our main site

Changing the Landscape of Cancer Care and Tumor Treatment in Central New York

In July of 2007, Hematology-Oncology Associates of CNY (HOA) celebrated its 25^th anniversary as a medical practice and its 21^st anniversary as a Community Clinical Oncology Program (CCOP) with the National Cancer Institute (NCI).  HOA is the only CCOP in the United States not affiliated with a university or medical school. There are only two CCOPs in New York State – the other located on Long Island. 

Hematology-Oncology Associates CCOP is an extraordinary opportunity that allows the practice to participate in clinical cancer trials and offer a variety of investigational treatments for various stages and types of cancer. The research also includes cancer control and prevention trials, the results of which contribute to cancer prevention and treatment options worldwide. Grateful to be serving our community, there is much for which to be thankful and to celebrate.

The practice is now comprised of thirty-six providers – fourteen physicians and twenty-two nurse practitioners/physician assistants.  The physicians, Drs. John Gullo, Santo DiFino, Jeffrey Kirshner, Anthony Scalzo, David Churchill, Heidi Puc,
Richard Cherny, Dennis Kotlove, M. Daniel Bingham, Tracy Alpert, Joseph Navone, Stefania Morbidini, Benny Wong and Olga Kligerman, maintain their specialties in Hematology/Medical Oncology or Radiation Oncology.

In addition to occupying 50,000 square feet in their largest, most comprehensive “hub” located in Brittonfield Office Park in East Syracuse, Hematology-Oncology Associates celebrated the opening of a new, 13,000 square foot comprehensive cancer center adjacent to Community General Hospital in February of 2007.  This center is home to the Varian Clinac iX, the most advanced model of linear accelerator available to date. This machine can perform Intensity Modulated Radiation Therapy (IMRT) as well as Image Guided Radiation Therapy (IGRT). The site also offers a 16-slice CT scanner. This advanced technology, combined with state-of-the-art infusion/chemotherapy delivery, clinical research, psychosocial, nutritional, laboratory and pharmacy services provides an excellent venue for the delivery of outstanding patient care. The practice also has satellite offices in Rome and Medical Center West in Camillus.

The mission of the practice is to provide the highest level of quality care in a healing environment for the mind, body and spirit of patients dealing with cancer and blood disorders. In concert with all the traditional medical services and clinical research that HOA provides, the Integrative/Complementary Therapy program remains vibrant after four years of operation. The intention of these modalities is always to augment conventional treatments and promote a state of well-being by enriching the quality and level of inner peace that life offers. In this spirit, the practice is committed to developing a Cancer Prevention and Wellness Center at Medical Center West in Camillus.

Construction of a 1,000 square foot addition to the Brittonfield Cancer Center commenced in early May. This addition will house the vault for the CyberKnife®.  “Access to this technology will be a true blessing for our community and our practice,” stated Maryann Roefaro, CEO of Hematology-Oncology Associates.  “We will be able to offer novel treatment options that do not currently exist in Syracuse. It will truly change the landscape of tumor treatment in our community.”

Made by Accuray, the CyberKnife® is the only FDA approved, completely robotic, stereotactic radiosurgery system available in the world that targets and destroys small and previously inaccessible tumors or lesions anywhere in the body. As a non-invasive operation, CyberKnife® has proven to be an effective alternative to surgery or conventional radiation, or a complement to such, for treating vascular abnormalities, tumors, functional disorders and cancers with sub-millimeter accuracy. Hematology-Oncology Associates will be the ONLY provider of CyberKnife® in Central New York.

CyberKnife® is expected to be in operation come late Fall 2007.  An Open House will introduce area physicians to the new technology and Accuray training sessions will enhance ability to provide this application to patients.

According to Jeff Seeber, HOA physicist, image guidance coupled with computer controlled robotics allows the CyberKnife® system to continuously track and correct for patient movement throughout a treatment.  Radiographic images of the patient are acquired continuously during treatment. The CyberKnife® system analyzes these images and compares them in real time with reference images that indicate the correct treatment position of the patient.  Based on this analysis, the CyberKnife® Robotic Manipulator, with its synchrony tracking system, repositions itself to account for any deviation from this optimum position.  Because of this precision, the CyberKnife® system does not require invasive head or body frames to stabilize the patient.

A 6-MV linear accelerator is attached to the CyberKnife® Robotic Manipulator allowing the radiation oncology team to attack tumors from many more positions than conventional radiotherapy.  As a result, the radiation can be more precisely focused on the tumor while sparing healthy tissue and sensitive organs.  The flexibility of the CyberKnife® system allows for treatment of both intracranial and extracranial tumors, such as of the spine, lung, prostate, liver and pancreas. 

While a third radiation oncologist, Dr. Stefania Morbidini, joins the staff with CyberKnife® experience, Drs. Tracy Alpert and Dennis Kotlove, both HOA radiation oncologists, plan to participate in an intense week of CyberKnife® training at Accuray in California this fall. This will include CyberKnife® applications for a total body course and will be followed by an on-site visit to an established facility. Finally, Accuray will provide on-site support during the initial weeks of treatments in the Central New York area.

