Houston Methodist Cancer Annual Report 2013

Leading CanCer Care & researCh

2013

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A proud trAdition of excellence, with A new nAme.The Methodist hospital is now houston Methodist hospital. This new name reflects the pride in who we are and where we are from. Our commitment to advancing medicine with global impact begins in houston, Texas, where we pioneer a better tomorrow through research, cutting-edge innovation and breakthroughs to rewrite the future of health.

thAt’s the difference between prActicing medicine And leAding it.

Leading Medicine: an Overview 3

Breaking new grOund 5

Pursuing MedicaL discOveries 9

advancing TechnOLOgy 13

deLivering BeTTer OuTcOMes 17

educaTing fOr TOMOrrOw 19

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contents

Leading Medicine: an Overview Breaking new ground Pursuing Medical discoveries advancing Technology delivering Better Outcomes educating for Tomorrow

3 Houston Methodist Cancer Center

H O U STO N M E T H O D I ST C A N C E R C E N T E R

Our oncologists are committed to bringing the latest

technologies and advanced treatment options to our

patients as quickly as possible. We do this through our

relationship with the Houston Methodist Research

Institute where we have dedicated teams of world-renowned

researchers conducting basic and applied cancer research.

The Houston Methodist Research Institute is one of the

largest research facilities in Texas with $55 million in

total research funding and more than $5 million in cancer

specific funding supporting 96 active clinical protocols.

Our specialized oncologists partner with our researchers

to rapidly translate discoveries made in the laboratory

to the clinical setting. Houston Methodist has recently

developed the infrastructure to support multi-phase

clinical research. The New Drug Development Program

provides researchers with the sophisticated framework

and support to conduct early-phase clinical research

and “first in human” studies with drugs. Our ability to

conduct Phase I clinical drug trials allows us to bring

beneficial treatment options to our patients sooner.

Not all patients respond in the same way to prescribed

cancer treatments, thus the need for developing personalized

therapies unique to each patient. In response, our

physicians at Houston Methodist Cancer Center have

established a variety of specialized treatments and services

that target aggressive and rare cancers. These cancer-specific

programs focus on the reduction of cancer development,

the discovery of new treatments for highly resistant cancers

and the provision of specialized and complex treatments.

Our commitment to our patients is unconditional and

unrestricted, heartfelt and genuine. And our determination

to cure cancer is resolute, uncompromising and boundless.

At the Houston Methodist Cancer Center we are committed to a comprehensive, multidisciplinary team approach in the detection and treatment of cancer in an environment that is rich in collaboration and compassion. Our highly trained and specialized clinicians provide individualized therapies, optimizing treatments for each patient.

Houston MetHodist cancer center LeadersHip

Barbara L. Bass, Md, facs

Timothy B. Boone, Md, Phd

gavin w. Britz, Md, MBBch, MPh, faans

e. Brian Butler, Md

Jenny c. chang, Md

alan L. kaplan, Md

reginald f. Munden, Md, dMd, MBa

James M. Musser, Md, Phd

richard J. robbins, Md, facP

Learn more at houstonmethodist.org/cancer

active cLinicaL protocoLs96

$5 millioncancer researcH funding

3Cancer

Letter froM tHe director: Moving forWard, WitH vision

The Houston Methodist Cancer Center is on an amazing growth trajectory with outstanding new hires in both clinical and research areas; expansion of programs supporting high-risk prevention and genetically-motivated treatment protocols; new collaborations with nanotech experts; and the addition of new fellowships in medical oncology and thoracic surgery, to name only a few. The inspiration behind this growth is the desire to eradicate cancer and to support those who have it. I am honored to share with you highlights of the past year in the pages of this report.

Our patients are our biggest motivation for growth – growth in programs that help them reduce their risk of developing cancer, programs that increase their chances for successful elimination of cancer, and programs that improve their lives after treatment. We have invested in a high-risk breast cancer program, genetic sequencing technology and expertise to better target personalized treatment of triple negative breast cancer. The Houston Methodist Neurological Institute and the Departments of Otolaryngology and Radiation Oncology worked together to design tools for functional avoidance of key pathways in the brain – helping to preserve quality of life after treatment for neurological or ENT cancers.

