Archive for June, 2009
Clarity Image Guided Radiotherapy System
Dr. Goyal is enjoying a few well deserved days off and asked me to fill in for him today to share with you an exciting new development in our radiation oncology department. We are pleased to announce that the Bienes Cancer Center is the first in South Florida to have the Resonant Medical Clarity Image Guided Radiotherapy System in our facility. I am including some wording directly from Resonant’s website:
Guiding Innovation in IGRT
Resonant Medical develops, manufactures and commercializes 3D ultrasound image-guided adaptive radiotherapy products. Our goal is to help cancer centers make significant improvements in radiation therapy planning, verification and delivery – to advance patient care.
We design high-performance products based on next-generation technologies that exceed the technical and clinical requirements of our customers while respecting the realities of operating cancer centers. Our commitment to manufacturing high-quality, safe and reliable medical equipment is demonstrated by our stringent quality system and ISO 13485 certification.
Presently, multiple aspects of our innovative technologies are being validated in real clinical settings, and we enjoy frequent collaborations with clinics and academic institutions across the continent.
Our radiation oncology physicians, Dr. Lav Goyal and Dr. Irina Grosman, plan to use this new technology initially for patients with certain types of breast cancer and certain patients with prostate cancer. Eventually they expect to be able to use this sophisticated system for many other types of cancers as they treat patients using radiation therapy.
For more information on our newest development please visit Resonant’s website.
-Bienes Cancer Center Executive Director, Maureen Mann
National Cancer Survivors Day
I am pleased to say that several bloggers have commented on how important the I CAN COPE session was to them and the importance of such support services. I thank you for the feedback and welcome future comments or observations to enhance our dialogue about the importance of support services not just during treatment but also after.
We recently hosted another support program in honor of the National Cancer Survivors Day (NCSD) on Sunday, June 7th, 2009. The Bienes Comprehensive Cancer Center at Holy Cross Hospital has maintained this tradition for more than a decade and a half with a wonderful lunch or dinner gala sprinkled with special recognition of a “Cancer Survivor” and “Caregiver of the Year” award. Lots of wonderful prizes are raffled off to the survivors and it is a lot of fun to celebrate life. This year our event was held at the Hyatt Regency Pier Sixty Six for 250 guests. Reverend Joanne Afshar, M. Div., BCC, provided the opening prayer and blessed the event as we began; this is one of new traditions since this task was always done by one of the Sisters of Mercy, Sister Margaret, who recently retired and left the State. She was missed but everyone welcomed Reverend Afshar as we have in the Cancer Center as well. I would also like to thank Mr. Earl Mogk, a longtime cancer survivor and previous “Cancer Survivor of the Year” recipient for his wonderful opening speech, which set the tone for survivorship at the event.
We celebrated life, honored those patients, who lost the battle against cancer in a moment of silence, and held our usual candle lighting ceremony for those survivors present and those who could not be present. One of our oncology nurses, Cathy Baranski, RN, OCN, underscored the ceremony with her special rendition of “Hero” followed by another special song, “Wind Beneath My Wings.” During this event there is so much sharing among survivors and their guests; some of them only see each other at this event annually but the significance of this day is so meaningful that it cannot be expressed in words. We received lots of feedback during and after the event as well as several phone calls expressing their gratitude to Holy Cross Hospital for hosting this event each year. For some survivors, this will be the extent of the emotional support that they will reach for and for others it is just the tip of the iceberg. This is one of the reasons the Cancer Center continues to offer various levels of emotional support programs and groups.
The Bienes Comprehensive Cancer Center offers several cancer support groups to meet the needs of our patients and families/caregivers. When seeking online support groups, please make sure it is from a trusted individual or organization. A couple of trusted sites are: The Breast Cancer Network Of Strength (formerly known as Y-ME National Breast Cancer Organization), which offers a men’s support line, and Cancer Care, Inc., offering a good range of free online support groups. I believe on-line support groups fulfill needs for some individuals for a variety of reasons. I still do encourage the face-to-face contact whenever possible or desired.
What are your thoughts on support groups or any other aspect of cancer support? What role has cancer support played in your cancer treatment experience?
