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The Student News Site of Stony Brook University

The Statesman

The Student News Site of Stony Brook University

The Statesman


    Cancer Center brings patient care to an individual level

    A small bell hangs in the pediatric cancer section of the Stony Brook University Cancer Center that young patients can ring once they finish their chemotherapy. (EFAL SAYED/ THE STATESMAN)

    Young Stony Brook University Cancer Center patients sit in the medical offices, where doctors are discussing with them and their parents the seriousness of being diagnosed with cancer. They anxiously anticipate the minute they can run out of the office, into the hallway and through the door into the aquatic-themed painted waiting room of the pediatric cancer section of the center. They may have cancer, a disease that brought more than 3,000 people through the glass sliding doors of the Cancer Center in 2010, but they just want to get to the waiting room where they can ring that bell.

    It’s just a bell. A small bell that once belonged to a firetruck and was provided by the Firefighters Cancer Support Network. There’s a bigger one down the hall for the adult patients, too.

    But to cancer patients at Stony Brook, it’s more than that. Much more than that. To them, it’s the significance of a new life.

    Children share the same look that their adult cancer patient counterparts have in the medical offices only a hallway away. The bell can’t be touched until their chemotherapy is over, but once the time comes, everyone is watching. As the sounds of the humming of the bell resonate throughout the two-floored Cancer Center, fellow patients, doctors and nurses clap in excitement, congratulating the patient who just got through one of the hardest experiences of their long or short life.

    Stony Brook University Cancer Center does things of this nature to lighten the otherwise gloomy situation of being diagnosed with cancer all of the time.

    Multidisciplinary Means Many People for One Person

    The Stony Brook University Medical Center has embraced the notion of multidisciplinary care, which means that multiple doctors work behind the scenes to benefit the patient’s experience. While a patient may go to one primary doctor within the Cancer Center, there are multiple people working together in the laboratories and many hallways of the center to give the best advice, treatment and help with overcoming this potentially fatal disease.

    Since 2000, the number of new cancer patients at Stony Brook has increased. In 2000, there were 2,248 patients. In 2010, there were 2,270 new patients.

    Medical Oncologist Andrzej Kudelka said he works with about 10-12 doctors, including radiologists, pathologists, nurses and surgeons, for one patient.

    Each doctor has a focus that they are specialized in. For oncologists, it’s specializing in treating cancer with non-surgical treatments such as chemotherapy and radiation. For a surgical oncologist, it is using surgery as a way of removing cancer, such as removing a breast if it’s breast cancer. Radiologists interpret images such as MRIs, x-rays and ultrasounds. Meanwhile, pathologists focus on the study of blood, fluid and tissue samples. There are so many aspects to not only diagnosing, but treating and caring for the patients, all of whom have unique cases despite the categorization of a type of cancer in a specific area, such as in the lungs or brain.

    “It quickly gets very complex,” Kudelka said of the amount of people involved in treating a patient. Each doctor plays a distinct and important role in working to find a cure for the patient’s medical problems. Rather than having all of the doctors go to the patient, he personally tells the patient what is going on with their treatment.

    Paintings of flowers line the hallways of the Stony Brook University Cancer Center, while outside a sunflower sculpture by a patient's husband stands to welcome new patients. (EFAL SAYED/THE STATESMAN)

    When it comes to explaining the situation to the patient, he gives the short version, which includes what the doctors found and how they are going to proceed in the treatment. He asks his patients if he can contact them over the phone as results come in, and said 90 percent of the patients will agree. The others want to just be asked to come in to speak about it face-to-face, even if they think they know what the diagnosis is.

    It’s something to cherish, Kudelka said, when the information they can give to the cancer patient is good news. But unfortunately, that’s not always the case.

    “There’s a method in conveying information; do it at the time when the patient is ready and wanting to hear information,” Kudelka said, adding that he’ll discuss everything at the pace the patient wants, which means slowly and in small pieces.

