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Mount Sinai Leaders Discuss the Future of Medicine
at the 2016 Aspen Ideas Festival
More than 570 Participants Screened Onsite
for Heart Disease Risk, and 745 for Skin Cancer: 6 Potential
Melanomas Discovered
(ASPEN, CO, July 5, 2016) The
future of medicine and health care delivery, the promise of
cancer breakthroughs, and ethical issues regarding
increasing organ donation by living donors were among the
topics explored by leaders from the Mount Sinai Health
System during the 2016 Aspen Ideas Festival held in Aspen,
Colorado. Presented by the Aspen Institute and The Atlantic,
the festival is unique in its dedication to the global
exchange of ideas.
“What excites me the most about medicine in the short term
is that we have learned about immunology and immunotherapy
and how it is affecting cancer treatments. The breakthroughs
have been remarkable,” said Kenneth L. Davis, MD, President
and CEO of the Mount Sinai Health System. “We have seen
amazing therapies, vaccines, and experimental therapies work
to put people—who were once considered hopeless cases—into
remission.”
In a panel discussion on “Cancer Breakthroughs: The Promise
of New Treatments,” Steven Burakoff, MD, Director of The
Tisch Cancer Institute at the Icahn School of Medicine at
Mount Sinai, said, “Though President Nixon’s ‘War on Cancer’
was waged 45 years ago, we have begun to make progress in
the last five to eight years. Through basic science
research, we have learned to manipulate the immune system
and use genome sequencing of cancer cells, which have
allowed us to identify mutations in the DNA that we can
target with drugs that in some cases can control the growth
of cancer.”
Describing breakthroughs in personalized cancer treatment
and patient success stories were experts from The Tisch
Cancer Institute: Joshua Brody, MD, Director of the Lymphoma
Immunotherapy Program; Matthew Galsky, MD, Director of
Genitourinary Medical Oncology; and Ross L. Cagan, PhD,
Director of the Center for Personalized Cancer Therapeutics.
As for other long-term goals in medicine, Dr. Davis said
that he “looked forward to breakthroughs in neuroscience
where drugs could be developed that could make a difference
for patients.” He said, “With the help of imaging and
genetic studies, we are now on the right track for
developing drugs to treat Alzheimer’s disease. We now know
that the changes that happen in the brain occur as early as
25 years preceding symptoms. That means that there is a
marker that will allow us to begin therapies decades before
one is symptomatic and that drugs can be targeted to slow
the progression.”
During a “Deep Dive on Drug Prices” discussion, Dr. Davis
said, “The question we have to consider is: What is the fair
return of investment of developing a drug? What troubles me
most about the high cost of new drugs to treat Hepatitis C,
for example, is that instead of pricing them as a fair
return on investment, the drug companies are pricing in
terms of how much money they are going to save the health
system down the line because we don’t have costs related to
the patient.” He noted: “What happened to the social
contract between drug companies, taxpayers, and the
consumers whereby drugs would be priced so that people could
afford them? The polio vaccine was very inexpensive. Imagine
if we had priced the polio vaccine in terms of the savings
in health care costs that would result? Many would not have
been able to afford it.”
In a discussion on “Organ Donation: How do we Share a
Precious Resource?”, Sander S. Florman, MD, Director of the
Recanati/Miller Transplantation Institute at The Mount Sinai
Hospital, said that even if we make great strides to
increase the numbers of donors, deceased organ donations are
not enough to close the gap and provide enough organs to
everyone who needs them. “We need to really focus our
efforts on increasing the number of living organ donations.
In order to do that, we should consider removing the
disincentives to living organ donation.”
Dr. Florman explained, “Current federal laws allow for
reimbursement to donors for travel- related expenses and for
lost wages: we should fund these for everyone who wants to
be a donor. We should make it easy for everyone to donate.
They literally give a piece of themselves to save another
person’s life. And if removing disincentives isn’t enough,
then we should consider appropriate incentives to increase
the number of living donors.”
