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Knowing your family history can save lives

January 23rd, 2012

Lynch Syndrome International

Did you know that one out of every 35 patients that get colon cancer, also has Lynch Syndrome. Lynch Syndrome is a hereditary disorder caused by a mutation in a mismatch repair gene in which affected individuals have a higher than normal chance of developing colorectal cancer, endometrial cancer, and various other types of aggressive cancers, often at a young age.

Lynch syndrome has no gender, ethnic or cultural preference. It targets families, predisposing them to cancer at a younger than average age. Children of a Lynch syndrome parent possess a 50% risk of acquiring a mutation. During their lifetimes, those diagnosed face up to an 80% risk of contracting colon cancer and, women have up to a 60% risk of contracting endometrial cancers. An increased risk exists of contracting a myriad of other cancers. Lynch syndrome cancers are extremely aggressive and don’t have the extended “dwell time” (time tumors live and exist in the body until becoming cancerous) as other cancers, thus the reason it is very important to obtain regular surveillance testing.

LYNCH CANCERS LIFETIME RISKS
Colon Cancer – Up to 80% General Population 2%
Endometrial Cancer – Up to 60% General Population 1%
Stomach – Up to 13% General Population – 1%
Ovarian – Up to 12% General Population 1%

The only known method of accurately diagnosing Lynch syndrome is through genetic testing. If the family medical history indicates three family members, two of which are directly related to a third, and who each sustained Lynch cancers (Colorectal Cancer, Endometrial Cancer, Gastric Cancer, Ovarian Cancer, Hepatobiliary Cancer, Pancreatic Cancer, Ureter Cancer, Renal Pelvic Cancer, Skin Cancer (Muir Torre) and Brain Cancer. genetic testing should be discussed with one’s physician.

Once Lynch syndrome has been diagnosed, a highly targeted screening and medical management program is essential and may be lifesaving. During routine surveillance screening, tumors may be discovered and are more easily removed or treated before becoming life threatening. To learn more about Lynch Syndrome go here: Lynch Syndrome International

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Posted in Breast Cancer, Cervical Cancer, Colorectal Cancer, Lung Cancer, Pancreatic Cancer, Parotid Cysts, Prostate Cancer, Skin Cancer, Uncategorized

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Best of Manhattan Award goes to The Farber Center

January 4th, 2012

FOR IMMEDIATE RELEASE

The Farber Center for Radiation Oncology Receives 2011 Best of Manhattan Award

U.S. Commerce Association’s Award Plaque Honors the Achievement

NEW YORK, NY, December 10, 2010 — The Farber Center for Radiation Oncology has been selected for the 2011 Best of Manhattan Award in the Medical Centers category by the U.S. Commerce Association (USCA).

The USCA “Best of Local Business” Award Program recognizes outstanding local businesses throughout the country. Each year, the USCA identifies companies that they believe have achieved exceptional marketing success in their local community and business category. These are local companies that enhance the positive image of small business through service to their customers and community.

Various sources of information were gathered and analyzed to choose the winners in each category. The 2011 USCA Award Program focuses on quality, not quantity. Winners are determined based on the information gathered both internally by the USCA and data provided by third parties.

About U.S. Commerce Association (USCA)

U.S. Commerce Association (USCA) is a New York City based organization funded by local businesses operating in towns, large and small, across America. The purpose of USCA is to promote local business through public relations, marketing and advertising.

The USCA was established to recognize the best of local businesses in their community. Our organization works exclusively with local business owners, trade groups, professional associations, chambers of commerce and other business advertising and marketing groups. Our mission is to be an advocate for small and medium size businesses and business entrepreneurs across America.

SOURCE: U.S. Commerce Association

CONTACT:
U.S. Commerce Association
Email: PublicRelations@uscaaward.com
URL: http://www.uscaaward.com

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Radiation Treatment for Parotid Cysts at The Farber Center

December 12th, 2011

The development of parotid gland lymphoepithelial cysts in the early stages of human immunodeficiency virus (HIV) infection is considered a precursor to acquired immunodeficiency syndrome (AIDS).
Parotid enlargement greatly affects the quality of life of these patients. Many patients may experience emotional and psychological distress due to discrimination in personal and work relations as a result of their facial disfigurement.
Standard treatment for this disorder has been superficial parotidectomy, repeated fine-needle aspirations or observation alone. There is also another option. A brief course of low dose radiation therapy offers many advantages over surgery. Operative morbidity and mortality are avoided, and personnel are not exposed to HIV-infected body fluids.

