In 23 years, Siteman Cancer Center has skyrocketed into the highest echelon of cancer care centers.

 by Christy Marshall

Few life events are more heartbreaking than to find out that you have — or someone you hold near and dear has — been diagnosed with cancer.

Local businessman Al Siteman knows all about that. In the 1980s, one of his closest friends was dying of brain cancer. It troubled Siteman that his friend had to trek time and time again to MD Anderson in Houston for treatment. Already on the board of Jewish Hospital and Washington University, Siteman wanted to elevate local cancer care so in November, 1999, he and his wife, Ruth, wrote a check for $35 million to fund a cancer center; six months later all the monies needed were raised. Two years later, the Alvin J. Siteman Cancer Center debuted in the Center for Advanced Medicine building and in 2004, the center was awarded the Comprehensive Cancer Center designation from the National Cancer Institute, placing it among the top cancer centers in the U.S. Then in 2006, it joined the National Comprehensive Cancer Network (NCCN) a group of 32 of the world’s eminent cancer centers charged with setting the standards and guidelines for cancer care.

After Dr. Timothy Eberlein assumed his current post as director of Siteman Cancer Center and Washington University School of Medicine, he declared Siteman would have expertise in every kind of cancer — and work on eradicating the fear of treatment.

“To me, there's really two things that are really different here from any other cancer center,” Dr. Eberlein says. “One, we made a commitment years ago when we started developing Siteman Cancer Center that we would have experts who specialized in every kind of cancer. That way we provide very unique treatments that you can only get because you have experts in surgery, medical oncology, radiation oncology, et cetera.”

For anyone who has been diagnosed or spent time with someone who has, the trip for treatment can be terrifying. Dr. Eberlein recognizes that.

“The second thing is we wanted every patient to have a very unique, supportive, nurturing, caring experience that provides maximum hope for their outcome,” he says, adding that a staff member now individually walks the patient to their appointments. “We wanted every patient to feel as though they were the only patients that cancer center cared for that year, even though we care for 75,000 unique patients.” Dr. Eberlein estimates Siteman will see 12,500 new cancer patients in 2024.

“Every single employee at Siteman Cancer Center feels that they have an integral, important role in the care of the patient, no different than the doctor who may be this world-famous medical oncologist,” he says. “But the nurses, the nutritionist, the therapist, the data managers who keep track of our clinical trials, every one of those individuals have that same passion. It's been something that we emphasized from day one. And I have to say, it's pretty unique.”

The fight to cure ventures beyond the walls of Siteman.

“Twenty-five years ago, we created a program, unique among NCI centers, called the Program for the Elimination of Cancer Disparities (PTCd),” Dr. Eberlein says. “It uses education, outreach, partnerships with organizations such as churches in North County, in St. Louis City, the Urban League, and the Breakfast Club which is a group of African-American women professionals who had breast cancer and who are committed to improving the care of breast cancer patients in their community. Similarly, there's a group of African American men called the Empowerment Network, and they have been very active in having black men screened and are great support for black men who have prostate cancer.”

The outreach effort has paid off with double-digit drops in the percentage of the number of women arriving with stage IV breast cancer and the number of people who die of both breast and colorectal cancer.

This summer, Siteman Cancer Center has moved to a newly constructed — and visually stunning — building on Forest Park Expressway and Taylor where all the cancer patients will go. The parking is exclusively for Siteman; the drop-off point for patients is less than 100 feet from the elevators.

“It was totally designed with the patient at the epicenter,” Dr. Eberlein says. “So, there's a lot of glass, there's a lot of open space. The infusion space is larger; there's room for family members and state of the art technology, internet, et cetera, et cetera. There are fireplaces for the patients and their families. There are healing gardens for them to look out the windows and see plants and trees. It was designed so that we, the experts, would come to the patient, rather than have the patient truck all over the medical center. The radiology support for the cancer patients will be in that building. Most of the patients will probably go to one floor and never leave.”

The one area where Siteman leaves many of its competitors behind is in the world of cancer research — and that research is, in large part, funded by the annual bike-a-thon, Pedal the Cause. (See story, p. 82).

“The goal is to provide tomorrow's treatments today,” Dr. Eberlein says. “We've been very successful. But because we are experts in all these different kinds of cancer, we don't just make those contributions in blood cancers, but we do it in breast cancer, brain cancer, head and neck cancer, and pancreas cancer, et cetera, because we are blessed with all these experts.”

The advances in research credited to Siteman’s scientists are astounding. First there is the genome sequence on various tumors. In 2009, the cancer center mapped the first human cancer patient’s tumor genomics. Eberlein says it took about two years and cost a little more than $1 million. With FDA approval, Siteman can now sequence that genome in less than 48 hours for less than $1,000.

“That technology was largely developed here at Siteman Cancer Center,” Dr. Eberlein says. “And it's been so successful that now we're expanding into other tumor types, like lymphoma and lung cancer. It's an example of Siteman Cancer Center building on the existing strength of Washington University, the [McDonnell] Genome Institute, but develops very innovative approaches.”

A second innovation: the development of the personalized vaccine.

“So how does that happen?” Dr. Eberlein asks. “Well, we sequence an individual cancer patient's tumor and we look at the antigens in that cancer. Each cancer patient, as you would imagine, is unique, like each individual is unique. We predict which of those antigens will be most powerful in developing an immune response against that particular cancer. And we've been quite successful in breast cancer, pancreas cancer. We're now expanding into brain cancer and prostate cancer.”

Childhood acute lymphoblastic leukemia used to be a death sentence. It isn’t anymore. Today, approximately 90 percent of patients afflicted with the disease survive.

“However, in the 10 percent that have recurrent leukemia, they tend not to respond very well to chemotherapy,” Dr. Eberlein says. “We had one of our adult researchers who was working with an immune cell called a natural killer cell, an NK cell, and was developing a program showing success of treating adult lymphomas with NK cells.”

One of the pediatric researchers who care for children with acute lymphoblastic leukemia wondered if the treatment would work on their patients. Eventually they tried it and 15 of the 17 kids tested, survived. “It was a paradigm shift in how to care for a particular tumor and it made Siteman Kids at St. Louis Children's Hospital a magnet for recurrent leukemia patients from all over the country,” Dr. Eberlein says.

The list of Siteman’s (and Washington University School of Medicine’s) successes is lengthy. The credit for the bulk of the funding can be traced back to Pedal the Cause. In early May, it was announced the organization had donated more than $1.5 million ti fund four new pediatric cancer research projects: advancing immunotherapies (CAR-T cells and NK cell therapies), developing therapies to target genetic mutations involved in pediatric cancers and creating a new Chat-GPT language model.

As David Drier, executive director of Pedal the Cause says, “We know as an organization that breakthrough cancer research is the best line of defense and the best recipe for a world without cancer.”