2013 Cancer Program Annual ReportReflecting 2012 Data

Comprehensive Cancer Center

Mount Sinai Medical Center’s Comprehensive Cancer Center takes a collaborative,

multidisciplinary approach to diagnosing and treating cancer. The award-winning cancer

treatment program cares for the whole person – body, mind and spirit. Medical oncologists,

radiation oncologists, surgical oncologists, pathologists and radiologists work together with

a support team of psychologists, social workers, pain specialists, nutritionists, rehab staff

and others to create customized treatment plans. They meet weekly at disease specific as

well a general cancer conferences to review complex cases, discuss innovative treatment

options and coordinate care across specialties using the guidelines established by the

leading cancer organizations including the National Comprehensive Cancer Network (NCCN),

American Society of Clinical Oncology (ASCO) and American Society for Therapeutic

Radiation and Oncology (ASTRO) to name a few. As an Academic Comprehensive Cancer

Program (ACSD) as designated by the Commission Cancer, our doctors are at the forefront

of medical research and lead clinical trials.

National Cancer Institute Clinical Trials: The prestigious, grant-funded Community

Clinical Oncology Program (CCOP) – created by the National Cancer Institute (NCI) –

is a nonprofit, community-based program that provides clinical research to cancer

treatment patients and those who may be at risk. The program allows Mount Sinai

patients to participate in promising clinical trials offering cutting-edge treatment

options before they become widely available to the general public.

o There are currently over 60 open cancer clinical trials available that cover a

variety of malignancies, MSMC patients have access to new drugs not yet

available in other centers.

Mount Sinai is the first Hospital in Florida to acquire and house the Evident

Microwave Ablation System to destroy tumors of the liver, kidney, lung, and to treat

other forms of soft-tissue cancers.

Consecutive winner of the “Outstanding Achievement Award” from the Commission

on Cancer (CoC) of the American College of Surgeons for three cycles (2005, 2008 &

2011) the only hospital in the State of Florida to have achieved this level of

excellence.

Mount Sinai Medical Center’s Comprehensive Breast Center was the first center in

Florida to be accredited by the National Accreditation Program for Breast Centers

(NAPBC), devoting itself to early detection, diagnosis, treatment, support and follow-

up care.

The Cancer Committee at Mount Sinai Medical Center (MSMC) is comprised of a group of

cancer professionals. This multidisciplinary administrative and clinical group includes

members from different disciplines in cancer care: physicians representing all aspects of

oncology, radiology, pathology, palliative care, dermatology and other specialties; allied

health professionals involved in diagnosis, treatment, follow-up care and family support for

cancer patients; and hospital administration. The Cancer Committee monitors all activities

related to treatment, education, research and outreach that support a quality cancer

program for our community. They work in conjunction with the Cancer Program to deliver

compassionate and high-quality care to patients, rendered at state-of-the-art facilities, and

enhanced by investigational protocols and treatments. The committee operates in

compliance with the requirements for accreditation from the American College of Surgeons

Commission on Cancer and our commitment to continued quality improvement programs

and patient centered care.

Cancer Committee Members:

Juan Paramo, MD Chair, Department of Surgical Oncology

Elisa Krill-Jackson, MD Vice Chair, Department of Medical Oncology

Robert Goldszer, MD Chief Medical Officer, Administration

Stuart Kaplan, MD Breast Leadership Program, Breast Center, Radiology

Brian Katz, MD Department of Dermatology

Nicholas Kuritzky, MD Department of Radiation Oncology, Chairman

Todd Lasner, MD Department of Neurosurgery

Jose Lutzky, MD Department of Medical Oncology, Melanoma Program

Thomas Mesko, MD Department of Surgical Oncology, Chairman

H Michael Moyses, MD Department of Radiation Oncology

Robert Poppiti, MD Department of Pathology, Chairman

Estelamari Rodriguez, MD Department of Medical Oncology, Lung Cancer Program

Barry Shipman, DMD Prosthetics & Maxillofacial Reconstruction

Henry Wodnicki, MD Department of Surgery

Robert Alonso Director, Marketing

Julia Becker, RHIA Director, HIM

Debbie Belcher Manager, Breast Center

Guerna Blot, RN Manager, Inpatient Oncology Unit

Gail Brown, LCSW Social Services

Florence Buenconsejo, ARNP Clinical Operations Director, Cancer Center

Carlos Bitar Executive Director, Cancer Center

Lisa Gonzalez-Alpizar, PhD Oncology Support Care

Craig McCollough, PhrmD Clinical Manager, Cancer Center Pharmacy

Dharma Mirabent Director, Rehab Services

Yvonne Nuñez, BSHA Manager, Community Clinical Oncology Program

Joanna Palmer Manger, Public Relations

Berta Rios, PhD American Cancer Society

Ana L Ruiz, CTR Manager, Cancer Registry

Sandy Sotnick, MSRD Nutritional Services

Breast Center

The Lila and Harold Menowitz Comprehensive Breast Center has been designated as a

Breast Imaging Center of Excellence by the American College of Radiology, and is the first

accredited National Accreditation Program for Breast Centers (NAPBC) in the state of

Florida.

