Cedars-Sinai Medical Center

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A BI-WEEKLY PUBLICATION FROM THE CEDARS-SINAI CHIEF OF STAFF July 19, 2013 | Archived Issues

P&T Panel Changes Formulary; FDA Issues Warning About Olmesartan Medoxomil

Pharmacy Focus

June decisions by the Pharmacy and Therapeutics Committee include several changes to the formulary. Also, the U.S. Food and Drug Administration is warning that the blood pressure drug olmesartan medoxomil can cause intestinal problems known as sprue-like enteropathy.

» Read more


Meetings and Events


Grand Rounds

Click here to view upcoming grand rounds.


Upcoming CME Conferences

Click below to view a complete list of all scheduled Continuing Medical Education conferences.

Medical Staff CME Newsletter - July 2013 (PDF)

Cedars-Sinai Launches Initiative to Further Enhance Patient Privacy

To help prevent unauthorized access to patient medical records, a two-pronged initiative is being launched by Cedars-Sinai.

» Read more

CS-Link Tip: Up to Date

Lisa Masson, MD, associate medical director of Ambulatory Information Systems, reminds us that if physicians have a need to consult Up to Date to answer a clinical question, they can access this resource from within CS-Link™ by navigating to Web Activities on the Main Tool Bar.

» Read more

Medical Staff Members Enjoy Fireworks, Josh Groban at Hollywood Bowl

Nearly 400 medical staff members and their families joined the crowd at the Hollywood Bowl on July 3 for a night of patriotic music, fireworks and a performance by Josh Groban.


» Read more

U.S. News & World Report, Best Hospitals 2013-14

A Message From Thomas M. Priselac, President and CEO

I would like to let you know that Cedars-Sinai has been named to the "Honor Roll" and is nationally ranked in 12 specialties in the U.S. News & World Report "Best Hospitals 2013-14" rankings, which were released Tuesday. While it is a very positive recognition of the tremendous work of everyone at Cedars-Sinai, and certainly a source of pride, it is important to keep some of these rankings, including the U.S. News one, in proper perspective.

» Read more

New Members Elected to MEC

Several physicians have been elected to member-at-large positions on the Medical Executive Committee.

» Read more

Unit Closures Continue as Part of Nurse Call System Replacement; 7 NW to Close This Weekend

To help further enrich the health, safety and satisfaction of patients, Cedars-Sinai is replacing its current nurse call system with the Responder 5 Nurse Call System. The new system expands nurses' ability to monitor a variety of parameters and provides tools for real-time reporting and extractable data.

» Read more

Achilles A. Demetriou, MD, PhD, Former Department of Surgery Chair, 1946-2013

Achilles A. Demetriou, MD, PhD, an internationally distinguished surgical scientist who spent nearly four decades investigating and treating liver disease, and who led Cedars-Sinai's Department of Surgery to national distinction, has died. He was 67.


 

» Read more

Danny Malaniak, Former Associate Vice President for Academic Affairs, 1930-2013

During nearly four decades at Cedars-Sinai, Danny Malaniak earned a reputation as a virtual force of nature – a man who possessed great passion for the institution and knew how to get just about anything done fast. As a senior member of Cedars-Sinai's leadership team, Malaniak was instrumental in the growth of its academic and research enterprises, earning the position of associate vice president for Academic Affairs.

» Read more

Circle of Friends Honorees for June

The Circle of Friends program honored 179 people in June. Circle of Friends allows grateful patients to make a donation in honor of the physicians, nurses, caregivers and others who have made a difference during their time at Cedars-Sinai. When a gift is made, the person being honored receives a custom lapel pin and a letter of acknowledgement.

» Read more

New Study on Popular Prostate Cancer Protein Provides Insight Into Disease Progression

Researchers at the Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute have uncovered for the first time the vital role a popular protein plays in the stroma, the cell-lined area outside of a prostate tumor.

