Genome Research the next frontier

John Mendelsohn prepares to leave M.D. Anderson presidency but not the fightagainst cancer

The walls of John Mendelsohn's office at the University of Texas M.D. Anderson Cancer Center are crammed with celebrity photos and memories. Amid images of Henry Kissinger, Lance Armstrong and Arnold Schwarzenegger, Mendelsohn points to one of George H.W. Bush skydiving on his 75th birthday with the cancer center's emblem emblazoned on the chute.

"He and Barbara Bush have been incredibly generous with their time. They lost a child to cancer. It still brings tears to his eyes when he talks about it," Mendelsohn said. "That same illness in that same child today has a cure rate of over 70 percent. When that happened in the '60s it was very difficult to cure a child. So there's an example of the kind of progress that's been made."

During Mendelsohn's 15-year tenure as president at the world-famous institution, a lot of progress has been made in the fight against cancer. Under his leadership, Anderson has more than doubled in size, research projects and treatment options. It regularly appears atop the list of the best cancer hospitals in the United States.

In our society we tend to try to live with freedom without restriction and hope that medicine will develop a pill or an inoculation or a procedure to take care of problems. That's not only not intelligent but it's also expensive.

But Mendelsohn believes there is much more to be done — and, at 74, he's forging ahead.

After he officially retires as president on Aug. 31, he will spend six months at the Broad Institute of MIT and Harvard, where he will study the latest in research technology. "It will give me a chance to reimmerse myself and also get me out of the way of the new head of M.D. Anderson so he can take over this wonderful organization and move it forward with his imprint," Mendelsohn said.

Mendelsohn will return to Anderson in March 2012 as co-director of the Institute for Personalized Cancer Therapy at Anderson, where he will oversee research in the promising area of genomics. He also will join the James A. Baker III Institute for Public Policy at Rice University as a senior fellow in health and technology.

During an interview with CultureMap, Mendelsohn looked back at his tenure and the future of the fight against cancer. Here are some excerpts:

CultureMap: How hard is it to stick around an institution when you're not top dog anymore?

John Mendelsohn: I've worked with some fabulous people and together we've grown (the cancer center) in almost every parameter you can imagine. I think it's time for a change. I had the good fortune of being able to move into a role as co-head of our new institute of Personalized Cancer Therapy where the goal is to, over the next five years, do research taking a patient's tumor and in real time measuring the genetic aberrations in that tumor and prescribing some of the new experimental drugs designed to attack those abnormal genes. We have very good evidence this will increase response rates to new drugs.

CM: How revolutionary is this?

JM: It's pretty new in cancer. In infectious diseases, we began doing this 100 years ago. It's important to remember that in 1900, the most common cause of death was pneumonia and then tuberculosis. We developed chemical agents that were specific for the germs that cause these diseases. In cancer, the work doing research to design drugs to act on the products of genes that cause cancer began around 1980. The laboratory at University of California San Diego (which Mendelsohn co-headed) was one of of the first to postulate (the idea). So you might say I'm circling back to the kind of work I did then.

CM: Do you think we'll find a cure for cancer in your lifetime?

JM: We're going to improve the cure rates, there's no question. But will we ever eliminate cancer? No. We certainly haven't eliminated pneumonia. We're not going to get rid of germs; we're not going to get rid of cancer. Right now, if you're under 85, cancer is the most common cause of death in the country and it's the most common cause of death from a disease in the world. I think we will be able to move it down from No. 1, but we will not be able to eliminate all cancers because malfunction of genes is part of the deal. It's going to happen.

CM: How have survival rates changed?

JM: When I was born, a third of cancer patients lived five years. Today two-thirds of cancer patients live five years and the great majority of those have their disease eliminated. The number of deaths from cancer are going down, but we're a growing population and more and more people are living longer. After about age 55 or 60, the incidence of cancer goes up dramatically. We certainly have increased cases of cancer because we're living longer, but the deaths are declining in spite of that, which means we're making progress.

CM: How are we going to get the death rate of cancer down?

JM: Half of the work has to be done by developing more sophisticated treatments and doing fundamental molecular genetic research, but the other half depends on people who are healthy and who are at risk of getting cancer. We have to change their lifestyles. About 30 percent of all cancer deaths would disappear if we all quit smoking. And if we all quit smoking and stayed trim and exercised and had a balanced diet and routine checkups I believe that would account for the other 50 percent in increased cancer deaths.

