A New Program to Screen for Lung Cancer Shows Success at Mount Sinai Morningside

Updated on Jul 24, 2024 | Featured, Mount Sinai Morningside

Javier Zulueta, MD

A new program at Mount Sinai Morningside represents a valuable tool to catch lung cancer—the  cancer responsible for the most deaths in both men and women—at its earliest stages when it is most treatable.

Harnessing the power of leading-edge technology, the Incidental Lung Nodule Program employs artificial intelligence to sift through radiology reports ordered for patients for various conditions, looking for incidental lung nodules. These innocuous-seeming spots, often discovered during routine tests for unrelated issues, can be silent harbingers of a potentially life-threatening condition.

The program is marking its first anniversary. In just one year, it has identified more than 3,000 patients, including smokers, former smokers, and non-smokers, who may be at risk. Of these, more than 1,500 people are being actively monitored for any changes in their lung nodules, enabling early detection and intervention.

Early detection is critical, according to Javier Zulueta, MD, Chief of the Division of Pulmonary, Critical Care and Sleep Medicine at Mount Sinai Morningside.

“Our goal is to engage physicians, smokers, former smokers, and the public in early detection,” he says. “Through screening programs like ours, we can catch cancers early and significantly improve health outcomes.”

The program operates automatically, with computed tomography (CT) scans ordered for various conditions systematically scrutinized by computerized algorithms. For example, patients who may undergo scans for other cancers, heart disease, or following surgeries may be candidates for this program. Upon detection of a lung nodule, a multidisciplinary team, including specialized pulmonologists, steps in. Patients are quickly contacted, and a comprehensive follow-up plan is set in motion, ensuring monitoring, timely diagnosis, and treatment.

“The Incidental Lung Nodule Program shows our commitment to medical excellence and our dedication to serving the West Harlem community, which has elevated rates of lung cancer,” says Dr. Zulueta. “We offer not just treatment but empowerment through knowledge and early detection.”

Mount Sinai Health System has been a pioneer in the effort to diagnose lung cancers.  The International Early Lung Cancer Action Project, whose goal is to ensure smokers and former smokers receive low-dose CT, was started at The Mount Sinai Hospital and has expanded around the world.  Likewise, the Incidental Lung Nodule Program will be expanding across the Mount Sinai Health System.

According to the American Cancer Society, lung cancer is the second most common cancer in both men and women, not including skin cancer. Prostate cancer is more common in men and breast cancer is more common among women. Lung cancer is the leading cause of cancer deaths, according to the society. Most people diagnosed with lung cancer are 65 or older.

At the Mount Sinai Morningside Spine Program, the Personal Touch Is Key to Healing

Updated on Mar 5, 2024 | Featured, Mount Sinai Morningside, Your Health

Team members at the Spine Program at Mount Sinai Morningside include, from left, Kiran Ballani, Rachel Newman, PA-C, Patrick Reid, MD, Lauren Mcnoble, PA-C, Divaldo Camara, MD, and Priscilla Garcia

If you are having problems with your back and believe you may need to consult with a surgeon, then Mount Sinai has a program for you.

Mount Sinai Morningside has launched a Spine Program with a uniquely personalized and integrated approach. In addition to its advanced and compassionate clinical providers, the Spine Program is one of the few in New York City to have a care coordinator who focuses on helping patients find the right specialist for their needs.

Priscilla Garcia, a clinical navigator for the Spine Program, is one of the many people who make it work. She helps patients get what they need as soon as possible, prioritizing non-surgical treatments when possible.

“My role is to triage patients,” she says. “Some patients think they need a neurosurgeon right off the bat, but if they’re in pain, I schedule them with one of our pain management specialists first.”

If patients need multiple appointments, she often will try to schedule appointments in the same day for the patient’s convenience. A pain management specialist may order an MRI and notice something that a neurosurgeon should evaluate, so she will try to make that happen on the same day—a more efficient and convenient option for patients.

“It’s great for the patient because they don’t have to go home and come back again in a short timeframe. And the patients feel that we are addressing all their needs in a holistic way” she says.

