Taking it to the streets

When U.S. Surgeon General Jerome Adams, M.D., visited MD Anderson last December, he urged the institution’s health care professionals to not only work toward developing new cancer treatments, but also to direct their efforts at preventing cancer wherever possible.

Ernest Hawk, M.D., vice president and division head of Cancer Prevention and Population Sciences, understands well how prevention efforts can save lives.

“It’s estimated that between one-third and one-half of all cancers are preventable in 2019. But to achieve that goal, we have to take action at the personal and population levels,” says Hawk.

Moon Shots Program helps advance cancer prevention

MD Anderson has long worked to advance cancer prevention through research, education and patient care. With the launch of the Moon Shots Program®, MD Anderson expanded its commitment by establishing the cancer prevention and control platform – an engine to help the institution continue taking cancer prevention programs beyond the walls of MD Anderson and into communities where people live.

These programs must be:

• evidence-based, meaning they draw upon the best available research to improve people’s health;
• scalable, meaning they can be replicated or expanded over time to meet the health needs of large populations; and
• impactful, meaning they make a measurable improvement.

“The platform complements our traditional efforts by working to advance public policies, educational programs and the delivery of community-based services at the population level in order to reduce cancer risk,” says Hawk, who co-leads the platform. “Most importantly, the platform helps MD Anderson address cancer risk factors where they concentrate – among underserved and less-connected sectors of the population.”

The Moon Shots Program is a collaborative effort to accelerate the development of scientific discoveries into clinical advances that save patients’ lives. To enable this mission, the program created 10 research platforms that provide unique expertise, technical support and infrastructure to support MD Anderson and Moon Shots® teams.

In the spirit of the Moon Shots Program, the platform is a team-based effort, with 10 employees leading a variety of programs. These programs interact with and complement one another, and operate through dynamic collaborations with the Moon Shots and MD Anderson experts. The platform is led by Hawk, Mark Moreno, vice president of Governmental Relations, and Michael Walsh Jr., the platform’s executive director.

“The Moon Shots Program helped us better organize our experts and resources so that we could further dedicate ourselves to community-based actions that advance cancer prevention,” says Hawk. “It’s a great honor and privilege to be able to work outside our walls to try and make a difference in the community. We have a passionate team, all of whom are energized by the potential of making a very big difference in Houston, across Texas and beyond.”

Two programs that epitomize the mission and scope of the platform are Be Well Communities™, focused on empowering communities to lead healthier lives, and EndTobacco®, working to eliminate the burden of tobacco use and nicotine addiction.    

How Be Well Communities are changing the culture of health to prevention cancer

Be Well Communities is a place-based strategy for cancer prevention, meaning the platform works with specific communities to establish initiatives that improve wellness, which lowers the risk of cancer and a variety of other chronic diseases.

Ruth Rechis, Ph.D., is director of Be Well Communities. She was a young girl when her sister passed away from leukemia, so she’s familiar with the impact cancer can have on families. As a 25-year cancer survivor herself, she also knows the challenges of treatment and survivorship.

At just 15, she was diagnosed with Hodgkin’s lymphoma and went through six months of chemotherapy and radiation therapy. Although the treatments were successful, she now lives with a higher risk for breast cancer, cardiac issues and thyroid problems, and occasional skin cancers caused by the radiation.

“I’ve been dealing with cancer my entire life. The idea that we can reduce people’s risk for cancer – that they may never have to endure chemotherapy or radiation or anything like that – is pretty exciting to me,” says Rechis.

Baytown, the third largest city in Harris County, was selected as the inaugural Be Well Community, and the platform worked closely with the Baytown community to launch Be Well™ Baytown in November 2017. The initiative is led by MD Anderson and sponsored by ExxonMobil.

MD Anderson provides backbone support to more than 16 community partners in Baytown – individuals, schools, businesses, government agencies and health care providers – to put evidence-based programs and solutions into effect. These programs target five areas known to increase cancer risk, including poor diets, low physical activity, tobacco use, excessive ultraviolet radiation exposure, and limited access to recommended preventive care and screenings.

“Our goal is to take this gift of cancer prevention and put it into programs that will help people now and will be sustainable in the long term. These are programs, led by our partners, that are changing the culture of health within the communities where we work,” says Rechis.

The Be Well Communities team draws upon the expertise of MD Anderson faculty as well as other programs within the platform, such as EndTobacco, to bring the best initiatives forward to the community.

Already in Baytown, Rechis notes evidence of behavior change, such as children eating healthier and being more physically active, and more produce being made available to Baytown residents. As programs expand and take root in Baytown, the platform is looking into launching similar initiatives elsewhere, tailored to the needs of that community.

EndTobacco

The EndTobacco program has a clear mission, evident in its name. As the leading cause of cancer and preventable deaths, tobacco use exacts a tremendous burden in the U.S. Through the leadership of Jennifer Cofer, director of EndTobacco, the platform seeks to reduce youth smoking, limit exposure to secondhand smoke and increase cessation attempts among current smokers.

Cofer also is driven by a personal mission. Both her grandparents started smoking at age 13, so she grew up around cigarettes. She battled personal health issues from secondhand smoke, but also became aware of the powerful addiction through her grandparents’ struggle to quit smoking.

Motivated to make a difference for her grandparents and others, she chose to go into public health.

“I knew when I found public health that I could help change the tobacco-control landscape, either through cessation, policy change, destigmatizing what smokers go through, or preventing kids from starting to smoke,” says Cofer. “That’s what I knew my calling would be. Being here at MD Anderson is a perfect fit.”

Unfortunately, both her grandparents succumbed to tobacco-related illnesses, but she was able to help them both successfully quit smoking.

Through EndTobacco, she and her team lead a variety of efforts to improve public policy, education, prevention and cessation services, both locally and nationally.

“We’re implementing evidence-based actions in communities and across the state. These include partnering with universities adopting tobacco-free policies, and training health care providers to deliver best practices for tobacco-cessation treatment,” says Cofer. “We have the honor and privilege of enabling substantial actions to end tobacco-related cancers.”

For instance, EndTobacco coordinated with The University of Texas System to launch the Eliminate Tobacco Use initiative in 2016. Representatives from all 14 UT System institutions joined together to discuss best practices and policies, and by June 1, 2017, all 14 institutions were tobacco-free. The initiative continues to grow each year, and now includes additional universities across Texas and the nation.

EndTobacco also served as an educational resource to policy makers passing legislation to raise the minimum age for buying tobacco from 18 to 21, with the exception of those in the military. The program also established a program to train health care providers to deliver MD Anderson’s state-of-the-art tobacco cessation approach to their patients.

These programs have the potential to save thousands of lives from tobacco-related disease, ultimately aligning perfectly with the goals of the platform and the Moon Shots Program – to save lives through scientific discoveries.