At USC Arcadia Hospital, robotic surgery is an everyday feature of treatment for local gastric surgery patients.

When paired together, the words “robot” and “surgery” might conjure visions of the future. But robotically assisted surgery is already transforming top-notch medical care.

Sharon Shiraga, MD, an upper-gastrointestinal surgeon with �ԹϹ��� who practices at USC Arcadia Hospital, is an expert in general and minimally invasive surgeries involving the stomach, esophagus and abdominal wall.

Dr. Shiraga answers a few questions about robotic surgery’s role in the care she provides at USC-AH.

How does the robot work? How does the surgeon use it?

During the procedure, the surgeon sits at a nearby console and uses hand and foot controls to guide the robotic instruments.

A surgical robot does not operate on its own — it is completely controlled by the surgeon.

Every movement the surgeon makes is translated in real time into precise movements of tiny instruments inside the patient through small incisions. The robot provides a high-definition, magnified 3D view of the surgical area and instruments that can bend and rotate like a human wrist (and even more).

This allows the surgeon to operate with greater precision, especially in tight spaces, which can help improve accuracy, reduce tissue trauma and support a safer recovery.

Are there cases where robotic surgery is especially helpful?

Robotic surgery is especially helpful in cases where the operation requires fine dissection, delicate suturing or work in tight spaces. In general surgery, it is commonly used for complex hernia repairs (including large ventral and recurrent hernias) and foregut procedures such as hiatal hernia repair, reflux surgery and other upper abdominal operations where precision is critical.

Robotic surgery is also widely used across many other specialties. Urology uses it frequently for prostate and kidney surgery, gynecology for hysterectomy and complex pelvic surgery, and thoracic surgery for procedures in the chest.

How does the robot help to provide better treatments and outcomes?

Robotic surgery helps surgeons perform complex operations with greater precision by providing a magnified 3D view and instruments that move with wrist-like flexibility.

This can improve the surgeon’s ability to carefully dissect tissue, control bleeding and perform fine suturing — especially in tight spaces like the pelvis, upper abdomen or around critical blood vessels.

For many patients, this translates into smaller incisions, less pain, reduced blood loss, fewer wound complications and a faster recovery compared with traditional open surgery.

What robotic surgical options are available for stomach cancer?

Robotic surgery is an advanced minimally invasive option for selected patients with stomach cancer, including partial or total gastrectomy. A key part of stomach cancer surgery is removing not only the tumor, but also the surrounding lymph nodes, since gastric cancer often spreads to lymph nodes first.

The robotic platform provides magnified 3D vision and highly precise instrument control, allowing surgeons to perform a more meticulous lymph node dissection and fine-tissue separation around major blood vessels — helping improve cancer clearance and surgical margins.

For the right patient, robotic gastrectomy can also offer the benefits of minimally invasive surgery, including smaller incisions, less pain, reduced blood loss and faster recovery, while maintaining the same cancer surgery principles as open surgery.

This combination of precision and minimally invasive recovery is why robotic surgery is becoming an important option in modern stomach cancer care.

What should patients know about how robotics are advancing the field?

Patients should know that robotics is not “automatic surgery” — it is a tool fully controlled by the surgeon. As robotic technology continues to advance, surgeons can offer minimally invasive options for more complex cases that previously required large incisions.

However, not all surgeries can be performed with the robot. Experienced surgeons continuously train and stay current with the latest techniques, research and technological improvements to deliver the safest and most effective care with the safest treatment plan.

The field is evolving rapidly, and today’s robotic platforms are expanding what is possible in cancer surgery, hernia repair and many other specialties, while maintaining a strong focus on safety and long-term outcomes.

What robotic surgical services does USC-AH provide?

At USC-AH, our robotic surgery program continues to grow, and we now have two robotic systems available to serve our community. This expanded capability allows more patients to access minimally invasive surgery with less waiting, while supporting advanced procedures across general surgery, urology, gynecology and thoracic surgery.

What kind of outreach does the team do with the community?

USC-AH is committed not only to excellent patient care but also to serving as a true pillar of the community. We recently hosted a robotic surgery demonstration for local high school students, giving them a firsthand look at the technology that is transforming modern medicine.

Welcoming these students was an incredible experience. Seeing their curiosity and excitement as they interacted with the robotic platform was truly inspiring.

Opportunities like this help spark interest in science and innovation, and we are proud to play a role in inspiring the next generation of future physicians, scientists and engineers.

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At USC Verdugo Hills Hospital, robotic prostate cancer surgery improves patient outcomes.

Prostate cancer affects 1 in 8 men in the United States, and surgery can be a life-saving option. Thanks to innovations in robotic surgery, many patients can recover fully with vital nerves intact.

Rene Sotelo, MD, a urologic surgeon at USC Verdugo Hills Hospital, part of �ԹϹ���, is an internationally recognized expert in robotic procedures.

Here, he answers frequently asked questions.

What do men usually worry about most before prostate cancer surgery, and what do you wish they knew?

Most men worry about two things: urinary leakage and sexual function. Those are very real concerns, as some degree of urinary or sexual side effects can occur after surgery. However, many patients improve over time, and we have effective treatments to help with recovery.

What I wish patients knew is that the surgeon’s experience and technique play an important role in minimizing potential side effects. We plan the operation with these issues in mind, using meticulous techniques and nerve-sparing strategies when they are oncologically safe.

How do you determine if surgery is a good option for a patient with prostate cancer?

Some prostate cancer tumors grow slowly and can be safely monitored, while others require active treatment. When we think about surgery for prostate cancer, we focus on three main factors: how aggressive the cancer is, the patient’s overall health and the individual’s priorities.

For men with localized cancer and a longer life expectancy, surgery can offer excellent cancer control. At the same time, we are honest about the trade-offs. It’s important for patients to understand that any prostate cancer treatment — whether surgery, radiation or focal therapies — can affect urinary control and sexual function.

For that reason, the decision is never automatic. We balance cancer control with quality of life and choose the option that best fits the patient’s goals.

What kinds of prostate cancer treatments are available at USC-VHH?