    “I’m constantly talking to patients of cancer,” said Patricia Farrelly, a surgical oncologist at the Breast Care Center. Her office is in the hallway behind the front desk of the Breast Care Center, where nurses and secretaries adorned in pink scrubs greet and speak with patients waiting for their appointments. Sparkling pink ribbons hang from the ceilings by the glass divider.

    Farrelly said talking to patients about their diagnosis, especially when it is bad news, is difficult at times, “but as a doctor, I have to dissociate.”

    She sees the multidisciplinary teams of the Cancer Center as “one stop shopping.”

    “Everything is here,” she said. She works with multiple other doctors and can easily arrange for a CAT scan or MRI, or ask questions to another surgeon. She can also refer to the Tumor Board, which exchanges consultation, information and collaboration among the different departments of the center. “All together, it’s a great advantage of the patient as well as physician.”

    Farrelly was a doctor at a private practice in New York City, and said that the process was a lot different there. If a patient showed her films of their disease, she’d be able to read them, but would have to refer the patient to another doctor and then ask that the patient tell her about it later on.

    “It was disjointed,” Farrelly said.

    For Farrelly, her patients who are freshly diagnosed with cancer “know it, but have no knowledge of cancer,” she said. The nurses will go in first to interview the patient, and then discuss the situation with her, who will follow in after to speak with the patient again. Then she’ll ask the person to get dressed and come into her office, where she will draw pictures and show X-rays and talk about the plan to proceed with their care.

    It’s always catered to the individual.

    An Individualistic Point of View

    In August 2001, Eileen Tobin became a cancer patient.

    She went to Michael Pearl, the current director of the gynecological oncology team at the center, back when he was working in a private practice.

    Tobin was diagnosed at Stage 3C, the last stage before Stage 4, which is when the cancer has spread so far that it becomes irreversible. Now she’s an ovarian cancer survivor, but with recurrences, so she goes in for periodic treatments. Her cancer has become maintainable, and she has been very happy with the treatment since the first day.

    Tobin stayed with Pearl as he moved to the Cancer Center.

    “I think he’s a wonderful doctor cause 10 years later, here I am,” she said. “I always appreciated the fact that he was very honest. He tells you what the story is, doesn’t sugar coat. He and his staff are very much the same way; very caring but very realistic.”

    That technique makes her feel comfortable being in their hands.

    “Even though it’s difficult and not going to get better, the staff is very supportive, helpful and generally supportive in light of that situation,” she added.

    A memorial path, waterfall and rose bushes are on the side of a path leading up to the entrance of the center, where valet parking is also available. (EFAL SAYED/THE STATESMAN)

    She loves the feeling the building itself gives off. Someone is always at the front desk ready to greet the newcomers, and lead the patient to where he or she has to go. And of course there’s the valet parking. When you’re not feeling well, she said, not having to worry about parking your car is a big deal.

    From there, she’ll go into the Cancer Center where she is always greeted and then to registration. Once she is registered, she waits.

    Tobin had her chemotherapy at the Cancer Center for two straight years from 2008 to 2010.

    “I always feel like I know what’s happening,” she said. “If the chemo is not up right away, they always explain what’s happening. If a blood test is required, they explain why you would need the blood test. If you are delayed in getting a seat, if there’s no chair, you don’t sit there waiting. They keep you apprised at what’s happening.”

    One day she was sitting with her sister when she started to feel her foot getting a bit itchy, which is a sign of an allergic reaction. Everyone around her was calm and talking and kidding around with each other, and she quietly told her sister to tell a nurse about her situation.

    “She told my nurse my feet were itchy, and by the time she stood up to the desk, I had at last five nurses there,” Tobn said. “They were very aware what was happening. They got right down to business. They can change like that to a very professional system. They all knew what the next one was going to be doing.”

