Patients love these Upstate doctors

This gallery contains 9 photos.

    Every year the Upstate Foundation celebrates National Doctor’s Day in March by collecting tributes from grateful patients and families – and hand-delivering messages of gratitude to the physicians. Among the Upstate physicians receiving the highest number of tributes … Continue reading

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Leaders focus on Cancer Center’s next phase

Leszek Kotula, MD, PhD, in his lab. He is one of Upstate's researchers who seeks to benefit cancer patients with advancements in diagnostic and treatment options (PHOTO BY WILLIAM MUELLER)

Leszek Kotula, MD, PhD, in his lab. He is one of Upstate’s researchers who seeks to benefit cancer patients with advancements in diagnostic and treatment options (PHOTO BY WILLIAM MUELLER)

Upstate Cancer Center officials are improving outcomes for cancer patients by integrating the medical care, research, education and outreach programs that are already in place.

“We have outstanding research faculty, outstanding clinicians and some of the best cancer-fighting technology around, and spirited community outreach efforts. These all work to win the war against cancer for our patients,” says Jeffrey Bogart, MD, interim director of the cancer center. “When we align all that Upstate does in the field of cancer care, we intensify our institutional might in battling this disease.”

The institution has a long history of providing collaborative multidisciplinary care with integrated cancer clinics dating back to the 1990s. Bogart says the depth and breadth of subspecialty expertise at Upstate is unmatched in the region and unique in the number of fellowship-trained doctors specializing in cancer. The new structure of the cancer center facilitates a team-based approach organized around specific tumor sites, including breast cancer, lung cancer, genitourinary malignancies, head and neck cancer, neurologic cancers and cancers of the liver, pancreas and gallbladder, among others. Upstate also houses the only children’s cancer treatment facility in the region.

In his role as interim director, Bogart, who also serves as chair of radiation oncology, oversees all cancer care and cancer-related research at Upstate.

He says a stronger alignment between the cancer center and the academic institution will “strengthen our cancer care, accelerate scientific discovery, bolster our academic programs and extend our community outreach and education efforts far beyond our campus.” Bogart adds that this new structure puts the cancer center in the best position to grow and respond to the changing market and health care reform dynamics. It will also set in motion Upstate’s long-term strategy of earning a National Cancer Institute designation.

NCI-designated centers are recognized for their scientific leadership, resources and the depth and breadth of their research in basic, clinical and population science.

“This is an important designation that reflects on an institution’s integrated approach to cancer care,” Bogart says.

Assisting Bogart is the newly created Cancer Center Leadership Committee, which includes broad representation from campus, including department chairs, nursing, research and hospital leadership. Gennady Bratslavsky, MD, professor and chair of the urology department, is vice chair. Other key appointments include Leszek Kotula, MD, PhD, associate professor of urology and biochemistry and molecular biology, for basic and translational research; Ajeet Gajra, MD, associate professor of medicine, for clinical affairs; Stephen Graziano, MD, professor of medicine, for clinical research; and Leslie Kohman, MD, SUNY Distinguished Professor of Surgery, for community outreach.

This article appears in the fall 2016 issue of Cancer Care magazine.

Posted in cancer, community, health care, medical education, research | Tagged ,

Breast cancer survivor preaches screenings

BY JIM HOWE

Janet Bacon’s breast cancer is rare in one way, but typical in another: It shows the importance of early detection.

Bacon, 59, of Syracuse, had skipped her annual mammogram in 2014 – she had let a lot of things slide that year after losing her best friend.

Janet Bacon. (PHOTO BY SUSAN KEETER)

Janet Bacon. (PHOTO BY SUSAN KEETER)

In 2015, a resident health advocate – someone trained by Upstate to help neighbors find medical information and promote health – called Bacon to ask whether she had gotten that annual mammogram to screen for breast cancer, as part of the She Matters program (see
“How to obtain a mammogram,” below).

“So I went for it,” Bacon says of the mammogram she got in March 2015. “I didn’t think anything of it. They called me back for an ultrasound. About a week later, they said I needed a biopsy. I didn’t think anything of that, either,” she says, noting she had been called back for a biopsy years ago that amounted to nothing.

