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Best Hospitals 2006

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BREAST CANCER
Memorial Sloan-Kettering Cancer Center

The facts are no less grim for being frequently repeated. One in nine women will be diagnosed with breast cancer in her lifetime, and nearly one in four of them will succumb to the disease. Because there are so many different forms and stages of breast cancer, knowing exactly what you’re dealing with, and how to treat it, can spell the difference between life and death. Doctors at MSK have seen just about every variation of the disease. The hospital’s 65 specialized medical oncologists, surgeons, and radiologists treat some 92,000 breast patients each year and oversee 2,800 breast-cancer surgeries annually, second only to Institut Gustave-Roussy in Paris. MSK is not only the country’s most highly regarded breast-cancer-surgery center but also a top research hub, with some 30 clinical trials going on at any time. “Clinical trial treatment is some of the best you can get,” says Dr. Marisa Weiss, founder and president of Breastcancer.org, an advocacy group. You’re getting access to the latest therapies, she says, and “you’re so closely watched.” MSK’s breast-cancer team is headed by Dr. Larry Norton, a onetime presidential appointee to the National Cancer Advisory Board of the National Cancer Institute, who has made a number of the field’s most important breakthroughs. Most recently, he created a chemotherapy regimen that gives the same doses of chemo but more often, providing breast-cancer patients better results with surprisingly fewer side effects. “He’s been an innovator for decades,” says Weiss, “in clinical and laboratory work, patient advocacy, and mentorship.” MSK is currently operating at full capacity, but in 2009, it’s scheduled to complete its sixteen-story Breast and Imaging Center, set to be the largest such facility of its kind.

RUNNER-UP: New York–Presbyterian, Beth Israel, and St. Vincent’s have highly regarded breast-cancer programs, but NYU Medical Center’s program is widely seen as second only to MSK’s.

LUNG CANCER
Memorial Sloan-Kettering Cancer Center

Sadly, a lung-cancer diagnosis is usually a death sentence: In a recent study, the disease was found to be fatal for 90 percent of men and 84 percent of women diagnosed with it. That’s why a patient’s best hope lies with a team of doctors who can attack the condition with a 360-degree approach. MSK patients have access to the city’s highest concentration of medical oncologists, surgeons, pathologists, and radiation oncologists who specialize in lung cancer, and lung cancer only. Among them: Dr. Kenneth Rosenzweig, the city’s only radiation oncologist dedicated exclusively to the disease; Dr. Mark Kris, known for his role in establishing a new treatment for lung cancer by finding new chemotherapy agents to shrink tumors prior to surgery or radiation therapy; and thoracic-surgery chief Dr. Valerie Rusch, whose department performs the largest number of lung-cancer resections in the New York area, yet still ranks among the best for length of hospital stay and mortality. Recent advances coming out of MSK’s clinical trials include Avastin (a tumor-shrinking drug tried at MSK for seven and a half months and approved by the FDA several weeks ago) and Iressa (a cancer-cell growth suppressor).

RUNNER-UP: NYU Cancer Institute’s widely cited for its strong contingent of lung-cancer specialists and its research. NYU is also the only hospital in the city to participate in the creation of the first national registry of patients considered at high risk for the disease.

COLON CANCER
Memorial Sloan-Kettering Cancer Center

How’s this for a roster of talent? Dr. David Kelsen, MSK’s chief of gastrointestinal service, oversees a team of oncologists that includes Dr. Leonard Saltz, who was the principal investigator on two new chemotherapy agents that have received FDA approval in the past six years, including Camptosar, the first new drug for colon cancer in 40 years. Saltz’s colleague Dr. Nancy Kemeny developed a revolutionary technique for delivering chemo for metastasized cases through the liver (rather than through an arm) via an implantable pump—which, along with Saltz’s drugs, has contributed to the doubling of overall survival rates for colon cancer in the past ten years. Then there’s MSK’s colorectal surgical team, headed by Dr. W. Douglas Wong, often said to be the premier rectal surgeon in New York. A giant in the field and the president-elect of the American Society of Colon and Rectal Surgeons, Wong has been a leading developer of surgical techniques, as well as the pioneer of presurgery ultrasound analysis of rectal tumors. Currently, he’s the only doctor in Manhattan experimenting with an artificial bowel prosthesis that may eliminate the need for a colostomy bag. Wong’s team also includes laparoscopic surgeon Martin Weiser and Dr. José Guillem, who’s leading a national study on the genetic indicators of colon cancer. Together, the five doctors perform some 970 surgeries a year, among the highest number in the city. “Their surgeons are well trained, incredibly current, and adept at the complicated and not-so-complicated cases. And they have terrific oncologists,” says Dr. Ronald Bleday, a leading colorectal expert at Brigham & Women’s Hospital in Boston.


A radiology suite at New York-Presbyterian, Weill Cornell.  