» Read more

Cedars-Sinai Launches Initiative to Further Enhance Patient Privacy

To help prevent unauthorized access to patient medical records, a two-pronged initiative is being launched by Cedars-Sinai.

The initiative will include an MD educational campaign and a continuing review of the policies and regulations related to the medical staff's use of electronic medical records, to ensure that they reflect the current state of technology use and security.

Cedars-Sinai will also be adding even more backup safeguards and redundancies to its preventive monitoring and computer security systems.

Physicians are reminded of the following policies:

  • Never share your password. A physician's user ID and password are for the physician's use only and should not be given to anyone else, including office employees.
  • Medical staff members must request a separate user ID and password for each member of their private-practice staff who needs to access Cedars-Sinai's electronic medical records. To obtain an application, contact EIS at (310) 423-6428.
  • Medical staff members will be held accountable for any inappropriate access of Cedars-Sinai medical records by his or her private-practice employees.

"Patient privacy and confidentiality are crucial elements in overall quality of care," said Chief of Staff Steven S. Galen, MD, who announced the initiative in a memo to medical staff members last week. "Physicians who have even the slightest suspicion that anyone has knowledge of their password should change it immediately."

To change your password, visit cslinkcentral.org, then click "Manage Password" on the right side of the screen.

CS-Link Tip: Up to Date

Lisa Masson, MD, associate medical director of Ambulatory Information Systems, reminds us that if physicians have a need to consult Up to Date to answer a clinical question, they can access this resource from within CS-Link™ by navigating to Web Activities on the Main Tool Bar.

Access Up to Date in two quick steps:

  • Click Web Activities on the Main Tool Bar.
  • In the Web Activities dropdown, click Up to Date.

When the physician finishes with Up to Date, they can easily return to CS-Link by clicking the Close button in the Up to Date window.

To view screen shots of this tip, please click this CS-Link Central link, scroll down to the bottom of the page under Tip of the Week, and click on the tip titled "Up to Date" for July 19.

It should be noted that several other resources can be accessed through the Web Activities drop down, including the OR Schedule, Antibiotic Susceptibility and Cost form, and the BiliTool to calculate the risk of a term infant developing hyperbilirubinemia.

Medical Staff Members Enjoy Fireworks, Josh Groban at Hollywood Bowl

Nearly 400 medical staff members and their families joined the crowd at the Hollywood Bowl on July 3 for a night of patriotic music, fireworks and a performance by Josh Groban.

The Hollywood Bowl Orchestra also performed during the annual Independence Day celebration.

Click on the image above to see photos from the event.

U.S. News & World Report, Best Hospitals 2013-14

A Message From Thomas M. Priselac, President and CEO


I would like to let you know that Cedars-Sinai has been named to the "Honor Roll" and is nationally ranked in 12 specialties in the U.S. News & World Report "Best Hospitals 2013-14" rankings, which were released Tuesday. While it is a very positive recognition of the tremendous work of everyone at Cedars-Sinai, and certainly a source of pride, it is important to keep some of these rankings, including the U.S. News one, in proper perspective. Our outstanding rankings this year in U.S. News provide a particularly meaningful time to make this point.

As you know, over the past several years there has been a proliferation of "rankings" and "scorecards" of hospitals, covering such areas as quality, reputation and clinical outcomes. At Cedars-Sinai, we carefully review the methodology of these rankings to determine which ones provide a meaningful measurement of our progress toward fulfilling our institutional mission and strategic goals, as some of these "rankings" have significant flaws in their methodology. If we place undue focus on external rankings instead of on other metrics that are a more accurate and meaningful measure of our progress in fulfilling our mission, we risk becoming distracted from our mission of serving our community, the nation and the world with outstanding clinical care, research, educational programs and community service.

Over the past several years, there has been increasing skepticism nationally of the U.S. News hospital rankings, based on peer-reviewed analyses highlighting some of the weaknesses in the methodology. Other studies showed that U.S. News rankings did not always correlate with widely accepted rankings on hospital safety and quality, such as the federal Hospital Compare website. In addition, consumer research has shown that rankings such as U.S. News have less influence on consumer decisions than had previously been thought.