This time was different.

“It was cancer. I was devastated. I couldn’t speak at first,” she says.

She was diagnosed with ductal carcinoma in situ, found very early, at stage zero. This would normally be treated with a lumpectomy – surgical removal of the cancerous tissue, not the whole breast – followed by whole-breast radiation to prevent recurrence.

But Bacon’s case was unusual – so much so that her doctors plan to publish a case study of it. She has scleroderma, a complicated, chronic disease of the connective tissue that has also affected her kidneys.

Radiation can cause scarring in people with scleroderma, so that would tend to rule out the usual treatment, says Bacon’s radiation oncologist at Upstate, Anna Shapiro, MD.

Radiation oncologist Anna Shapiro, MD.

Radiation oncologist Anna Shapiro, MD.

“It would be a shame for her to have a mastectomy,” says Shapiro, but an operation to remove the entire breast was a likely alternative to avoid the radiation.

The multidisciplinary team at the Upstate Cancer Center decided, however, that a lumpectomy could be done if followed by a type of radiation called brachytherapy, which targets an area small enough to minimize the scarring.

Bacon’s brachytherapy involved inserting tiny radioactive pieces through a tube into a balloon implanted at the lumpectomy site, twice daily for a week.

Brachytherapy is successful for a select group of patients, such as Bacon, who are generally at low risk for recurrence, Shapiro says.

Bacon feels fortunate not only for the care she received, but for her family, which includes a brother and six sisters living down South, as well as nieces and nephews, who came to lend support.

“They ran straight here to me the day I had surgery” in May 2015, she recalls. After the operation, her surgeon, Upstate’s Scott Albert, MD, told her relatives in the waiting room that the operation was a success.

Surgeon Scott Albert, MD

“He did a wonderful job,” Bacon says. Radiation treatment followed a month later, and a mammogram in October 2015 showed no trace of cancer.

Bacon has wasted no time in recommending regular mammograms to her female relatives, noting the family history of breast cancer includes not just herself but a niece who died of the disease.

Bacon says she is doing well, goes to routine check-ups every four months and will take anti-cancer medication for five years.

“I think breast cancer is my passion now. I don’t want anyone to go through what I went through.” She says, “the No. 1 thing is getting a mammogram.” She adds she is consistent in reminding her neighbors to get a mammogram.

She is now a resident health advocate herself and  works to keep her 300 or so neighbors in the Toomey Abbott Towers on Almond Street informed about their health, particularly through She Matters programs.

Shapiro echoes the need for mammograms and outreach programs like She Matters.

”The reason we’re so successful at improving success in curing breast cancer is because we’re able to diagnose it so early. The success story of breast cancer really lies in early detection. Typically a mammogram picks up something small,” Shapiro says.

Albert notes that Bacon’s type of cancer is usually only picked up through a mammogram.

Janet Bacon (left) and Martha Chavis-Bonner (seated), both of whom are resident health advocates, sign people up for mammograms and colorectal cancer screening at the Mary Nelson Back to School Barbecue, held in August in Syracuse. (PHOTO BY SUSAN KEETER)

Janet Bacon (left) and Martha Chavis-Bonner (seated), both of whom are resident health advocates, sign people up for mammograms and colorectal cancer screenings at the Mary Nelson Back to School Barbecue, held in August in Syracuse. (PHOTO BY SUSAN KEETER)

How to obtain a mammogram

The New York State Cancer Services Program offers breast, cervical and prostate cancer screening for residents who meet income eligibility and age requirements. Call 866-442-2262 for details.

In addition, may public health departments (check with the one in the county where you live) provide access to low-cost or no-cost mammography and other cancer screenings for people without health insurance coverage.

The Upstate Cancer Center’s “She Matters” program makes mammography available to underserved women living in Syracuse Housing Authority locations in downtown Syracuse. The program includes education and awareness about the disease, as well as general wellness.

