Genitourinary Oncology Physicians Awarded Prestigious 2017 Castle Connolly Top Doctors Designation

The Weill Cornell Medicine and NewYork-Presbyterian Genitourinary Oncology Program is proud to announce that our physicians have been identified as Castle Connolly 2017 Top Doctors for cancer in the United States and in the New York Metro area. This further validates our long-standing commitment to patient care and the advancement of medicine. 

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WCM/NYP Genitourinary (GU) Medical Oncologists

Each year, Castle Connolly, an established healthcare research company located in New York, bases its selection through a peer-review process, extensive research and screening of nearly 100,000 nominations. This nomination shows that not only do our physicians have a great reputation, but they are also recognized by other doctors who can attest to their commitment to the field of genitourinary oncology.

“Within the Genitourinary Oncology Program, we are dedicated to providing cutting-edge care and access to clinical trials for people with all stages and types of prostate, kidney, bladder and testicular cancer,” said Scott Tagawa, MD, Medical Director of the Genitourinary Oncology Research Program at Weill Cornell Medicine.

Diagnosing and using the latest technologies to molecularly characterize and find the right treatment for each patient is an individualized process. Physicians in the Genitourinary Oncology Program, as well as other cancer experts throughout Weill Cornell Medicine and NewYork-Presbyterian, utilize an approach to treatment known as precision medicine that assesses individual variability in the tumor’s genes and microenvironment. This allows our physicians and researchers to better understand and predict which treatment approach will work best for each patient, without using a “one-size-fits-all” approach.   

According to Dr. Tagawa, “Patient care is our utmost priority and winning this prestigious Castle Connolly Top Doctors award is a testament to our dedication to improving the lives of our patients. I’m honored to be part of such a comprehensive and multidisciplinary team.”

Congratulations to the GU physicians on this outstanding achievement!

About Castle Connolly and America’s Top Doctors
CC 2017
The mission of
Castle Connolly Medical Ltd. is to help consumers find the best h
ealthcare. They publish a variety of books including the “Top Doctors” series, the most popular of which is America’s Top Doctors®. Doctors who are among the very best in their specialties and in their communities are selected for inclusion.

 

Thinking Beyond Survival – Cerebrovascular Complications of Cancer

Babak Navi_headshotBabak B. Navi, MD, MS
Stroke Center Director
Assistant Professor of Neurology
Weill Cornell Medicine | NewYork-Presbyterian

Over the past decade, there has been tremendous progress in cancer therapeutics. This includes targeted agents that act on specific receptors in cancer cells, immunotherapy which harnesses the body’s immune system to attack cancer cells, and personalized medicine whereby oncologists use different combinations of cancer drugs to optimize the chance of success based on the molecular profile of the tumor. These amazing scientific advances have led to prolonged survival for people with several cancer types, and it is possible that in the not-too-distant future, cancer will become more of a chronic disease with periodic flare-ups similar to what has occurred with diabetes and HIV. However, with this paradigm shift, long-term quality of life and well-being has become more important, and preventing diseases and complications that can affect these factors is paramount.

Stroke is the leading cause of disability in the United States. In addition, in many parts of the world, including Asia, it is the leading cause of death. In the United States alone, 800,000 people each year suffer stroke and this number is expected to rise as average life expectancy increases. Many factors can increase a person’s risk for stroke including age, hypertension, diabetes, high cholesterol, obesity, and smoking. Besides these traditional stroke risk factors, we now know that cancer and its treatments also increase the risk of stroke. In particular, patients with certain types of cancer, such as lung, pancreatic, and bladder cancers, as well as patients with metastatic disease, tend to have the highest risk. For instance, elderly patients with newly-diagnosed lung cancer face roughly an 8% risk of stroke in the first year after being diagnosed with cancer. In addition, cancer patients’ stroke risk varies with time and is highest in the first 3 months after diagnosis, when some cancer patients face up to a 3-fold higher risk of stroke than usual. It also turns out that certain necessary and potentially life-saving cancer treatments, including some forms of chemotherapy and radiation, can increase stroke risk.

At the moment, the exact reasons why cancer patients face a heightened risk of stroke are unclear. It is well known that circulating cancer cells can alter individuals’ clotting systems to promote clot formation but exactly how they do this is uncertain. Furthermore, doctors know that certain chemotherapy and radiotherapy treatments can damage blood vessels, but once again, the exact mechanisms underlying these processes are poorly understood.

At Weill Cornell Medicine and NewYork-Presbyterian, my team is actively working to determine what the exact risks of stroke are in people with newly diagnosed cancer, what clinical factors and biomarkers in blood can help doctors identify high-risk patients, and what the optimal strategies are to prevent and treat stroke in cancer patients. One particular study that we are currently enrolling into is entitled MOST-Cancer. This study uses cutting-edge ultrasound and blood tests to evaluate the predictors and mechanisms of stroke in people with cancer. If you or a loved one has cancer and are interested in learning more about these studies, please email our team at stroketrials@med.cornell.edu or call 212-746-6757.

May is National Stroke Awareness Month. The main intent of this campaign is to raise awareness about the symptoms and signs of stroke and to educate the public to call 911 if they suspect stroke. The most popular campaign is FAST, which stands for Face, Arm, Speech, and Time – Time to call 911.

If you or a companion develops unexplained facial asymmetry, arm weakness, or speech changes, you should call 911 immediately so that an ambulance is activated to provide rapid delivery to the closest stroke center. This is imperative as there are medicines and surgical procedures that have been proven to improve outcomes after stroke but these are only effective in the first few hours after stroke onset. Therefore, if stroke is suspected, do not hesitate, call 911, as it could be life saving!

Furthermore, I recommend that cancer patients have a frank discussion with their doctors about their individual risks for stroke and other cardiovascular diseases, as well as potential strategies to reduce their risks through medicines and lifestyle modifications.

We’ve made great strides in oncological care so that patients routinely get cured or live many years with their disease. Therefore, it is now time that we turn our attention to long-term quality of life, and in particular, to preventing stroke and the other secondary complications of cancer.

Stroke_BE FAST SIGN NEW

Mini Organs: What Organoids Can Tell Us

Historically, cancer research has been conducted using cell lines that grow in a petri dish. We’ve been able to learn a lot and make much progress in the fight against cancer using this approach, but it also has some limitations, as the environment is not truly reflective of the way cancer cells grow and metastasize within the human body – a three-dimensional (3-D) environment. Additionally, cell lines can mutate over time and then sometimes no longer reflect the genetic and molecular variants of cancer cells.

Over the past 10-15 years, medical research has evolved and grown (literally and figuratively) – what used to only be possible in sci-fi movies and imaginations is now a reality as we create mini-models of bodily organs in the laboratory. These 3-D structures are also known as organoids, and an exciting area of this research is related to cancerous tumors.

Cancer biopsies remove tumor cells directly from the body. Often these biopsies are conducted when a primary tumor is found and removed, and sometimes also if the cancer has grown and spread to other locations throughout the body. This is because tumor cells evolve and change over time, especially as they try to develop workarounds in response to treatment. From the tumor cells that are removed in a biopsy, we’re analyzing the pathology and learning about the cancer on the molecular and genetic level, including any mutations we may be able to target.

Another way we’re able to use these tumor cells is to grow organoids in order to replicate the tumor outside of the body. This 3-D representation of the tumor allows us to conduct research in a way that better addresses the complex structure of the cancer. It is a form of precision medicine or personalized medicine, and allows us to test how an individual patient’s cancer cells may respond to a wide range of treatments.

This video created by the Englander Institute for Precision Medicine provides an overview of how this process works: