Montefiore in the News
March is National Colorectal Cancer Awareness Month
Montefiore-Einstein Center for Cancer Care Experts Available to Comment
BRONX, NY (March 1, 2011) -- Montefiore, the University Hospital and Academic Medical Center for Albert Einstein College of Medicine, is committed to clinical and academic excellence, and providing seamless, coordinated care to our community. Experts from the Montefiore-Einstein Center for Cancer Care are available to comment on all aspects of colorectal cancer treatment including prevention, screening, multi-disciplinary care and psychosocial support.
MULTIDISCIPLINARY CARE IS KEY TO OPTIMAL COLORECTAL CANCER TREATMENT
With proper screening and recognition of risk factors, colorectal cancer is highly treatable. For most patients with cancer of the colon or rectum, multi-disciplinary treatment that involves specialists in medical oncology, radiation oncology, surgery and genetics is key to addressing the disease appropriately and maximizing each patient's survival. For example, a patient diagnosed with colon cancer at any stage can work with medical oncologists and genetic counselors to determine whether a hereditary factor, such as Lynch Syndrome, is present. This type of family pre-disposition may not only affect the type of treatment the patient receives, but can also prompt outreach to their families to inform them and encourage screening. For another subset of patients, those with advanced rectal cancer, neoadjuvant (pre-operative) chemotherapy and radiation is the standard of care. At every stage, multidisciplinary management in the academic medical center setting is ideal, since all specialists needed are available to work with the patient to develop a single, unified plan of care, and patients have access to the latest treatment options via clinical trials.
- Rebecca A. Levine, MD, colorectal surgeon and Assistant Professor of Surgery, Montefiore-Einstein Center for Cancer Care
PATIENT NAVIGATORS AS GUIDES HELP INCREASE NUMBER OF AT-RISK PATIENTS WHO UNDERGO COLONOSCOPY
A 2006 NYC Department of Health survey of people with terminal colon cancer revealed that lack of access and education about screening colonoscopy prevented many of them from getting this potentially life-saving exam. In response, "patient navigators" were introduced to identify at-risk patients and help them break down barriers (language, insurance, etc.) to the screening process. At Montefiore, navigators have been chosen based on qualities and skills that make them easy for local residents to identify with. In the Bronx community, ability to speak Spanish is key, as well as friendliness, compassion, and good organizational skills. Montefiore's patient navigators do not have clinical backgrounds, although each has experience working in the healthcare setting. To prepare for the role, each must complete an orientation program where they learn about colorectal cancer and the screening process. At Montefiore, a registered nurse works with the navigators to ensure quality care. On the job, their guidance of patients includes:
- Scheduling appointments for direct colonoscopies for patients without any troublesome symptoms (no need to wait for a consultation with a gastroenterologist before procedure)
- Answering patients' questions about the procedure
- Scheduling consultation appointments for patients who need to see a physician before their procedure
- Letting patients know what they need to do to prepare for their colonoscopy
- Sending results of patients' procedures to their referring physicians
The result: an expected increase of more than 500 patients undergoing colonoscopy since navigators were introduced at Montefiore in 2008.
- David Greenwald, MD, Director, Gastroenterology Fellowship Program and Professor of Clinical Medicine, Montefiore-Einstein Center for Colon Health, and patient navigators are available to discuss how the Navigator program has substantially increased the number of at-risk patients who undergo colonoscopy. Patients who have been helped by navigators are also available for comment.
RADIATION THERAPY IN THE MANAGEMENT OF COLORECTAL CANCER
Radiation oncologists play a major role in the management of colorectal cancer. Historically, their involvement in colorectal cancer cases begins after tumors are surgically removed. But recent studies have demonstrated that radiation prior to surgery allows shrinkage of the tumor and can help to prevent a patient from having a permanent colostomy bag. Additionally, smaller radiation fields can be used in neoadjuvant radiation, thereby protecting healthy surrounding tissue. At Montefiore-Einstein Center for Cancer Care the most advanced radiation techniques, such as image-guided radiation therapy (IGRT), intensity-modulated radiation therapy, and stereotactic body radiation therapy are used to deliver radiation treatment as part of a coordinated multi-disciplinary treatment plan.
- Shalom Kalnicki, MD, Chairman of Radiation Oncology, and Keyur Mehta, MD, Radiation Oncologist, Montefiore-Einstein Center for Cancer Care
INNOVATIVE REGIONAL THERAPY FOR ADVANCED COLON CANCER
Hyperthermic intraperitoneal chemotherapy (HIPEC) is an innovative regional therapy to treat advanced-stage abdominal cancers including colon cancer that have not responded to traditional treatments (radiation, surgery, chemotherapy). Performed at a limited number of cancer centers in the U.S., HIPEC involves introducing high-dose, heated chemotherapy to the tumor site during surgery. This complex procedure involves surgical oncologists, anesthesiologists, perfusionists and nurses. Dr. Steven Libutti has completed more than 200 HIPEC procedures and is now performing them at Montefiore. In addition, regional therapy options such as surgical resection, radiofrequency ablation and isolation-perfusion are available for the management of metastatic colon or rectal cancer to the liver.