We offer modern prostate cancer care focused on minimally invasive techniques and personalized treatments.

One of the main surgical options is robotic-assisted prostate surgery. This approach is often associated with less blood loss and faster recovery compared to traditional open surgery. The risks, including urinary incontinence and erectile dysfunction, vary depending on the patient and the extent of the disease.

For patients with localized prostate cancer, we also offer noninvasive or minimally invasive options. These include high-intensity focused ultrasound (HIFU) or external beam radiation therapy, which aim to treat cancer while minimizing damage to surrounding areas.

When patients hear ‘robotic surgery,’ what do they usually think it means — and what is the reality?

Many patients imagine a robot making decisions or operating independently, and that is not true. Robotic surgery is completely surgeon-directed.

The robot is simply a highly advanced tool that translates the surgeon’s hand movements into precise actions inside the body.

What are the steps involved with robotic surgery for prostate cancer?

We first complete a preoperative evaluation, including cardiology clearance when appropriate.

The procedure is performed under general anesthesia. We make a few small incisions and insert specialized instruments connected to a robotic system. The surgeon controls everything from a console, using a magnified three-dimensional view that allows for very precise movements.

The prostate is carefully separated from the surrounding tissues and removed. The bladder is then reconnected to the urethra and a temporary catheter is placed to allow healing.

Do robotics help better protect the patient’s nerves?

Robotic technology has significantly improved how we see and perform prostate cancer surgery. About 90% of prostate cancer surgeries in the United States include robotic assistance.

The enhanced magnification and precision allow surgeons to better identify and work around the nerves involved in urinary control and erections — structures that may be more difficult to visualize with other surgical approaches.

That said, the data show that long-term cancer control and functional outcomes still depend heavily on patient factors and surgical expertise.

Robotics improve consistency and recovery, but they do not eliminate risks. Ultimately, they give experienced surgeons better tools to perform a very delicate operation.

What can patients expect during the recovery process?

Patients are not alone in the recovery process. We actively support them before and after prostate surgery, and we track PSA levels closely to watch for signs of cancer.

Most patients are walking quickly and go home after a short hospital stay, often just one day. Urinary control may be imperfect early on, but this often improves over weeks to months with time and pelvic floor exercises.

Sexual function may take longer to recover and depends on factors such as age, baseline function, whether nerve-sparing was possible, and the surgeon’s experience and technique.

What do you tell patients who may be feeling overwhelmed and unsure about how to proceed?

Fear is natural with any surgery, and part of our job is to help patients work through those fears. I encourage patients to ask questions and focus on truly understanding their options rather than rushing into a decision. Feeling overwhelmed is normal, but our team is prepared to help turn that uncertainty into a clear, informed plan.

What are some features of the prostate cancer care at USC-VHH and Keck Medicine – Glendale?

Our team-based, multidisciplinary approach allows us to personalize treatment, use minimally invasive techniques when appropriate and focus on both cancer control and long-term quality of life. We guide patients with clear information and support them through every step of the process.

Patients also benefit from being part of the Keck Medicine health system, which provides access to highly specialized expertise.

For local patients, it’s an added advantage that this expertise is available so close to home. But we do also see patients from outside Los Angeles who choose us for our high level of care.

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A storyline on a popular TV show led Sheila Rodriguez to the USC Living-Donor Liver Program.

On Christmas Day in 2023, Sheila “Shey” Rodriguez was watching a “Grey’s Anatomy” episode that took her by surprise. In the episode, character Meredith Grey donates part of her liver to her father. “I’m watching this and I’m thinking, is this a real thing? Can people actually donate a portion of their liver?” says Sheila, 35.

To find the answer, Sheila, who works as a public safety dispatcher for the city of Placentia, opened her laptop and quickly discovered the USC Living-Donor Liver Program, part of the USC Transplant Institute, which is part of �ԹϹ���.

As she read the site, Sheila realized that the fictional character’s experience is, in fact, a real thing: Liver donations can come not only from deceased donors but also from living donors.

Reading the site further, Sheila learned that over 12,000 Americans are on the waitlist for a liver transplant, and thousands of people die waiting for a liver donation each year.

Rarity of ‘nondirected’ organ donors

While many U.S. transplant programs offer living-kidney donations, only a small number of programs, including the one at Keck Medicine, can perform living-liver donations.

Living donors are rare, but rarer still are donors like Sheila who are willing to donate their organs to a stranger (nondirected donors). Of 485 livingliver transplants performed in 2020, only 12% were nondirected, according to the Scientific Registry of Transplant Recipients.

“They’re a unique group of people who come forward out of the goodness of their hearts,” says Hyosun Han, MD, a hepatologist and medical director of the USC Living-Donor Liver Program.

A public safety dispatcher who at times gives CPR instructions to 911 callers over the phone, Sheila knew the value of providing strangers with lifesaving help.

“As a first responder, Sheila has the experience and mindset of helping others,” says Navpreet Kaur, MD, a liver transplant surgeon and surgical director of the USC Living-Donor Liver Program.

“I thought about the people on the waitlist,” says Sheila, who lives in Ontario, California. “I thought, if that were my family member and I couldn’t donate my liver to them, I’d want someone to help.”

How are you evaluated as a potential organ donor?

On that Christmas Day, Sheila decided to offer the gift of life.

After she completed an online questionnaire, an independent living donor advocate from Keck Medicine called Sheila to learn more about her interest and motivation. Once Sheila confirmed her wish to move forward, she had various blood tests as well as CT and MRI imaging.

She met with several Keck Medicine team members — including a social worker, psychiatrist, dietitian and surgeon — who evaluated Sheila’s physical and mental health.

The team also determined that Sheila would have financial and social support for the two to four weeks of typical recovery time.

As with any donor, the USC Transplant Institute team, including her hepatologist Brian Kim, MD, informed Sheila about the procedure and its potential risks. “A lot of people on our team weigh in to make sure a nondirected donor is a good candidate and has a full understanding of what they’re doing,” Dr. Kaur says.

