Multidisciplinary Medicine Enhances Patient Care
By Cora Lee Foster, MD
Collaboration among professionals
in different medical specialties leads to new approaches to treatment and
better patient outcomes. Surgeons at Cayuga Medical Center have worked closely
over the years with our colleagues in Imaging Services and the Laboratories to
introduce new minimally invasive surgical procedures.
How imaging enhances cancer
diagnosis and surgery
Perhaps one of the more widely
known examples of how imaging enhances surgery is a procedure known as
lymphatic mapping and sentinel node biopsy, which is used to locate breast
cancer and melanoma spread.
One of the problems doctors always
face in treating breast cancer and malignant melanoma is determining if and where
the disease has spread. Cancer cells typically travel from the tumor to the
site of nearby lymph nodes, but until lymphatic mapping and sentinel node
biopsy were developed, surgeons could not pinpoint the exact pathway or the
specific nodes affected.
Radiologists, pathologists, nuclear
medicine specialists, and surgeons at Cayuga Medical Center worked together to
introduce lymphatic mapping and sentinel node biopsy locally by participating
in clinical trials in 1998. Today we routinely trace the path of certain types
of cancer cells and identify the first (sentinel) lymph node into which
migrating cancer cells might have drained.
This technology, which is called
lymphoscintigraphy, employs special radiographic tracers and a state-of-the-art
hand-held Gamma probe which help surgeons pinpoint the exact location of
effected lymph nodes. This is a significant breakthrough in cancer diagnosis
and, for many breast cancer and melanoma patients, results in less invasive
surgery and minimal follow-up therapy if the cancer has not spread to the
Multidisciplinary approach to
We use a similar technique in
surgery for hyperparathyroidism, a condition that is treated by identifying and
removing an abnormally functioning parathyroid gland. Historically, what has
made this surgery challenging is locating these four tiny glands in the neck
and then successfully identifying the one that is causing the problem.
With standard surgical treatment
for hyperparathyroidism, we had to wait several days for blood tests to confirm
that we had removed the appropriate one of the four parathyroid glands.
At Cayuga Medical Center, through a
very successful collaboration with Imaging Services and the Laboratories, now
we can quickly identify the suspicious parathyroid gland using a radioactive
tracer, a a sestamibi scan, and a hand-help probe. While the patient is still
on the operating table, the Lab can then confirm the diagnosis within twenty
minutes by using a new rapid intra-operative parathyroid hormone test. This is
a significant advancement in patient care for people diagnosed with
Bringing new medical advances to
Every member of a multidisciplinary
care team brings specialized knowledge and the latest findings to the table
whenever we introduce new approaches to patient care. Physicians on staff at
Cayuga Medical Center regularly attend national professional meetings so that
we can teach our colleagues about new developments and introduce new techniques
and technology into our practice of medicine. We also pursue advanced
certification in our areas of specialty and network with colleagues at other
With each success, we look for
additional ways in which we can collaborate to expand local services and
enhance patient care with faster diagnoses and less invasive treatment. Our
multidisciplinary approach to cancer care through the Cayuga Medical Center
Tumor Board has proven so effective over the years that we are looking to
develop other clinical teams for patients with thyroid disease, breast cancer,
and other disease sites. In this way we can continue to streamline care while
providing the very latest treatment, both of which benefit our patients.
Foster is board certified in general surgery, serves on the medical staff of
Cayuga Medical Center, and is in practice with Surgical Associates of Ithaca.
She introduced the latest technique for hyperparathyroidism surgery, led the
clinical trial for sentinel node biopsy at Cayuga Medical Center, and is a
candidate for membership in the American Association of Endocrine Surgeons. Dr.
Foster can be reached at (607) 273-3161.