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Entries Tagged as Cancer

Cancer Center Spans 30 Years

In the mid-1980s, the medical staff treating cancer patients at Intercommunity Hospital believed it was time to bring radiation therapy to Fairfield. They presented the idea to hospital CEO Gary Passama and he agreed. It was the first step in bringing advanced medicine close to home.

Local physicians, led by surgeon Robert Parker, M.D., approached Napa oncologist Florian Ploch, M.D., for help creating the new service. When the Gateway Medical Plaza was built in 1986, it was designed to house radiation oncology on the first floor, complete with the latest linear accelerator. The NorthBay Cancer Center opened in 1987 and Dr. Ploch became the medical director of radiation oncology, a position he has held for 29 years.

"When the cancer center opened, it was strictly radiation oncology," Dr. Ploch remembered. "Medical oncology, including chemotherapy, was only provided to hospitalized patients. It was toxic medicine and the patients were very sick."

Medical oncology and a clinical trials program were added to the center in 1993, making chemotherapy available on an outpatient basis.

In 1996, the center became the first civilian facility in Solano County to earn accreditation from the Commission on Cancer of the American College of Surgeons.

The medical oncology department now includes James Long, M.D., Brian Vikstrom, M.D., and Jonathan Lopez, M.D., all board-certified internists/oncologists/hematologists, and oncoplastic surgeon Jason Marengo, M.D.

Cancer Warning Signs

If you experience any one of the following symptoms consult with your doctor.

  • Changes in bowel or bladder habits
  • A sore that doesn't heal
  • Unusual bleeding or discharge
  • Lumps or thickened areas in the breast, testicle, or elsewhere
  • Indigestion or difficulty swallowing
  • Change in size, color, shape or thickness of a wart, mole or mouth sore
  • Cough or hoarseness that doesn't go away

Rx for Complex Therapies

Pharmacy Down the Hall Delivers
for Cancer Patients


Oncology Pharmacist Jan Lindsey outside the chemical mixing room.

You can't just walk into this pharmacy and pay for an over-the-counter sinus medicine or bottle of antacid tablets. In fact, the public can't even walk into this specially designed pharmacy at all. The only clientele served here are the patients of NorthBay Cancer Center.

Cancer patients have specific yet unique pharmaceutical needs, and if they are undergoing chemotherapy and other cancer treatments, they need to have their infusion drugs mixed shortly after they arrive for their appointment. So, when architects were designing the new cancer center, they placed the pharmacy just down the hall from the Medical Oncology infusion room.

"Having it just steps away from the infusion center, rather than at the hospital across the parking lot, will help us serve our patients in a more timely fashion," said Hy Ton, pharmacy manager.

These drugs also need to be mixed in a carefully controlled environment, Hy explained, and so the pharmacy includes a special room with a ventilation system more advanced than current regulations require. "In fact, we are well ahead of the curve in terms of compliance."

In this negative pressure room, air pressure is lower than outside air pressure. "That allows us to completely contain fumes within the room. The ventilation system recirculates the air nearly 50 times every hour and it is filtered through a highly advanced HEPA filter before it is vented outside," Hy explained. "To maintain strict sterile cleaning standards, even the walls and ceiling have been painted in such a way so that not a single particle or molecule from the medicines can stick to the surface."

The pharmacy also mixes non-chemotherapy IV drugs to treat dehydration, nausea/vomiting and infections.

What makes this oncology pharmacy even more special are the experts who staff it. Along with a team of highly trained technicians, Jan Lindsey, a board-certified oncology pharmacist ensures the optimal use of chemotherapy, as well as providing personal consultations with patients.

Having the pharmacy and its staff so close to patient treatment rooms offers another bonus, Hy added. "Our pharmacists are specialized, and have the training and clinical knowledge to manage much more complex therapies. We can meet directly with the patient and answer any questions or concerns they might have about the medicines, or any possible side effects."

While the pharmacy currently only serves Cancer Center patients, plans call for staff to provide medicines for other specialty services such as rheumatology in the near future, Hy noted.