After Sheila underwent two days of evaluations, the living-donor liver committee discussed Sheila’s case and determined she would make an excellent fit as a living-liver donor. They then moved forward with matching her to a recipient.

Compassionate post-transplant care

On June 27, 2024, the transplantation procedure at Keck Hospital of USC went successfully for both Sheila and her recipient.

After the surgery, Sheila recalls being wheeled into the recovery room and, to her delight, receiving a handwritten note from her anonymous recipient. “The card said, ‘I’m thankful for your gift, and I’m going to take care of it,’” she says.

Sheila, who had never been hospitalized before, says she greatly appreciated the Keck Medicine team’s care and attention. “My experience at Keck Medicine was wonderful,” she says. “My team really took care of me.”

“We have a very compassionate group of health care providers who care about our patients and are very proud of our outcomes for donors and recipients,” Dr. Han says. “We rely on donors like Sheila who are making a major sacrifice, so we see it as our commitment to make the process as safe and enjoyable as possible for them.”

While Sheila felt pain and discomfort for about three weeks, “everything’s been perfect since then,” she says.

Advocacy for living-liver organ donation

This past New Year’s Day, Sheila walked in the Rose Parade as part of OneLegacy Ambassadors, a group of volunteer advocates for organ, eye and tissue donation. As she spoke with other donors and recipients, Sheila was especially moved by the families who chose to donate their late children’s organs.

“Even in the midst of such heartbreak, these families chose to give hope to other families,” she says.

Now, as a OneLegacy Ambassador, Sheila continues to spread hope — and information. It still gives her pause when she encounters people who don’t realize that the liver is the only internal organ that can regenerate and achieve 100% of its function after donation.

For anyone interested in becoming a living-liver donor, Sheila offers these simple but profound words: “You can save someone’s life.”

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After Dionne Harmon, a nonsmoker and marathon runner, learned she had lung cancer, a USC Norris team used advanced tech and medicine to get her on the path to a speedy recovery.

As a nonsmoker who had completed three marathons by her mid-40s, Dionne Harmon had no reason to be worried about her health.

But in 2023, Dionne, an entertainment executive producer and president of Jesse Collins Entertainment, came across a Kim Kardashian Instagram post about getting a full-body MRI scan, noting the technology had saved some of her friends’ lives. Dionne looked into it and found other people had gotten the scan and caught diseases early.

After a few months, in early 2024, Dionne and her fiancé, Jesse, received whole-body scans. Days later, the company that offers the scans called Dionne with unsettling news: Her scan showed a mass in her lung. Dionne’s primary care doctor quickly referred her to a pulmonologist, who ordered an X-ray that confirmed the presence of a mass.

“At this point, the C word is starting to come up,” recalls Dionne, 47.

The pulmonologist then ordered a CT scan that showed the mass was sizable and active, and that it had to come out. Dionne received a referral to Graeme Rosenberg, MD, a thoracic surgeon with USC Norris Comprehensive Cancer Center, part of �ԹϹ���.

Dr. Rosenberg advised Dionne to have a biopsy to determine what the mass was, as well as surgery to remove it. He also emphasized the positive: “She had very minimal risk factors. She was a young, active nonsmoker who had a healthy lifestyle.”

The biopsy confirmed the unfortunate results. “It was definitely cancer,” Dionne says. Even so, the biopsy and the size of the tumor indicated early-stage cancer.

Quick action from medical team

Dionne remembers how quickly the Keck Medicine team acted. In just a few days, she was in surgery to remove the tumor.

To assist with her procedure, as with most of his thoracic surgeries, Dr. Rosenberg used a state-of-the-art surgical robot. With a camera and four arms that the surgeon controls, the robot allowed the team to avoid opening Dionne’s chest and instead perform a more precise surgery, shortening the recovery time from months to weeks.

During surgery, however, the surgical team learned that, behind the dominant tumor, there was a smaller tumor that hadn’t appeared on imaging. The team also found cancer in two of Dionne’s lymph nodes.

As a result, her diagnosis changed from stage IB cancer (typically confined to a tumor) to stage IIIA (spreading to other parts of the body). “This is when the whole team that takes care of lung cancer patients came together,” Dr. Rosenberg says.

At its weekly meeting, Keck Medicine’s multidisciplinary team of surgeons, oncologists, radiologists, pathologists and pulmonologists discussed Dionne’s case and treatment plan. Also, Dionne met with Jorge Nieva, MD, a USC Norris medical oncologist who informed her about stage IIIA lung cancer and the possible treatments.

Fortunately, Dr. Rosenberg had made what Dionne now calls “probably the best decision ever”: He ordered DNA testing — specifically, next-generation sequencing — on a portion of her lung that was removed. This test is performed for almost all USC Norris lung cancer patients to gain more information about the cancer.

The DNA test revealed that Dionne’s cancer had an EGFR (epidermal growth factor receptor) mutation, which is more common in younger nonsmokers with lung cancer. The EGFR mutation meant that Dionne could have a high cure rate without undergoing four months of chemotherapy and radiation therapy and instead for three years take a personalized medicine that targets the cancer.

While chemo attacks rapidly replicating cells, including but not limited to cancer, targeted drugs aim at the cancer cells directly. If chemo is a carpet bomb, targeted drugs are a heat-seeking missile.

Dionne welcomed this news — and the testing that made it possible. In her eyes, “the DNA test was lifesaving,” she says.

Targeted medicine for lung cancer patients with the EGFR mutation can improve outcomes by about 80%, Dr. Nieva notes. “The outlook for many lung cancer patients has really improved because of new technologies and advancements in surgery and in our understanding of the molecular drivers of cancer,” he says.

Hospital stay ends, care continues

Dionne’s care did not end with the surgery. She praises Dr. Rosenberg, Dr. Nieva and the rest of her Keck Medicine team for communicating with her and supporting her during her recovery.

Even when she played “Dr. Google” and found scary stuff online, Dr. Rosenberg talked her through it, Dionne recalls. “He advocated for me every step of the way.”

