By Michelle TalsMa everson

W hen a patient suspects that

they might have breast

cancer, the wait for further

testing and an official diagnosis can be

agonizing. With this in mind, Banner

MD Anderson Cancer Center on the

Banner Gateway Campus, opened the

Undiagnosed Breast Clinic — a place

where women who suspect breast

cancer can get quick answers to some

of their most daunting questions.

Stephanie Byrum, M.D., F.A.C.S., a

general surgeon at Banner MD Ander-

son with special training in the treat-

ment of breast diseases, says that the

Undiagnosed Breast Clinic was modeled

after the benign breast clinic at MD

Anderson Cancer Center in Houston.

Providing resulTsByrum says the clinic is operated in

such a way that patients who might

have breast cancer get the answers

they need in as short a time as possible.

“A patient can get imaging done,

have a biopsy performed, get results,

and meet with physicians within a

24-hour turnaround,” Byrum says.

“Whatever the results, there is a sense

of relief knowing that either that they

are okay or that they have a treatment

plan in place.”

At the clinic, results and all consul-

tations needed for a treatment plan are

available to the patient by their second

appointment. Byrum adds that if the

OCTOBER 2012a PuBlicaTion For coMMuniTy Physicians

Banner MD Anderson Cancer Center patient Leaann Benzer, with her surgeon, Dr. Stephanie Byrum.

inside2 Center of Excellence3 Saving time, saving lives4 Palliative Program

5 Building a culture6 Defining ‘cutting edge’8 Meet Banner MD Anderson physicians

Undiagnosed Breast Clinic pioneers new level of care Provides rapid results — and relief — to women when they need it most

2 OCTOBER 2012 ROunDS

patient is diagnosed with cancer, they

are referred to the center’s Comprehen-

sive Breast Program.

TeaM aPProach“We [the physicians and staff members]

take a team approach; the Comprehen-

sive Breast Program has a strong team,

which is great for patients,” she says.

The Undiagnosed Breast Clinic,

which officially launched this past

April, is currently open one day a week.

Byrum says the clinic is off to a strong

start and she has ambitious hopes for

its future.

“Our goals with the Undiagnosed

Breast Clinic are to eventually have

daily operation, continue to have result

turnaround in 24 hours or less, and

ultimately serve more patients,” Byrum

says. “The quick service helps to relieve

that anxiety and provide relief. Every-

thing we do is about supporting the

patient.”

Leaann Benzer, the clinic’s first pa-

tient, says that she received same-day

results when she was tested for cancer.

Unfortunately, she was diagnosed with

early stage breast cancer and had to

undergo treatment. But, she believes

her expedited treatment helped to

relieve some of the tension and stress

of her condition.

“Nobody would choose to have

cancer, but as far as dealing with Ban-

ner MD Anderson, they were wonder-

ful,” Benzer recalls. “They were always

friendly and up-to-date… I know that

I’ve done everything I can do to fight

this disease.”

relieving anxieTyBenzer’s case exemplifies one of the

main missions of the clinic: to catch

any potential cancer in the earliest

possible stage, Byrum explains. She

adds that relieving some of that anxiety

patients may have about waiting to

find out their results is one of the

strong points of the program, too.

“To get their results quickly and,

if needed, have a treatment plan

established, lifts a weight off their

shoulders,” Byrum says.

To refer a patient to the Undiag-nosed Breast Clinic, call 480-256-3433.

A Center of Excellence

Once patients meet with a physician in the undiagnosed Breast Clinic, they are sent to the Women’s Imaging Center for appropriate testing. From diagnostic mammography and MRI to ultrasound and image-guided biopsies, this imaging center is second to none.

The center is designated as a Breast Imaging Center of Excellence by the American College of Radiology (ACR). This designation is awarded to breast imaging centers that achieve excellence in all of the ACR’s voluntary breast-imaging accreditation programs.

The accreditation certifies that Banner MD Anderson Cancer Center has achieved high practice standards in image quality, personnel qualifications, facility equipment, quality control procedures, and quality assurance programs.

