Which surgery provides best long-term outcome for kidney cancer?

Gennady Bratslavsky, MD, leads the Department of Urology.

Gennady Bratslavsky, MD, leads the department of urology.

Used to be, when surgery was recommended for kidney cancer, surgeons would remove an entire kidney. Now research shows patients fare better 10 years after surgery if the operation removes just the tumors.

It makes for a trickier operation, but the kidney-sparing surgery gives patients a decreased risk of developing chronic kidney disease, according to an Upstate study published recently in the journal, Urologic Oncology.

Urology resident Michael Daugherty, MD, and his mentor, Gennady Bratslavsky, MD, analyzed a national database, concentrating on people between the ages of 20 and 44 who underwent surgery for small, localized kidney tumors. “We looked at these younger patients because we wanted to see what effects the surgery itself would have on the patient and their long-term outcomes. With the younger patients, they were assumed to have less underlying diseases, less chance of having hypertension or heart disease or things that would possibly cause them to have an earlier death.”

They compared cancer-specific survival and overall survival between those who had their kidney removed and those who just had the tumors removed. They found no difference in cancer-specific survival, “which means the surgical removal got rid of the cancer in both ways equally,” he says. In overall survival, however, “those treated with the entire removal of the kidney did worse at 10 years. Those that had the nephron-sparing surgery did better in the long term.”

Not all kidney cancers are treated with surgery. Many factors including the type of cells involved help doctors decide what to recommend. “These cancers may be very different in their sizes, their behaviors and their prognoses,” says Bratslavsky, who leads the department of urology at Upstate.

Some kidney cancers are hereditary, passed from parents to children through a defective gene. Some are not. Some are discovered incidentally, when a patient has a medical image for another reason, and a tumor is revealed on a kidney. Many are discovered only after a patient notices blood in his or her urine.

“Unfortunately when patients present with symptoms, the disease may be much more advanced,” says Bratslavsky.

iStock_000017857727MediumUpstate physicians offer methods of destroying tumors without traditional surgery, and newer treatments that tap into the body’s own immune system to destroy cancer cells. “Active surveillance” is another important option when tumors that are slow growing or for patients for whom surgery would be too risky. Most of the surgeries for kidney cancer at Upstate are done laparoscopically, through tiny incisions, using robotic assistance.

No matter which type of cancer is diagnosed, Bratslavsky says, “it’s very important that patients with kidney tumors are managed in a setting where they can be provided with a multidisciplinary approach, such as at Upstate.” Radiologists, pathologists, medical oncologists, urologists and others come together in one room to discuss a particular patient’s options. This is where the question is asked, and answered: Which treatment, which surgery offers the patient the best outcome?

Read the study abstract in the journal, Urologic Oncology

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Numbers help tell the story of the Upstate Cancer Center

Print

17.4 million dollars were raised through the Foundation for Upstate — drawn from 18,449 gifts and pledges — to help build the $74 million Upstate Cancer Center.

preview140 villages, towns or cities in New York have residents who receive cancer care at Upstate University Hospital.

1 sky light in the healing garden lets natural light into the first floor of the George E. and Caryl Lee Johnson Radiation Oncology Center.

48 steps take you to the top of the Jim and Juli Boeheim Stairway of Hope from the cancer center lobby.

146 cassions secure the foundation, the deepest of which is 57.35 feet below the first floor.

Hear a radio interview about the new Upstate Cancer Center

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Plan now for ‘E-Race Cancer’ half marathon and 5K

A half marathon and 5K on Sept. 13 in Baldwinsville is designed to raise money for integrative medicine at the Upstate Cancer Center. It’s called “E-Race Cancer.”

The race is sponsored by RBC Wealth Management. The event will include a free 1-mile fun run, live music, food vendors and a mascot run. The races start and end at the Lysander Town Office Building. The 5K is $25, and the half marathon is $35. Register by Aug. 24 to be guaranteed a long-sleeve performance shirt.

“Our goal is to help people with cancer thrive and to promote wellness while caring for those with disease and illness,” says Kaushal Nanavati, MD. An assistant professor of family medicine, Nanavati is the medical director of integrative therapy at Upstate Medical University.

