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Cancer

Port Jefferson goes pink to raise awareness

by TBR Staff - September 30, 2015

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The Village of Port Jefferson will be awash in pink all through October as part of John T. Mather Memorial Hospital’s breast cancer awareness and outreach called “Paint Port Pink.”

The event’s mission is to stress the importance of screening, early detection and education about breast cancer and to help raise funds for the Fortunato Breast Health Center Fund for the Uninsured at Mather. “Paint Port Pink allows Mather Hospital to build on our breast cancer outreach efforts by involving the entire community in a month-long campaign that is highly visible and offers important breast health information,” said Mather board member Judith Fortunato. Participating partners will distribute breast cancer education cards containing information on breast self-exams.

Paint Port Pink is presented by Astoria Bank with the support of North Shore Hematology Oncology Associates, Long Island Physician Associates, LI Anesthesia Physicians, the Greater Port Jefferson Chamber of Commerce, People’s United Bank, Suffolk Plastic Surgeons, The Richard and Mary Morrison Foundation, A World of Pink, Empire National Bank, Gordon L. Seaman and Harborview Medical Services.

Many activities will be held throughout the month to bring the community together. To kick off the event, a Tree Lighting Ceremony will be held at Village Hall tonight (Oct. 1) at 6:30 p.m. Mayor Margot Garant and Mather board member Judith Fortunato will flip the switch to light up the Village Hall tree in pink lights. All are invited. Local schools will provide music, and a flock of pink flamingos will make an appearance.

At the same time, merchants will be displaying pink lights in their windows. The water in the downtown fountains will be “pinked” with environmentally safe dye. Village Hall, the Village Center, the Port Jefferson Ferry Terminal and Mather Hospital will be illuminated by pink spotlights. Theatre Three’s marquee will blink with pink lights. In addition, pink banners will adorn the light poles and some restaurants will offer special pink drinks.

Through Oct. 31, several events will raise funds to benefit the Fund for the Uninsured at the Fortunato Breast Health Center as well as breast cancer treatment services at Mather. Students at Edna Louise Spear Elementary School will launch their “Your Change Can Make a Change” promotion, collecting change using the Center’s giant hourglass while Port Jefferson Middle School students will sell and wear pink shoe laces and Frisbees.

Earl L. Vandermeulen High School cheerleaders and the Student Organization will begin their “Flamingo Flocking” fundraising campaign. The pink plastic suburban icons will be placed on the lawns of friends and supporters along with a note explaining that friends or family paid to have them “flocked” and explaining that if they make a donation, the flock will migrate to any yard they choose.

The 9th annual Pink Rock Golf Classic at the Port Jefferson Country Club will be held on Oct. 5. Registration is at 11 a.m. followed by a barbecue lunch at 11:30 am and a shot gun start at 1 p.m.

Mather Hospital’s 50th annual Gala, One Enchanted Evening, will be held on Oct. 23 at the Hyatt Regency Long Island, Hauppauge, from 7 to 11 p.m. The gala will include the presentation of the Community Service Award and Theodore Roosevelt Awards for service to the hospital and the community.

Finally, on Oct. 29, Cold Spring Harbor Laboratory Director of Research David L. Spector, Ph.D., will speak about his research on “Searching for New Ways to Halt the Progression of Breast Cancer” at a free educational seminar at Mather Hospital’s new Long Island Anesthesia Physicians Conference Center starting at 6:30 p.m. For more information or to register, call 631-686-7878.

‘Victory at Ojai’ by Marge Governale. Image from North Shore Art Guild

Tales of survival and hope at North Shore Art Guild’s latest exhibit
Mather Hospital has also teamed up with the North Shore Art Guild, the Village of Port Jefferson and the Port Jefferson Conservancy to present Artists United Against Breast Cancer, a juried art show currently on view at the Port Jefferson Village Center through Oct. 31. Featuring the works of more than 70 artists, the exhibit is inspired by the personal transformation, hope, love, fear, loss and victory associated with breast cancer. Choice of mediums included oil, acrylic, digital art, digital photographs and soft sculpture.

The show’s theme is “Victors of Survival, A Celebration of the Warrior Within Each of Us.” “Victors of Survival is not just about breast cancer. It’s about personal transformation, the person you become having faced the experience,” said Mac Titmus, vice president of the Art Guild and coordinator of the show. “It’s about the emergence of the warrior within, and the struggle that brings it forth. It’s about … how [the artists] choose to transform that passion into expression.”

Many of the artists in the show have been afflicted with breast cancer or have close family members who have.

One painting in the show stands out among the crowd. A woman stands atop a mountain, her arms raised in triumph. The woman is also the artist, Marge Governale of E. Setauket, and she is celebrating not only reaching the mountain’s summit, but surviving breast cancer. “It’s a painting of me right after I finished my treatment in October 2013, when I went with my daughter on a trip to Ojai, California,” said Governale.

In the painting, Governale’s hair is short, just growing back after chemotherapy. “I had not been exercising. My daughter said ‘let’s hike,’ and I made it the top of that mountain,” she said. It felt so good that I was able to get back to some of the things I loved after my treatment. That was a victory for me.”

“I only started painting because I had breast cancer,” she said. “Good things sometimes come from bad things.”

The winners were announced on Sept. 1. The judges included Judith Fortunato, Holly Gordon, Ward Hooper and Lori Horowitz.