Banner MD Anderson Cancer Center’s Breast Center is now fully accredited in mammography, stereotactic breast biopsy, breast ultrasound and ultrasound-guided breast biopsy. Banner MD Anderson Cancer Center is proud to be the first Banner Health facility in Arizona to acquire the Breast Imaging Center of Excellence accreditation and is proud to be among an elite group of breast imaging centers that have achieved this designation. The Breast Imaging Center of Excellence designation reflects the importance we place on providing the highest quality of care to our patients.

Refer a patient to the Women’s Imaging Center by calling 480-543-6900.

Leaann Benzer’s breast cancer was caught in the early stages thanks to Banner MD Anderson Cancer Center’s undiagnosed Breast Clinic.

BannerMDAnderson.com 3

By Brian sodoMa

A patient walks into the Suspicion

of Cancer Clinic at Banner MD

Anderson Cancer Center in

Gilbert with back pain and a doctor’s

referral. Within a few hours a malignant

tumor on his lumbar spine is diagnosed

and an appointment is made with an

oncologist to begin treatment.

If only it could always be this easy.

Dr. Nikunj Doshi, division chief of

internal medicine at Banner MD Ander-

son, knows all too well that often times

an accurate cancer diagnosis can mean

jumping from one specialist to another,

eating up precious time and bringing

added frustration to patients.

“When you’re sick the last thing you

want to do is travel to different places

and then wait for those places to com-

municate with each other,” Doshi says.

The Suspicion of Cancer Clinic works

to alleviate this by offering a multi-

disciplinary, research-driven approach

that houses numerous needed specialties

under one roof to help deliver an accurate

and timely cancer malignancy diagnosis.

Saving time saves livesSuspicion of Cancer Clinic brings faster, more accurate results

With cardiologists, pulmonologists,

endocrinologists, nephrologists, neu-

rologists, gastroenterologists, oncolo-

gists, hematologists, radiologists and

surgeons all working in one place, many

minds can weigh in on each case, help-

ing to eliminate obvious non-factors

and zero in on the real problem.

“Our goal is to minimize unnecessary

intervention and expedite the clinical di-

agnosis,” Doshi says. “We want to know

‘Is this a malignancy or just noise?’”

More complicated cases are referred

to a tumor board that meets every Tues-

day and Thursday. The group of special-

ists then comes to a consensus for either

further testing or treatment, Doshi says.

Open for one year, Doshi hopes

the Suspicion of Cancer Clinic can be

a resource for local physicians helping

their patients find an accurate cancer

diagnosis in an efficient and timely

manner. The site takes both physician

and self-referrals.

To make a referral to the suspicion of Cancer Clinic, call 480-256-3433 or go to www.bannermdanderson. com/physicians.

New clinical trials spur new treatment, growth

By sTePhanie conner

At Banner MD Anderson Cancer Center, a growing clinical trials pro-gram is helping patients today and in the future.

“Research is an integral component of our organization. In addition to seeing patients, we are a knowledge development organization,” says Lee Seabrooke, M.A., MBA, the Center’s director of research. “It’s important to align the knowledge we develop with the problems we’re trying to solve.”

The clinical trials program currently offers phase II and III drug trials. Four trials — including those for pancreatic cancer, colorectal cancer, breast can-cer and chronic lymphocytic leukemia — are actively enrolling patients. And that’s just the beginning, which is an impressive start in just one year.

“In addition, we have a growing pipeline of about 18 trials that will be offered in the near future,” Seabrooke says. Those trials will explore thera-pies for metastatic melanoma, ovarian cancer, bladder cancer and more.

“Although the research organization is small at this point, it’s in a continu-ous growth mode,” Seabrooke adds. “Over time, we expect to have a very robust enterprise.”

Banner MD Anderson Cancer Center has been officially accepted into the national Cancer Institute’s (nCI) Southwest Oncology Group (SWOG) and Gynecology Oncology Group (GOG) as an affiliate of The university of Texas MD Anderson Cancer Center in Houston, TX. The SWOG and GOG memberships represent major steps for the research program at Banner MD Anderson that will provide additional access for our patients to new and innovative therapies within nCI sponsored clinical trials.

Dr. nikunj Doshi

4 OCTOBER 2012 ROunDS

By deBra gelBarT

The Palliative Care program at

Banner MD Anderson Cancer

Center is much more than keep-

ing patients comfortable.