Interpretations are made by a board certified and fellowship trained radiologist specializing

in mammography. In addition, each mammogram and Magnetic Resonance Imaging (MRI)

are evaluated with Computer Assisted Detection (CAD), which can identify additional areas

that may need further evaluation.

At the Comprehensive Breast Center, digital mammograms are performed by highly trained,

mammography certified radiologic technologists who are sensitive to their patients’ needs

for comfort and privacy.

Our digital mammography, ultrasound, MRI and biopsy equipment is designed specifically

for maximizing excellence in breast imaging and diagnosis.

Patients have the opportunity to discuss the results of their diagnostic mammograms with

the radiologist during their visit. Both the patient and the referring physician receive timely

reports and test results.

Our Patient Navigator is responsible for maintaining contact and tracking all patients with

abnormal screening mammograms and assisting those patients in relieving concrete and

emotional barriers to care. Responsibilities of the Patient Navigator include ensuring all

patients receive the recommended care/treatment in a timely manner, facilitate all patient

procedure appointments, provide psycho-educational material on the importance of a good

breast health plan, and provide additional support to patients who are breast cancer

survivors during their diagnostic appointments. All patients upon learning of a breast cancer

diagnosis, are contacted by, or scheduled to meet with, the Patient Navigator and provided

related literature/brochures on their diagnosis and treatment, as well as an opportunity to

discuss their diagnosis.

2013 Stats:

Digital Screening Mammography 7,716

Digital Diagnostic mammography 7,701

Breast Ultrasound 8,001

Breast MRI 454

Procedures 1,479

(including FNA, Ultrasound Guided Core Biopsy, Stereotactic Guided Core Biopsy, MRI

Guided Core Biopsy, Cyst Aspiration, Galactogram, Breast Needle Localization, and Sentinel

Node Injection)

Total annual procedures 25,351

Oncology Supportive Care

At Mount Sinai Comprehensive Cancer Center we are dedicated to a patient centered care.

The Oncology Supportive Care Department is comprised of highly skilled, multi-disciplinary

team members that include Clinical Licensed Social Workers, Psychologists, and

Nutritionists. We provide both individual and group therapy addressing the emotional needs

of our patient’s ranging from coping with the initial diagnosis, adapting and adjusting to

treatment, to processing end of life issues. Our team addresses emotional, social, and

nutritional needs while balancing the wishes of our patients to preserve quality of life. The

Oncology Supportive Care professionals are an integral part of oncology care provided at

Mount Sinai.

Every area of the cancer center has a dedicated Licensed Clinical Social Worker / Patient

Navigator who specializes in working with the unique needs of each patient and their

families. Our Social Workers / Navigators are responsible in performing distress screening

on all new cancer patients and providing intervention and referral as needed and as early as

possible. They are experienced mental health professionals with a wide range of expertise in

Psychotherapy, Crisis Intervention and Counseling. As Patient Navigators, they are

responsible in assessing potential barriers to access to care on all new cancer patients and

providing intervention to mitigate failure to comply with treatment and increase treatment

compliance based on identified potential and/ or actual barrier. Our Social Workers are also

available to provide education on advanced directives, disability, assistance with obtaining

needed oncology medications, logistical issues such as transportation and temporary

lodging, and can provide referrals for financial assistance.

Mount Sinai Comprehensive Cancer Center offers multiple support groups in both our Miami

Beach and Aventura locations facilitated by our Social Workers. As part of the Medical

Center we represent the Cancer Center on the Bioethics Committee and the Cancer

Committee. Our team members are active members of local, state and national

organizations and some hold positions of leadership within several local professional

organizations. We are partnered with community organizations such as the American

Cancer Society by hosting their Look Good Feel Better program and The Cancer Support

Community. The department organizes annual events such as Ladies’ Spa Day and

Survivors Day for the patients and their families.

Tuesday, October 15, 2013Program: 10:30 a.m. – 3:30 p.m.Registration begins at 10 a.m.