At Cedars-Sinai, we have rigorous metrics in place to assess our quality, efficiency and effectiveness in patient care, research, education and community benefit. We will continue to focus on those metrics to not only help us assess our performance, but more importantly to help us continually improve. One of the hallmarks of our institution and the people who work and practice here is that even though we operate at the highest levels, we are always looking for ways to improve on that excellence.

Although it is not the primary focus for how we measure our progress, the below U.S. News rankings are nonetheless one of many recognitions for your outstanding work. In addition to being named to the national Honor Roll (#13 among all U.S. hospitals), here are specialty rankings:

  • Cancer (#26)
  • Cardiology and Heart Surgery (#9)
  • Diabetes and Endocrinology (#14)
  • Ear, Nose and Throat (#29)
  • Gastroenterology and GI Surgery (#5)
  • Geriatrics (#23)
  • Gynecology (#12)
  • Nephrology (#22)
  • Neurology and Neurosurgery (#14)
  • Orthopedics (#9)
  • Pulmonology (#20)
  • Urology (#10)

Everyone involved with Cedars-Sinai can be proud of our numerous national accolades. Each one of you, in many different ways, contributes to the excellence in Cedars-Sinai's clinical, research, teaching and community benefit programs. Thank you for your continued commitment to our mission, to our patients and to our community.

New Members Elected to MEC

Several physicians have been elected to member-at-large positions on the Medical Executive Committee:

Ilana Cass, MD
OB/Gyn

Stephen Copen, MD
Medicine

Gene Liu, MD
Surgery

Peggy Miles, MD
Medicine

Thomas Webb, MD
Anesthesiology

 

The new members take office Jan. 2, 2014.

Unit Closures Continue as Part of Nurse Call System Replacement; 7 NW to Close This Weekend

To help further enrich the health, safety and satisfaction of patients, Cedars-Sinai is replacing its current nurse call system with the Responder 5 Nurse Call System. The new system expands nurses' ability to monitor a variety of parameters and provides tools for real-time reporting and extractable data.

To complete this work, units are being closed on a rotating basis for 14 days. On Saturday, July 20, 7 Northwest will close and any remaining patients will be relocated to 7 Northeast and available medical/surgical beds on other units.

Beginning Monday, July 22, patients routinely admitted and transferred to 7NW will be placed on 7NE and any available medical-surgical beds.

7 Northwest is expected to reopen Monday morning, Aug. 5, pending inspection and permission to reopen.

Units expected to have nurse call replaced this calendar year include the following:

  • August – 8 Northeast and 8 Northwest
  • September – 4 Southeast and 4 Southwest
  • October – 8 Southeast and 8 Southwest

If you have any questions regarding these unit closures, please contact Vice President and Chief Nursing Officer Linda Burnes Bolton, DrPH, RN, FAAN, at 310-423-5191 or burnesbolton@cshs.org, or Peachy Hain, RN, director of Medical, Surgical and Rehabilitation Nursing, at 310-423-6747 or peachy.hain@cshs.org.

Achilles A. Demetriou, MD, PhD, Former Department of Surgery Chair, 1946-2013

Achilles A. Demetriou, MD, PhD, an internationally distinguished surgical scientist who spent nearly four decades investigating and treating liver disease, and who led Cedars-Sinai's Department of Surgery to national distinction, has died. He was 67.

Demetriou was widely known for his research of artificial and cell-based liver support systems, transplantation biology and genetic abnormalities in liver disease. He held nine patents in connection with his research, lectured around the world, and wrote extensively about liver disease and related subjects in the highest quality, peer-reviewed journals and textbooks.

The soft-spoken physician, who helped pioneer the development of a bioartificial liver two decades ago, died June 20 at home in suburban Cleveland after a long battle with liver cancer.