This specialty has only been board-

recognized as a separate discipline

since 2008. After 2012, physicians in

other disciplines who sit for the board

exam in palliative medicine will be

required to complete a fellowship in

palliative medicine specifically. “This

is not end-of-life care and it’s not

hospice,” said Kerry Tobias, D.O., who

completed her residency and is board

certified in palliative medicine and

pain management as well as directs

the Palliative Care program at Ban-

ner MD Anderson. “I don’t manage a

cancer patient’s diagnosis; I manage

the patient’s symptoms as much as

possible regardless of the reasons for

those symptoms.”

Patients suffering from significant

nausea, constipation, pain, shortness

of breath or weakness — among other

symptoms — can benefit from a pallia-

tive medicine physician’s care, said To-

bias, who completed her residency in

physical medicine and rehabilitation.

PaTienTs BeneFiTPalliative care is not just for current can-

cer patients or terminal patients, she em-

phasized. “A cancer survivor can suffer

from residual neuropathy, for example,

or fatigue,” she said. “My job is to allevi-

ate those symptoms or make it easier for

that patient to cope with them.”

Typically in the past, cancer pa-

tients in treatment and suffering side

other specialist at the cancer center. But

they must have a current or past cancer

diagnosis; carry participating health

insurance; and permit forwarding of

their medical records from their current

or previous treating physician.

“Our goal is to ensure the highest

quality of life for cancer patients un-

dergoing treatment or those who have

completed treatment and for cancer

survivors who have residual symptoms,

by optimizing pain management and

by alleviating or reducing the severity

of other symptoms,” Tobias said.

A patient’s physician (including a primary care provider) can refer a patient to the Palliative Care program by calling 480-256-3433.

effects looked to their oncologist to

address treatment of those side effects.

But palliative medicine makes it possi-

ble for the oncologist to focus solely or

primarily on treatment of the diagnosis

and on additional medical issues that

arise. The palliative medicine physi-

cian develops a regimen of treatment

modalities to reduce the severity of the

patient’s symptoms. Treatment may in-

clude medications, pain management

applications and recommendations for

low-grade aerobic exercise, Tobias said.

QualiFy For carePalliative Care program patients are

not required to be under the care of a

Banner MD Anderson oncologist or any

Palliative Program alleviates symptoms, provides comfort Banner MD Anderson Cancer Center model is not ‘end of life’ care

Kerry Tobias, D.O.

BannerMDAnderson.com 5

The past year

has been an

exciting one

— one filled with

great pride.

I always tell

people that when

you build some-

thing from the

ground up, it’s not

for the faint of

heart. It took a lot of hard work and

a bit of faith to open a brand new

cancer center. And in just our first

year, we’ve had a lot of opportunities

to celebrate.

Together, we’ve opened a beauti-

ful facility. We’ve built a culture of ex-

cellence and professionalism. We’ve

hired the very best physicians and

staff. We’ve established a compre-

hensive breast cancer program and

are developing other comprehensive

programs. We’ve recently opened

four clinical trials with 18 more in

the pipeline. We’ve established our-

selves in the community as experts

in our field, and we’ve seen more

than 3,500 patients.

And that’s just in our first year.

I’m also proud of our efforts to

integrate with The University of

Texas MD Anderson Cancer Cen-

ter in Houston. We have seamlessly

integrated our computer systems, we

communicate with their staff regu-

larly, and we communicate regularly

with our colleagues to continue our

evolution and growth.

What we have built in the past

year is a cancer center that

brings together

oncology

experts in medication therapy, ra-

diation, surgery, imaging, pharmacy,

psychology, physical therapy, nutri-

tion and more to provide superior

multidisciplinary care.

When I came here a year and

a half ago, our building was under

construction. And after just one year,

we’re exploring expansion opportuni-

ties. In fact, we have already begun

the installation of a third linear

accelerator to meet the increasing

need for radiation treatments. This is

a tremendous accomplishment for a

center as young as ours, and I believe

the best is yet to come.

Thank you for your continued support. As always, please contact me if you have any questions about Banner Md Anderson Cancer Center

or referring a patient. i can be reached at 480-256-3335.

