The childhood journal of Kevin Chan, M.D., foreshadowed his future: At the tender age of 6, he wrote that he wanted to be a surgeon when he grew up. “I liked the idea of fixing broken arms and legs,” Chan said. “Back then, those were the procedures I could relate to.”
Although his passion for medicine never waned, Chan eventually chose a new specialty. Today he is head of reconstructive urology and a clinical associate professor of surgery at City of Hope, specializing in urology and urologic oncology.
Chan’s interest in urology was launched soon after he entered USC medical school and met Donald G. Skinner, M.D., its urology chair. “He did these amazingly elegant urologic surgeries, and afterward the patients were doing very well,” Chan said. “I was immediately drawn to urology.”
In particular, Chan was inspired by the neobladder procedure pioneered by Skinner. In this complex surgery, a new bladder is created out of intestine, and the kidneys are connected to this pouch, which is connected to the urethra, or as Chan explains to his patients, “the original plumbing.”
According to Chan, if a patient’s bladder needs to be removed, most urologists offer only an “incontinent diversion,” in which the urine drains into an external bag.
However, City of Hope has a much higher percentage of “continent diversions,” either the neobladder or an Indiana pouch, an internal pouch fashioned from intestine that allows the patient to drain urine by passing a tube through a small opening in the abdomen, called a stoma. No drainage bag is necessary. » Continue Reading
“With bladder cancer, the majority of patients that I see can be cured,” said urologist Kevin Chan, M.D., head of reconstructive urology at City of Hope. “The challenge is to get patients the same quality of life that they had before surgery.”
To meet this challenge, Chan and the urologic team at City of Hope ensure that bladder cancer patients who need a cystectomy, or bladder removal, are fully aware of their options. According to Chan, the majority of urologic surgeons will recommend only an “incontinent diversion,” in which the urine drains into an external bag.
But at City of Hope, 60 percent of patients receive “continent diversions” — either a neobladder or Indiana pouch—in which a section of intestine is used to create an internal reservoir. The neobladder allows patients to urinate out of their urethra, whereas the Indiana pouch results in a stoma on the abdomen that patients catheterize to empty.
“We spend an hour with each patient, explaining all three reconstructive procedures,” said Chan. “We go through the pros and cons of each one in that patient’s particular situation. And as long as it’s reasonable and makes sense from a cancer perspective, we will do everything we can to give them the reconstruction they want.” » Continue Reading
The spine can be affected by many different kinds of tumors.
Malignant, or cancerous, tumors can arise within the spine itself. Secondary spinal tumors, which are actually much more common, begin as cancers in another part of the body, such as the breast and prostate, and then spread, or metastasize, to the spine.
Because the spinal cord is enclosed within the rigid, bony spinal column, any abnormal growth can cause problems by compressing the spinal cord and nerves, or compromising the structural integrity of the spine.
Here, City of Hope’s Mike Chen, M.D., Ph.D., an assistant professor of neurosurgery, discusses spinal tumors, their diagnosis and how City of Hope is leading the way in less-invasive spine tumor surgery.
For other interviews with City of Hope experts, go to our list of City of Hope podcasts.
Learn more about becoming a patient or getting a second opinion by visiting our website or by calling800-826-HOPE (4673). You may also request a new patient appointment online. City of Hope staff will explain what’s required for a consult at City of Hope and help you determine, before you come in, whether or not your insurance will pay for the appointment.
Although most cancer occurs in older adults, the bulk of cancer research doesn’t focus on this vulnerable and fast-growing population.
City of Hope and its Cancer and Aging Research Team aim to change that, and they’re getting a significant boost from Professional Practice Leader Peggy Burhenn, R.N., M.S., C.N.S. As the 2015 recipient of the Oncology Nursing Society’s Excellence in Care of the Older Adult with Cancer Award, Burhenn is calling attention to the overarching need for such care, as well as to City of Hope’s efforts and its progress.
The Oncology Nursing Society is a national organization for oncology nurses that supports education, research and certification. It is the largest organization of its kind in the U.S. and sets standards for oncology care. It gives this particular award each year “to recognize and support an oncology nurse who demonstrates age-sensitive health interventions, quality care, and symptom management to older adult patients with cancer.” Burhenn received a similar award from the Los Angeles chapter of the organization in fall 2014.
“It is truly an honor for me to receive this award,” Burhenn said. “I accept it not only for me but for my colleagues who are taking the journey with me to improve care for older adults, specifically the geriatric resource nurses, geriatric patient care assistants and other members of the Geriatric Resource Interdisciplinary Team, which I like to call GRIT.” » Continue Reading
Liz Graef-Larcher’s first brain tumor was discovered by accident six years ago.
The then-48-year-old with a long history of sinus problems and headaches had been sent for an MRI, and the scan found a lesion in her brain called a meningioma – a tumor that arises in the meninges, the layers of tissue that cover and protect the brain and spinal cord.
Meningiomas compress the nerve tissues near them, and can cause a variety of problems including seizures, headaches, blurred vision. and personality or memory changes. They’re the most common type of brain tumor in adults, according to the American Cancer Society, and occur twice as often in women.
