17 things you need to know about Torrance Memorial’s cancer care
today and into the future.
Written by Michelle Abt, Brie Cadman, Colleen Farrell, Carole Jakucs, Peg
Moline, Nancy Sokoler Steiner, Laura Roe Stevens, Laura Watts
Very little about cancer can be considered positive. It’s a frightening
diagnosis and a challenging journey to recovery. Torrance Memorial Hunt
Cancer Institute is committed to providing the best cancer care in the
South Bay. And with the new alliance with Cedars-Sinai, patients will
have more access to cutting-edge technologies and clinical trials, just
for starters. In a word, the partnership is changing everything. Here
are just a few of the reasons Torrance Memorial is the first step on the
road to recovery.
1. The Hunt Cancer Center
The Hunt Cancer Center will have one focus: to serve the patient. The center will consolidate many of Torrance Memorial’s existing
cancer treatment services in the new building, due to open in December
2019. Nurse navigators, genetic counseling services, the Torrance Memorial
team of oncology experts as well as Cedar-Sinai specialists and clinical
research trials with Cedars-Sinai will move into the Center. Even the
parking (this is Los Angeles after all) has been designed with cancer
patients and their support teams in mind. “We wanted a comfortable
environment,” says Heidi Assigal, vice president of business and
operations for Torrance Memorial Health System. “The environment
will be relaxed and open—yet private and efficient—allowing
patients to feel comfortable where they really will be spending a lot
of time.” This starts with the 32 chemotherapy infusion service
areas. “They’ll be quiet, with internet and TV and plenty
of room, while still giving staff a good visual connection and helping
patients not feel shut off. I think we struck a good balance in the new
center.” The key, says Assigal, will be the care clusters—groups
of four so each nurse can focus on their group and patients can feel that
personal attention. Even the exam rooms reflect the reality of treating
cancer patients. “Some really important conversations take place
there,” she says. We tried to think of everything.”
2. Doctors Leading the Fight
David Chan, MD, leads the breast cancer clinical research for Torrance
Memorial Physician Network.
Their team is developing liquid biopsy technology that could be groundbreaking
for breast cancer detection and monitoring. Additionally, the team participates
in a number of clinical trials using novel treatment approaches for DCIS,
triple negative breast cancer, hormone receptor positive breast cancer
and HER2 positive breast cancer.
“David Chan is a rare combination of leading cancer researcher and
empathetic, patient-oriented physician,” says Heidi Assigal. Dr.
Chan, who will join several oncologists in the Hunt Cancer Center, also
literally wrote the book on breast cancer—and has authored 17 studies
on breast cancer. Good hands, indeed.
3. Partnership with Cedars-Sinai
In 2018, Torrance Memorial established a formal affiliation with Cedars-Sinai,
one of the nation’s foremost academic health systems. The goal of
this affiliation is to bring the resources and expertise of Cedars-Sinai’s
clinical specialties and programs to the South Bay. From oncology to neuroscience
to advanced medical research and clinical trials, this partnership will
expand our community’s access to the best in medical care.
In certain specialties—including all types of cancer—Cedars-Sinai
physicians will partner with Torrance Memorial physician leaders to help
our patients access the latest clinical trials, new treatments and advanced
technology.
As our relationship with Cedars-Sinai continues to grow, we fully expect
the benefits and opportunities for our patients to expand.
“At Torrance Memorial, we already have very high quality and patient
experience ratings, new facilities and equipment and a great staff,”
says CEO Craig Leach. “The addition of the Cedars-Sinai relationship
will only strengthen our foundation as the South Bay’s premier hospital
system.”
4. On-Site Genetic Counselor
Imagine learning you carry a gene mutation that puts you at higher risk
of cancer or that may explain why you developed cancer. It would potentially
impact not only your health situation but also those of your family members.
It’s not the kind of news you’d want to receive or discuss
over the phone.
