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COOK’s Medical Care Company Medical Equipment & Supplies Large Retail Showroom • Homecare Services Professional Supplies 283-5238 • 1-888-283-4321 R. 785 Wyoming Ave., Kingston, PA 18704 We Care. book of lists 2003 This Year’s edition marks the ninth installment of the region’s most sought-after and extensive source of business news and market information. Additional copies can be purchased for $ 13 95 , or subscribe to the Northeast Pennsylvania Business Journal ($28 for 12 issues) and receive the Book of Lists FREE. Call the 570-207-9001 or 877-584-3561 extension 5420. Corporate rate discounts available for volume orders. Focus on oncology care: By Beth W. Orenstein An estimated two million people will be diagnosed with cancer this year, according to the National Institutes of Health (NIH). But thanks to advances in screenings and treatments, the news won’t be as devastating or life-threatening as it once was, especially for those diagnosed with breast and other solid cancers. Here’s a look at some of the advances in cancer care that are available from hospitals and imaging facilities that serve northeast Pennsylvania: ■ Sentinel node biopsy Women with breast cancer have a new, less invasive option for detecting its spread.The procedure, called sentinel node biopsy, enables doctors to check for cancer while sparing unaffected lymph nodes. Not having to remove unaffected lymph nodes is significant, says Lee B. Riley, M.D., Ph.D., director of the cancer center at St. Luke’s Hospital and Health Network based in Fountain Hill, because, for many women, removing nodes in the armpit area disrupts the natural movement of lymph in the body. Lymph, which contains lymphocytes, a type of white blood cell, plays an important part in the immune system. Disruption of lymph can cause a disorder known as lymphedema, which causes swelling, limited movement and discomfort and increased risk of infection. During sentinel node biopsy, Riley says, a harmless dye is injected around the breast tumor.The dye is absorbed into the lymphatic system, highlighting the pathways through which tumor cells travel before lodging themselves in the sentinel lymph nodes. During the biopsy, two to four sentinel nodes are removed and examined to see if they have been affected by cancer. Studies have shown that if cancer has not affected those nodes,“there is a 95 percent-plus chance it has not spread to any other nodes, so further removal of lymph nodes is unnecessary,” Riley says. Compared to traditional biopsy, a sentinel node biopsy is a less invasive procedure, meaning a quicker recovery and less post-op pain, Riley says.And because unaffected lymph nodes are left intact, the risks of lymphedema and nerve damage are greatly decreased. Riley says sentinel node biopsies also are useful in treating other cancers such as skin and colon. ■ Intensity Modulated Radiation Therapy (IMRT) Radiation therapy utilizes high-energy X-ray beams for the treatment of cancer. IMRT uses a computer to generate images to plan and deliver more tightly focused radiation beams to tumors than is possible with conventional radiotherapy,says Norman Schulman, M.D., medical director of Radiation Medicine Specialists of Northeast Pennsylvania, Forty Fort. State-of-the-art linear accelerators are fitted with an accessory called a multi-leaf collimator, which uses up to 120 computer-controlled mechanical “fingers” to St. Luke’s Cancer Center has more radiation therapy options for cancer treatment than any other area hospital • Intensity Modulated Radiation Therapy (IMRT) with more than 392 patients treated since 2000 • Electronic Compensation • 3D Conformal Therapy • Brachytherapy – Prostate seeds – Mammosite – High-dose radiation • CT Simulation • Two state-of-the-art linear accelerators with multileaf collimation Ask your doctor or call us for more information at 610-954-4300 or 1-866-STLUKES (toll free). St. Luke’s Hospital & Health Network is a member of the University of Pennsylvania Cancer Network The Region’s Leader in Cancer Care 801 Ostrum Street • Bethlehem • 1-866-STLUKES (785-8537) www.stlukescancercenter.org 24 • NORTHEAST PENNSYLVANIA BUSINESS JOURNAL • SEPTEMBER 2003
Technology, biological care top list of advancements NORTHEAST PENNSYLVANIA BUSINESS JOURNAL • SEPTEMBER 2003 • 25 shape the beam of radiation so that it conforms to the three-dimensional shape of the tumor as defined by the IMRT plan. The technology allows doctors to deliver higher dose radiation to the tumor while sparing surrounding healthy tissue, Schulman says. IMRT is used for prostate and head and neck cancers and recurrent or primary tumors near a spinal cord or other sensitive structures, Schulman says. IMRT is under investigation for the treatment of breast cancer. ■ Gamma knife The Gamma Knife is a precise and powerful tool for treating certain tumors and vascular malformations in the brain. It is not a knife, but an instrument that uses 201 cobalt sources to deliver finely focused beams of radiation, Schulman says. The beam from each individual source is delivered through holes in a helmet-like device.All