To help the field advance in research and treatment, we created two new programs that we have highlighted in the report: One is a collaboration of cancer centers that work together to speed clinical research on promising protocols. Another is a program that standardizes advanced radiation practices for seven institutions across Eastern Europe.

With growth must come a commitment to excellent and compassionate patient care. At the Houston Methodist Cancer Center, we provide each patient with highly personalized, multidisciplinary care, along with some of the most hopeful new clinical trials available today.

We look forward to what is ahead and where this growth will lead us. Most importantly, we look ahead to the elimination of cancer in all its forms.

Jenny chang, MdDirector, Houston Methodist Cancer CenterHouston Methodist HospitalProfessor of Medicine, Weill Cornell Medical CollegeFull Member, Houston Methodist Research Institute


5

C H A l l E N g I N g T H E N O R M TO C R E AT E N E w T R E AT M E N T S f O R b R E AST C A N C E R

mAnAging risk: stArt by recognizing it

The goal of the Houston Methodist high-risk prevention program is to identify

women who are at an increased risk of developing breast cancer. The program

provides these women with a comprehensive breast cancer risk assessment, regular

clinical exams, nutrition counseling, genetic counseling and, when appropriate,

genetic testing. Specialized breast oncologists and genetic counselors work with

patients to determine each individual’s risk, based on the patient’s personal

and family history.

Once risk is determined, the team is able to make recommendations to reduce risk,

ranging from FDA-approved medications and more intensive surveillance to lifestyle

modifications, exercise, nutrition and access to clinical trials targeting risk reduction.

AdvAncing breAst cAncer treAtment: shorter triAls for fAster results

To eliminate cancer, our researchers study both prevention and treatment of

breast cancer, and we are able to offer access to clinical trials for patients in the

prevention program and those undergoing active treatment. We look for effective

drugs that have fewer side effects than existing medications. We also look for ways

to get safe, effective treatments to patients faster.

To expedite the process of moving drugs from research to clinical care, we are

initiating studies in which we give an experimental drug for one year rather than

the common 5-year trial span. We measure a surrogate endpoint, such as

mammographic density, before and after treatment. If patients show improvement

in the surrogate, the drug can be studied for efficacy in a larger population.

Houston Methodist Cancer Center is committed to eliminating cancer in all its forms. We serve patients with breast cancer by providing comprehensive, patient-focused care, including aggressive prevention, innovative research, and forward-thinking clinical physicians that challenge us to consider new ways of curing cancer.

“every woman on the planet should know her risk, especially women with a family history of breast or ovarian cancer, personal or family history of Brca1 or 2 mutation and/or a personal history of abnormal biopsy. More can be done to prevent breast cancer. The tools we have are for everyone.”

Tejal Patel, Md Leader, high risk Program - Breast

Houston Methodist Cancer Center


E xC l U S I v E T R I A l S f O R b R E AST C A N C E ROne such trial looks at hydroxytyrosol – a derivative of

olive oil – for biomarker modulation in women at increased

risk of breast cancer. Hydroxytyrosol is endorsed by the

European Food Safety Authority (EFSA) for heart health, and it

is shown to produce fewer side effects such as hot flashes.

It has also shown activity against breast cancer cell lines

in the laboratory. The trial will evaluate breast density

in patients after one year of treatment with hydroxytyrosol.

In addition to prevention, we also actively pursue clinical

trials to fight existing breast cancer. Jenny Chang, MD,

director of the cancer center, is the principal investigator

for NECTAR, a study which tests if Everolimus will

effectively stunt the growth of triple negative breast

cancer (TNBC).

Everolimus is used to treat kidney cancer, but it has been

shown to be effective in blocking cell growth caused by

the same genetic mutations that are common to TNBC.

