WHILE MARCH IS WOMEN’S History Month, women are shaping the future of healthcare, as they make approximately 80 percent of healthcare decisions. Hospitals and physicians are continuing to push the envelope of what is possible, pursuing state-of-the-art medical care for breast cancer and other conditions that affect women. This year’s Chief Medical Officers Roundtable, which explores the latest advances in patient care for women, features the following medical thought leaders:
Atlantic Health System Chief Medical and Chief Academic Officer Jan Schwarz-Miller, M.D.;
- Capital Health SVP, Chief Medical Officer Eugene J. McMahon, M.D., MBA, FCAP;
- Englewood Hospital and Medical Center Chief Medical Officer Michael T. Harris, M.D.;
- HackensackUMC VP, Medical Affairs Lisa Tank, M.D., FACP, CMD;
- Holy Name Medical Center EVP, Chief Medical Officer Adam Jarrett, M.D., M.S.;
- Rutgers Cancer Institute of New Jersey Chief Medical Officer Deborah L. Toppmeyer, M.D.;
- Saint Peter’s University Hospital Chief Medical Officer Niranjan Rao, M.D.;
- The Valley Hospital VP, Chief Medical Officer Joseph Yallowitz, M.D., MPH.
Atlantic Health System
By Jan Schwarz-Miller, M.D., Chief Medical and Chief Academic Officer
At Atlantic Health System Cancer Care, we are working on new treatment approaches for women with breast cancer, particularly those with “triple negative” breast cancer or TNBC. A diagnosis of TNBC means that the three most common types of receptors known to fuel most breast cancer growth—estrogen, progesterone and the HER-2/neu gene—are not present in the cancer tumor. This also means that TNBC does not have receptors that are targets for many treatments we have today, and are more likely to recur. Therefore, in collaboration with a local clinical stage biotechnology company, we are planning to investigate a novel agent that directly and uniquely attacks the TNBC cell’s metabolism, potentially making it more sensitive to chemotherapy or immunotherapy. About 15 percent to 20 percent of all breast cancers in the United States are TNBC.
By Eugene J. McMahon, M.D., MBA, FCAP, Senior Vice President and Chief Medical Officer
Capital Health offers women all of the latest healthcare services they need with insight and support regarding the medical issues they care about most. Our Center for Comprehensive Breast Care is a nationally certified breast center that provides annual screenings, advanced diagnostics, genetic counseling and testing, leading-edge oncology care, a high risk breast cancer program, and a nurse navigator through survivorship—all under one roof. For nearly a quarter of a century, our Regional Perinatal Center has helped women who experience high-risk pregnancies so they have all the support they need in place throughout their pregnancy, during delivery, and after. That means a dedicated team around the clock, including 24/7 in house obstetrical, neonatal, anesthesiology and midwifery coverage. Capital Health Medical Group has also expanded its women’s health services over the last few years to include multiple locations throughout the region. Whether you’re a young woman just starting out, a busy mom or professional with a long to-do list or a mature woman managing menopause or other agerelated issues, women can now more easily find a primary care provider who specializes in their unique health issues.
Englewood Hospital and Medical Center
By Michael T. Harris, M.D., Chief Medical Officer
With advances in medical technologies and treatments, we can offer more personalized care plans for women diagnosed with breast and/or gynecologic cancer. As a rule, the earlier cancer is caught the better the prognosis. Englewood Hospital and Medical Center uses a breast MRI system, including a digital 3-dimensional mammogram, which produce precise images of breast tissue in slices from many different angles to detect abnormalities. Our surgical specialists take a high-tech, conservative approach to surgery, intricately removing diseased tissue using minimally invasive techniques while preserving nearby healthy tissue. For gynecologic cancers, surgeons can perform delicate, complicated procedures using robotic and image-guided technologies to more precisely and accurately remove lesions and tumors, reducing the need for hysterectomies and complete removal of female organs. Our radiation oncologists use an advanced level of technological intelligence using motion management software and real-time tracking to safely and precisely target tumors without harming nearby healthy tissues. These leading radiation therapies can be administered in fewer visits in less time for a more effective and comfortable experience. In addition, our genetic counselors provide risk assessments and genetic counseling to women with a high risk of developing breast and/or ovarian cancer due to personal and/or family history, and offer options to manage that risk.
By Lisa Tank, M.D., FACP, CMD, Vice President, Medical Affairs, Chief, Division of Geriatrics
Hackensack University Medical Center, now a member of Hackensack Meridian Health, within the Heart and Vascular Hospital has created the Women’s Cardiac Institute to meet the unique needs of women with cardiovascular issues. The Institute has taken an aggressive approach to treating and managing all cardiovascular diseases. Our cardiologists offer treatment and prevention programs that offer advanced and effective care for women. Services include comprehensive cardiac evaluation and testing; diet and fitness assessment and especially preventative and health maintenance care. HackensackUMC’s Betty Torricelli Institute for Breast Care offers digital breast Tomosynthesis, or 3D mammography, for all women having a screening mammogram. 3D mammography offers improved cancer detection across all breast densities. Tomosynthesis has also proven to reduce the number of call-backs for further imaging, decreasing patient anxiety. This state-of-the-art technology has increased accuracy, providing peace of mind. In breast surgery, the SAVI SCOUT® surgical guidance system has helped reduce surgical delays, improve patient experience, optimize surgical planning and conserve breast tissue for the patient. The system locates and directs the removal of specific breast tissue during a breast lumpectomy for cancer or a surgical breast biopsy. Here at HackensackUMC, we are proud to provide the highest quality, evidence-based, academic, state-of-the-art medicine.
