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Lisa’s HopkINNS Helps

Below is a message from our friend, Lisa Eidelberg, who is filling a much needed gap in treatment logistics.

Lisa writes:

HopkINNS Helps was created after a conversation I had with a pancreatic cancer patient named David Sokoloff.  David had a successful whipple surgery at Johns Hopkins Hospital and was doing great until sadly, the cancer returned with a vengeance.  David’s hope for survival was a trial that Hopkins was running, which required him to fly to Baltimore (from Florida) approximately every three weeks and stay in a hotel for days at a time with his caretaker. The hotel next to the hospital was offered at a reduced Johns Hopkins patient rate, but still somewhat expensive.  Through a Southwest Airline grant, David had his flights paid for, however his hotel bills were adding up each month, making an already stressful situation harder.

It was then that I realized the financial suffering many pancreatic patients face.  The expenses they incur simply trying to get treatment could be staggering, and virtually impossible for most.

Lisa’s HopkINNS Helps is a fund, overseen by the Nikki Mitchell Foundation, that provides lodging to those patients and families in need of long term, world class treatment.  Without this lodging, many patients are forced to seek help at local hospitals by medical staff that are unfamiliar with pancreatic cancer.  As a result, the outcomes are not nearly as good.  Since it’s inception in May, we have sent several patients, numerous times to comfortable hotels to ease the burden and anxiety of their situation. Our goal is to continue to work in tandem with the Nikki Mitchell Foundation, to help reduce some of the financial stress associated with pancreatic cancer.

To support Lisa in her efforts to help patients make a donation at nmf.kindful.com

Blackberry Farm Show featuring Jessi Colter, The Sisterhood and Jamey Johnson Raise $35,000 for NMF

Blackberry Farm, located in the foothills of the Smoky Mountains in Walland, TN, hosted a benefit concert for Nikki Mitchell Foundation on November 13, 2019.

The luxury resort sits on 4,200 acres of beautiful land and held an intimate show in Bramble Hall with artists Jessi Colter, The Sisterhood (Alyssa Bonagura and Ruby Stewart) and Jamey Johnson. Jessi, Alyssa and Jamey are Honorary Board members of NMF and were close friends of our namesake Nikki Mitchell. A small auction raised $9,500 in addition to $25,500, a portion of the proceeds, from Blackberry Farm.

The Witches of St. Andrews’ Charity Bike Ride Raises $20,000 for Pancreatic Cancer

The Witches of St. Andrews

The Witches of St. Andrews, a non-profit in Panama City, FL, hosted their 3rd annual charity bike ride on October 26, 2019. The Witches group was created in 2017 when seven women gathered to honor one of their own by organizing a charity bike ride to raise money dedicated to pancreatic cancer research and to support local patients suffering from pancreatic cancer.

The ride this year was in honor of Dr. Gregory Grantham and cancer survivors everywhere. The large group gathered, decked out in witchy costumes and ready to make some noise and “ride for a cure.” They rode down Beck Avenue in St. Andrews and ended it with brunch. There was also a contest for best costume and best decorated bike. The Witches raised over $20,000 and donated it to Nikki Mitchell Foundation, which supports their goals to fund pancreatic cancer research, while helping patients.

The 8th Annual Homecoming Golf Tournament and Concert Raises $514,000

 Jamey Johnson’s 8th annual Homecoming event on October 6-7, 2019, was presented by Nikki Mitchell Foundation. The event began with a morning golf tournament at Cottonwood Golf Club and an evening concert at the Biscuits Stadium, both in Montgomery, AL.

Celebrity golfers included PGA professionals John Daly and Boo Weekley. The tournament featured a variety of unique events, such as an archer and ball launcher, win a car with a hole in one, costumes and food cooked on the course. The winning team was Tootsies, lead by Steve Smith of Nashville.

The concert’s first year at the new location, the Biscuits Stadium, was a huge success. The large size of the stadium allowed the foundation to triple their previous ticket sales, with over 6,000 people attending the concert. The live music included performances by Jamey Johnson, Toby Keith, Kid Rock, Randy Houser, Randy Quaid, comedian Ron White, Lee Brice, Jerrod Neimann, Sweet Lizzy Project, Ray Scott, Brandon Elder from American Idol, Watley and Co. and the Down Home Boys. 

