End of Year Review: Top Ten Surgery Advances of 2015
It’s the time of year when many of us take stock in the passing year’s accomplishments and set our intentions for the coming year. In 2015, the Department of Surgery’s researchers and physicians made significant strides in some of the most challenging areas of medicine. Many of this year’s top-ten advances concern our fundamental understanding in the mechanisms of cancer and the development of better treatment approaches based on these insights. The faculty’s perseverance has paid off in both lab discoveries as well as in novel therapies that are changing lives now—continuing to benefit the sickest of patients both here and around the globe. One more reason for hope this season!
1. The Transformative Power of POEM
For some patients, a breakthrough in therapeutic treatment can truly mean everything. Chris suffered for over a decade with achalasia, an esophageal disorder that gradually worsened until he could no longer eat or drink anything. This year, a new therapy called per oral endoscopic myotomy, or POEM, restored his ability to swallow and turned his life around. Read more about Chris's story or learn more about Esophoageal Disoders. Clinicians can also register for a hands-on POEM CME course on January 8, 2016.
2. Providing Hope for Children with Liver Disease, One Country at a Time
Each year, approximately 600 children in the United States are able to receive life-saving living-donor liver transplantation thanks to the availability of well-equipped hospitals and highly trained medical personnel. More than 90% of these children grow to adulthood and lead full and healthy lives. But in less privileged countries, children with complex medical conditions are not as fortunate. Medical centers often lack personnel with sufficient training to perform complex surgeries, and even if a surgeon is qualified, the resources to perform such procedures may be unavailable. Families with sick children face one of two stark choices: wage a massive fundraising campaign to raise hundreds of thousands of U.S. dollars to bring their child to the United States for a transplant, or simply watch their child die.
Two doctors decided to do something about this grim reality—establish pediatric liver transplant programs in countries where that option does not exist.
Dr. Tomoaki Kato, Japanese-American surgeon and surgical director for the Liver and Intestinal Transplant Program at NYP/Columbia, joined with Dr. Pedro Rivas-Vetencourt, a native Venezuelan, American-trained transplant surgeon at Policlinica Metropolitana in Caracas. Not only would they begin offering pediatric transplants to local Venezuelan children in need, but they would ensure that generations of children to come would also have that option, by training local surgeons and establishing new transplant programs.
Having established a non-profit organization called FundaHigado America (FHA) and performed more than 70 liver transplants in Caracas since they began their ambitious project, Drs. Kato and Rivas-Vetencourt are now poised to bring the option of liver transplant surgery to other countries in need.
3. Emperor of Maladies: A Biography of Cancer
Is there anyone whose life has not been touched by cancer, either directly or indirectly? Siddhartha Mukherjee’s book The Emperor of Maladies: A Biography of Cancer gained international acclaim for his profound exploration into the history and science of our most virulent, if not ubiquitous, disease. This year, PBS presented Emperor of Maladies in a 6-hour, three-part documentary series across the country. Dr. Mukherjee, a cancer physician and researcher at the Herbert Irving Comprehensive Cancer Center, won the Pulitzer Prize in 2011 for his unprecedented work. Check out the panel discussion on the future of cancer research with Ken Burns, Katie Couric, Dr. Mukherjee, and other Columbia oncologists by visiting: cancer.columbia.edu/.
4. BRCA and Pancreatic Cancer: New Research Sheds Light on Deadly Cancer
We have Angelina Jolie to thank for helping to educate the general public about the role BRCA gene mutations play in increasing the risk of breast and ovarian cancers. More women are now seeking genetic testing and considering prophylactic mastectomy to prevent breast cancer. This year’s BRCA research also shed light on another critical, albeit lesser known, effect of BRCA mutations: their relationship to pancreatic cancer. According to research performed at Columbia and elsewhere, we now know that between 10 and 20% of pancreatic cancers are linked to BRCA gene mutations. Based on this watershed research, experts concluded that patients with pancreatic cancer should be more widely tested for BRCA mutations. Such testing could have significant implications for preventing pancreatic cancer in family members.
Learn more about the link between BRCA and Pancreatic Cancer.
5. Breast Cancer: Not Your Grandmother’s Surgery
Compared to what it was just a few decades ago, the treatment of breast cancer has evolved by leaps and bounds. Through ongoing research underway at our center in 2015, the Division of Breast Surgery established new protocols standardizing the use of a set of breast-conserving techniques that allow many women to undergo less invasive and more effective surgeries than ever before. Together, these sophisticated approaches enable our Columbia surgeons to perform better targeted surgeries, ensuring cancer cells are removed, while maximizing preservation of as much natural breast tissue as possible.
NYP/Columbia is the first center in the US to offer advanced options such as SaviScout (to effectively localize tumors), MarginProbe (to ensure clean margins are achieved during surgery), and LYMPHA, a highly successful microsurgical technique that prevents lymphedema in over 90% of patients undergoing lymph node dissection. Another advance in care, intraoperative radiation therapy (IORT) is allowing patients to have a single dose of radiation therapy in lieu of making daily trips to the hospital for 6 weeks or more following surgery. Of note, 2015 also saw expansion of IORT to include the first known case in which this therapy has been used to treat male breast cancer.
