Archive for September, 2014

Cancer: No Longer a Death Sentence


Chandrakanth Are, MD

The six letter word “cancer” can still hit a serious blow to the mind, heart and soul. Even for someone blessed with enormous fortitude, the diagnosis of cancer can be devastating. But there is good news around. While we may not have found the magic bullet for treating cancer we are definitely better than a few decades ago. The survival of all patients for five years from their initial diagnosis from all types of cancer has increased from 50 percent in the 1970’s to 66 percent in the 1990’s. Similarly, we have also seen a decrease in the death rates from all types of cancer since 1990 in men and since 1991 in women. Compared to the peak rates in 1990 for men and 1991 for women, the cancer death rate for all sites combined in 2006 was 21 percent lower in men and more than 12 percent lower in women.

While the figures on a broad scale look somewhat reassuring, what does it mean to an individual patient? The patient that is seen in the clinic and told that she has colon or rectal cancer that has spread to the liver. Less than three or four decades ago, there really were not that many options to treat these kind of patient other than provide palliative care. We have come a long way from there to current day that many of these patients go on to live beyond not just five years but even ten years. How did this happen? This is due to the combination of improved radiology, better chemotherapy and safe surgery.

The current state-of-the-art radiological tools such as CT scan and MRI tell us exactly the extent of the disease which helps us plan clearly as to who needs an operation and more importantly who does not. While it is important not to deny a patient that needs an operation it is even more important and paramount not to operate on someone that does not need one. For a long time there was only one chemotherapy drug available for treating patients with colon and rectal cancer that has spread to the liver. Within the last 15 years, we have seen an impressive introduction of new drugs that has created a paradigm shift in the management of these types of patients. Lastly, surgery for removing a portion of the liver has also evolved significantly. These procedures were very risky and associated with a very high mortality rate in the 1970’s. We can currently perform these procedures safely with minimal mortality and most of the patients go home to resume normal lives.

These advances do not give us reason to sit on our laurels but they provide us the impetus to go out and tell patients and public that there is more to do. More to do so as to, increase the awareness, that there is a state-of-the-art Cancer Center within the heart of Nebraska that can provide cancer care unparalleled to any other institution in the world. More to do so as to, keep the patients and public educated of the options available to treat cancer. More to do so as to, promote the cutting edge research taking place at the Nebraska Medical Center to find novel treatment options for cancer. Finally, more to do so that we can take care of patients with cancer and heal not only the disease but mind, body and soul. For, cancer these days does not always have to be synonymous with a death sentence.

Neurosurgery Training Program is Part of What Makes the Med Center Special


William Thorell, MD is an associate professor of neurosurgery at the University of Nebraska Medical Center.

As surgeons, we’re always gratified to hear from patients who’ve had great recoveries from serious injuries or diseases. Treating those conditions and helping people down the road to recovery are the reasons my colleagues and I became neurosurgeons. And those outcomes are a big part of what makes the med center a special place. But it’s more than a hospital; it’s more than a medical school. It’s where the areas of patient care and education come together that really sets this center apart.

A great example of this is the UNMC Neurosurgery Training Program. A few weeks ago, it wrapped up its 21st year. Lyal Leibrock, MD and Leslie Hellbusch, MD started the program back in 1993 with the goal of developing the neurosurgical expertise available in Omaha and throughout the region. The program’s first resident, John Treves, MD, graduated in 1998 and true to the program’s original goal, Dr. Treves still practices at Midwest Neurosurgery and is a key faculty member for the training program here at the med center.

The quality of the training program has increased over the years. It’s intensive training which lasts six to seven years. As you can imagine, it’s highly sought-after training for residents. They do rotations at The Nebraska Medical Center, the state’s largest hospital, as well as Children’s Hospital and Medical Center and Nebraska Methodist Hospital. Those who are accepted are some of the most bright and talented medical students from their respective schools. The reputation and success of the training program can be traced back directly to the culture set forth 21 years ago by Drs. Leibrock and Hellbusch; and continued on by my colleagues and partners who have continued to lead the program in the years since.

As a proud graduate of the program myself, I’d like to congratulate this year’s residents: Joe Cheatle, MD and Kyle Nelson, MD. Joe and his family will be relocating to South Carolina for practice and Kyle and his family will return to their home state of Minnesota.

Including Dr. Treves, many of the program’s graduates continue to practice neurosurgery in the region. These include: Mark Puccioni, MD, Brad Bowdino, MD, Guy Music, MD, Dan Tomes, MD, Scott Boswell, MD and myself.

