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Breast Surgical Oncology
Breast Surgery Care at Renown Health Renown Breast Surgery Care, located within the Center for Advanced Medicine B, is a comprehensive, fully integrated breast surgery clinic, addressing a wide spectrum of breast problems ranging from benign to cancerous: Benign breast conditions such as fibroadenoma, phyllodes tumors, and nipple discharge Breast cancer risk assessment and genetics High risk breast lesions such as atypical ductal hyperplasia, atypical lobular hyperplasia, LCIS, papillary lesions, and radial scars Advanced breast cancer surgical techniques including oncoplastic surgery for best aesthetic outcomes possible and nipple sparing mastectomies, working closely with skilled plastic reconstructive surgeons. Our highly experienced breast surgical oncologists are continuing to expand our team to better meet the evolving needs of our community and beyond. We are excited to soon be incorporating an oncology wellness team who can further support our patients with focused nutritional guidance, functional assessments for prehabilitation needs prior to surgery or medical treatments, and guidance for development of physical activity and other exercise programs, for best outcomes in cancer treatment as well as future risk reduction. The National Accreditation Program for Breast Centers (NAPBC) is a rigorous process designed to ensure high quality care for breast centers by meeting thoughtfully created standards that are constantly being reviewed and updated for ongoing improvement of patient care. We are the only NAPBC-accredited program in Northern Nevada.
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Lung Cancer Screening and Early Detection
Lung cancer is the leading cause of cancer deaths in both men and women in the U.S. The good news is the five-year survival rate increases dramatically if lung cancer is treated before spreading to other parts of the body. Julie Locken, MD, of Renown Health Imaging, explains more. What are the signs and symptoms of lung cancer? As you might expect, most lung cancer symptoms appear in the chest and can affect your breathing. Watch for signs such as: Persistent cough Constant chest pain Shortness of breath Wheezing Bloody or rust-colored phlegm Hoarseness Swelling of the neck Pain or weakness in the shoulder, arm or hand Recurring pneumonia, bronchitis or other lung infections Loss of appetite and loss of weight can also be signs of lung cancer That said, there are usually no symptoms in the early stages of lung cancer, which means getting screened can truly be a lifesaver. If you have a history of smoking, you should get screened as a precaution. What are the risk factors of lung cancer? Around 80% of lung cancer cases stem from a history of smoking tobacco. But there are other known causes, such as secondhand smoke, radon, asbestos and diesel exhaust. It’s important to do what you can to eliminate exposure to all of these to reduce your lung cancer risk. People with an immediate relative – a parent, sibling or child – diagnosed with lung cancer and people between 50 and 80 years old are also at higher risk and may need to consider screening. People who are at the highest risk are those with a history of smoking tobacco, particularly smokers who averaged one pack of cigarettes per day for 20 years or more, as well as former heavy smokers who quit in the last 15 years.
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Dr. Max Coppes to Lead William N. Pennington Institute
Max Coppes, M.D., Ph.D., MBA who has served as Nell J. Redfield Chair of Pediatrics at the University of Nevada School of Medicine (UNR Med) and pediatrician-in-chief at Renown Children’s Hospital for the last six years has announced he is stepping down to lead Renown’s Pennington Cancer Institute on a full-time basis. Dr. Coppes will continue to serve as Professor of Pediatrics and Internal Medicine at UNR Med. “Our goal is to improve the health of Nevadans and reduce the burden of cancer,” said Thomas Graf, CEO of Renown Health. “Having Dr. Coppes as our clinical leader for the William N. Pennington Cancer Institute on a full-time basis reflects Renown and UNR Med’s commitment to increase access to cancer care, foster a deeper partnership with UNR Med on clinical trials, collaborate on cancer research opportunities, and enhance medical education and post-graduate training. We are thrilled to have Dr. Max leading this important effort.” Today’s announcement comes two weeks after the William N. Pennington Foundation announced a $15.5 million gift to the Renown Health Foundation to help establish the William N. Pennington Cancer Institute at Renown. Dr. Coppes, a pediatric oncologist by training, has experience in leading large-scale, nationally recognized academic cancer center