Houston Methodist is the only site in the U.S. to offer

these pilot studies.

To learn more about our clinical trials, visit houstonmethodist.org/clinicaltrials

6Houston Methodist Cancer Center

gene sequencing uncovers the clues for personAlized treAtment of triple negAtive breAst cAncer

Dr. Angel Rodriguez’s mission is to find a “druggable”

target for every patient’s triple negative breast cancer (TNBC),

and to ensure that these patients have access to

promising drugs that might kill their cancer. To do this,

he has teamed with Foundation Medicine, a genetic

sequencing company, and The Patient Advocate Foundation,

a group that helps patients fight for access to clinical

trials and works with pharmaceutical companies as well

as health insurance providers to get affordable access to

potential medications.

When a patient is diagnosed with TNBC, a biopsy is

taken of the patient’s tumor. DNA is extracted and

sent to the lab for genetic sequencing to identify the

genetic mutation that is causing the cancer to grow.

Once that mutation is identified, it is compared to

a large database of existing drugs that are shown to

have an effect on that broken gene. These drugs might be

in clinical trials or only approved to treat other diseases.

Sometimes it is difficult for patients to get into a trial,

or it is cost prohibitive to buy the medications that

are not covered by insurance. The Patient Advocate

Foundation then steps in and provides the patient

with expertise and resources to gain access to the drugs.

This technique represents a different way of looking

for a cure for cancer. With no universal genetic target

for TNBC, Rodriguez looks for a mutation that is

unique to each patient’s tumor and attacks that

specific genetic defect. His team is collecting data and

identifying sub-types of TNBC to eventually prove this

technology – genetic sequencing of tumors – can make

a difference for patients with TNBC.

7

“having these three components working together – the hospital, genetic sequencing and patient advocates – is crucial to making a difference in TnBc, which currently does not have a target, or an identified genetic mutation that causes the cancer to grow, like other breast cancers do.”

angel rodriguez, Md Leader, Triple negative Breast cancer Program



mAstectomies thAt preserve the nipple for A more nAturAl result

While we look for a cure, we also invest in the most advanced practices for treating breast cancer.

Sherry Lim, MD, surgical oncologist, and Pierre Chevray, MD, reconstructive plastic surgeon,

work as a team to offer nipple-sparing mastectomies and breast reconstruction.

Sparing the nipple is a complex technique that is not commonly offered by all surgical

oncologists in this field. It does, however, provide much more natural results for patients.

The procedure involves strategically placed incisions either partially around the areola,

effectively camouflaging most of the surgical scar while preserving the nipple, or along the

crease of the breast, which preserves the nipple and leaves almost no visible scar.

Dr. Lim has a high level of expertise and experience in this technique having performed

more than 75 nipple-sparing mastectomies at Houston Methodist with excellent outcomes.

criteriA for pAtients to quAlify for nipple-spAring surgery:

• The tumor must be more than 2 cm away from the nipple

• The tissue around the nipple must show no signs of cancer according

to pathology taken at the time of surgery

“results are clearly superior when we use the patient’s own tissue for reconstruction. we can maintain a more natural breast shape following a nipple-sparing mastectomy.”

Pierre chevray, Md, Phd reconstructive Plastic surgeon

To refer a patient for a nipple-sparing mastectomy call, 713.790.3333



E A R ly - p H AS E R E S E A R C H : b R I N g I N g T R I A l S f R O M b E N C H TO b E D S I D E fAST E R

At Houston Methodist, we are establishing the requisite framework to conduct intricate

and sophisticated Phase I drug trials. We are leading the practice to genetically alter

a patient’s immune cells to target and attack a specific cancer. Our researchers

are developing new tools that can detect biomarkers for disease and the risk for certain

cancers. All of our tests, developments and treatment algorithms have one priority in mind:

offering better treatments and outcomes to our patients.