CM: Looking back at the past 15 years, what are you the most proud of?

JM: We have honed this cancer center into an organization that is able to give the best evidence-based and research-driven care any cancer patient could want. We have tremendous expertise and strong research programs that are available to bring new science to the patient when standard therapy doesn't work. We work in a very collaborative way here. We're a very caring place. Even though everyone here either has cancer or is afraid to have cancer, it's a place of hope.

CM: M.D. Anderson has grown so much during your tenure. How large do you think it should be?

JM: Right now were seeing about 100,000 patients a year, 30,000 new registrations a year. We have 18,000 employees and almost 12 million square feet. The numbers are big. The growth has been driven by demand. Patients are looking for expertise. We're committed to grow. As patient care grows, we continue to grow in research, education and prevention.

The growth rate has to slow down. You get to a certain size you lose your efficiencies and you run the risk of being depersonalized. So far we've not depersonalized people. People worry about coming to M.D. Anderson because it's such a big place, but once you've settled into your breast clinic or your sarcoma clinic or your breast clinic and get to know your team, it's quite personal.

CM: Will future growth take place at the Texas Medical Center location or elsewhere?

JM: Over the past few years, we've developed regional care centers in four areas in greater Houston. That program may expand. Because this is a team approach, it's hard to duplicate that intensive collaborative environment away from the mother ship. But once the treatment plan is set up, a lot of what we do can be done without requiring the patient to come to Holcombe Boulevard.

CM: We've seen so many changes in the fight against cancer over the last 15 years. Will we see as many or more in the next 15 years?

JM: I think we'll see more. I've never seen change do anything but grow faster or blow up. I don't think we're going to blow up.

There are going to be advances in surgery. We now operate with robots and with tiny instruments so you don't have to make huge incisions and complication rates are going down. We are learning to use radiotherapy in more sophisticated ways, with imagining technology. We're learning how to harness the immune system. You don't hear much about immunotherapy. But I think in the next 15 years it is going to become much more important. We now understand the immune system well enough to begin to manipulate it. It's already an important component in fighting cancer.

CM: I noticed a photo of George Foreman on your wall.

JM: He gave us $1 million and seven dollars. Why seven? He said, "A lot of people give you a million dollars; no one has given you a million seven." And he was right. He gave it to us because we took good care of one his aunts, who was not well off. We didn't know she was related to anybody. He said, "You treat everybody the same at M.D. Anderson. I appreciate it and I want to give you a gift for that reason." That was very generous.

unspecified

A-list treatment

Luxe plastic surgery center injects River Oaks with cutting-edge techniques, posh recovery suites, secret access, and more

Photo courtesy of Nuveau PlasticSurgery + Medical Aesthetics

Nuveau's sleek River Oaks center boasts designs from CASA.

With the holiday season in full swing and many prepping for a new look for the new year, image-conscious Houstonians have a new option for cutting-edge cosmetic treatments and plastic surgery in one of Houston’s most elite neighborhoods.

Nuveau Plastic Surgery + Medical Aesthetics, a local leader in cosmetic medical procedures, has quietly opened a sleek new facility in River Oaks (3720 Westheimer Rd.). Owned and operated by renowned (and board-certified) plastic surgeon Dr. Edward Lee, the facility offers myriad reconstructive surgeries for men, women, and children, as well as beauty treatments, touch-ups, and more.

Aside from top-of-the-line technology, instrumentation, and treatments, the boutique center has personalized service and features to the tony RO crowd. A secret entrance ensures privacy for discreet clients, much like similar operations in Los Angeles and New York.

Another top-drawer feature: Tastefully appointed pre-op and post-op suites keep patients in-house, rather than having to leave posh treatment centers and head to crowded hospital rooms for recovery.

In keeping with Lee’s insistence on a medicine-first approach, anesthesia for patients is provided by Medical Anesthesia Associates, an MD-only group.

A cut above

Notably, the center places a primary focus on plastic surgery, which, for the uninitiated, has a clear distinction from cosmetic surgery. Randy Rakes, managing partner, tells CultureMap that it’s important for clients to understand the difference.

