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Transforming Cancer Care

There are few words one can hear that are as devastating as “You have cancer.”

Tonya Lafler received that life-changing diagnosis in June 2015 at age 41, shortly after finding a lump in her breast. But she said from the moment she arrived at the Stony Brook University Cancer Center for her first mammogram and ultrasound and met with the “warm and outgoing” technician, she knew she was in good hands.

Lafler was diagnosed with a stage III triple negative tumor and underwent bilateral surgery. “But because of the care I was getting, not once did I feel like I was going to lose the battle. These people welcomed me with open arms, from the surgeons to the nurses to the mammogram technician to the oncologists to the heart doctor,” Lafler said. “I built relationships with many teams of the Cancer Center. They were all part of my care plan.”

Linda Bily, the Cancer Center’s director of Cancer Patient Advocacy and Community Outreach, explained what makes the care Lafler received unique. “The first time you walk in, you realize that you and your family members are not alone. We’re giving you hope, insight and resources for you and your whole family,” Bily said. “We have a team approach to care. You get a team of experts on your type of cancer.”

The Cancer Center is on the cusp of a transformational cancer moment, with advanced technology, a state-of-the-art facility for research and clinical care, and a renewed national focus on the disease.

In addition to seeing doctors and nurses, patients may meet with a patient advocate, nutritionist, clinical trial specialist, financial counselor and genetic counselor.

“All of the support staff explain everything in layperson’s terms, addressing issues such as transportation to treatments. We want the patient to feel comfortable with all of the new information,” Bily said.

There’s another important way the Cancer Center stands apart. “We have all kinds of resources for patients — not just medical information, but other resources, such as support groups on how to explain cancer to children, bereavement groups, groups for children of cancer patients and exercise programs,” she said.

Lafler explained the importance of those resources from the patient’s perspective.

“I never felt it was necessary to diagnose my symptoms online,” she said. “I never felt neglected; I never felt like I didn’t have enough information. And everything I needed was convenient. Everything was in the same building or a football field away.”

“Patients remember how they were treated even more than the treatments,” Bily said. “All the staff, volunteers and community members who work with our patients or donate funds or goody care bags agree that we get back so much more than we give. It is an honor to share the cancer journey with our patients.”

Synergy With the University

What makes this level of patient care possible is the momentum in cancer care and research that is fueled by a collaborative energy propelled by vision. The Cancer Center is on the cusp of a transformational cancer moment, with advanced technology, a state-of-the-art facility for research and clinical care, and a renewed national focus on the disease.

The coalescing of this cancer moment is not lost on the Cancer Center’s director, Yusuf A. Hannun, MD.

“It’s very exciting and very energizing,” Hannun said. “One of the things that distinguishes Stony Brook Cancer Center from other centers nationwide is that we are physically, psychologically and socially integrated with Stony Brook University. We have a lot of support, a lot of involvement and a lot of energy across the campuses.”

In his five years leading the Cancer Center, Hannun has assembled his own dream team of researchers, physicians and staff members who are dedicated not only to finding cures, but also to providing compassionate care to patients with an emphasis on sustaining the best quality of life.

The Cancer Center has 12 teams dedicated to treating specific cancers. Collectively, the doctors have treated more cases per year than any other hospital in Suffolk County.

Comprehensive Team Approach to Care

Each clinical care team, under the supervision of Deputy Director for Clinical Affairs Samuel Ryu, MD, typically includes surgeons, medical oncologists, radiation oncologists, several other specialty doctors, nurses and a social worker to address the different stages of care. What’s more, each team is empowered to lead clinical trials, which helps patients now and leads to new therapies for those in the future.

The teams specialize in three areas: surgical, medical and radiation oncology disciplines. These experts work closely to make an individualized treatment plan tailored for each patient’s needs. “The patients appreciate the dedication of the team members,” Bily said.

A main contact for the patient is the nurse navigator or coordinator. This professional coordinates appointments, answers questions and helps guide each individual through treatment. “This role is so important to patients. They know they have someone they can call or email with any questions,” Bily added.

The multidisciplinary approach ensures that patients not only receive comprehensive care for their disease, but that their psychosocial needs are addressed through extensive support services as well.

“We have plans to add to the support services at the Cancer Center,” Ryu said. “Our goal is to make the experience of cancer treatments easy and convenient for patients and less of a burden for their caregivers.”

The Cancer Center offers specialized clinical services featuring programs that address the comfort and emotional journeys for patients and their caregivers, such as psychological care, pain management, cancer survivorship and palliative care. Currently, more than 3,000 newly diagnosed individuals are treated here annually.

Advances in Research

Of course, without research, cancer medicine would be stagnant. “We would still be practicing it as we did 50 years ago, which was pretty brutal,” said Hannun. He is a firm believer that the academic environment is paramount to continuing the momentum of cancer research — and ultimately finding cures.