6. History of Medicine - Expect the Unexpected.
Think history is boring? Not here, it’s not – we guarantee it! Check out the Department of Surgery’s History of Medicine series, where the truth is better than fiction. Here you’ll discover fascinating stories about medical advances at the Vatican, Islam’s ‘Golden Surgeon’, the disgraced brain of President Garfield’s assassin, the ingenious surgery that saved the world’s smartest man, and much more. Check out all of the History of Medicine stories.
7. Lab Notes: Chipping Away at Cancer’s Walls
For some difficult-to-treat forms of cancer even the strongest drugs fail to slow the disease’s steady march because they cannot penetrate their target, the very cells causing deadly havoc in the body. Researchers at Columbia University Medical Center made significant strides in 2015 by finding new ways to help chemotherapy drugs reach cancer’s ground zero. Dr. Matthew Bacchetta, together with colleagues from the Department of Engineering and Department of Medicine, developed a new method of delivering micro-liters of drug-infused liquid into lung cells. The new method could provide much more effective treatment of lung diseases like cystic fibrosis, bronchopneumonia, chronic obstructive pulmonary disease, and lung cancer. Meanwhile, Dr. Kazuki Sugahara discovered a way to deliver medications into the core of pancreatic tumors, which are especially resistant to penetration by traditional chemotherapy medications. Dr. Sugahara has received major funding from the National Institutes of Health/National Cancer Institute, as well as a 2015 Translational Research Grant from the Pancreatic Cancer Action Network, for this groundbreaking work.
In another line of research, Dr. Yvonne Saenger, a pioneer in cancer immunotherapy, has recently developed an immune gene panel that is effective in predicting clinical outcomes in melanoma. The panel is currently undergoing multi-center validation in collaboration with the National Cancer Institute. These avenues of research are just a few of the many that are deepening our understanding of, and improving our ability to treat, the most challenging forms of cancer.
8. Colorectal Surgery: Minimally Invasive Surgeries and Unique Approaches Restore Continence
After months of blinding pain, 27-year-old Matt Teichman underwent surgery to remove part of his colon, which was severely inflamed by Crohn’s disease. His initial relief was tempered by revulsion at the new waste bag he found attached to the outside of his body. Matt quickly overcame his initial fear and grew adept at living with his ostomy; in fact he adapted so well that he went on to help others adjust to and care for their ostomies.
And then, Matt’s surgeon was able to remove his ostomy with a second surgery, restoring his normal colorectal function. Surgeons at the Division of Colorectal Surgery are able reverse many patients’ ostomies as part of a highly unique initiative with careful planning at the time of their initial surgeries. They often restore or maintain patients’ continence, even in complex cases, through the use of nonsurgical as well as minimally invasive surgical approaches. Learn more about this exceptional program, as well as the division’s highly unique pelvic floor program.
9. Columbia Surgery and the Wider World
They say that the best thing to do with one’s talent is to share it. Physicians and researchers at Columbia are doing just that, reaching to the far corners of the earth to share their knowledge and skills. In China, the Columbia HeartSource team has been integrally involved in the planning and development of a unique cardiac-focused hospital designed to offer the highest level of advanced cardiac care; a model that could shift the paradigm of cardiac care for millions of Chinese. Previously, Columbia HeartSource has been involved in improving cardiac care in several sites in the Middle East, while helping 35 affiliate hospitals in the U.S. to elevate their care. Also in China, breast surgery chief Sheldon Feldman, MD, worked with several hospitals in 2015 to educate their surgeons about the latest advances in breast cancer diagnosis and treatment—sharing best practices in surgical care, and more. Through these and other efforts, specialists at Columbia are advancing the quality of medical care around the world, quite literally.
Meanwhile, the Department is also focused on ensuring that Asian patients in the U.S. can access care at NYP/Columbia even if language may be a barrier. The Columbia Asian Health Program includes free assistance from interpreters in Chinese, Korean, and Japanese who are available to help patients arrange appointments, understand test results, navigate across departments for various parts of their care, and more.
10. Breast Cancer - Thyroid Cancer Link
Physician-researcher Jennifer Kuo, MD, Director of the Thyroid Biopsy Program at NewYork-Presbyterian/Columbia, published research confirming a link between breast cancer and thyroid cancer. According to Dr. Kuo’s study, young women who undergo treatment for breast cancer have a significantly increased risk of developing thyroid cancer. Compared to the general population, breast cancer survivors’ risk was found to be:
- 16% versus 0.33% at age 40
- 12% versus 0.35% at age 50
Dr. Kuo says that clinicians should be aware of this increased risk for thyroid cancer when taking care of breast cancer patients. “Doctors may want to add a thyroid exam to patients’ physical exams in the years following treatment for breast cancer. If a patient has a nodule they wouldn’t otherwise biopsy, a previous history of breast cancer might be a good reason to take a biopsy as a precautionary measure.”
Read more about the link between breast and thyroid cancer.