teams in both the U.S. and Canada. El Dr. Coppes llegó a Reno en 2014 procedente de la British Columbia Cancer Agency de Vancouver, donde ocupó el cargo de presidente responsable de seis centros oncológicos regionales y dos centros de investigación del cáncer. He was an attending physician at BC Children's Hospital and a professor of Medicine and Pediatrics at the University of British Columbia. During his career, Coppes served as senior vice president at Children's National Medical Center in Washington, D.C. and held positions at several prestigious facilities in the U.S. and Canada including The Hospital for Sick Children (SickKids) in Toronto, Georgetown University, The National Cancer Institute, and the Cleveland Clinic. Since 2016, Dr. Coppes has served in the joint leadership role as the Nell J. Redfield Chair of Pediatrics at UNR Med and pediatrician-in-chief at Renown Children's Hospital, a position made possible through generous philanthropic support from the Nell J. Redfield Foundation along with investments by Renown Health and the School of Medicine. In 2016, the Pennington Foundation recognized the need for enhanced care and expertise for pediatrics and donated $7.5 million to Renown Children’s Hospital to establish the William N. Pennington Fund for Advanced Pediatric Care. “As the Nell J. Redfield Chair of Pediatrics at the University of Nevada, Reno School of Medicine and pediatrician-in-chief at Renown Children's Hospital, Dr. Coppes blazed the trail for the integration of academic and clinical missions at UNR Med and Renown. He demonstrated visionary leadership and undoubtedly will bring the same energy and vision as the clinical leader for the William N. Pennington Cancer Institute,” said Melissa Piasecki, Acting Dean of UNR Med and Chief Academic Officer for Renown Health. “Dr. Max Coppes is an extraordinary leader. In the last six years he has done much to elevate the standard of pediatric care available in our community,” said Sy Johnson, President and Chief of Staff of Renown. “Thanks to Dr. Coppes’ leadership, the generosity of the Pennington gift and other donors, 100,000 area children now have access to pediatric specialists and contemporary healthcare services at the region’s only children’s hospital. Now, less than 3% of all pediatric patients and their families need to leave the area for specialty care. That is an incredible accomplishment.” Significant achievements made under Dr. Coppes leadership include: Advancing Renown Children’s Hospital, the only dedicated children’s hospital in northern Nevada, offering programs and services for families from a 100,000 square mile area, from Sacramento, CA to Salt Lake City, Utah. Renown Children’s provides the area’s only Children’s Emergency Room, Pediatric ICU (PICU), children’s imaging center and the largest neonatal ICU (NICU), a level III intensive care unit. Under his leadership, the following service lines were established; adolescent medicine, pediatric hematology/oncology, pediatric nephrology, pediatric infectious diseases, pediatric ophthalmology, pediatric orthopedic surgery, pediatric cleft and craniofacial surgery, pediatric urology, pediatric dentistry, and pediatric emergency medicine. Hiring and supporting a team of over 40 pediatric physician specialists. These clinicians provide 30,000 patient visits annually, offering an exceptional level of care to help families. As a testimony to the community’s confidence in the care provided, market share for pediatric services at Renown Health is now close to 90%. Renown’s membership in the Children’s Oncology Group (COG), which gives local pediatric cancer patients access to the world’s largest organization devoted exclusively to childhood cancer and most leading-edge treatments. Application to establish a 3-year accredited (by the Accreditation Council for Graduate Medical Education (ACGME) pediatric residency program in Reno. If approved in September 2022, Renown Health and UNR Med will start training four new pediatricians each year starting in July 2023. Successful application to the Nevada Governor's Office of Science, Innovation & Technology to receive financial support to fund a new Graduate Medical Education program. Renown Children’s Hospital was awarded $ 870,433 for the new pediatric residency program. New construction of an expanded Neonatal Intensive Care Unit (NICU) with increased capacity to 49 bassinets, an expanded Pediatric Intensive Care Unit (PICU) with increased capacity to 16 private patient and family rooms, and a new Renown Children's Hospital in-patient floor with increased capacity for 38 private patient and family rooms for a total capacity of 58 pediatric beds on Level 4 of Renown Regional Medical Center. In 2021, Dr. Coppes was named the Healthcare Hero Community Partner by Northern Nevada Business Magazine.