What is Radiation Therapy and how does it work?
Radiation therapy is the use of high energy x-rays to destroy dividing cells. In this case it works just like a regular X-ray only it uses higher energy.

Is Radiation Therapy safe?
Radiation has been used successfully to treat patients for more than 100 years. It is used for cancer and benign diseases. Many advances have been made to ensure that radiation therapy is safe and effective. Before you begin receiving radiation therapy, your radiation team will carefully tailor your plan to make sure you receive safe and accurate treatment. Treatment will be focused in the parotid region, sparing the healthy tissue around it. Throughout your treatment, members of your team check and re-check your plan. Special computers are also used to monitor and double-check the treatment machines to make sure the proper treatment is given. Radiation therapy will not make you radioactive after treatment.

What should I expect during treatment?
The actual treatment takes only minutes from start to finish. Here’s what you can expect:
Every day, the radiation therapists will assure correct position, including the use of the immobilization device if that is a part of treatment. Once correct placement is assured, the therapists will leave the room and go to the control area to closely monitor you on a television screen.  There is a microphone in the treatment room so you can always talk with the therapists.  Each session is painless; you don’t see it, taste it, or smell it; it is just like getting an X-ray.   You will be on the treatment table for 10-15 minutes; most of this time is spent setting you up. You will go home/work directly after completion of your treatment and return to a normal routine.
Treatments are scheduled five days a week, Monday through Friday, for two to three weeks.

What should I expect post-treatment
The response to treatment is rapid. The parotid gland becomes soft and fluctuant by the third or fourth treatment and regresses almost completely within 1 month.

Here is a link to the journal article where the pictures below were taken from

example of before treatment and 2 months after treatment

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Lung Cancer Treatment at The Farber Center

November 7th, 2011

Elekta Infinity with VMAT

Our Elekta Infinity with VMAT technology system offers a non-invasive alternative to surgery and traditional radiation therapy for people that have been diagnosed with lung cancer or tumors that have spread to the lungs. We are the first and only treatment facility in NYC to offer Elekta VMAT technology, which uses the most sophisticated 3D imaging and intensity modulated radiation therapy that helps conform the radiation beams to the shape of your tumor. This next-generation therapy allows the radiation to be delivered precisely to the intended area with state-of-the-art image guided techniques, allowing clinical staff to spare more surrounding healthy tissue and better avoid nearby critical anatomy. Sophisticated monitoring tools such as body laser scanning further enhance precision by monitoring treatment in real-time to ensure that the dose is delivered as precisely as the radiation oncologist prescribes it. The flexibility to deliver treatments in uninterrupted rotations of the linear accelerator allows for faster treatment times (often as little as 7 minutes per day).

We are also the first and only in NY to offer the same state-of-the-art system used by renowned MD Anderson’s BrainSuite. Anatom-e combines the best anatomic atlas’, the best papers that define standards of care, and treatment guidelines with CT scans. This allows our radiation oncologists a second check in developing a precise plan that avoids potential anatomical structures that if treated may contribute to side effects. We are part of a research collaboration that allows us access and participation in ongoing protocols.

Why Choose Radiosurgery with Elekta Infinity for Lung Cancer?
It’s Painless.
Non Invasive.
Requires No Anesthesia.
It’s an outpatient procedure which is completed in only five treatments.

We are Manhattan’s first freestanding radiation oncology treatment center completely conceived with your comfort and well-being in mind. Here you can relax by the fireplace, slip into a plush robe in your own private dressing room, and take in the peaceful calm of our beautiful flora aquarium. To us, the tranquility of a spa-like setting is part of your healing process. But the real comfort of being at The Farber Center is knowing that you’re treated by Ivy League-trained physicians with the most advanced radiation technology, which means faster treatment, fewer side effects, and a greater potential for cure.

