Ask the Doctors: Dr. Mark Shapiro and Dr. David Dubin

Posted on by Michael Chananie
Mark Shapiro, MD
Mark Shapiro, MD, chief of radiology

For decades, screening for and treating lung cancer has had two big challenges— detecting very small tumors as early as possible, and then restricting radiation treatment to only the small tumor that moves around every time the patient breathes without harming healthy tissues.

David Dubin, MD
David Dubin, MD, chief of radiation oncology

In 2017, Englewood Hospital was named a Screening Center of Excellence by the Lung Cancer Alliance for its commitment to lung cancer screening. Since 2014, the Englewood team has screened over 1,100 at-risk smokers and former smokers, diagnosing 10 cancers in patients who had no symptoms. Englewood Health is also the first in New Jersey, and one of the first in the nation, to offer stereotactic body radiation therapy (SBRT), a lung cancer treatment using motion detection to offer extremely precise treatment.

How can we prevent lung cancer?

If you’re a smoker, take steps to quit. Englewood Health’s Graf Center for Integrative Medicine offers a smoking cessation program consisting of eight weekly group sessions where you will learn strategies to quit. All meetings are led by an experienced licensed clinical social worker certified through the American Lung Association’s Freedom from Smoking Program. The Graf Center also offers meditation to aid relaxation, and acupuncture to reduce nicotine cravings.

How do you find lung cancer earlier and treat it more effectively?

At Englewood Health, we offer patients low-dose CT screening for lung cancer (LDCT), an imaging procedure that provides more detailed images than conventional X-rays and has been proven to find cancer earlier, when it is more likely to respond to treatment. Once a CT scan detects a potential tumor, we provide rapid and seamless diagnosis and treatment. Similar to colonoscopy for colon cancer, or mammography for breast cancer, LDCT is an effective cancer screening that has been shown to reduce cancer deaths.

What makes LDCT the best lung screening option?

LDCT is a quick, painless test; no fasting or special preparations are required, and the scan takes less than a minute. Low-dose CT uses lower amounts of radiation than a standard chest CT and has been shown to detect cancer in patients before the onset of symptoms alert them that anything is wrong; early detection saves lives. Medicare and most third-party payers now cover LDCT for patients who qualify.

Once lung cancer is detected, what is most important to consider when seeking treatment?

When it comes to treatment, we focus on accuracy and precision. Delivering high doses of radiation to small, targeted areas is especially challenging in the lung because the target moves as the patient breathes. To be most effective, we have to know exactly where the target is. SBRT allows us to track the exact location of a tumor with submillimeter precision throughout the treatment.

Posted December 2018

Do you have a question for a doctor?

From your head to your toes, and everywhere in between, the Englewood Health has you covered. Ask a question about your health. Selected questions will be answered in this column.

Third Annual Cancer Symposium Focuses on Cancer Screening and Case Studies

Posted on by John Williams

The Lefcourt Family Cancer Treatment and Wellness Center and the Englewood Health Physician Network hosted the Third Annual Cancer Symposium on November 29, 2018. This year’s symposium — “Cancer Case Studies and Screening Guidelines” — focused on the primary care physician’s role in the delivery of cancer care. Presentations included case studies on breast, prostate, gynecologic, lung, liver, and thyroid cancer; a review of screening guidelines; and special presentations on cancer survivorship and cancer in geriatric patients. Attendees included primary care physicians as well as healthcare providers involved in the care of patients with cancer.

 
Posted December 5, 2018

The Leslie Simon Breast Care and Cytodiagnosis Center Earns National Breast Center Certification

Posted on by Michael Chananie
NQMBC Certified Quality Breast Center seal

December 3, 2018 — The Leslie Simon Breast Care and Cytodiagnosis Center at Englewood Health has been recognized as a Certified Quality Breast Center by the National Consortium of Breast Centers (NCBC) as part of their National Quality Measures for Breast CentersTM program (NQMBC); it is the only breast center in Bergen County to earn the certification.

The NQMBC program offers facilities providing breast health care the ability to track and measure quality performance measures in more than 30 individual quality indicators, and compare their performance with other centers across the United States and beyond.

“Earning this certification is a testament to the ongoing efforts of our doctors, nurses, and other staff to bring the safest, highest-quality, and most technologically advanced care to our community,” says Warren Geller, president and CEO of Englewood Health. “The Leslie Simon Breast Care and Cytodiagnosis Center at Englewood Health remains committed to ensuring that our patients have the best possible experience, and receive the best possible outcomes.”

The Leslie Simon Breast Care and Cytodiagnosis Center is at the forefront of breast care treatment in northern New Jersey. With private waiting rooms, a spa-like environment, rapid diagnosis with an opportunity to discuss results with a physician, and an in-house team of specialized pathologists and radiologists, whose primary focus is on breast disease, each patient is treated with a unique, custom-tailored experience. And in the event that a patient has a positive finding, it is reviewed by a multidisciplinary team of surgeons, medical oncologists, radiation oncologists, pathologists, radiologists, nurse practitioners, genetic counselors, and other breast care specialists to tailor a treatment plan specific to the patient.

Ask the Doctor: Dr. Asit Shah

Posted on by Michael Chananie

Many people don’t think about bone and muscle health on a daily basis, or realize they have a need for treatment. But when the seasons change, our choice of physical activity often changes. And if we’re not prepared, injuries can arise.