Dr. Rosenberg takes an engaged approach to patient recovery, he explains. “Patients want to be active in what they can do after the diagnosis, so I talk with them about nutrition, fitness, psychological health and connections with friends and family,” he says.

For months after Dionne’s surgery, he says, “We worked together really closely to get her back to doing the things she wants to do.”

One thing Dionne definitely wanted to do was run another marathon. In April 2025, about a year after her surgery, she completed the Paris marathon. “That was a really big milestone for me,” she says.

At her 18-month follow-up, all of Dionne’s scans were clear. She is now in remission, with no measurable cancer, Dr. Nieva says.

“Getting my care at Keck Medicine, having access to the most high-tech equipment and resources, having people who were always forward-thinking and not just checking the boxes — it was the best possible outcome for the worst situation,” Dionne says.

And she’s aware that, if she had not gotten that full-body MRI scan, she likely would not have learned of the cancer until many months later, after it had progressed. Stage IV lung cancer can rarely be treated with surgery, and it resists drug therapy.

While a full-body MRI scan can result in false positives and isn’t cheap, “it was definitely a blessing,” she says.

Extending the benefits to others

Now, Dionne wants to share the benefits of her experience with others.

In 2025, she formed the Lung Cancer Awareness Foundation to raise awareness that lung cancer is not just a smoker’s disease and that nonsmokers can benefit from lung scans to detect disease early.

“The earlier we find lung cancer, the better the long-term outcomes,” says Dr. Rosenberg, a foundation board member.

“It’s very easy as an adult, with life and work and family, to neglect your health,” says Dionne, noting that she’s now “less Type A” than she used to be. “It’s important that you take care of your body.”

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Jose “Gabe” Rios, 50, grew up watching his father, grandfather, aunts and uncles struggle with neurofibromatosis type 2 (NF2), a rare genetic disorder that can cause a type of noncancerous tumor called an acoustic neuroma to grow in and around the inner ears — and sometimes the brain and spinal cord.

When Gabe started to notice hearing loss at the age of 18, he knew he had inherited NF2, which causes chronic pain, dizziness, hearing loss and sometimes life-threatening complications. He also understood the serious impact the disease could have on a patient’s mental health.

“I actually felt normal, because I didn’t know any other way,” he says. “At the same time, I was in denial because I didn’t want to suffer like my family members had.”

Not ready to consider the worst-case scenarios, Gabe chalked his NF2 up to fate and continued living his life.

A condition impossible to ignore

In 2006, when Gabe was in his early 30s, the symptoms escalated.

“It wasn’t just the hearing loss,” Gabe says. “There was also the vertigo and the headaches. I knew I had to do something.”

Eventually, Gabe was diagnosed with an acoustic neuroma, a tumor that grows on the auditory nerve and which is commonly associated with NF2. When surgeons removed it in 2007, Gabe lost the rest of the hearing in his left ear.

For four years, Gabe didn’t notice much of a difference in his life. After all, he could still hear out of his right ear.

Then, in 2011, his acoustic neuroma symptoms returned. He would soon find out that an acoustic neuroma tumor was wrapped around his remaining auditory nerve.

Finding a surgeon he could trust

Gabe had selected �ԹϹ��� for treatment simply because it was covered by his insurance plan. However, Steven Giannotta, MD, a neurosurgeon with the USC Brain Tumor Center, part of USC Neurosciences and Keck Medicine, quickly won Gabe over with his expertise and pioneering work in skull base surgery. Even more importantly, he was straightforward and honest.

He told Gabe that it would be impossible to remove the acoustic neuroma without leaving him totally deaf.

Gabe explained to the doctor that he wanted to prepare first. He signed on for American Sign Language courses, completing three semesters before his symptoms became unbearable.

On December 9, 2011, he had the surgery to remove the acoustic neuroma and lost what remained of his hearing.

Gabe experienced struggles often shared by the late-deafened. Communication became a challenge, which led to increasing isolation.

He also had to find a new career. He had been a high school teacher, but without any knowledge of the Americans with Disabilities Act or options available to deaf teachers, he felt he had no choice but to leave the profession. Eventually, he found a new path: rehabilitation counseling for people with disabilities.

A new treatment becomes necessary

NF2 is a persistent, ongoing condition. As Gabe rebuilt his life, new acoustic neuroma tumors developed, and the ones that had been removed kept growing back.

In 2021, Dr. Giannotta told Gabe that he didn’t want to keep putting him through surgeries just to remove tumors that were going to return. He recommended a new approach: infusion-based treatment.

Gabe was referred to Frances Chow, MD, a neuro-oncologist with the USC Brain Tumor Center.

“She explained so much about my condition and options for treatment,” Gabe says.

Dr. Chow recommended Gabe begin regular infusions with bevacizumab, a drug that blocks new blood vessel growth that tumors need to develop.

“Since that time, my tumors have been stable,” Gabe says. “And I’ve had no side effects.”

Infusions provide a new lease on life

Initially, Gabe went in for infusion treatments every two weeks. Then every four weeks. Recently, Gabe was cleared for treatment once every six weeks.

It often helps patients on bevacizumab to eat before going home, so when Gabe arrives at the infusion center, he’s always presented with a menu. After the 30-minute infusion, he has his meal and drives home.

Between treatments, Gabe takes good care of himself.

“Many people tell me I’m lucky, and I am,” he says. “But what many people don’t see is the amount of water I make sure to drink and the amount of sleep, exercise and support I make sure to get.”

Gabe used to struggle with the toll NF2 took on him and his family. Today, he says that Dr. Chow and the success of the infusions have given him hope.

“I’m not angry at the world anymore, because there’s help for me,” Gabe says.

The biggest benefit he’s experienced? Being more present for his 12- and 13-year-old children.

“I can go to all their sports events, and I actually have the energy to cheer them on,” he says. He regularly shares with Dr. Chow photos of his recent adventures — balancing on a skateboard, working out at the gym, traveling internationally and more.

Last year, Gabe completed a doctorate in higher education leadership. Someday, he hopes to run a university.

