper Professor as selected by the Minnie Stevens Piper Foundation. Dr. Lam received a $5,000 award, certificate and gold pin.
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The Leukemia & Lymphoma Society funds blood cancer research around the world, provides free information and support services, and is an advocate for all blood cancer patients seeking access to quality, affordable, coordinated care. Dr. Mesa has been principal investigator or co-principal investigator in more than 70 clinical trials for patients with myeloid disorders and played a lead role in various FDA approvals. He has been a funded investigator from the National Cancer Institute throughout his career and currently is co-principal investigator of the NCI-funded Myeloproliferative Neoplasms Research Consortium. Dr. Mesa was named director of the cancer center in August 2017. He is a professor and holds the Mays Family Foundation Distinguished University Presidential Chair. |
Ruben A. Mesa, M.D., director of the Mays Cancer Center, the newly named home to the UT Health San Antonio MD Anderson Cancer Center, has been named to the board of directors of The Leukemia & Lymphoma Society.David Morilak, Ph.D., professor of pharmacology, director of UT Health San Antonio’s Center for Biomedical Neuroscience and member of the Mays Cancer Center, the newly named home to UT Health San Antonio MD Anderson Cancer Center, received a $899,547 research award from the Cancer Prevention & Research Institute of Texas. The funds will be used to study mechanisms and new treatments for cognitive impairment associated with a type of hormone treatment used in men with prostate cancer.
Robert H. Quinn, M.D., professor and chairman of the Department of Orthopaedic Surgery, was named chairman of the American Academy of Orthopaedic Surgeons Council on Research and Quality.
Amelie G. Ramirez, Dr.P.H., director of the Institute for Health Promotion Research, has been named one of 12 new Komen Scholars by Susan G. Komen, the world’s largest nonprofit funder of breast cancer research. Dr. Ramirez will receive $600,000 over three years to study Latina breast cancer.
Ruben Restrepo, M.D., RRT, FAARC, professor of respiratory care, was inducted as a Fellow of the American College of Chest Physicians.
Adriana Segura, D.D.S., was named interim dean of the School of Dentistry, effective June 1. Dr. Segura, professor of comprehensive dentistry, served as the school’s associate dean for academic, faculty and student affairs.
Robert M. Taft, D.D.S., FACP, professor and the chair of the comprehensive dentistry department, was installed as president of the American College of Prosthodontists.
Amy Tawney, M.B.A., SPHR, a human resources professional with more than 25 years of experience in a variety of industries, has been named vice president and chief human resources officer for UT Health San Antonio.
Richard P. Usatine, M.D., professor of dermatology and cutaneous surgery, and professor of family and community medicine, was elected to the board of the International Dermoscopy Society.
Jeremy Viles, D.N.P., M.B.A., RN, was named the inaugural chief nursing officer for the Mays Cancer Center, the newly named home to UT Health San Antonio MD Anderson Cancer Center, and as assistant dean of the clinical practice in the School of Nursing.
Susan Weintraub, Ph.D., professor of biochemistry and structural biology, was named a Fellow of the American Association for the Advancement of Science.
Sweet potato, carrot and turmeric soup recipe
Spice it up with our sweet potato, carrot and turmeric soup: a healthy recipe that also fights cancer.
Ingredients
4 tbsp olive oil
5 carrots, chopped
1 apple, chopped
2 sweet potatoes, chopped
2 turnips, chopped
2 tsp grated ginger
1 tsp salt
1 tsp pepper
4 cups low-sodium vegetable broth
½ tsp turmeric
½ tsp fresh basil
Directions
- Heat olive oil in a large pot over medium heat. Add carrots, apple, sweet potatoes, turnips, salt, pepper and ginger. Stir to combine. Cook for 5 minutes, stirring occasionally.
- Add vegetable broth, stir. Add in turmeric and basil, stir. Bring to a full boil and then turn heat down to low. Cover pot and let simmer for 45 minutes, stirring occasionally.
- Remove pot from heat. Use an immersion blender to puree soup. You may also carefully transfer soup into a high-powered blender or food processor to puree.
- Spoon into serving bowl. Garnish with fresh basil and serve.
This recipe was adapted from The Rx Cookbook: Cancer-Fighting Recipes, Restaurants & Markets, produced by the Institute for Health Promotion Research.
Learn more about cancer-fighting recipes in Mission magazine.
Game your way out of pain: Pain management
By Lety Laurel
Have you ever donned headphones while exercising, with the goal of making the time go by faster and minimizing the discomfort? Or given a child an electronic device during a vaccination so he won’t focus on the pain and fear? What seems at first like simple distraction techniques may hold the key to pain management.
Maureen Simmonds, Ph.D., PT, is exploring the effect of computer games and virtual reality on the perception of pain.