Best in Show went to Len Sciacchitano for “What Will He Think.” “I remember the terror in my cousin’s eyes when she first told me she had cancer and a breast had to be removed. I can only imagine how she felt when she was faced with that diagnosis, the moment she heard, “You have breast cancer,” said Sciacchitano. “I’m sure it is a moment that remained in her mind for the rest of her life. I do not know how it feels and tried to visually imagine her emotions when she realized she needed major surgery and a portion of what she had known was being taken away,” he said.

Joanna Gazzola garnered first place for “Defiant Yet Vulnerable.” “I have had two friends and one relative who had cancer and who handled their illnesses with grit, determination and courage. One has survived for almost a decade so far and does walks to raise money for cancer research every year. The other two have passed, but provided so much inspiration to me,” said Gazzola. “I can only hope that I live and die with as much grace and thoughtfulness as they had,” said Gazzola.

Second place went to Zhen Guo for “Breasts are the Essence,” soft sculpture. Said Guo, “A woman’s breasts are symbolic of her multifaceted nature in many ways. They are the source of nourishment for infants, of warmth and security for her children, of sexuality and attractiveness for her mate. When they are injured, her whole being and all the people who know her are injured, too.”

Evelyn Adams, whose painting, “Unite & Fight For A Cure” won third place, said, “My mother passed away of breast cancer in 2008 at the age of 60. I became so mad with the disease. However, as time passed by, I began to accept the reality of the disease and now I really do support the fight for breast cancer. Showing my support, I expressed my view for a cure in a special way. I cast my hand and then incorporated clay made breast, and also placed over 100 pieces of pink ribbons around a pedestal in which represent all families who are coming together and bringing awareness to breast cancer.” She went on, “Therefore, my main idea of this piece is to encourage viewers, families who had a family member died of breast cancer and those who are fighting breast cancer of hope for a cure.”

Honorable mentions went to Bernadette De Nyse for “Mortality Realized,” Joanna Gazzola for “Conflict, Denial and Understanding,” Neil Leinwohl for “New Blooms,” Lynellen Nielsen for “Grace,” Susan Silkowitz for “Abuela” and Angela Stratton for “The Protector.”

The Port Jefferson Village Center is located at 101A. E. Broadway. An artist reception will be held on Saturday, Oct. 3, from 4 to 7 p.m. on the second level with raffles, blind auctions and art sales. All of the artists have agreed to donate 25 percent of any sales to support breast health care at the Fortunato Breast Health Center of Mather Hospital. For further information about the art show, call 631-802-2160.

Long Island man brings first responders’ fight to Washington, D.C.

by Victoria Espinoza - September 16, 2015

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North Shore natives travel to Washington with hopes of swaying lawmakers to renew health care benefits

Commack911Ceremony_BrendaLentsch_08w — John Feal speaks at the September 11 memorial ceremony in Commack last week. Photo by Brenda Lentsch

The 9/11 first responders who have fought for years to get health care support are heading back to Washington, D.C., in hopes of ushering in the renewal of the James L. Zadroga 9/11 Health & Compensation Act. And for one Nesconset resident, change cannot come soon enough.

Parts of the bill will expire next month, and other parts in October 2016.

The James Zadroga 9/11 Health and Compensation Reauthorization Act would extend the programs of the original Zadroga act indefinitely. It was introduced to Congress in April and currently has 150 bipartisan co-sponsors.

“When this bill expires, our illnesses do not expire,” said John Feal, founder of the FealGood Foundation, in a phone interview. Feal, of Nesconset, has been walking the halls of Congress for the past eight years to help get this bill passed.

He is also a 9/11 first responder who worked on the reconstruction at Ground Zero, and lost half of his foot in the process. He suffered from gangrene, but he says his injuries “pale in comparison to other first responders.”

President Barack Obama signed the current Zadroga act into law in 2011 and established the World Trade Center Health Program, which will expire in October if not renewed.

The WTC program ensured that those whose health was affected by 9/11 would receive monitoring and treatment services for their health-related problems. It consists of a responder program for rescue and recovery workers and New York City firefighters, and a survivor program for those who lived, worked or went to school in lower Manhattan on Sept. 11, 2001.

The Zadroga act also reopened the September 11th Victims Compensation Act, which allows for anyone affected to file claims for economic losses due to physical harm or death caused by 9/11. That will expire in October of next year.

Feal said he was asked by television personality Jon Stewart to come on “The Daily Show” in December 2010, but the Nesconset native said he did not want to leave the real legislative fight in D.C. Instead, he helped get four 9/11 responders to the Dec. 16, 2010, episode, who helped shed light on the ongoing battle these responders were dealing with in Congress.

“He was definitely one of the reasons the bill got passed,” Feal said of Stewart. Stewart accompanied Feal and many other first responders when they traveled to Washington, D.C, on Wednesday, Sept. 16, and took part in a mini rally.

The bill did not pass the first time it was presented to Congress back in 2006. A new version was drafted in 2010 and passed in the House of Representatives, but was having trouble getting through the Senate due to a Republican filibuster. The bill received final congressional approval on Dec. 22, 2010, and was enacted by the president on Jan. 2, 2011.

“As we get older these illnesses will become debilitating,” Feal said. “Not extending this bill is criminal. People will die without it. It’s a life-saving piece of legislation.”

Jennifer McNamara, a Blue Point resident and president of The Johnny Mac Foundation, is also actively involved in the fight to keep responders health costs covered. Her late husband, John McNamara, passed away in 2009 from stage IV colon cancer.