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Departamento destacado: Children’s Infusion Services
Help us celebrate the holiday season by sharing joy with our Children’s Infusion Services team! Thinking about blood can make any of us squeamish, and seeing it can be even more intimidating to the children in our lives. Being treated for a condition that requires blood transfusions or chemotherapy infusions is no easy feat, especially during the holiday season. This time of year, we are proud that we can offer our pediatric patients the power of proximity and excellence by having access to high level care close to home. The Children’s Infusion Services (CIS) department at Renown Children’s Hospital is committed to bringing the gift of quality care to our community’s youngest patients. Whether they are caring for a child with a blood disorder or giving expert infusion care for a child battling cancer, no team does what they do better than these expert nurses, medical assistants, intake coordinators and physicians. ‘Tis the Season to Bring Hope As the only pediatric oncology and hematology program in the region, the CIS department has a lot of responsibility on their shoulders. From inpatient chemotherapy to outpatient infusion services, this team treats a long list of pediatric blood conditions including: Pediatric cancers Anemias Immune-mediated blood disorders Sickle-cell disease Bone marrow failure syndromes Bleeding disorders “Our team provides a large variety of services from labs draws, sedations for procedures, infusions for diagnoses such as Crohn's disease, blood transfusions, as well as chemotherapy,” said Jen Torres, RN. “Our team works extremely well together. We try to go above and beyond for our patients every day. It may be something as simple as a hug to comfort a parent or a special birthday gift for a patient.” “My job allows me to work with several departments and providers when coordinating care for our littlest of patients,” added Jane Strawn, Intake Coordinator. “I assure proper authorizations are in place for the care that is needed, I communicate with our families when scheduling appointments, I organize End of Treatment Celebrations, as well as birthday shout outs and work closely with our Child Life team to help make the challenging appointment little easier.” To best serve their patients, the team thrives on being expert multitaskers. Central line care, chemotherapy administration, blood transfusions, medication management, preventative injections, lab draws, lumbar punctures, biopsies, imaging – you name it, they do it. And they do it all with the utmost focus on safety and support. “Our days have a lot of variation, as we perform a number of different services,” said Meagan Bertotti, RN. “We provide infusions for patients with chronic or acute medical conditions and chemotherapy/biotherapy treatment to patients undergoing cancer treatments. Overall, though, we work as a team to make these difficult procedures and treatments as easy as possible for the patients and families by providing engagement and support.” “While we handle a lot of chemotherapy treatments for pediatric patients, we also do other infusions and transfusions as well such as blood and platelet transfusions, enzyme replacement therapies, different types of injections such as Rabies vaccine or Synagis for high-risk babies who need that extra protection during the RSV season, and lab draws,” said Chelsea Angues, RN. “We care for patients that get their therapies from outside hospitals, but the patient lives within the Reno area. We receive orders from those outside hospitals to care for those patients, so they can still be with their families and not have to travel.” As members of the Children’s Oncology Group, a highly-regarded clinical trials group where over 90% of pediatric cancer patients across the U.S. receive treatment, teams like CIS in Renown Children’s Hospital deliver the highest standard of care. This partnership is a true testament to the devoted collaboration and relationship-building this team commits to on behalf of their patients every day. "One of the biggest accomplishments of our team is the fact that we became a member of the Children’s Oncology Group, and the Children's Infusion Center and Pediatric Oncology became one unit,” said Shelby Nolte. "Instead of being a clinic on one side and an infusion center on the other, we really came together to make it a whole unit that collaborates on almost everything.” “We've put much time into trying to understand other departments, their flow, their rationales and their processes so we can come to a solution that benefits our patients the greatest,” added Tiffany Macie, RN. “We've taken the last few years to really build our relationships with our pharmacy staff, our lab staff and our central supply resources. Our relationship building extends beyond the walls of the Renown building as well and out to the community providers too. In the past few years, we've been able to build relationships with the providers in the community where they trust they can send us their patients for treatment and lab draws. Finally, we've spent much time working on the relationships as a team. It's emotional work we do on our unit, and these families become our family. It's important to us that we take the time to be together outside of our shifts to enjoy one another and laugh!” In the compassionate realm of pediatric healthcare, CIS knows that the complexities of a cancer or blood disorder diagnosis can take an emotional toll on their patients and families. The team firmly believes that emotional support can be as important as the physical and medical support throughout each patient’s unique care journey, striving to be a comforting presence during daunting times. “The most important part of my day is collaborating with the Children's Infusion team to make life manageable for the families that are going through this experience,” added Shelby Nolte, Senior Medical Assistant. “We work as a team to make life easier for the blow of a cancer diagnosis. We are there for our families in every way. If they need a shoulder to cry on, an ear to listen or just someone to play cards with or tell a funny story too, we are there.” “One of the things our team does extremely well to help our patients and their families with new diagnoses is to simply meet them where they are,” said Tiffany Macie. “That looks different for every family and every patient. We work in an environment where can build relationships with our patients and their families. This allows us the unique opportunity to really get to know them. We learn their fears, their joys, their worries, what their family lives are like, and we learn how to best meet them where they are.” Transcending the conventional boundaries of care, the CIS department closely supports each patient, offering them solace tailored to the unique fabric of each family's life.
