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The Journey to Support Cancer Care in Westchester County

Cancer care in Westchester|||
Sonya Keshwani. Courtesy of Styleesteem Wardrobe

If you or a loved one has cancer, you want these Westchester healthcare providers and nonprofits in your corner.

It’s natural to be frightened when you’re told that you have cancer. But in Westchester County, groundbreaking technologies and the world’s finest physicians make most cancers highly treatable. In the pages that follow, you’ll read about just a few of the lifesaving innovations in cancer care that county doctors are using to fight the disease.

Proton Therapy: A New Day in Cancer Treatment

While proton therapy is relatively new, its technology dates to the development of the atomic bomb.

“After World War II, with all of the scientific advancements that went into the development of nuclear weapons, some scientists were looking for ways the new technology could actually be beneficial to society as well,” says Jonathan Weinbach, CEO of the New York Proton Center (nyproton.com) in Harlem, the first and only proton center in New York State.

Jonathan Weinbach
Jonathan Weinbach. By Philip Greenberg for the New York Proton Center.

It took decades, but scientists succeeded, and proton therapy is now the gold standard for treating complex cancers located near vital organs, such as the brain and spine, and pediatric cancers too risky to treat with other, less targeted, radiologic methods.

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The New York Proton Center — in partnership with Memorial Sloan Kettering Cancer Center, Montefiore Health System, and Mount Sinai Health System — took 10 years to develop. It opened in 2019, and Weinbach, a Larchmont resident, became CEO in 2021. To date, the Center has treated about 2,500 patients from the New York area and beyond, including many Westchester residents.

“Essentially, the technology allows you to deliver the radiation with precision to the affected area and stop it on a dime.”

“Essentially, the technology allows you to deliver the radiation with precision to the affected area and stop it on a dime,” says Weinbach. “So, if you have a tumor on your optic nerve, we can hit the tumor, essentially kill the tumor, and radiation won’t affect other tissue in your brain.

“We treat more than 50 percent of the population of kids [with cancer] in New York City with solid tumors,” adds Weinbach. “Avoiding getting exposure to vulnerable areas you don’t want it is really important for pediatric patients,” in whom radiation can cause developmental disabilities or health problems later in life.

Currently, NYPC also has 22 trials in process, and 98% of its patients take part in studies.

Survivor Profile: A New Lease on Life

Professional musician Gil Chimes says he’s had a “marvelous career” and a “wonderful life.” Now 80, the Mount Vernon resident is going strong. But things might have been different had it not been for the team at the New York Proton Center.

Chimes’ cancer journey began three years ago, when he was diagnosed with lung cancer. After a 10-minute consultation with an oncologist, Chimes was scheduled for a surgery in which a large part of his lung would have been removed, effectively ending his career as a singer and harmonica player.

Soon after, Chimes was watching TV and saw a news report about the opening of the New York Proton Center.

“I hadn’t heard of proton therapy, but when I learned about its precision and ability to preserve vital organs, like lungs, with reduced side effects or detrimental impacts, it sounded like a promising option,” he says.

A week later, Chimes, his wife, and daughter were meeting with the Proton Center’s chief medical officer, Dr. Charles Simone, and his team.

“They spent, like, two hours with us to describe this procedure,” says Chimes. “It’s noninvasive, and there’s no chemo. They shoot a beam into the tumor, and the tumor dissolves. I get off the table, get in the car, drive home, and it’s like nothing happened.”

Though he must return to the Proton Center for regular scans and expects the cancer to recur, Chimes has been cancer-free for more than two years — still singing and making music.

Gil Chimes
Gil Chimes. By Ken Gabrielsen.

Innovations in Neurosurgery

In the 21st century, state-of-the art neurosurgery techniques and treatments are providing hope to the 84,000 Americans diagnosed with brain tumors every year. At Westchester Medical Center, Dr. Simon Hanft, chief of Neurosurgical Oncology, is committed to providing personalized medical care to each of his patients, using a combination of traditional and cutting-edge neurosurgical technologies.

One of the more exciting technologies currently being used by WMC neurosurgeons is called brain mapping. The technology works by “gathering information from a patient’s MRI to produce a real-time visual of neural networks for surgeons to reference as they operate,” says Hanft.

Dr. Simon Hanft
Dr. Simon Hanft. Courtesy of Westchester Medical Center.