He was a New York City Firefighter and worked more than 500 hours at the World Trade Center in the aftermath of 9/11. He worked with responders to get support for the Zadroga bill before he died.

“I made him a promise to continue to lend support to get this legislation passed,” Jennifer McNamara said in a phone interview. When her husband passed away, she said there weren’t as many responders getting sick as there are now. “People are dying more quickly, and more are getting diagnosed with cancers and other illnesses.”

The two big issues that McNamara said she feels need to continue to be addressed are monitoring these diseases and coverage of costs once someone is diagnosed. McNamara said she believes that if there were better monitoring programs earlier on, her husband could’ve been diagnosed before his cancer was stage IV, and he could’ve had a better chance.

“These people did tremendous things for their country,” McNamara said. “They shouldn’t have to guess about whether they are going to be taken care of.”

Mather Hospital takes trophy in regatta for pancreatic cancer research

by Elana Glowatz - September 14, 2015

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Port Jefferson Yacht Club hosted its sixth annual Village Cup Regatta on Saturday, raising funds for pancreatic cancer research through the Lustgarten Foundation and for John T. Mather Memorial Hospital’s palliative medicine program.

The regatta pits the hospital and Port Jefferson Village against one another in a friendly competition for the Village Cup, a trophy which the hospital has now won two years in a row following a village reign of three years.

Participants raised about $64,000 for the cause through this year’s race, according to yacht club member Chuck Chiaramonte. The sum will be split between the Lustgarten Foundation and the palliative care program, which is focused on improving patients’ quality of life.

Chiaramonte said over the six years of the regatta, the event has raised more than $300,000.

The yacht club — formerly known as the Setauket Yacht Club — supplied the boats and captains for the event, which included a parade of boats, games and face painting for children at the harborfront park, and a trophy presentation at the adjacent Village Center.

Chiaramonte said the club looks forward to the event every year.

“It was really meant to just be a joyous occasion and share the love of the water and boating with our neighbors,” he said.

Suffolk County veteran leader Mario Buonpane dies

by Rohma Abbas - September 9, 2015

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Mario-Buonpane-9-11-Memorial-Huntington-town-2014-4_ABBASw — Mario Buonpane pays respects at a 9/11 memorial ceremony at Heckscher Park last year. File photo by Rohma Abbas

Mario C. Buonpane, Jr., a staunch local veterans’ activist, avid golfer and a family man, died on Monday after losing a vicious battle with prostate cancer. He was 83.

Buonpane, best known for his work with Huntington Town’s veterans — having served as a charter member and chairman of the Huntington Town Veterans Advisory Board and a past commander of the Northport American Legion Post 694 — is credited with spearheading the rehab of the Northport Veteran Administration Medical Center’s golf course, which brought golfers to the grounds and proceeds to the hospital, according to his son Mark Vincent (Buonpane).

Mario Buonpane speaks at last year’s town remembrance of 9/11. File photo by Rohma Abbas

“That’s his legacy,” Vincent said. “That will remain and serve the community for years and years to come.”

He received an honorable discharge from the U.S. Army and he joined the town’s veterans advisory board as a charter member in 1987. He became chairman in 1993, and since its inception, the group enhanced Veterans Plaza at Huntington Town Hall with the completion of a number of memorials honoring veterans of all wars fought by the U.S.

“Our Veterans Plaza is one of the finest on Long Island and we still have plans to improve it,” he wrote in a list of his accomplishments.

He was also the chairman of the legion’s Veterans Affairs Golf and Tournament Committee, through which he helped negotiate a contract to take over the golf course in 1996. When the group took over, the course hadn’t been mowed in five years, the greens were diseased and there were no facilities, according to Buonpane. Since then, the course touts a clubhouse with a deck, new fairways and more.

Buonpane was instrumental in getting the Northport American Legion’s Boys State and Girls State programs up and running. The programs select girls and boys off to participate in a model governments to teach them how they work, and under Buonpane’s leadership, the number of candidates the legion has sponsored has grown, from one in 1982 to about 20. The program, “teaches you how to be a good citizen,” Vincent said.

Aside from his many community contributions, Buonpane was, at heart, a family man, The father and husband, who worked for Grumman as an electrical engineer and designed electrical harnesses on the lunar module always had time for sports with the kids, Vincent said.

“He taught us great values, he taught us how to earn things the honest way, play by the rules, tell the truth and have great integrity,” Vincent said.

On his work at Grumman, Vincent said, “he contributed to the greatest journey humans had ever done.”

Buonpane’s dedication and never-give-up attitude was his trademark, the son said. He took up running in his 50s and could only run a few laps around the track but ultimately trained until he completed the New York City Marathon. He still went to the gym, even with stage 4 cancer.

“He was tough,” Vincent said. “He was a trooper.”

Others in the Huntington Town community were touched by Buonpane’s contributions, too. Supervisor Frank Petrone issued a statement on Buonpane’s death.

“He worked tirelessly to support efforts ensuring that we all remember, honor and respect our veterans and that veterans got the services and benefits they earned by serving our country,” he said. “We will miss his presence as the master of ceremonies at our wreath ceremonies and other veterans’ events.”

Joe Sledge, communications director at the Northport VA, also spoke highly of Buonpane’s contributions. Sledge said he had known Buonpane since he first started working the VA 23 years ago.