A recent grant of $25,000 – the latest in an ongoing effort from the Susan G. Komen Foundation’s Central New York affiliate — helps expand this outreach to include Toomey Abbott Towers, Pioneer Homes and Almus Olver Towers.

She Matters was founded in 2014 and receives support from the housing authority and several community and Upstate organizations and departments.

This article appears in the fall 2016 issue of Cancer Care magazine. Hear a radio interview/podcast about the She Matters program.

 

 

 

 

Posted in cancer, community, health care, illness, medical imaging/radiology, patient story, prevention/preventive medicine, public health, surgery, volunteers, women's health/gynecology | Tagged , , , , , , , , , , , , , ,

Lung cancer vigil celebrates survivors, memorializes the departed

Candles lit dozens of luminaries outside of the Upstate Cancer Center for Thursday evening's Lung Cancer Vigil.

Candles lit dozens of luminaries outside of the Upstate Cancer Center for Thursday evening’s Lung Cancer Vigil.

Caregivers and patients gathered at the Upstate Cancer Center Thursday, on the evening of the Great American Smokeout, for a candlelight vigil calling attention to lung cancer.

“Even though everybody’s heard of it, a lot of people don’t realize that lung cancer kills more women and men than the next four cancers combined,” said Leslie Kohman, MD, who has been caring for lung cancer patients at Upstate for more than three decades.

Luminaries decorated the front of the Upstate Cancer Center during the vigil.

Luminaries decorated the front of the Upstate Cancer Center during the vigil.

She described the tobacco industry as “a gigantic worldwide industry trying to create victims” as she pointed out that 1.5 million people died because of lung cancer last year. That makes lung cancer the biggest cancer killer in the world. “That’s a burden we just don’t want to have going forward.”

Kohman, a surgeon, is the director of outreach at the cancer center. She told the audience that her patients over the years exhibited desperation, fear and anxiety, but also hope and inspiration. Then, family members and survivors spoke at the ceremony.

Darlene Barbato told of the eerie similarities between her diagnosis and that of her daughter, Amy.

Cathy Bonacci spoke about her sister, who died at age 43: “Optimism and courage were the things that defined who she was. Not the disease.”

And Glenn Wells, whose lung cancer was discovered when he underwent lung cancer screening, shared how he does not feel like a survivor because surgery treated his cancer. “I didn’t go through the chemotherapy and the radiation, and the toll that that takes on your family and those around you.”

Indu Gupta, MD, is health commissioner for Onondaga County,

Indu Gupta, MD, is health commissioner for Onondaga County,

Onondaga County Health Commissioner Indu Gupta, MD, told the audience that prevention remains key. She explained that 40 percent of American adults smoked cigarettes in 1965, the year cigarettes were required to add a health precaution to their labels. Today, that percentage has dropped to about 17 percent nationally, and about 20 percent in Onondaga County.

Gupta encouraged those in attendance to help create a social norm that is smoke-free and to support smoke-free policies. Even though treatments available at the Upstate Cancer Center have improved survival, Gupta said, “our focus should be to try to prevent these preventable diseases.”

Rev. Terry Culbertson, director of Spiritual Care at Upstate, sang during the vigil and shared a poem: "Faith is the bird that feels the light and still sings when the dawn is dark."

Rev. Terry Culbertson, director of Spiritual Care at Upstate, sang during the vigil and shared a poem: “Faith is the bird that feels the light and still sings when the dawn is dark.”

Posted in addiction, cancer, community, lung/pulmonary

What to expect at your first visit to Upstate Cancer Center

The reception area in the lobby of the Upstate Cancer Center. (PHOTO BY SUSAN KAHN)

Upstate Cancer Center staff members begin preparing for a patient’s first visit soon after the appointment is scheduled. They request radiology and laboratory results and other information from your referring physician, so cancer specialists can review those reports before you arrive.

For your first consultation, please allow at least 1½ hours.

You will meet with a cancer doctor and other members of your treatment team to discuss your options and determine the recommended course of treatment. Patients may be referred or request a second opinion.