RUNNER-UP: New York–Presbyterian, Weill Cornell’s Jay Monahan Center for Gastrointestinal Health, named after Katie Couric’s late husband, has research and clinical excellence comparable to MSK’s. Dr. Jeffrey Milsom, the city’s most accomplished laparoscopic colorectal surgeon, and his colleague Mark Pochapin recently developed a procedure for patients with difficult-to-remove polyps that’s only offered at Weill Cornell.

PROSTATE CANCER
Memorial Sloan-Kettering Cancer Center

Anyone unfortunate enough to be given a prostate-cancer diagnosis usually finds himself facing a choice: surgery or radiation. Which route to take depends on a number of factors, from how old you are and whether you’re healthy enough to handle an invasive procedure to how far the disease has advanced and how willing you are to risk loss of sexual function. While a number of programs feature a star surgeon or radiation team, MSK’s urology department is said to be the most well-rounded program overall. On the diagnostic front, there’s Joe Torre’s oncologist, Howard Scher, a self-proclaimed “tiebreaker” on radiation-versus-surgery who specializes in customizing treatment plans. The surgical team, led by Dr. Peter Scardino, performs a total of 750 radical prostatectomies per year, making it one of the busiest programs in the country. Scardino was among the earliest doctors to refine a technique invented by Johns Hopkins prostate legend Patrick Walsh, which helped raised the percentage of men able to maintain sexual function from near zero at one point to 50 to 70. And in 1997, Scardino performed the first nerve graft on a radical prostatectomy patient—now a regularly offered service at MSK—successfully replacing the erectile nerve with a nerve from another part of the body. MSK is also home to Dr. Michael Zelefsky, who just published the largest study to date of an external-beam radiation-therapy technique that many prostate doctors are hailing as the wave of the future. It uses something called intensity-modulated-radiation therapy (IMRT) to deliver concentrated pinpoint beams to the prostate. The idea is to treat the disease while minimizing sexual, urinary, and other side effects. Although the rate of erectile dysfunction in the men studied was still 49 percent, all patients retained urinary continence, and the technique proved effective in removing the cancer in 67 to 89 percent of the cases studied.

RUNNER-UP: New York–Presbyterian, Columbia University Medical Center also has a program for IMRT as well as a genitourinary oncology team headed by Dr. Daniel P. Petrylak, who recently discovered that chemotherapy may work on some severe prostate cancers. It also has a Center for Holistic Urology, which has had promising results with betulonic acid, a compound found in birch trees.

GIVING BIRTH
New York–Presbyterian Hospital, Weill Cornell

Bringing Junior into the world, happily, isn’t usually a life-and-death situation. But if things go wrong, the best place to be is New York–Presbyterian, Weill Cornell. Cornell is one of just eight institutions in New York City with a Level 4 (the highest rating) neonatal intensive-care unit (NICU) and one of just two hospitals in the city with an extracorporeal membrane oxygenator (ECMO), essentially an infant heart-lung machine, said to be the state-of-the-art technology in emergency neonatal care. Of the 50 OB/GYNs on staff at Cornell, ten are high-risk specialists, and they get a lot of practice, delivering more high-risk babies than any other hospital in New York. Last year, the team delivered approximately 4,800 children, 50 percent of whom fell into the high-risk category. Led by Dr. Frank Chervenak, Cornell doctors are also research forerunners. Dr. Robin Kalish, director of clinical maternal fetal medicine, has identified genetic markers that can help identify patients who may be at risk for preterm labor in multiple births. “Cornell has a very strong maternal-fetal medicine unit,” says Dr. Mehmet Genç, an internal-fetal-medicine specialist at Brigham and Women’s Hospital in Boston, one of the most highly thought-of OB/GYN hospitals in the country. “It’s one thing to have a single famous doctor, but you really have to have a group with expertise. That’s what makes the difference at Cornell.” Cornell’s eleven labor-and-delivery suites are spacious and attractive and outfitted with modern birthing beds. Recovery takes place in one of the 50 shared or 11 private rooms, including three suites. Cornell’s uptown sibling, Columbia, which also has a Level 4 NICU and ECMO device, also excels in the high-risk category—19 out of 31 OB/GYNs are high-risk experts (though they split their time between Columbia and New York–Presbyterian’s Allen Pavilion in Inwood). Located in the newly constructed Morgan Stanley Children’s Hospital, Columbia’s NICU is part of a unique, comprehensive high-risk-pregnancy program. Specially trained obstetricians and pediatric subspecialists (in neonatology, cardiology, cardiac surgery, genetics, orthopedics, urology, neurology, neurosurgery, pediatric surgery, and other disciplines) can manage the care of a high-risk pregnant woman, all under one roof, from the earliest stages of pregnancy through the birth of her child and beyond.

RUNNER-UP: Mount Sinai has a Level 4 NICU, and highly respected labor and delivery practices.


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