That’s why the Hunt Cancer Institute has a genetic counselor on-site
to provide medical guidance and emotional support. “Genetic counseling
is a key component of multidisciplinary care for cancer,” says Mary
Wright, senior VP of the nursing office. “And this can be difficult
information for people to hear and absorb. Having someone to connect with
in person can make a big difference.”
5. Nurse Navigators
Getting a diagnosis of cancer is devastating enough. But as anyone who
has tackled cancer knows,
it’s just the beginning. The journey toward treatment can be almost
as overwhelming as the disease itself.
This is where the nurse navigator program at Torrance Memorial’s
Hunt Cancer Institute steps in. Nurse navigators guide patients along
the path to recovery by helping them make informed medical decisions,
assisting with scheduling multiple doctors’ appointments and tests,
making sure they stay on track with their treatment plans, running interference
on insurance issues and offering emotional support. All this is at no
additional charge to patients.
The ultimate success for a patient, of course, is survival. And Torrance
Memorial is uniquely equipped to lead a patient through that phase as
well. Cancer survivorship coordinator Miriam Sleven, RN, MS, OCN segues
patients as they complete treatment and move forward with their lives.
“One of my most important roles is as a coach,” Sleven says.
“I help survivors practice talking to their doctors and asking questions,
so they will get the answers they need.”
6. Tumor Board
One of Torrance Memorial’s cornerstones, the Tumor Board brings a
crucial, multidisciplinary
approach to all types of cancers. Nurse navigators, surgeons, pathologists,
oncologists, radiologists and more meet weekly to address prevention,
early detection, diagnosis, treatment plans and survivorship. All these
experts collaborate on the best treatment plan for every stage and every
possibility.
“Patients see and appreciate how comprehensive this approach is,”
says Andrew Horodner, MD, chairman of Torrance Memorial’s Tumor
Board, oncologist and hematologist with Torrance Memorial Physician Network.
“We spend as much time as needed on each case, and our team is well
coordinated and collegial. We look at everything involved, from cellular,
genetic and pathology characteristics to imaging, to ensure we provide
a personalized treatment plan for each and every patient.”
7. Cancer Clinical Trials
The oncology program at Torrance Memorial has been very active in developing
new cancer
treatments, allowing our patients to receive new technologies years before
they are available to the general public. These treatments have included
such important treatment advances like HER2 targeting antibodies and CDK4/6
targeting pills in breast cancer, EGFR targeting drugs for lung cancer,
and immune checkpoint inhibitors in melanoma, lung, kidney and bladder cancers.
“Our relationship with Cedars-Sinai will allow us to expand our clinical
trial offerings, providing the best cancer care for our patients close
to home,” said Hugo Hool, MD, director of the Hunt Cancer Institute
and oncologist/hematologist at Torrance Memorial Physician Network –
Cancer Care.
8. TrueBeam Radiation Therapy
The very word “radiation” can be terrifying. It also can be
an important treatment tool. The good news: Torrance Memorial is utilizing
the latest in radiation therapy, TrueBeam, a state-of-the-art linear accelerator
that helps zero in on tumors while sparing normal tissue.
“The TrueBeam has two great strengths: high precision and flexibility,”
notes Thyra Endicott, MD, a radiation oncologist at the Hunt Cancer Institute.
“It can be used for treating tiny tumors with very tight dose margins
and highly exact setup, and it can be used to treat broader areas if the
cancer has already spread to adjacent lymph nodes.”
Qinan Bao, the lead physicist working with TrueBeam, notes it enables better
treatment by targeting the tumor volume more precisely. As a result, it
“gives a smaller dose to the critical organs, so the patient may
experience fewer side effects.”
And because normal tissue is less likely to be damaged, higher doses of
radiation can be delivered. If a patient is a good candidate for the therapy,
a team of experts will develop the best course of treatment. “It’s
a wonderful machine,” Endicott says, “but the people behind
it are the most important variable.”