Orlando’s Journey

With dreams of becoming a director someday, 20-year-old cinematography student Orlando Torres was much more comfortable behind the camera, until a dramatic diagnosis compelled him to step into the spotlight.

 

Read more >

Making Her Whole Again

Janet Fowler went 12 years without a mammogram. She was busy keeping a roof over her family’s heads and being a caregiver for others, including her boy-friend who had liver cancer. But she knew she was taking a chance with her health.

Read more >

New Mammogram Controversy Women Should Know

A British study published this year that questions the usefulness of annual screening mammography for women age 40–59 doesn't take the latest technology into account, says Jason Marengo, M.D., oncoplastic surgeon at NorthBay Healthcare in Fairfield.

The randomized study began enrolling patients in 1980, and followed their course for an average of 21.9 years. The authors' conclusion was that undergoing an annual mammogram did not improve women's survival from breast cancer any more than a physical exam alone. "Many of the mammograms performed during this study were done before the era of digital mammography," says Dr. Marengo. "In the past 10 years, women have benefited greatly from the added contrast and detailed image provided by digital mammography. This has been particularly true with patients who have denser breasts."

Digital mammography actually improves detection of cancer in dense breast tissue by up to 70 percent, says Dr. Marengo, noting that as women age, their breasts usually become less dense. Mammography has been found in multiple studies to be an effective tool to screen women at risk and improve their survival from breast cancer. High quality mammography, on average, is able to detect breast cancers significantly smaller than what can be detected by a physical exam performed by a clinician or a patient.

"Finding breast cancer at an earlier stage and size using mammography not only has a survival advantage. A smaller cancer may require less radical treatment," explains Dr. Marengo.

Cancer Center Launches Survivorship Program

The NorthBay Cancer Center has been giving its patients the STAR treatment since May 2014, in collaboration with a national program. Survivorship Training and Rehabilitation, or STAR, ensures cancer patients receive quality care long after initial life-saving treatments have ended.

"After a cancer diagnosis and treatment, patients have to learn to live with a ‘new normal,'" explains Brad Gould, service line director for Cardiovascular and Oncology Services. "For many, that ‘new normal' may mean dealing with the after-effects of chemotherapy, radiation and surgery, fatigue, weakness, insomnia, memory loss, anxiety and depression."

Patients are referred to the STAR Program by their NorthBay oncologists, whether they are in remission, living with cancer or cured. A survivorship plan is created to improve their daily function and well-being.

"We've always provided post-cancer treatment care," Brad stresses, "but the STAR program is a true survivorship plan. We follow our patients for months, even years after their treatment."

Ten-Second Test Leads to Lung Cancer Diagnosis

Ronnie Link gets a hug from NorthBay Cancer Center nurse navigator Keni Horiuchi, R.N.

Left: Ronnie Link gets a hug from NorthBay Cancer Center nurse navigator Keni Horiuchi, R.N.

When Vacaville Realtor Veronica “Ronnie” Link received a flier in the mail offering a low-cost lung cancer screening, she didn’t hesitate to accept the offer. Although she no longer smoked, she looked forward to the test’s assurance that she was as healthy as she felt.

 

She never expected a cancer diagnosis. But thanks to her chance encounter with a screening offer, the NorthBay Cancer Center found her lung cancer at an early stage and referred her for treatment. She considers herself cured.

Lung cancer is one of the greatest challenges the cancer community faces today, mainly because early screening has been limited. Lung cancer usually is not diagnosed until a patient has symptoms, and by then the survival rate is very low. Smoking cessation is the most important thing you can do to decrease the risk of lung cancer. But for those who have quit after smoking for many years, the risk is still significant. Ronnie, 64, had smoked for 40 years, although less than a pack a day. When she finally quit some years ago, she thought she had avoided the pitfalls of long-term tobacco use. “When I was growing up, everyone smoked,” Ronnie says. “Smoking meant you were an adult. It wasn’t until my grandchildren started asking about my smoking that I realized I needed to quit.”