In another panel on the ethics of editing the genetic code,
Eric Schadt, PhD, Director of the Icahn Institute for
Genomics and Multiscale Biology at the Icahn School of
Medicine, said that gene-editing technologies such as CRISPR
will have a dramatic impact on how we treat or even prevent
disease in the future. “By using CRISPR, it will be possible
to cure or prevent diseases by repairing the genetic
mutation at the earliest stage of development. However,
there are many ethical and safety implications that come
with the power of this technology, so we need to have a
conversation on how to control and guide the technology to
ensure it is not abused.”
At the Aspen Institute Ideas Incubator, Prabhjot Singh, MD,
PhD, Chairman of the Department of Health System Design &
Global Health at the Mount Sinai Health System, launched
ATLAS, which uses satellite data, bottom-up annotations, and
machine-learning methods to deliver insights to frontline
workers at the point of care. “We know that blind spots in
the health of communities inevitably become hotspots of
infectious or chronic conditions,” he said. “We need a new
generation of scalable, socially engaging technologies that
enable community insiders to use and share insights with
health systems.”
For the duration of the Festival, Mount Sinai Heart experts
offered complimentary blood pressure and cholesterol
screenings to more than 570 participants. Individuals were
also encouraged to download the “Circle of Health” app,
which focuses on modifiable risk factors of cardiovascular
disease that can account for 90 percent of heart attacks and
strokes (BE-WAT: Blood pressure, Exercise, Weight loss,
Alimentation, and Tobacco). The app was developed by
Valentin Fuster, MD, PhD, Director of Mount Sinai Heart and
Physician-in-Chief of The Mount Sinai Hospital.
A team of dermatologists from the Kimberly and Eric J.
Waldman Department of Dermatology at Mount Sinai also
provided 745 skin cancer screenings, identifying 6 possible
melanomas, the most deadly type of cancer, and 40 potential
non-melanoma skin cancers (basal cell and squamous cell
carcinomas).
Two years ago, Melanie Sacks from Stanford, California, was
screened by a Mount Sinai dermatologist at the 2014 Aspen
Ideas Festival. The dermatologist noticed a lentigo, a small
pigmented spot on the skin with a clearly defined edge
surrounded by normal-appearing skin, on her face and
recommended that she see her local specialist for follow-up.
“I thought it was a birth mark,” said Ms. Sacks. “It didn’t
stick up, and it didn’t look like any of the scary pictures
of melanoma.”
This year, Ms. Sacks reported that after a biopsy, her
doctor told her she had a lentigo meligna, a melanoma that
was present in the top layer of the skin. She was able to
have it removed. “It was really a scary experience that has
changed how I wear sunscreen,” said Ms. Sacks. “So, I am
grateful to Mount Sinai for finding something that could
have been potentially really devastating to me.”
After four years of similar screenings at the Aspen Ideas
Festival, Mount Sinai dermatologists have performed a total
of 2,591 screenings, identifying 36 possible cases of
melanomas. Screenings al
also detected a total of 196 potential non-melanoma skin
cancers (131 basal cell and 65 squamous cell abnormalities).
About the Mount Sinai Health System
The Mount Sinai Health System is an integrated health system
committed to providing distinguished care, conducting
transformative research, and advancing biomedical education.
Structured around seven hospital campuses and a single
medical school, the Health System has an extensive
ambulatory network and a range of inpatient and outpatient
services—from community-based facilities to tertiary and
quaternary care.
The System includes approximately 7,000 primary and
specialty care physicians; 12 joint-venture ambulatory
surgery centers; more than 140 ambulatory practices
throughout the five boroughs of New York City, Westchester,
Long Island, and Florida; and 31 affiliated community health
centers. Physicians are affiliated with the renowned Icahn
School of Medicine at Mount Sinai, which is ranked among the
highest in the nation in National Institutes of Health
funding per investigator. The Mount Sinai Hospital is ranked
as one of the nation’s top 10 hospitals in Geriatrics,
Cardiology/Heart Surgery, and Gastroenterology, and is in
the top 25 in five other specialties in the 2014-2015 “Best
Hospitals” issue of U.S. News & World Report. Mount Sinai’s
Kravis Children’s Hospital also is ranked in seven out of
ten pediatric specialties by U.S. News & World Report. The
New York Eye and Ear Infirmary of Mount Sinai is ranked 11th
nationally for Ophthalmology, while Mount Sinai Beth Israel
is ranked regionally.
For more information, visit
www.mountsinai.org
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