Three thematic programs are driving this cutting-edge research: Cancer Lipids and Metabolism; Oncogenic Drivers and Mechanisms of Carcinogenesis; and Imaging, Bioinformatics and Engineering Sciences. These areas have been identified according to Hannun as having high levels of scientific excellence and opportunities for interaction and collaboration among scientists. They also build on disciplines of exceptional strength at Stony Brook University, including applied math, physics, engineering sciences, computational biology, imaging, metabolism, chemistry and computer sciences. The goal is to create more effective and targeted treatments, as well as prevent specific cancers.

An abundance of research talent at the Cancer Center, including Hannun’s nationally recognized leadership in the study of lipids, distinguishes this regional research hub.

Patricia Thompson is deputy director of research at Stony Brook Cancer Center. In addition to her work with the research programs that includes co-leading Imaging, Bioinformatics and Engineering Sciences, Thompson leads a research effort on targeted imaging that focuses on advancing efforts to prevent breast cancer and its recurrence.

“One of the markers that we’re studying is breast density, and we’re doing that with a novel MRI approach,” she said. “We’re actually very excited because we believe that we are having an anti-cancer effect on breast density with novel agents. To study this, we are running a trial right now to test the effect of non-steroidal anti-inflammatory drugs on breast density as a strategy to reduce the risk of breast cancer in the population.”

The Cancer Center has more than 60 cancer-related research projects taking place across the University, as well as an impressive roster of 70 clinical trials in the works.

“Most patients don’t understand exactly what a clinical trial is when they first come to the Cancer Center,” Bily said. “When there is an appropriate trial, a team member explains the options and process involved with enrolling. It’s the patient’s choice to participate.”

Yusuf A. Hannun, MD, is a firm believer that the academic environment is paramount to continuing the momentum of cancer research — and ultimately finding cures.

This is a perfect opportunity to explain how clinical trials can move cancer research forward. “Most patients are very open to participating in trials, not only for themselves, but also to make a difference in the future for others,” she said.

The MART: Raising the Bar in Patient Care

One of the ways that Stony Brook will continue to deliver cutting-edge cancer care with improved efficiency, while doubling its capacity to provide cancer treatment, is through the new multimillion-dollar Medical and Research Translation (MART) building. Due to open

its doors in fall 2018, the eight-level, 240,000-square-foot facility will be devoted to imaging, neurosciences, cancer care and cancer research, enabling scientists and physicians to work side by side to advance cancer research and imaging diagnostics. The building will also contain a 300-seat auditorium for conferences, lectures and other events.

As the site of the new outpatient Cancer Center, the MART will have clinical care areas that cater to patient needs. Various groups of physicians, nurses and staff members advised the planning committees on what to include for an optimal and inviting environment for patients and family members. The floor plan enables physicians, researchers and patients to interact within a convenient and effective clinical flow.

“I’m very excited about transitioning to the MART building,” Bily said. On behalf of patients and their families, she asked for three specific areas to be included: a resource center, which will have books, computers and comfortable couches; a large wellness room, which will include a mobile ballet barre; and a cancer boutique with a one-chair beauty salon, where patients can be pampered to help improve their self-image during treatments and where vendors will sell prostheses, wigs and mastectomy bras.

The Kavita and Lalit Bahl Center

Another way Stony Brook Medicine is transforming cancer care is through The Kavita and Lalit Bahl Center for Metabolomics and Imaging, which will be permanently housed in the MART building. This unique translational research center capitalizes on the Cancer Center’s expertise in three major areas: cancer research and treatment, imaging, and metabolomics, the latter of which enables the targeting of cancer metabolism pathways once thought to be untreatable by traditional drug therapies. The Bahl Center reflects the Cancer Center’s overall research goal to foster discovery in a collaborative environment.

The Bahl Center was made possible by two generous donations from Kavita and Lalit Bahl totaling $13.75 million.

The Center is a testament to the Bahl family’s commitment to ensuring that Stony Brook Medicine is consistently on the cutting edge of personalized cancer research, diagnostic imaging breakthroughs and individualized cancer care. The first donation allowed for the purchase of a cyclotron, which is a particle accelerator that will be in close proximity to PET scanners.

“The cyclotron and radiochemistry open up a floodgate of opportunities,” Hannun said.

Thompson also looks forward to the possibilities that the new technology will provide. “The cyclotron is going to enable us to make nuclides locally and do our own labeling locally so that these molecules with very short half-lives (20 minutes) can go straight from the cyclotron to our patients,” she said. “That gives us opportunities to build molecules that we label with high intensity to deliver to the tumor at maximum doses so that not only can we image the tumor, these can be made toxic only to the tumor cell.”

Lina Obeid, MD, dean of research at Stony Brook University School of Medicine, said the Bahl Center will play a significant role in Stony Brook Cancer Center’s receiving NCI designation. The National Cancer Institute Cancer Centers Program is one of the anchors of the nation’s cancer research effort. There are currently 69 NCI-Designated Cancer Centers in the United States.

The new cyclotron and PET scanners will also be located in the MART building, Obeid said. “This, together with our expertise in lipids and metabolism, makes Stony Brook Cancer Center a very unique place that has all this really fantastic expertise that’s being harnessed toward studying cancer.”

Meryl Schoenbaum is a freelance writer and editor based in California.

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