Holy Name Medical Center
By Adam Jarrett, M.D., M.S., Executive Vice President, Chief Medical Officer
Holy Name Medical Center’s new Breast Center is a state-of-the-art facility that makes it easy to receive the best in personalized breast care at a single location. The Breast Center delivers timely, accurate results and a high-quality experience that emphasizes privacy, convenience, and compassionate professionalism by a team skilled in the most advanced techniques and technologies. Together with our Regional Cancer Center, Holy Name provides the full spectrum of breast cancer treatment modalities, including surgery, radiation therapy, chemotherapy and new targeted therapies which block the growth and spread of cancer, but spare healthy cells. An area that is of great interest to clinicians is the management of estrogen receptor-positive (ER+) metastatic breast cancer. Anti-estrogen hormonal therapy plays an important role in treating ER+, but patients eventually develop resistance to this therapy. Major progress has been made in identifying how resistance occurs, with several targeted treatments now available at our Cancer Center that stop the progression of cancer substantially in patients and improve their survival rates. Our cancer specialists also utilize medications called PARP inhibitors, which enhance the effectiveness of chemotherapy in women who carry the BRCA gene mutation. As new targeted therapies are developed, they will become available
to our patients.
Rutgers Cancer Institute of New Jersey
By Deborah L. Toppmeyer, M.D., Chief Medical Officer
As the state’s only National Cancer Institute-designated Comprehensive Cancer Center, Rutgers
Cancer Institute of New Jersey’s core mission is translating basic science findings from the laboratory to the beside through the design and implementation of innovative clinical trials for patients. A better understanding of the unique molecular characteristics of cancer has ushered in the era of “precision medicine,” leading to a “targeted” rather than “one-size-fits-all” approach to treatment. An example at Rutgers Cancer Institute is a clinical trial for patients with advanced or metastatic Estrogen Receptor (ER+) breast cancer, the most common type of breast cancer. Immune therapy that boosts the body’s natural defenses to fight cancer is an innovative approach being explored in breast cancer. Leveraging the immune system, we have designed a clinical trial partnering a novel humanized antibody, pembrolizumab, that essentially deactivates the “cloaking device” that cancer cells use to escape recognition by the immune system, with a standard hormonal therapy, fulvestrant. Although the efficacy and safety is the primary goal of the study, correlative laboratory studies also will be performed to identify biomarkers that will help us more “precisely” predict which patients will benefit from immune therapy. This tailored and personalized approach will continue to evolve as the foundation of cancer treatment in the future that will ultimately change the natural history of the disease.
Saint Peter’s University Hospital
By Niranjan Rao, M.D., Chief Medical Officer
Saint Peter’s is addressing the issue of women’s health by combating the diseases that most affect women—from breast and gynecological cancers to broader disease categories such as diabetes—on multiple fronts and with multiple approaches. When it comes to breast cancer, for instance, Saint Peter’s not only applies the most recent imaging technologies to detect and combat the disease, we carefully guide the treatment of every patient by providing a breast navigator to help women coordinate their care, tackle insurance issues, and even help with transportation or childcare concerns. Such an approach helps prevent patients from falling through the cracks and ensures that they get through the process smoothly. Directly related to the issue of breast cancer in women, Saint Peter’s is launching a cardio oncology program in 2017 that is designed to protect the cardiovascular health of patients who undergo surgical, radiation or chemotherapy treatment for cancer, especially important for women with breast cancer. Patients treated for cancer are reportedly at 20 percent higher risk for congestive heart failure. Saint Peter’s is the first hospital in central New Jersey to institute such a program. The preventive goal of the program is to promote cardiac and overall wellness.
The Valley Hospital
By Joseph Yallowitz, M.D., MPH, Vice President, Chief Medical Officer
The Valley Hospital offers breast seed localization, a more accurate and patient-friendly procedure, to precisely pinpoint and remove small benign and cancerous breast tumors or abnormal breast tissue. A radiologist injects a low-energy radioactive “seed” the size of a grain of rice into the breast tissue to mark the exact location of the tumor or abnormal tissue. We have also implemented an anesthesia program that is helping to reduce and control pain before, during and after surgery. With new medications that are longer-lasting (up to three days) hospital stays can be shortened or sometimes even eliminated. In addition, we are proud of our team approach to providing patients with the latest oncoplastic surgical techniques, which combine the newest plastic surgery techniques with breast-conserving s urgery (such as a lumpectomy) for the best cosmetic result possible. For those women who require a mastectomy, immediate reconstruction is the standard of care.