Cutting-edge TAMC Cancer Care Center sets high standard in northern Maine
Consider this: When cancer care began in Aroostook County in the 1940s the cost of office visits was $1. Today, cancer care is much more sophisticated with a dedicated TAMC Cancer Center, specialists, cutting-edge technology, and new research leading the way.
“When I first started, we couldn’t do any oncology therapy as an outpatient; all chemo was inpatient,” recollects Ronald Rohe, MD, TAMC’s longtime director of Hematology and Oncology. “So every Monday morning, I would admit five to 10 patients so I could give their chemo to them, and after a few days, they would go home. Then everything changed almost overnight. Therapy was allowed to be given as an outpatient service.”
“We can conduct research in the latest journals and medical textbooks without waiting. If I need to access a patient’s medical information while I’m in conference with them, I can bring it up on the screen and discuss it with them.”
TAMC’s director
Hematology/Oncology
Thanks to the expertise of Dr. Rohe, TAMC has developed a reputation as a go-to hospital in the area for cancer treatment. “Dr. Rohe has developed excellent relationships with physicians throughout Maine as well as those at the major New England cancer centers, i.e., Dana Farber Cancer Institute, Mass General, etc.,” said Nancy Cronkite, a longtime Aroostook Cancer Care staff member.
Long before Dr. Rohe entered the scene, The Aroostook Medical Center began providing care for cancer patients. The first tumor clinic in Aroostook County opened at Presque Isle General Hospital on March 13, 1947.
In 1978, in response to demand for oncology services, Dr. Rohe joined the staff as part of an outpatient program with Dana-Farber to serve patients in rural areas. He stayed on at the hospital after the program ended. In addition to serving patients in Presque Isle, he traveled all over Aroostook County to provide care, saving his patients from having to drive long distances. He also continued to work with his former co-workers at Dana-Farber consulting on diagnoses and treatment. Thanks to his strong relationships, patients from northern Maine who are initially seen at Dana-Farber are referred back to him for future treatment.
Over the decades, the approach to cancer has changed dramatically, he notes. “The changes we are seeing now are patients are beginning to receive less of a smorgasbord of chemotherapy even though that can work well in many cases,” says Dr. Rohe. “Now we are working toward having a patient’s cancer cells examined and tested to find out what drug or drugs are appropriate for that particular cancer. Currently, labs can give us a genetic makeup of the tumor, which tells us what enzymes work well against it. This technology is very exciting and progressing very quickly.”
Another welcome innovation in cancer treatment is the pivotal advances in electronic technology. “Now, we can get results from Dana-Farber and other organization almost instantly,” Dr. Rohe says. “We can conduct research in the latest journals and medical textbooks without waiting. If I need to access a patient’s medical information while I’m in conference with them, I can bring it up on the screen and discuss it with them.”
A major development in cancer care at TAMC in recent years is the new state-of-the-art 4,500-square-foot Cancer Center. This occurred in 2008, when TAMC realized it had outgrown its 2,300-square-foot oncology clinic and exceeded the capabilities of the staff to keep up with steadily increasing volumes.
Another welcome development is the integration of radiation oncology. John Mullen, MD, is TAMC’s full-time radiation oncologist. Dr. Mullen represents one of the most important aspects of the Cancer Center – the expert clinicians. Besides Drs. Rohe and Mullen, Gibson “Kip” Crawford, PA-C, Vatsala Kirtani, MD, and Arjun Sood, MD, make up the practice. These providers and a dedicated staff work closely with primary care practitioners and other medical professionals to make sure that patients are getting the most effective treatment available right here in Aroostook County.
“This procedure offers a shorter recovery time than traditional surgical breast biopsy and allows for precise, accurate analysis with minimal discomfort and scarring.”
Radiation Oncologist
TAMC
“An excellent example of the collaborative cancer care that TAMC provides to its patients is our Tumor Board,” said Dr. Mullen. “The Tumor Board is a place for multi-disciplinary treatment. Our surgeons, medical oncologists, radiation oncologists, pathologists, physical and occupational therapists all meet weekly to discuss diagnosis and treatment of all patients. This gets all staff on the same page in regards to caring for our patients which has been shown to lead to better outcomes.”
It is treatment that only gets better with time.
Learn more about TAMC’s leading cancer care at (207) 768-4151 or tamc.org.