 

 

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Zach is ready to play ball again after cancer treatment

Zach Ellingson has monthly appointments with his oncologist, Karol Kerr, MD.

Zach Ellingson has monthly appointments with his oncologist, Karol Kerr, MD.

At the age of 8, Zach Ellingson had heard of cancer. It was a disease that other people got.

“Thinking about it now,” he says as a 12-year-old, “I know that I am ‘other people’ to other people.”

Zach is recovering from acute lymphocytic leukemia, the most common type of cancer in childhood, a cancer of the blood and bone marrow.

“He was a very, very sick boy for a while,” says his mother,  Jennifer DeWeerth, of Clinton.

She says that Zach started getting sick around spring break of second grade in 2010. He had one cold after another, and pink eye, and strep throat, and he was very tired. The family cancelled a weekend trip because Zach was feeling so bad. That weekend, he started vomiting dark blood.

His pediatrician ordered blood tests and quickly sent Zach to Upstate Golisano Children’s Hospital. Doctors found that Zach had the second highest white blood cell count they had ever seen.

“I was terrified. I had no idea what was going on,” Zach recalls. “I knew something was up judging by their emotions and facial expressions.”

Karol Kerr, MD

Karol Kerr, MD

The first night in the pediatric intensive care unit, Richard Sills, MD, took care of Zach. Then Karol Kerr, MD, oversaw the youngster’s treatment, which included seven months of chemotherapy infusions, followed by radiation. After that, Zach took a chemotherapy pill daily for three and a half years. He missed almost half of third grade.

Today he’s a sixth grader who comes for blood tests and a checkup every month at Upstate.

Leukemia left Zach with a brain that does not work like it used to. He does not think as fast as before, and his short term memory is lacking, DeWeerth says of her son. He fatigues easily, but he is getting back into sports. He plays soccer, lacrosse and football.

previewZach says he was hospitalized for a couple months, but it felt like years. Sleeping in the hospital was difficult with the oxygen mask he wore at first. He missed his friends, and his parents and brother.

But the worst part? “Probably just the suspense,” he says. “I really didn’t know if I was going to make it or not.”

The nurses and doctors were nice, Zach says. “They really took good care of me. And, there was a Tim Horton’s.” He has fond memories of blueberry muffins his mom brought him from the café and bake shop.

DeWeerth says her son has recognized some positives that came from his experience. “He has been able to see how strong he is, and it has given him a sense of compassion for others.”

Learn about the preview of the Upstate Cancer Center

Listen to a radio interview about the Upstate Cancer Center

Read the new Cancer Care publication

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New publication shares mission of Upstate Cancer Center: Caring for patients, searching for cures, saving lives

cancercareWelcome to Cancer Care, the premiere issue of a quarterly publication dedicated to cancer patients, families and friends, caregivers, researchers, donors and everyone else touched by cancer.

This issue of Cancer Care heralds the opening of the Upstate Cancer Center, the Syracuse region’s most comprehensive resource for the diagnosis and treatment of cancer. You will find a full array of outpatient services for children and adults offered under one roof, in a gleaming new building made possible in part through community donations.

We have the region’s only cancer program approved by the American College of Surgeon’ Commission on Cancer, achieving maximum commendation for the last 10 years. And, we are the region’s only provider for children previewwho have cancer. Upstate is proud to be part of the Children’s Oncology Group, an international network which provides the same treatments and recovery rates as high-profile national centers.

Our team of experts delivers personalized care, tailored to each individual patient, using a true multidisciplinary approach. Surgeons, medical oncologists, radiation oncologists and other specialists work together as part of a staff of 90 board-certified physicians, all of whom teach as professors in Upstate’s College of Medicine.

Our Cancer Research Institute is staffed with scientists who are dedicated to finding cures for cancer and translating laboratory discoveries to patient care.

Within the walls of the Upstate Cancer Center, you will find top-notch medical care, a variety of support services and many nice details (a healing garden, meditation room, family education center and such.) But most importantly, this is where you will find hope.

Learn about the preview taking place Saturday, July 19

Read the premiere issue of Cancer Care

Hear a radio interview about the Upstate Cancer Center

To subscribe to Cancer Care, send your name and address to magazine@upstate.edu

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New Vero machine targets tumors with precision

Vero_UZ_Brussels_newUpstate is one of only three institutions in the United States to offer the Vero, a 9-ton ring of sophisticated cancer weaponry that allows radiation oncologists to pinpoint tumors and deliver radiation with unprecedented precision.