Nikki Mitchell Foundation also accepted toy donations for the Montgomery area Marine Toys for Tots and gave them a check for $5,000. Toys for Tots is another charity close to Jamey Johnson’s heart. Overall, Nikki Mitchell Foundation raised $514,000, which will go to their mission to prevent, detect and cure pancreatic cancer.

For information on sponsorships or how to get involved in 2020, contact golf@nikkimitchellfoundation.org.

Photos of the event are HERE.

NMF Friends Raise $1,000 with the “Aluminum Man” event

The Aluminum Man participants

NMF friends Trevor Haines of DOJO Chattanooga and Carol Noon hosted the Aluminum Man event – a fundraising event riff on the Ironman Triathlon, which was held at the same time. While the Ironman competitors did a 2.4 mile swim, 112 mile bicycle ride and a marathon 26.22 mile run, the Aluminum Man competitors went the same distance, but in feet. After the 2.4 foot “swim” in a wading pool (with many lifeguards on duty!), they were on to the 112 foot bike ride. After the 26.22 foot run, they were worn out and grabbed ice cold beer in aluminum cans!

The hilarious event on September 28, 2019 was well-attended and raised awareness of Nikki Mitchell Foundation in Chattanooga, TN. They raised almost $1,000 and mailed a check to the foundation wrapped in…aluminum foil.

More Patients to Receive Wound Vacs After Their Pancreatic Surgery

The following summary comes from Javed et al. and was recently published in the Annals of Surgery, the preeminent surgical journal, in June 2019.

https://journals.lww.com/annalsofsurgery/Fulltext/2019/06000/Negative_Pressure_Wound_Therapy_for_Surgical_site.7.aspx

Despite a substantial decreased in the mortality associated with the Whipple procedure, postoperative complications, albeit non-life-threatening are frequently observed. Surgical site infections are a common complication, and in the immediate postoperative period add morbidity and in the long run can impact long-term outcomes in patients with pancreatic cancer due to delays in receipt of systemic therapy after surgery. Simply put, a surgical site infection occurs when pathogens such as bacteria infect the incision site. In case of a surgical site infection, in the days following the surgery, the incision often becomes tender, swollen and red, and purulent discharge may be observed. Management of this complication can range from antibiotic administration to need for a reoperation, depending on its severity. Surgical site infections can prolong hospitalization, result in readmissions, and increase healthcare costs. Individuals considered “high risk” for surgical site infections are those who have either undergone preoperative stenting of the bile duct or received neoadjuvant chemotherapy, or both. In this population the rate of surgical site infections of over 30% has been reported. 

 

Given this knowledge, this study sought to evaluate the impact of negative pressure wound therapy (sometimes referred to as “wound vacs”) on the rate of this complication. The authors conducted a randomized controlled trial evaluating the benefit of using this device in high risk patients. Patients were randomly assigned to receive the device or a standard wound closure. The device consists of a foam dressing over the incision that is connected to vacuum suction via tubing and works by keeping the incision dry (less favorable for growth of pathogens). 

 

Over a one-year period, 123 high risk patients who underwent Whipple procedure were included in the study. Surgical site infection occurred in 9.7% (6/62) of patients who received the device and in 31.1% (19/61) of patients in the standard closure group (P = 0.003). The relative reduction in risk of developing surgical site infection was 68.8%. Furthermore, on cost analysis surgical site infections were found to independently increase the cost of hospitalization by approximately 23.8%.

The use of negative pressure wound therapy resulted in a significantly lower risk of SSIs. Incorporating this intervention in surgical practice can help reduce a complication that significantly increases postoperative morbidity and healthcare costs.

Take home points:

  1. Surgical site infections are common, especially in high risk patients following the Whipple procedure.
  2. Negative pressure wound therapy (or wound vacs) can lower the risk of surgical site infections in high risk patients by almost 70%.

 

 

 

 

 

Image- KCI Negative Pressure Wound Therapy dressing. Image credit: https://www.kci-medical.sg/SG-ENG/vactherapy

“Traler Park” Show Raises $59,000 for NMF

On June 18, 2019, country music artists Jamey Johnson, Lee Brice, Rob Hatch, Dallas Davidson, Jerrod Niemann and Randy Houser took the stage at the Franklin Theatre in Franklin, TN. Calling their crew “Traler Park,” these long-time friends and musical collaborators took the stage to share both their music and stories.

