Archive for the ‘Medical Professionals’ Category

Lung Transplant Program Begins at Nebraska Medicine

One of a Few Institutions Nationwide Offering All Solid Organ Transplants

Nebraska Medicine is home to one of the most reputable and well-known organ transplant programs in the country. In the decades since the first transplant in 1970, its nationally and internationally renowned specialists have performed thousands of heart, liver, kidney, pancreas and intestinal transplants. After years of planning and preparation, the organization is launching a comprehensive Lung Transplant Program. The addition makes Nebraska Medicine one of a few institutions nationwide to offer all solid organ transplants under one roof.

“We are thrilled to offer this lifesaving treatment,” says Heather Strah, MD, medical director of lung transplantation. “The addition of lung transplantation takes Nebraska Medicine’s already elite solid organ transplant program and elevates it to the highest level in the country.”

Nebraska Medicine first offered a lung transplant program in 1995, which remained in operation until 1998. The program now looks to once again shape the field of patient care, offering a multidisciplinary team of surgeons, physicians, respiratory therapists, psychologists, social workers, dietitians, nurses and others. Professionals will provide patients support from pre-evaluation to long-term follow-up care.

“A transplant program requires a large team of people pulling in the same direction,” says lung transplant surgical director Aleem Siddique, MD. “This program is the product of a great deal of hard work. It will allow us to provide world-class care to the people of Nebraska and surrounding states.”

Patients will no longer need to travel hundreds of miles for treatments of end-stage lung disease. Nebraska Medicine’s program will also assume the care of appropriate patients who received lung transplants at other institutions.

“Patients who have been transplanted far from Omaha often have a tremendous burden on them,” says Dr. Strah. “The time and financial resources required to receive follow-up care can be astonishing. With our new program, patients will have expert care close to home while ensuring superior care coordination with their transplant center. In addition, patients who were too ill to travel and receive a transplant may now be candidates locally.”

Nebraska Medicine’s Lung Transplant Program will offer single lung, double lung and heart-lung transplants. Although the transplant process is very unpredictable, clinicians hope to evaluate 20-30 patients and transplant 10 patients in the first year. Some diseases that may require a lung transplant include cystic fibrosis (CF), chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, pulmonary hypertension and many other chronic lung diseases.

“Patients who survive their first year after transplant are typically expected to survive seven or eight years,” says Dr. Strah. “But, there are lots of patients I follow who were transplanted 10, 15, 20 years ago and are still enjoying relatively good health. That’s what we want for everyone. We want nothing more than to provide the best treatment possible for those who walk through our doors.”

Along with extraordinary patient care, the program will provide lung education, research and innovation. Clinicians will also work to promote the importance of organ donation.

“Nationally, it’s estimated that 18 people die every day while waiting for organ transplants,” says Dr. Siddique. “A single donor may save up to eight lives. For the donor or their family, it’s an opportunity for altruism that may be deeply rewarding.”

To register as an organ donor, visit www.donatelifenebraska.com. To learn more about the Lung Transplant Program at Nebraska Medicine, visit NebraskaMed.com/Transplant.

 

Experimental treatment regimen effective against HIV

University of Rochester public relations

Gend0421UNMC’s Howard Gendelman, M.D.

Protease inhibitors are a class of antiviral drugs that are commonly used to treat HIV, the virus that causes AIDS. Scientists at UNMC designed a new delivery system for these drugs that, when coupled with a drug developed at the University of Rochester School of Medicine and Dentistry, rid immune cells of HIV and kept the virus in check for long periods.

The results appear in the journal Nanomedicine: Nanotechnology, Biology and Medicine. While current HIV treatments involve pills that are taken daily, the new regimens’ long-lasting effects suggest that HIV treatment could be administered perhaps once or twice per year.

Howard Gendelman, M.D., professor and chair of the UNMC Department of Pharmacology and Experimental Neuroscience, designed the investigational drug delivery system, a so-called “nanoformulated” protease inhibitor.