"Achilles Demetriou's creative genius immeasurably advanced the understanding of liver disease, and his leadership blazed new paths for Cedars-Sinai's surgical innovation," said Thomas M. Priselac, president and chief executive officer of Cedars-Sinai Health System.

Demetriou became chair of the Department of Surgery in 1995 and spent a decade building a succession of programs and services in liver transplantation, neurosurgery, orthopedics, urology, spine surgery and other specialties.

Colleagues credit Demetriou with elevating the department's surgical residency program by attracting many of the best and brightest candidates with the dual promise of surgical training and laboratory experience. His programs would spawn a new generation of surgical scientists. Demetriou's talent and his diplomatic treatment of others, many recalled, made him an effective department chairman.

"He was a fine surgeon and leader, and more importantly, a gentleman of the greatest integrity," recalled Bruce Gewertz, MD, Cedars-Sinai surgeon-in-chief, vice president for Interventional Services, vice dean of Academic Affairs and the H & S Nichols Distinguished Chair in Surgery. "He's the architect of our modern Department of Surgery. His legacy remains strong in the hearts of those he supported."

Demetriou spent 13 years at Cedars-Sinai, serving a stint as director of the medical center's Liver Support Unit. In 1998, he was named the Esther and Mark Schulman Chair in Surgery and Transplantation Medicine.

He never wavered from his professional passion and lifelong research aim: searching for solutions to acute liver failure. He wrote 200 papers in peer-reviewed journals, edited the standard guide "Support of the Acutely Failing Liver" and was associate editor of the definitive "Textbook of Surgical Research." His nine patents included one for an artificial liver apparatus and another for a novel gene associated with liver cirrhosis.

"He was a consummate surgical scientist who was very smart and very creative, and he made major scholarly contributions to our understanding of the surgical and cell-based treatment of liver disease," said Shlomo Melmed, MD, senior vice president for Academic Affairs, dean of the Medical Faculty and the Helene A. and Philip E. Hixon Chair in Investigative Medicine. "At Cedars-Sinai, he significantly expanded the platform for surgical excellence and innovation that we continue to enjoy."

Born in Cyprus, Demetriou received his medical degree from Hebrew University-Hadassah Medical School in Jerusalem and his PhD in biochemistry from George Washington University in Washington.

He served his internship at the Albert Einstein College of Medicine in New York and his residency in surgery at Vanderbilt University in Nashville. Demetriou spent three years as a research fellow in biochemical pharmacology at the National Institutes of Health in Bethesda, Md.

Before joining Cedars-Sinai in 1992, he was director of the S.R. Light Surgical Research Laboratory at the Vanderbilt University School of Medicine, where he also held the Paul W. Sanger Chair in Surgery and served as chief of surgical services at the Nashville VA Medical Center.

In 2005, Demetriou moved to the University Hospitals Health System in Cleveland, where he became chief operating officer; he also held the position of vice dean for Clinical Affairs at the affiliated Case Western Reserve University School of Medicine. He retired at the end of 2012.

Demetriou also served on several National Institutes of Health panels and was a faculty member of the U.S. Food and Drug Administration's Training School for FDA staff. He also was a founding member of the Cell Transplant Society and the World Association of Hepato-Biliary-Pancreatic Surgery. In 1998, he was elected into the Academy of Athens as a Corresponding Member.

"Achilles was a great surgeon and a great scientist who mentored large numbers of young faculty," recalled Zab Mosenifar, MD, co-director of the Women's Guild Lung Institute at Cedars-Sinai and the Geri and Richard Brawerman Chair in Pulmonary and Critical Care Medicine, who worked closely with Demetriou. "He was savvy and tough but had a soft and tender side to him. I am saddened immensely by his loss."

Danny Malaniak, Former Associate Vice President for Academic Affairs, 1930-2013

During nearly four decades at Cedars-Sinai, Danny Malaniak earned a reputation as a virtual force of nature – a man who possessed great passion for the institution and knew how to get just about anything done fast.