Who should see an orthopedist?

Dr. Shah: People should be tested for bone health in general, but especially if they have a family member with osteoporosis or osteomalacia. These conditions can be passed on, but are treatable. Those with targeted issues such as shoulder pain or arthritis pain should also take special care.

What suggestions would you make for keeping exercise safe?

Dr. Shah: We see a lot of people repeating the same workout over and over, which can actually be harmful and cause further injury. It’s not good to swim, bicycle, or lift weights all year long. You should change your exercise routine every three months or so. And remember not to overdo it.

How can people prevent injury in the fall and winter months?

Dr. Shah: In the fall and winter, people are starting to clean their gutters, tend their lawns, rake leaves, and shovel snow—all activities that rely on your low back, your quads, and your shoulders. So it’s important to spend a lot more time on your core exercises, stretching out your quads, and strengthening your back to get those muscles activated again. And if you’re an avid skier, remember that you have to get your body trained again before picking up a set of skis.

With the holidays around the corner, how can people avoid accidents while celebrating?

Dr. Shah: We see a tremendous increase in fractures when families bring elderly loved ones home for the holidays, taking them out of their controlled environments. Make the home environment safe—remove loose rugs from the bathroom, fix unstable handles or balusters on the railings. We also see wrist fractures and ankle sprains from people falling on snow and ice, so wear appropriate footwear for the weather. Lifting and moving heavy objects, like boxes of holiday decorations, also takes a toll. Always bend at your knees and hips, rather than your spine, and lift with your legs.

What are the best practices for healing an injury?

Dr. Shah: The general musculoskeletal injury takes about six to eight weeks to heal. The most important thing I can say is work with a physical therapist to heal injuries. There’s a common misconception that if you go to the gym on a regular basis, you won’t benefit from physical therapy. But many people aren’t exercising properly at the gym, which only makes them hurt themselves more. And stretching some parts of the body, like the hip, knee, or shoulder, requires help. Physical therapists play a more important role in rehabilitation than most people realize.

Posted November 2018

Tracy Scheller, MD, Appointed Medical Director of Graf Center for Integrative Medicine and Joins the Englewood Health Physician Network

Posted on by Michael Chananie

November 16, 2018 – Tracy Scheller, MD, has been appointed medical director of the Graf Center for Integrative Medicine at Englewood Health and has joined the Englewood Health Physician Network. Dr. Scheller is board certified in obstetrics and gynecology and has been an attending physician at Englewood Hospital for close to two decades. Her clinical interests include gynecology, integrative medicine, infertility, menopause, women’s wellness, nutrition, and weight loss. In addition to her role as medical director of the Graf Center, she will continue her gynecology practice in Englewood.

Under Dr. Scheller’s direction, the Graf Center offers safe, evidence-based services, including acupuncture, therapeutic massage, wellness coaching, nutritional counseling, yoga, Reiki, and stress management. These therapies have been shown to help minimize nausea, reduce pain, and relieve stress and anxiety. The center’s team of licensed and/or certified practitioners work closely with a patient’s doctor to establish a wellness plan.

“Helping patients at all stages of their lives through a combination of traditional medicine and complementary therapies is how I feel I can make the greatest difference,” says Dr. Scheller. “I’m thrilled to have the opportunity to lead the Graf Center for Integrative Medicine at Englewood Health, where we will expand patients’ access to evidence-based services, to promote healing and wellness.”

Dr. Scheller received her MD from the University of Texas Health Science Center at Houston Medical School, followed by an obstetrics and gynecology residency at Memorial Hermann–Texas Medical Center. In addition to her MD, she holds an MBA from the University of Houston and an MS in human nutrition from Columbia University’s Institute of Human Nutrition. She is currently pursuing an integrative medicine fellowship at the University of Arizona Center for Integrative Medicine.

“As a member of the Englewood Health Physician Network,” she adds, “I’ll be able to collaborate more closely with colleagues across disciplines through a shared electronic medical record and closer communication, to improve patient care. I look forward to sharing my expertise in holistic care and in integrative medicine, to help our patients achieve better health.”

“We are very excited to welcome Dr. Scheller to our team of renowned specialists and providers. Dr. Scheller’s expertise in gynecology and integrative medicine will help meet an important need in our community,” said Dr. Stephen Brunnquell, president of the Englewood Health Physician Network. “As our network continues to grow, we remain focused on ensuring that our patients have access to leading care right here, in their own backyard.”

She is a fellow of the American College of Obstetrics and Gynecology and has been a principal investigator on a clinical trial for osteoporosis prevention.

Ask the Doctor: Dr. Srikant Kondapaneni

Posted on by Michael Chananie

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.

Posted November 2018

Rita’s Story – Cancer Care

Posted on by Michael Chananie

 

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.

Posted November 2, 2018

Englewood Health, Tenafly Schools Raise Awareness for Anxiety in Youth

Posted on by Michael Chananie

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.

Ask the Doctor: Dr. James McGinty

Posted on by Michael Chananie

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.

Posted November 2018

Englewood Health, The Art School at Old Church Host The Art of Healing

Posted on by Michael Chananie

Art of Healing 2018
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.