UAB Cancer Center Spotlight: Carla Perna

Carla Perna...Expert of all things UAB Clinical Trials 

UAB’s Carla Perna will be the first to tell you about the amount of effort behind clinical trials. She is program director of clinical trials regulatory affairs at the UAB Comprehensive Cancer Center. She handles the administrative side of clinical trials conducted here at the Cancer Center.  She has been in cancer research for 10 years and at UAB for five years.  In her words, she has the experience of working with passionate people where the research and progress is phenomenal. 

In Mrs. Perna’s free time you can find her spending time with her husband and best friend of 17 years, Dr. Sam Perna. Their hobbies include photography, nature walks, and cherishing the time they get to spend with their two sons Zach, 30, and Nathan, 26.

Describe your job, what does a typical day look like?

“If you plan it, it isn’t gonna happen. Things happen in clinical trials and they have got to be handled ASAP, usually. They move very fast. There might be something that happens with a patient and they need approval. A typical day involves a lot of meetings. I meet with my team a lot. I interact with the sponsors. Right now, we have 22 trials we are trying to activate. Our activation rule right now is 90 days from the time that we start the protocol, which is very tough at an academic center because you rely a lot on other departments. Keeping things going, setting out fires, that’s what I’m doing most of the day.”

What are some of the greatest challenges in your job?

“Prioritizing. It is often hard to complete something. You are always juggling. Nothing is ever done. One reason I love my job is that I always have something to do. Getting adjusted to the fact that sometimes you have to put something to the side to move to another is sometimes difficult.  I actually like it. I have a lot of things juggling at one time. And I think that’s the challenge for me is to not let something fall off, to know everything that is going on and to know when it needs to get handled because it is so much, but having the team I have is essential for success. They are excellent.”

How can you promote clinical trials in a positive way?

“Doing what I do really gives it a positive spin. I come to work every day and I have a purpose. That’s one of the reasons I love my job. I talk about what I do to a lot of people. They’ll say ‘what do you do’ and I say ‘clinical trials’ and they automatically think I’m a nurse. And many people do not realize all the work it that goes into getting a clinical trial. Even up from the pharmaceutical company developing a drug, to getting it to the point of even having a trial in humans.”

What inspires you about those participating in clinical trials?

“Phase I studies are fascinating because it’s the first in human trials. And those patients… I think all of our patients are heroes, but those phase I patients, to be the first willing to try something and know that they are testing toxicities and safeties. They already have a horrible disease and they already feel bad and they are willing to give something back to science I think is very admirable and very heroic to do that.”

What would you tell people who are considering participating in a clinical trial?

“You need to talk to your family. You need to weigh all your options. I don’t think that clinical trials are for everybody. I think that they need support. It is a big step to do a clinical trial. There are a lot of steps to it. These people are sick and they have to follow a regimen, steady visits. I would love to say I encourage everyone to do it but I don’t think it is for everyone because if you can’t be compliant it messes up the data. The support of the family is huge. I would say absolutely consider it.  But make sure you know all of your options. If you have family support and weigh all your options that is when you consider it.”

What advice would you give to people who are interested in a career in regulatory affairs?

“I think it is a field that will continue to grow. I think it is important to the future of our health care. And it is fascinating. One of the best things is to get the results of what your clinical trial has done. Especially when it is a drug that has proven to be effective and to know you were a part of that.”

How has experience been at UAB?

“Fantastic. I have been doing cancer research for 10 years. I’ve been here five of those years. The first five was at a smaller hospital. It was a great stepping stone to coming here. I think it would have been harder had I not had the experience at a lower level and a lower volume. The volume here is massive. You know we are one of 40 NCI-designated cancer centers in the United States, I mean to be part of that is a big deal. The people that do research here are just passionate about what they do. I think that that is what it takes if you are going to do research. No matter if you’re doing bench site or you’re doing therapeutic, you have to be passionate because it is tedious.”

How did you get involved in research?

“I just fell into research. Someone said hey I think you’d love research. And I did it. It wasn’t a goal of mine or anything. I was like everybody else. I never thought how a drug got to the pharmacy: all the work that went on to get it there, all the people that went into clinical trials to know that it would work and even be safe. People go day to day and don’t even think about it.”

Anything else you would like to add?

“I feel very proud to work at UAB. It is a leading academic site and the research is phenomenal. When I’m in another state and I tell them I work at UAB I expect them to know where I’m talking about. And if they don’t it’s a little insulting (she laughs).
I hope to retire here. I love it.”

Recognizing a Global Threat

This past week, I traveled to New York City to attend a United Nations General Assembly meeting. More than 22 heads of state, including President Obama, were in the city as well. The security was incredible; police and barricades were everywhere, and I had to go through metal detectors and X-rays to enter my hotel. Having just recognized the 10-year anniversary of 9/11, it was obviously that the impact of that terrible day will obviously be felt for decades, if not centuries, to come.