The Cockrell Center for Advanced Therapeutics and the New Drug Development Program

provide researchers with a sophisticated infrastructure to conduct early-phase clinical

research and “first in human” studies. The Cockrell Center is also staffed with specialized

nursing teams that have experience with complex investigational drug protocols.

Current studies at the Cockrell Center include Phase I trials for leukemia, lymphoma,

solid tumors, Crohn’s disease and sickle cell disease.

Over the course of 2013, the Cockrell Center added capabilities and expertise to support

a growing portfolio of research. The center recruited Kapil Bhalla, MD to serve as medical

and scientific director. Dr. Bhalla is a scientific leader in the field of translational medicine.

Eileen Dickman, PhD, joined the center as director of Phase I Clinical Trials. Her basic science

background and clinical research experience provide strength for translational research.

As part of the New Drug Development Program in Cancer, led by Swaminathan Iyer, MD,

the Houston Methodist Cancer Center brought next-generation genetic sequencing

capabilities in-house and recruited Bryce Portier, MD, to serve as medical director

of solid tumor molecular diagnostics. Dr. Portier’s research centers on the

identification and validation of novel molecular biomarkers. This combination

of technology and specialized expertise will provide highly personalized genetic

research and diagnostics for patients.

No other disease in the world has the resources, funding and cautious optimism associated with it more than cancer. Houston Methodist Hospital is one of the leaders in this crusade to predict, treat and ultimately eradicate this health menace.

To learn more about our early-phase research, call 713.790.3333


11

C E l l A N D g E N E T H E R A p I E S AT TAC k CA N C E R f R O M T H E I N S I D EThe Center for Cell & Gene Therapy (CAGT), a partnership of Houston Methodist, Baylor College of Medicine

and Texas Children’s Hospital, is one of the country’s leading centers for the development of cellular and genetic

treatments for adults and children with cancer.

At the CAGT, researchers genetically engineer patients’ own immune system T-cells to selectively attack and kill

lymphomas, leukemias, brain cancers and cancers of the bone marrow. The early-phase trials are showing promise.

Helen Heslop, MD, director of the Adult Stem Cell Transplant Program, and her team are advancing this type of

research by adding new growth factors to make modified cells more active and to reduce side effects.

geneticaLLy-Modified t-ceLL studies

grants

11ongoing triaLspatients participating

50

3 largestHouston MetHodist is one of tHe

sites in tHe country for tHis type of researcH.


tHe LeukeMia and LyMpHoMa society aWarded cagt

tHe nationaL cancer institute reneWed an

$6.25 milliongrant as a specialized center of research (scOr).

grant to the cagT for the study of pancreatic, nasopharyngeal, and sarcoma cancers.

$11 million

cagT investigators transfer an artificial receptor called a chimeric antigen receptor (car) of the patient’s T-cell, to enable the T-cells to recognize cancer cells.

To learn more, visit houstonmethodist.org/cagt


5 0 T E ST S I N A S I N g l E D R O p : N E w v - C H I p M E AS U R E S b I O M A R k E R S O N T H E S p OTScientists from the Houston Methodist Research Institute were awarded $4.2 million from the National Institutes of Health to develop a small, low-cost device for rapid, highly accurate, point-of-care blood testing that was invented by Department of Nanomedicine faculty member Lidong Qin, PhD.

Dr. Qin’s volumetric bar-chart chip, or “v-chip,” can

detect biomarkers in a single drop of blood at the time a

doctor sees the patient. The chip quickly measures insulin

and other blood proteins, cholesterol, and signs of viral

or bacterial infection. It can even determine a patient’s

risk for hepatocellular carcinoma, the most common type

of liver cancer. Its speed, flexibility and accuracy also

make it useful in an emergency setting to quickly diagnose

and treat patients with substance abuse disorders.

“The v-chip is accurate, cheap, and portable. it requires only a drop of blood, not a vial, and can do 50 different tests in one go.”