The process

The nanoformulation process takes a drug and makes it into a crystal, like an ice cube does to water. Next, the crystal drug is placed into a fat and protein coat, similar to what is done in making a coated ice cream bar. The coating protects the drug from being degraded by the liver and removed by the kidney.

When tested together with URMC-099, a new drug discovered in the laboratory of UR scientist Harris (“Handy”) Gelbard, M.D., Ph.D., the nanoformulated protease inhibitor completely eliminated measurable quantities of HIV. URMC-099 boosted the concentration of the nanoformulated drug in immune cells and slowed the rate at which it was eliminated, thereby prolonging its therapeutic effect.

“The chemical marriage between URMC-099 and antiretroviral drug nanoformulations could increase drug longevity, improve patient compliance, and reduce general toxicities,” said Dr. Gendelman, lead study author, who has collaborated with Dr. Gelbard for 24 years. “We are excited about pursing this research for the treatment and eradication of HIV infections.”

The two therapies were tested together in laboratory experiments using human immune cells and in mice that were engineered to have a human immune system. Drs. Gendelman and Gelbard believe that the nanoformulation technology helps keep the protease inhibitor in white blood cells longer and that URMC-099 extends its lifespan even more.

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Harris Gelbard, M.D., Ph.D.

Dr. Gelbard, director of UR’s Center for Neural Development and Disease, developed URMC-099 to treat HIV-associated neurocognitive disorders or HAND, the memory loss and overall mental fog that affects half of all patients living with HIV.

He tested it with several protease inhibitors, including the nanoformulated version developed by Dr. Gendelman, as any patient prescribed URMC-099 would also be taking antiretroviral therapy. The goal was to determine whether the drugs could be safely administered together. Much to the surprise of Drs. Gelbard and Gendelman, URMC-099 increased the effectiveness of the nanoformulated drug.

“Our ultimate hope is that we’re able to create a therapy that could be given much less frequently than the daily therapy that is required today,” Dr. Gelbard said.

UNMC researcher: Top arthritis drug underused

by Tom O’Connor, UNMC public relations

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James O’Dell, M.D.

A UNMC rheumatologist revealed study results at a major national conference earlier this month which showed that physicians are underutilizing methotrexate, the leading drug for rheumatoid arthritis (RA), or not keeping patients on the drug long enough before switching them to more expensive biologic drug options.

James O’Dell, M.D., Bruce Professor of Internal Medicine and chief of the UNMC divisions of rheumatology and immunology, delivered the message at the annual meeting of the American College of Rheumatology and the Association of Rheumatology Health Professionals in San Francisco.

Study results

To better understand how methotrexate is utilized for RA treatment in the United States, Dr. O’Dell’s research team performed an exhaustive review of anonymous claims data on 274 million patients, representing 92 percent of all prescription drugs written in the U.S. The claims data was produced by Symphony Health Solutions.

From this data, researchers were able to follow the treatment course of 35,640 RA patients between 2009 and 2014. The key findings were:

  • 15,599 (43.8 percent) continued treatment with oral methotrexate.
  • 17,528 (49.2 percent) added or switched to a biologic treatment.
  • A biologic was added at a median of 170 days and 41.5 percent of patients added a biologic agent within 90 days of the initiation of oral methotrexate.
  • Only about 7 percent of patients followed were switched from oral to subcutaneous administration of methotrexate.

“There are some major concerns here,” Dr. O’Dell said. “It shows that we’re not doing all we should with methotrexate, our No. 1 therapy for rheumatoid arthritis.”
Methotrexate is the anchor drug for a class of drugs known as disease-modifying anti-rheumatic drugs (DMARDs). The DMARDS are much less expensive than the other class of drugs used to treat RA called biologics. Previous studies have shown that the DMARDs produce the same clinical benefits in the majority of RA patients as the biological treatment.

If oral methotrexate is not producing the desired results, Dr. O’Dell said the next step should be to try patients on subcutaneous methotrexate at a higher dose.