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What to do when the hair is gone

October 24th, 2011

Follea Wig


Hair loss is one of the most common side effects of chemotherapy. Some people prefer to let their baldness run its course untreated and unhidden. For others, losing their hair makes them feel raw, and exposed. What is most important to know is that what ever your choice, you should know that some insurance companies will reimburse women for the purchase of a medical cranial hair prosthesis (wig).
Most insurance companies will require a prescription from your physician or oncologist for a medical cranial hair prosthesis. Many of the companies will not cover wigs and it will be important to have the correct wording (medical cranial hair prosthesis) in the prescription in order to get reimbursement.
It is also suggested that you obtain a letter of medical necessity from your physician, oncologist, or dermatologist. This will be an explanation of the need for the medical cranial hair prosthesis and the medical cause for the loss of hair. It will also be necessary to provide a paid receipt for the medical cranial hair prosthesis for the insurance company.
Information necessary for insurance reimbursement:
A prescription for a medical cranial hair prosthesis from your physician
A letter of medical necessity from your physician
A paid receipt for the medical cranial hair prosthesis
A confirmation of prosthetic coverage from the insurance company

Since a wig is not everyone’s choice below are some wig options and alternatives:

www.caringandcomfort.com
A unique option is to use your hair or donated hair to make your own wig. You can send just one head of hair (one ponytail) and they will match the color and texture to provide the rest needed to complete the wig. (About 3 heads of hair are used to make each wig.)

www.follea.com
A great choice for women is the Gripper-2 Cool which features a hand-tied lace top, with small open lace-front. They chose to incorporate a soft-lined, close-wefted back that passes the “hairdryer test”. That is, if you blow a hairdryer (or a strong wind) on the back of your head, you don’t see the wefts. In order to accomplish this they have almost doubled the density in the back top and side sections just below the crown, in comparison to the original Gripper Cool. The advantages of this design include allowing more air to pass through to the scalp, to keep the wearer cool, as well as letting the style lay closer to the back of the head. It also vastly reduces the risk of hair inverting through the cap compared to an all hand-tied back.follea gripper
In NYC you can get them from:

Michelle Duncan
380 Lenox Avenue Ste 3A
New York, NY 10027
917-733-4160
www.charlesduncanbeaute.com

http://www.y-me.org
The Y-Me National Breast Cancer Organization provides wigs, prostheses and mastectomy bras to women whose budget just won’t stretch to cover the cost of those items. Contact them to find out where the closest affiliate office is located that has a Wig Bank. The NBCO offices often have salons where women can try on items before taking them home.

http://andrewdisimonewigs.com
American Cancer Society volunteer and NYC veteran hairstylist, Andrew DiSimone offers the largest selection of all hand tied wigs in New York City and complementary 24 hour drop off wig servicing at his NYC hair salon for as long as you need to wear it. Wigs by Andrew Disimone are revolutionary hair systems with graft technology – not old style weft design. Each hair loss system is essentially a stocking thin layer of skin or lace with human or synthetic hair tied to it one at a time! They have an easy on/off design that allows your own hair to grow underneath. No tapes or bond to hold them on, and they fit incredibly well. A custom mold of your head can be made, plus you can request any hair texture, color and length up to 20″.

http://www.4women.com/
BeauBeau® head scarves are designed specifically for hair loss due to chemotherapy, alopecia or other medical conditions. They’re unique, fashionable and versatile!

Choose head scarves from Soft rayon, delicate silk, workout fabrics, headwarmers – lined with exquisitely soft cotton. Their chic cancer scarves focus on uniqueness over mass production, creating beautiful cancer headwear to compliment your wardrobe from casual to elegant.

http://www.forzieri.com
For luxury head scarves from designers like Missoni and Cavalli this site is great.

http://www.headcovers.com
This site was created by a breast cancer survivor and has some great sleep caps and hats.

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Posted in Breast Cancer, Cervical Cancer, Colorectal Cancer, Lung Cancer, Pancreatic Cancer, Prostate Cancer, Skin Cancer, Uncategorized

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OPEN HOUSE NEW YORK

October 6th, 2011

OHNY

Open House New York will be held this year on October 15 and 16, with private residences, commercial space (The Farber Center included), hotels, unbuilt corners of parks, and architects’ offices opening their doors to the public. This is the 9th annual open house New York weekend.