Patrick Reid, MD, left, and Divaldo Camara, MD. “What sets us apart is how we try to make it easier for patients,” says Dr. Reid. “Some try to do it with computer systems or software, but we are devoting human resources to it.” To make an appointment, call 212-523-8500.

Patrick C. Reid, MD, Director of the Spine Program and Chief of Neurosurgery at Mount Sinai Morningside, makes every effort to help patients get care quickly and easily.

“When people go to the doctor, it can be confusing, especially with something as complex as the spine and surgery. Many times, people are forced to navigate the system themselves and hope for the best,” he says. “But an easy way to improve care is to get the patient in the right room with the right specialist, and that’s what we do in our program.”

Patients with spine issues are often older, and reducing the number of trips to the doctor’s office is beneficial.

“Any patient who sees us needs to have things simplified as much as possible,” says Dr. Reid. “People who have jobs, childcare needs—they all need help coordinating their health care. You don’t want to miss two days of work. That’s the benefit of having a navigator who’s had a lot of experience coordinating these things—it’s invaluable.”

The program at Mount Sinai Morningside has all the advantages of a major academic medical system, including access to the latest equipment and to the most advanced treatment techniques.

“But what sets us apart is how we try to make it easier for patients,” says Dr. Reid. “Some try to do it with computer systems or software, but we are devoting human resources to it.”

Only a small percentage of patients at the Spine Center actually receive surgery.

“There are a full range of treatments we can try before suggesting surgery,” says Dr. Reid. “But if our colleagues are running out of options trying to make a patient feel better, then we start having the discussion about surgery—the risks and benefits and likely outcomes.”

In addition, patients with back or neck pain often have health issues that contribute to their condition, and one of the advantages at Mount Sinai Morningside is ready access to specialists in many other areas throughout the Mount Sinai Health System.

“We see many patients with conditions such as diabetes, hypertension, or heart disease, and we will help them get the any additional treatments as quickly as we can,” Dr. Reid says.

Learn more about the Spine Program at Mount Sinai Morningside
To make an appointment, call 212-523-8500

Mount Sinai Morningside Launches Incidental Lung Nodule Program to Promote Early Diagnosis of Lung Cancer

Mar 31, 2023 | Featured, Mount Sinai Morningside, Your Health

A photo showing Javier Zulueta, MD, Rahul Agarwal, MD, and Fernando Carnavali, MD.

Javier Zulueta, MD, right, is joined by, from left, Rahul Agarwal, MD, and Fernando Carnavali, MD.

Lung cancer is by far the leading cause of cancer deaths in the United States accounting for about one in five cancer deaths. It is difficult to detect because there are often no symptoms in its earliest stages—only 16 percent of lung cancers in the United States are detected at a localized stage.

Lung cancer screening for smokers and former smokers, like the Early Action Lung Cancer Action Program (I-ELCAP), has been found effective in detecting lung cancer at earlier stages. However, as more lung cancers are being detected in non-smokers and many are ineligible for screening under the I-ELCAP guidelines, additional tools are needed to detect lung cancers early and save lives.

The newly launched Incidental Lung Nodule Program (ILNP) at Mount Sinai Morningside opens a new path for early detection guided by methodically identifying the patients with lung nodules at most risk for lung cancer and ensuring they receive timely interventions.

How the Incidental Lung Nodule Program Works

CT scans ordered for other illnesses and injuries are methodically scanned by computerized search—a more equitable and inclusive tool for detecting lung cancer early. All of those scans with a reported and documented incidental lung nodule are reviewed by a team led by a pulmonologist with special expertise in lung nodules.

Research has shown that about 25 percent of individuals who have a CT scan of the chest will have an incidental lung nodule detected, most of which need follow-up. Approximately five percent of the individuals with lung nodules may have lung cancer. With an early diagnosis, lung cancer can be successfully treated in the majority of patients.

All scans with findings are entered into a database for tracking and follow-up. The ILNP team notifies the ordering physician and the patient’s primary care provider, if available, via Epic, phone call, or letter, with a specific follow-up recommendation. If the ordering physician was in the Emergency Department and there is no primary care provider available, the ILNP team will reach out to the patient directly.