Gail Model and BRCA 1 and 2
Greetings! I have asked one of our outstanding breast surgeons to step in and do a guest blog for me. Dr. Joseph Casey is a board certified general surgeon and a fellowship trained breast suregon who is a member of the oncology team at the Bienes Cancer Center. Here are some of his thoughts:
When we take a history from a patient we always ask if they have any awareness of a relative with breast cancer. This gives us a clue if there may be something in their genetic make-up that increases their risk of developing breast cancer.
Of course the more relatives they can think of who have had breast cancer the more concern we have that they may be carrying a harmful genetic mutation. This is especially true if we find out that those relatives were young or premenopausal when diagnosed with the disease.
There is a formula available online called the Gail model that helps put a number value on a woman’s breast cancer risk. One of the elements in the calculation has to do with the number of first degree relatives who have had breast cancer. First degree relatives would be mothers, sisters and daughters. This number is then entered into the formula along with other parameters and the program gives a percentage number of the risk. The average woman has a one in eight chance of developing breast cancer in her lifetime. This would be about a 12% risk. If the risk is calculated to be 20% or greater, it is considered high enough that the American Cancer Society recommends additional imaging such as MRI to be done.
Because the Gail model only considers first degree relatives in its formula it probably underestimates the genetic component of the risk. It only makes sense that grandmothers, aunts, and even uncles with breast cancer confer additional risk. The Gail model is therefore not perfect but at least it gives us a ballpark number to start with. Good judgment, however, is still required!
If there appears to be a number of relatives with breast cancer and they are particularly young or if the patient herself is young (under fifty) we may be dealing with specific mutations known as BRCA1 and BRCA2. These can be diagnosed with a blood test or more recently with an oral swab. But the BRCA mutations account for less than 10% of breast cancers. They are most commonly found in families with Ashkenazi Jewish backgrounds. However I personally have had African-American and Hispanic patients who have tested BRCA positive.
The BRCA testing is expensive and most insurances require formal genetic counseling before they will pay for it. If the woman is BRCA positive the lifetime risk of breast cancer is as high as 60% to 80%. There is also an increased risk for ovarian cancer, so many women in this situation will give serious consideration to both prophylactic mastectomies as well as removal of the ovaries before the cancer appears.
It’s important to remember that a negative BRCA test doesn’t mean you are not going to get breast cancer. In fact most cases of breast cancer have no identifiable risk factors including genetics. How many times have I heard a woman tell me she doesn’t need a mammogram because “it” doesn’t run in her family? No one is immune although immunity is something I would like to work on! - Joe Casey, M.D.
The Power of Healing Spirit
Last Sunday, June 7, the Cancer Center celebrated National Cancer Survivors Day. My role as representative of the Spiritual Care Department of Holy Cross Hospital allowed me to say the Invocation at our Celebration of Life program. To “invoke” means to “give voice to,” or “to bring forth,” and what a privilege it was to bring forth and celebrate the power of Healing Spirit. I would like to share with you the words of that holy moment:”In your image, O God, you created us; you looked at us and called us ‘very good.’ With thanksgiving we invite your presence among us as we come together today to Celebrate Life! We praise and bless you; we forget not all your benefits. We remember your admonition to ‘choose life, so that we may live.’ O God, we have seen courage and fortitude surface from places we knew not of; strength and resiliency that knew no bounds. In your great mercy you sustained us. Unto you we sing a new song, for you have done marvelous things!”
Now, Great Healer, out of your bountiful goodness renew us with good food to nourish our bodies, fellowship that connects ours souls, and fun to lift our spirits. As we Celebrate Life, may we together shout for joy, “Let everything that has breath, praise the Lord.”
Spirit was lively in this celebration, and I think beneficial for all (200+) in attendance. Let’s have a reunion next year!
About the Center
The Michael & Dianne Bienes Comprehensive Cancer Center in Fort Lauderdale, Florida is the Cancer Care Leader in Broward County. Dedicated to providing patients with precise diagnosis, the latest and most advanced treatment and aftercare options, we offer a multidisciplinary approach to care, a compassionate and spiritual healing environment, and an affiliation with the National Cancer Institute. We are also working together with Massachusetts General Hospital Cancer Center to provide South Florida residents with rapid access to specialized cancer care and genetics counseling.
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