More cancer patients seek treatment in Las Vegas
It was the diagnosis Paul Bodner never thought he would receive.
The longtime Las Vegan spent his 40-plus-year career in the health care industry, as a hospital CEO and later a health care consultant. He said he had always adhered to "a totally healthy lifestyle - eating right, exercising, (doing) all of the right things."
When he began experiencing hip pain earlier this year, he was examined by an orthopedic surgeon. In March, following a series of tests, scans and a biopsy, the doctor determined that Bodner had a type of lung cancer called adenocarcinoma that had metastasized to his hip and brain.
"This was so stunning a piece of information," said 65-year-old Bodner who, on the advice of a family friend, immediately flew to the acclaimed MD Anderson Cancer Center in Houston in search of a second opinion. Doctors there quickly confirmed the diagnosis.
The good news (if there was any to be had) was that the physicians saw no need for Bodner to remain in Texas for treatment. "They said there was nothing there they would do that would be different than (the care) I could get here at a good cancer center in Las Vegas, so go home."
He did, and immediately began investigating local treatment options, which turned out to be plentiful as there are several cancer centers in Southern Nevada. Bodner was referred by a physician friend to Comprehensive Cancer Centers of Nevada, which has 13 locations throughout the Las Vegas, Henderson, Boulder City and Pahrump.
Bodner was recently treated with the CyberKnife, a robotic radiosurgery system that targets hard-to-reach cancerous and noncancerous tumors noninvasively, by essentially painting them with high doses of radiation. Its extreme accuracy leaves the body's other healthy tissue unscathed. The multimillion-dollar machine, located at Comprehensive Cancer Centers' Summerlin Medical Center location, is the only one of its kind in Southern Nevada.
"It was remarkably without any discomfort," he recalled of the 45-minute procedure, which targeted his brain lesions. "I didn't feel a thing - not a zap, no heat, no intensity, nothing."
Bodner's physician, Dr. James Sanchez, has been with Comprehensive Cancer Centers for two decades and serves as president of the practice.
"Cancer treatment is very complex, and in this day and age it requires a multidisciplinary approach, meaning that oftentimes the medical oncologist is working with the radiation oncologist who is also working with a surgical cancer specialist," he said. "We have to work together. That's where we get the best outcomes."
Comprehensive Cancer Centers of Nevada is affiliated with the Johnsson Comprehensive Cancer Center at the University of California, Los Angeles, as well as US Oncology, one of the nation's largest cancer-care service providers. Comprehensive Cancer Centers of Nevada now has the 20,000 patients it sees annually involved in about 150 clinical trials, which Sanchez said is part of the "personalized cancer therapy" provided locally.
"We're very enthusiastic about our research program. We plan on expanding extensively in this direction," he said. "We feel that with our alliances with UCLA and US Oncology that we have a portfolio of treatments that rival any major cancer institute in the United States, and there shouldn't be any reason for people to leave (Southern Nevada for treatment)."
"I think part of the poor publicity that Las Vegas has gotten in cancer care in the past was that this care was fragmented, meaning that a doctor in one office would try to work with a doctor in a totally different office. We've taken this (process) and internalized it so that everything is occurring within our office, and that helps speed up the process. It helps improve the quality care of the patient and it improves the (treatment) outcomes."
Sanchez said Comprehensive Cancer Centers is "constantly looking to expand in the nonclinical area of research. We're also expanding in the clinical area, as well as just primary care of our cancer patients."
Although the company already has more than 450 employees, "We're constantly hiring," he said, especially "well-qualified and trained" research nurses.
"We've had significant growth in our practice at practically every location throughout the valley," he said.
By expanding offices and opening new facilities, "It requires us to bring on new employees, whether it be a receptionist at the front desk all the way down the line to a clinical nurse."
Big changes are also under way at Nevada Cancer Institute, which earlier this year was acquired by the University of California, San Diego Health System.
The center, now called UC San Diego Nevada Cancer Institute, is helmed by CEO Michael "Mickey" Goldman, founder of Insight Oncology Inc., an oncology consulting and management services company that has developed cancer centers throughout the country.
Goldman explained that by extending UCSD's presence into the state, local patients and practitioners now have access to a National Cancer Institute-designated facility, which is the university's Moores Cancer Center in La Jolla, Calif.
Also available here are "the benefits and ... academic milieu that goes on with that," he said, including clinical trials and other research as well as medical specialists. "So, you have a level of expertise and innovation that hasn't existed here in Nevada."
Because the university is monitoring the center's operations, "They have an accountability for what goes on ... not only here to the community, but they have an accountability to the regents of the University of California, so just the acquisition (of the center) sort of raised the bar (for cancer care locally)," he said. "(The regents) are pretty tough. They have very high standards, and they like to see those standards met."
