Lung cancer is the leading cause of cancer death among American men and women, with a new diagnosis handed down every two and a half minutes. That’s the bad news. The good news is that lung cancer is also one of the most preventable cancers. While other cancers are principally the result of genetic predisposition, the main causes of lung cancer are well known and controllable.
The guidelines for preventing lung cancer are: don’t smoke, avoid indoor pollutants (second-hand smoke, radon gas, and asbestos fibers), and limit your exposure to the mixture of air pollutants we call smog. These, in addition to regular exercise and healthcare, are also the basic rules for general lung health and for preventing other respiratory conditions, such as chronic obstructive pulmonary disease (COPD) and interstitial lung disease.
What are the symptoms of lung cancer?
Dr. Kondapaneni: Symptoms include coughing, blood-streaked mucus, wheezing, chest pain, shortness of breath, and fatigue. It’s important to note that symptoms typically present in the later stages, when treatment may be less effective. That’s why, for those for whom it is appropriate, being screened before symptoms appear is important.
Why is it important for pulmonary patients to see a doctor locally?
Dr. Kondapaneni: Being able to obtain treatment locally is crucial, as many pulmonary conditions can make travel extremely taxing. For anyone with a breathing disorder, a two- or three-hour round trip to New York City can be exhausting. That’s why having a pulmonary team at Englewood Health is so beneficial to patients in the area.
What other pulmonary conditions do you treat at Englewood Health?
Dr. Kondapaneni: I get a lot of patients with poorly controlled asthma. Management usually includes prescriptions for inhalers, but we also offer IV infusion therapy and bronchial thermoplasty.
For COPD, we provide pulmonary rehabilitation, in which a team of specialists guides the patient toward optimal pulmonary health and fitness. The program includes guided training sessions on breath control, coughing, and airway clearance. We also educate the patient on how to manage symptoms through nutrition and hydration.
Who is the typical candidate for lung cancer screenings?
Dr. Kondapaneni: The typical candidate is between 55 and 74 years old and has smoked at least a pack a day for 30 years, or the equivalent, and either is currently smoking or quit during the past 15 years.
A little over a year ago, Rita Valvano was at home with her grandchildren, of which there are nine—five girls and four boys.
On this particular day she had an appointment scheduled for her annual mammogram and was debating whether or not to attend. For 20 years Rita had mammograms performed and for 20 years they had all been clean. She was probably okay to skip one, right?
“For no particular reason, I decided to shuffle the kids off to school and attend my appointment. I truly almost didn’t go. Looking back I’m sure glad I did,” Valvano said.
Stage 1 breast cancer. Very small. She was lucky to have found it as early as she did.
It’s been a long year for Rita—but thanks to the support she’s received from her family, her friends and her doctors and nurses at Englewood Health, she’s been able to endure treatment, remain positive and get on the other side of this cancer.
November 2, 2018 – Anxiety is the leading mental health challenge among American youth, but is one we often don’t talk about. To increase awareness and sensitivity around the pervasiveness of childhood anxiety, and to begin a dialogue among family and educators, Englewood Health joined with Tenafly Public Schools and OCAY: Our Community Allied with Youth to cosponsor a screening of Angst: Raising Awareness Around Anxiety on Oct. 23 at Tenafly Middle School.
According to the National Institute of Health, anxiety disorders affect more than one-quarter of teenagers. Approximately 80 percent of children and teenagers suffering from anxiety do not receive treatment, and 20 percent will struggle with depression before graduating from high school. Englewood Health, Tenafly Public Schools, and OCAY aim to bridge that gap by highlighting the importance of this issue and ways to deal with it, while connecting students who are suffering and clarifying the pathway to help.
Angst, a documentary exploring the stress and anxiety today’s students are facing, was first shared with Tenafly school district faculty and staff on Oct. 22, and then with parents and students of grades six through 12 on the following evening, with more than 300 in attendance. The film centers on interviews with young adults sharing their experiences with anxiety, its impact on their lives and relationships, and what they have learned. It also features mental health experts identifying causes and sociological effects of anxiety, as well as resources for help.
Following the 43-minute screening, David Drapkin, LCSW, clinical social worker, psychotherapist, and manager of behavioral health programs at Englewood Health, led a clinical discussion, along with a question-and-answer session. Response to the film has been overwhelmingly positive, initiating important conversations between staff, students, and parents.
Other speakers included Suzanne Bassett, assistant to the superintendent for special services, and Janet Gould, student assistance counselor; co-advisor to the senior peer leadership program; and anti-bullying specialist at Tenafly High School.
“I can’t say enough good things about tonight,” Bassett said, following the event.