Lidong Qin, Phd associate Member, houston Methodist research institute department of nanomedicine

Learn more about our Cancer research at houstonmethodist.org/ourresearch




A DvA N C E D M A p p I N g O f T H E b R A I N H E l p S p R E S E Rv E H U M A N f U N CT I O N SIn an effort to make medicine more personalized and improve outcomes, physicians at Houston Methodist Hospital are using all the imaging data that the patient has received to make surgical and radiation therapy decisions that could lead to better outcomes and provide fewer side effects for patients.

Surgical deficits in the brain, head and neck can lead to

long term side effects that dramatically diminish the

quality of life of the patient. It is important for physicians

to be able to visually understand where critical or eloquent

pathways exist in the brain or in the head and neck area,

and to have a predetermined idea of where blood vessels

and cranial nerves lie. Eloquent areas in the brain include

speech, visual and motor fiber tracts.

The brain and the head and neck area are the most complex

in having a 3-D and stereoscopic understanding of

indiv idual patients. Using technologies integrated in a

Computer Augmented Virtual Environment (CAVETM) called

Plato’s CAVETM, surgeons and radiation oncologists are able

to plan surgery and radiation therapy by understanding the

precise location of the safest corridors of approach for

their radiation beam or surgical scalpel.

Gavin Britz, MD, chair of the Department of Neurosurgery,

David Baskin, MD, vice chair of the Department of

Neurosurgery and director of the Kenneth R. Peak Center

for Brain and Pituitary Tumor Treatment and Research,

Donald Donovan, MD, chair of the Department of

Otolaryngology, Mas Takashima, MD, member of the

Department of Otolaryngology, and Brian Butler, MD,

chair of the Department of Radiation Oncology, use

this visual decision-making platform to design the best

and safest strategy for the patient and to plan therapies well

in advance of delivering them. “For those of us in the

neurosurgical spectrum, Plato’s CAVETM provides a preoperative

way to delineate the important fiber tracts in the brain and

determine the best surgical corridor to access lesions,” says Britz.

“It is absolutely one-of-a-kind.”Houston Methodist

physicians are developing techniques that better preserve

the most important human functions –the very things that

make us who we are and enable us to communicate with

our world. By advancing the art of functional avoidance,

we can better treat patients with brain, ear, nose and

throat tumors which lie close to the eloquent pathways

that create or store memories, fetch words, make our

fingers feel and our ears hear.

Anatomic avoidance techniques are well defined, using

images of structures such as the brain stem or the spinal

cord. Functional avoidance goes several steps further,

identifying and avoiding the electronic and chemical

circuitry in the brain that brings to life essential activities

such as speech, thought process, word recall, or meaningful

gestures of a hand or an eye.

Drs. Butler, Britz, Baskin, Donovan and Takashima

have integrated a functional map of the brain that

identifies “safe” corridors through which surgeons

a n d radiation oncologists can navigate for the

best outcome. On a case-by-case basis, physicians use the

functional map, reference markers and a triangulating

GPS-like system to safely work within millimeters of a

critical functional pathway.

The map also identifies which pathways are serial or parallel.

Serial pathways have no redundancy, so there is no recovery

if they are disrupted. This vital information further helps

determine the safest approach to a tumor.



With the pinpoint accuracy provided by mapping functional

pathways in the brain comes the need for microsurgical technology

to help surgeons maneuver along those tiny corridors to the

tumors. Surgical microscopes magnify a ¼-inch section into

a huge visual world for a surgeon, and there has been an explosion

of surgical instrumentation such as micro-scalpels and other

micro tools. Still, many tumors can be challenging to access.

David Baskin, MD, director of the Kenneth R. Peak Center

for Brain and Pituitary Tumor Treatment and Research at

Houston Methodist, has collaborated with Rice University’s

Nanoscience Department to invent several of these tools

including a nano-syringe, which selectively kills brain cancer

cells by delivering chemotherapy drugs directly into the cells, and

a mitochondrial “smart bomb” that targets mitochondria

in glioblastoma cells and destroys mitochondrial activity.