9. 3-D Breast Imaging
The battle against breast cancer continues at Torrance Memorial Medical
Center, and one of the best weapons today is 3-D mammography. “The
center has always been the leader in diagnosis and bringing cutting-edge
technology to the South Bay. 3-D mammography provides a 41% increase in
detection of invasive breast cancers, which can reduce the number of callbacks
by 15%,” according to co-clinical directors Julie Sim, MD and Sarina Pai, DO.
A conventional mammogram creates a two-dimensional image of the breast
from two X-ray images of each breast. Several studies have found 3-D mammograms
find more cancers than traditional 2-D mammograms and also reduce the
number of false positives. And a three-year analysis published by JAMA
Oncology found the benefits last over time. While 3-D imaging may soon
be the standard of care, only Torrance Memorial offers it in all four
of its breast centers.
For information on mammography or any of the other services offered at
the Polak Breast Diagnostic Center, please call 310-517-4709.
10. Bronchoscopy
Lung cancer is more common than you think, causing more deaths from cancer
than breast, prostate and colon cancer combined. While smokers have a
high risk of developing lung cancer, nonsmokers can get it too.
Diagnosing lung cancer early and finding tumors when they’re still
small can help improve patient outcomes, says John T. Abe, MD, a physician
at Torrance Memorial Physician Network. board-certified in pulmonary and
critical care medicine.
Of the different types of bronchoscopy, one of the latest is electromagnetic
navigation bronchoscopy
(ENB), says Abe. This cutting-edge diagnostic tool, can biopsy areas of
the lungs that previously could only be biopsied by performing invasive
surgery and opening a patient’s chest.
“Another important diagnostic tool we use is endobronchial ultrasound,”
Abe adds, “which allows us to sample mediastinal lymph nodes without
surgery and assists in appropriately assigning a stage to patients with
lung cancer.” In addition, a lung CT scan can find tumors early,
also without invasive surgery. “We treat patients as an interdisciplinary
team, calling on our experts in pulmonary medicine, critical care, cardiothoracic
surgery, oncology and radiation oncology to provide the best treatment
for each.”
11. Liquid Biopsies
A new type of biopsy is under investigation at Torrance Memorial, and it
may change the way we detect and treat cancer.
The new method is known as a liquid biopsy, and it is much less invasive
than a standard biopsy, which can require surgery. Instead, it analyzes
DNA or other genetic material produced from tumor cells circulating in
the blood.
In partnership with liquid biopsy companies, three clinical trials are
currently underway at the Hunt Cancer Institute. A national multicenter
feasibility trial is developing a DNA/RNA blood test to diagnose breast
cancer in its early stages. Another trial aims to better diagnose lung
cancer so patients will need fewer scans and biopsies.
Detection is just one of the hopes for liquid biopsies. A third clinical
trial is identifying specific genetic markers or mutations that can help
physicians choose the most appropriate course of care. Though all studies
are in the development phase, the promise of liquid biopsies is great,
and Torrance Memorial is at the forefront of this exciting technology.
12. Team Collaboration
Sometimes one plus one equals three. That’s what thoracic surgeon
Clark Fuller, MD, says of the partnership between Torrance Memorial and
Cedars-Sinai. “It’s a blending that truly benefits patients,”
he explains.
Take Fuller himself. A full-time faculty member at Cedars-Sinai, his current
collaboration with Torrance Memorial and Cedars-Sinai was a good model
for how the two teams could work together. His specialty is lung surgery,
which traditionally requires a large incision—but the minimally
invasive techniques he pioneered reduce both the incision and the recovery
time. Hospital stays decrease from an average of nine days to two, and
recovery times are measured in weeks not months. Only 40% of thoracic
surgery performed in the United States is minimally invasive, Fuller says,
and Cedars-Sinai is “the epicenter of that certainly in the Western
hemisphere, if not the world.”
World-class care relies on an interdisciplinary approach, bringing surgeons,
oncologists and others together to take on and defeat cancer. Torrance
Memorial, Cedars-Sinai and doctors like Fuller will take that teamwork
to new heights.
