Risk Of Developing Liver Cancer After HCV Treatment

Thursday, October 14, 2010

Dr. Melissa Palmer discusses her career in hepatology


Dr. Melissa Palmer discusses her career in hepatology as well as the importance of fundraising to further AASLD's goals.


Dr. Melissa Palmer is the Clinical Professor of Medicine and Director of Hepatology for NYU Hepatology Associates in Plainview, NY. Being an advocate for liver disease research throughout her career, she states: “the advances made in the prevention and treatment of liver disease have been truly remarkable, yet the field of hepatology receives scant attention from the media and little financial support compared with other disease states.” As emphasized by the recent Institute of Medicine report, the burden of viral hepatitis in the US continues to grow. Dr Palmer notes that “the efforts of AASLD in support of the passage of bill HR 3974 [Viral Hepatitis and Liver Cancer Control and Prevention Act of 2009] are to be applauded. Without increased funding of programs aimed at prevention, early diagnosis, and aggressive treatment of liver disease, the increasing morbidity and mortality due to liver disease is predicted to become overwhelming.”

1. What led you to a career in hepatology?

I was fortunate to have been introduced to the field of hepatology by Hans Popper, who was one of my instructors at Mount Sinai Medical School when I was a first-year medical student there 1980. My fascination with the field was further enhanced by Fenton Schaffner, who mentored my initial research in liver disease during medical school and eventually during my hepatology fellowship. Applying my personal interest in nutrition and exercise (I was a nationally qualified competitive bodybuilder from 1988-1991), to my medical career, led to my early publications that emphasized the importance of weight reduction on liver abnormalities in overweight people. This finding has proven to be even more relevant in today’s world as the obesity epidemic continues to rise.

2. Why is hepatology important, why should the liver warrant more attention and what opportunities exist for curing liver diseases?

The advances made in prevention and treatment of liver disease have been truly remarkable, yet the field of hepatology receives scant attention from the media, and little financial support compared to other disease states. HCC is now the 3rd leading cause of cancer deaths in the U.S. and the obesity epidemic has been shown to parallel this increasing incidence. As emphasized by the recent Institute of Medicine report, the burden of viral hepatitis in the U.S. continues to growii. The efforts of AASLD in support of the passage of bill HR 3974 are to be applauded. Without increased funding of programs aimed at prevention, early diagnosis and aggressive treatment of liver disease, the increasing morbidity and mortality due to liver disease is predicted to become overwhelming.

3. Are you still researching? If so, what is the focus of your current research in hepatology?

My current clinical research is focused on NASH and new treatments for HCV. In my daily practice I underscore the importance of nutrition and exercise as a crucial part to both prevention and cure of liver disease. I am eagerly anticipating the publication of the textbook “The Gastroenterology and Liver Disease Nutrition Desk Reference” in 2011, where as one of the editors, as well as the author of the section on liver disease, I was able to emphasize the importance of this often overlooked component of liver disease in the prevention and/or treatment of our liver disease patients.

4. Why are the AASLD grants, awards, programs, and fellowships important to emerging investigators in hepatology? Why should anyone support AASLD? What effect do the AASLD awards, grants, and fellowships have on the field of hepatology?

It’s important for health care practitioners involved in liver disease to participate in clinical trials. The goal is to steadily advance the efficacy of the treatments we can offer our patients.
AASLD funding is needed to provide promising young researchers the opportunity to explore their interest in liver disease and to conduct studies that have the potential to advance the field. Funding from traditional sources have either significantly decreased or has remained stationary. Without additional sources of funding, new contributions to the field will remain stagnant, and the scourge of liver disease will overwhelm the medical community. Donations to the AASLD research fund are essential so that the exploration of new treatments, diagnostic tests and preventive measures can continue. We must support the next generation of liver researchers to foster the growth of our discipline.

5. What have you gained personally and professionally through your association with AASLD? And how has it formed your practice or your own research?

Being a member of AASLD for the past two decades has enhanced my clinical skills and knowledge, thereby enabling me to deliver the highest quality of care to my patients.
Hepatology is arguably the most stimulating and cerebral medical specialty. The liver is a uniquely multifunctional organ, and the treatment regimens for many liver diseases are often complex. I enjoy the intellectual challenge involved in treating liver disease.

I always look forward to AASLD’s annual meeting. The lectures and poster presentations are an excellent opportunity to increase my knowledge base, especially as to the latest developments in the field. The collegial atmosphere is energizing, and I enjoy interacting with many old friends and new acquaintances. Networking with fellow hepatologists at AASLD meetings is useful and important for expounding upon new ideas and concepts which can then be applied to the treatment and care of patients.

The Liver Meeting® is AASLD’s moment of highest profile, but throughout the year, AASLD--with its regular publications, conferences, seminars, and website--is invaluable as a resource for the practitioner dedicated to liver disease.

6. What do you see as AASLD’s role today and in the future of hepatology?

Going forward, I foresee AASLD’s objective as continuing to improve the quality of liver care through enhancing the education of medical practitioners; increasing the promotion and funding of research; continuing the development and application of standards and guidelines, and to increasing their impact on healthcare policies and procedures.

AASLD should strive to increase its visibility with the public, and enhance its position as the pre-eminent spokes organization for liver disease via all media channels. AASLD should continue to be the principal resource for professional and practice information, education and interaction pertaining to the liver.
I support AASLD’s decision to increase its emphasis on fundraising. Greater public awareness of AASLD and its mission is essential for maximizing revenue intake. For our discipline to continue to thrive, I would like to see AASLD utilize all media channels in furtherance of this objective. To this end, AASLD requires additional financial support to carry out its strategic objectives.

7. Please explain your personal success in soliciting donations for AASLD?

The technique for obtaining donations to the AASLD research fund is straightforward. Patients and their loved ones want to support ongoing research and are typically ready, willing, able, and more than happy to contribute. They want to feel that they are a part of the liver community and that they are helping to prevent and cure liver disease. What I have discovered is that most people do not know where to donate, nor do they know the procedure for making a donation. My office staff and I have facilitated the process by placing donation flyers in the AASLD display stand in patient waiting areas and in each exam room. My staff is well versed on answering questions and explaining the donation process to patients and their loved ones. I have educated my staff as to the purpose and goals of the AASLD, and they can intelligently and accurately answer most questions on that arise. Finally, I have found that my patients who are enrolled in clinical trials are typically eager to donate their study visit stipend to AASLD. Promoting AASLD's research fund through my office is a component of my personal commitment to quality liver care. A similar approach is needed from other AASLD members in order to help AASLD succeed in its mission, which after all, is our mission as well.

In closing, I am hopeful that this article will spur enthusiasm among my peers to raise funds for AASLD.



Dr. Palmers Website http://www.liverdisease.com/

Find Dr. Palmer On WebMD http://exchanges.webmd.com/hepatitis-exchange/groupstory/13563321

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