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18A Director of Multiple Sclerosis Program | Cleveland Clinic Lou Ruvo Center for Brain Health W hen Timothy West, M.D., applied to medical school at the University of California, San Francisco, he intended to study pediatrics. A biology buff who has always been fascinated by how the body and mind work, West re-evaluated his choice of medical specialty as the result of a family tragedy. "My mother had a very severe multiple sclerosis flair-up relapse that put her in a wheelchair the summer before I went to medical school, and that same summer my father had a stroke, so I had both parents in wheelchairs due to neurological causes," said West, who was also chief neurology resident at the University of California, San Francisco, and completed a fellowship in clinical neuroimmunology that was funded by the National Multiple Sclerosis Society. "I discovered there was so much to learn and be done about multiple sclerosis – there's been an explosion of knowledge in the past 15 years or so – and I wanted to devote my life to it." He is poised to do just that in his new post as director of the multiple sclerosis program at the Cleveland Clinic Lou Ruvo Center for Brain Health, which provides diagnosis and ongoing treatment for patients with cognitive disorders and support services for family members who care for them. West joined the Cleveland Clinic last summer in conjunction with the facility's expansion of its clinical services, a move that was intended to better address the health care needs of Nevadans. The clinic added both a movement disorder program and a multiple sclerosis program, with West at the helm of the MS component, where he has created a comprehensive MS program that includes individualized clinical care, research into new treatments, and support for physical and emotional symptoms. The local team will collaborate extensively with staff at the Mellen Center – one of the world's leading programs for MS treatment and research – at Cleveland Clinic's main campus. "Patients can experience technologically advanced on-site services in Las Vegas while having the support and trusted expertise of the Mellon Center," said West, who described multiple sclerosis as a disease where an individual's immune system basically turns against the brain and attacks it rather than protecting it like it's supposed to. "Cleve- land Clinic resources and collaboration ensure all patients receive the best possible care." PHYSICIAN Dr. Timothy West PHYSICIAN West will bring clinical trials that will specifically address the needs of patients in Las Vegas, and will also partici- pate in active clinical research to determine how MS affects cognition, find better ways to predict which patients will progress more rapidly and discern whether vitamin D deficiency contributes to disease development or progression. "Vitamin D is a hot top in MS research and literature right now," said West, who estimated that there are some 2,500 people afflicted with MS in the Las Vegas valley alone, and said that the new multiple sclerosis program will fill a much-needed gap in care. "There are a lot of really great neurologists in town who have done a great job, but one of the troubles is the field is moving so rapidly, and the way we think about the about the disease is constantly evolving, and as such it's kind of difficult for general neurologists to keep up with the field," West said. "So one of the things I can do is stay in touch with what's going on in the world of MS." This includes keeping abreast of new medications and treatment options. "In 1993 the FDA approved the first medication to treat MS," West said. "Since then we have had eight approved medications. There is also a new pill that seems to work great and be very safe that went to the FDA for approval this year on Feb. 28. There are also two other medications in the works that should maybe come out next year, so we're all looking forward to that." Patients in the new MS program will also have access to the center's new physical, occupation and cognitive therapy program to help them manage their condition. "MS patients tend to be complicated and can have problems with bladder control, depression, pain, numbness, tingling and stiffness, so what we're trying to do is create a comprehensive clinic where any and all complaints can be treated," West said. "I try to convey a sense of hope to my patients that there are a lot of people spending a lot of time and money and energy trying to eliminate multiple sclerosis, and I think that working together collectively we can beat it." —By Danielle Birkin Medical Oncologist W | Comprehensive Cancer Centers of Nevada RESEARCH Dr. Wolfram Samlowski RESEARCH hen entering college, Dr. Wolfram Samlowski was looking to go into family medicine like his father. But he quickly found a desire for lab research and he also saw great satisfaction in working with cancer patients. With the change in course, Samlowski still moved quickly through school, finishing his bachelor's degree in three years and his medical degree in the same amount of time. Jumping right into the oncology field with his residency at Wayne State University in Detroit, Samlowski has had a solid research run topping 30 years. At 56, he shows no signs of slowing, with about a dozen clinical trials for cancer drugs going on right now. He has another half-dozen in the pipeline too, work he says will likely be a "game changer" in the field of melanoma treatment. Overall, he has participated in roughly 100 trials over the years. "My dad worked until he was 72 and he's still alive at 90, so maybe I can make it that far. I don't know. I've certainly kept the love and enthusiasm for what I do and so as long as that holds up, I'll keep on going," he added. Samlowski's focus for the better part of the past 25 years was on melanoma and kidney cancer research. But more recently, he has been working with sarcoma, or connective tissue, cancer patients too, largely the result of little inter- est on the part of other physicians to treat them. These patients often have a tumor, or mass, on a muscle or tendon or in the bone that can sometimes grow to large sizes. Traditionally, they have been treated with radical surgery. But today chemotherapy and radiation have produced more successful outcomes where the tissues are better preserved, Samlowski explained. In the past decade, cancer research has made leaps, not simple strides. With the identification of certain gene mutations in patients, a more targeted approach to drug development is on the rise and Samlowski appears to be at the forefront of this movement. "I'm challenged beyond belief. I think the lesson I've learned is that by investing some effort, even in people with what people consider hopeless diseases, they can gain surprising benefits and sometimes very surprising results," he added. "This has been gratifying, intellectually stimulating. … It's almost science fiction." Samlowski's pursuits have also resulted in the creation of a new Las Vegas lab for diagnostic blood testing. It's called True Cells, and its new technology can complete tests in 48 hours, whereas normal testing can take between four to eight weeks, Samlowski said. Waiting for the tests can be costly when it comes to patient care, as the informa- tion helps the oncologist weed out therapies that may accelerate the disease in certain patients. "Some of the drugs may not mesh with their (a patient's) particular mutation. Some can make it worse or better," he said. "You have to know within a short span of time if the patient's going to get better or worse." Prior to arriving at Comprehensive Cancer Centers of Nevada (CCCN), Samlowski spent 27 years at the University of Utah and four years at the Nevada Cancer Institute. He calls his latest tenure "a great opportunity." What he enjoys most about CCCN is fewer bureaucratic hurdles when it comes to chasing down research grants and actually setting up clinical trials. A study that often took six to seven months to initiate at a university, he says, with CCCN can get started in less than a month in many cases. The affiliation with U.S. Oncology and its access to 1,400 physicians and one million patients nationwide for studies makes for a great platform to quickly get clinical trials into the group's pipeline, he explained. "It's very cost and time efficient," he said. "I think there's another model developing with the way research may go in this country." Samlowski's work, in conjunction with the other research being done by his colleagues, is catching the attention of people around the nation. The physician sees about 50 patients a day and about 20 percent of his overall workload is from out of state patients. "I think that medical tourism is alive and well," he added. "I think it's important for us in Las Vegas to provide a high standard of care both for people who live here locally and for the broader area." —By Brian Sodoma