As a senior member of Cedars-Sinai's leadership team, Malaniak was instrumental in the growth of its academic and research enterprises, earning the position of associate vice president for Academic Affairs.

He didn't use spreadsheets or algorithms. Instead, he wrote notes to himself and relied on a kaleidoscopic knowledge of the organization, energy and charm to help build Cedars-Sinai into one of the nation's premier academic medical centers.

Malaniak died this week after a long-standing illness, surrounded by his family at his Glendale home. As word of his passing spread through Cedars-Sinai, physicians, researchers, assistants and others recalled a leader who became the institution's administrative glue through much of the 1970s, '80s and early '90s, setting the stage for the modern-day health system.

"Danny was one of a kind," said Thomas M. Priselac, president and chief executive officer, and the Warschaw Law Chair in Health Care Leadership. "He brought to his work and his relationships with everyone he came in contact with the best that one can offer. His passion for his life, his work and most important of all his relationships with others were without parallel. Cedars-Sinai has lost a treasured part of our history, and I have lost a dear friend."

Malaniak's knack for solving sticky problems was almost legendary. The man who spoke six languages knew exactly who to call if a doctor needed extra lab space. He could find a spare freezer if one was needed for an experiment. He knew just the right person to ask – and how to ask – for funds to buy supplies or equipment. He also knew how to make others feel content even if he couldn't help them.

 "That was Danny – a sincere, hyper-energetic force of nature who never said, 'It can't be done,'" recalled Glenn D. Braunstein, MD, vice president of Clinical Innovation and the James R. Klinenberg, MD, Chair in Medicine. "He went out of his way to help new faculty get on the right path and break down any barriers they encountered. Their success was Danny's success. He will be greatly missed by the Cedars-Sinai family."

Malaniak arrived at Cedars-Sinai in the mid-1950s after several years in the U.S. Army. Just as he did in the military, he rose through the hospital's ranks, bringing a contagious enthusiasm for the organization, which would eventually honor him by establishing the Malaniak Award for Excellence in Postdoctoral Research.

After he retired in 1994, Malaniak served as a consultant. He also visited Cedars-Sinai frequently on his own time, holding court at his favorite couch on the Plaza Level near the North Tower elevators, calling out to doctors and others as they passed by to engage them in conversation and offer hugs.

"Danny was a gentle and sensitive giant of the bygone era of early Cedar-Sinai builders and leaders," recalled Shlomo Melmed, MD, senior vice president for Academic Affairs, dean of the Medical Faculty, and the Helene A. And Philip E. Hixon Chair in Investigative Medicine. "He loved our institution and devoted his every fiber to assuring the thriving of our nascent academic enterprise. His unmitigated support and counsel laid the foundations for the modern thriving system we have become. We will miss him sorely, yet we continue to celebrate the fulfillment of his decades of effort."

Malaniak was equally passionate about his native Ukraine and his heritage.

Born Bohdan Zenowij Malaniak, he spent his early years in Ukraine. Toward the end of World War II, his immediate family fled Soviet occupation, spending a year in Slovakia before winding up in a camp for displaced person in Germany after the war.

His family immigrated to the United States in February 1948, settling in Glendale. Several months later, Malaniak enlisted in the Army, serving six years on active duty and another 17 in the U.S. Army Reserve. During the Korean War, he was stationed mostly in Tokyo, assigned to the Armed Forces Radio Service, Far East Network. Malaniak visited Korea and had vivid memories of the Incheon Invasion.

Malaniak reached the rank of command sergeant major.

He returned to Los Angeles when his military service came to an end in 1954. A year later, he married Eleanor Croft Garvin. The couple were married 56 years before Malaniak's wife, who worked as manager of the Division of Cardiology, died last year. They raised three children.

As he established himself at Cedars-Sinai, Malaniak remained deeply involved in Ukrainian causes.