Lung cancer usually is not diagnosed until a patient has symptoms, and by then the survival rate is very low.

With the help of a nicotine patch, she kicked the addiction in three months.

Last June, NorthBay Medical Center and the NorthBay Cancer Center began offering low-dose CT lung scans to former smokers who are patients of the Center for Primary Care and who meet the criteria of being at high risk for lung cancer. Ronnie was one of the first patients to participate in the screening.

When her initial scan revealed a shadow, she was referred to pulmonologist Dr. Maqbool Ahmed. He thought she might have a lung infection so he ordered a course of antibiotics. Five weeks later, a second scan showed the shadow remained. He explained her options, which included a biopsy, a PET Scan, and surgery.

She underwent a PET scan at NorthBay Medical Center and received the unwelcome diagnosis of lung cancer. Two days later she met with cardiothoracic surgeon Dr. Samer Kanaan, a specialist in thoracic oncology. He performed a video-assisted RUL lobectomy to remove the entire upper right lobe of her lung. Dr. Kanaan is the only surgeon in Napa, Solano, and Sonoma counties trained in this minimally invasive surgery.

Ronnie reviews her lung x-rays with cardiothoracic surgeon Samer Kanaan, M.D.

“Fortunately, Ronnie’s cancer was caught at Stage 1— making it very curable,” says Dr. Kanaan. “I’m convinced that this type of lung cancer screening saves lives.”

More patients die every year of lung cancer than of breast, colon and prostate cancer combined, according to Dr. Kanaan. That’s because lung cancer does not have the screening protocols of
the other three types of cancer.

Ronnie was playing golf just a month after her surgery. Her follow-up care includes a CT lung scan every six months. She’s so grateful for the early screening test that she wants to make it available to others who might not be able to afford it.

“I’ve created a local foundation to help low-income Solano County residents have access to early lung cancer screening,” she says. “I don’t want anyone to miss a lifesaving test because of finances.”

For more information about Ronnie’s foundation, call her at (707) 447-7011.

Scanning for an Early Cure

Recent studies have shown conclusively that detecting lung cancers at a very early stage, before they cause any symptoms, can result in a surprisingly high rate of survival. The best way to detect these cancers early is to screen those who are at risk with computerized tomography, or CT scans. A lung scan is completed in the time it takes to hold one breath, less than 10 seconds. The scan uses a low dose of radiation and no IV contrast material is required. The American Cancer Society has just endorsed this screening test.

NorthBay Medical Center and NorthBay Cancer Center are sponsoring a low-cost lung cancer screening CT for patients of the NorthBay Center for Primary Care who meet the “high-risk” criteria defined in a national screening protocol.

This includes being an ex-smoker between the ages
of 55 to 74 and having a 30-pack-a-year history. The cost is $265 and includes the CT scan and a review of the scan by a physician. The results are also reviewed by the multi-disciplinary lung tumor board at the cancer center.

For further information, please call (707) 646-4008.

New Choice for Breast Reconstruction Following Cancer Surgery

“In terms of recovery time, breast implant-based reconstruction is often the easiest to physically recover from.” —Jason Marengo, M.D.

A diagnosis of breast cancer can be overwhelming. Not only do you have decisions to make for treatment, you also have choices when it comes to breast reconstruction. Until now, cancer surgery came first, and plans for reconstruction followed at a later date.

Meet Jason Marengo, M.D., the newest member of the Center for Specialty Care, a NorthBay affiliate, in Fairfield. Dr. Marengo is an oncoplastic surgeon—one of a handful of surgeons nationwide trained in both surgical oncology and plastic surgery.

He knows first-hand how breast cancer surgery can have long-term consequences—his grandmother is a breast cancer survivor.

“My grandmother had breast cancer at a time when procedures were much more invasive,” Dr. Marengo remembers. “I witnessed how she coped with the side affects of such radical surgery.”

While a surgical resident at UC San Diego, he had a mentor who was dually trained in plastic surgery and surgical breast oncology. The physician was performing breast reconstruction at the same time he removed breast cancer.