Gabe is also interested in participating in clinical trials to help future generations of NF2 patients. After he dies, he plans to donate his brain to researchers. Even when discussing death, he maintains his sense of humor: “I’ll probably give it to �ԹϹ���, because they’re kind of good at what they do, aren’t they?”

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By 2013, Niki Kozak, a radio host and promotions director, had been living with melanoma for six years. She was first diagnosed with early-stage melanoma in 2007. The disease had brought its share of challenges to the avid outdoorswoman, but otherwise, she was thriving.

“I had a supportive husband, a young adult son launching his own successful life, an adorable little dog and a fat orange cat, a job that paid me to talk and give stuff away, and weekends on my bike with friends,” Niki says. “I was in the best shape of my life, both mentally and physically.”

Then one morning in April 2013, while hosting her morning country music show, Niki suffered a seizure on-air. She was taken to her local emergency room, which delivered a deeply troubling update: her melanoma had metastasized to her brain, lungs and soft tissues, making her a stage IV cancer patient.

Niki had lost both parents to cancer, so she was determined to get the best care possible. Niki’s husband, Frank, had been deeply impressed by the exceptional level of coordinated care he witnessed at the USC Norris Comprehensive Cancer Center, part of �ԹϹ���, when his own mother was undergoing treatment there.

For Niki and Frank, the decision on where to get treatment was easy. Niki reached out to the USC Norris Comprehensive Cancer Center. She says knowing that it is a National Cancer Institute-designated Comprehensive Cancer Center also contributed to their choice.

Their faith was well-founded. “My care team was built, coordinated and in contact with us before we even knew what treatments I was going to need,” Niki says. Her treatment regimen soon began and would take place at both Keck Hospital of USC and USC Norris Cancer Hospital.

Surgery, innovative radiotherapy and more

Niki’s treatment included two craniotomies performed by neurosurgeon Charles Liu, MD, PhD.

About a month after Niki’s first surgery, she began treatment with the USC Stereotactic Radiosurgery Center. This center, which specializes in innovative radiation oncology treatments for brain and spine tumors, is a multidisciplinary partnership of two Keck Medicine entities: USC Norris Comprehensive Cancer Center and the USC Brain Tumor Center.

Niki began undergoing stereotactic radiosurgery (SRS), which would prove foundational to her treatment. It is an exceptionally precise, targeted radiation procedure. In Niki’s case, a device called the Gamma Knife was used to deliver the SRS that would eradicate her brain tumors.

Radiation oncologist Eric Chang, MD, ultimately performed 10 rounds of stereotactic radiosurgery on Niki to eliminate a total of 37 tumors. Gabriel Zada, MD, co-director of the USC Brain Tumor Center, also oversaw Niki’s treatment.

Niki praises Dr. Chang as a pioneer for pushing her SRS treatment beyond what would be customary (to treat just a few tumors). By having more of her tumors treated with SRS, Niki was able to avoid undergoing whole-brain radiation therapy, which can pose some long-term health risks.

“If not for Dr. Chang’s desire to change the paradigm of limiting SRS’s use to ‘four lesions or fewer,’ I would be facing some lifelong consequences that often result from whole-brain radiation,” Niki says. “He pushed boundaries that are now considered new standards.”

For Niki, the SRS process involved an early morning pre-check, followed by anesthesia. Once Niki was unconscious, she would receive intracranial lidocaine shots and be fitted with a head frame. From there, an MRI would map the number and location of tumors to be targeted.

Once in the device, her head frame would be locked into place to restrict her movement. The machine then applied small beams of gamma rays to damage the DNA of the targeted cells, ultimately causing them to shrink and die.

Niki would spend anywhere from 20 minutes to three and a half hours in the machine. Fortunately, she could listen to music while undergoing treatment. The 1960s and 1970s songs she preferred kept her mood up and helped her keep track of how much treatment time remained during each session.

Niki praises her entire care team for making her experience as pleasant as possible. “A great nurse, good music and an anesthesiologist to relieve the pain of the frame placement certainly helped,” she says. “Also, every provider I came across was a great listener. It takes a special person to show proper empathy and also make you laugh, even when you have a searing headache and think you might vomit. I feel like I made some lifelong friends there.”

She adds: “I’ve spoken with many patients who have experienced radiosurgery at other institutions around the U.S., and not all seem to follow the same ‘patient comfort’ process.”

This year, Keck Medicine will also start offering SRS treatment via an even more advanced device. It is installing the newest version of the Gamma Knife device, which offers both frame-based and frameless SRS treatment, Dr. Zada says.

Niki’s care from Keck Medicine would also go on to include 22 months of immunotherapy using two different types of immunotherapy drugs, a lung lobectomy, subcutaneous lesion removal from dermatologist David Peng, MD, rheumatologic treatment for some immunotherapy side effects, and months of targeted drug therapy.

Bright future ahead

Today, Niki is back to enjoying an active lifestyle, having completed a century bicycle ride, run a marathon and hiked the Italian Alps and the Canadian Rockies.

Since there is no cure for melanoma, she continues annual follow-ups with medical oncologists, brain MRIs with radiation oncologists and dermatology checkups every five or six months.

When meeting people facing their own cancer journeys, Niki makes sure to let them know that having access to a comprehensive cancer center like USC Norris can make a huge difference — not only for the specialized care it provides, but also for the integrated approach that takes extra travel and recordkeeping off a patient’s shoulders.

“Being treated for cancer and its side effects can feel like a full-time job,” she says. “Hauling yourself from location to location while dragging along records, imaging and clinic notes to keep your ring of doctors all in the loop is exhausting. This is where my recommendation for comprehensive cancer centers comes into play. Having a team that can communicate and offer specialized care for all the varied treatments you will need is huge. Having a team ‘under one roof’ can save you so much stress and headache.”

She also advises patients to rely on their community, whether that includes their medical team, friends or family.

“If you don’t have support friends or family, ask your doctors about the nurse coordinators who are available,” she says. “You can also ask about patient advocates and support groups that the hospital offers or is aligned with. With cancer comes anxiety, even for the calmest individual. Find your people — the ones who hear you, who ‘get’ you and who make you feel like an appointment is something to look forward to.”

