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more articles by Foster, Cora , MD  |  author's bio

Multidisciplinary Medicine Enhances Patient Care

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 sentinel node.


Multidisciplinary approach to hyperparathyroidism


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 hyperparathyroidism.


Bringing new medical advances to our patients


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 medical centers.


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.


Dr. 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.


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