Read More About Department Spotlight: Children’s Infusion Services
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Research Shows Genetic Approaches to Breast Cancer Screenings Yield More Accurate Results
Clinical researchers with the Healthy Nevada Project co-author research paper with findings that emphasize the need for a comprehensive approach to breast cancer risk assessment – including a focus on genetic medicine – to help ensure that individuals at high risk are identified and supported proactively rather than reactively. Breast cancer is a leading cause of cancer death among women in the United States. According to the American Cancer Society, about 1 in 8 women will develop breast cancer and about 1 in 39 women will die from breast cancer. Breast cancer is associated with increased age, hereditary factors, obesity, and alcohol use. Since 1990, breast cancer death rates have declined progressively due to advancements in treatment and detection. In Nevada there are an estimated 2,310 new breast cancer cases a year, and genetic mutations such as in the genes BRCA1 or BRCA2 remain a top risk factor for this prevalent disease. Recognizing the urgency for progress in breast cancer research, a collaborative effort between physicians, advanced practice providers and scientists from the Healthy Nevada Project® (HNP) and Helix have unveiled groundbreaking research. This study explores how genetic screenings are a necessary supplement to traditional testing methods, together offering more accurate insights into a patient's likelihood of developing breast cancer in the future. HNP is operated by Renown Genomic Medicine and the Institute for Health Innovation and is one of the largest community-based population health studies in the country. Their team works in collaboration with Helix, a leader in precision health that delivers comprehensive genomic solutions. Together, this dynamic partnership aims to understand breast cancer risk factors and pave the way for more effective preventative measures. The combined research team studied 25,591 female HNP participants to evaluate the performance of different genetic screening approaches to identify women at high risk of breast cancer. The results of this research suggest that a combined monogenic, or single-gene, and polygenic, or multi-gene, approach to breast cancer screenings helped produce more accurate results and more closely identify study participants who have a high genetic risk of developing the disease. "Based on this research, we are advocating a shift in approach which would improve breast cancer risk assessment through a combination of effective family history ascertainment and genetic screening,” said Joseph Grzymski, PhD, principal investigator of the Healthy Nevada Project, research professor at the University of Nevada, Reno School of Medicine and co-author of the breast cancer research paper. “This tailored approach, founded on the assessment of individual genetic risk, not only intends to elevate patient well-being but also will improve efficiency and equity in healthcare." Complementing the team’s research on leveraging genetics to identify women at low genetic risk of breast cancer that could safely defer mammogram screenings by five to 10 years that was released in late 2023 in JAMA Oncology, the study suggests that incorporating genetic information can assist in personalizing breast cancer screenings and optimizing the use of screening resources. "Existing disparities persist across various facets of breast cancer screening and treatment; however, genetic screening is clearly a powerful tool to help facilitate early intervention for those at higher risk,” said Jamie Schnell Blitstein, APRN, a primary care nurse practitioner at Renown Health and co-author of the breast cancer research paper. “By placing a heightened focus on risk, we underscore the pivotal role of preventative breast cancer screening.” Despite the availability of effective methods for early screening, co-authors of this research found that 78 percent of women with a family history of breast cancer had their risk ascertained only after a breast cancer diagnosis. The findings emphasize the need for a comprehensive approach to breast cancer risk assessment – including a focus on genetic medicine – to help ensure that individuals at high risk are identified and supported proactively rather than reactively. “These findings that can profoundly impact how healthcare is delivered were only made possible by all the participants who were willing to consent to research,” said Alex Bolze, PhD from Helix and co-author of the publication. “Broad-scale collaboration projects like these between Renown Health and UNR that engage large populations where participants share both their genetic information as well as electronic health records drive advancements in preventative medicine, as well as fundamental biological research.” The research paper was officially accepted on Jan. 29, 2024, and will be published by Elsevier, Inc. on behalf of the American College of Medical Genetics and Genomics. The contents of the paper will appear in the international journal Genetics in Medicine Open. Read the full article by visiting sciencedirect.com. The Healthy Nevada Project is currently recruiting new study participants. Free to all Nevadans with a saliva sample or blood draw, participants and their referring providers receive access to whole-exome sequencing and clinical grade results that help provide insight into their unique genetic risks tied to heart disease and certain cancers. If you are interested in enrolling in the study, schedule a Virtual Consent Appointment through MyChart or contact the Renown Institute for Health Innovation at RenownIHI@renown.org or (775) 982-6914 to be connected to a Genomic Representative. About Renown Health Renown Health is the region’s largest, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. Con una fuerza laboral diversa de más de 7,000 empleados, Renown ha fomentado una cultura de excelencia, determinación e innovación de larga data. La organización se compone de un centro de urgencias, dos hospitales de cuidados agudos, un hospital infantil, un hospital de rehabilitación, un grupo médico y una red de atención de urgencias y Hometown Health, la compañía de seguros sin fines de lucro más grande de la región y de propiedad local, Hometown Health. Renown is currently enrolling participants in the largest community-based genetic population health study, the Healthy Nevada Project®. To join the Renown Health team, visit renown.org/careers. Acerca de Helix Helix es la compañía líder en genómica y vigilancia viral de la población cuyas operaciones se basan en el cuidado clínico, la investigación y el análisis de datos. Helix enables health systems, life sciences companies, payers, and government partners to accelerate the integration of genomic data into patient care and public health decision-making. Learn more at helix.com.