Sylvester Comprehensive Cancer Center Taking The Lead In Fight On Lung Cancer

The numbers surrounding lung cancer are eye-opening. More than 228,000 people are diagnosed each year in the U.S., and nearly 160,000 people die, 10,000 of them in Florida. Five-year survival rates overall stand at just 16 percent. Lung cancer claims more lives than breast, prostate and colon cancer combined.

Now, there is reason for hope at Sylvester Comprehensive Cancer Center, part of UHealth – University of Miami Health System. As with all cancers, early detection of lung cancer leads to increased survival. The challenge with lung cancer is that symptoms usually don’t appear until the later stages. Recent developments, however, have changed that outlook, giving patients and physicians at Sylvester new optimism.

Since 2011, the team of lung cancer experts, surgeons, pulmonary physicians, and oncologists at Sylvester has offered patients a lung cancer screening program in conjunction with recommendations by a number of national professional organizations, including the International Early Lung Cancer Action Project (I-ELCAP).

One of the largest randomized controlled clinical trials in the National Cancer Institute’s history showed that low-dose CT screening could reduce lung cancer mortality rates by at least 20 percent.

Dr. Richard Thurer, professor of surgery and co-leader of the Lung Cancer Screening Program at Sylvester, says the scan is “a game changer. To have this technology to detect lung cancer at its earliest stages means we can potentially save more lives.”

For Rita Seiff, a low-dose CT scan changed her life. The Boca Raton resident heard a talk about the screening from a Sylvester surgeon in 2012 and, as a former smoker, felt the doctor was talking to her.

Seiff hadn’t smoked in 26 years, having quit when she was 40. She admits she was in denial. “I had had a chest x-ray six months earlier which showed nothing. Thankfully, I learned about the CT scans and did something.”

The scan found cancer in the upper right lobe of her right lung, and the lobe was removed in surgery, allowing the 66-year-old to return to playing golf and living her life.

“Hearing about the scan added years to my life,” said Seiff, who paid the $350 scan fee because it was not yet covered by insurance. That has changed.

Medicare recently announced that it covers lung cancer screening for Medicare beneficiaries who meet the requirements. Patients must be 55 to 77 years old, have no symptoms of lung cancer, have a smoking history of at least 30 pack years and smoking cessation of 15 years or less. A pack year is calculated by a person’s average number of packs per day, multiplied by the number of years he/she smoked. For example, a person could have a 30 pack history by smoking one pack a day for 30 years, or two packs a day for 15 years.

Many physicians and researchers applaud the Medicare ruling but point out that it doesn’t go far enough. While smoking is the leading cause of lung cancer, up to 30,000 cases of lung cancer occur each year in people who never smoked.

“We are trying to better understand the other risk factors,” said Thurer. “We know that there are occupational hazards, other environment exposures, and genetic predispositions.”

For Sylvester patients who do require surgery, Dr. Dao M. Nguyen, professor of surgery at the University of Miami Miller School of Medicine, leads the team of thoracic surgeons at Sylvester. Nguyen’s research focuses on targeted therapies for lung cancer and he is an expert in minimally invasive thoracic surgery. That is also the specialty of Dr. Nestor Villamizar, who recently joined the team.

While the Medicare ruling includes the five million older Americans who are most at risk, others can still get a low-dose CT screening through Sylvester’s ongoing screening program available in Miami, Kendall, Plantation and at Sylvester in Deerfield Beach. CT screening is also a covered service, without copays or deductibles for many insurance programs under the Affordable Care Act.

For more information or to schedule an appointment, call lung cancer screening program coordinator Marie Charles at 305-243-9069. 

Above content is provided by Sylvester Comprehensive Cancer Center

Sylvester’s Ovarian Cancer Early Detection Clinic Helps Patients Gain Upper Hand

When 41-year-old Ivanna Vidal learned in 2013 that she carried the mutation for the BRCA2 gene, she knew she had an increased risk for developing breast and ovarian cancer. She had herself tested because of her family’s extensive breast cancer history.

Her first move was to have a prophylactic double mastectomy. As she decided on a date for the surgical removal of her ovaries, the reality of that genetic risk took hold. In between six month screenings, Vidal developed stage 3 ovarian cancer.

Following surgery in July 2014, the mother of twin girls began chemotherapy and is now a patient at the newly created Ovarian Cancer Early Detection Clinic at Sylvester Comprehensive Cancer Center, part of UHealth – University of Miami Health System.

Women like Vidal are the reason for the clinic, led by Dr. Brian Slomovitz, Division Director of Gynecologic Oncology at Sylvester. “We used to think ovarian cancer was a silent disease, giving patients no warning,” Slomovitz says. “We now know much more.”

Ovarian cancer does show symptoms, such as abdominal pain, bloating or swelling — but they are often mistaken for other illnesses such as gastric disorders or urinary tract infections. Slomovitz warns that women need to be aware of these subtle changes and see a doctor if they persist longer than 10 to 14 days.

Slomovitz says Vidal’s cancer was caught early enough to give her a good prognosis for the future. “Unfortunately, that’s often not the case,” he adds. There is no good screening test for ovarian cancer, “so we want to identify more women who are at high risk.”

Like most cancers, early detection is key and the risk of diagnosis increases with age.  Women with a strong family history of breast or ovarian cancer should be tested to determine if they carry a genetic mutation that increases their risk for the diseases.

Women with BRCA mutations have up to a 40 percent chance of getting ovarian cancer and up to an 80 percent chance of getting breast cancer. Once a woman tests positive, the expertise of the team at Sylvester’s Early Detection Clinic truly comes to light.

Patients visiting the clinic will see a gynecologic oncologist, genetic counselor and a radiologist specifically trained to identify gynecologic cancers. Blood work and ultrasounds are also performed on site by trained experts, and nurse navigators escort patients through the healthcare system.

One preventive move for women who are beyond their child-bearing years is to remove the ovaries and fallopian tubes. Others prefer to be monitored more closely with frequent screenings.

Board-certified senior cancer genetics counselor Talia Donenberg helps patients make decisions once their test results are in. She said women with hereditary ovarian cancer make up 15 to 20 percent of all cases because of the discovery of more genes involved in inherited cancers. Patients who come to the clinic undergo risk assessment and genetic counseling to determine if they may benefit from genetic testing and which genes should be analyzed. Patients who have already had genetic testing are also welcome.

“Each woman is different and we are here to help them learn the facts and learn their options,” says Donenberg. “Knowledge is power that can save your life.”

For patients who have already been diagnosed with ovarian cancer, Slomovitz and the team of gynecologic cancer experts are using Sylvester’s genetic testing capability to identify each patient’s genetic mutation and then determine which specific therapy might prove beneficial. Among the treatment possibilities is a newly approved drug, Lynparza (olaparib), for advanced, BRCA-mutated ovarian cancer.

“We offer a personalized approach that is really where cancer treatment is heading,” says Slomovitz. “By learning more about each patient’s specific mutation, we can more accurately target the therapy and better treat these patients.”

The Ovarian Cancer Early Detection Clinic is located at Sylvester Comprehensive Cancer Center in Miami and at Sylvester in Deerfield Beach. For more information, call 305-243-5302.

Above content is provided by Sylvester Comprehensive Cancer Center.



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