Tuesday, November 23, 2021

11-23-2021 - About Cancer Centers and Watching Football


Sylvester Comprehensive Cancer Center in Miami

There are Cancer Centers and There are Cancer Centers

Now here’s something which might offend some of you, but I do want to get it said. It’s about what the Federal Government’s National Institutes of Health refers to as NCI (National Cancer Institute) Cancer centers. 

In our English language, any doctors who treat cancer, usually oncologists, can call their facilities cancer centers. If they feel they are treating all, or most aspects of the disease, they can tack on the word ‘comprehensive.’ Thus, ‘cancer centers’ or ‘comprehensive cancer centers’ can call themselves whatever they choose if they decide to on their own and that is what they believe they are. 

Ah, but the Federal Government’s National Institutes of Health and its National Cancer Institute see it otherwise. The NCI has established criteria which must be met if facilities are to be officially designated as Cancer Centers or ‘Comprehensive’ Cancer Centers. 

Oversimplifying a bit, these criteria require that applicants for these designations meet the NCI’s apparently high standards (or there would be more than the small number designated) for (1) cancer prevention, (2) clinical services and (3) cancer research.  Meeting all three qualifies an institution as an NCI designated Comprehensive Cancer Center while meeting them, but to a lesser extent, still qualifies an institution as an NCI designated Cancer Center. 

At present there are 71 such Centers officially so designated by the NCI. Seven are Basic Laboratory Centers at which patients are not usually treated. Fifty-one meet all three standards mentioned above and are designated as NCI Comprehensive Cancer Centers. The remaining thirteen, having met at least one of the standards mentioned above are designated as NCI Cancer Centers. 

Obviously, there is a difference between what a facility might call itself and what the National Cancer Institute considers it to be. But let’s look at this locally, specifically in Florida where many followers of this blog reside. 

There are only two NCI designated Cancer Centers in Florida, the Moffitt Comprehensive Cancer in Tampa and the Sylvester Comprehensive Cancer Center in Miami. The Moffitt Center is designated as a Comprehensive Cancer Center according to the NCI’s standards but the Sylvester Comprehensive Cancer Center, despite its so naming itself, is simply just an NCI designated Cancer Center, not meeting all three of the standards which would enable the NCI to add the word “Comprehensive” to its designation. 

There are two other major facilities in Florida which are satellites of NCI-designated facilities located in other States, both of which qualify as Comprehensive Cancer Centers in those States. They are the Mayo Clinic branch in Jacksonville, affiliated with the Mayo Clinic in Minnesota, and the Cleveland Clinic branch in Broward County which is affiliated with the Case Western Reserve University Comprehensive Cancer Center in Ohio. 

In advertisements in newspapers, magazines and on TV, Sylvester is careful to correctly limit mention of its NCI designation to “Cancer Center” but in these same ads, they always manage to mention their own self-bestowed title of “Comprehensive Cancer Center,” a designation they do not have from the NCI. This is intentionally deceptive and I find it objectionable since it could mislead patients as to Sylvester’s actual NCI designation. 

In a TV commercial frequently seen in South Florida, Dr. Stephen Nimer, Director of Sylvester’s Cancer Center, speaks of the importance of having an NCI designation as a cancer center, pointing out that Sylvester is the only one in its region so designated. He is joined by the heads of similar facilities, all in their white jackets, located at Harvard, Yale, Stanford, Johns Hopkins, Northwestern, and Rutgers Universities as well as at the Roswell Institute in Rochester, N.Y.  All of these facilities are NCI-designated Comprehensive Cancer Centers, except Sylvester, which of course manages to tack on its self-bestowed designation of 'Comprehensive’ somewhere in the commercial (Look under the word 'Sylvester’ for it). 

This is what I would refer to as a half-truth. Sylvester attempts to make its NCI designation appear to be more than it is. Becoming a Comprehensive Cancer Center does not come from being in the same TV commercial along with directors of NCI-designated Comprehensive Cancer Centers.  It has to be a designation given by the NCI.

That being said, there are many excellent oncologists and cancer treatment programs in our region, some affiliated with Sylvester and some affiliated with institutions without any NCI designation whatsoever. 

Recognizing that the research available to the nation's leading hospitals may take years to reach the local hospitals where most people seek treatment, arrangements such as the Sloan-Kettering Cancer Alliance are being formed to make this knowledge locally accessible sooner.

I might add that ten years ago, in my wife’s final illness, she was treated at Sloan-Kettering Memorial in New York for the hemotologic problems caused by years of various treatments for her cancer in Europe and elsewhere.  There, she was under the care of the staff of the very competent Dr. Nimer who headed that department in New York at that time and is now at Sylvester.

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Watching Football

Planning on watching a lot of NFL and college football on TV over Thanksgiving weekend?  Here are some tips on picking winners.  It may help you beforehand if you've seen any of the teams play before.  If not, you ought to know who the winner will be after the first quarter.

1. To win, a team has to score points. The team with the best offensive line will enable their quarterback to pass and their runners to run and they will score points and win.  A good offensive line will make mediocre passers and runners look good.  End of story!  So first, watch the play of the offensive lines. That can tell the whole story.

A tough offensive line

2. But if both teams have excellent offensive lines, it follows that they both will score a lot of points and it will be a high-scoring game, like basketball, so you have to look deeper.

3. Given equally good offensive lines, it comes down to which team has the best defense.  We know both defensive lines will be outgunned by those great offensive lines, so it comes down to how good their secondary, their pass defenders and linebackers are. The team that covers the receivers best, that intercepts passes and limits the gains of the running backs best, will win.

And that's how to watch a football game.  

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