Click here to see a flowchart showing the communication pathway.

How Do Patients Seek Evaluation and Treatment

Javier Zulueta, MD, a lung nodule expert and pulmonologist at Mount Sinai Morningside, leads a multidisciplinary clinic that accepts referrals from physicians and is available directly to patients. Patients who need evaluation by the nodule clinic will be offered an appointment within one week of notification. They will be evaluated by a pulmonary specialist, and a plan will be established according to guidelines, including a wide variety of diagnostic and treatment options depending on the characteristics of the nodule:

  • Blood test for cancer biomarkers
  • PET scan
  • Pulmonary function tests
  • Biopsy by robotic bronchoscopy or CT guidance
  • Evaluation by Thoracic Surgery

Smoking cessation will be offered to anyone who is a current smoker. All patients will be given a plan for CT scan follow-up within a predetermined period of time—anywhere between three and 12 months.

Patients may require exam and follow-up or diagnostic interventions like image-guided bronchoscopy or percutaneous biopsy. If cancer is diagnosed, the patient will be presented at Mount Sinai Morningside’s weekly multidisciplinary lung cancer and nodule conference. After review of all diagnostic and staging tests, a decision regarding treatment will be made. This can vary depending on the stage but includes thoracic surgery for early stages and oncologic assessment for all.

Patient Follow-Up

Patient not requiring immediate care will be prompted to repeat their CT scan on a recommended schedule and will continue to receive evaluation through the ILNP. The ILNP program navigators will contact the primary care physician, other provider, or the patient directly if patient is not getting the recommended diagnostics.

For more information or to refer a patient to the Lung Nodule Clinic, please call 212-523-3589.

 

 

Mount Sinai Doctors Medicine Multispecialty Offers Collaborative Care in a New Space at Mount Sinai Morningside

Updated on Jun 30, 2022 | Community, Featured, Mount Sinai Morningside

Left to right: Javier Zulueta, MD, Rahul Agarwal, MD, and Fernando Carnavali, MD 

A new practice specifically addressing the needs of ambulatory patients has opened in the Ambulatory Care Center at Mount Sinai Morningside.

Mount Sinai Doctors Medicine Multispecialty offers a wide range of specialty care that allows an integrative team approach for chronic disease management and several new programs where specialists collaborate on patient care. Many patients benefit from having all of their sub-specialists in one office where physicians work together to improve patients’ health. The practice is located at 440 W. 114 Street, Sixth Floor.

“What’s different here from the way we provided care to our patients in the past is we have experts across many specialties caring for patients all in the same place,” says Arthur A. Gianelli, FACHE, President, Mount Sinai Morningside. “We think this is a wonderful opportunity to provide collaborative care to our patients because we know nothing is simple about getting multiple physicians to coordinate your care.”

He adds, “We can provide care for any stage of life, compassionate care for you and your family, your loved ones, right here in the community.”

There are seven subspecialties in the new practice: Allergy and Immunology, Endocrinology, Diabetes and Bone Diseases/Weight Management, Infectious Diseases, Gastroenterology, Pulmonology, Nephrology, and Rheumatology.

In addition, there are four new programs:

Travel Medicine works with patients on the prevention and management of health problems associated with travel. The physicians at Mount Sinai Morningside are board certified in infectious diseases and experts in destination-specific health risks and preventative measures. These specialists address travelers’ vaccination requirements, and answer questions and make recommendations regarding disease exposure.

Venous Thromboembolism (VTE) utilizes a multidisciplinary approach to manage VTE by working closely and cross referring to colleagues in cardiology and cardiothoracic surgery. The team provides follow-up care to patients who were discharged from the hospital or Emergency Department to determine the cause of VTE, evaluates the duration, risks, and benefits of anticoagulation therapy, and works to avoid the development of Chronic Thromboembolic Pulmonary Hypertension as a complication of acute pulmonary embolism.