To safely reach dangerous tumors, Dr. Baskin uses a

mapfor neural navigation, and manipulates a tiny 2.8

millimeter endoscope that provides a high-definition,

real-time view into the front base of the patient’s skull,

the brain stem and the spinal cord, all through the

patient’s nostril, with no incisions. He also uses a

technology called BrainPath to safely pass microscopic

tools and treatments into deep, hard-to-reach places in

the patient’s brain.

The combination of neural imaging, functional avoidance,

microsurgical tools and pinpoint radiation technology

continues to propel advancements in treatment for

tumors of the brain, ear, nose and throat. Physicians and

researchers at Houston Methodist are in the driver’s seat

on pushing these advancements forward.

S A f E ly N Av I g AT I N g A b R A I N M A p T O D E l I v E R I N N O vAT I v E , p I N p O I N T T R E AT M E N T S

“using fusion technology accurately combines multiple high-resolution images; we can see fiber tracks in the brain, along with arteries, veins and the tiny corridors we can navigate in without damaging functional capacity for the patient. we can actually see where we are in the brain with one millimeter accuracy.”

david s. Baskin, Md Professor, vice chairman and residency director department of neurosurgery

director, kenneth r. Peak center for Brain and Pituitary Tumor Treatment and research

Learn more at houstonmethodist.org/peakcenter


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The Lung Cancer Screening Program at Houston Methodist Hospital provides at-risk individuals with the most effective and progressive screening tools available for early stage lung cancer diagnosis. In 2011, the National Lung Screening Trial, funded by the National Cancer Institute, showed that low-dose helical computed tomography (CT) significantly reduced the number of lung cancer deaths compared to a standard chest x-ray. The Lung Cancer Screening Program was launched as a result of the study’s findings.

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E A R ly D E T E CT I O N w I T H lO w - D O S E CT R E D U C E S l U N g C A N C E R M O RTA l I T y 2 0 p E R C E N T

“Low-dose CT has the advantage of locating an early

nodule with the least amount of radiation. This is the

only method currently available that can screen for

early lung cancer,” says Shanda Blackmon, MD, MPH,

associate professor in the Department of Surgery and

Cardiothoracic Surgery at Weill Cornell College of

Medicine in Houston at Houston Methodist Hospital,

and associate member of Houston Methodist

Research Institute.

A significant problem in the early diagnosis of lung cancer

is its asymptomatology in the initial stages. “If the lung

cancer manifests in the periphery of the lung, for example,

it will not impact breathing or cause a cough.

Breathing symptoms become evident when a tumor

impedes the airway or pain occurs as a result of tumor

growth into the chest wall,” says Dr. Blackmon. Further studies

show that most findings on CT are nodules that are 10

millimeters or less in size; within this group, more than

95 percent are benign. “If the nodule is smaller than eight

millimeters, it may be too small to be evaluated,” she says.

“We will be careful to watch those who do not yet need a biopsy

and make sure we do not over-biopsy benign nodules.”

Researchers in the National Lung Screening Trial

concluded that the use of low-dose CT reduced lung

cancer mortality by 20 percent compared with individuals

who received standard chest x-rays.


“Breathing symptoms become evident when a tumor impedes the airway or pain occurs as a result of tumor growth into the chest wall.”

shanda Blackmon, Md, MPh Thoracic surgeon and director, Lung cancer screening Program


There is no effective treatment protocol for women with high-

grade endometrial cancers. To help determine the best course

of adjuvant therapy in these patients, the gynecological oncology

group at Houston Methodist is participating in a clinical

trial for women with advanced-stage endometrial cancer.

“It is a randomized, Phase III trial that compares two treatment

regimens in patients with advanced-stage endometrial cancer,”

says Aparna Kamat, MD, associate professor and director of

gynecological oncology.

Initial treatment of endometrial cancer calls for removal of

the uterus and ovaries. There is no general agreement as to

what constitutes the best adjuvant therapy post surgery

for patients with metastatic disease, as very few Phase III

studies have been done comparing different regimens.