He served for 30 years as manager, member and president of the Los Angeles-based Ukrainian National Choir "Kobzar" and organized several major fundraising events. He also served on the board of directors for the California Associa­tion to Aid Ukraine, which provided humanitarian support for the Ukrainian people.

Malaniak helped lead collaborations between Cedars-Sinai and Ukrainian scientists and medical professionals. Following a 2006 visit of then-Ukrainian first lady Kateryna Yushchenko, he spearheaded the launch of an international healthcare fellowship program to provide training for medical professionals to improve outcomes for critically ill children in his native land.

Asked a few years ago if he had any advice for young people, Malaniak responded with his characteristic selflessness: Take advantage of educational opportunities. Stay healthy. Respect your parents and teachers. And serve your community.

He applied the same type of principles at Cedars-Sinai.

One longtime friend, Zab Mosenifar, MD, recalled Malaniak showing up at his office many years ago after Mosenifar received a promotion. Malaniak came to hug his friend.

Mosenifar, co-director of the Women's Guild Lung Institute and the Geri and Richard Brawerman Chair in Pulmonary and Critical Care Medicine, is among those who would run into Malaniak on the couch in the Plaza Level. The physician would relish those moments together.

"He was a very decent man, a good man, an honest man," Mosenifar recalled. "If there are pillars that would be holding up Cedars-Sinai Medical Center, he would be the pillar with zeal. That's how I remember him."

A private family service will be held. Malaniak's family asks that any donations in his honor be made through Cedars-Sinai to the General Clinical Research Center: Malaniak Award for Excellence in Postdoctoral Research, or to the California Association to Aid Ukraine.

Danny Malaniak with Shlomo Melmed, MD

Circle of Friends Honorees for June

The Circle of Friends program honored 179 people in June.

Circle of Friends allows grateful patients to make a donation in honor of the physicians, nurses, caregivers and others who have made a difference during their time at Cedars-Sinai. When a gift is made, the person being honored receives a custom lapel pin and a letter of acknowledgement.

Click here for more information about the program and for a list of past honorees.