MUST RSVP. For information and to register, call 305.535.3407

Breakfast & Lunch Provided Free Parking Door PrizesBreakfast provided by: Levin Home Health and High Standards Health Services

Lunch provided by: Medivation, Incyte and Seattle Genetics

Mount Sinai Comprehensive Cancer Center 4306 Alton Road, Main Conference Center 2nd Floor

Spa DayPlease join us for a day of pampering and relaxation

Help support the Mount Sinai Comprehensive Cancer Center by purchasing a limited edition Key To The Cure T-shirt, designed by Pucci, and modeled by Jennifer Aniston, at Saks Fifth Avenue Bal Harbour.* 100% of the purchase price of each T-shirt will be donated to our cancer center to help fight women’s cancers. For more information on how you can participate in Key To The Cure, visit www.msmcfoundation.org/KeyToTheCure.

*Subject to availability

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10TH ANNuAl lAdieS’

Screening Programs

The National Cancer Institute conducted a National Lung Screening Trial comparing two

ways of detecting lung cancer: low-dose helical computed tomography (CT) and standard

chest X-ray. Scientists found a 20% reduction in deaths from lung cancer among current or

former heavy smokers who were screened with CT versus those screened by chest X-ray.

The purpose of this program is to diagnose the disease in its earliest possible stage. Utilizing

low-dose Computerized-Tomography (CT), lung cancer screenings offers hope for survival

through early detection for high-risk patients. Mount Sinai Comprehensive Cancer Center

has established The Lung Cancer Screening Program, CTs for screening of patients is offered

at a reduced rate. The lung screening program has been featured in numerous printed ads

including: Pharmacy Choice, South Florida Sun Times, Sunny Isles Beach Sun, Miami Beach

News, PR Newswire and FHA News Clips.

During Lung Cancer Awareness month in November, the program offered free screening CTs

to patients who met the following screening criteria:

• Current smokers 55 to 74 years of age

• 30 pack-year history of cigarette smoking or higher (pack-year history = number

of cigarettes smoked per day x number of years smoked) and without a history of

lung cancer.

• Former smokers who have quit within the past 15 years

Patients who had a questionable result on their CTs were referred back to their referring

physician for further evaluation.

Lung Cancer Screening Program

Mount Sinai Medical Center 4300 Alton Road • Miami Beach, FL 33140

Mount Sinai Aventura 2845 Aventura Boulevard • Aventura, Florida 33180

305.535.3434 • msmc.com

Scan Me!Scan this QR code to learn more about the

Lung Center of Excellence at Mount Sinai Medical Center.

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MS 8970 Lung Cancer Screening Program Brochure v2.indd 1 1/11/2013 12:20:06 PM

Early Diagnosis is Essential

When it comes to lung cancer – the leading cause of cancer death among men and women – tobacco users are among the most likely to develop the disease and the least likely to survive. Tobacco use accounts for 87 percent of lung cancer deaths in the United States, and smokers are up to 30 times more likely to develop lung cancer. But there is good news: When diagnosed early, more than 90 percent of lung cancers can be cured with prompt surgical intervention.

To learn more about Mount Sinai’s lung screening program,

or to schedule an appointment, please call 305.535.3434.

Low-dose CT Screenings Can Save LivesIn an effort to give at-risk patients a greater chance of survival, Mount Sinai Medical Center has developed a screening program aimed at diagnosing lung cancer at its earliest stage using low-dose computerized tomography (CT) scans. Because lung cancer typically doesn’t manifest signs and symptoms in its earliest stages, screenings increase the chance of diagnosing it early, when it can be more successfully treated.

What is a CT Scan? A CT scan is a painless, efficient exam. It combines a series of X-ray views taken from many different angles utilizing computer processing to create cross-sectional images of the bones and soft tissues inside your body. As a Radiation Safety Provider, Mount Sinai follows strict safeguards to ensure patients undergo diagnostic tests and screenings with the least amount of radiation exposure possible. Our radiologists are board certified, fellowship trained and sub-specialized, which helps provide the most accurate diagnosis possible.

Who Should Be Screened? Longtime tobacco smokers are among the most at-risk for lung cancer. Although others may also qualify, lung screenings are recommended for current and former smokers, ages 55 to 74, who have smoked one pack of cigarettes a day for 30 years and have no known history of lung cancer.

What Happens After the Screening? Your lung screening results are sent directly to your physician. If the screening reveals the need for further care, our patient navigator will contact you and guide you through any necessary next steps, such as additional testing, treatment and follow-up care. Our patients can rest assured that Mount Sinai Medical Center is a leader in comprehensive lung care. Our team of pulmonologists, thoracic surgeons and oncologists are highly trained and offer innovative interventions such as minimally invasive lung surgery, oncology treatments and superior quality lung and thoracic imaging that provide the best outcomes.