“It was he who sponsored my entry into the American Legion over 14 years ago,” he said. “He made many significant contributions to Northport VA Medical Center through his time, talent, and countless generous acts. All who knew him would agree that Mario was a thoughtful, hard-working man whose life’s mission was to brighten the lives of others, especially hospitalized veterans. He will be sorely missed.”

Stony Brook’s Tannenbaum uses math to tackle cancer

Power of 3

by Daniel Dunaief - August 28, 2015

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Tannenbaumstonybrookw — Professor Allen Tannenbaum. Photo from Stony Brook University

It’s a dangerous enemy that often turns deadly. Worse than its potentially lethal nature, however, cancer has an ability to work around any roadblocks scientists and doctors put in its path, rendering some solutions that bring hope ineffective.

Researchers around the world are eagerly searching for ways to stay one, two or three moves ahead of cancer, anticipating how the many forms of this disease take medicine’s best shot and then go back to the business of jeopardizing human health.

Allen Tannenbaum, a professor of computer science and applied mathematics and statistics at Stony Brook University, has added a field called graph theory to some of the tools he knows well from his work in medical imaging and computer vision.

A normal, healthy cell is like a factory, with genes sending signals through proteins, enzymes and catalysts, moving reactions forward or stopping them, and the genetic machinery indicating when and how hard the parts should work.

Cancer, however, is like a hostile takeover of that factory, producing the factory equivalent of M16s that damage the cell and the individual instead of baby toys, Tannebaum suggested.

By analyzing how proteins or transcription networks interact, Tannenbaum and his colleagues can develop a model for the so-called curvature of interactions.

Looking at the interactions among parts of the genetic factory, Tannenbaum can determine and quantify the parts of the cell that are following cancer commands, rather than doing their original task.

Curvature isn’t so much a bending of a physical space as it is a change in the way the different proteins or transcription factors function in the discrete networks Tannenbaum uses in cancer and biology.

“The parts are not doing their job the same way,” Tannenbaum said. “We can look and see graphically how different things compare.” He and his collaborators recently published their findings in the journal Scientific Reports.

Using mathematical formulas to define a range of interactions, Tannenbaum can determine how quickly a cancer or normal cell can return to its original state after a disturbance. This ability is called its robustness.

The study “brings to light a new way to understand and quantify the ability of cancer cells to adapt and develop resistance,” explained Tryphon T. Georgiou, a professor in the Department of Electrical and Computer Engineering at the University of Minnesota, who has known Tannenbaum for over 30 years and collaborated on this study. “It also provides ways to identify potential targets for
drug development.”

Tannenbaum studied cells from six different tumor types and supplemented the study with networks that contain about 500 cancer-related genes from the Cosmic Cancer Gene Census.

In treatments for cancers, including sarcomas, researchers and doctors sometimes try to pull the plug on cancer’s energy network. This method can slow cancer down, but cancer often resumes its harmful operations.

Using models of cancer on a computer, Tannenbaum and the five graduate students and four postdoctoral fellows can run virtual experiments. He can hand off his results to biologists, who can then run tests. Once those scientists collect data, they can offer information back to Tannenbaum.

“This is a team effort,” said Tannenbaum, who works with scientists at Memorial Sloan Kettering, the University of Texas MD Anderson Cancer Center and Brigham and Women’s Hospital.

Georgiou described Tannenbaum as a “brilliant scholar” and a “mathematician with unparalleled creativity,” who has been a “pioneer in many fields,” including computer vision. Indeed, a computer vision program could assist nurses in the intensive care unit on different shifts assess the level of pain from someone who might not otherwise be able to communicate it.

Georgiou called Tannenbaum’s work on cancer a “mission” and said Tannenbaum is “absolutely determined to use his remarkable skills as a mathematician and as a scientist” to defeat it.

Tannenbaum, who recently took his grandchild to a Mets win at CitiField, said coming to Stony Brook in 2013 was a homecoming, bringing him closer to his native Queens. He cited two famous graduates from Far Rockaway High School: the physicist Richard Feynman, who helped develop the atomic bomb, and Bernie Madoff.

He and his wife Rina, who is a professor in materials science and engineering at Stony Brook, live in Long Island City.

Tannenbaum hopes to continue to build on his work applying math to solving cancer.

“There’s a lot of mathematical play left and then testing the predictions in a biological/medical setting,” he said.

New tool helps reduce brain surgery risks

by Giselle Barkley - August 21, 2015

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Huntington neurosurgeon touts procedure’s success

BrainSurgeryPreOp2w — This diffusion tensor imaging shows the patient’s nerve, brain and other tissue matter surrounding the white mass, which makes it easier for surgeons to diagnose and treat their patients. Photo from Ericca Ardito

When Jean Noschese’s left hand started to go numb, she didn’t expect her doctor’s visit to lead to brain surgery at Huntington Hospital, where she met Dr. Robert Kerr, a neurosurgeon who had a new way of operating on the brain.

On Oct. 16, 2013, Noschese experienced a head-on collision while driving in Hauppauge. The car accident left her in need of several surgeries, including ones to repair her rotator cuff and replace her hip. But it was when she started losing sensation in her left hand, in 2014, that she went to a specialist. Noschese, who initially wondered if her issue with her hand was related to her crash, was rushed to the hospital after her hand specialist thought Noschese was experiencing a stroke.

But instead of a stroke, the doctors found a three-by-four-centimeter lesion on the right side of her brain that caused paralysis on the left side of her body. Her lesion wasn’t caused by the crash, but from Noschese’s breast cancer that had metastasized to her brain. Noschese was diagnosed with breast cancer in 2005.