- Steven K. Libutti, MD, FACS, Director of the Montefiore-Einstein Center for Cancer Care, The Marvin L. Gliedman, M.D. Distinguished Surgeon, Professor and Vice-Chairman, Department of Surgery, and Professor, Department of Genetics
RESEARCH PROMISING FOR PATIENTS WITH KRAS-MUTANT COLORECTAL CANCER
For patients with metastatic colorectal cancer (their disease has spread to other parts of the body), the most common treatment for incorporates oxaliplatin (chemotherapy) and bevacizumab (monoclonal antibody) as a frontline therapy, and irinotecan (chemotherapy), either alone or in combination with anti-epidermal growth factor receptor (EGFR) antibodies as a second line therapy. However, these antibodies are ineffective in patients whose tumors test positive for a genetic variation known as KRAS mutation. Research now underway at Montefiore-Einstein may offer promise to patients with KRAS mutant colorectal cancer, who are often categorized as an "orphan group" because of their limited therapeutic options. The research focuses on the anti-cancer activity of reovirus serotype-3 in combination with chemotherapy. Reovirus, a common community-acquired virus that causes mild flu-like gastrointestinal and respiratory symptoms, can also infect and cause degenerative changes in cancer cells.
- Sanjay Goel, MD, MS, medical oncologist and researcher at Montefiore Medical Center and Albert Einstein College of Medicine.
CANCER AND NUTRITION
Do the foods we eat impact our risk of getting colorectal cancer? Medical and nutrition experts agree that a healthy diet - one that is low in animal fats and high in fruits, vegetables and whole grains -- can reduce the risk of chronic diseases and keep the body healthy and strong. In addition, there are certain foods that can help keep the colon healthy and ward off disease.
- Maria Romano, MS, RD, CDN and Amanda Bontempo, BS, RD, CDN, ambulatory oncology dietitians, Montefiore-Einstein Center for Cancer Care
In March,the Montefiore-Einstein Center for Cancer Care will host free nutrition workshops at two sites. Sponsored by The Psychosocial Oncology Program of Albert Einstein Cancer Center, the workshops will focus on general nutrition, the importance of reading food labels, and interpreting the claims on the outside of food packages:
"Deciphering the Food Code: Food Labels, Ingredients and Health Claims"
Wednesday, March 23 from noon-1:30 p.m.
Montefiore-Einstein Center for Cancer Care, 1521 Jarrett Place, Bronx, NY
Thursday, March 24 from 2-3:30 p.m.
Montefiore Medical Center's Moses Division, 111 E. 210th St., Tishman B Conf. Rm, Bronx, NY
- Both workshops will be presented by Maria Romano, MS, RD, CDN and Amanda Bontempo, BS, RD, CDN, ambulatory oncology dietitians, Montefiore-Einstein Center for Cancer Care
Join us for a live demonstration of how to prepare colon-healthy meals and side dishes using fresh fruit and vegetables. Presented as part of Montefiore's Green Cart Partnership Program, these on-going cooking demonstrations provide patients with easy-to-follow, healthy cooking tips and encourages them to shop for fresh produce at NYC Green Carts located throughout the Bronx.
"Live Cooking Demonstration - Keep Your Colon Healthy"
Friday, March 18 at 11:30 a.m.
Montefiore's Comprehensive Health Care Center, 305 East 161st Street, Bronx, NY
- The demonstration will be led by Anne Votaw, research assistant, Montefiore's Department of Family and Social Medicine; and Helen Persovsky, MS, RN, CDN, clinical dietitian
YOGA WORKSHOP FOR COLON CANCER PATIENTS & SURVIVORS
The simple stretches, deep breathing and relaxation exercises associated with the practice of yoga may do more than just help us relax and stay toned - they may also provide healing benefits for people with cancer and other serious illnesses. Bronx Oncology Living Daily (BOLD), a free program of monthly experiential and educational workshops designed to empower and nurture those affected by cancer, will offer a yoga workshop for colon cancer patients and survivors. Funded by the EIF-Revlon Run/Walk for Women and The New York Yankee Stadium Community Benefits Funds, BOLD programs are offered on the Montefiore and Einstein campuses and are open to Montefiore patients and people in the Bronx community who are living with cancer.
- Please contact Montefiore's Office of Public Relations for details about this special yoga workshop in March.