MS 8970 Lung Cancer Screening Program Brochure v2.indd 2 1/11/2013 12:20:06 PM

Outpatient Cancer Center Oncology Treatment

The outpatient center at Mount Sinai Comprehensive Cancer Center in Miami Beach

and Aventura cares for patients and delivers quality care to a wide variety of multiple cancer

diagnoses and blood disorders. The expertise of the nursing staff in delivering highly-

specialized cancer treatments is highlighted in a mixture of all staff nurses who are

chemotherapy and biotherapy certified, while others have obtained oncology nurse

certification from the national Oncology Nursing Society. The nursing team serves as the

patient advocate in facilitating a multidisciplinary approach to the patient’s care.

The treatment room at both Mount Sinai and Aventura is comprised of a centralized

nursing station, individual patient cubicles and private bedrooms, some of which offer a

spectacular view of downtown Miami and Biscayne Bay. The satellite center at Aventura is

strategically located in North Dade to provide services to a specific patient population. To

make patient’s treatment visits more enjoyable, cubicles and bedrooms are equipped with

televisions and DVD players.

The treatment room operates on a twelve hour a day schedule, Monday through

Friday, or until ‘the last patient leaves for the day’ to accommodate patients who need to

work during their treatments. Generally, patients receive their treatments on the same day

of their visit after seeing their physician. Individualized patient care is the goal of the

treatment room. All efforts are made to limit patients’ wait times, while ensuring

medications are administered to patients safely. Beepers are provided to patients so they

may freely roam the center and eventually receive a page once their medications are ready.

The treatment room at Miami Beach opens on weekends on a limited basis, to provide

continued care to patients who have started their treatment regimens during the week.

The treatment room at Miami Beach and Aventura serves as a vital component in

participation with research protocols and investigational trials. The nursing staff works

closely with research coordinators to participate in research regimens that will hopefully one

day make it to FDA approval for commercial use. The treatment room also serves as the

ground breaking arena for the initiation of new medication regimens, not currently offered

by other community and local cancer centers.

In essence, the treatment room shares in the vision of the Cancer Center in

delivering safe and comprehensive oncology care to the greater community that it serves,

and calling South Florida it’s home.

Cancer Data Center

The Cancer Data Center at Mount Sinai captures complete history, diagnosis, treatment, and

health status for every new cancer patient in the hospital system. This information is also

submitted to the National Cancer Data Base for comparison to other facilities in the US for

quality measures. Data for this report reflects cases first seen or diagnosed in 2012.

Total number of new cancer cases diagnosed and or treated during 2012 = 1,582

Our patients sometimes travel a long distance to be treated at Mount Sinai.

0 50 100 150 200 250 300

1

Most often treated cancers at MSMC - 2012

Leukemia Lymphoma Bladder Thyroid Colon

Kidney Melanoma Prostate Lung Breast

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2012 County of Residence

Accountability Measures

Mount Sinai Medical Center participates in the Commission on Cancer’s - Cancer Program

Practice Profile Reports, otherwise known as CP R. This web based tool compares cancer

programs across the country and evaluates the treatment they offer their patients based on

certain criteria. This program currently reviews patients with Breast, Colon and Rectal

cancers and measures six treatment items from these cancers. Data submitted from the

hospital to the National Cancer Data Base is analyzed and returned to the hospital for

review.

The six review items are:

1. Radiation therapy is administered within one year (365 days) of diagnosis for women

under age 70 receiving breast conserving surgery (lumpectomy or partial

mastectomy) for breast cancer.

2. Combination chemotherapy is considered or administered within four months (120

days) of diagnosis for women under age 70 with a Stage T1cN0M0 or Stage II or III

hormone receptor negative breast cancer.

3. Tamoxifen or third generation aromatase inhibitor is considered or administered

within one year (365 days) of diagnosis for women with Stage T1cN0M0 or Stage II

or III hormone receptor positive breast cancer.

4. At least 12 regional lymph nodes are removed and pathologically examined for

resected colon cancer.

5. Post-surgical chemotherapy is considered or administered within four months (120

days) of diagnosis for patients under the age of 80 with Stage III (lymph node

positive) colon cancer.

6. Radiation therapy is considered or administered within six months (180 days) of

diagnosis for patients under the age of 80 with Stage T4N0M0 or Stage III and who

are receiving surgical resection for rectal cancer.

Any patient cases whose measure appears to fall below the established rates are reviewed.

Treatment updates are made to the database to ensure the most up to date information has

been gathered on each individual patient.

Mount Sinai Medical Center has consistently ranked in the highest performance rates for all

these measures since the program’s start date in January 2005.

Measure Estimated Performance Rates

2009 2010 2011

1. 92% 91% 91%

2. 100% 95% 86% *

3. 93% 91% 98%

4. 89% * 88% * 92%

5. 91% 74% * 77% *

6. 80% * 67% * N/A

Rates with an asterisk (*) have been calculated to still meet the confidence intervals set by the

Commission on Cancer to 90% and above.