“When I saw the incredible psychological difference this made for women, I knew this was my field,” Dr. Marengo says.

After his general surgery training, Dr. Marengo completed a Surgical Breast Oncology Fellowship at UT-Southwestern Medical Center in Dallas. Following this fellowship, he completed a Plastic and Reconstructive Surgery program at the University of Utah.

“I feel that I am in a unique position to provide a truly comprehensive surgical plan to our patients,” Dr. Marengo says. “Breast reconstruction is often only discussed in the context of recreating a breast after mastectomy. I believe that reconstructive principles should be applied to every breast procedure, from the smallest breast biopsy to recreating a breast after mastectomy.

“These principles, classically used in breast lift, breast reduction, and breast augmentation, provide me with the tools to not only remove a breast cancer, but through careful placement of incisions and the use of breast-shaping techniques, restore and in some cases improve the breast’s appearance.”

These reconstructive principles also guide his approach to the cancer portion of the operation.

“The principle here is to remove the cancer with as little damage to existing breast structures as is oncologically safe,” he adds. “This is a marriage of surgical oncology and plastic reconstructive principles, often referred to as oncoplastic surgery, but in my case done by a single surgeon with dual oncology and reconstructive training.”

Women have a number of options to reconstruct their breasts after mastectomy. Each has the potential to provide an excellent outcome. Two questions can help a patient with her decision: What is the anticipated recovery time? And, is radiation required as part of the patient’s treatment course?

In terms of recovery time, breast implant-based reconstruction is usually the easiest to physically recover from, Dr. Marengo explains. When radiation is required following surgery, breast reconstruction using a patient’s own tissues is preferred.

“In addition, I can further contour the breast through fat transfer,” he adds. “In this procedure, fat is harvested using liposuction, and transferred to the breast to improve the contour and create a more natural-looking breast.”

For further information, please contact the Center for Specialty Care at (707) 646-4180.

 

News Briefs

Girls Rock:

Elizabeth Fry, a Vacaville breast cancer survivor who is the co-founder of the Midnight Sun Foundation, was honored with the second annual Christine Franklin award during the NorthBay Spirit of Women Girls’ Night Out, Nov. 9, at the Vacaville Performing Arts Theatre. Applauding is Jane Prather, service line director for women’s health services at NorthBay Healthcare.

 

R2D2:

Dr. Deborah Murray poses with Colin Kent, of Fairfield, a Type 1 diabetic who lead the 10-mile family ride in the NorthBay first-ever Ride to Defeat Diabetes—or R2D2—on Oct. 14. There was also a 25-mile and a 60-mile ride. The event raised more than $4,000 for the NorthBay Center for Diabetes and will be used to start community support groups for diabetics.

 

Parties Galore:

It was all about putting smiles on the faces of youngsters in December, as NorthBay Healthcare hosted parties at two elementary schools and at the ABC (A Baby’s Coming) Prenatal Program. NorthBay employees hosted parties for 62 classrooms in all—at Padan Elementary School in Vacaville and at Fairview Elementary School in Fairfield, delivering everything from pizza and cupcakes to colorful paper, pens, printers and ink. For the ABC event, NorthBay teamed up with Genentech of Vacaville to host a party that featured Santa Claus handing out teddy bears courtesy of Genentech and a trip to Santa’s workshop for all, hosted by NorthBay Healthcare.

 

Coping with Cancer

Dr. Jonathan López examines patient Bereniece Wilson.

Cancer patients may experience pain, but what causes it can depend on the kind of cancer, how advanced the cancer may be, its location and even its treatment, according to Jonathan López, M.D., hematologist/oncologist with the NorthBay Cancer Center. Either way, cancer patients should rest assured that there are an array of medications and treatments available to help them cope with whatever may come their way.

Is one kind of cancer more painful than another? It depends on several factors, Dr. López notes. “In the early stages of breast cancers, for example, a patient may not feel pain. But, if a cancer has metastasized—to bone or the liver, for example—that could cause pain in those areas. Pancreatic cancer, in its early stages, is also painless but later in the disease process patients will report a boring pain in the abdominal area that can radiate to the back. They may also experience weight loss, nausea and vomiting,” he adds.