“What we found in patients who made a treatment change was that 87 percent added a biologic instead of trying subcutaneous methotrexate,” he said. “Patients switched to biologics too quickly – 41 percent switched in three months or less.”

Dr. O’Dell said switching to subcutaneous methotrexate can prevent the need for – or significantly extend the time to – a biologic.

The study found that 72 percent of patients who switched from oral to subcutaneous methotrexate stayed on this treatment for 5 years. The other 28 percent eventually needed a biologic, at a median of 289 days on subcutaneous methotrexate.

“The bottom line,” Dr. O’Dell said, “is that more appropriate optimization of methotrexate could lead to better control of RA and produce significant cost savings. Oral methotrexate is underdosed in clinical practice, and subcutaneous methotrexate is underutilized.”

Dr. O’Dell hopes to submit his research findings to a leading scientific journal in the near future.

From refugee to M.D.: Dr. Nguyen and his family come to America

Posted by Kalani Simpson
immigrant-stories-013z-1024x707During UNMC International Week, Dr. Nguyen told the story of his family’s immigration to the U.S.
Dr. Quan Dong Nguyen’s first step toward becoming an American began when his father went in to report to the new communist government and disappeared for the next 42 months.

During the early 1970s, despite the Vietnam War, Dr. Nguyen’s family lived a relatively normal life in South Vietnam. But after the fall of Saigon on April 30, 1975, when Dr. Nguyen was 8 years old, things changed. The North Vietnamese communist army invited those who were working with the government of the Republic of South Vietnam, like Dr. Nguyen’s father, a physician, and his uncle, who was a provincial chief of police, to come and “meet the new government to learn about the new policies.”

They didn’t see his father again for three and a half years.

When the family finally reunited, they decided they needed to escape. They were among the millions who fled Vietnam during the decade following the fall of South Vietnam.

Dr. Nguyen, professor and McGaw Memorial Endowed Chair in Ophthalmology, and inaugural director of the Stanley M. Truhlsen Eye Institute, told his story as part of UNMC’s International Week.

To make their escape, the Nguyen family – Dr. Nguyen, his parents and his three brothers – piled into a fishing boat, filled mostly with the elder Dr. Nguyen’s patients, many of whom were Chinese. The Nguyens attempted to pass themselves off as Chinese, too.

They picked the stormiest time of year to make the journey. A time when even the murderous pirates they were hoping to avoid would rather stay on dry land. Only about two of every 10 boats making these types of escapes made it, Dr. Nguyen said.

“The ocean,” he said, “usually wins.”

He was seasick, and afraid. That first night, two of the boat’s four engines broke down. The next night, another engine, gone. They were all but drifting on the open sea.

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Dr. Nguyen’s father, Dong So Nguyen, at Pulau Bidong, a refugee camp in Malaysia, in 1979. The elder Dr. Nguyen was president of the camp, his son said. He later resumed his medical practice in Virginia.
People died on that boat. Dr. Nguyen was just a kid: “You just have to let it go in your mind,” he said. The bodies were released into the ocean so that the journey could continue.

At last, they saw land – an island in Malaysia. He can still remember the relief.

It was an uninhabited island. They didn’t know what would happen next. All they knew was, where they were now was better than where they had just been.

After three days, Malaysian police found them. They went to another Malaysian island, Pulau Bidong, which has been set up as a refugee camp, to live among thousands and thousands of fellow Vietnamese refugees. “The life was rough,” Dr. Nguyen said. “But for the first time, people felt like they had freedom again.”

At the refugee camp, emissaries from other countries came to see if they could take in some of the refugees. Germany, Dr. Nguyen said, would take engineers. Australia wanted farmers. Denmark welcomed orphans and kids who had left family behind.

Dr. Nguyen’s parents spoke French. Their educations were French. France would surely take them.

But, no. They wanted to go to the place which would be least likely, in all the world, to turn Communist.

“We didn’t want to escape a second time,” Dr. Nguyen said.

They applied to come to America.