The tumors occur in approximately seven to eight of every 100,000 people and about 80 percent are noncancerous. They can be removed by surgery, but unless the meningioma is causing symptoms, most doctors, including Graef-Larcher’s, usually advise monitoring over time.
Then, in 2009, Graef-Larcher was given a series of follow-up MRIs, and this time the scans found another brain tumor – one that had metastasized from her lung. “Although I had no symptoms, my doctor told me that I had cancer in my pelvis, abdomen, lungs and brain,” she said. » Continue Reading
If there is one truism about hospital stays it is that patients want to get out. For many, however, the joy of being discharged is tempered by the unexpected challenges that recovery in a new setting may pose.
Even with professional help, the quality of care and treatment that patients receive at City of Hope is hard to replicate in the home or even in a professional care facility. Readmission to the hospital may be required to attend to issues that might have been resolved had the original posthospital care been more thoughtful; the training a bit more comprehensive.
That was the situation that Brenda Thomson, City of Hope’s director of case management and village operations, observed about two years ago when she began looking at patient readmissions.
“What City of Hope does far exceeds what [patients] get at other places,” Thomson said. “[Patients] may leave with quite extensive drains, wounds and medication regimens.”
She looked at the situation and found that some care providers had gaps in their procedures when it came to treating patients with specialized needs. And these were not just in-home care providers. She found this was also the case at long-term acute facilities, skilled nursing facilities, acute rehab and hospice care.
So Thomson began developing a training program to remedy the situation. Led by City of Hope, the program is now called the Transition of Care Community Coalition and includes 35 of the leading transitional health care organizations, with 90 individual participants, from Los Angeles, Riverside, San Bernardino and Orange County counties.
Ask any patient: Nurses are as pivotal in their care as doctors. They answer the call of a patient in the middle of the night, they hold the patient’s hand as he or she takes on yet another round of treatment and, in the best-case scenario, they wave goodbye as the patient leaves the hospital, healthy and happy.
When everyone has gone home for the day and the family is finally sleeping, nurses remain. No matter what road a patient takes, nurses are the constant, supporting them along the ride.
That’s not an echo you hear, it’s another study linking weight to breast cancer risk. It’s also another reason to improve the health of our overall community.
In a report published online June 11 in the journal JAMA Oncology, researchers have concluded that women who are both obese and postmenopausal face a substantially higher risk of invasive breast cancer than their normal-weight counterparts.
They based their findings on data from more than 67,000 postmenopausal participants in the Women’s Health Initiative, which measured height, weight, frequency of mammograms and incidence of breast cancer.
The risk of invasive breast cancer was greatest for women with a body mass index greater than 35, the researchers found; they had a 58 percent higher risk than normal-weight women. A normal body mass index for women is considered to be 25. If you’re wondering what a “greater than 35 BMI” looks like, the BMI calculator from the National Heart, Lung, and Blood Institute calculates that a woman who is 5’6″ and weighs 220 pounds would have a BMI of 35.5. » Continue Reading
Cancer and other life-threatening illnesses can be overwhelming experiences for adults. For children, who lack the life experience and context to put their diagnosis in perspective, the treatment and follow-up can be especially isolating. City of Hope’s youngest patients recently got a chance to overcome that isolation.
More than 1,700 guests — City of Hope’s pediatric patients and survivors, plus their families — gathered on City of Hope’s Duarte campus for a special celebration of life, complete with kids, adults, doctors and nurses, all of whom understand the impact of treatment for cancer and other diseases.
The “Pacific Paradise”-themed pediatric picnic featured carnival-style games, comic artists, a face-painting booth, themed play zones, performances, and special appearances by cast members from Disney Channel’s comedy series “K.C. Undercover” and “Girl Meets World.” Festivities even included a “City of Hope’s Got Talent” variety show featuring pediatric cancer survivors.
Most important, the picnic gave patients and their families the chance to have a good time with other patients and families who had experienced, or were still experiencing, the treatment journey. It also gave patients a chance to connect with their doctors, nurses and other health care providers in a nonclinical environment. » Continue Reading
Small is beautiful.
That’s the idea behind City of Hope’s Healthy Living Community Grant Program, according to Nancy Clifton-Hawkins, M.P.H., M.C.H.E.S, community benefit manager at City of Hope.
As part of a pilot project designed to improve the overall health of its home community, City of Hope will give about $30,000 in grants to organizations that help San Gabriel Valley residents eat right, exercise and make other lifestyle choices that can reduce their risks of cancer and diabetes. “Most likely, this means six awards of $5,000 each,” Clifton-Hawkins said. “We recognize this may not seem like a lot of money. But, in this case, a little can go a long way.”
The goal is to provide what she called “sparks” to start new projects and improve existing ones “through creativity and passion” and “by leveraging resources such as funding and networking.”
“We are going to be able to address some of the issues around health, health care and access that are not in our wheelhouse,” Clifton-Hawkins said, referring to the institution’s core missions of lifesaving patient-focused cancer care and biomedical research. “There are wonderful nonprofits, government agencies and other organizations that do this stuff every day. The point is to help connect the dots, invest in what they do and encourage them to take it to the next level.” » Continue Reading