Sometimes the pain comes from where tumors are located. “If there is a tumor on the liver, for example, and it grows enough to push and rub against other organs or the ribs, this can cause enough pain to bring someone in to the doctor,” he notes.

A sudden onset of painful sinuses is what brought Bereniece Wilson to an Oakland doctor in November 2011.

“I was in a tremendous amount of pain,” she recalls. Her diagnosis was Nasopharyngeal carcinoma (sinus cancer). She came under the care of Dr. López in December because she has a daughter living locally and she needed family support.

“She was in a terrible amount of pain, was not sleeping, had nausea and vomiting and was just miserable. I started her on medications, and that initially helped,” he says.

Bereniece then underwent a series of radiation and chemotherapy treatments in January. “And that, along with the combination of the pain medications, has really helped her the most,” Dr. López says.

“I’m really feeling good now,” she says. “I’m done with my treatments, and I have no pain. The medications were able to just break it down.”

While Bereneice’s cancer treatments helped her feel better, others may experience uncomfortable side effects.

“Some medications can cause a burning or numbness in the hands and feet, indigestion or an irritation in the mouth,” Dr. López notes. Fortunately, these side effects are in many cases short-lived.

It is critically important for cancer patients to be honest with their doctor about their aches and pains—all of them—even if they consider them to be minimal or think it’s not important enough to bother the doctor over.

“If I know my patient is experiencing pain somewhere, I can monitor it. It may be normal, or not. It may be a sign the cancer has spread, or is a result of the treatment. If we know what is causing the pain, we can find the underlying cause and then work to eliminate it.”

When it comes to confessing to discomfort, men are the worst, Dr. López jokes. “I’ll ask him how he’s doing, he says he’s fine and then I look over to the spouse, who is maybe frowning or shaking her head. I will investigate that body language,” he stresses.

He also counts on his nurses to pass along any comments. “Often, patients feel more comfortable telling the nurses about their pain,” he observes. “People tell them their troubles and I count on our nurses to fill me in.”

And please don’t avoid mentioning pain because you’re afraid you’ll become addicted to medications, he requests. “Cancer-related pain can be severe, but we need to get control of it. Pain can cause depression, which can worsen the pain, causing a downward spiral or more problems. Pain control helps prevent this. It really is a quality-of-life issue.”

Tips for Managing Cancer Pain

  • Notify your doctor right away if you have any new pain, or if it is getting worse or if the pain medication is not working.
  • Take your medication on a regular schedule as instructed. Don’t skip doses or wait for pain to get worse before taking the medication.
  • Take the medication even if you are not feeling any pain. It is more difficult to get your pain under control if you wait for it to occur.
  • Let your doctor know if you experience side effects, such as constipation, nausea, vomiting or drowsiness.
  • Help your doctor to determine the right pain control methods by keeping track of where the pain is typically located, how it feels, if there is anything that makes it worse or better, or if there are changes in levels of pain based on time of day or level of activity.

Another Pitch to Strike Out Cancer

Genentech-Vacaville and the Sacramento River Cats are teaming up again to help raise funds for the NorthBay Cancer Center.

Genentech-Vacaville’s Strike Out Cancer event is a collaboration with the River Cats—the Triple A baseball affiliate of the Oakland A’s—to raise funds for the NorthBay Cancer Center.

When the two organizations teamed up in 2011, it was a winning season for the River Cats and $64,000 was raised. For the 2012 season, Genentech has pledged $100 per strike out at home games up to $50,000.

Genentech’s Strike Out Cancer event officially kicked off on June 30, 2012, but the fund-raising will continue throughout the entire baseball season, according to Dolly Rivero-Mendieta, event coordinator for Genentech-Vacaville.

NorthBay Cancer Center staff have used Genentech funds on items and services that help increase patient comfort, such as mattresses, beds and a blanket warmer.

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