Surgery-free breast biopsy now offered at TAMC
“We found an abnormality in your mammogram.” These seven words evoke fear in anyone who has ever waited for mammogram results, or who has ever heard them spoken. Although most “abnormal mammograms” do not result in a breast cancer diagnosis, a breast biopsy must be performed in order to be certain. Until recently, this involved general anesthesia and a surgeon’s scalpel. Now, however, The Aroostook Medical Center (TAMC) has added a service, stereotactic breast biopsy, that will give Aroostook County women an option that does not include surgery and can be performed in an outpatient setting.
Unlike traditional surgical biopsy, stereotactic breast biopsy is a minimally invasive procedure that uses only local anesthesia and allows the patient to return to normal daily activities immediately following the procedure. The procedure uses only a small, quarter-inch incision rather than making more substantial cuts to obtain a tissue sample of the abnormal area identified in the mammogram. Although some patients will still need to undergo a surgical biopsy, most patients that need a breast biopsy can have their biopsy done stereotactically.
Stereotactic breast biopsies are being performed at the J. Paul and Blanche Levesque Imaging Center on TAMC’s A.R. Gould Memorial Hospital campus by Dr. Robert Leatherman, who is board certified by the American Osteopathic Board of Radiology.
“This procedure offers a shorter recovery time than traditional surgical breast biopsy and allows for precise, accurate analysis with minimal discomfort and scarring.”
Imaging Medical Director
TAMC
“This form of breast biopsy is ideal for many patients,” explained Dr. Leatherman, TAMC Imaging Medical Director. “This procedure offers a shorter recovery time than traditional surgical breast biopsy and allows for precise, accurate analysis with minimal discomfort and scarring.” Patients are already being accepted for the procedure, which is new for Aroostook County, just in time for National Breast Cancer Awareness Month this October.
During a stereotactic breast biopsy, the patient lies down on a special table that has a hole in the surface. The breast is lightly compressed, with about the same or less pressure than exerted by standard mammogram paddles, to keep the breast immobilized. The biopsy probe is inserted through the small incision in the breast. The radiologist guides the probe to the location of the abnormality, which is shown on a detailed x-ray image. The probe is multidirectional and can collect tissue samples from multiple locations without the need to cut more incisions. The procedure typically takes about an hour to complete.
Healthcare providers, such as Lucy Richard, WHNP, are pleased to be able to offer this service as an option for Aroostook County women.
“Stereotactic breast biopsy is another example of the commitment of TAMC to bring state of the art treatment for their patients closer to home,” said Richard, a women’s health nurse practitioner at TAMC’s Women’s Health Center. “The service can be performed as an outpatient in the imaging center, and the results are as accurate as when a tissue sample is removed surgically. For my patients, the benefit of not having to travel over two hours one way to have this type of biopsy performed; and the fact that it is about one third of the cost of a surgical biopsy will be huge.”
Patients such as Colleen Murphy agree. Colleen had a stereotactic biopsy at Eastern Maine Medical Center in Bangor, the same procedure that is now being offered at TAMC.
“The procedure was relatively painless and I felt only some minor discomfort,” said Murphy. “Overall, the experience I had was no worse than what one would go through while donating blood. I am glad to hear this is now being offered locally!”
The American Cancer Society recommends that women do breast self-examinations regularly and have a yearly mammogram starting at age 40. The earliest signs of breast cancer are often seen on a mammogram long before being felt through self-examination.
Discovering breast cancer early can mean the difference between life and death, something that Richard is quick to remind her patients, “Anyone who finds a breast lump, experiences breast changes, or suspects that something is wrong should seek out the advice of their healthcare provider.”
We’ve all seen them, the vast assortment of ads on television. Some touting the latest exercise trend; a famous athlete promoting a new car; rock stars with new clothing lines and so on.
Ads pertaining to your health are significant but how often do we act after seeing them? One health ad in particular, which aired late in January, potentially saved the life of an Aroostook County man.
Jim Alward and his fiancée, Dee Dee Cyr, were at home on a chilly winter night watching television when an ad encouraging folks to schedule a routine colonoscopy came on. “After the ad I encouraged Jim to schedule an appointment to get checked, and not to wait till his 50th birthday. We talked about it a great deal,” said Dee Dee. With some hesitation on his part and positive encouragement from Dee Dee, Jim scheduled his appointment.
“Going in wasn’t so bad and the procedure itself went well,” says Jim. “The procedure was over and I was preparing to leave when the doctor came in to speak with us.”