The Nebraska Medical Center’s neurology/neurosurgery program was ranked 31st nationally on US News and World Report’s list of America’s Best Hospitals.

U.S. News & World Report Again Ranks The Nebraska Medical Center as One of America’s Best Hospitals

Omaha, Neb – U.S. News & World Report surveyed nearly 5,000 hospitals nationwide to come up with this year’s list of Best Hospitals. For 2014-15, U.S. News evaluated hospitals in 16 adult specialties and ranked the top 50 in most of the specialties. Just 3 percent of the hospitals analyzed for Best Hospitals earned national ranking in even one specialty.

The Nebraska 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. This is the best performance for the hospital in terms of national recognition in these rankings. The Nebraska Medical Center was also high performing in six other specialties including:

  • Cardiology and heart surgery
  • Diabetes and endocrinology
  • Ear, nose and throat
  • Geriatrics
  • Gynecology
  • Orthopedics

In addition to these rankings, U.S. News & World Report ranked The Nebraska Medical Center as the top hospital in the state.

“We are truly honored to be recognized as a leader in so many different areas,” said Bill Dinsmoor, CEO of the clinical enterprise that includes The Nebraska Medical Center. “It’s a reflection of the serious medicine and extraordinary care our physicians and staff provide to our patients every day.”

U.S. News publishes Best Hospitals to help guide patients who need a high level of care because they face particularly difficult surgery, a challenging condition or extra risk because of age or multiple health problems. The annual rankings, now in their 25th year, recognize hospitals that excel in treating the most challenging patients.

“We see patients from all 50 states and over 40 countries,” said Brad Britigan, MD, dean of the University of Nebraska Medical Center (UNMC) College of Medicine and president of the clinical enterprise that includes The Nebraska Medical Center. “Thanks to our world-renowned physicians and specialty programs, we’re able to diagnose and treat the sickest of the sick.”

Serving as the teaching hospital for UNMC, research is also at the forefront, especially when it comes to life-changing cancer therapies.

“Our scientists and cancer specialists are working together every day to stop cancer and save lives,” said Jeffrey Gold, MD, UNMC chancellor and board chairman of the clinical enterprise. “We are providing breakthroughs. I’m very proud of the teamwork that defines our remarkable academic medical center.”

U.S. News recognizes hospitals that perform nearly at the level of their nationally ranked peers and represent valuable regional sources of quality care.

“The data tells the story – a hospital that emerged from our analysis as one of the best has much to be proud of,” said U.S. News Health Rankings Editor Avery Comarow. “A Best Hospital has demonstrated its expertise in treating the most challenging patients.”

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. Using the same data, U.S. News produced 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 2015” guidebook, available in August.

Biocontainment Unit Uniquely Qualified to Assist with Ebola Outbreak if Needed

A representative from the U.S. State Department visited the med center this morning to take a closer look at the capabilities of The Nebraska Biocontainment Patient Care Unit located on campus here. This was strictly a fact-finding mission, to make government officials aware of the unit’s capabilities in case the need arises for treatment of patients with the Ebola virus here in the U.S.

“We are uniquely qualified to care for these types of patients,” said Philip Smith, MD, medical director of the unit. “The unit has been operational for nearly ten years, and our medical staff has been drilling for countless hours for this type of event. At this point, the most severe threat has been in west Africa, but we’re prepared to care for American citizens if necessary.”

The Biocontainment Unit is only one of four such units in the country equipped to handle an outbreak of this nature. The others are at Emory University in Atlanta, GA, which is already receiving two American citizens who have contracted Ebola, The National Institutes of Health in Maryland and a facility in Missoula, MT.

“We want to make it very clear that we haven’t been notified of any patients who are headed to Nebraska for treatment,” said Angela Hewlett, MD, associate medical director of the unit. “This representative was only here to learn more about our unit and to determine if it meets the qualifications necessary for Ebola patients in the future. We’re honored that national health leaders have expressed confidence in our ability to help address this global health crisis. This is a clear indication that the med center is an international resource in health care, research and education.”

If a patient were to be treated in the unit, there would be no danger to others on campus or anyone else in the area. “The Ebola virus is very difficult to contract,” said Dr. Smith. “The risk it would pose to people outside the unit would be zero, and this is something that can be very safely treated without infecting health care workers.”

The unit has never been officially operational since it opened in 2005. However, it was designed to provide a full spectrum of care, from quarantine to intensive care treatment. It is designed to handle everything from smallpox, SARS and avian influenza to the Ebola virus. It is staffed by 30 highly-trained medical professionals who have special training in disaster management, cardiac life support and bioterrorism.