Tulane Doctors Extend Their Reach in 2024
"We're Not Going Anywhere; We're Going Everywhere!"
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As part of the next phase in Tulane University's partnership with LCMC Health, Tulane Cancer Center physicians have begun seeing their patients at the East Jefferson General Hospital Cancer Center. |
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The facility -- located at 4204 Houma Blvd., Metairie, LA 70006 -- features
- Radiation Oncology and Nuclear Medicine on the first floor
- Outpatient Exam Rooms and an Infusion Area on the second floor
Tulane Cancer Center's Stem Cell Transplant Program -- now known as the East Jefferson General Hospital Transplant and Cellular Therapy Center -- is also making the move to a newly renovated inpatient unit on the seventh floor of East Jefferson General Hospital and outpatient clinical space on the sixth floor -- Suite 620 -- of East Jefferson's Medical Office Building, located at 4224 Houma Blvd., in Metairie.
Tulane Cancer Center patients currently enrolled in cancer clinical trials will continue to be followed by their physicians and clinical research teams at the new East Jefferson facilities.
This transition is the next phase in Tulane University's partnership with LCMC Health, which will expand local access to comprehensive and specialty care, advance academic medicine, and boost innovation and training opportunities throughout a broader footprint in the Gulf South region.
“Just because some of our physicians are relocating does not mean we are going anywhere; it means we are going everywhere! We are ensuring that our top-notch doctors are as accessible as ever and bringing the future of medicine to even more people in our community,” says Kim Peters, CEO of the Tulane University Medical Group. “Providing continuous coverage and care for our patients is our top priority, whether at a TUMG-operated clinic or in an LCMC Health facility.”
For cancer clinic or stem cell transplant appointments with your Tulane oncologists, please call 504-988-6300 . For directions to the East Jefferson General Hospital Cancer Center, please click here.
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Study Compares Outcomes of Less- to More-Aggressive Surgeries for Papillary Thyroid Microcarcinomas |
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The incidence of thyroid cancer worldwide has increased over the last few decades. The majority of cases — approximately 80% — are papillary thyroid cancers, and of these, about 30% involve small tumors, no larger than 1 cm, also known as papillary thyroid microcarcinomas (PTMC).
In 2009, the American Thyroid Association (ATA) recommended thyroid lobectomy — a procedure that involves removing half the thyroid gland, the lobe that has the cancer — as a more conservative option to removal of the entire gland for PTMC patients.
In 2015, active surveillance was added to the ATA guidelines. "Active surveillance, or monitoring the nodule to make sure it doesn't increase in size or spread to the lymph nodes, is a valid option for many patients," said Emad Kandil, MD, MBA, professor and Elias Hanna Chair in Surgery. "For others, surgery is required."
The goal of this study was to analyze and compare the outcomes of PTMC patients who underwent extensive removal of the whole thyroid with those who underwent less extensive lobectomy to compare overall survival, cancer-free survival, and recurrence.
Kandil and his team used the National Institutes of Health SEER database (Surveillance, Epidemiology, and End Results Program) to retrospectively analyze the outcomes of 6,064 PTMC patients treated between 2000 and 2019. Of these, 3,652 underwent the more extensive total thyroidectomy, and 2,412 underwent partial lobectomy.
Of those patients who opted for total thyroidectomy, 82% were women, their tumor sizes were larger, and 12.3% had regional metastases, compared to 2.9% in the partial lobectomy group. Additionally, 0.4% of the total thyroidectomy patients had distant metastases compared to no distant metastases in the lobectomy patients.
"This tells us patients who underwent total thyroidectomy had more aggressive cancers overall," said Kandil.
When analyzing cancer recurrence, the data showed that although those who underwent total thyroidectomy had more aggressive tumors in general, their recurrence rate was one-third that of those who underwent less extensive surgery — 0.3% vs. 1%, respectively.
"There was almost triple the recurrence rate in the lobectomy group," said Kandil. "The group treated more aggressively has more advanced disease than those treated with less extensive surgery, but their cancer recurrence rate was lower."
There was also a slightly higher overall mortality rate in the lobectomy group — 8.1% vs. 5.2% in the total thyroidectomy group.