“You have to understand, you have to go through hundreds of hours of training and cases — face and the entire body — to get that board certification, and go through rigorous testing in order to meet that specification,” he says.

Why is that important? The industry, Rakes notes, is rife with practitioners such as “OBGYNs or dermatologists or people who have not really been trained in the art of plastic surgery, who take a class somewhere and learn how to do liposuction or a fat transfer — and then they're ‘experts’ in aesthetic surgery.”

That’s especially key when selecting a provider for highly invasive — and potentially serious — procedures such as facelifts, eyelid surgeries, tummy tucks, liposuction, rhinoplasty, breast lifts and augmentations, breast reconstruction, and more, Rakes adds.

In an era of Instagram beauty demands, more choosy clients are opting for streamlining facial features. To that end, Lee is one of a select few surgeons in the U.S. who regularly performs “V-Line '' surgery. The set of procedures, popularized in South Korea where Lee honed many of his skills, aim to narrow the width of the jawline and the face.

Aesthetics with an expert eye

Lee’s elegant, 5,500-square-foot center is adorned with CASA Houston designs, Italian-influenced finishes, and soothing elements evocative of a modern art museum or luxury spa. The facility houses a Visia Skin Analysis Studio and seven treatment suites aesthetic work such as Botox, microneedling, VI peels, Halo Laser Resurfacing, Moxi Non-Ablative Laser, Broad Band Light Photofacials, Coolsculpting, Emsculpt, and more.

Rakes says that his registered nurses, nurse practitioners, physician assistants, and estheticians are elite, by design, as he and Lee insist on credentials. “All of our injectors are licensed in the State of Texas,” he says. “Most places don't have that, the reason being is that they are much more highly skilled than a traditional, regular nurse injector. So they have a much higher skill set. The people who do our lasers and things of that nature have 10 to 15 years of experience, so clients know that they're getting the best possible treatment with the best possible devices — we own every medical device that's considered cutting edge in the industry.”

Facing forward

Rakes, a longtime medical industry processional with a keen eye for trends and technology, says that his clients aren’t just looking for traditional services, but new technologies and treatment, such as PRP and other regenerative therapies. “I think patients are kind of moving a little bit away from the traditional Hyaluronic fillers like Restylane and really looking for something with a more natural approach.”

His treatment teams stimulate collagen with fillers such as Radiesse, “and then we combine that with energy-based devices to even further lift the tissue and work as a synergy between using the injectable and the device, because the combination of both of those things give the patient the best possible results,” Rakes notes. Lee and Rakes also focus facial care on medical-grade skincare brands Alastin, Revision, and Elta MD.

A global scope

Aside from his board certification in plastic surgery, Lee has also trained in craniofacial and pediatric surgery. His medical mission work has taken him to Thailand, Haiti, and Cambodia, where he has performed surgeries for nonprofits such as Operation Smile and Smile Train for those in need.

Those in need of non-traditional treatments can also trust Lee, says Rakes, who points to Lee’s work in the cosmetic and plastic surgery-obsessed Korea. “Some of the Korean techniques are much more advanced than the techniques that are available here in the United States,” says Rakes. “Dr. Lee does a lot of things that other physicians here just don't do.”

Those interested should book early, Rakes advises, as the holiday and new year rush is in full swing. The center offers “pre-buying” slots where clients can reserve space and time. “We’ve been very busy,” says Rakes, noting the local celebs who’ve shared the work they’ve received there on social media. “I think people come here because they know they’re getting the very best treatment and results available.”

Nuveau Plastic Surgery + Medical Aesthetics River Oaks Houston

Photo courtesy of Nuveau PlasticSurgery + Medical Aesthetics

Nuveau's sleek River Oaks center boasts designs from CASA.

Genome Research the next frontier

John Mendelsohn prepares to leave M.D. Anderson presidency but not the fightagainst cancer

City of Houston announces boil notice updates, timeline, and important tips

Affluent Houston suburb leads region for highest holiday spending budgets in U.S.

Santa Claus comes to town for a fight in Violent Night

A-list treatment

Luxe plastic surgery center injects River Oaks with cutting-edge techniques, posh recovery suites, secret access, and more