When young Dr. Nguyen settled in the U.S., in northern Virginia, in 1980, he was going into the eighth grade. Though his father was a physician and his mother was an attorney, they were starting over, from scratch, with nothing. They were on food stamps and welfare for the first year, and that was difficult – but they were grateful for the kindness that they received.

“You always remember,” he said, “the first (secondhand) table that people gave to you.”

At school … how to put this politely? “Young teenagers are very nice,” Dr. Nguyen said, “but they also can be quite unfriendly.”

Looking back, the adult Dr. Nguyen forgives those kids. They were just young children, and their new classmate may as well have been from outer space.

But at the time, he thought to himself: how could he be on even ground with them? How could he be the kid in class who wasn’t behind everyone else? In learning a foreign language! And in that, he excelled.

(To this day, if he lectures in South America, for example, he’ll do some of it in Spanish as a sign of cultural respect.)

He went to Phillips Exeter Academy, Yale, Penn, Harvard and Johns Hopkins. He became a doctor.

Now he lives in Omaha, Neb.

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Nguyen and Do in front of the Truhlsen Eye Institute at UNMC.
He married another Vietnamese American, Dr. Diana Do, the daughter of his father’s medical school classmate. Dr. Do is also a professor of ophthalmology and visual sciences at the Truhlsen Eye Institute. Their three children are Vietnamese Americans. Dr. Nguyen and Dr. Do are teaching their children both Vietnamese and American cultures.

He will tell anyone who will listen that despite “many different things in this country that, yes, can make one feel angry,” we should also know this is the greatest country on earth, with many generous, philanthropic citizens and numerous opportunities.

So, after all of these years, does he consider himself truly, fully American?

Well, maybe not quite 100 percent: “I still do not understand all of the jokes yet,” he said (showing that of course he does).

But as a member of the audience said emphatically, “No, Dr. Nguyen, you are an American.”

Most of us are Americans through sheer luck, an accident of birth.

Dr. Nguyen earned his (red and white) stripes the hard way.

Langnas family also shared stories

Frieda Langnas, mother of Alan Langnas, D.O., professor and chief of transplantation, and Dr. Langnas’ sister, Susan Feber, also spoke via teleconference at the presentation. They told the story of how Frieda and her husband separately, as children, emigrated to the U.S. as their families were refugees who escaped the Nazis before and during World War II.

The Truth About Lung Cancer

Alissa_Marr

 

Alissa Marr, MD

There are many myths surrounding lung cancer, one of the deadliest of all cancers. While the death rate still remains very high for lung cancer, we are making tremendous strides in diagnosing and understanding the underlying genetic changes in the different types of lung cancer that are helping us provide new therapies that we hope will ultimately improve survival rates. Oncologist and lung cancer specialist Alissa Marr, MD, sheds some light on lung cancer.

Lung cancer is the number one cause of cancer-related deaths in both men and women.

True
Each year in the United States, more people die from lung cancer than from colon, breast and prostate cancers combined. Of the approximately 228,000 cases that are diagnosed each year, almost 70 percent result in death.

You will know when you have lung cancer.
False

A lack of symptoms often allows lung cancer to go undetected until it reaches advanced stages. Symptoms such as chronic cough, coughing up blood, shortness of breath, chest pain and unexplained weight loss -may be some of the symptoms that result from lung cancer.

Anyone can get lung cancer.
True
While smokers have a 10 to 30-fold increased risk of developing lung cancer, 15 percent or more of cases occur in people who have never smoked. Approximately 23,000 deaths occur annually among non-smokers in the U.S. Smoking cigars and pipes and exposure to second-hand smoke also increase one’s risk. Other non-smoking causes include radon and possibly exposure to diesel fumes, lead, arsenic, grain dust, farming chemicals or home cleaning products.

You may have radon in your home and not know it.
True
Radon is a colorless, odorless gas that’s a decay product found in soil and rocks and can get trapped in houses and buildings. It is estimated that one in 15 homes in the U.S. will have high radon levels. In Nebraska, that number is even higher. Approximately one out of every two radon tests conducted in the state have elevated levels of radon. You can get your house tested for radon with an in-home kit or by a certified service provider.  Winter is a good time to do testing as you get the best results when a closed home is maintained for 12 hours prior to and during the test.