Dr. Alpert sees the CyberKnife® as an evolving treatment modality which provides the highest level of conformality thereby limiting toxicity. The process is more intricate as physicist and physician work in tandem to contour out critical organs from radiation while providing enhanced accuracy.  Encouraging referring physicians to consider it for their patients, she states that it can provide “dramatic responses in only a few treatment sessions.”

Patient treatments are typically completed in 2-5 sessions over one to two weeks.  Cumulative dose can be escalated due to the ability to better spare nearby normal structures.  Another benefit is that patients with previous radiation therapy can be retreated effectively. An example is palliative treatment of spinal metastasis after external beam radiotherapy to the chest for lung cancer.  The CyberKnife® can effectively treat the involved vertebral body and spare the immediately adjacent spinal cord and lung.  “The treatment plans are a step above Intensity Modulated Radiation Therapy in terms of conformality,” notes Dr. Alpert.

Collaboration with physicians of other specialties, such as neurosurgery, thoracic surgery, urology, GI, ENT, and general surgery, continues. Specialists maintain their relationship with their patients by being involved in the planning. For deeper, non-bony tissues, specialist physicians may insert fiducials (currently markers that are gold “seeds”) through a minor procedure to pinpoint a tumor. These are permanent, compatible with both MRI and CT scans and aid in planning, treatment and follow-up.

Teamwork proceeds as, following treatment, patients receive periodic checks for well over a year from both the referring specialist and the radiation oncologist. It often takes several months to see tumors regress or resolve. However, pain response is much more rapid than with conventional treatment.

Dr. Dennis Kotlove cites the advantages of CyberKnife® treatment for brain lesions.  Unlike Gammaknife radiosurgery, no frame is attached to the skull and instead of applying one treatment, 3-5 treatments are given which is less likely to cause damage to critical structures. 

Benign lesions in the brain can also be treated with CyberKnife®.  Arteriovenous malformations (AVM) and other blood vessel abnormalities are treated to avoid hemorrhage and provide a better prognosis for surrounding tissues. Acoustic neuromas, benign tumors in the area of auditory nerves, can also be treated with less chance of damage to hearing and adjacent cranial nerves.

Standard radiation is still the treatment modality for advanced lung cancers wherein a larger area is treated, while CyberKnife® is effective for patients with Stage I or II lung cancer. Larger doses of radiation can be given to increase cure rates while sparing dose to normal lung tissue, decreasing the chances of pulmonary compromise.

Dr. Kotlove is encouraged by preliminary findings and expects promising results in the next five years on the application of CyberKnife® for patients with prostate cancer. Studies are continuing from groups in Florida and Long Island.  While a typical course of treatment for prostate cancer is about nine weeks of daily radiation, the CyberKnife® technology can be delivered in 1-1½ weeks.  Early results show profiles on sparing healthy tissues, namely rectum and bladder, to be better than IMRT.

Hematology-Oncology Associates is extraordinary because of the over two hundred employees that make quality care, compassion and excellence their priority. The practice is committed to developing partnerships with their patients such that the journey is never walked alone. Hematology-Oncology Associates was thrilled to announce their support and affiliation with Unique Connections, Inc.

Unique Connections is a 501 (c) (3), tax-exempt corporation that was established under the guidance and support of physicians, staff and cancer survivor/patients of Hematology-Oncology Associates.  This newly incorporated entity was granted tax-exempt status in May of 2006.  The mission of Unique Connections is to facilitate the cancer journey for patients in Central New York.

Programs and services have been developed to provide support and guidance to cancer patients irrespective of their medical practice or hospital affiliation.  The only prerequisite to becoming a recipient of benefits from any program of Unique Connections is a diagnosis of cancer. The first program developed is a Patient Mentoring Program called, “A Rare Connection.”  A diagnosis of cancer is a life-altering event regardless of the outcome of the disease process and in an effort to provide love, support and guidance to ease this journey, a “mentor or buddy” that has lived through this process is paired with a newly diagnosed cancer patient of the same or similar disease. This relationship can make the road traveled less difficult. 

A second program offered by Unique Connections is a “Complementary Therapy Award Program” that allows cancer patients to apply for vouchers that will pay for a series of complementary therapies such as massage therapy, reiki, therapeutic touch, healing touch, and foot reflexology.  Additional information regarding Unique Connections can be found at www.Unique-connections.org .

States Maryann Roefaro, “We are grateful to our referring physicians for entrusting the care of their patients to us.  We are privileged to have patients trust us with their lives. We are committed to providing the myriad of services our constituency needs and desires. For everything – we say Thank You!”

[Cyberknife HOACNY] [FAQ's] [Cyberknife Team] [Lodging/Transportation] [Resources] [Press Release] [Contact Us/Info] [CyberKnife Advantage] [Patient Experience]