Currently, standard treatment for advanced-stage endometrial

cancer consists of six cycles of carboplatin, a platinum-based

antineoplastic agent that interferes with DNA repair, and paclitaxel,

a mitotic inhibitor in the taxane class of antineoplastic drugs

that is used to interfere with cell division. In this standard

treatment, there is no radiation therapy.

“The objective of our phase III trial is to study the efficacy of

combination chemotherapy and radiation. Women will first be

given cisplatin, a platinum-based agent, and radiation therapy.

This will be followed by additional chemotherapy with

carboplatin, another platinum-based drug, and paclitaxel

for four cycles,” says Dr. Kamat.

Houston Methodist will enroll five women. A total of 840

patients will be involved at more than 350 locations in the

United States, Canada and South Korea.

D E f I N I N g T R E AT M E N T p R OTO C O l S f O R E N D O M E T R I A l C A N C E R

“we use a combination of chemotherapeutic agents because each drug impedes cancer cell growth in different ways. This study will help us determine if radiation therapy offers more benefit for these patients in addition to chemotherapy.”

aparna kamat, Md gynecological Oncologist


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S E T T I N g R A D I AT I O N O N C O lO gy p R OTO C O l S A N D q UA l I T y STA N DA R D S I N E AST E R N E U R O p EPhysicians and physicists at the Houston Methodist Hospital, under the direction of Brian Butler, MD, chair of the Department of Radiation Oncology, are leading the way in helping countries in Eastern Europe establish high-quality, consistent standards for treating patients using Intensity Modulated Radiation Therapy (IMRT).

Dr. Butler and his team worked with local physicians and physicists in Poland, Bosnia

and Herzegovina to build a quality standards and protocol initiative. As part of this

pioneering program, Dr. Butler created a comprehensive protocol resource manual

which establishes the underpinning of a consistent standard for high-quality care and

treatment for the patient.

Approximately 30 physicians across the eight centers in Eastern Europe currently

participate in this initiative. They have created a way of standardizing IMRT across

multiple locations in countries that have not yet developed the expertise in treating

patients with this highly specialized treatment.

Each center will send patient images to the central hub in Warsaw, where radiation oncologists

and physicists with experience in IMRT work — virtually and in person — with local

physicians to identify the best treatment plans. Every week, Dr. Butler holds an interactive

video conference to review these cases. Participants present cases to Dr. Butler and his

team to review staging procedures, treatment planning, target delineation, criteria for

radiation dosing and side effects. They discuss specific cases and ways to avoid critical

pathways, such as the spinal cord or optical nerves.

In addition to web-based interactive medicine, the European physicians and physicists

come to Houston Methodist to train with our team of experts. Correspondingly, Dr. Butler

and his team visit the Eastern European sites twice per year to further exchange ideas

and expertise with a broader audience.

This initiative brings hope to patients across Eastern Europe by providing experience,

expertise and advanced treatment skills to places they didn’t exist. It also educates physicians

and physicists, enabling them to grow the pool of experience and training in their own

communities and countries.


POLANDBOSNIA &

HERZEGOVINA

•• •

•

•

Houston MetHodist is standardizing iMrt protocoLs across MuLtipLe Locations in eastern europe.


I N T E g R AT E D T R A I N I N g f O R f U T U R E f E l lO w S A N D R E S I D E N T S

239Houston MetHodist HospitaL

acgMe-accredited acgMe residents

33(plus 5 non-acgMe residents) (plus 5 non-acgMe) residency programs

In 2014, Houston Methodist will make two slots available for physicians wishing to join a

new ACGME-accredited Hematology-Oncology Fellowship program. The fellowship was given

impetus by Alexandria T. Phan, MD, gastrointestinal medical oncologist, who recently came

to Houston Methodist from MD Anderson Cancer Center. “As the number of elderly grows,

and people live longer, so will the number of patients with age-sensitive conditions like

cancer, which is almost 100 times higher,” says Dr. Phan.