Once you have been a smoker, you cannot reduce your risk for lung cancer.
False
It is never too late to quit. Smokers can gain an estimated six to 10 years of life by quitting smoking and will see a reduction in cancer risk within five years of kicking the habit and an estimated 80 to 90 percent risk reduction in 15 years.

There is no way to screen for lung cancer.
False
A low-dose CAT scan is offered at Nebraska Medicine. Screening CT scans can hopefully detect lung cancer at an early stage, when cure rates are much higher. The screening test is recommended for high-risk groups that includes individuals who are at least 55 years old; have a 30-pack history (equivalent to smoking one pack each day for 30 years or three packs each day for 10 years) and are either currently smoking or have quit within the past 15 years. Please discuss with your primary medical provider if you think you may qualify for this screening test.

Clinical trials may be the best treatment option.
True
Clinical trials are carefully monitored research studies that may give you access to potentially life-saving treatment. Nebraska Medicine participates in many clinical trials for lung cancer. Talk with your doctor about whether a clinical trial is the right treatment decision for you.

To learn more or to schedule an appointment with a physician, call (800) 922-0000.

Stroke Center Receives Fifth Consecutive Recertification

For the fifth consecutive time, Nebraska Medicine’s Stroke Center has been recertified by the Joint Commission as a Primary Stroke Center. The program has been certified by the Joint Commission since 2005 and was the first nationally certified stroke center in the state.

“This certification signifies that the services we provide have the critical elements to achieve long-term success in improving outcomes,” says Matt Pospisil, executive director of Neurology and Orthopaedic Services. “Nebraska Medicine’s Stroke Center has more neurovascular provider expertise than any other health system in the region including two vascular neurologists, a neuro hospitalist, stroke APRN, a neuro intensivist and is the only facility in the area with two fellowship-trained endovascular specialists.”

Nebraska Medicine Named Best in State

U.S. News & World Report Releases 2015-16 Best Hospitals

It’s happened again. U.S. News & World Report has named Nebraska Medicine – Nebraska Medical Center the state’s top hospital. The annual U.S. News Best Hospitals rankings, now in their 26th year, recognize hospitals that excel in treating the most challenging patients.

In rankings by state and metro area, U.S. News recognized hospitals that perform nearly at the level of their nationally-ranked peers in one or more specialties, as well as hospitals that excel in multiple common procedures and conditions.

Nebraska Medicine’s Nephrology and Urology programs ranked 43rd and 44th respectively.

“It’s very rewarding for everyone at Nebraska Medicine to receive this kind of recognition,” says Lisa Runco, executive director of Cardiology and Digestive Disease and Kidney. “It really speaks to the quality of care provided across our entire system.”

U.S. News publishes Best Hospitals to help guide patients who need a high level of care because they may face a particularly difficult surgery, a challenging condition or extra risk because of age or multiple health problems. Objective measures such as patient survival and safety data, adequacy of nurse staffing and other data largely determined the rankings in most specialties.

The specialty rankings and data were produced for U.S. News by RTI International, a leading research organization based in Research Triangle Park, N.C. U.S. News used the same data, as well as the new Best Hospitals for Common Care ratings, first published in May, to produce the state and metro rankings.

The rankings are available at http://health.usnews.com/best-hospitals and will appear in the U.S. News “Best Hospitals 2016” guidebook, available in August from the U.S. News Store.

75 Percent of Top Cancer Doctors in State are at Nebraska Medicine

When you’re battling cancer, you want to know you’re receiving care from the best. Now you can be sure. According to Newsweek’s list of “Top Cancer Doctors 2015,” 75 percent of the top cancer doctors in the state are at Nebraska Medicine.