13. Cancer Support Groups
“The first thing people say [after diagnosis] is ‘Why me?’”
says Kristel Quinto, the psychosocial coordinator of oncology services
at Torrance Memorial. She’s charged with starting new groups to
support the existing women’s, men’s, head and neck, lung cancer,
breast reconstruction and mastectomy groups.
“When you’re in a peer support group, you don’t feel
so alone,” Quinto asserts. “You might still feel
overwhelmed, but there’s nothing like knowing you can talk to people
going through the same thing. The groups provide a safe environment where
everyone embraces you with love and kindness.”
Quinto says the gatherings are very positive and are led by expert facilitators—some
of whom are cancer survivors themselves—who have a special passion
for advocating and supporting the members. “Our goal as a team is
to make sure our patients and their families receive a balance of support
in achieving physical, emotional, social and spiritual wellness for better
health outcomes.” All the groups deal with a wide variety of types
of cancer. For more, search support groups at TorranceMemorial.org.
14. Teaming Up to Beat Breast Cancer
Torrance Memorial’s entire cancer care team—which includes
male and female breast cancer specialists—is committed to delivering
leading-edge breast cancer care in a warm, compassionate and supportive
environment. But some women who have breast cancer may feel more comfortable
or supported discussing certain health issues with a female health care provider.
That’s why our breast cancer patients have the option to choose female
health care providers—including a radiologist, medical oncologist,
radiation oncologist, breast cancer surgeon, plastic reconstructive surgeon
and nurse navigator—for all aspects of their breast cancer care.
“A female breast cancer patient may feel more comfortable expressing
concerns or talking about sensitive issues with a female health care provider,”
says Vanessa Dickey, MD, an oncology hematology specialist at Torrance
Memorial Physician Network. “If we can cut through that embarrassment,
it will make the patient feel more at ease and give them one less thing
to worry about.”
15. The da Vinci Xi Robot
R2-D2 in the operating room?
Well, almost. Under the watchful eye—and hands—of skilled surgeons,
major operations become
minimally invasive procedures thanks to a robot. The da Vinci Surgical
System offers surgeons increased precision compared to other types of
surgery, and patients experience less pain, decreased blood loss and shorter
recuperation time.
Torrance Memorial began using the system in 2006, and now utilizes the
newest technology available with the Xi robot to aid the skilled robotic
surgery team led by Hoa Van, RN, BSN. Robotic surgery greatly improves
the experience of cancer patients, says surgeon Ramin Mirhashemi, MD.
“We are at the cutting edge at Torrance Memorial Medical Center,
there is no doubt in my mind,” he says.
16. A Celebration of Living
“It’s a celebration of survivors and their loved ones, an acknowledgement
of the team that got them through. It’s a celebration of living,”
Miriam E. Sleven, RN, MS, OCN enthuses about National Cancer Survivors
Day at Torrance Memorial, observed annually with a dinner, a banner to
sign, a keynote speaker and doctors and patients sharing their stories.
“Dinner is served by our Luminaries and Novas, Torrance Memorial
volunteers. The keynote speakers are different every year, and range from
scientists to survivors. One year we had a survivor who shared her journey
of resilience through multiple cancers, another year we had a doctor talking
about chemobrain,” Sleven continues. “From my perspective
it’s a great uplifting and meaningful event and I know the patients,
families, staff and speakers who attend feel the same. It’s a beautiful
celebration and we invite all survivors and their loved ones to attend
this free event the first Wednesday evening in June.”
17. There’s No Place Like Home: Torrance Memorial Home Health
This award-winning department, headed by Theresa Ferry, RN, BSN, MBA, CHCA,
provides nurses
who make visits to patients’ homes to provide services such as assessments,
wound care, blood draws and infusions. They teach patients how to manage
their chronic illnesses through symptom monitoring and medication management.
They also provide rehab therapists to assist with fall prevention and
home exercise programs, social workers to help arrange for community services
and caregivers and home health aides to assist with bathing, meals and
light housekeeping. “We’re focused on a high bar for quality,”
says Ferry. “It literally starts at the top, with our CEO, Craig
Leach.”