Doctors wanted to perform brain surgery the following day, on Dec. 22, 2014, according to Noschese,

“It’s overwhelming to hear that you need brain surgery,” she said.

A large mass is located in the left hemisphere of the brain prior to the operation where Dr. Robert Kerr used Synaptive Medical’s BrightMatter Plan. Photo from Ericca Ardito

But Kerr, who met with Noschese when she entered the hospital, reassured her and reviewed the procedure with her. A new brain-mapping technique, using the Synaptive Medical’s BrightMatter Plan product, involves several new tools, including a highly engineered tube that splits brain tissue fibers and allows neurosurgeons to access difficult and deep parts of the brain easily. The procedure also utilizes a fiber optic, high definition telescope that creates a “cone of visualization” that allows surgeons to clearly view all planes of the brain they are working on.

The technique also features a procedure called the myriad, which uses a blunt suction device that peels off tumors from dangerous or sensitive areas without damaging surrounding areas in the brain.

“Traditionally, surgeries for deeper regions actually involve destroying a certain amount of tissue to get to the target area,” Kerr said.

According to Kerr, in traditional brain surgeries, metal retractors are used to create a pathway so surgeons can access target areas of the brain. Doctors use the retractors to pull the edges of the brain apart and create a pathway.

Kerr said the issue with this technique is that, regardless of how careful a surgeon is, he or she may still push on these retractors, which widens the pathway the surgeon created from surface of the brain to the target area. As a result, the patient is left with a hole in part of the brain, which means the patient will take longer to recover from the surgery.

Stony Brook Medicine Neurosurgeon Dr. David Chesler said Synaptive Medical’s BrightMatter Plan procedure is only appropriate under certain circumstances.

“Tumors that come right to the surface, where they’re easily approachable, I don’t think there’s any benefit to using this technique, because the tumor is right there,” Chesler said. Chesler took a course for the procedure about two years ago. While he thinks the technique is beneficial, he does not think it is a be-all and end-all procedure for brain surgery.

While the procedure is minimally invasive, may decrease the chance of injuring the patient during the operation and allows surgeons to approach lesions or blood clots, Chesler said there are some downsides to the technique. He said that the technology of this technique is not new, but simply creates a new system that makes it easier for surgeons to implement.

Additionally, minimally invasive procedures double or triple the length of an operation, depending on the surgeon and the nature of the surgery. Surgeons who may not be very experienced may leave parts of lesions or tumors and blood clots behind because of limited visualization.

A large mass is located in the left hemisphere of the brain has been removed with the use of Synaptive Medical’s BrightMatter Plan. Photo from Ericca Ardito

Surgeons can only see what is at the end of the tube, which is around the diameter of a dime.

Kerr said this procedure will decrease patients’ recovery time. Patients are usually tired following the surgery and require extensive amounts of rest before they are discharged from the hospital. Noschese, however, was alert and speaking two hours after the surgery. Not only did she regain sensation in her hand, but she was also able to grab and hold onto a variety of objects.

Chesler, like Kerr, said patients who receive traditional surgeries for deep-seated lesions or blood clots can do well. He said his patients’ deficits were more related to the “structures involved with the tumor,” as opposed to the approach used. Chesler has seen both good and bad outcomes from this technique

According to Kerr, few surgeons are using this technique.

“Neurosurgeons are skeptics and slow adopters and I think that’s appropriate,” Kerr said, explaining why more surgeons may stick to traditional brain surgery practices.

While Chesler said the procedure should be used for the right case and with an experienced surgeon, he said staff are looking to adopt this technique at Stony Brook University Hospital. Chesler, who does both pediatric and adult neurosurgery, said he is simply looking for the right case. Recently he hasn’t come across a case that calls for the technique.

Doctors must demonstrate the procedure and illustrate its benefits when introducing the technique to the hospital. Hospitals need to invest in the procedure for a surgeon to officially implement it.

Although Chesler said there are other systems that surgeons can use to reach a similar goal, Kerr said the technique is a glimpse into the future of this type of surgery.

“I think this technology reflects the future of neurosurgery and accessing deep-seated lesions in a kinder, gentler, more precise way,” Kerr said. “I think this is representing a future paradigm shift in the way that brain surgery is done, and I think that we will see many more adopting this in a very short period of time.”

Kings Park native helps young cancer patients regain strength

by TBR Staff - August 20, 2015

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NYCFC_Paul-Fick-w — Paul Fick, center, poses for a group photo after the coin flip for the Major League Soccer game at Yankee Stadium. Photo from Liz Zarins

By Clayton Collier

Kings Park native Paul Fick has helped hundreds get “back in the game.”

This past Saturday, Fick had the opportunity to help 22 Major League Soccer soccer players get their game started with the coin flip at Yankee Stadium prior to the match between the New York City Football Club and the Montreal Impact.

Before a crowd of more than 27,000, Fick was selected for the honor by Coco Joy in recognition for his work with Back in the Game, an organization he co-founded that helps young cancer patients regain strength, balance, flexibility, and confidence in an effort to return the children to a condition where they can participate in sports and physical activities again.

“It’s really not about me at all,” he said. “I just have been the beneficiary of working with these children and getting to watch them progress through their treatment. It’s about the program; it’s not about one individual. I was the representative, but it was great to see Back in the Game get more awareness so we can help more kids throughout the area.”