“This recognition reinforces the commitment we have made to quality cancer care with the building of the Fred and Pamela Buffett Cancer Center and the world-class physicians that are leading this effort,” says Theresa Franco, Vice President, Cancer Center Clinical Operations. “It is an honor to work with such talented individuals who successfully integrated research, clinical care and education to provide the most comprehensive cancer experience for our patients.”

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“These rankings speak volumes for the quality of our program and emphasize the importance of the world-class facility that we are building,” says Jeffrey P. Gold, UNMC chancellor and chair of the Nebraska Medicine Advisory Council. “We are thrilled that so many UNMC and Nebraska Medicine physicians have been identified as among the country’s best in the field of cancer care.”

“Nebraska Medicine is unique in its collaboration among physicians and scientists that allows us to offer the latest cutting edge treatments to our patients,” says Sarah P. Thayer, MD, PhD, associate director for Clinical Affairs and physician-in-chief at the Fred & Pamela Buffett Cancer Center and chief of the Division of Surgical Oncology. “The high quality and level of caring provided by our physicians side-by-side with of our staff of nurses, therapists, techs and many other members of our team, reflect our dedication to providing the best in cancer care to our patients.

“When the Fred & Pamela Buffett Cancer Center project was launched, we committed to attracting the best physicians to provide the very best care for patients here in Nebraska,” says Kenneth Cowan, MD, PhD, professor of oncology at the Eppley Cancer Institute and director of the Fred & Pamela Buffett Cancer Center. “We are actively engaged in recruiting top physicians who are at the forefront of cutting-edge, compassionate cancer care, and will continue to recruit outstanding physicians to join the Cancer Center after it opens in early 2017.”

“Nebraska Medicine and the Fred and Pamela Buffett Cancer Center are very fortunate to have so many of the Top Cancer Doctors in the 2015 Newsweek list,” says Julie Vose, MD, chief of the hematology/oncology division in the UNMC Department of Internal Medicine and associate director of clinical research and co-chair of the lymphoma program at the Fred & Pamela Buffett Cancer Center. “This is an excellent example of combining the best patient care with education and research to optimize cancer care for the region.”

This list was compiled through peer nominations and extensive research conducted by a physician-led research team with Castle Connolly Medical LTD., the publisher of America’s Top Doctors. Each year, Castle Connolly receives nearly 100,000 nominations via this process. Doctors at Nebraska Medicine comprise 15 of the 20 doctors chosen. See list below.

Learn more about this recognition and the doctors who made the list. •Alison Freifeld, MD, infectious disease
•Carl Greiner, MD, psychiatry
•Daniel Lydiatt, MD, head and neck surgery, otolaryngology
•James Armitage, MD, hematology/oncology
•James Edney, MD, surgical oncology
•James Gigantelli, MD, ophthalmology
•Jean Grem, MD, medical oncology
•Julie Vose, MD, hematology/oncology
•Kenneth Cowan, MD, medical oncology
•Peter Coccia, MD, pediatric hematology/oncology
•Philip Bierman, MD, hematology/oncology
•Russell Smith, MD, head and neck surgery, otolaryngology
•Sarah Thayer, MD, surgical oncology
•Steven Remmenga, MD, gynecologic oncology
•William Lydiatt, MD, head and neck surgery, otolaryngology

Medical Center Proud to Have Six Programs Recognized as Blue Cross Distinction Centers

When you need to make a physician referral, the hospital you select can have a direct impact on the care your patient receives and his or her outcome. To help you with these important decisions, Blue Cross Blue Shield developed the Blue Distinction Centers recognition program to identify hospitals with proven expertise in delivering specialty care.

Research confirms that Blue Distinction Centers and Blue Distinction Centers+ demonstrate better quality and improved outcomes for patients, with lower rates of complications and readmissions than their peers. Blue Distinction Centers+ also are more than 20 percent more cost efficient.