Here’s how it works:

The patient lies on the treatment “couch.” After he or she is positioned, the Vero moves freely around the patient. With its unique pivoting head, the machine moves as necessary to provide unrestricted access to the tumor from nearly any angle.The advanced imaging technology built into the Vero shows a 3D view of tumors and organs. previewThe technology allows tumors — even those that move or shrink — to be located, targeted and then treated in real time.

The Vero can be used for many types of tumors and may be used on tumors that have spread and for those that are hard to reach surgically. Once the tumor is identified, the Vero’s precise delivery of radiation is achieved through several beams at different angles and intensities — all directed at the tumor. This means that radiation is concentrated on the tumor and less so on surrounding healthy cells and tissues. The customized treatment provides hope for greater cure rates and fewer side effects.

The Vero is housed in a specially constructed space in the new Upstate Cancer Center. Its addition complements existing technology to provide greatest breadth of treatment options in the region.

Learn about the preview of the Upstate Cancer Center

Hear a radio interview about the cancer center

Read the new publication, Cancer Care

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Sculpture, artwork in cancer center reflect outdoors

The artist, Steinfeld with her sculpture, which was installed July 9. Photo by Susan Kahn.

The artist, Ellen Steinfeld with her sculpture, which was installed July 9. Photo by Susan Kahn.

Sculptor Ellen Steinfeld was focused on creating something that would be welcoming and uplifting, representative of life and hope. When she finished, she had created a shimmery “Tree of Hope” model out of stainless steel.

previewHer work was chosen as the sculpture that will greet patients, visitors and staff at the cancer center entrance, several yards from the main Upstate University Hospital entrance.

“It’s like a tree, but it’s very abstracted. I tried to have the whole image personify the universal symbol of well-being,” says Steinfeld, of Buffalo. She says admirers “can read into it what they want. There is, like, a bird at the top symbolizing flight, or hope. Some of the exterior shapes can be symbolic of a heart or a person.”

Shapes were cut from sheets of steel like dress patterns are cut from fabric. Photo by Susan Kahn.

Shapes were cut from sheets of steel like dress patterns are cut from fabric. Photo by Susan Kahn.

Once Steinfeld made her design, she had raw steel shipped to a factory for a special finish that removes steel’s natural dullness. She worked with a computer-aided design programmer to create a cutting pattern. The shapes were cut using a precision waterjet cutting machine.

Then Steinfeld worked with a fabricator at the old Bethlehem Steel mill in Lackawanna to assemble the tree.

The tree is about 7 feet tall and will be mounted on a pedestal. In daylight, the sun will provide subtle variations in color. Lights at night “will produce much more dramatic and magical effects,” she says.

Both of Steinfeld’s parents died from cancer. So have many of her friends. “Art is part of the healing process, as far as I’m concerned,” she says. “Art is the living life. It represents life. That’s why it’s so important.”

The sculpture in front of the cancer center was welded at a foundry in Buffalo.

The sculpture in front of the cancer center was welded at a foundry in Buffalo. Photo by Susan Kahn.

Meet three more artists:

marius.bugMarius Dumitran

Of East Syracuse

Works: Photographs of plants, landscapes, trees and birds. An architect, he has been the senior project manager for the cancer center.

Background: “I used to be a painter. My passion for photography basically began when I wanted to learn more about painting clouds, because they are so elusive. From clouds, I jumped to flowers.”

Context: “It is proven psychologically that nature gives us a certain balance and refuge. That’s why many cancer centers try to set themselves in natural environments.”

GiehlMary Giehl

of Syracuse

Work: 4-foot wide wall installation called “Under a Microscope,” crocheted from sewing thread. Each circle takes about 45 minutes to craft. The finished product is mounted with insect pins.

Inspiration: algae. When people look at her work, “I’m hoping that they will think of organisms. Will they think of algae? Probably not. But the name ‘Under the Microscope’ will give them the direction of looking at cells or organisms.”