How to prepare:

  • Research the type of cancer with which you have been diagnosed before your appointment, because being informed can help you make choices about your treatment options. The Upstate Cancer Center website includes resources in the “Cancer Types” tab.
  • Learn about your physician by typing his or her last name into the “Find a Doctor” section of the main Upstate website.
  • Write down any questions and bring them with you.
  • Invite a family member or friend to accompany you to help listen and take notes during your appointment.
  • Let the appointment scheduling staff know if you need translation services or interpretation for the hearing impaired.

What to bring with you:

  • A completed medical history form (download a blank copy here);
  • A list of the medications you currently take, including over-the-counter medications;
  • Health insurance card;
  • Employer’s name, address and phone number, if you are covered under your employer’s insurance plan;
  • Advance directives, or “living will,” if you have one;
  • Your referring physician’s name, address and phone number;
  • Parking ticket for validation.

How to make an appointment:

Call the Upstate Cancer Center at 315-464-4673 to schedule a consultation.

This article appears in the fall 2016 issue of Cancer Care magazine.

Posted in cancer, community, health care, illness | Tagged , , , ,

Physical therapist first to cross finish line

 

Men’s winner Lee Berube of Syracuse representing Upstate Medical University in the J.P. Morgan Chase Corporate Challenge. (PHOTO BY DENNIS NETT/SYRACUSE.COM)

Upstate Medical University’s Lee Berube was the fastest man to finish the 3 1/2-mile J.P. Morgan Chase Corporate Challenge race this June at Onondaga Lake Park. Berube finished in 17 minutes, 36 seconds.

Berube, 25, of Syracuse is a doctor of physical therapy who has been running since he was 6 years old. “I really do love it,” he says of running, which is like a hobby for him now. He rises at 5 a.m. to run five or six days a week, and he does speed work with the Syracuse Track Club every week.

Upstate co-worker Cara Lavier wasn’t far behind Berube, with a time of 22 minutes, 17 seconds. She was the fourth woman to cross the finish line.

Lavier, 37, of Chittenango is a registered nurse who began running at about the age of 9 with her father. In 2014 she was part of a four-person team from Upstate that traveled to London to compete in the Corporate Challenge championship race.

This article appears in the fall 2016 issue of Upstate Health magazine.

Posted in community, fitness, health care, nursing, physical therapy/rehabilitation | Tagged

Renewed lives: Pancreas transplants mean patients with diabetes can skip insulin injections

Patrick Nolan felt better shortly after surgery that gave him a new pancreas. (PHOTO BY KATHLEEN PAICE FROIO)

BY AMBER SMITH

Patrick Nolan, 52, remembers spending his 11th birthday at Upstate University Hospital with a new diagnosis of diabetes. The Syracuse native lived with the disease for 41 years, routinely checking his blood sugar and injecting insulin up to six times per day.

Nolan received the first pancreas transplant at Upstate since Rainer Gruessner, MD, became chief of diabetic services. Days after Nolan’s operation, Harry Tynan, 39, of Oswego also received a pancreas transplant.

Transplant nephrologist Oleh Pankewyz, MD (PHOTO BY ROBERT MESCAVAGE)

Both men had Type 1 diabetes, a disease in which the pancreas does not produce the insulin necessary for the body to process sugars. Both suffered kidney damage from diabetes, and each underwent a kidney transplant, Nolan in 2011 and Tynan in 2013. Today, pancreas transplants have further improved their lives.

“It’s a complete change just to look forward and not have to do injections,” says Tynan. “I’m ready to pick up the insulin pen – and now I don’t have to.”

Nolan says “wow” whenever he checks his blood sugar. He’s not used to such healthy numbers, and he’s not used to the freedom of not having to check his blood sugar so frequently. “I’m reliving my youth,” he says.

Harry Tynan also received a pancreas transplant.

The transplanted pancreas produces insulin as soon as it’s sewn into place. This helps the body maintain a stable level of blood sugar, avoiding dangerous fluctuations. A patient keeps his or her original pandfscreas, which continues to produce enzymes that aid in the digestion of food.