Nebraska Medicine is proud to have six programs representing 21 specialties recognized by this program. Three programs have been recognized as Blue Distinctions Centers+ — Blue Cross’s highest recognition. These are cardiac care, knee and hip replacement and spine surgery. Bariatric surgery, complex and rare cancers and transplant were recognized as Blue Distinction Centers and include these specialty areas: liver cancer, pancreatic cancer, primary brain cancer, esophageal cancer, gastric cancer, head and neck cancer, acute leukemia, primary bone cancer, bladder cancer, rectal cancer, soft tissue sarcomas, thyroid cancer, adult pancreas transplant, pediatric autologous and allogeneic bone transplants, pediatric liver transplant, adult autologous and allogeneic bone marrow and stem cell transplant and adult heart care.Mike-Moulton

Michael Moulton, MD

The selection criteria used to evaluate facilities was developed with input from the medical community and includes general quality and safety metrics, program specific metrics, the know-how and expertise of the medical team, the number of times the hospital has performed the procedure and the hospital’s track record for procedure results.

“This recognition is a significant marker of our experience and expertise and reflects our excellent outcomes in cardiac care as well as our ability to provide quality outcomes at a reasonable cost,” says Michael Moulton, MD, chief of Cardiovascular and Thoracic Surgery at the University of Nebraska Medical Center (UNMC). “We are a very busy heart center that provides outstanding care and participates in ongoing clinical trials and education. These are the types of things that attract top physicians and caregivers to our program and help us excel.”

“To be recognized by a third party and one that has a vested interest is a true indicator of our success,” says William Lydiatt, MD, director of the Head and Neck Surgical Oncology Section at UNMC. “It is very rewarding to be recognized by our peers as having a valuable program. We see large volumes of patients in many specialty areas. This experience allows us to continually improve and provide the highest level of care. It’s also what enables us to treat some of the most complex cases and to do it well.”

“This recognition represents an objective assessment of our ability to provide high-quality and high-level spine care,” says Kenneth Follett, MD, PhD, professor and chief of Neurosurgery at UNMC. “We have a staff of physicians and other health care professionals with a high level of experience and training in dealing with spinal disorders. This includes health care specialists from multiple disciplines all in one location which allows us to provide a full spectrum of spine care from simple to complex in an efficient and cost-effective manner.”

“Receiving this recognition is a result of the experience, skills, depth of expertise and the commitment to high quality care that our staff provides to our patients,” says Kevin L. Garvin, MD, professor and chair of the Department of Orthopaedic Surgery and Rehabilitation at UNMC. “Our clinical faculty are skilled in the prevention, diagnosis and treatment of musculoskeletal disorders, ranging from minor injuries to the most complex surgical procedures, including revision arthroplasty and osteotomies. Our team works diligently every day to make the proper diagnosis and prescribe an appropriate and comprehensive course of treatment.”

Validating this recognition, Nebraska Medicine has been ranked one of America’s best hospitals and the top hospital in the state by the U.S. New & World Report’s 2014-15 Best Hospitals list. The medical center is ranked 36th nationally for its cancer care, 29th for gastroenterology and GI surgery, 29th in nephrology, 31st in neurology and neurosurgery, 41st in pulmonology and 25th in urology. Nebraska Medicine was also high performing in six other specialties, including cardiology and heart surgery, diabetes and endocrinology, ear, nose and throat, geriatrics, gynecology and orthopaedics.

New Strides Gained in Diagnosis and Treatment of Lung Cancer

rudy-lackner
Rudy Lackner, MD

Important strides are being made in the way we screen, diagnose and treat lung cancer. New screening guidelines, in addition to new diagnostic and treatment techniques, are helping doctors find lung cancer earlier and treat it more efficiently, says Rudy Lackner, MD, thoracic surgeon at Nebraska Medicine.

Nebraska Medicine not only offers low-dose CT scan lung cancer screenings, but provides a full spectrum of lung cancer care by a team of surgeons, oncologists, radiologists, nurses and others dedicated to the treatment of lung cancer. Studies show that the chance for long-term survival improves when the medical team involved is dedicated to lung cancer treatment.

Lung cancer screening guidelines published in the Journal of National Comprehensive Cancer Network (NCCN) recommend that individuals age 55 to 74 that have smoked a 30-pack history should be screened with low-dose CAT scan. The guidelines were developed after a study sponsored by the National Cancer Institute and published in the New England Journal of Medicine indicated that screening can reduce lung cancer mortality by 20 percent.