The news the doctor delivered was not what they had expected. “I expected my procedure to be a ‘right in, right out’,” recalls Jim. “I wasn’t even expecting to see the doctor once we were done.”
The doctor told Jim and Dee Dee they found a tumor in Jim’s colon and recommended that it be removed. “We scheduled the surgery as suggested which led to nine and a half inches of my colon and the tumor to be removed,” said Jim. “We had talked about cancer and what that meant to me and my family, but to me I wasn’t one of those people who had cancer; I mean I had no symptoms.”
Cancer is not prejudiced and knows no borders and to hear those words … “you have cancer” is life altering. It was a short time after the surgery when the doctor contacted Jim.
“The moment when the doctor said to me ‘you have cancer,’ I was shocked. It was numbing, almost like grabbing onto an electric fence,” Jim recalls. “I hung up the phone and just stood there. I did work the rest of the day, but in a mindless/numbing mindset.”
Jim’s cancer was at a stage three. Spooked by the news, Jim’s family immediately went into action scheduling colonoscopies for themselves.
As the next to the youngest in his family he and his siblings knew age was not a factor. The realization of walking around with this cancer and no symptoms added to the roller coaster of emotions Jim and Dee Dee would experience in the coming months, and the “what ifs” that continue today. “There is that constant worry of what if it comes back,” says the couple glancing at each other. “We have a lot to be thankful for and look forward to the future in our new home and upcoming nuptials,” says Dee Dee.
For Jim and Dee Dee and for others having cancer or knowing someone affected by the horrible disease another level of awareness and realization comes to the fore front about the impact it can have on one’s family and workplace.
“People get passionate about a cause,” said Lisa Miles, general manager for Townsquare Media. That proved true this spring when TAMC and Townsquare Media partnered on the first ever, Rally on the Roof on May 17, to benefit Aroostook Cancer Care (ACC) and Relay for Life.
Camping out on the roof above the Giberson Day Surgery Unit for the full 24-hours were Jason Parent, director of advancement for TAMC and Lisa. Prior to the chilly night’s rest, Jason and Lisa were joined on the roof throughout the day by “detainees” from throughout central Aroostook. Sent to the roof by the TAMC judge, each detainee was responsible for raising their bail by calling friends and family to work their way off.
“As is typically the case, the Aroostook County community came through to help their friends and neighbors in need,” said Lisa.
“Aroostook Cancer Care is a vitally important service TAMC provides to the region. Without it, area residents would have to travel to Bangor to get the same comprehensive care,” said Jason. “Through the funds raised by the ‘Rally on the Roof’ TAMC will be able to purchase needed equipment and items to help us provide even better care and comfort our patients at a very vulnerable time.”
Lisa and Jason came together recently to see firsthand the impact the Rally had on the way treatment is delivered to patients once they leave ACC and to meet with Jim. Since April, Jim has been receiving his bi-weekly treatments at TAMC’s ACC.
“I am here every other Wednesday for about three hours,” Jim says. “Once I leave here (ACC), my treatment continues ‘on the go’ for another 48 hours at home or work with the new bubble pump.”
Up until just recently Jim would have medication administered by a pump the size of a brick (and weighing almost as much) that was suspended around his waist like an anchor. “The old pump was just awful,” says Jim. “It was noisy, bulky, heavy, and cumbersome — I stayed home because I didn’t want folks see the old pump and ask questions.”
Patients were provided with a plastic box that contained a key and a spare battery which they needed to carry with them at all times with the older pump. Now, thanks to the support by funds raised during Rally on the Roof, patients have what they call a bubble pump.
“The new pump, the size of a baseball, can be carried under my shirt in this neat little pouch or placed in my shirt pocket,” Jim proudly shared. “The new pump and pouch are a huge improvement as the other design was outdated and it was time for the new technology.” With funding support from the Rally, pouches are provided to the patient for ease in carrying the new pump. “There are no worries with this new pump. I wish everyone could see how great this new technology is-what they did up on that roof was wonderful. Having people support what we are going through here medically is heartwarming; all I can say is thank you.”
During the interview, Jim said he used to look forward to counting the number of treatments remaining on both hands, then one hand, and now it’s down to two fingers. “Seeing a new day makes me happy,” Jim says with a smile on his face. “Rainy days used to bother me, heck I never looked forward to winter until now; I love each new day. To me, it’s not just another day.”