"This is very interesting data," said Kandil. "You start with two groups. One has more aggressive tumors than the other, but when you offer the more aggressive tumor more aggressive surgery they actually do better. These patients experienced less recurrence and better overall survival." (Overall survival refers to the percentage of people with a specific type and stage of cancer who have not died from any cause during a certain period of time.)
The data did not show a significant difference in cancer-specific survival between the two groups. (Cancer-specific survival refers to the percentage of people with a specific type and stage of cancer who have not died from their cancer during a certain period of time.)
What does this mean for patients? "We need to be very careful about offering patients with small cancers active surveillance or lobectomies," said Kandil. "I have a huge passion for minimal intervention, but the problem right now is we have no idea about which small cancers will progress and metastasize versus which will not. And currently, there is no reliable panel of genetic markers to help guide in our decision making."
But there is a non-surgical treatment option that could help. Radiofrequency ablation (RFA) is a procedure that reduces the size of tumors or nodules using radio waves. "RFA can shrink or literally kill the cancer in some patients," said Kandil, who has performed about 1,000 of these procedures over the past four years — the largest experience in the country. "It's not just a modality of treatment, but also a prognostic tool that could help to tell us which cancers are aggressive and which are not. Less aggressive tumors will respond more favorably to RFA and more aggressive tumors will not and maybe these are the patients who should undergo total thyroidectomy."
Data like these may help to change the ATA guidelines. In the meantime, Kandil and his team hope this study sends a message to physicians about being very careful before choosing active surveillance and less aggressive lobectomy as treatment options for PTMC.
"Of course, if you have an older patient with multiple medical problems, who is extremely sick and likely to die from some other health issue, then maybe active surveillance is a reasonable option. But thyroid cancer is most often diagnosed in middle-aged females. So until the guidelines are changed, the onus is on physicians to evaluate published data carefully and take it from there."
Dr. Kandil says this study would not have been possible without the contributions of Research Assistant Professor Eman Ali Toraih, MD, PhD, MSc, who was responsible for the gathering and biostatistical analysis of this data.
“This research provides a pivotal perspective in the debate surrounding optimal surgery for small thyroid tumors,” said Dr. Toraih. “Total thyroidectomy tangibly reduces recurrence rates and confers an overall survival advantage – remarkable gains for patients. And while the data reveals uncertainty regarding cancer-specific mortality benefits, total thyroidectomy appears no worse than less extensive options in this regard. These insights compel refinement of molecular markers determining who stands to gain most. But for many papillary microcarcinoma patients, these findings spotlight total thyroidectomy’s benefits warranting consideration when weighing treatment options.”
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Welcome Jorge Caso, MD —
New Head of the Section of Urologic Oncology
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Dr. Caso is a fellowship-trained urologic oncologist with special expertise in the use of the da Vinci robot for the management of kidney, bladder, and prostate cancers.
"I have always aimed to be on the cutting-edge technologically, which aligns me perfectly with Tulane's goals," said Caso. "The Department of Urology's motto is 'Cutting-Edge Without the Cut.' This lines up well with what I've been trying to do."
Offering minimally invasive options — like the single-port robot — for more complex surgeries is a major goal for Dr. Caso. "Since I've arrived at Tulane, we performed the first retroperitoneal nephrectomy in the region using the single-port robot," said Caso. "We've also done a groin dissection — which is extremely rare to be done at all — but we've managed to do it with the single-port robot, which I think is one of the first cases in the country, and we have more lined up."
Dr. Caso also has an interest in academic research. "The Department of Urology has a very rich research history. I look forward to working with my colleagues here to continue that tradition." At the upcoming meeting of the Southeast Section of the American Urological Association, he will be presenting data generated through a retrospective analysis of the effectiveness of minimally invasive surgeries among patients in the National Cancer Database.
"We wanted to examine outcomes of minimally invasive surgeries at a nationwide level," said Caso. "For example, some urologists will only do nephrectomies on metastatic disease. We compared the outcomes of nephrectomies to partial nephrectomies, and it turns out, at least in these large databases, that patients who had partial nephrectomies seem to do better."
Although his current focus is on getting his clinic up and running at Touro, he does eventually plan to offer clinical trials as well.
