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Dr. Forcade on a Promising Treatment to Help Patients Battling Metastatic Liver Cancer

Posted on: August 25, 2014

When There is No Cancer Cure, There Can be ‘Cancer Control’

Carlos Forcade, MD

Chief, Interventional Radiology, Northern Westchester Hospital

Some radical cancer therapies are being replaced in favor of treatments that honor a person’s wish for quality of life over prolongation of poor life.

One example is an interventional radiology treatment at Northern Westchester Hospital using trans arterial radioembolization, or TARE.  TARE shows promise in prolonging quality of life for many patients battling liver cancer and metastatic colorectal cancer in the liver.

This unique interventional treatment delivers Yttrium-90, a radioactive isotope, directly to a tumor through the vascular system. It is a scientifically sophisticated technique for giving NWH patients a cancer treatment that doesn’t harm the healthy cells.

First, What is Interventional Radiology?

A subspecialty of Diagnostic Radiology, Interventional Radiology uses image guidance to perform minimally invasive procedures to treat a wide range of diseases.

Better Outcome for Our Patients

More than three-fourths of liver cancer patients can’t have surgery; TARE with Yttrium-90 gives patients more time.  And as an interventional radiology procedure, it offers the benefits of a minimally invasive treatment:

  •    Reduced infection rates, risk, pain and recovery time
  •    Shorter hospital stays
  •    Uses under local anesthesia instead of general anesthesia

TARE with Yttrium-90 is an advanced treatment that is invaluable for patients with primary and secondary malignancies of the liver who have previously exhausted or who do not have other options in combating their liver cancer.

How TARE with Yttrium-90 Works

Tumors need a blood supply, which they actively generate, to feed themselves and grow. Interventional radiologists are uniquely skilled in using the vascular system to deliver targeted treatments via catheter throughout the body. In treating cancer patients, Interventional Radiologists can attack the tumor from inside the body without medicating or affecting other parts of the body.

Combining the radioactive isotope Yttrium-90 (also known as Y-90) into microspheres to deliver radiation directly to a tumor allows for a higher, local dose of radiation to be used-without subjecting healthy tissue in the body to the radiation.

 trans arterial radioembolization Northern Westchester HospitalEach microsphere is about the size of five red blood cells in width. These beads are injected through a catheter from the groin into the liver artery supplying the tumor. The beads become lodged within the tumor vessels where they exert their local radiation that kills the cancer cells. Y-90 radiates from within and is administered via the hepatic artery. Y-90 treatment is approved by the Food and Drug Administration for the treatment of inoperable liver cancer and metastatic colorectal cancer in the liver.

While this advanced treatment doesn’t cure liver cancer, the lives of patients at NWH are being extended and their quality of life is improved with Yttrium-90 microsphere treatment.

The Team Approach at NWH

Paramount to the application of this leading-edge treatment is the multidisciplinary collaboration at Northern Westchester Hospital between the Interventional Radiology Department and the Radiation Oncology Department, led by Dr. Alfred Tinger, Chief of Radiation Oncology in The Cancer Treatment and Wellness Center.

There are other interventional radiology treatments available at Northern Westchester Hospital that are used to treat primary liver cancer, as well as other cancers that have metastasized in the liver, such as colorectal cancer, breast cancer, gynecologic cancers, melanoma, and others. These nonsurgical interventional radiology treatments are:

  • Trans arterial embolization (TAE)
  • Trans arterial chemoembolization (TACE), which delivers chemotherapy directly to the liver
  • Radiofrequency ablation (RFA), which kills the tumor with heat to treat the cancer locally.

Editor’s Note:  Carlos Forcade, MD, is Director of Interventional Radiology at Northern Westchester Hospital in Mt. Kisco, NY.  For more information or for a referral please call the Interventional Radiology Department at 914.242.8154

NWH is one of only 5 Hospitals in New York State to offer Yttrium-90 therapy for the treatment of liver cancer. (The other hospitals are: Memorial Sloane-Kettering, NYU, Mt. Sinai and NY Presbyterian.)

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New York Nursery Nurse Discusses Newborn Screening and PKU

Posted on: February 20, 2014

Why Will My Newborn Get a PKU Screening?

By Martha Zavras, RN III, Northern Westchester Hospital

Northern Westchester Hospital maternityIf you, a family member, or close friend is pregnant, it is important to know that your newborn will be screened for several serious medical conditions, as mandated by New York State. Among the conditions screened is PKU. What is this blood test for, and what do the results mean for your new baby and your family?

As a Nursery nurse, I often administer the PKU test to newborns, also explaining to parents why it must be given so early in life. PKU is the abbreviation for phenylketonuria, a metabolic disorder. In New York State, the PKU screen, which is a simple blood test, also screens for many other disorders, including thyroid problems and some types of anemia.

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New York Cardiologist Explains the Meaning of Cholesterol Numbers

Posted on: February 11, 2014

Understanding Your Cholesterol Numbers (post 2 of 3)

By Robert Pilchik, MD, Chief of Cardiology at Northern Westchester Hospital

First, a short review of cholesterol basics: The two types of cholesterol in your body – low-density lipoprotein (LDL) and high-density lipoprotein (HDL) – behave totally differently. Over time, excess LDL in your body, largely from fatty foods you eat, builds up in your artery walls as hard plaque, narrowing these vessels and restricting blood flow to your heart and brain. This condition, atherosclerosis, is THE leading cause of heart attack and stroke. By contrast, HDL acts as a vacuum, ridding the arterial walls of cholesterol and flushing it from the body. Continue reading

New York Robotic Surgeon on Colonoscopy

Posted on: November 1, 2013

Preventing a Precancerous Polyp from Becoming Colon Cancer

Wishner,(Jerald Wishner, MD)

150,000 new cases of colon & rectal cancer are diagnosed each year in the United States. Screening to identify early stage tumors or precancerous polyps is critical to optimize the chance to cure this otherwise fatal disease. Colonoscopy is the optimal way to facilitate this. Despite its excellent record for safety and detection of disease, most studies show only 50% of Americans are screened appropriately. Common reasons for lack of screening are fear of the procedure, fear of the prep, embarrassment and lack of information about the safety, need and timing of screening.
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New York Doctor Tips for Searching for Medical Info Online

Posted on: September 16, 2013

by Dr. Harlan Weinberg, Medical Director of Pulmonary and Critical Care Medicine at NWH

Weinberg, (Harlan Weinberg, MD)Medical knowledge and information management is crucial to the delivery of health care.

“But nothing has changed clinical practice more fundamentally than one recent innovation: the Internet…Falsehoods are easily and rapidly propagated on the Internet: once you land on a site that asserts a false rumor as truth, hyperlinks direct you to further sites that reinforce the falsehood…1

As physicians, we are struggling to figure out how best to use this technology in the interests of our patients and ourselves. Although the Internet is reshaping the content of the conversation between doctor and patient, we believe the core relationship should not change…Physicians are in the best position to weigh information and advise patients, drawing on their understanding of available evidence as well as their training and experience.” (NEJM 2010; 362:1063-66; Untangling the Web — Patients, Doctors and the Internet; P. Hartzband, MD et al).

So, let’s look at some helpful suggestions that will unburden our medical internet searches: Continue reading