“A CAT scan can detect lung cancer nodules in stage IA when the cure rate can be as high as 90 percent or more,” says Dr. Lackner. “With traditional X-rays, approximately 75 percent of lung cancer cases are found in stage III/IV, when cure rates drop to 5 percent and lower.”

“The most challenging aspect of this screening is determining what should be done if nodules are found,” says Dr. Lackner. “This is where our expertise comes into play. We have a long track record of performing lung cancer screenings and treating lung cancer patients.”

“Whether we biopsy the patient will depend on factors such as the size of the nodules and whether the nodules are increasing in size and multiplying,” says Dr. Lackner. “About 50 percent of the population will have lung nodules from exposure to things like fungus or respiratory tract infections, but only 2 percent of these individuals will have cancerous nodules.”

Nebraska Medicine lung cancer team uses a new minimally invasive biopsy technique called electromagnet navigation bronchoscopy – a computer-guided system that allows physicians to take multiple biopsies and determine immediately if they are cancerous. The biopsies are large enough to allow for mutation analysis and the development of customized chemotherapy. This procedure can also be used for pleural dye marking of nodules for surgical wedge resection, placement of fiducial markers for sterotactic radiotherapy and therapeutic insertion of brachytherapy catheters into malignant tissue.

“With this new technique, we can start therapy the very next day as opposed to a week or two later,” says Dr. Lackner. “In the past, we would have to wait for the biopsy results, followed by an outpatient surgery procedure to stage the tumor.” At the time of the diagnosis, Dr. Lackner says they can also perform an endobronchial ultrasound, a procedure that can be performed during the bronchoscopy to stage the lung cancer. “It allows us to view regions of the lungs and surrounding chest area that have traditionally required more invasive surgical procedures to evaluate,” says Dr. Lackner. “If the lymph nodes are negative but the tumor is positive for cancer, we can perform surgery to remove the cancer at the same time. No one else in the area is doing it this way.”

Nebraska Medicine lung cancer team also treats some of the sickest and most complicated patients that other hospitals won’t treat. “Because of our experience and dedicated expertise, we are comfortable treating the elderly as well as high-risk patients who have had other complications like heart disease, lung disease or other medical problems.”

“We’re the only ones in the area who routinely perform surgery on stage III lung cancer patients after chemotherapy and radiation,” he says. “We also have an active program for performing minimally invasive lobectomies and segmentectomies.”

The lung cancer team also includes a certified tobacco treatment specialist who can provide one-on-one smoking cessation counseling. “I tailor the program to the patient’s needs and past experiences,” says Jill Selzle, PA-C, certified tobacco treatment specialist. “Studies show that pharmacological therapy and behavior modification alone are effective, but the combination of counseling and medication provides more effective results.”

Lung cancer is the most common cause of cancer deaths in both men and women in the United States and is the most preventable. It causes more deaths in women than breast, cervical, uterine and ovarian cancers combined. “I am hopeful that this new screening, combined with new diagnostic and treatment techniques will help turn those statistics around,” says Dr. Lackner.

Dr. Lackner works side-by-side with Apar Kishor Ganti, MD, a hematologist/oncologist specializing in lung, head and neck cancers, Karin Trujillo, MD, who with Dr. Lackner, are the only thoracic surgical oncologists in Nebraska with practices limited to cancers of the chest. The other members of his team dedicated to the care of lung cancer patients include oncologists Anne Kessinger, MD and Alissa Marr, MD, radiation oncologist Weining (Ken) Zhen, MD, pathologist William West, MD and radiologist Matthew DeVries, MD.

To learn more, make a referral or connect with a member of Dr. Lackner’s team call 402-559-5600 or visit us online at NebraskaMed.com/Cancer/Lung-Cancer.

Click on the icon below to learn more about upcoming oncology focused CME opportunities.oncology-cme

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