Dr. Nicholas Taylor is the Department Chairman of Oncology for St. Luke’s University Health Network. He and Dr. Joseph Russo, Section Chief of Women’s Imaging for St. Luke’s University Health Network, spoke to Local Flair about the new St. Luke’s Monroe Campus Cancer Center AND MEDICAL OFFICE BUILDING that opened on November 20.
Local Flair: What new cancer services are now being offered at the Monroe Campus?
Dr. Taylor: St. Luke’s Monroe Campus now has the region’s newest cancer center. Services include Infusion (chemotherapy), Radiation Oncology, Medical Oncology, Surgical Oncology and Gynecologic Oncology.
LF: Why did you decide to provide these services?
Dr. Taylor: We’ve had an overwhelmingly positive response to our presence in Monroe County. The community trusts us to take care of them. Our goal was to bring the top-notch cancer program that St. Luke’s is known for to the Pocono region to make it easier for patients to get excellent cancer care close to home.
LF: What’s the news in women’s reproductive cancers for diagnosis and treatment?
Dr. Taylor: We continue to offer state-of-the-art cancer treatments including minimally invasive surgery. We have clinical trials available for endometrial and ovarian cancer.
The latest innovations for detecting breast cancer are available. Automated Breast Ultrasound and 3-D mammography are some of the newer tools used to screen women with dense breasts. We offer a personalized screening program with imaging based on a patient’s risk and breast density.
LF: How often should women be checked for these various types of cancer?
Dr. Taylor: We recommend that women go for annual visits with their gynecologist. Pap smears, although not done annually for the majority of women, are an effective screening tool for cervical cancer. There are no effective screening tests for ovarian or uterine cancers. Bleeding after menopause or unusual abdominal/pelvic pain should be checked immediately. Annual mammograms are recommended after age 40 for women considered average risk. If a woman is at high risk she should begin screening at age 35 or ten years prior to a first-degree relative with breast cancer.
LF: Are you seeing more early detection? How does it help one’s prognosis?
Dr. Taylor: Cervical cancer has become a rare disease in the U.S. due to Pap and HPV screening. Endometrial cancer is usually diagnosed at an early stage because abnormal/post-menopausal bleeding is one of the initial symptoms of uterine cancer. Ovarian cancer does not have a reliable screening test yet. Cancers that are diagnosed early have much higher cure rates than those that are diagnosed in advanced stages.
LF: What are the most significant changes you have noticed over the past 10 years regarding these health issues?
Dr. Taylor: Fortunately, there have been many advances in women’s cancers in the past several years. The HPV vaccination is very successful at reducing infection with high-risk types of the HPV virus. Strides are being made to identify tests that can screen for ovarian cancer. Minimally invasive (robotic) surgery has advanced our ability to perform sentinel lymph node biopsies for patients with endometrial and cervical cancers.
There have been advancements in ovarian cancer treatment that can significantly reduce the risk of recurrence (PARP inhibitors). Immunotherapy is playing a larger role in the treatment of gynecologic cancers- trials are ongoing for all cancer subtypes. Genetic testing of cancer specimens is identifying potential treatments for patients with recurrent cancer and helping to shape our initial management as well. Genetic testing to evaluate for inherited cancer susceptibility syndromes (BRCA, Lynch) is now mainstream and affordable. There is a lot more hope than ever before.
LF: Are you a proponent of DNA testing for these diseases?
Dr. Taylor: There are two types of DNA testing for cancer patients: testing the cancer DNA and testing the patient’s DNA. We test the patient’s DNA to check if they have inherited a risk for certain types of cancer from their parents. This is important because often there are things that can be done preventively to help people with inherited cancer susceptibility so they don’t get cancer. For example, removal of the ovaries significantly reduces a BRCA 1 or 2 mutation carrier’s risk of ovarian cancer. St. Luke’s offers genetic counseling to help see which patients would benefit from having their DNA checked for cancer susceptibility.
I am a proponent of evaluating the cancer DNA as well, as it can help identify candidates for clinical trials and in some cases can help tailor therapy to limit toxicity and potentially maximize response. Certain cancers require DNA testing to optimize initial treatment.
LF: Aside from the genetic component, what lifestyle choices can help improve women’s chances of not getting cancer?
Dr. Taylor: Overall, the best bet is not to smoke, eat a balanced diet and exercise regularly. Obesity increases the risk of 12 types of cancer.
LF: What question do you get asked most often by patients?
Dr. Taylor: “How long have I had this?”
LF: What is the biggest myth about getting or treating these cancers?
Dr. Taylor: The biggest myth I deal with frequently is that surgery will cause cancer to spread; that “once the air hits the cancer, it spreads.” Thankfully, this is not true!
LF: Do you have future plans to enhance these services?
Dr. Taylor: We’ve partnered with our colleagues in Radiology to open a brand-new Regional Breast Center in January 2018. This means that state-of-the-art imaging equipment like 3-D Mammography and Automated Breast Ultrasound (ABUS) will be available on site to patients in Monroe County. The benefit is that if a woman’s mammogram shows an abnormality, we are able to read it and, in many cases, perform a same-day biopsy. This obviously helps to ease anxiety, as the waiting time to “find out” is reduced dramatically.
For more information, visit cancer.slhn.org.