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At the start of 2024, Sam Riegel was thriving. His career as a voice actor and producer was flourishing, and his role-playing media company, Critical Role, was at the top of its game.  On the personal side, Sam loved traveling, food, playing Dungeons & Dragons, rooting for the Dodgers and making memories with his family.

“I was a happy, healthy father of two kids and husband to an incredible wife, just going about my life,” Sam says. “I was honestly feeling great.”

In March, however, the actor noticed that he had lost the ability to taste anything sweet. He took a COVID test, and it came back negative. Sensing something wrong, Sam was quick to call his doctor, who referred him to an otolaryngologist.

The ear, nose and throat specialist soon diagnosed him with a form of tonsil cancer known as oropharyngeal carcinoma. The news alarmed Sam, especially because he relied on his voice to support himself and his family.

In order to survive the disease while still preserving his voice, he needed to find a medical center with a team of multidisciplinary experts ready to work together on every aspect of his care.

Sam’s doctor told him that he would find the expertise and advanced specialty care he needed at �ԹϹ���. There, he was treated by Uttam Sinha, MD, a head and neck surgeon and director of the USC Head and Neck Center, part of Keck Medicine and the USC Caruso Department of Otolaryngology – Head and Neck Surgery.

Dr. Sinha wasted no time starting Sam’s treatment. In April 2024, he removed the voice actor’s tonsil, along with parts of his tongue and soft palate, performing transoral robotic surgery (TORS). Sam spent three days recovering in the hospital before going home. After surgery, he says, he lost his appetite and some weight.

Following surgery, he began 25 days of radiation therapy over six weeks overseen by radiation oncologist Adam Garsa, MD, of the USC Norris Comprehensive Cancer Center, also part of Keck Medicine.

Patients who receive radiation for cancers of the mouth and throat often experience fatigue and problems with taste and saliva production. Each week after undergoing radiation therapy, the impact of treatment would intensify as the days wore on. Like many patients, Sam felt exhausted, had trouble swallowing and eating, lost more weight and eventually “got sick of ice cream and nutrition shakes.”

While radiation therapy can be challenging, it’s highly effective. On the last day of his treatment, Sam breathed a sigh of relief and turned his focus to the next challenge: restoring his voice.

“As a voice actor, I was particularly anxious about regaining my voice and diction,” Sam explains. “My salivary glands were damaged. My mouth was constantly dry. Scar tissue was tight in my throat, and neck muscles were raw.”

Sam began working with a multidisciplinary team of nutritionists, physical therapists, speech pathologists and swallow therapists. Over the course of six months, they guided him through the recovery of his mouth and throat, helping his body relearn how to eat, swallow and speak.

“Thanks to daily vocal, jaw, neck and tongue exercises, I regained my voice,” Sam says. “After months of physical therapy, my mouth strength and flexibility improved. And about a year after radiation, my taste and saliva came back.”

Today, Sam reports that he’s recovered. He continues to express gratitude for all of the physicians and providers who cared for him. “I’m more or less back to normal thanks to the many doctors, nurses and therapists at Keck Medicine,” he says. “They offered all sorts of support, treatment, counseling, therapy, dietary supplements, pharmaceutical help and regular check-ins.”

Today, he’s relieved to no longer be thinking about cancer every day. “I wake up each day happy and healthy, without anxiety about the grim specter of mortality,” he says. “When it does come up, I’m able to laugh about my experiences and share tips with other folks going through it.”

Sam’s favorite piece of advice: rely on others. During his own experience, he made use of a particular tip often shared by the Keck Medicine team to lean on his support system.

“I invited all my friends and family members to drive me to radiation appointments,” Sam says. “I got to catch up with so many people I didn’t see on a regular basis, and it reminded me how connected we all are.”

He also has words of encouragement for other cancer patients. “There will be times — many times — when it feels like you will never get better, when you start shutting down mentally and giving up spiritually. That’s okay. It’s part of the journey. But you owe it to yourself and your loved ones to convince yourself to keep fighting. Do anything you can to battle this beast. And eventually, something will work.”

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In 2023, Wen Ning was a new dad enjoying his first year of fatherhood when he began experiencing some unusual symptoms. At first, he felt overly tired. Soon after, he began developing double vision and muscle weakness.

These symptoms took him by surprise. Until then, Wen had always lived an active and healthy lifestyle. A self-proclaimed foodie, he loved connecting with new cuisines. As a consulting health care actuary, he often traveled for work. Wen says, “I was always very physically active. My favorite hobbies include playing tennis and going on hikes.”

When symptoms first began, Wen says, “Mentally, I felt what every new dad felt: exhaustion. But ultimately, I found out it was more than just ‘new dad’ fatigue.”

As his symptoms worsened, Wen decided to see a doctor. He consulted numerous physicians who chalked his symptoms up to the rigors of new parenthood. Then he saw a neuromuscular physician who, in the beginning of 2024, diagnosed Wen with myasthenia gravis, a rare autoimmune condition that causes fatigue and muscle weakness which can impact the ocular muscles that move the eyes, causing double vision.

Further scans revealed Wen had a thymoma, an extremely rare tumor that is often associated with myasthenia gravis. A thymoma develops on the thymus gland, which is in the upper chest behind the breastbone. The thymus plays a key role in the immune system by producing T-cells as well as hormones, particularly during childhood and adolescence.

Wen’s thymoma needed to be surgically removed, but his neuromuscular specialist was not a surgeon. Luckily, he did not have to go far to find a referral.

“At the time, my one-year-old son had a best friend who lived down the street from us, and his parents were surgeons,” Wen says. Specifically, they had trained under Anthony Kim, MD, a thoracic surgeon with �ԹϹ���.

“They immediately recommended that I see Dr. Kim,” Wen says. “They had witnessed Dr. Kim in the OR as well as with patients in the clinic and emphasized that he was the best surgeon they had ever trained with. It’s rare for patients to be able to get that level of insight, and it left no doubt in my mind that Dr. Kim was the right provider for me. To this day, I’m so grateful to have made this connection.”