Context: She worked for 20 years as a nurse at Upstate University Hospital, caring for patients in the emergency department and the adult and pediatric intensive care units. She cared for children with cancer. And four years ago, she lost her brother to kidney cancer.

touchetteMMary Touchette

of DeWitt

Works: Semi abstract watercolors with mixed media called “Queen’s Lace” and “Pussy Willows.”

Message: “I would certainly hope my art would give people a connection with God our maker and to give them strength to get through. Cancer is a terrible thing to have to experience.”

Context: Her infant daughter, Ann was diagnosed with acute lymphocytic leukemia in 1976 and treated at University Hospital until her death in 1983. Later, her brother died from lung cancer.

 Read a new magazine, Cancer Care

Hear a radio interview about the Upstate Cancer Center

Learn about the cancer center preview

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Growing a 4-season healing garden for the cancer center

Trees and plants were installed in June in the healing garden. Below right: landscape architect Diane Burkard talks with Martin Cleaver of ProScapes. Photo by William Mueller.

Trees and plants were installed in June in the healing garden. Photo by William Mueller.

Patients receiving infusions gaze through windows at the foliage of a four-season garden growing on the roof of the Upstate Cancer Center’s second floor. Visitors may rest on its benches. The space feels like a courtyard, with the cancer center on one side, a computer warehouse behind, and Upstate University Hospital on the other.

preview“It’s quite warm and sunny there,” says Danielle Carr, the project manager at Environmental Design & Research who oversaw the garden project.

One challenge was to choose plants that will be ornamental, even through Central New York winters. Add to that the challenge of planting on a roof. “The weight of everything and the cultural conditions are different on a roof,” says project designer Diane Burkard, also of EDR. “The growing conditions are more challenging and more severe, and the extremes of heat and cold are greater.”

She says that evergreens of various colors are included, along with plants that have interesting bark. “We have river birch and red twig dogwood, and we have different junipers. We have some Japanese maple in there. Those have a beautiful outline. The form of the tree is graceful.”

Around the trees are plants that do not grow tall and that offer variety in color and texture, says Carr.

“There are seasonal changes from early spring vegetative growth, to flowering, to colorful fall foliage. With the grasses and the perennials, there is movement. A gentle breeze will move things around so it’s not static.”

Such a peaceful space will appeal to those seeking respite — plus the birds that are part of nature.

Landscape architect Diane Burkard talks with Martin Cleaver of ProScapes. Photo by William Mueller

Landscape architect Diane Burkard talks with Martin Cleaver of ProScapes. Photo by William Mueller

 

Plant your own

Planting a seasonal Central New York garden means finding plants that provide interest throughout the year. This list–from Environmental Design & Research’s Diane Burkard, who designed the rooftop healing garden for the Upstate Cancer Center –includes spring bulbs, summer flowering perennials, fall blooming grasses and evergreens that provide structure and a backdrop for other plants during their growing season.

Spring

Anemone blanda (Windflower)

Scilla siberica ‘Spring Beauty’ (Spring Beauty Wood Squill)

Eranthis hyemalis (Winter Aconite)

Summer

Geranium ‘Rozanne’ (Cranesbill)

Rudbeckia fulgida ‘Goldsturm’ (Goldsturm Black-eyed Susan)

Hemerocallis ‘Pardon Me’ (Pardon Me Daylily)

Autumn

Amsonia hibrichtii (Threadleaf Blue Star)

Bouteloua gracilis (Blue grama Grass)

Panicum virgatum ‘Shenandoah’ (Shenandoah Switch Grass)

Winter

Juniperus sabina ‘Buffalo’ (Buffalo Savin Juniper)

Cornus stolonifera ‘Farrow’ (Arctic Fire Red-twig Dogwood)

Betula nigra ‘Heritage’ (Heritage River Birch)

Listen to a radio program about the Upstate Cancer Center

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Nature theme provides refuge during cancer care

AmeriCUWhen you set out to design a cancer center, “there is a level of hopefulness that you want to communicate,” says architect Saul Jabbawy. “Where does hope come from? Hope comes from being in a great medical facility. A cutting-edge modern look reassures people of the level of care they’re going to receive.”

previewAt the same time, you want a calm environment that will help people feel relaxed.

That was the challenge for Jabbawy and the design team. He is the director of design for EwingCole, the architectural and engineering design firm for the construction of the Upstate Cancer Center.