Fick was also recently nominated as the Leukemia & Lymphoma Society’s Man of the Year. Gilbert Salon, a volunteer for Back in the Game for the last five years, said the recognition is well-deserved.

“He’s been running that program for nearly 10 years,” he said. “His dedication, year after year, all the work he puts in, it’s really amazing.”

The program is run through Professional Physical Therapy in Garden City and is funded by the Miracle Foundation.

The idea for Back in the Game was started by Rob Panariello, a Professional Physical Therapy founding partner, and his friend Peter Menges. The inspiration for the program began when Menges’ son, Bobby, broke his leg on a relatively mild slope while skiing after doctors deemed him to be in remission from cancer. It wasn’t until after the fact that they realized that, while his son had responded to the treatment in getting rid of the cancer, his body had not fully recovered.

“His body wasn’t ready to go back to physical activities yet,” Fick said.

Paul Fick, a co-founder of Back in the Game, which helps pediatric cancer patients regain their strength, balance and flexibility, exercises with some of his young patients. Photo from Fick — Paul Fick, a co-founder of Back in the Game, which helps pediatric cancer patients regain their strength, balance and flexibility, exercises with some of his young patients.
Photo from Fick

Menges said at the time of his son’s injury, he realized that there needed to be a heightened focus on post-treatment life for children like Bobby.

“I think the disconnect was that the physicians were encouraged because the kids were responding favorably to the treatment and wasn’t that great, but what they weren’t seeing was a kid that used to participate in soccer or lacrosse or football, can’t even participate in gym class,” Menges said of his experiences following his son’s cancer treatment. “So yeah, they’re doing fine from a treatment standpoint, but they’re not doing well from a physical participation life standpoint.”

Menges said once the concept was organized, Fick was brought in to structure the program into what it is today.

“He was a real catalyst for taking the idea, figuring out how to make it work and bringing it to life,” he said.

To make the idea of Back in the Game a successful reality, the men presented the idea to Dr. Mark Weinblatt at Winthrop-University Hospital. Weinblatt’s endorsement was crucial to the program getting off the ground.

“Doctor Weinblatt was very supportive in recognizing the need for the program and referring the kids to us,” Fick said. “The trust that he had in Rob and myself enabled us to work with the kids. If we didn’t have that, it would have been very difficult.”

Nine years later, Weinblatt said the program is a terrific success.

“A lot of our patients, who really had a lot of difficulty in getting back to their usual routine, found it an immense help, not just in sports but in feeling good about themselves in day-to-day activities,” he said. “Walking around, going up stairs; the things we take for granted have been helped a lot by the program. They really do a terrific job with our patients.”

Through their work with the Miracle Foundation, the services provided by Back in the Game come at no cost to the families of the children recovering from cancer.

Though Fick doesn’t like to take any credit, Menges said the program, like Saturday’s game at Yankee Stadium, couldn’t have occurred without Fick getting things started.

“Paul has embraced the concept and program from the beginning, and transformed it from an idea into a highly organized and professional program,” he said. “He is great with the kids and parents, and has continuously worked to grow and improve the program. His dedication and passion is incredible.”

Free breast screenings at Huntington Hospital

by Giselle Barkley - August 20, 2015

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Dolan&PinkAidw — Joseph Volavka, far left, stood alongside Dolan Family Health Center and Pink Aid members to celebrate the $25,000 grant. Photo from Dolan Family Health Center

Woman can receive free mammograms, sonograms and breast biopsies at Huntington Hospital’s Women’s Center and the Charles and Helen Reichert Imaging Center at Huntington with the help of a new grant.

On Friday, Aug. 7, Pink Aid, an organization that aims to help women receive and survive breast cancer treatment, gave the Dolan Family Health Center a one-year, $25,000 grant.

According to Joseph Volavka, senior administrative director of the Dolan Family Health Center, around 23 percent of the center’s patients pay out of pocket for their regular appointment. The purpose of the grant is to encourage women who may not have health insurance to receive free breast screenings, which can be costly. Most patients usually have enough money to pay for their regular appointments, so the grant gives more women the opportunity to get additional health care than they would otherwise receive due to financial limitations.

“We are very grateful for this grant, which will help so many women to get the medical care that they need, and it will also help their families.” Kathy Giffuni, RN, nurse manager of the Dolan Family Health Center, said in a press release.

Protect against uptick in scalp skin cancer cases

by Giselle Barkley - July 31, 2015

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Skin_Cancer_Sunscreen-w — People should go through several bottles of sunscreen in one season. Using an ounce of sunscreen is ideal, as companies measure the SPF of a sunscreen by applying that amount of sunscreen to the body. Photo by Giselle Barkley

A little dab here and a little dab there. That’s usually how people apply sunscreen to their skin, according to Dr. Michael Dannenberg of Dermatology Associates of Huntington, chief of dermatology at Huntington Hospital. But with around one in five people developing skin cancer on their scalp, a dab of sunscreen isn’t enough.

Skin cancer is one of the most prevalent cancers in America, and cases for scalp cancer have increased in the past several years. While those who don’t have hair may be more prone to getting scalp cancer in comparison to those with hair, anyone can develop any form of skin cancer on this area of their body.

Squamous cell and basal cell carcinoma are common for those who are frequently exposed to the sun and those who are losing hair. Melanoma can also develop on the scalp. In 1935, one in 1,500 people developed melanoma, but the rate has since increased. Now, one in 50 people have a lifetime risk of developing melanoma.