The show hosted over 300 guests, and debuted Nikki Mitchell Foundation’s latest PSA. The video had interviews with pancreatic cancer patients, family members and a patient advocate, giving insight into the foundation’s work. The foundation raised over $59,000, which goes to programs to prevent, detect and cure pancreatic cancer.

NMF Gives a $20,000 Seed Grant at the Pancreas Club Conference

Award winner Dr. Jayanth Shankara Narayanan is front and center.

Nikki Mitchell Foundation attended the 53rd annual Pancreas Club Conference to give out several awards. The $20,000 Nikki Mitchell and Pancreas Club Seed Grant was presented to Dr. Jayanth Shankara Narayanan, PhD, a Junior faculty member under Dr. Rebekah White. NMF strives to promote and fund Junior faculty researchers who are working on promising pancreatic cancer research.

The foundation also donated a $1,000 Pancreas Club Award for the best oral presentation of clinical or basic science by a resident or fellow. Additionally, the Nikki Mitchell Award of $1,500 went to the most promising research project by a young investigator (Junior faculty, within 5 years of practice, post training.)

NMF Medical Board directors Dr. Christopher Wolfgang and Lindsey Manos were in attendance, and Dr. Wolfgang was one of the lecturers. The event took place on May 17-18, 2019 in San Diego, CA.

 

Safety of Robotic Whipples

 

Above is a photo of the da Vinci Surgical System. Not seen, is the surgeon’s console station. At the console, the surgeon sits aside the robot and can manipulate the robot’s arms to perform the surgery. Whereas a surgeon only has two arms, the robot seen above has four. These additional arms give the surgeon more options during the surgery.
Image credit: https://www.intuitive.com

The following summary comes from Emanuele F. Kauffmann, MD and colleagues, and was recently published in Surgical Endoscopy in January 2019.

Link to article: https://link.springer.com/article/10.1007%2Fs00464-018-6301-2

Over the recent decades, improvements in preoperative management and introduction of new surgical techniques has seen a substantially declined the morbidity (rate of complications) associated with pancreatic surgery. Among these, the most intriguing innovations has been the introduction of the surgical robot as a tool to assist the surgeon. When using this platform, surgeons may enjoy increased control, a 3-D view of the abdomen, and greater magnification of the surgical field, while minimizing the length of required incisions. In this article, the authors sought to evaluate the outcomes of robotic pancreatic oduodenectomy (also known as the Whipple procedure) as compared to its classic open counterpart. The authors chose to evaluate immediate oncological outcomes including resection margin status (see our August blog post on resection margins for more information). Additionally, they evaluated long-term patient outcomes including recurrence of disease and overall survival.

In order to draw meaningful conclusions, the authors performed a propensity score match. It is a widely used statistical tool that allows us to balance groups of patients that otherwise in the real world might not be similar due to various aspects of clinical decision making. Based on features of patients in one group, patients with similar characteristics are identified from the other group that serve as a control. Once done these selected groups are compared rather than the entire patient population.

Encouragingly, there were no differences observed in the rates of negative resection margins in both groups. Additionally, the authors found that the long-term outcomes including recurrence of disease and overall survival were equivalent regardless of robotic or open surgical approach.

Take home points:

  1. Surgeons can perform the same procedure, using either techniques to achieve similar rates of tumor clearance.
  2. Patients who undergo a Whipple via either technique have similar long-term outcomes.

It is important to remember that each patient and their disease is unique. Consequently, some patients may not be ideal candidates for a robotic approach. Furthermore, surgical experience and training in using a robotic console are required to use it effectively. Therefore, it should be expected that these similar outcomes are achieved when the surgeons performing the robotic procedures are trained in the field, and are past their learning curve.

NMF Raises $7,000 from Annual Online Auction

The Nikki Mitchell Foundation’s annual auction closed Monday, March 25th.  The auction raised over $7,000, sold 10 items and brought in around 40 bidders from 12 states. Funds raised benefit the non-profit whose mission is to prevent, detect and cure pancreatic cancer.

Nikki Mitchell, the foundation’s namesake, was Waylon Jennings’ business manager for 22 years and the foundation has close ties to the music industry. The auction included items from Jamey Johnson, Kris Kristofferson, Willie Nelson, Alison Krauss and Brad Paisley. In addition to the country music auction items, unique art like a hand carved skulls and wood signs were sold.