National Cancer Institute Leader Visits Mount Sinai

Nov 5, 2018 | Cancer, Community, Featured, Research

From left: Luis M. Isola, MD, Professor of Medicine (Hematology and Medical Oncology), and Pediatrics; Ramon Parsons, MD, PhD, Director, The Tisch Cancer Institute; Norman E. Sharpless, MD, Director, National Cancer Institute; and William Oh, MD, Deputy Director, The Tisch Cancer Institute, and Associate Director of Clinical & Translational Research for the Institute.

Aging is one of the greatest risk factors for developing cancer, which is most frequently diagnosed among people aged 65-74. But there are no simple explanations for the “multifaceted” science behind this connection, according to Norman E. Sharpless, MD, Director of the National Cancer Institute (NCI).

On Thursday, September 13, Dr. Sharpless addressed the topic in a seminar titled “The Dynamic Interplay between Cancer and Aging,” which he presented before a standing-room-only crowd in Davis Auditorium on The Mount Sinai Hospital campus. Dr. Sharpless has devoted much of his career to studying the connection between cancer and aging. Developing a better understanding of this relationship is particularly important, he said, because people over the age of 65 make up the fastest growing segment of the nation’s population.

Dr. Sharpless was invited to speak about his own research by The Tisch Cancer Institute at the Icahn School of Medicine at Mount Sinai, where he spent the earlier part of the day meeting with leaders of the Institute and medical school. He had lunch with postdoctoral fellows and students who work in Mount Sinai’s cancer-focused laboratories, and met with faculty and staff who oversee Mount Sinai’s Cancer Center Support Grant. The grant provides Mount Sinai with its NCI designation as one of an elite group of U.S. institutions committed to the research and treatment of cancer.

During the day’s meetings, Dr. Sharpless shared his vision for NCI programs and discussed trends in funding and cancer research. The Tisch Cancer Institute received its NCI designation for the fi rst time in 2015 and is preparing to renew the competitive grant in 2019. Since his appointment to the NCI in 2017, Dr. Sharpless has spent time visiting NCI-designated cancer centers around the country. On his recent trip to New York City, he also visited the Albert Einstein Cancer Center.

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Do I Need a Biopsy or Surgery for My Thyroid Nodule?

Updated on Jun 30, 2022 | Head and Neck, Your Health

Thyroid nodules are very common. These masses within the thyroid gland are composed of tissue and/or fluid and are estimated to be present in more than 50 percent of those aged 50 and older.  Nodules can run in families, are more common in women, and increase in frequency with age.

Patients diagnosed with a thyroid nodule often ask if their nodule needs to be biopsied or surgically removed. Sometimes the answer is yes, but often the answer depends on a number of patient and nodule-related factors. Catherine Sinclair, MD, FRACS, head and neck surgeon at Mount Sinai West, explains why your nodule may, or may not, need special attention.

How do you know if you need a biopsy?

More than 95 percent of thyroid nodules are non-cancerous, although a family history of thyroid cancer in a first-degree relative or whole-body/neck/chest radiation exposure may increase the risk. Nodules have a low cancer risk, so whether to biopsy depends on the size and ultrasound appearance of the mass.

Over the past decade, many nodules smaller than one centimeter have been incidentally detected on imaging (CT, MRI) that was ordered for another reason. Often these nodules were inappropriately biopsied, and, if the biopsy was positive for thyroid cancer, overly extensive total thyroid surgery was performed. Recent data from Japan and the United States suggests that appropriately selected thyroid cancers can remain stable over time. Termed “microcarcinomas,” these cancers are less than one centimeter in size and may be adequately managed without surgery or with limited thyroid surgery.

How is risk measured?

In an effort to reduce “incidentally diagnosed” microcarcinomas, the American Thyroid Association (ATA) Guidelines for Thyroid Nodules and Differentiated Thyroid Cancer classifies nodules into risk categories for biopsy based on thyroid nodule size and ultrasound appearance. Those classified as high-risk nodules should be biopsied when more than one centimeter in size, whereas low-risk nodules—depending on their appearance on ultrasound—should not be biopsied until they are one and a half to two centimeters in size. Many thyroid surgeons perform their own ultrasounds and use the ATA risk classification system (along with any biopsy results) to determine who should have a biopsy, which nodules should be operated on, and which nodules can be safely observed.

