July 30, 2009
The Hematology & Oncology Center at Portsmouth Regional Hospital represents superb state-of-the-art resources for cancer patients — in diagnostic technology, treatment options, physician expertise, nursing care and the intensive multi specialty reviews that virtually every cancer case receives in the weekly Cancer Conference.
With its participation in national clinical trials for new cancer drugs, PRH adds to this a layer of leading-edge research and access to national experts directly involved in new treatment options.
“Most of all, it’s a ‘win-win’ for our patients,” says PRH Hematology Medical Director Paul Poulin, MD. “Our commitment to quality care is reinforced by our involvement in clinical trials. It gives our patients access to the most advanced treatments available and it helps us remain in the forefront of cancer treatment.”
Dr. Poulin and fellow hematology/oncology specialists Prashant Shankar, MD and Christine Wasilewski, MD are the physician faces of medical oncology at PRH but far from its only important resources.
The Cancer Conference
Meeting early every Thursday morning, the Cancer Conference brings together more than 25 clinicians from differing specialties — medical, surgical and radiation oncologists, diagnostic radiologists, pathologists, nurses, technicians and social workers — to review cases and present their differing-specialty perspectives for treating PRH cancer patients.
“It’s a give-and-take discussion that examines each case from every angle to arrive at a consensus on the optimal treatment plan,” says Dr. Wasilewski. “Patients don’t attend but their cases are thoroughly reviewed — the feasibility of surgery, the advantages of chemotherapy, the possibilities of radiation oncology. Essentially, they receive consults from 25 specialists.”
Adds Dr. Shankar, “Beyond that, we often have outside speakers — nationally known authorities — who take part in these discussions. A patient’s ‘consult’ may well involve the views of a national expert.”
“Clinical trials take these capabilities up a notch,” Dr. Shankar says. “They cover the range of the cancers we most commonly see — breast and lung cancers, lymphomas — and all stages and approaches. These are national trials based at tertiary centers like Dana-Farber Cancer Institute in Boston, with most coming through the NIH’s Cancer Trials Support Unit. We may place one or two patients on a protocol that involves thousands of patients across the country.”
Running a trial is not as simple as just deciding to test a new drug on a patient because the idea sounds promising, Dr. Shankar says, noting that it takes about a month to be certified for a trial. When the staff learns about one that seems likely to be useful for the future, they’ll seek participation even though they don’t have any applicable patients for it at the moment. They usually have 10 to 15 trials open at any given time.
These are “Phase II” or “Phase III” trials. While Phase I involves testing a new drug on a small group of patients for the first time to determine its safety, Phase II focuses on the drug’s effectiveness (and, still, safety) and Phase III on confirming its effectiveness, monitoring any side effects and comparing it to existing treatments.
“These aren’t experimental agents,” Dr. Poulin emphasizes. “These are treatments that have been rigorously tested. They may have been applied to one type of cancer and we’re testing it on another. They let us home in on the best uses of a drug.
“And they’re very disciplined,” he says. “Trials not only give our patients the opportunity to receive treatments that might not otherwise be available to them, they’re closely monitored by the specialists who run them. So our patients have the benefit of expertise beyond our walls.
“And involvement in trials helps us as clinicians stay on the leading edge of medicine. We get expert advice from those specialists — national experts. They’re valuable sounding boards.”
Portsmouth Regional Hospital — Cancer Center Excellence
The 16-station infusion room is staffed by nurses noted for both technical skills in administering chemotherapy and the human warmth that cancer patients need psychologically. The reclinerchairs-like stations are grouped together in an open space to encourage sharing and mutual support among patients. Joking and laughing are big there.
Durham resident Wayne Dyer learned this up close, after discovering a lump in his armpit. Testing suggested a diagnosis of Hodgkin’s lymphoma, and he quickly found himself a patient of Dr. Shankar and on a four-drug chemotherapy regimen called ABVD.
“It was impressive to me that the first time I went in they all knew my name and bent over backwards to make sure everything was going well for me,” he says. “Every step of the way they constantly checked on me and made sure I understood what was going on. I don’t think I was caught off guard by anything.” His own brand of humor focused on the hair loss associated with his chemotherapy — and how good he looked without eyebrows.
Today, he says, “I’m doing great. I’ve had some minor side effects that were expected — a slight decrease in lung function, mild tingling in my feet — that we hope will clear up. I told them that compared to the alternative, I can live with that.”
Visit the main page for the Hematology & Oncology Center at Portsmouth Regional Hospital