Building a culture of excellence at Banner MD Anderson Cancer CenterBy dr. edgardo rivera, Medical direcTor

6 OCTOBER 2012 ROunDS

By Brian sodoMa

For a long time, a radiologist’s

work seemed to only be as-

sociated with imaging. But in

the past decade, advances in imaging

technology combined with other tools

have helped to create actual treatments

that are extending lives and minimiz-

ing side effects for cancer patients.

Dr. Andrew Price, an interven-

tional radiologist with Banner MD

Anderson Cancer Center, sees radio-

embolization — or “Y-90” — treat-

ment for metastatic and primary liver

cancers as the biggest game changer

in his field of late.

radioeMBolizaTionRadioembolization uses a small

catheter inserted through the groin

to deliver tiny beads loaded with the

radioactive isotope, yttrium-90, or

Y-90, directly into the feeding arteries

of a tumor. This selective approach

delivers a high dose of radiation

directly into the arteries of tumor

cells, while minimizing the impact

on surrounding normal liver tissue.

The outpatient procedure is generally

well tolerated and associated with

minimal side effects. It can often lead

to a dramatic improvement in tumor

burden, Price explained.

“It has been shown to improve

quality of life and prolong survival,

giving hope to those patients with ad-

vanced liver cancer,” Price says.

Finding Y-90’s place in a treat-

ment plan is still being investigated.

In many cases, a patient has failed

several rounds of chemotherapy

defining ‘cutting edge’

Dr. Andrew Price

BannerMDAnderson.com 7

before trying Y-90. But more evidence

is surfacing that indicates using the

treatment earlier in a program may

produce better results.

TrueBeaM linear acceleraTorRadiation oncology has also seen

significant advances through the years,

and there may be no greater example

of these strides than some of the state-

of-the-art technology found at Banner

MD Anderson Cancer Center.

Dr. Emily Grade, a radiation on-

cologist at the center, said the site’s

state-of-the-art Varian TrueBeam linear

accelerators are one of her best options

for better pinpointing treatments and

minimizing side effects when treating

cancer. The image-guided radiation

therapy (IGRT) system uses 3D and 4D

technology to give Grade the ability to

effectively locate tumors on the move.

“Tumors in the body don’t just

stay still. They can move daily by a few

millimeters or more in one direction or

another,” Grade says.

Once the tumor is effectively

tracked, the machine’s state-of-the-

art collimators allow Grade to shape

the treatment field almost perfectly to

within a millimeter of the tumor. Past

technologies, she explained, didn’t

have the contouring ability that the

newer machines have that now allow

her to be more exact with where in the

body she can deliver the treatments.

“The whole goal is to treat only the

tumor and avoid the normal tissues,”

Grade added. “As we get better technol-

ogy we can go higher with our doses.

Often, the higher the dose, the better

the cure rate.”

sTereoTacTic Body radiaTion TheraPySpecialists at Banner MD Anderson

also use Stereotactic Body Radia-

tion Therapy (SBRT), which uses a

specific coordinate system to more

exactly localize a tumor in cases like

lung, spine, brain and other can-

cers. Image-guided HDR (High-Dose

Rate) Brachytherapy is also used in a

dedicated Brachytherapy suite. This

method of treatment uses a radioac-

tive source placed in the target, such

as a breast or for a gynecologic tumor

and delivers a high dose in a short-

ened time precisely. This approach

allows some patients to receive treat-

ment for breast cancer in one week

rather than six weeks.

The multi-disciplinary team

environment also complements the

state-of-the-art technology found at

Banner MD Anderson, Grade added.

Specialists housed under one roof meet

regularly to discuss and make treat-

ment decisions for cases. This collabo-

ration also decreases travel time and

frustration for patients.

“We meet and talk about all the cases

collaboratively and this provides the best

care for patients. It’s one of the big rea-

sons I chose to come here,” Grade says.