In the past, much of the work at Nevada Cancer Institute's Summerlin campus was research-based. Goldman said going forward that is likely to change, since a massive amount of research and phase one clinical drug trials are already conducted at UCSD. The university, he said, "felt like they had a pretty strong research infrastructure already."
In Las Vegas, the plan is to take the results of the university's "bench research" and bring it to patients via a facility that offers "one-stop" shopping, of sorts - where nearly all of the necessary treatments and services are housed under the same roof.
"The goal here is to be collaborative with partners in the community - with physicians, hospitals and leaders in the community to help improve (caregiving)," Goldman said.
Often in cancer care, "What happens is you go to the doctor and they say, 'I want you to go over here and have this test done, and go over here and see this one,' and you have to chase your records all over the place and make appointments. It's a full-time job just being sick," he said.
"What we do is say, 'If you come to us, we have the imaging here, we have the lab here, we have all of the people for the most part that you will need to help guide your care, and we're actually going to talk about it ahead of time. We're going to get our diagnostic information, we're going to sit down and put together a plan for you that addresses not only your clinical needs, but also your personal needs' "
Goldman said plans for UC San Diego Nevada Cancer Institute include the creation of an "integrated comprehensive breast program" that may see "physicians working together in a way that they're traditionally not accustomed to." For example, following an initial diagnosis, a breast cancer patient is often first sent to consult with and be operated on by a surgeon before seeing a medical or radiation oncologist.
At UC San Diego Nevada Cancer Institute, he said, the specialists will instead gather together to discuss the patient's case, evaluate test and scan results, among others, and determine collectively the best course of treatment. "We plan that ahead of time and then we implement the plan based on what we understand would be best for the patient, so the patient can participate in the process as well."
The center plans to hire numerous additional employees - from psychologists to social workers, dietitians and mammographers to ultrasound technicians among them - in the coming months and years.
"A lot of things are developing which are not finalized. Clearly we are looking to offer new programs and services, add value to the community, improve care delivery, improve patients' satisfaction in a variety of different ways," Goldman said. "These kinds of centers aren't built overnight. It's not like you come in, you put this is place, put that in place, rev up the engine and off you go. We'll be building and developing this place for years."
Children's Specialty Center of Nevada also is growing. The pediatric cancer care center, located in Las Vegas, recently opened a second outpatient clinic in Reno.
The practice, formerly called Children's Center for Cancer and Blood Diseases of Las Vegas, was established in 2006 and features a trio of board-certified pediatric hematology/oncology providers, as well as a nurse practitioner (another full-time nurse may be hired in the future).
Children's Specialty Center is the only clinic of its kind in Southern Nevada to boast board-certified pediatric rheumatologists to service its patients, who range in age from just days old through 18 years.
"It's such a small niche of medical care overall because there are just not that many kids who get cancer," said Wendy Dahl, Children's Specialty Center's clinical administrator.
The clinic has seen more than 5,000 patients since 2007 and is equipped to treat all types of pediatric cancers (with the exception of providing bone marrow transplants, which are not performed at any medical facilities in Nevada).
Because pediatric oncology is largely research driven, most of the center's young patients are involved in research studies, the drug protocols for which direct their treatments.
"They determine the dosing of the medications and what medications they are on, the time intervals they get it and all of the different treatments that go along with the scans," Dahl said. "We dose them in a totally different way that adults are dosed, and it is much higher."
The emotional impact of cancer can be just as difficult as the actual treatment. The center has a psychologist and other support systems in place to assist children and their families.
"To watch these little kids go through it, I hear people say it is gut-wrenching but really it is heart-wrenching, but heart-growing at the same time," Dahl said, especially for the clinic's physicians and staffers. "Even though we don't make them sick, our job is to help them get better."
But the road to recovery is expensive.
"The financial part of it is incredibly costly to a family," Dahl said, "and even families that have really good insurance, it still will impact their lifestyle because of the cost of the treatment."
Cure 4 the Kids Foundation was created in 2007 as the charitable arm of Children's Specialty Center. The foundation provides funds to cover medical costs for children who are without health insurance, as well as those whose family's plans do not cover all aspects of their cancer treatment. (For donation information, visit cure4thekids.org.)
"We buy their drugs, we do their (chemotherapy) infusions, we (pay for) almost everything that they would ever be paying out of pocket for here," Dahl said. "To have the ability to do that and have these patients know that no matter what's going on with them (financially) that we'll still seem them, it's very unique."
So is the sense of acceptance and belonging that grows between patients and the staff at Children's Specialty Center.
"They just become part of the family. We love them, they love us," Dahl said. "It's because of that feeling that they're home when they're here."
Being at home in Las Vegas to receive cancer treatment has made all the difference for Bodner. He is chronicling his cancer battle on his blog, caringbridge.org/visit/paulbodner, with the hope that sharing his story with others - especially fellow cancer patients - will encourage them to "continue to be positive in their mind, and believe that there's an opportunity here for them to get well," he said. "They've got to believe that."
