Practice Style

I provide a uniquely personal cancer care to my patients. Being diagnosed with cancer is one of the most stressful events in one's life. Sorting through information, finding a caring physician and trying to get the very best treatment can be even more stressful than the disease itself. Quite often, treatment of cancer requires a multi modality approach. For example, during the course of treatment of a patient with breast cancer, she will encounter a surgeon, a medical oncologist, radiation oncologist, and also nutritional and psychological support staff. Coordinating such a care is not easy. Being in the hands of caring physicians is extremely important. Dealing with cancer is a very personal experience. Patients need lots of hand holding. They also need a physician who can be their advocate.

I maintain a small and very personalized medical practice, as such, I can provide a level of care that other oncologist simply cannot. I love caring for patients and I love practicing oncology. I treat my patients as if they are my family members. To that extent, my patients can call me anytime directly on my cell phone or they can contact me directly by e-mail, whatever that works best for them. I take time to listen to my patients. There is always a lot to be said and heard. My visit time with each patient is a long one, whereby all the issues and questions are heard and answered. And always, I am the one answering all the questions, not a nurse, not a medical student or fellow.

My approach to cancer patients is different from many others. I spend as much time as is needed with each patient. For past many years, the healthcare system has worked against majority of physicians, whereby medical practices are seeing more and more patients and spending less and less time with them. When it gets to cancer, this does not work. I have resisted the HMO dictated practice mannerism. The most frequent comment I hear from my patients is that, " nobody told us this", or "nobody sat down to talk to us like you do".

Here is an example of how I care for my patients. A young mother, diagnosed with breast cancer two years ago, called me in early summer, stating that she is in lots of pain and she is told to have MRI, from Head to Toe by her doctor in Germany, and that her New York Oncologist and his other doctors are trying to help her, but this has not been easy. She was referred to me by another patient. She wanted to be seen urgently. I accommodated her request and saw her shortly. She came in one evening, accompanied by her husband and their little boy. She was first diagnosed with breast cancer two years ago, after her surgery, she met with an oncologist, whom she simply hated. The oncologist was very impersonal and scared her, and put fear in her heart.

Soon after her breast surgery, a lump grew under her arm. She decided that she could not get proper care in United States and traveled to Germany for care. Paying cash to a clinic in Gemrnay, she underwent surgery there. They removed one lymph node from under her arm. They told her that she had cancer in that node; and that she needed immune therapy program, along with chemotherapy, all kinds of vitamins and drips and oral and intravenous support to get rid of her cancer. She consented to all of these. Several weeks later, she came back to the States and found another oncologist to carry on the German protocol of chemotherapy. Meanwhile, all family resources were being drained by this German clinic. Imagine paying cash for your surgery and MRI and CT scans and Chemotherapy in Germany. When it gets to cancer, we do what we think is correct and that is what she did. She came to me, thinking that cancer is growing all over her body, and that she needed more aggressive treatment.

I heard all of her story on the phone as well as in person. The challenge was to sort through her cancer history and figure out how much cancer she may have and then provide her with at treatment plan. After spending about two hours with her and her husband that night, I convinced them to relax and allow me to collect all her cancer data and then make a plan. Although she had an estrogen receptor negative cancer, her German physician has advised her to take Arimidex, which she was taking. She was also told to continue with chemotherapy in the States. I convinced her to stop the Arimidex and hold off on any treatment until we sort through all the information. I planned to get the tissue from Germany to analyze and also do a BRCA mutation analysis and Oncotype her tumor and then decide what to do. She had very recent imaging studies which were all negative. Doing all this took time, yet we gathered all the pertinent information that we could.

My approach to her, is an example of how I approach each cancer patient. I reviewed her original diagnosis. Luckily her first surgery was done in New Jersey and her tumor tissue was available for evaluation. Her original tumor was very small. She also had a lymph node tissue in Germany which was reported to contain cancer. Over next several days, we located the hospital and the pathologist who had her tumor tissue. I spoke with the pathologist in Germany and arranged for her tissue to be sent to me. This took about three weeks. In the interim, I arranged for her to have a BRCA mutation analysis as well as an Oncotype testing of her original tumor that we had in United States.

When her lymph node tissue arrived from Germany, I looked at her slides with a pathologist. We could not see any sign of cancer in her node. We performed special staining of her tumor tissue and were able to detect a very small, microscopic tumor in that node. Her recent PET scan and MRIs and ultrasound examinations were all normal. She had absolutely no evidence of cancer in her body. Although she had a microscopic spot of cancer in her node, since her original tumor was very small and since two years had past and we had no objective evidence of caner, she simply did not need any treatments. I sent a summary of her case to two of my oncologist colleagues. They both agreed that she did not need any treatments now.