But it was another threat to our society that was discussed at this U.N. meeting – non-communicable diseases (NCDs), which were recognized as a threat to global health. Each year, NCDs kill 36 million people worldwide. This new focus on the threat of NCDs, which include cancer, diabetes, cardiovascular disease and stroke, is critical to worldwide health.

The economic consequences of NCDs are staggering. Cumulative losses for low and middle income countries are estimated to surpass $7 trillion. Population-based measures such as reducing tobacco use through taxation and enacting clean indoor air laws, as well as reducing unhealthy eating and physical inactivity, could be delivered to these countries at a cost of about 40 cents per person per year. The same principles can be applied in the United States for about $3 per person per year. That’s a bargain if I ever saw one!

It is time for us to elevate prevention of these diseases to a new level. We owe it to ourselves to do so.

-Ed Partridge, M.D.

Heading South: Colorectal Cancer Rates Decrease, But Not Much

A new study this week revealed that fewer people are being diagnosed with colorectal cancer, and the number of people dying from the disease is decreasing as well. This is due in large part to an increase in the number of people getting screened, as well as reducing or eliminating risk factors such as smoking and obesity.

The news for us in the South, however, is not quite as good. The highest rates of colorectal cancer deaths are in the South and Appalachia. While death rates fell by as much as 33 percent in several Northeastern states, the decrease was only 15 percent or less in six Southern states, including Alabama.

Why is this the case? There are several reasons. Southern states are generally poorer than Northern states, and they tend to have more residents without health insurance who may forgo the regular screening that experts recommend for people over age 50. Southerners are also more likely to be obese and to smoke. Alabama is actually the second fattest state in the nation, with a 32.3 percent obesity level. Of the 10 states with the highest obesity rates, nine are in the South.

The UAB Comprehensive Cancer Center is committed to addressing disparities such as these. Our location in the heart of the Deep South makes us a natural leader in developing research and delivery programs to understand and eliminate cancer health disparities. Our Deep South Network for Cancer Control has been quite active and successful in making progress in these arena among minority populations. We have recently begun expanding our research efforts in obesity to better understand the connection between nutrition and cancer. This work is being led by world-renowned nutrition scientist Wendy Demark-Wahnefried, Ph.D, who joined the Cancer Center in 2010.

Rest assured that our scientists are working every day toward our goal of eliminating cancer as a public health problem. I truly believe that this will soon be a reality.

-Ed Partridge, M.D.

Bridging the Gap

While progress is being made in the fight against cancer, a new report from the American Cancer Society shows that there are still disparities in cancer death rates between people of lower and higher socioeconomic statuses.

Using education as a measuring stick, the study found that people with a high school education or less died at a rate of up to five times higher than those with at least four years of college education. Among men, those with less education died of cancer at rates more than two and a half times than those of men with college degrees. These numbers among women were almost identical.

Why is this the case? Studies have shown that people with less education - often those in lower socioeconomic situations - are more likely to engage in risky health behaviors, such as smoking, poor nutrition and lack of physical activity. Likewise, these populations are less likely to have access to the care they need and screenings for early detection.

It is our duty to continue to address these disparities, which has been a longstanding commitment of the UAB Comprehensive Cancer Center. While we launch new research and discover new treatments, we must also look for ways to deliver all of these discoveries to every single person, regardless of where they are in life.

-Ed Partridge, M.D.

Recognizing Differences

 

Deep South Network team members gather in Birmingham
to discuss cancer disparities.

As we recognize National Minority Cancer Awareness Week this week, I am reminded that one of the failures of our nation and current health-care system is the unequal delivery of our medical discoveries to all segments of the population. While new discoveries and research are helping us make a difference in the fight against cancer, we must also be aware that delivering these discoveries differently causes cancer health disparities. We must remember that minorities suffer a disproportionate share of the cancer burden, as do segments of the population that are less educated, have lower income and/or no health insurance.

Cancer death rates in African Americans and other minority populations are often substantially higher. Reasons for this are fairly clear, as these populations are less likely to get age-appropriate cancer screenings, most likely to engage in activities that increase risk (such as tobacco use, unhealthy eating or lack of physical activity) and are less likely to get high-quality treatment when cancer is diagnosed. Poverty, low education and lack of insurance contribute substantially to these differences.

The UAB Comprehensive Cancer Center has a long history of working in communities and in the laboratory to understand and eventually eliminate cancer disparities. To do so requires partnerships with communities to assist them in helping to increase screening rates and physical activity and encourage healthy eating.

We have major community-based programs in the Mississippi Delta, the Alabama Black Belt and inner-city Birmingham to do just that. Through our Deep South Network for Cancer Control, we have already demonstrated that these partnerships can close the gap in screenings. Building trust, relationships and infrastructure in these communities allows us to effectively export cancer knowledge.

The Cancer Center serves a region of the country with a large African-American population and a rapidly growing Hispanic population. Because of this, we are determined to eliminate cancer disparities in Alabama and beyond.

-Ed Partridge, M.D.