Wen saw Dr. Kim in April 2024 and was scheduled for surgery the following month in May at Keck Hospital of USC. A bilateral thymectomy was performed to remove the tumor and his thymus gland on both sides of his chest.

“A bilateral thymectomy is quite rare, but thankfully Dr. Kim had performed this procedure many times,” Wen explains. “The surgery required going under anesthesia and eight incisions along my rib cage, but it went very smoothly.” Wen was in surgery for five hours and remained an inpatient at Keck Hospital for three days during his recovery.

During that time, Wen says, he received strong support from Dr. Kim and his team. “Every single nurse, physician assistant and physician who I encountered as part of my treatment team at Keck Medicine supported me with patience and empathy. I only ever had positive things to say about my treatment team at Keck Medicine during my inpatient stay. The process of making appointments and asking questions of Dr. Kim was very stress-free. There were no surprises on my surgery day. Dr. Kim and his team also kept my family in the loop the entire time. They made an ordeal that should have been very scary as calm and manageable as possible.”

Recovery was gradual and painful, but Dr. Kim and his team made sure to prepare Wen for what to expect and to support him along the way. “With eight incisions on my torso and a large mass removed from my chest, I dealt with a lot of pain in the months to come,” Wen says. “Dr. Kim’s team checked in with me frequently, and I was able to reach out to them with any questions that came up, such as when an unexpected rash developed on my neck shortly after being discharged.”

He adds: “Not feeling alone during the recovery process and being prepared for what was to come, however painful, was an empowering feeling that helped my recovery. I was able to return to my all my normal physical activities, including tennis and wrangling a toddler, within three months.”

Today Wen says he is feeling much stronger. “I am completely recovered from surgery, but I continue to take maintenance medications for my myasthenia gravis. Nonetheless, both Dr. Kim and my neuromuscular specialist have confirmed that I am physically much improved compared to when they first met me. The surgery was an overwhelming success.”

Wen says he wishes he had met Dr. Kim at the start and not the middle of his journey. “I wish I had known Dr. Kim earlier. I found out in our introductory meeting that his wife is the cousin of my friend from college! We were both completely stunned. I think knowing Dr. Kim earlier would have saved me so much time and frustration in finding out the root cause of my symptoms.”

When asked what advice he would give to patients frustrated with trying to gain an accurate diagnosis, he says: “My biggest advice would be to advocate for yourself. Do not stop until you find the answers to your health questions that you’re looking for, and make sure you find the right provider team to treat you. I saw many physicians of varying specialties who all told me my mild symptoms were a result of nothing more than being a new dad. However, I kept advocating for myself over the course of a year, feeling that there must be a better explanation. Ultimately, it turned out I was correct as there was a rare tumor causing all my symptoms.”

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In the fall of 2023, musician Cynthia Ellis noticed some shaking in her mouth and lips when she tried to play the piccolo or flute. For a member of the Pacific Symphony, as well as a flute instructor and musical director of the ensemble Laguna Flutes, this was a troubling problem.

Cynthia had been experiencing temporomandibular joint issues (commonly known as TMJ) from an orthodontic retainer that didn’t fit properly. After seeing a neurologist to rule out degenerative neurological disorders like multiple sclerosis and myasthenia gravis, she sought help from numerous specialists over the next several months, including physical therapists, dentists and a chiropractor. They all offered expertise in treating musicians for TMJ, but the uncontrollable shaking progressed.

By February 2024, Cynthia’s oral tremor was so bad that she could no longer play the flute. She was experiencing profound weakness, leaving her unable to form the correct embouchure to play. “My jaw was also not moving correctly, affecting the entire musculature of my embouchure,” she adds.

“It was so frustrating to be away from my performances,” she says. Cynthia continued to research her problem, including specialists who might be able to help.

In the summer of 2024, her research led her to the USC Musician’s Neurology Clinic, part of USC Neurosciences and .

She asked her general practitioner if she should seek care at the clinic, and he gave his immediate approval. His own son was receiving treatment at USC Norris Comprehensive Cancer Center, also part of Keck Medicine, and he thought highly of the health system and its staff.

A neurologist for the music makers

Xenos Mason, MD, is a perfect fit for the USC Musician’s Neurology Clinic. As a horn player with Orchestra Nova Los Angeles (formerly the Los Angeles Doctors Symphony Orchestra), the neurologist is well-versed in the challenges that brass and woodwind players face. He is also a leading expert in movement disorders.

Music requires artistry, but also a particular type of athleticism. All musicians must develop strength, dexterity, precision of movement and endurance, plus an impressive level of breath control for brass, woodwind and voice. The USC Musician’s Neurology Clinic was developed to diagnose and treat neurological disorders that specifically affect professional, student and amateur musicians, including musician’s dystonia, nerve injuries, nerve entrapment and pain management.

To achieve optimal results, experts include not only neurologists, but also neurosurgeons, physical therapists and occupational therapists. The clinic is also an affiliate site for the Dystonia Coalition, an organization dedicated to advancing research, improving treatment therapies and finding a cure for dystonia.

When a patient like Cynthia comes in, Dr. Mason conducts a comprehensive evaluation to diagnose and understand the neurological root of their problem, whether it’s an unexplained decline in technique, loss of tone or pitch control, spasms or pain.

In Cynthia’s case, Dr. Mason identified a neurological disorder called focal dystonia, which causes sustained involuntary movements in a specific body part. The specific type that affected Cynthia’s lips and mouth is known as embouchure dystonia.

“The diagnosis was a game changer,” Cynthia says. “Dr. Mason was able to refer me to the leading physical therapists who work with embouchure problems, and their help was invaluable.”

Having developed a global network of experts in musician care over the years, Dr. Mason was also able to connect her with support groups and a nonprofit organization called The Embouchure Project, which helps musicians with all kinds of embouchure dysfunctions.

An artist reclaims control of her instrument

With Dr. Mason’s recommended supports in place, Cynthia’s recovery gradually picked up tempo.