OHNY weekend offers you rare access and insight into hundreds of architecturally and culturally significant sites in all five boroughs. This annual weekend of urban exploration and architectural discovery also includes free talks; fun youth and family activities; and tours on foot, bicycle, and even by canoe.

Some of those spots require reservations, and OHNY’s reservation system is officially open. The full list of sites for the weekend can be downloaded here: OHNY LINK The OHNY website is a little slow this a.m. as the rush to reserve a spot continues, so be patient, here is the link to register: OHNY.

You can see below that The Farber Center will have open dialogue tours with the architect from 12:30pm to 2:30pm Saturday October 15th and Sunday October 16th.

The Farber Center part of OHNY

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5 Day Prostate Cancer Treatment

September 26th, 2011

When you are researching prostate cancer there are a lot of treatment options out there and I highlighted them in a previous blog. What I would like to highlight today is a 5 day course of treatment.

What is a 5 day course of treatment? It is a five-day, non-invasive treatment for prostate cancer (called “stereotactic body radiation therapy” or “SBRT”). SBRT is a specialized form of IMRT (intensity modulated radiation therapy) that delivers high doses of radiation over a period of five days. Instead of giving small doses of radiation each day for several weeks, SBRT involves delivery of very focused beams of high-dose radiation. Several beams are aimed at the tumor from different angles. When for other cancers it is delivered in a single fraction it is known as stereotactic body radiosurgery. Like other forms of external radiation, these treatments are painless.

Currently there are nuances determined by which machine you are treated on. Cyberknife is one machine, another is Elekta Infinity which is what we have here at The Farber Center.

TOTAL TREATMENT TIME: 45 minutes on CyberKnife vs. 20 minutes on Elekta Infinity.

TREATMENT PLANNING: Both CyberKnife and Elekta Inifinity use Monte Carlo based dose calculations. Unlike other planning software programs that use theory models to calculate dose, Monte Carlo is statistical planning and the most accurate. Because Elekta Infinity utilizes a multileaf collumater, which can change shape instantaneously we can mimic the shape of the prostate as seen from different beam angles better, compared to the circular aperture in a CyberKnife system. This will reduce the normal tissue being irradiated from various gantry angles. Thus we can achieve better DVH (Dose Volume Histogram) with LINAC based prostate SRT compared to CyberKnife.

TARGETING THE PROSTATE: None of these machines can track the motion of the prostate throughout treatment AND adjust delivery accordingly. The CyberKnife System uses invasively implanted fiducials as reference points to identify the exact location of the prostate. Patients will wait approximately one week after insertion of the fiducials before CyberKnife treatment planning can begin to ensure that fiducial movement has stabilized.

At The Farber Center for Radiation Oncology we have a completely non-invasive approach to targeting the prostate. We use a RadiaDyne balloon. The balloon acts primarily as an immobilizer reducing the daily variations in location of the prostate, and allowing the rectum and prostate to be positioned in a more predictable and reproducible location during the treatment course. Because of the decreased probability of the prostate moving out of the treatment fields, smaller treatment margins around the prostate may be used. This will have the effect of lowering the radiation dose to the normal tissue surrounding the prostate and lowering the incidence of potential side effects to normal tissues. We also take a second Cone Beam CT Scan in the middle of treatment to verify the position of the prostate. This together with the placement of the RadiaDyne ballon ensures consistency in the location and motion of the prostate during the course of treatment. Due to the fact that we can complete a entire treatment including setup and imaging in under 20 minutes, the amount of prostate motion documented from studies (Both, et al) is kept at a clinical minimum.

KEY POINTS with Elekta Infinity:
5 Day Treatment
No need for surgical procedure
No Hormones
Better bladder DVH
Higher Rate of Erectile Function Preservation
CBCT to see prostate/rectum interface

In my opinion, the most important factors in selecting the right team are the reputation, training and experience of the radiation oncologists and their support staff (physicists, dosimetrists, therapists, nurses, etc.) in treating prostate cancer using SBRT.

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Prostate Cancer Treatment

September 13th, 2011

Let’s take a closer look at the most common cancer in American men, prostate cancer. Why, because its prostate cancer awareness month and 1 man in 6 will be diagnosed with prostate cancer in his lifetime.

