By Chauncey Mabe
Portrait by Scott McIntyre
Haitian immigrant women in Miami have among the highest incidence of cervical cancer in the U.S. For cultural reasons, Haitian women generally avoid pelvic examinations, says Dr. Stephen Nimer, director of the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine. As a result, they miss out on Pap smears, the best way to prevent the disease.
UM responded to this public health crisis not by trying to convince Haitian women to visit gynecologists and submit to pelvic exams but by sending Creole-speaking community health care workers into the neighborhood to test women for the HPV virus that can cause cervical cancer.
“We have one of the most diverse communities in the world here in South Florida,” Nimer says. “Prevention is not one-size-fits-all. You must deliver your message in a way that is culturally sensitive and culturally compatible so that people will lose weight or stop smoking or not engage in risky behavior. Everything is colored through the lens of community diversity.”
That cultural sensitivity is emblematic of the commitment to patient care Nimer has brought to Miami in the five years since he was recruited from Memorial Sloan Kettering Cancer Center in New York by Donna Shalala, former president of UM. In New York, Nimer was a renowned leukemia researcher who often treated celebrities such as playwright Susan Sontag, actor Gene Wilder, journalist Jonathan Alter, and soccer player and reality TV star Ethan Zohn.
“In New York, I had the opportunity to take care of some amazing people,” says Nimer, who discusses celebrity patients only when pressed, and then only those who have spoken publicly about their treatment. “Some of them were famous, some were not. It’s a privilege to take care of anybody.”
That quality of humility was probably not on Shalala’s list of must-have qualities when she recruited Nimer. She wanted a doctor and researcher who could guide the Sylvester Comprehensive Cancer Center to the highest ranks, including the coveted National Cancer Institute designation.
“NCI designation is important in so many ways,” Nimer says. “It would bring in federal dollars, it would help us attract better faculty and it would help with philanthropy. There are certain grants you can’t even apply for unless you are an NCI-designated cancer center. A study by the Washington Economics Group predicts NCI designation will be worth $1.2 billion to South Florida.”
Since coming to UM, Nimer has hired more than 100 cancer doctors and researchers, many of them from places like Johns Hopkins and Harvard. He has helped boost philanthropy from $9.9 million a year to $21.2 million a year. The number of patients the UM center sees has also doubled since his arrival, from 3,500 in 2012 to 7,000 in 2017.
Nimer also joined directors from the Moffitt Cancer Center in Tampa (currently Florida’s only NCI-designated cancer center) and the University of Florida Health Cancer Center to meet with Gov. Rick Scott, an effort that won $60 million in state money each year—divided among the three hospitals over a five-year period—to help achieve NCI designation.
“It’s a bit like turning in a 1,500-page income tax return,” says Nimer with a smile, noting that UM will be ready to apply for NCI designation in about a year and a half. “NCI designation is all about the research. That’s what they will judge us on. The dollars the NCI will give us will support the various core research facilities we have.”
In an era of great progress in cancer research and treatment, the internet has been a boon to cancer researchers, too. In the past, Nimer says, a scientific paper would take four to six months to reach publication. Now, it appears online as soon as it is accepted by a journal. “There is much more communication than there used to be,” he says. “The internet has really changed the way we do science.”
In Nimer’s field—leukemia and related blood cancers—stem cell research, immunotherapy and epigenetics promise exciting breakthroughs with new therapies and drugs.
“The treatments are working better and better,” Nimer says. “But the goal of curing cancer remains pretty elusive. So it’s probably not going to be one approach; it’s probably going to take more than one therapy to cure most cancers.”
At UM, Nimer’s emphasis on patient care means a multidisciplinary approach. A single lung cancer patient, for example, may be treated by a team that includes a surgeon, medical oncologist, radiation therapist and nurse navigator to help with appointments and other patient details.
“Some people think an academic hospital means you are going to be taken care of by a medical student,” Nimer says. “The reality is you have expertise far beyond your own physician.”
If Nimer had it made in New York—and he agrees he did—he is fully committed to life in his new city. Since moving to Miami, for example, Nimer has taken up serious cycling, putting in as much as 100 miles each weekend. He is, he says, in the best shape he’s been since college.
“When recruiting new faculty, I tell them this is a young, up-and-coming city,” Nimer says. “Our center is a young, up-and-coming center. You can get in on the ground floor. I think Miami is going to be one of the three great American cities of the future. And this is going to be one of the great cancer centers in the U.S.”
Originally appeared in the Summer 2017 Issue.