According to Dr. Tara Huston, a surgeon in the Melanoma Management Team for Stony Brook Medicine, there will be 74,000 new cases this year of melanoma in the United States alone. Huston also said that this form of skin cancer usually requires a surgeon’s attention, as it calls for “a larger excision margin than either basal or squamous cell skin cancer.”

Huston and her team help patients with various forms of skin cancer. While dermatologists treat skin cancers like melanoma if caught early, people with more advanced stages of skin cancer may need surgery and additional treatment to recover. A patient’s lymph nodes are also examined. Lymph nodes are responsible for the drainage of certain parts of the skin. Doctors can further repair issues found from examining the nodes associated with the cancer in that area.

Sunburns, above, and increased sun exposure increase an individual’s risk of getting skin cancer like Melanoma, which accounts for four percent of cases, but 75 percent of skin cancer-related deaths according to Dr. Huston. Photo from Alexandra Zendrian

Although skin cancer of the scalp is not difficult to detect, Dr. Dannenberg says it can be missed because it is on the head. Lesions can vary based on the form of skin cancer on the scalp. Yet, it is easy to detect, especially when people receive frequent haircuts. According to Dannenberg, his office receives countless referrals from barbers and hairstylists who may find a cancerous lesion on their client’s heads.

Huston agreed with Dannenberg regarding the role of barbers and hairstylists, as a number of skin cancer lesions are identified by these professionals.

Squamous cell carcinoma appears in dull, red, rough and scaly lesions, while basal cell carcinoma appears as raised, pink and wax-like bumps that can bleed. Melanoma on the scalp appears as it would on any other part of the body — irregularly shaped, dark-colored lesions.

While sunscreen is more often associated with skin protection, dermatologists like Dannenberg also recommend protective clothing and hats. Cloth hats allow the wearer’s head to breathe while protecting the scalp. Hats with a three and a half inch or more rim offer the best protection, as they cover the head while protecting the ears and other parts of the face or neck. While people can also use straw hats, the hats should be densely woven and not allow sun to penetrate. Hats as well as sunscreen and protective clothing should be used together to provide people with the best form of sun protection.

“Nobody is completely compulsive about putting on that hat every moment they walk out the door,” Dannenberg said. “Likewise, even for people [who] are using sunscreens, people tend not to use enough of it and they don’t reapply it as often as necessary.”

One ounce of sunscreen might be hard to hold without dripping down the side of someone’s hand, but it is the amount of sunscreen people should use on their entire body. Dannenberg also says that sunscreens usually last for about three hours before people need to reapply.

Since few people follow the directions when applying sunscreen, Dannenberg as well as the American Academy of Dermatology recommend people use sunscreens with at least SPF 30. Using sunscreens with higher SPF counts means that people can under apply and still get some degree of sun and ultraviolet radiation protection.

Huston said individuals who don’t want to wear sunscreen or those with a history of tanning should seek a dermatologist and schedule appointments at least once a year to conduct a full body skin examination.

According to Huston, operating on areas of the head like the ears, nose, eyelids, lips and scalp is difficult because of the surrounding tissue.

“Reconstruction of a 2 cm defect on the nose may require multiple stages/surgeries in order to optimize the aesthetic result,” Huston said in an e-mail interview.

While some patients need skin grafts upon the removal of a cancerous lesion, Huston said, “incisions on the scalp can lead to alopecia, or hair loss along the incision line, if it stretches, and can be very upsetting to patients.”

Both Huston and Dannenberg emphasized the importance of protecting the skin and skin cancer education. Dannenberg hopes that the rates of skin cancer will decrease if people are more consistent about protecting their skin with protective attire, sunscreen and hats.

“We’ve been talking to people for years about wearing hats…telling them that as fashion always seems to follow need, that these hats are going to be coming in style,” Dannenberg said. “We’re hoping that over the next 10 or 15 years, we’ll be able to get a drop in the incidences of skin cancer.”

Melanoma risks and prevention

Medical Compass

by David Dunaief - June 10, 2015

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Longer days are here again, and you can feel the jubilance of people coming out of hibernation after a long, hard winter. Summer weather will be here before you know it, and millions will be heading to the beaches.

What could possibly be wrong with this picture? With all these benefits, you need to be cognizant of cutaneous (skin) melanoma. It is small in frequency, compared to basal cell and squamous cell carcinomas, responsible for only about 5 percent of skin cancers; however, it is much more deadly.

STATISTICS
Unfortunately, melanoma is on the rise. Over the last 40 years from 1970 to 2009, its incidence has increased by 800 percent in young women and by 400 percent in young men (1). These were patients diagnosed for the first time between 18 and 39 years old. Overall, the risk is greater in men, with 1 in 37 afflicted by this disease in his lifetime. The rate among women is 1 in 56. It is predicted that in 2014, there will have been over 76,000 cases, with over 12 percent resulting in death (2).
Melanoma risk involves genetic and environmental factors. These include sun exposure that is intense but intermittent, tanning beds, UVA radiation used for the treatment of psoriasis, the number of nevi (moles), Parkinson’s disease, prostate cancer, family history and personal history. Many of these risk factors are modifiable (3).