    But it’s not always a serious situation when she’s waiting while at the center. Throughout her 90 treatments of chemotherapy, which could go from two to eight hours a day, she was able to go on the computers available to the patients, or watch the flat screen televisions. She and her sister did Christmas shopping and made Christmas cards one year, and planned two of her daughters’ weddings another time as she went through chemotherapy.

    Tobin is a member of Long Island Ovarian Cancer Education Advocacy Networking Support, also known as LI OCEANS, where many other members are also patients of Stony Brook’s Cancer Center. The woman’s group has donated more than $55,000 through fundraisers over the years to research for ovarian cancer at the Center.

    “[It has] a lot of things going for it,” said Sandy Rich, the president of LI OCEANS, of the Cancer Center. “Our members have been very pleased with the care.”

    LI OCEANS also has an annual vigil in front of the center, where a list of names of those battling or lost the battle is read in memory. Patients and doctors speak at the ceremony, and a nurse also sings.

    “I never felt like a number,” Tobin said. “I know I was because the room was packed, but I never felt like it. I always felt like they were concerned.”

    “I always felt like that was a good place to be,” she added about the center. “I would have sought out another place if I did feel like that. I always felt like they were right there with what I needed.”

    Setting the Mood

    Linda Bily is a 13-year breast cancer survivor, and she’s the Supervisor and Patient Advocate at the Cancer Center.

    Being a survivor is one of the reasons she has such a good relationship with the new patients that are walking past the memorial bricks and the waterfall on the path to the entrance every day.

    “Oh, you get it,” cancer patients will tell her as they worry about losing their hair or the process of what’s next in the journey that is cancer.

    As she walks through the first and second floors of the Cancer Center, it’s as though she’s gliding through the many facets of a home. People sitting at the front desks of the multiple sections of the center wave and say hello to her, giving her a smile. She’s also always updating the racks of pamphlets and brochures of outreach programs — in English and Spanish — that could save a patient a little tension and provide a bit more ease in regards to a situation like dealing with a husband or wife who has cancer. She adds knitted scarves and hats to a weaved basket near her office that were made specifically for cancer patients from a local knitting club. Inside her second-floor office are teddy bears with little pink ribbons on their chest and a lot of hats, including a cowboy hat and a New York Yankees cap.

    Downstairs is a handmade quilt made by Smithtown Stitches in October 2006 that once hung in Bily’s office when there was less space. Each patch of the quilt was made by an individual person.

    “Stony Brook is not only a good cancer center, it’s a good hospital,” said Tony Cruz, regional director of the Firefighter Cancer Support Network. “We have a personal connection to Stony Brook and a good experience with them, with the staff itself. [The hospital is] not only progressive in education and learning about new things and dealing with cancer, but that personal care that we’ve witnessed in the firefighters and EMS people.”

    A bigger bell stands that is used for patients to ring after their chemotherapy, signifying the end of their treatment and the beginning of a new life. (EFAL SAYED/THE STATESMAN)

    Cruz and Ron Barz, a member of the Firefighter Cancer Support Network, both had cancer, but went to their local cancer centers. But Stony Brook is local to their fire station, the Hauppauge Fire Station off of Route 111. After fostering a strong relationship with the center, they’re now on the Cancer Advisory Group, where they are only two men among 15 women. They advocate the importance of firefighter and EMS givers care.

    “Firefighters are a different breed of people,” Cruz said. “They’re leaders no matter if they have one day in the fire service or 50-60 years. We lead people during the times they have their worst day. Now with that being said, when the firefighters need help, we’re kind of fish out of water, because we’re usually the ones giving the help and now we need the help.”

    Firefighters are just one of the many types of people that are treated for 12 different types of cancer, including melanoma, sarcoma, breast and lung. And they are just one of the many types of people that go to Stony Brook’s Cancer Center.

    And they are just one of the many thousands of people that get treated by numerous doctors through multidisciplinary care until they can finally say they are cancer-free, or at least safe for now.

    And when that time comes, they get their chance to ring that bell.

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