Along with introducing a discussion, the district’s hope was to enhance resources for students’ mental health and wellness to facilitate prevention and relief through healthy habits. In addition to the film, attendees had access to coping tools, resources for help, and screening for students to determine unhealthy anxiety levels.
America loves a weight loss story—look no further than the myriad television shows dedicated to weight loss journeys for proof of this fact. “My 600-Pound Life,” “The Biggest Loser” and “Revenge Body” just to name a few. But when it comes to how those struggling with obesity lose weight, our culture often stands in judgment of choices that we deem ‘lazy’ or ‘cheating.’ Bariatric surgeries, or weight loss surgeries, have long faced public scrutiny, and those who undergo these procedures are often seen as trying to merely escape diet and exercise. However, over the past decade, studies have shown that once someone crosses over into the category of obesity, losing weight – and keeping it off- through diet, exercise, and even medications becomes a much less realistic option. So, for many people struggling with obesity, weight loss surgery is their best and only option if they wish to lower their chances of developing diseases like diabetes or high blood pressure and live a longer life.
Who is the typical candidate for bariatric surgery?
Dr. McGinty: The typical candidate is someone who has struggled with their weight for long time, has made multiple attempts at losing weight through diet and exercise and is now weighing at least 80-100 pounds over their ideal body weight. This person is typically at risk for, or already has, diseases related to obesity, like diabetes, high blood pressure or sleep apnea.
What are the most popular weight loss surgeries?
Dr. McGinty: The two most widely used bariatric surgeries are the Roux-en-Y gastric bypass and the vertical sleeve gastrectomy. Both are done utilizing minimally invasive techniques which minimize pain, hospital stay, and complications. These operations work by changing the way that hormones that are made inside the intestine communicate with organs that control hunger and metabolism. Thus, patients are able to eat regular food, but their appetite is better controlled, they are satisfied with smaller portions, and their weight set point is lowered to a more normal level.
What are some of the benefits of weight loss surgery?
Dr. McGinty: Multiple studies have shown there is not only a health and quality of life benefit, but also a survival benefit among overweight people who opt for surgery. A study in the New England Journal of Medicine showed a more than 50% reduction in deaths from heart disease, a 90% reduction in deaths from diabetes related complications and a 60% reduction in dying from various cancers. As a result, those who had surgery saw a 40% reduction in mortality compared to those that did not have surgery.
Linda Senter (far left), had the idea to incorporate art into healing at Englewood Health. Pictured from left to right, Linda Senter, Lisa Beth Vettoso, The Art School at Old Church.
October 29, 2018 – In an ongoing collaboration, Englewood Health and The Art School at Old Church hosted a reception on Oct. 17 celebrating The Art of Healing, their annual art exhibition and community partnership. The reception, which was free and open to the community, showcased more than 50 works from 21 local artists who were present to discuss the art lining the halls of Englewood Hospital. More than 150 people attended to see the new artwork debut.
The Art of Healing exhibitions began in 2014 when Linda Senter had the idea to bring art into the hospital as a means of connecting with patients, believing relating to individual experience and emotion is a strong part of the healing process.
“The goal was to enhance the healing environment of the hospital through art, and also to bring in local artists so that they could have a venue for showing their artwork,” Senter said. “I think art has a very positive healing effect. It makes people feel better, it can distract you from whatever the issues or problems are. Hospital employees, patients, and visiting families have all been commenting on how positive they feel when they see the artwork.”
Submissions for the program come from students and teachers who are part of The Art School at Old Church, as well as local artists outside the school. Works are selected and curated by The Art School, and Gallery Manager Emma Abad coordinates layout and placement in the hospital hallways.
Lisa Beth Vettoso, Executive Director of The Art School at Old Church, emphasizes the impact of art on patients, beyond simple aesthetics. “For me it’s really thinking about the experience that a patient is going through from the broader perspective of the whole person—not just about their treatment on a medical level, but also about how they are recovering and coping mentally and emotionally. A lot of the work, both in terms of the exhibit and everything else we do in partnership with the hospital, is really focused on how each person is working through a difficult time so we can bring that little bit of something that resonates with them, lightens their spirits, and maybe shifts their focus.”
Vettoso has been excited to grow The Art of Healing partnership ever since she took on the role of Executive Director at The Art School. The Art of Healing Patient and Family Workshops have been a popular aspect of the program, with two instructors from The Art School at Old Church spending six hours a week at The Wilson Kaplen Infusion Center at Englewood Health. The artists, Jill Cliffer Baratta and Brenna Scheff, varied in their backgrounds and areas of expertise, have a small art room supplied with a variety of materials. Patients and families have the option of coming to the art room, or participating from their individual rooms during treatment. The artists make their rounds offering patients art supplies and guidance in painting, drawing, and jewelry making.