“Educating and training physicians takes up to a decade. Graduate medical education must

be expanded now to ensure timely access for high-quality services. We cannot expand adequate care

and optimal treatments without specialists, but we can be better prepared for the future by

acting now to meet this growing demand and train the next generation of oncologists,” she says.

Houston Methodist has put in an application for an integrated six-year cardiothoracic surgery

program which, if approved, will begin in July of 2014. Customized from the standard

eight-year cardiothoracic residency, the six-year program condenses the curriculum and

reduces rotations that are not essential to cardiothoracic surgery. Houston Methodist is

distinctively positioned to offer this program, which is only operational in approximately

20 facilities, according to Shanda Blackmon, MD, MPH, attending physician in the

Department of Surgery. “We are uniquely suited to train integrated thoracic residents

because of our tight link to research, cancer care, benign disease and transplant. There are

very few institutions across the nation that can provide residents with such exposure at

such high volume,” says Dr. Blackmon.


At Houston Methodist, we’ve built a legacy of ingenuity that spans multiple decades and disciplines. In the last 95 years, we’ve transformed from a humble 19-bed community hospital to a global leader in health care, treating patients from 90 countries in more than 8,150 visits last year. In 2004, Houston Methodist established a long-term affiliation with Weill Cornell Medical College and New York-Presbyterian Hospital in New York City. Through this affiliation, three internationally renowned institutions collaborate to bring tomorrow’s advances to our patients today. Together, we provide cutting-edge clinical and biomedical research, and education and training for future physicians and scientists. One of the nation’s top research medical schools, Weill Cornell Medical College ranked No. 15 in the 2015 U.S. News & World Report Best Medical Schools list. For Houston Methodist clinicians and researchers, “leading medicine” is a holistic call for excellence in every aspect of patient care. We consistently rank among the best hospitals in the country. In 2013, U.S. News & World Report named Houston Methodist the “Best Hospital in Texas” for the second consecutive year, with 12 specialties recognized in the Best Hospitals list. Houston Methodist is consistently recertified to Magnet status for exceptional nursing. Because of our reputation, the finest researchers and clinicians from around the world are joining us to build on our legacy of ingenuity and accelerate the discovery and delivery of better care and better cures. That’s the difference between practicing medicine and leading it.

FAST FACTS*

132Operating rooms

2,157Licensed Beds(1,721 operating beds)

4,471affiliated Physicians

8,150international Patient encounters (from 90 foreign countries)

15,791employees

85,042inpatients in 2013

234,944emergency room visits in 2013

616,317Outpatient visits in 2013

*houston Methodist data includes five hospitals in greater houston

hOUsTOn MeThOdisT Leading MediCine YesTerdaY, TOdaY, and TOMOrrOw

FORTUNE is a registered trademark of Time inc. and is used under license. from FORTUNE Magazine, february 3, 2014 ©2014 Time inc. FORTUNE and Time inc. are not affiliated with, and do not endorse products or services of, Licensee.

Accelerating discovery and delivery to patientsat houston Methodist, we are dedicated to defining the future of medicine. we engineer discoveries in the lab to become clinically useful products, channel the best innovations through early stage clinical trials and actively transition those innovations to our industry partners. Our commitment to the full cycle of discovery and delivery sets us apart as leaders who provide patients from around the world access to the latest health care advances.

leaders in research

More than 840 active clinical protocols$55m TOTaL researCh fUnding in 2013

Photo courtesy of whr architects, inc. © aker/Zvonkovic Photography, houston, Texas

see all the ways we’re leading medicine at hmleadingmedicine.com


houston Methodist hospital6565 fannin street houston Texas 77030 houstonmethodist.org/cancer

Leading MediCine YesTerdaY, TOdaY and TOMOrrOw.at houston Methodist we have a proud tradition of revolutionizing medicine. Our past achievements have built a legacy that spans multiple decades and disciplines, and that same culture of excellence inspires us to be the pioneers of tomorrow.

Documents

Houston Methodist Cancer Annual Report 2013