So you just got diagnosed with prostate cancer and need to know your options: There is a lot to think about when choosing the best way to treat or manage your prostate cancer. You should always get a second opinion, especially if you have many treatments to choose from. Prostate cancer is a complex disease, and doctors may differ in their opinions about the best treatment options. You will want to weigh the benefits of each treatment against its drawbacks, side effects, and risks.

Current Treatment Options include the following:

ACTIVE SURVEILLANCE
The concept of active surveillance, or watchful waiting means watching the patient closely with regular PSA tests and digital rectal exams every 3 to 6 months. Transrectal ultrasound-guided prostate biopsies may be done every year as well. Treatment is started if the cancer seems to be growing or getting worse, based on either a rising PSA, a change in the rectal exam, or biopsy results.

SURGERY
A surgical approach toward the treatment of prostate cancer is called a prostatectomy. There are several prostatectomy options:

1. Radical Retropubic Prostatectomy: The most common type of prostatectomy involves making an incision in the abdomen and removal of the prostate from behind the pubic bone.
2. Nerve-sparing prostatectomy: The surgeon cuts very close to the edges of the prostate. Care is taken to spare the nerves responsible for erections that run alongside the prostate. In cases when the nerves cannot be spared it may be possible to perform a surgical grafting procedure.
3. Laparoscopic Radical Prostatectomy (LRP): minimal invasive surgery. Very small incisions are made in the abdomen, into which the surgeon inserts narrow instruments fitted with cameras (laparoscope) and/or surgical tools, allowing the surgeon to visualize and operate on the internal structures without cutting open the entire abdomen.
Side effects of prostatectomy
 include urinary incontinence (stress and total), erectile dysfunction (ED) and impotence, and post-operative complications.

RADIATION THERAPY
There are several radiation options for the treatment of prostate cancer.
1. External beam radiation therapy involves focusing a beam of ionizing radiation to the tumor while sparing the surrounding tissue. Treatments are given Monday through Friday and last less than 30 minutes.
2. 3-Dimensional Conformal Radiotherapy (3D-CRT) is a method of treatment delivery that combines multiple radiation treatment fields using 3-Dimensional computer planning to produce a high-dose area of radiation that conforms to the shape of the area to be treated.
4. Intensity modulated radiation therapy (IMRT) is an advanced form of 3D-CRT that modifies the intensity or strength of each radiation beam. It utilizes a sophisticated system of treatment delivery that allows a precise adjustment of the radiation beam intensity to the tissue within the target area while minimizing effects on surrounding tissue.
5. IGRT or Image Guided Radiation Therapy is another technology that can also be used to ensure better targeting of daily radiation treatments.
5. The Newest Technique is Stereotactic body radiation therapy (SBRT) is a specialized form of 3D-CRT that delivers high doses of radiation over a period of five to ten days.
6. Brachytherapy refers to the technique of implanting small radioactive sources directly into the prostate gland. This procedure takes place under anesthesia, usually in the operating room. Brachytherapy is generally used only in men with early stage prostate cancer that is relatively slow growing. There are two methods of delivering this type of radiation to prostate cancer:

HORMONE THERAPY
is also called androgen deprivation therapy (ADT) or androgen suppression therapy. Often hormone therapy will be used in addition to other treatment. It may consist of a combination of injections and oral tablets. Therapy typically begins at least two months prior to radiotherapy and may be recommended for up to three years depending on the clinical situation.

To find out more or speak directly to Dr. Leonard Farber, please visit The Farber Center for Radiation Oncology

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Have Cancer and Need a Helping Hand?

August 29th, 2011

Lotsa Helping Hands was created to answer the question what can I do to help? If you are caring for someone with cancer or in a crisis, or going through one yourself, chances are you have heard this question a lot. And, if you have watched a friend or loved one in need, you have probably asked the same question. Everyone wants to help, but no one knows exactly what to do. Its simple, free and private! How does it work?

1. Visit the Create a Community Page
In literally minutes, you, a friend or family member can fill out the form on our Create a Community page. Simply enter the name of the community being created and your name and email address. Who should create the community?

2. Invite members who want to help
Next, enter the names and email addresses of those you wish to be part of your community. Start with people who have expressed interest in helping. You can keep adding names once your community is created. Members have to be invited to join your community or request membership. Members receive a “welcome” email message about the community, with sign-in information.

