SURGICAL ONCOLOGY

LICH's surgical oncology program features extensive expertise and experience in state-of-the-art surgical management of a full range of malignancies. Whenever appropriate, LICH surgeons utilize minimally invasive approaches in both the diagnosis and treatment of cancer. In addition, our physicians are pioneers in the field of bloodless surgery and can use these techniques to treat patients who may have been deemed inoperable at other institutions.

When treating breast cancer, our surgeons' goal is to limit surgical resection as much as possible without compromising cure rates. When appropriate, LICH offers breast conservation surgery (lumpectomy), routinely combined with sentinel node biopsies to provide accurate staging. For women undergoing a mastectomy, skin-sparing approaches and innovative reconstructive techniques allow excellent cosmetic and functional results.

For even the most major resections, our thoracic oncology program features the equipment and technical expertise to offer minimally invasive surgical approaches-including Video-Assisted Thoracic Surgery-which allow patients to recover quickly with very short hospitalizations. We also offer Lung Sparing Excision when appropriate. Obstructing tumors within the airway and esophagus can be managed utilizing a combination of endoscopes, lasers and stents. Combinations of surgery, radiation and/or chemotherapy allow us to successfully treat patients with advanced cancers who may be considered beyond help elsewhere.

For colorectal cancer, LICH offers advanced treatment options, not only to fully eradicate disease, but also to preserve normal function when feasible. Utilization of sphincter preservation and nerve-sparing resections in more cases of rectal cancer, when appropriate, has allowed a much higher quality of disease-free survival. In addition, state-of-the-art minimally invasive laparoscopic colectomy is available. In the few patients that require colostomies, a dedicated stomal therapist and ancillary support programs are available.

LICH offers an extensive and comprehensive program to treat all types of head and neck cancers. Working with neurosurgeons, our head and neck surgeons specialize in treating the difficult cancers at the skull base, utilizing endoscopic techniques that remove cancer without using external facial incisions. In addition, our head and neck surgeons work closely with reconstructive specialists on all applicable cases as part of our focus on quality of life and preservation and reconstruction of function.

For genitourinary cancers, LICH offers a full spectrum of services, and we are particularly renowned for the treatment of prostate cancers. Selected prostate cancer patients can receive cryosurgery, during which narrow probes are used to freeze the cancer cells. Our surgeons are leaders in the field in bloodless radical prostate surgery and also specialize in laparoscopic prostectomy.

LICH is a center of excellence for gynecological cancer care and treats the full range of gynecologic cancers. In addition to offering more advanced surgeries, our surgeons have the expertise to perform minimally invasive surgeries such as laparoscopy and hysteroscopy, which usually allow patients to go home on the same day of surgery. Our staff, which performs close to 400 operations annually, is also experienced in such complex surgery as pelvic exenteration, in which pelvic organs are removed in order to cure the cancer and then reconstructed to restore almost normal function.

RADIATION ONCOLOGY

Radiation therapy is a vital part of the treatment for many types of cancer. Our radiation oncologists work closely with surgeons and medical oncologists in the treatment of patients. Their goal is to maximize cure while maintaining optimal organ function and quality of life.

By using the newest technologies that maximize radiation to the tumor and minimize radiation to surrounding normal organs, patients can benefit from improved outcomes with respect to function and quality of life. We utilize such modern technological advances in radiation oncology as:

• Three-dimensional conformal external beam radiation therapy, a type of computerized radiation that allows the radiation oncologist to concentrate the radiation in the region of the cancer and minimize the dose to the surrounding normal organs.
• Intensity modulated radiation (IMRT) is the latest technique in external beam radiation and may be helpful in certain cases. IMRT optimizes radiation delivery by employing a computer-aided algorithm to repeatedly adjust the intensity of each of the hundreds of segments of distinct radiation beams-giving the radiation oncologist the ability to precisely sculpt dose delivery.
• Brachytherapy, in which radioactive seeds are implanted directly into the tumor or tumor bed, is used to treat prostate cancers, gynecologic cancers, breast cancers, soft tissue sarcomas, eye tumors, head and neck cancers, certain lung cancers, as well as other malignancies.

HEMATOLOGY AND MEDICAL ONCOLOGY

The Division of Hematology and Medical Oncology offers chemotherapy for the full range of hematologic and solid tumor malignancies. When feasible, therapy is conducted in the context of our program of clinical trial research. Promising investigational agents, as well as chemotherapy and novel targeted therapies are made available to our patients. The division conducts a fellowship program, which is integrated with that at the State University of New York, Health Science Center at Downstate.

The program's responsibilities include oversight of the designated Oncology unit on the eleventh floor of the Fuller Building, as well as the Ambulatory Unit, which administers chemotherapy, blood transfusions, and other intravenous treatments and minor procedures. In addition to chemotherapy and blood product transfusion, cancer-related procedures and treatments are rendered including apheresis and bone marrow aspiration/biopsy. The division also conducts outpatient clinics in Medical Oncology and Hematology.

For pediatric hematology-oncology, LICH has a long tradition of caring for children and adolescents with cancer, and we have special expertise in the areas of leukemias and lymphomas. Our comprehensive program includes board-certified physicians, specialized oncology nurses, a state-of-the-art chemotherapy and transfusion unit, an intensive care unit for larger procedures, and a full array of pediatric subspecialties and psychological support services.