  • Coleen J. Abelarde, RN
  • Carlos Anaya, MD
  • John B. Andrews, MD
  • Pedrina Arguera
  • M. William Audeh, MD
  • Hyun W. Bae, MD
  • Suadu Bah, RN
  • C. Noel Bairey Merz, MD
  • Shahriar Bamshad, MD
  • Donna M. Bias, RN, BSN
  • Keith L. Black, MD
  • Alexandria Borys, RN
  • Glenn D. Braunstein, MD
  • Barry J. Brock, MD
  • Philip G. Brooks, MD
  • Neil A. Buchbinder, MD
  • Mathew H. Bui, MD
  • Agnes M. Butler
  • Adelia G. Cabuhat, RN
  • Ilana Cass, MD
  • Patrice Ceballos
  • Kirk Y. Chang, MD
  • Yzhar Charuzi, MD
  • Peter Chau, MD
  • Wen Cheng, MD
  • Meshe D. Chonde, MD
  • William W. Chow, MD
  • Harry Chu, RN
  • Ray M. Chu, MD
  • Stephen R. Corday, MD
  • Maria S. Corral
  • Alicia Cypressi, RN
  • Dudley S. Danoff, MD
  • Mark M. Davidson, MD
  • Robert W. Decker, MD
  • Rick B. Delamarter, MD
  • Margaret Diacheysn, RN
  • Alice R. Dick, MD
  • J. Kevin Drury, MD
  • Marla C. Dubinsky, MD
  • Julie A. Dunhill, MD
  • Cheryl L. Dunnett, MD
  • Darryl M. Eddy, RN, BC, BSN
  • Dawn S. Eliashiv, MD
  • Fardad Esmailian, MD
  • Richard Essner, MD
  • Jeremy A. Falk, MD
  • David E. Fermelia, MD
  • Robert A. Figlin, MD
  • Madelyn M. Foronda, RN
  • Stuart Friedman, MD
  • Ramin Gabbai, MD
  • Donna Gallik, MD
  • Francine J. Gates
  • Eli Ginsburg, MD
  • Armando E. Giuliano, MD
  • Sherry L. Goldman, RN, NP
  • Jerome E. Goldwasser, MD
  • Mark O. Goodarzi, MD
  • Steven B. Graff-Radford, DDS
  • Stephen L. Graham, MD
  • Leland M. Green, MD
  • Paul B. Hackmeyer, MD
  • Antoine Hage, MD
  • Behrooz Hakimian, MD
  • David S. Hallegua, MD
  • Solomon I. Hamburg, MD
  • Michele A. Hamilton, MD
  • Andrew E. Hendifar, MD
  • David M. Hoffman, MD
  • Stuart Holden, MD
  • Jethro L. Hu, MD
  • Gabriel E. Hunt, Jr., MD
  • Leonel A. Hunt, MD
  • Quyen N. Hurlburt, RN
  • Nenita D. Iglesia
  • Josefina N. Inocentes, RN
  • Karen J. Jimenez, RN
  • J. Patrick Johnson, MD
  • Stanley C. Jordan, MD
  • Dinah Juanillo, RN
  • Saibal Kar, MD
  • Adam D. Karns, MD
  • David Kawashiri, MD
  • Tami Kendra-Romito
  • Ali Khoynezhad, MD, PhD
  • Dong U. Kim, MD
  • Terrence T. Kim, MD
  • Ellen B. Klapper, MD
  • Jon A. Kobashigawa, MD
  • Peter Koh, OD
  • Penelope Grace Kornbluth, MSN, ANP, APRN-BC
  • Gary E. Leach, MD
  • Roger L. Lerner, MD
  • Ronald S. Leuchter, MD
  • Michael C. Lill, MD
  • Simon K. Lo, MD
  • Alex Lopez
  • Rajendra Makkar, MD
  • Dwight L. Makoff, MD
  • Adam N. Mamelak, MD
  • William J. Mandel, MD
  • Eduardo Marban, MD, PhD
  • Luella M. Marchany
  • Donna Marsh, RN
  • Ana R. Martinez
  • Peggy Mays
  • Philomena McAndrew, MD
  • Gerard McKearin, RN
  • Robert J. McKenna, Jr., MD
  • Shlomo Melmed, MD
  • Kiarash Michel, MD
  • Amin Joseph Mirhadi, MD
  • Cathleen P. Moran, RN
  • Mary C. Nasmyth, MD
  • Ronald B. Natale, MD
  • Alan C. Newman, DDS
  • David G. Ng, MD
  • Frederic G. Nicola, MD
  • Nicholas N. Nissen, MD
  • Raena S. Olsen, DO
  • Guy D. Paiement, MD
  • John Pappas, LCSW
  • Timothy Parker
  • Jignesh K. Patel, MD, PhD
  • Brad Penenberg, MD
  • Glenn B. Pfeffer, MD
  • Deborah Prevost, RN
  • Alfred Rahban, MD
  • Nina Redl
  • Madison F. Richardson, MD
  • Robert Richter, MD
  • Susan L. Roberts, RN
  • Luvelina N. Rodolfo, RN
  • Anne W. Rosenblatt, RN, MSN
  • Fred P. Rosenfelt, MD
  • Gary G. Rosengarten, PhD
  • Howard L. Rosner, MD
  • Steven B. Rubins, MD
  • Jeremy D. Rudnick, MD
  • Vivian L. Salle, RN
  • Bessy G. Samayoa
  • Bruce A. Samuels, MD
  • Howard M. Sandler, MD, MS
  • Gregory P. Sarna, MD
  • Jay N. Schapira, MD
  • Edward J. Share, MD
  • Michael M. Shehata, MD
  • Robert J. Siegel, MD
  • Allan W. Silberman, MD, PhD
  • Amanuel Sima, MD
  • Enrique Slodownik, MD
  • Aretha P. Smith
  • Karyn Morse Solky, MD
  • Harmik J. Soukiasian, MD
  • Jasminka Stegic, MS, ANP-BC, CCRN
  • Jerrold H. Steiner, MD
  • Daniel J. Stone, MD, MPH, MBA
  • Leslie Stricke, MD
  • Liliya Swarth, RN
  • Nicholas R. Szumski, MD
  • Steven W. Tabak, MD
  • Jane Tavyev Asher, MD
  • Alfredo Trento, MD
  • Richard Tuli, MD, PhD
  • Mark K. Urman, MD
  • Michael B. Van Scoy-Mosher, MD
  • Eric Vasiliauskas, MD
  • Arthur I. Waltuch, MD
  • Xunzhang Wang, MD
  • Alan Weinberger, MD
  • Michael H. Weisman, MD
  • Lisa S. Wilson-Newsome
  • Edward M. Wolin, MD
  • Lewis Y. Wyatt, MD
  • Clement C. Yang, MD
  • Shelley Yee, MD
  • Evan M. Zahn, MD
  • Phillip C. Zakowski, MD