3. Enter volunteer tasks
Go to the Administration Tab in your community and begin posting needs with our easy to use templates. This may include dinner on Monday, Wednesday, and Friday nights; or rides to medical appointments on Tuesday mornings. Members are notified by email when new needs are posted. The system sends reminders to volunteers so no one forgets their commitments.

4. Add more information to your community
Now, you can add more to your community – post photos, create custom sections, add resources from our nonprofit partners, and more. And, members can post well wishes, share announcements, and send messages to the family.

They also offer other coordination needs for military families. You can go here to see a video or start your own page: Helping Hands

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Posted in Breast Cancer, Cervical Cancer, Colorectal Cancer, Lung Cancer, Pancreatic Cancer, Prostate Cancer, Renderings, Skin Cancer, Uncategorized

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Integrative oncology

August 11th, 2011

The Farber Center for Radiation Oncology

So what is “integrative oncology?” It depends on who you ask. When you google “integrative oncology,” chances are, the modalities under discussion will usually focus primarily on various dietary changes and lifestyle interventions, such as exercise. You will also find that some will refer to it as quackademic medicine.

What does is mean to The Farber Center? It means we use and coordinate the best evidence-based treatments (i.e. surgery, chemotherapy, radiation therapy) with complimentary modalities (i.e. acupuncture, massage, stress reduction, herbal/botanicals, etc.) with the goal of treating your cancer, preventing recurrence and reducing side effects and symptoms. We do all of this in an environment that soothes and nurtures you.

No matter what kind of treatment a cancer patient receives, the fight against cancer is more than a physical challenge. It impacts everything from emotional well-being to financial stability. We believe that caring for a patient is caring for a person. We realize that people exist within a matrix of family, friends, jobs, homes, neighborhoods, geographical areas, and psychological and cultural environments, all of which can influence health and disease. Our mission is to develop a treatment plan that is right for our patient and their loved ones in an environment that supports and nurtures them.

Going to a physician who believes in integrative oncology won’t change your diagnosis, but it will put your body in a better place to get healthy. Integrative Oncology encourages living a healthy lifestyle to help the body in its’ innate abilities to fight and prevent cancer. This can be accomplished by learning strategies to reduce stress, increasing physical activity and eating healthfully (“anti-cancer diet & nutrition.”) Practicing these lifestyle changes creates a place where the healthy cells in your immune system can flourish and do their best work.

And when your cancer treatment is over The Farber Center for Radiation Oncology has joined forces with Urban Zen’s integrative therapy program (UZIT) and created OHE (optimal healing environment) classes to create a place/space where you can explore the issues that brought you treatment and to do what you can to prevent you or your loved ones from going through it again.

The 4-week integrative program is targeted to EMPOWER the cancer patent to get the best treatment of mind, body and sprit.

Program:
Initial consultation: with one of our physicians to review the overall scope of the program, the concept of functional medicine, heart disease, diabetes, obesity, “knowing your numbers,” and introduction of “Daily Health Log.” There are no out of pocket expenses for Farber Center patients.

Week 1: Nutrition/Zen*
Discuss various dietary options and specific guidelines for CA patients, esp related to preventing recurrences. Dieting,Supplements, Juicing, Fiber, etc.

Week 2: Movement/Zen*
Explore physical activity with emphasis on yoga

Week 3: Mind/Body/Zen*
Tools for stress reduction and empowerment

Week 4: Guest Lectures/Zen*
Nutrition, Stress Reduction, Adrenal Fatigue,Inflammation, Immunity,

*Zen: each week will include guided meditation and yoga practice with therapist from the Urban Zen integrative therapy program. The UZIT program is a 12 month program that includes training in yoga therapy, essential oil therapy, Reiki, nutrition, and contemplative care giving to addresses the key patient symptoms of PANIC- pain, anxiety, nausea, insomnia, constipation, and exhaustion.

To find out more about the program please contact The Farber Center at 212 300-0663

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Posted in Breast Cancer, Cervical Cancer, Colorectal Cancer, Lung Cancer, Pancreatic Cancer, Prostate Cancer, Skin Cancer, Uncategorized

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