Dr. Caso received his bachelor's degree in literature and his master's degree in public health from New College of Florida. After receiving his medical degree from the University of South Florida, he completed his urologic oncology fellowship at Duke University Medical Center. He is a member of the American Urological Association (AUA), the Society of Urologic Oncologists (SUO), and several other prestigious urologic organizations.
"The goal for me is to always be a good partner to my patients," said Dr. Caso. "It's very important not to dictate to them but get buy in from them as we move forward in their care and to focus on cutting-edge options that will achieve the best possible outcomes. That's my goal and that's very in line with what they're trying to do here at Tulane."
In addition to kidney, bladder and prostate cancers, Dr. Caso treats cancers of the ureter and penile cancers. To make an appointment with Dr. Caso, call 504-988-5271.
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Offering minimally invasive options — like the single-port robot — for more complex surgeries is a major goal for Dr. Caso.
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Pink Games Raise a Cumulative $284,000
for Tulane Cancer Center's Patient Relief Fund
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Student athletes from Cabrini High School, Mount Carmel Academy, St. Mary's Dominican High School and St. Scholastica Academy visited Tulane's Yulman Stadium recently to present their check for $31,470 — proceeds from last fall's Pink Games fundraisers.
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"Non sibi, sed suis"
Not for one's self, but for one's own
That's Tulane University's motto, and it could not have been more perfectly demonstrated than it was when a group of local student athletes, coaches and trainers visited Yulman Stadium to present a check for $31,470 to assist cancer patients in need.
A cancer diagnosis is extremely frightening, not only for the patient but for their loved ones as well. Add in the stress and extra burden of unexpected financial issues and the challenges can quickly become overwhelming.
But thanks to the efforts of students from Cabrini High School, Mount Carmel Academy, St. Mary's Dominican High School and St. Scholastica Academy, many local cancer patients will have that extra burden lifted a bit so they can focus more intently on following their treatment plans and getting well.
Funds donated represent the cumulative proceeds from each school's Pink Games fundraisers held last fall, and they will benefit Tulane Cancer Center's Patient Relief Fund.
Pink Games — a series of benefit volleyball games and other fundraising events often involving friendly competitions among grade levels at the participating schools — was started by David Mocklin, head athletic trainer at the Tulane Institute of Sports Medicine, nine years ago in an effort to help alleviate the stress of local cancer patients.
Struck by the number of local families he knew that had been touched by cancer, he wanted to do something to provide support. And it was important to Mocklin that the dollars raised remain here in the New Orleans community. "Tulane Cancer Center's Patient Relief Fund (PRF) benefits our local cancer patients, and 100% of donations go to patient relief grants, with no overhead or administrative expenses," said Mocklin. "The funds we donate go directly to patients who need them. That's what the Pink Games are all about."
Tulane Cancer Center's PRF was established in 1998 to help patients meet unexpected expenses associated with their care. It's often the only source available to our social worker to solve urgent problems — things like lack of transportation, meals or temporary lodging — that could become insurmountable impediments to the ability of a patient to follow his or her cancer treatment plan. These funds are also an important source of emotional relief for needy patients facing a cancer diagnosis.
The Pink Games have generated an incredible $284,000 in support of Tulane Cancer Center's patients over the years. We are deeply grateful and couldn’t be prouder of the students who raised these funds by living the Tulane motto and making a tremendously positive impact in the lives of their neighbors in need.
If you would like to make a donation to Tulane Cancer Center's Patient Relief Fund, please click here for more information.
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New Orleans Pelicans Game to Benefit
Cancer Crusaders
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Join the Cancer Crusaders on Thursday, February 22, at 7 PM, when the New Orleans Pelicans take on the Houston Rockets at the Smoothie King Center and a portion of your ticket price will benefit cancer research.
Cancer Crusaders – a non-profit, all volunteer organization with no administrative overhead – was founded in 1976 to raise funds for cancer research in the New Orleans area. The group has raised approximately $4.3 million since its incorporation in 1978, and these funds have been split equally between the cancer research programs at Tulane and LSU.
The Pelicans are also offering discounted parking in the Smoothing King Center that evening at a special group rate. Parking information is also available through the QR code or website.
See you February 22 at the SKC! GO PELS!
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or visit
To make a tax-deductible donation to Tulane Cancer Center
(Federal Tax ID# 72-0423889) please click here.
Thank you for your generosity and support!
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