As her muscle and ligament strength improved, she was able to start practicing again in small increments. Over time, her practice sessions grew longer and more frequent. By July 2024, she was able to go back to work part-time.

“My first performance in six months brought me to tears; I was so grateful,” Cynthia says.

Just one year later, Cynthia was back on her full schedule, only needing a few extra breaks to maintain her stamina throughout the day.

The flute player remembers how Dr. Mason and his team helped her maintain the mindset she’d need to rebuild confidence and perform again.

“They were so kind,” she says. “By telling me I’d get through this, they gave me a strong sense of hope.”

Today, Cynthia continues to practice her physical therapy exercises daily without fail. Her symptoms still come and go, but Dr. Mason says that she could eventually transition to a recovery pattern of “persistent improvement” that would lead to a full recovery.

When people ask Cynthia how she’s doing now, she simply answers, “Stronger and more positive each day.”

And to other musicians dealing with similar embouchure challenges, she advises: “Make sure you are seen by a provider experienced with working with musicians.”

To learn how musicians and medical professionals are working together to support and advance treatments for those with embouchure syndrome, visit .

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After battling hearing loss throughout her life, Claudia Gonzales became the first California patient to receive the robotically assisted procedure.

For Claudia Gonzales, answering the phone to chat with friends or clients is an unexpected and truly happy turn of events.

“This could not have happened a year ago,” says Claudia, 58, who stopped taking calls a few years ago after experiencing profound hearing loss in her right ear. Already deaf in her left ear, Claudia was forced to read voicemail transcripts and answer with texts.

That all changed in June 2024, when Claudia, a Covina resident and co-owner of an arts enrichment program for children, became the first person in California to undergo robotic cochlear implant surgery to restore hearing in her right ear.

The procedure, performed by Seiji Shibata, MD, PhD, an otolaryngologist with the USC Caruso Department of Otolaryngology – Head and Neck Surgery, part of , is not yet widely available. Keck Medicine is currently the only provider in Southern California that offers it.

But Dr. Shibata believes more cochlear implant surgeons will use robotic assistance in the future because it lowers the risk of damaging the inner ear during implantation.

For Claudia, taking the leap with this new form of surgery provided the opportunity to embrace life in a way that she had lost since losing nearly all her hearing.

Protecting the inner ear during implant surgery

Unlike hearing aids, which amplify sounds, cochlear implants convert sounds into electrical impulses that stimulate the auditory nerve, which sends signals to the brain.

The implants have two pieces, one that is surgically placed in the inner ear, or cochlea, and another that is an external sound processor fitted behind the ear.

One key to a successful surgery is to place the implant in the cochlea, a very delicate part of the inner ear, as slowly as possible. Dr. Shibata notes that surgeons who do this procedure have steady hands and are accustomed to working slowly, but even the steadiest doctors can’t move as precisely as the robot.

“We try to minimize trauma to the inner ear as much as possible when we are doing this, and I think the stability with the robot is superior,” Dr. Shibata says.

The idea, he explains, is that causing less trauma to this very sensitive part of the body should help patients develop fewer complications during recovery and may also lead to better long-term outcomes.

Cochlear implants only used to be placed in patients who were profoundly deaf, but the range of candidates has recently expanded to people who have some residual hearing in one or both ears. The procedure is relatively quick and performed on an outpatient basis and has been associated with few complications.

Dr. Shibata believes that employing the robot is an opportunity to make outcomes even better. He adds that this is particularly important for people who have some residual hearing. In those cases, minimizing trauma to the inner ear during surgery helps preserve what is left of their hearing, which gives them the best possible outcome.

Lifelong journey to restore hearing

Claudia was born deaf in her left ear, but the hearing in her right ear was strong when she was a child. As a young adult, her hearing diminished slowly in her right ear and she eventually used hearing aids that gave her the boost she needed to chat at parties, understand movies or television and participate in work meetings.

In her early 50s, however, her hearing in her right ear began a precipitous decline that, in only a couple of years, was taking a serious toll on her life. Even with the most powerful hearing aid on the market, she heard garbled speech, which made it difficult to communicate.

Like so many of the estimated 40 million American adults who experience hearing loss, Claudia began to socially withdraw because of her hearing loss. Untreated hearing loss can make communication difficult, leading to social withdrawal that can reduce mental stimulation and increase the risk of loneliness, anxiety, depression, cognitive decline and dementia.

“I had many people who depended on me — my husband, our son, my parents, my employees — and I felt like I was letting them down because I couldn’t be fully present for them,” she says.

Ultimately, with the comprehensive guidance of the USC Caruso audiology team, she sought the robotic implant procedure because she believed it would empower her to confidently run her business and look after her family.

Restored hearing after turning on cochlear implants

In Claudia’s case, Dr. Shibata was not trying to preserve any residual hearing, as she had lost all natural hearing in both ears by the time of her surgery. He still believed that using the robot would help preserve the structure of her inner ear to give her the best possible outcome.

Claudia underwent the new procedure at Keck Hospital of USC.

“It was unbelievable to me that it could be so smooth,” she says. “It was quick and painless.”

She was equally surprised that she experienced no common side effects, such as pain or dizziness, during her recovery from surgery.

She returned to Keck Medical Center of USC a few weeks after surgery to have her device turned on and immediately heard the audiologist ask, “Can you hear me?”

“I could not believe how lucky I was,” she says, noting that not all implant recipients hear or understand words right away.

Claudia began rehabilitation after surgery, as all patients do after receiving a cochlear implant, to help the brain relearn words and other common sounds. Claudia is continuing her rehab a year later, but she can now enjoy conversations in a variety of settings, listen to podcasts, run her business again and, maybe most importantly, she can answer the phone when her family needs her.

According to Dr. Shibata, more data is needed to fully understand the robot’s impact on longterm outcomes, but Claudia’s experience is a very positive first step.

Claudia is determined to get the most out of her restored hearing.

“I am so grateful for this technology and the doctors at �ԹϹ��� ,” she says. “I feel like I am getting a second chance at life, and I am taking advantage of this as much as I can.”  

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