the beams cross a single point, and it is only at that point that enough radiation is delivered to the affected tissue. Like IMRT, its advantage is its extreme accuracy, Schulman says. ■ P.E.T. scans Positron emission topography (P.E.T.) scans are used for diagnosis, monitoring tumor response to chemotherapy or radiation and in radiation treatment planning. P.E.T. differs from X-rays and other diagnostic imaging techniques because in addition to showing a patient’s anatomy, the test also looks at biological and physiological changes in the body, Schulman says. Patients receive a dose of a tracer-containing substance that accumulates in diseased tissue, Riley says.The patient then lies on an electrically powered table that moves through the scanner.The scanner creates a picture of the patient’s body and detects the tracer in the tissue. “A CAT scan generally can see down to 1 centimeter, whereas a P.E.T. scan can go down to almost 6/10ths of a centimeter,” Schulman says. Riley says P.E.T. scans have proven so useful in seeing whether cancer has spread that more insurance companies are reimbursing for them.“It’s become a very useful test not only to try to help people find out if they have cancer but also if the treatment for cancer is working,” he says. ■ Biological therapies Riley says advances in drug treatments for cancer that have come about as researchers learn more about human genes also have been impressive. For example, the Biological Therapy Program at St. Luke’s offers advanced cancer-fighting treatments in the form of molecular materials made by the body’s immune system, such as antibodies and growth factors. Examples of leading-edge immunotherapy being used at the Cancer Center are: High-Dose Interleukin-2 (IL-2), a promising treatment for melanoma and renal cell cancer, and the CancerVax vaccine for melanoma. ■ Cancer risks Programs are developing to help people reduce their risk of cancer even before it occurs. One such program is the Cancer Risk Program provided by the Northeast Regional Cancer Institute in Scranton. In addition to education, the program offers an in-depth risk assessment and one-on-one counseling program.“By doing that, people gain a more accurate idea of their and their family’s risk for cancer,” says Laura Toole, an oncology social worker who is director of the program. Knowing risk, people can make lifestyle changes and schedule more aggressive screenings for cancers they may be more likely to inherit,Toole says. In cases where family history and genetic testing confirms a predisposition for some cancers, people might also pursue clinical trials for preventive medicines and possibly prophylactic surgeries to prevent breast, ovarian or colon cancer. Dr. Normal Schulman F.A.C.R.O, Fellow, American College of Radiation Oncology Board Certified Radiation Oncology 190 Welles St. Forty Fort, PA (570) 714-8686 CANCER CARE with Expertise, Knowledge and Commitment to Technology ... is our MISSION CANCER CARE WITH EXCELLENCE ... Our cancer facility specializes in state-of-the-art radiation treatments and provides radiation treatments with high and low energies using photons and electrons. The cancer facility is the first in the region to use the NOMOS technology with Intensity Modulated Radiation Therapy (I.M.R.T.) and the BAT ultrasound system for daily localization for prostate cancer assuring more accurate localization of prostate cancer with reduced dose to normal structures such as bladder and rectum. YEARS OF EXPERIENCE ... Dr. Norman Schulman, medical director, has over 30 years of experience in treating cancer patients. Dr. Schulman states “the cancer facility prides itself in providing the latest technology in the region with radiation treatment planning using three dimensional conformal and IMRT planning techniques.” The facility has played a leadership role in the region with advancement in radiation treatments introducing coregistration of CAT, PET and MRI imaging for localizing tumor targets for diagnosis and treatment of cancer. Dr. Schulman works closely with the physicians involved in the patient’s care, such as the family doctor, medical oncologist and surgeons. WELL TRAINED STAFF ... From the first visit and throughout the care of the patient at the cancer facility, the staff is courteous and polite providing an atmosphere of family. The cancer facility is staffed by four certified therapists, two certified radiology technologists, a dosimetrist and other staff members. CONVENIENT ... The cancer facility is a privately owned clinic and we’re located in the Cross Valley West Professional Building at 190 Welles Street in Forty Fort, Pennsylvania. Plenty of free and easy parking. CANCER MASSAGE THERAPY ... The cancer facility provides complimentary massages to our patients during the course of radiation treatment by Caroline Howell, a certified oncology massage specialist. Massage can reduce stress, provide relaxation and comfort, relieve pain, minimize the side effects of radiation and chemotherapy, enhance circulation and oxygenation and fatigue. Call for a consultation at 570-714-8686
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