Dr. Andrew Price

PRESORTED STD

U.S. POSTAGE

PAID

LONG BEACH, CA

PERMIT NO.1677

Introducing Banner MD Anderson Physicians

HEMATOLOGy & MEDICAL OnCOLOGy SECTIOn

Tomislav Dragovich, MD, PhD, Section ChiefDigestive tract cancers including colorectal, esophageal, stomach, pancreatic, hepatobiliary

Gorgun Akpek, MD, MHSDirector of Stem Cell Transplantation and Cellular Therapy program

Shakeela Bahadur, MDLung, colorectal, breast cancers

Mary Cianfrocca, DOBreast Cancer Program Director

Jade Homsi, MDMelanoma, sarcoma, immunotherapy

H. uwe Klueppelberg, MD, PhDMultiple myeloma and other plasma cell disorders, lymphomas, myelodysplastic syndrome, brain cancers, head and neck cancers, thoracic cancers

Edgardo Rivera, MD, Medical DirectorBreast cancer

Kerry Tobias, DOPain management, palliative medicine, physical medicine, rehabilitation

Bryan Wong, MDGenitourinary cancers

OnCOLOGy SuRGERy SECTIOn

Stephanie Byrum, MDBreast surgery

Al Chen, MDGeneral surgery

Randall Craft, MDFull spectrum of both implant-based and autologous breast reconstruction, comprehensive plastic and reconstructive options for all areas of the body

Mark Gimbel, MDMelanoma, sarcoma, cancer of the stomach, small bowel, colon and rectum, thyroid, pancreas, liver, breast, and other rare cancers

Christine Landry, MDPancreatic cancer, carcinoid tumors, thyroid cancer, adrenal tumors, parathyroid tumors, melanoma, sarcoma, gastrointestinal cancers, breast cancer, liver tumors

Matthew Schlumbrecht, MD, MPHGynecologic oncology; gestational trophoblastic disease; a variety of surgical techniques including radical abdominopelvic exploration and minimally invasive procedures.

Rob Schuster, MDGeneral surgery

Thomas Shellenberger, MD Recurrent thyroid cancers, cancers of the oral cavity, oropharynx, and larynx, salivary gland cancers, advanced skin cancers and melanoma of the head and neck, complications from treatment of head and neck cancer.

Diljeet Singh, MDProgram Director, Gynecologic

Oncology; Program Director, Cancer Prevention & Integrative Medicine

Benny Tan, MDPlastic and reconstruction surgeonBreast cancer reconstruction and most forms of cancer reconstruction

Judith K. Wolf, MD, Section ChiefGynecologic oncology

RADIATIOn OnCOLOGy SECTIOn

Matthew Callister, MD, Section ChiefGastrointestinal, skin, sarcomas, and head and neck cancers

Emily Grade, MDBreast treatment including partial breast brachytherapy, prostate brachytherapy, gynecological and thyroid cancers

Terence Roberts, MD, JDBrain, lung and prostate tumors; stereotactic radiosurgery; partial breast brachytherapy

DIAGnOSTIC IMAGInG SECTIOn

Donald Schomer, MD, Section Chief, CAQ neuroradiologyOncologic diseases of the brain, spine, head and neck

John Chang, MD, PhDAdvanced magnetic resonance and computerized tomography imaging of gastrointestinal and genitourinary systems; imaging guided biopsies

Vilert Loving, MDBreast imaging and intervention

Harvinder Maan, MD, CAQ neuroradiologyDirector of neuroradiology neuroradiology and interventional spine procedures

Rizvan Mirza, MDAbdominal and pelvic magnetic resonance imaging

Susan Passalaqua, MDDirector of nuclear Medicine and Molecular Imaging Oncologic imaging, nuclear medicine, radiology, PET/CT

Andrew Price, MD, CAQ Interventional RadiologyInterventional radiology, including percutaneous tumor ablation, chemoembolization, and radioembolization

David Russell, MD, FACPBreast imaging and intervention

CRITICAL CARE SECTIOn

Shiva Birdi, MD, Section ChiefJijo John, MDDeven S. Kothari, MDDean Prater, MDRavindra Gudavalli, MD

InTERnAL MEDICInE SECTIOn

nikunj Doshi, DO, Section ChiefInternal medicine

David Edwards, MDInternal medicine

Ronald Servi, DOPulmonary medicine

PATHOLOGy SECTIOn

Kevin McCabe, DOSection Chief

Banner MD Anderson Cancer Center physicians are highly specialized in their fields

of expertise. Below is a listing of physicians currently on our full time staff. Physicians

continue to join Banner MD Anderson, so this list will continue to evolve.

To make a referral to a physician on our staff, please call 480-256-3433. To contact a member of medical staff, call 480-256-6444 and ask for the physician to be paged.