Gruessner explains that “the pancreas transplant works because it is the only way to create long-term normal glycemia, so you don’t run into the problems of low blood sugar anymore. It stabilizes glucose metabolism.” While a pancreas transplant can reverse some types of damage caused by diabetes, it can halt the progression of kidney disease, retinopathy and circulatory problems that could lead to dialysis, blindness and amputation. And with diabetes under control, patients reduce their risk of heart attack and stroke.

Mark Laftavi, MD, surgical director of the pancreas transplant program, explains that a pancreas transplant in a young person with hard-to-control diabetes “can cure diabetes in the early stages before it damages the body.”

People with diabetes who have already developed kidney disease may be candidates for kidney and pancreas transplants done at the same time, using organs from the same donor. Or, as in the case of Nolan and Tynan, they may undergo two separate transplant operations.

“If you have a living donor, you are better to do a living donor kidney transplant and then get a pancreas,” Laftavi says. “That’s the best option available at this time.”

Members of the transplant surgical team include, from left, Mark Laftavi, MD, Rainer Gruessner, MD, chief of transplant services, and Vaughn Whittaker, MD. (PHOTO BY ROBERT MESCAVAGE)

 

This article appears in the fall 2016 issue of Upstate Health magazine. Click here for an interview with Nolan and Tynan about how receiving a new pancreas changed their lives, and here for an interview with Gruessner about how pancreas transplants can help diabetics.

Posted in diabetes/endocrine/metabolism, health care, HealthLink on Air, illness, kidney/renal/nephrology, liver/ gallbladder/ pancreas, organ donation/transplant, pancreas/liver/gallbladder/bile ducts, patient story, surgery | Tagged , , , , , , , ,

Science Is Art Is Science: A crystal-clear view of a proton pump

A proton pump called vacuolar ATPase plays an essential role in several biological processes. Malfunctions in this pump lead to a wide spectrum of human diseases, including bone and kidney diseases, diabetes and cancer.

Biochemistry and molecular biology scientists in the laboratory of Stephan Wilkens, PhD, use X-ray crystallography to study the 3-D structure of the pump to understand its role in disease and to aid in the design of therapeutics.

These colorful images illustrate how sectors of the proton pump – the sectors responsible for using cellular energy to drive transport through the pump – pack together to form the crystals that the researchers study. This work involves postdoctoral researcher Rebecca Oot, PhD, and Wilkens in collaboration with Patricia Kane, PhD, and Edward Berry, PhD, from Upstate’s department of biochemistry and molecular biology.

This article appears in the fall 2016 issue of Upstate Health magazine.

Wilkens

Oot

Kane

Berry

Posted in health care, research, technology | Tagged , , ,

Recipe: Berry Good Wraps

High in vitamin C and antioxidants, berries of all sorts are good food choices eaten as they are. But you can also include them in recipes for meals. This wrap showcases strawberries, which are rich in a B vitamin called folate, which is responsible for making healthy new cells and preventing anemia and neural tube defects in developing fetuses. This recipe serves 2.

Renowned chef Cary Neff, left, is vice president of culinary for Morrison Management Specialists, which operates Upstate’s food services. He visited cafeterias on campus in June promoting Flavors 450, a hospital dining menu that features an array of more than 60 rotating recipes, each under 450 calories.

Ingredients

2 cups diced strawberries

1 diced peach

¼ cup finely chopped cilantro

2 tablespoons fresh orange juice

two 12-inch flour tortillas

4 to 6 slices of reduced-sodium deli turkey

½ cup fresh spinach leaves

Preparation

Combine the fruit, cilantro and orange juice into a fruit salsa. Heat the flour tortillas in a microwave for 30 seconds. Layer 2 or 3 slices of turkey on each of the warm tortillas. Then, spoon on the fruit salsa, and top with spinach. Fold tortilla to make a wrap.

Nutritional information

Serving size: 1 tortilla

286 calories

16 grams protein

46 grams carbohydrates

5 grams fiber

17 grams sugars

5 grams fat

24 milligrams cholesterol

889 milligrams sodium

This article appears in the fall 2016 issue of Upstate Health magazine.