What are the symptoms and treatment for thyroid nodules?

In addition to posing a cancer risk, nodules may also need to be removed if they grow very large (greater than four centimeters) and cause symptoms like difficulty swallowing, neck discomfort, hoarseness of the voice, and airway compression with shortness of breath. Frequently, a thyroid lobectomy—the removal of a portion of the thyroid gland—may be adequate treatment for a non-cancerous thyroid nodule as well as for small cancerous nodules that are less than four centimeters. However, patients should speak with their surgeon in detail beforehand about the many additional factors affecting surgery, such as the status of the other thyroid lobe, your age, and your personal preferences.

In summary, a thyroid nodule may require an operation if there is a high risk of the nodule being cancerous or if the non-cancerous nodule is large and causing symptoms.

Non-cancerous nodules that are asymptomatic should be observed with intermittent ultrasound follow-up when appropriate. If surgery is necessary, the least aggressive option that will effectively treat the nodule should be chosen.

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Catherine Sinclair, MD, FRACS, is a head and neck surgeon at Mount Sinai West, at 425 West 59th Street on the 10th floor. She is a board certified and fellowship-trained surgeon at the Head and Neck Institute, and treats all stages of thyroid disease and parathyroid disease.

To make an appointment with Dr. Sinclair, call 212-262-4444.

Dubin Breast Center Honors Three Individuals at Sixth Annual Benefit

Updated on Jun 30, 2022 | Breast Cancer, Community

From left, honorees Steven J. Burakoff, MD; Brooke Morrow; and Kara DioGuardi.

The Dubin Breast Center of The Tisch Cancer Institute at the Mount Sinai Health System recently held its sixth annual benefit at the Ziegfeld Ballroom in Manhattan. The celebratory event attracted 520 guests and raised a record $3.4 million to support the Center’s breast health and treatment programs.

From left, Eva Andersson-Dubin, MD; Kenneth L. Davis, MD, President and Chief Executive Officer, Mount Sinai Health System; and Elisa Port, MD, FACS.

The evening honored Kara DioGuardi, Brooke Morrow, and Steven J. Burakoff, MD, Dean for Cancer Innovation at The Tisch Cancer Institute. Eva Andersson-Dubin, MD, founder of the Center and a Mount Sinai Trustee, and Elisa Port, MD, FACS, the Center’s Director, presented the awards.

Ms. DioGuardi and Ms. Morrow, close friends who helped each other through two different breast cancer journeys at the Center, were recognized for their inspirational stories of survivorship and their ongoing support of the Center. Dr. Burakoff was honored for his overall commitment to cancer research and clinical care and for his role in leading The Tisch Cancer Institute to be recognized as a National Cancer Institute designated cancer program. Dr. Burakoff, the Founding Director of The Tisch Cancer Institute, is also Lillian and Henry M. Stratton Professor of Cancer Medicine at the Icahn School of Medicine at Mount Sinai.

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Breast Surgeon Receives Mother of the Year Award

Updated on Jun 30, 2022 | Breast Cancer, Community

Susan K. Boolbol, MD, and her children.

Susan K. Boolbol, MD, Chief of Breast Surgery at Mount Sinai Beth Israel, along with new TODAY show co-host and breast cancer survivor Hoda Kotb, recently was honored with the American Cancer Society’s 2017 Mother of the Year award at a special luncheon held at the St. Regis New York hotel in Manhattan.

Dr. Boolbol’s daughters, Emma and Mackenzie Boolbol, presented her with the award after reading a witty, rhythmic introduction that chronicled Dr. Boolbol’s life as a devoted mother and busy doctor who loves her work and cares deeply about her patients.

Kathie Lee Gifford, Ms. Kotb’s friend and longtime television co-host, presented Ms. Kotb with her award. Last year, Ms. Kotb adopted a daughter and became a mother for the first time after the age of 50.