Among the classes offered at The Art School at Old Church are a number specializing in jewelry-making—and one specifically in glass bead-making. After hearing about the school’s collaboration with Englewood Health, the instructor, Stephanie Maddalena, organized donations of handmade beads—a popular material among infusion center patients—to the instructors visiting the hospital.
“It’s a really nice connection,” Vettoso said, “because a big priority of mine since coming on board has been not only about reaching out to the community, but also making sure there’s a nice connection between our students and our teachers and what we’re doing outside of the school. So, it’s wonderful that it was something they came up with on their own, as well as a way to share their hard work.”
Though the program is built around providing support to patients, it also aims to help their loved ones. Those along for the ride often welcome opportunities to stay busy and engaged.
“We know that if somebody is going through an illness it doesn’t just affect them,” Vettoso said, “so that’s another opportunity for us to bring something to the hospital for caretakers who want to participate.”
Future goals for the program include expansion into other departments and patient rooms, and permanent art exhibits to create a community space for patients and visitors.
Englewood Health has also begun rolling out customizable artwork in patient rooms, allowing patients and families to choose from winter, spring, summer, or fall scenes based on current mood and emotion.
Vettoso hopes this month’s Art of Healing reception—phase seven—which included live jazz music and refreshments, will help spread the word that these artistic opportunities exist for those both in and outside the hospital.
For more information on The Art School at Old Church, visit tasoc.org.
Eight-month-old Jonathan is perched on his mother’s lap in a doctor’s office. Wearing a blue onesie, he sucks on a pacifier as his eyes cruise the room. Jonathan’s father takes the video that now boasts more than nine million views on YouTube. A doctor can be heard off–screen, narrating the process as he plays with the levels of Jonathan’s new cochlear implant. Prompted by the doctor, Jonathan’s mother begins speaking to him.
“Can you hear me Jonathan?” she coos.
Jonathan looks up at his mother, eyes wide, and drops the pacifier from his mouth. A toothless grin stretches across his face as he stares up at his mother and hears her voice for the first time.
Videos such as this one have gone viral for years. Jonathan himself is now eight years old and likely no longer remembers a time when he couldn’t hear. Cochlear implants, too, have come a long way since then. Rosemary Ojo, MD, a highly specialized ear surgeon, who performs cochlear implants has a passion to treat conditions, including unusual ones, that affect hearing and the ear in patients from eight months to 90 years old.
Who is a candidate for a cochlear implant?
Dr. Ojo: People for whom a cochlear implant is appropriate have such severe hearing loss that it affects the inner ear structure called the cochlea, which contains the organ of Corti. Regular hearing aids are ineffective in these cases. I tell my patients that a cochlear implant is like a computer that we put in the cochlear organ. The implant bypasses the damaged part of the ear, and via electrodes directly stimulates the hearing nerve that allows the brain to hear.
Is cochlear implant surgery a large part of your practice?
Dr. Ojo: Yes, there are very few physicians in our area who do the procedure—and I want people to know that they don’t have to cross the bridge to see a highly specialized ear surgeon.
What are the most common conditions you treat as an ENT?
Dr. Ojo: I see patients with a range of conditions, including age-related hearing loss, tinnitus (ringing in the ear), and large buildup of wax—usually the result of using cotton swabs, which over time push wax back into the ear. Patients also come to me with sinus complaints—usually infections, allergies, or post-nasal drip. Some patients have coughs that don’t go away after a cold, or acid reflux. Occasionally, I treat a patient who has cancer or a rare condition like Meniere’s disease or some other balance disorder.
To be healthy means more than just being disease free. Our health comprises our physical, psychological, emotional, and social lives. Just as we eat healthfully and exercise to support our bodies, it is important to develop habits that support the other pillars of health, as well. We need to find ways to manage stress, maintain social connections, live mindfully, and deal with emotional issues in the best way possible. This is where integrative medicine comes in.
What is integrative medicine?
Dr. Scheller: Integrative medicine refers to the use of conventional and complementary therapies together in a coordinated and evidence-based way, to facilitate the healing process. In integrative medicine, we consider the patient as a whole person and develop a plan for healing that addresses all aspects of health.
What is the difference between alternative medicine and integrative medicine?
Dr. Scheller: Alternative medicine refers to a non-mainstream approach that is used instead of conventional medicine. What we’re doing at the Graf Center for Integrative Medicine at Englewood Health is better described as complementary medicine: We use non-mainstream therapies together with conventional medicine, and all our treatments are supported by research and evidence.
Who might be a good candidate for integrative medicine?