PRESENTATION
Fortunately, melanoma is mostly preventable. What should you look for to detect melanoma at its earliest stages? In medicine, we use the mnemonic “ABCDE” to recall key factors to look for when examining moles. This stands for asymmetric borders (change in shape); border irregularities; color change; diameter increase (size change); and evolution or enlargement of diameter, color or symptoms, such as inflammation, bleeding and crustiness (4). Asymmetry, color and diameter are most important, according to guidelines developed in England (5).
It is important to look over your skin completely, not just partially, and have a dermatologist screen for potential melanoma. Screening skin for melanomas has shown a six-times greater chance of detecting them. Skin areas exposed to the sun have the highest probability of developing the disease. Men are more likely to have melanoma tumors on the back, while women are more likely to have melanoma on the lower legs, but they can develop anywhere (6).
In addition, most important to the physician, especially the dermatologist, is the thickness of melanoma. This may determine its probability to metastasize. In a recent retrospective (backward-looking) study, the results suggest that melanoma of >0.75 mm needs to not only be excised, or removed, but also have the sentinel lymph node (the closest node) biopsied to determine risk of metastases (7). A positive sentinel node biopsy occurred in 6.23 percent of those with thickness >0.75 mm, which was significantly greater than in those with thinner melanomas. When the sentinel node biopsy is positive, there is a greater than twofold increase in the risk of metastases. On the plus side, having a negative sentinel node helps relieve the stress and anxiety that the melanoma tumor has spread.

PREVENTION
The two most valuable types of prevention are clothing and sunscreen. Let’s look at these in more detail.

Clothing
Clothing can play a key role in reducing melanoma risk. The rating system for clothing protection is the ultraviolet protection factor (UPF). The Skin Cancer Foundation provides a list of which laundry additives, clothing and cosmetics protect against the sun (8). Clothing that has a UPF rating between 15 and 24 is considered good, 25 and 39 is very good, and 40 and 50 is excellent. The ratings assess tightness of weave, color (the darker the better), type of yarn, finishing, response to moisture, stretch and condition. The most important of these is the weave tightness (9).
Interestingly, the New York Times wrote about how major companies are producing sun protective clothing lines that are fashionable and lighter in weight. The article is entitled “Fashionable Options Reshape Sun-Protective Clothing,” published on July 17, 2013 (10).

Sunscreen
We have always known that sunscreen is valuable. But just how effective is it? In an Australian prospective (forward-looking) study, those who were instructed to use sun protective factor (SPF) 16 sunscreen lotion on a daily basis had significantly fewer incidences of melanoma compared to the control group members, who used their own sunscreen and were allowed to apply it at their discretion (11). The number of melanomas in the treatment group was half that of the control group’s over a 10-year period. But even more significant was a 73 percent reduction in the risk of advanced-stage melanoma in the treatment group. Daily application of sunscreen was critical.
The recommendation after this study and others like it is that an SPF of 15 should be used daily by those who are consistently exposed to the sun and/or are at high risk for melanoma according to the American Academy of Dermatology (12). The amount used per application should be about one ounce. However, since people don’t use as much sunscreen as they should, the academy recommends an SPF of 30 or higher. Note that SPF 30 is not double the protection of SPF 15. The UVB protection of SPFs 15, 30 and 50 are 93, 97 and 98 percent, respectively.
The problem is that SPF is a number that registers mostly the blocking of UVB but not so much the blocking of UVA1 or UVA2 rays. However, 95 percent of the sun’s rays that reach sea level are UVA. So what to do?
Sunscreens come in a variety of UV filters, which are either organic filters (chemical sunscreens) or inorganic filters (physical sunscreens). The FDA now requires broad-spectrum sunscreens pass a test showing they block both UVB and UVA radiation. Broad-spectrum sunscreens must be at least SPF 15 to decrease the risk of skin cancer and prevent premature skin aging caused by the sun. Anything over the level of SPF 50 should be referred to as 50+ (3).
The FDA also has done away with the term “waterproof.” Instead, sunscreens can be either water resistant or very water resistant, if they provide 40 and 80 minutes of protection, respectively. This means you should reapply sunscreen if you are out in the sun for more than 80 minutes, even with the most protective sunscreen (3). Look for sunscreens that have zinc oxide, avobenezene or titanium oxide; these are the only ones that provide UVA1 protection, in addition to UVA2 and UVB protection.
In conclusion, to reduce the risk of melanoma, proper clothing with tight weaving and/or sunscreen should be used. The best sunscreens are broad spectrum, as defined by the FDA, and should contain zinc oxide, avobenezene or titanium oxide to make sure the formulation not only blocks UVA2 but also UVA1 rays. It is best to reapply sunscreen every 40 to 80 minutes, depending on its rating. We can reduce the risk of melanoma occurrence significantly with these very simple steps.

REFERENCES:
(1) Mayo Clin Proc. 2012; 87(4): 328–334. (2) CA Cancer J Clin. 2014;64(1):9. (3) uptodate.com. (4) JAMA. 2004;292(22):2771. (5) Br J Dermatol. 1994;130(1):48. (6) Langley, RG et al. Clinical characteristics. In: Cutaneous melanoma, Quality Medical Publishing, Inc, St. Louis, 1998, p. 81. (7) J Clin Oncol. 201;31(35):4385-4386. (8) skincancer.org. (9) Photodermatol Photoimmunol Photomed. 2007;23(6):264. (10) nytimes.com. (11) J Clin Oncol. 2011;29(3):257. (12) aad.org.

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, go to the website www.medicalcompassmd.com and/or consult your personal physician.

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