According to the American Cancer Society, the annual awards luncheon—now in its 22nd year—has raised more than $5 million since its inception. Honorees are chosen for distinguishing themselves as remarkable mothers who inspire others through their abilities to balance parenting with social obligations, careers, and philanthropic activities. Past Mother of the Year honorees include fashion designers Vera Wang, Tory Burch, and Carolina Herrera, as well as Kathie Lee Gifford herself, and philanthropists Anne and Charlotte Ford.

In her acceptance speech, Dr. Boolbol said, “Before I was a mom, I thought about how much I would teach and inspire my children. The reality is that I am overwhelmed by how much I learn and am inspired by them every day.”

 

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How Do I Maintain a Healthy Diet with Short Bowel Syndrome?

Oct 9, 2017 | Cancer, Diet and Nutrition, Your Health

Patients with short bowel syndrome have unique dietary constraints because they have trouble absorbing nutrients. Kwai Lam, RD, clinical nutrition coordinator at the Mount Sinai Intestinal Rehabilitation and Transplantation Center, provides advice on how to obtain optimal nutritional intake with this difficult condition.

Kwai Lam, RD

In the United States, it is estimated that 10,000 to 20,000 people suffer from short bowel syndrome, a rare condition that occurs when an extensive length of the intestine is removed, typically during surgery to treat diseases, injuries, or birth defects.  It has debilitating effects, often contributing to poor quality of life and a greater chance of disease or death.

Dietary modifications aim to optimize nutrient and fluid absorption, and reduce diarrhea, malnutrition, and dehydration. What a patient can consume will depend on the anatomy of their remaining intestine. For example, the diet for someone with a colon will differ from someone without a colon. (See chart below.)

For all short bowel syndrome patients, foods with high sugar content should be avoided as they can exacerbate diarrhea. Meal planning should focus on including more complex carbohydrates such as bread, rice, pasta, and potatoes. Whole-grain products, raw vegetables, fruit peels, and nuts should be excluded due to their high fiber content and propensity to aggravate diarrhea. Dietary fat should be eaten in moderation, especially in individuals who have their colons since mal-absorbed fat in the colon along with a diet high in oxalate increase the risk of forming kidney stones.

Fluids with high sugar content, like juice and soda, cause an influx of water into the intestine, resulting in a laxative effect. Ideally, patients should consume fluid known as oral rehydration solution, which has a balanced ratio of sugar to sodium. Contrary to common beliefs, most sport drinks are not the best choice for this population, due to their high sugar and low sodium contents. Water and other fluids with no sodium or sugar, may be tolerated in some individuals who have their colon. However, these beverages tend to promote sodium and fluid loss, leading to further dehydration in individuals who have their colon removed. Oral rehydration solutions are recommended for all who have short bowel syndrome. They can be purchased commercially or made at home using three common household ingredients: water, table salt, and sugar.

 

Colon No Colon
Carbohydrate

 

 

Fat

 

Fiber

 

Oxalate

 

Fluids

 50-60% of calories

Complex carbohydrate

 

20-30% calories

 

Soluble fiber

 

Restrict

 

Oral rehydration solution and some hypotonic fluids

 40-50% calories

Complex carbohydrate

 

30-40% calories

 

Soluble fiber

 

No restriction

 

Oral rehydration solution

20th Annual Luncheon for Cancer Survivors

Updated on Jun 30, 2022 | Breast Cancer, Community, Patient Stories

Ami Rogé with her physician, Stephen C. Malamud, MD, Associate Professor of Medicine (Hematology and Medical Oncology).

About 200 cancer survivors, their families and friends, and Mount Sinai faculty and staff, recently attended the 20th annual luncheon celebrating National Cancer Survivors Day®. At the event, held on Sunday, June 11, in The Mount Sinai Hospital’s Annenberg West Lobby, attendees enjoyed a performance by Ami Rogé, a concert pianist and breast cancer survivor who was treated at Mount Sinai Downtown-Chelsea Center. Steven J. Burakoff, MD, Dean for Cancer Innovation, Icahn School of Medicine at Mount Sinai, discussed the state of cancer care. “Given our increasing success treating cancer, there are now more than 15.5 million cancer survivors in the United States,” he said. “We must focus more of our efforts on helping our patients cope as cancer survivors.”

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