“You never really get away from the fact that you’re struggling with cancer, but you want an environment that creates a level of visual stimulation that allows people to escape,” he says.

Exterior view of Cancer CenterThe gleaming blue glass-fronted building connects to Upstate University Hospital, sharing the circular drive entrance and a canopy-covered drop-off area. It consolidates outpatient cancer services for adults and children under one roof — and overlooking a four-season healing garden.

One of the first construction tasks was creating concrete bunkers up to 5 feet thick to house the sophisticated linear accelerators used in radiation oncology. While an integral piece of a modern cancer center, the equipment can be intimidating. So Jabbawy was mindful to create distractions.

A nature theme carries throughout the Cancer Center, and vibrant colors are juxtaposed against a white background in many hallways. Where possible, medical necessities are downplayed. For instance, “in infusion, we tucked all the sinks away so when you walk into the corridor the first thing you see is not a sink.”

The first thing you see is the garden, planted with foliage that will provide interest all four seasons. The infusion area is divided into an area for adults, and an area with zones for teens and children. The building contains rooms for medical exams and genetic, financial and other counseling services, plus a family resource center.

A grand staircase in the front of the lobby is meant to promote physical activity, although elevators are nearby.

Saul Jabbawy

Saul Jabbawy

Marius Dumitran

Marius Dumitran

Surrounding the outside of the building are narrow vertical windows against subtle horizontal lines, a feature that was deliberated for months, says Upstate’s Marius Dumitran, the senior project manager for the Cancer Center.

“If you look at that façade, it’s almost like musical notes in abstract,” he explains.

Let your mind conjure a song about hope.

Learn about the public preview

Learn about cancer care at Upstate

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What it takes to write a children’s book

Author Janine Werchinski-Yates says the book has been shipped to 16 states, plus five countries, including Canada, Mongolia, Ghana, Sweden and Germany.

Author Janine Werchinski-Yates says the book has been shipped to 16 states, plus five countries, including Canada, Mongolia, Ghana, Sweden and Germany.

Janine Werchinski-Yates of Baldwinsville appreciates exercising the creative side of her brain. “I’ve always liked writing,” she says. “I think it’s a nice release to get your ideas out there and use your imagination.”

The Upstate University Hospital laboratory technologist recently published a children’s book called “The Secret Sock Club.” Here’s what it took:

* The idea emerged from time spent in Laundromats. “I saw this little sock peeking out from under a clothes dryer, and I said ‘oh, that’s where they go,’ ” Yates says. Then her imagination conjured the Secret Sock Club.

* The time investment was about six years, start to finish. “It’s a learning curve to try to figure out how to get this together and make it happen.”

 * The illustrator, Michael Conway was the elementary school art teacher for Yates’ children. She had not seen him in a few years and then, at a time when she was frustrated by her search for an illustrator, she ran into him four times in one week.

At the Baldwinsville Public Library, she asked him, “Why do we keep seeing each other?”

“I don’t know,” he responded. “Do you have an art project or something?”

“Actually, I do,” she said. It turned out, Conway had always wanted to illustrate a book.

“The Secret Sock Club” sells for $15.99. Author Janine Werchinski-Yates says the book has been shipped to 16 states, plus five countries, including Canada, Mongolia, Ghana, Sweden and Germany.

“The Secret Sock Club” sells for $15.99. 

Yates was looking for an illustration with an old fashioned, comic feel, and Conway’s sketches were right on. “He’s really, really good at getting the emotions out of these socks,” she says.

* The cost of self publishing goes beyond the price of printing. There is also the cost of copyediting and layout, cover design and page illustrations, marketing and distribution, along with the fees to obtain the copyright, barcode and Internationl Standard Book Number. Depending on the number of copies and quality of materials, you may spend as little as $500 or more than $20,000.

* The assistance Yates needed, she got mostly from family members. Her oldest daughter, Francesca fine-tuned Yates’ language and helped edit the copy. Her youngest daughter, Ellie made suggestions about the story. Her son, Harrison set up her website at http://www.secretsockclub.com. Her sister, Rose put her in touch with someone who designed the book.

“I’ve had a lot of help, really, and a lot of good luck – which is sort of the theme of the book.”

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