Dr. Scheller: Anyone! You don’t have to have a disease or diagnosis to explore integrative medicine. This is the right move for those who want to take control of their health, make good lifestyle changes, and boost their overall wellness.
A central concept of integrative medicine is that the patient and practitioner operate as partners in the healing process. Why is this kind of relationship important?
Dr. Scheller: This kind of relationship gives patients the sense that they are part of the team. It is important because people need to take an active role in their own health and wellness. When you think about health, it’s a state of complete physical, mental, and social well-being—not just the absence of disease. We want people to take part in changing their nutrition, lifestyle habits, and stress levels.
October is National Breast Cancer Awareness Month – a great time for women of all ages to learn more about their breast health and double their efforts in surveilling for irregularities in their breast tissue.
Who is at high risk?
Dr. Goldfischer: Most women who develop breast cancer have no known risk factors. Only 5–10 percent of breast cancers occur in women with a genetic mutation, usually BRCA1
or BRCA2.
Women with a history of breast cancer are at increased risk for another breast cancer.
Women with a genetic mutation or a first-degree relative with one. Women of Ashkenazi Jewish descent are at increased risk for BRCA mutation, as well as other less-common mutations, such as CHEK2.
Women with multiple family members (maternal or paternal), especially first-degree relatives, who have had breast cancer. The age at diagnosis is important, with premenopausal occurrence increasing risk.
Chest radiation before the age of 30 increases the risk of breast cancer (as well as cardiac disease).
Women who have had one or more breast biopsies for ADH (atypical ductal hyperplasia) or LCIS (lobular carcinoma in situ).
At what age should women begin breast cancer screening?
Dr. Goldfischer: The American College of Radiology (ACR) recommends that women with an average risk of developing breast cancer begin annual screening mammography at age 40. Because younger women tend to have dense breast tissue, which can obscure masses, annual mammograms are important; sometimes supplemental breast ultrasound is indicated. High-risk women—those who have a first-degree relative (mother, sister, daughter) with breast cancer or who have a BRCA gene mutation—should begin annual screening 10 years earlier, but not before the age of 25. After the age of 75, women should consult their physician to determine whether they need additional screening.
What are the advantages of 3D mammography?
Dr. Goldfischer: At Englewood, almost all mammograms are 3D. With the traditional 2D mammogram, the X-ray tube is stationary and the breast tissue overlaps in the image. With a 3D mammogram, the X-ray tube moves in an arc around the breast. Images are obtained from multiple angles and synthesized by a computer, which creates thin slices that can be viewed individually. A special computer algorithm achieves 3D mammograms with the same radiation dose as 2D mammograms.
Nimesh Nagarsheth, MD, director of gynecologic oncology, practices gynecology, and gynecologic oncology at Englewood Health. Each year in September, we recognize Gynecologic Cancer Awareness Month— a good time for women of all ages to learn more about the cancers that affect the cervix, ovaries, uterus, vagina, and vulva. Raising awareness about cancers that occur “below the belt” in women is vital, as the key to survival is early detection and medical intervention. Until recently, public awareness of gynecologic cancers has been low, as many are uncomfortable talking about women’s reproductive health.
If a woman is diagnosed with a gynecologic cancer, what are her treatment options?
Dr. Nagarsheth: Treatment options depend on the type and stage of cancer; they may include surgery, radiation, chemotherapy, targeted therapy, immunotherapy, or a combination of these. At Englewood Health, we take a multidisciplinary approach to cancer. We customize the treatment plan in tandem with the patient, so every patient receives the most appropriate treatment.
Truth or myth: If you contract HPV, you will eventually get cervical cancer.
Dr. Nagarsheth: Myth. Not every patient with HPV develops cervical cancer. Though most cases of cervical cancer are caused by HPV, the majority of women with HPV do not develop cervical cancer. We’re in the process of learning why some patients with HPV are more susceptible than others to cervical cancer.
How is ovarian cancer typically detected?
Dr. Nagarsheth: There is no good screening process for ovarian cancer. Unfortunately, it is typically detected in its more advanced stages, when patients come to us with symptoms that are secondary to the ovaries having become enlarged or the tumor having spread. Patients frequently report intestinal discomfort, abdominal pain—symptoms of that nature.
Truth or myth: Young women don’t need to be concerned about gynecologic cancers.
Dr. Nagarsheth: Myth. Every woman, no matter her age, should know the warning signs and symptoms of gynecologic cancer. If not for yourself, then for the women around you. Problems such as postmenopausal bleeding, persistent nausea, vomiting, and abdominal distention should never be ignored. It’s all about knowing what is normal for your body and then taking action when something seems off.
Posted September 2018
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