Posted in diet/nutrition, fitness, health care, recipe | Tagged , , , , , , , ,

What’s Up at Upstate: A look at educational, health care, research and community endeavors

The Weiskotten Hall courtyard at Upstate Medical University.

Organ lessons and clinical exposure

A renewed curriculum for the first two years of medical school at Upstate introduces students to the body, organ by organ, and provides them with clinical exposure earlier in their academic careers.

Their study begins with molecules, cells and microbes and then focuses on the musculoskeletal system, skin and blood before moving to the nervous system, the circulatory and respiratory systems and more. In each unit, students learn what an organ and its cells look like, what they do, how they work and how they relate to the other organs and systems of the body. Woven throughout each unit are the basic sciences, including anatomy and cell biology, biochemistry and molecular biology, physiology and neuroscience, microbiology and immunology, pathology and pharmacology.

In addition, faculty members who also care for patients at Upstate University Hospital will teach small groups of students to use problem-based learning to analyze clinical cases.

Many medical schools follow a similar curriculum.

Easing the way home for hospital patients 

Upstate University Hospital offers a 20-bed Transitional Care Unit on a newly renovated floor for patients who no longer require acute care but continue to need specialized medical, nursing or other hospital ancillary services before returning to their homes.

Patients who may receive transitional care include someone with a new diagnosis of diabetes, someone recovering from surgery and needing complex wound care, or someone requiring intravenous antibiotics for a systemic infection. (Click here for a radio interview/podcast about the unit with Sharon Brangman, MD, medical director, and nurse Amy Rottger, unit manager.)  

Project aims to reduce HIV, similar infections

A five-year, $1 million grant from the New York State Department of Health will help prevent the spread of the human immunodeficiency virus, which causes AIDS. Doctors at Upstate’s Immune Health Services will provide pre-exposure prophylaxis, a daily pill called Truvada, to healthy HIV-negative adults and adolescents who are at risk for HIV or other sexually transmitted infections. HIV screening and health assessments are also available.

This is part of Gov. Andrew Cuomo’s goal to reduce the annual number of new HIV infections in New York state to 750, from an estimated 3,000, by the end of 2020. Studies show that people who take the medication as prescribed reduce their risk of getting HIV by more than 90 percent.

Research focuses on pregnancy, early childhood

The Global Maternal Child and Pediatric Health Program is designed to address the global health issues women face during pregnancy and children face during early childhood. The initiative combines research, clinical trials, education and training here and abroad.

The program is part of Upstate’s Center for Global Health & Translational Science, which already has done significant work in various global health issues, such as mosquito-borne illnesses including dengue and chikungunya. “We will now have a laserlike focus on emerging areas of research during pregnancy and early childhood,” says David Amberg, PhD, Upstate’s vice president for research.

Neighbors spread healthy information about parenting

Guest instructor Gwen Webber-McLeod (left) high-fives Tara Harris, a resident health advocate who initiated the parenting classes in the Healthy Neighbors program. (PHOTO BY SUSAN KEETER)

Resident health advocates help teach a parenting class as part of Healthy Neighbors, a health and wellness collaboration between Upstate and the Syracuse Housing Authority.

Ten residents of Pioneer Homes completed an eight-week training program to become health advocates, learning about cancer prevention, sexual health, physical activity and nutrition. Healthy Neighbors is expanding to the Toomey Abbott Towers, 1207 Almond St., and Almus Olver Towers, 300 Burt St.

This article appears in the fall 2016 issue of Upstate Health magazine.

Posted in aging/geriatrics, autoimmune, community, drugs/medications/pharmacy, education, health care, HealthLink on Air, illness, infectious disease, international health care, maternity/obstetrics, medical education, medical student, Medicare, nursing, prevention/preventive medicine, public health, research, sexuality, Upstate Golisano Children's Hospital/pediatrics, volunteers, women's health/gynecology | Tagged , , , , , , , , , ,