“Our brains have limited attentional capacity, so if we focus on something else, we can’t focus as much on the pain,” said Dr. Simmonds, a professor of physical therapy and research chair. “If you create games or have people do things that they would like to do anyway, and the decrease in pain is the secondary effect, it works well. You can have a positive effect on pain and it lasts beyond playing the game.”
Using a blend of sophisticated virtual reality equipment and simple physical and cognitive tests, Dr. Simmonds is working to understand the links between pain, mind and movement across conditions to better manage the impact of illness and injury.
Pain is one of the primary reasons patients see a doctor, and often they’re treated with prescription painkillers. Yet there’s a dark side to those drugs. It is estimated that 91 Americans die each day from an opioid overdose, according to the Centers for Disease Control and Prevention. More than 100 Bexar County residents died of an opioid-related overdose in 2015.
“We don’t understand a lot about pain and its complexity, and the fact that in many chronic conditions, pain becomes the disease,” she said. “It’s not a symptom of something else.”
Understanding that leads to better treatment options and outcomes for patients, she said.
“Most people don’t like pain. It’s unpleasant. But it’s not just a sensory experience, it’s also an emotional experience,” she said. “It has meaning for us in terms of ‘Am I going to end up in a wheelchair?’ or ‘Someone has just had brain cancer and I have a headache. Do I have cancer too?’ The way we think about that pain, the cognitive part, also influences the total pain experience. So it’s a multidimensional experience, not just a sensation.”
This biological, psychological and social phenomenon sometimes makes the brain the body’s worst enemy—or its best asset.
When people are injured or sick, they slow down. Patients fear movements they believe will be painful, and mentally link an increase in movement with a spike in pain.
Often, the anticipated pain is worse than the reality, Dr. Simmonds said. Overcoming the fear of pain becomes critical, because the path to recovery involves regaining normal motion and function. And the benefits stretch beyond physiological. The ability to function leads to better moods and better cognition.
“So the way we think is influenced by chronic pain, and likewise chronic pain is influenced by what we think and the way we think,” she said.
Dr. Simmonds’ lab is taking this mind-pain link and turning it on its ear. By manipulating the environment, they want to spur the body into movement, fooling the brain into recovery.
“This manipulation of the environment gives you the illusion of something that is not actually there, but you can have an effect on the mind and movement,” she said. “And because you also have this distraction that is going on, you lose some of the attentional capacity for focusing on pain.”
Small environmental tweaks have led to large discoveries. Patients walking on treadmills walk faster if the virtual reality environment around them, such as a hallway of pillars or a country road surrounded by trees, slows down.
“The slower the pillars move on the screen, the faster the person moves. And the faster it goes, the slower they walk,” Dr. Simmonds said. “So you can manipulate how fast something is moving and the person adjusts accordingly. And they don’t know because it’s quite subtle.”
The body responds similarly with auditory cues. Increasing or decreasing the speed of footsteps causes people to speed up or slow down their pace to walk in sync with the sound.
“They are speeding up without understanding it and it is not aggravating their pain. They don’t even know they are doing it,” she said. “By adjusting that preferred speed, they recalibrate. And when they are walking off the treadmill, they can maintain the increase in movement. It is quite fascinating.”
Dr. Simmonds’ lab is also exploring the use of avatars in pain management. Patients create an avatar and use that virtual body to identify regions of pain that echo their own. They then practice diminishing the pain on their avatar.
Just as human bodies are complex and unique, pain is a complicated, personal experience. And it’s invisible. Beyond the avatar or a pain scale, there is no way to demonstrate one’s level of pain. Similarly, there is not one way to treat pain.
“There is no panacea. It’s a very complex system, and there has been a lot of misdirected problem-solving from patients, caregivers, practitioners and policymakers,” she said. “I think it’s trying to understand that in a more holistic way that addresses the person with pain as opposed to just the pain itself.”
Medication may be appropriate for temporary use after surgery or during a spike in pain, but managing chronic pain is key, she said.
“With any chronic disease, you don’t expect to cure it. You have to learn to manage and live with it,” she said. “But if patients still expect to be cured of pain and for the pain to go away totally, and health care practitioners—be they physicians, nurses or physical therapists—think of pain as acute that should be cured and go away, then the expectations of both in terms of an outcome of treatment are going to be violated. It ain’t going to happen.”
Dr. Simmonds has experienced pain from both sides of the hospital bed. When she was 19, she broke her back and pelvis in a horseback riding accident. Since then, she’s had about 10 surgeries and has spent nearly 400 days in hospitals around the world. Rehabilitation has been a continuous part of her life, both as patient and as therapist.
It has impacted her research from the beginning, and continues to inform her work as an educator.
“I came to the realization that therapy is not what you do, it’s who you are. You’re the therapy,” she said. “By creating that therapeutic self in yourself and others, you can understand and empathize [with patients]. And if you legitimize the suffering and the misery that can sometimes come along with some days and you demonstrate a belief in the person and the difficulties they’re experiencing—if you make people feel better, they will do better.”