Lung Nodule(s) is an extension of the Lung Cancer Screening program at Mount Sinai Morningside. It will serve as a referral clinic for all patients who have a lung nodule(s) detected on computed tomography (CT) scans either incidentally or as part of a screening program. Following specific protocols for follow-up and diagnosis of nodules avoids unnecessary invasive procedures while maximizing the diagnosis of lung cancer in its earliest stage when it is most treatable.

Fracture Reduction is a joint effort of Endocrinology and Rheumatology to screen for osteoporosis in individuals over the age of 50 to reduce non-traumatic fractures. A large number of patients hospitalized with hip and other non-traumatic fractures will benefit from biochemical and bone density scan (DXA) evaluation to screen for and treat osteoporosis and reduce the risk of a subsequent fracture and other medical conditions that are caused by or made worse by fractures.

To make an appointment with the Medicine Multispecialty practice, call 212-523-8672.

Watch a video that shows the new space and hear from Mount Sinai Morningside leaders about how the physicians and care team work together to provide excellent patient care and service

Mount Sinai Morningside Earns National Honors for Its Cardiology and Cardiac Surgery Programs

Sep 28, 2021 | Featured, Mount Sinai Morningside

The Cardiology and Cardiac Surgery programs at Mount Sinai Morningside recently achieved two important milestones. Mount Sinai Morningside, along with Mount Sinai West, broke into the top 50 hospitals nationwide for Adult Cardiology and Cardiac Surgery as ranked by U.S. News & World Report, marking the first time that Mount Sinai Morningside has received a national ranking in these services.

This recognition is the result of attracting internationally recognized clinical leaders; recruiting exceptional physicians, nurses, and technicians; undertaking cutting-edge research and authoring influential peer-reviewed articles; investing in state-of-the-art equipment; and building modern administrative and clinical practice spaces at Mount Sinai Morningside.

Mount Sinai Morningside/Mount Sinai West Ranked Among Top in the Nation by U.S. News & World Report for Cardiology & Heart Surgery

 

 

In addition, Mount Sinai Morningside has, for the first time, earned a three-star rating from the Society of Thoracic Surgeons (STS) for its patient care and outcomes in isolated coronary artery bypass grafting (CABG) procedures. The three-star rating, which denotes the highest category of quality, places Mount Sinai Morningside among the elite hospitals for heart bypass surgery in the United States and Canada.

The STS star rating system is a highly regarded overall measure of quality in health care, rating the benchmarked outcomes of cardiothoracic surgery programs in the United States and Canada. The star rating is calculated using a combination of quality measures for specific procedures performed by an STS Adult Cardiac Surgery Database participant.

The STS scoring system is one of the most scientifically validated systems for heart surgery. Achieving the three-star rating is confirmation that our off-pump, multi-arterial and minimally invasive robotic coronary bypass procedures result in better outcomes for our patients.

Historically, approximately 6 to 10 percent of hospitals receive the three-star rating for CABG. The rating awarded to Mount Sinai Morningside was based on national data covering the period from January 1, 2020, through December 31, 2020.

“I am extremely proud of our Mount Sinai Heart team at both Mount Sinai Morningside and Mount Sinai West. This well-deserved recognition acknowledges their high level of clinical expertise, dedication, and teamwork,” said Valentin Fuster, MD, PhD, Physician-in-Chief of The Mount Sinai Hospital and Director of Mount Sinai Heart. Ranked 6th nationally for Cardiology and Heart Surgery by U.S. News & World Report, Mount Sinai Heart at The Mount Sinai Hospital is a world leader in cardiology care, cardiac surgery, and research.

“To achieve these esteemed distinctions at Mount Sinai Morningside during this unprecedented time speaks volumes about our team’s interdisciplinary and collaborative commitment to providing the highest quality of care and the best patient experience possible,” said Beth Oliver, DNP, RN, Chief Nursing Executive and Senior Vice President, Cardiac Services at the Mount Sinai Health System.

She added, “These are significant achievements for the Mount Sinai Heart team at Mount Sinai Morningside. We are proud that their collective efforts have led to our program receiving such important national recognition.”

Read more Featured stories about Mount Sinai

Pin It on Pinterest