New Study on Popular Prostate Cancer Protein Provides Insight Into Disease Progression

Researchers at the Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute have uncovered for the first time the vital role a popular protein plays in the stroma, the cell-lined area outside of a prostate tumor.

Researchers have long understood the function of the protein, Caveolin-1 (Cav-1), in prostate cancer, including its role in treatment resistance and disease aggressiveness. However, prior to this study, little was known about the role of Cav-1 within the stroma.

The study, published in the Journal of Pathology, found that a decreased level of the Cav-1 protein in the stroma indicated tumor progression — a function opposite to the known role of Cav-1 within a tumor. Inside the tumor, an increased level of this protein signifies tumor progression. These human tumor findings suggest that patients whose prostate tumor is surrounded by a stroma with decreased levels of the Cav-1 protein may have an overall worse prognosis and a higher chance of disease relapse.

"How a prostate tumor communicates with its microenvironment, or stroma, is a vital process we need to understand to assess the aggressiveness of a patient's disease and potential response to treatment," said Dolores Di Vizio, MD, PhD, associate professor in the Urologic Oncology Research Program and senior investigator of the study. "This research suggests that the cells surrounding a prostate tumor are equally as important as the tumor itself in helping understand the complexity of a man's disease. This early-stage research may provide a new, future marker that may ultimately aid diagnosis and treatment, and personalize prostate cancer therapy."

In addition to understanding the role of Cav-1 in the tumor microenvironment, researchers discovered that the loss of Cav-1 causes an increase of cholesterol in the stroma. Previous research findings suggest that cholesterol levels are related to aggressive prostate cancer, but cholesterol's role had never been evaluated within the stroma.

"Cholesterol has been shown to be a driver of prostate cancer progression," said Di Vizio. "For the first time in prostate cancer research, we found that when levels of Cav-1 decrease in the stroma, both cholesterol and androgens increase. This finding may partly explain a resistance to traditional treatments."

Though the findings are preliminary, the Cedars-Sinai researchers Di Vizio, Michael Freeman, PhD, vice chair of research in the Department of Surgery and professor/director of the Cancer Biology Program at the Samuel Oschin Comprehensive Cancer Institute, and post-doctoral fellows Matteo Morello, PhD, and Sungyong You, PhD, will continue evaluating the role of the Caveolin-1 protein in the stroma and its potential end benefit in patients.

The study was performed in collaboration with the Baylor College of Medicine, the University of Manchester, Harvard Medical School and the University of Florence and is funded by a National Institutes of Health grant from the National Cancer Institute.

NIH Funding: NCI R00 CA131472

Citation: J Pathol. 2013 May 31. doi: 10.1002/path.4217