This enables the surgeon to determine with greater authority whether surgery is appropriate in the first place, and if so, to conduct the surgery more safely and effectively, avoiding areas of the tumor that may impact brain functions, such as speech and movement.

“There are specific cases where I’ve used [brain mapping], and it has made me cautious about approaching certain areas of the tumor. In leaving those areas untouched, the patient has preserved aspects of language function,” says Hanft.

“The beauty of the GammaTile is it’s all taken care of in one fell swoop.”

Another technology that has made brain tumor treatment safer and more convenient is the GammaTile, a type of targeted, internal radiation therapy in which radioactive seeds are placed inside a postage-stamp-size piece of collagen and implanted inside the patient’s brain immediately following the removal of a tumor. Over time, the “tile” is absorbed by the brain.

“The seeds emit radiation into that immediate vicinity over weeks or months, treating the surrounding tissue where we know some microscopic tumor may reside and is most likely to be the source of the site of recurrence,” says Hanft. “The beauty of the GammaTile is it’s all taken care of in one fell swoop. The patient gets the tumor removed at surgery and then the tile is placed. They don’t need to come back for what are often draining, onerous radiation treatments.”

Car T-Cell Therapy: Using Genetically Re-Engineered T Cells to Fight Cancer

At White Plains Hospital/Montefiore, doctors are using a new technique that helps patients with advanced lymphomas, multiple myeloma, and refractory acute lymphoblastic leukemia fight cancer. The technique, known as chimeric antigen receptor (CAR T) therapy uses the patient’s own re-engineered T cells to fight the cancer in their bodies. The therapy is one of many innovative treatments available to cancer patients at the hospital.

Dr. Dan Costin
Dr. Dan Costin. Courtesy of White Plains Hospital.

Dr. Dan Costin, medical director, White Plains Hospital Cancer Program, is a big believer in the value of clinical trials for patients wanting access to therapies not yet available to the public. Since 2017, says Costin, more than 500 patients at the Center for Cancer Care have taken part in studies for the treatment of a variety of cancers, including bladder cancer, HER2 positive breast cancer, and lung cancer.

“CAR T-cell therapy … collects immune cells from the patient and re-engineers them in the lab to produce proteins on their surface that bind to antigens on cancer cells and then eradicate the cancer cells. For patients with advanced lymphomas, relapsed multiple myeloma, and refractory acute lymphoblastic leukemia who have not responded to other treatments, CAR T-cell therapy has proven transformational,” says Costin.

“For patients with advanced lymphomas, relapsed multiple myeloma, and refractory acute lymphoblastic leukemia who have not responded to other treatments, CAR T-cell therapy has proven transformational.”

In addition to groundbreaking therapies, patients may derive benefits from advanced imaging capabilities that excel in pinpointing disease location, the extent of the disease’s spread, and measuring response to therapy. White Plains Hospital is one of only 115 hospitals in the world to have PET/MRI imaging, which combines the details of an MRI with the metabolic information of a PET scan.

StyleEsteem Wardrobe

When she learned she had breast cancer at age 29, Sonya Keshwani, a media professional with a high-profile career, wasn’t about to let cancer, and the hair loss that comes with chemotherapy, affect her sense of style. A raven-haired fashionista, Keshwani purchased a blond wig, thinking she’d try a different look. But wearing a wig, however cute, eight hours a day was far more uncomfortable than she had expected.

“I was getting treated in the summer, so it was really hot, and the hair loss itself makes your scalp extremely sore and sensitive, and it gave me migraines,” Keshwani says.

Sonya Keshwani
Sonya Keshwani. Courtesy of Styleesteem Wardrobe.

So, she went searching for options. Online shopping resulted in head coverings that were “were drab chemo beanies that made me just look and feel like a sick person. They didn’t express any aspect of my style, and they all but outed me as a cancer patient because they were just like what you see in TV ads or brochures about infusion centers,” says Keshwani.

That’s when she decided to try making her own turbans.

“There was a mom-and-pop fabric store right next to my infusion center,” shares Keshwani, “so, it kind of became a ritual that each time I went for treatment, I’d go next door to that shop, bring home a few yards of cloth, and experiment with my mom’s sewing machine.”

In 2019, after her cancer treatment ended, Keshwani started StyleEsteem Wardrobe (styleesteemshop.com), an e-store that sells high-fashion turbans for every event, season, and occasion. “Women want to feel stylish and like we’re a little trendy, even during hair loss,” says Keshwani, adding, “This is not only about fashion; it’s also about helping people.”

Prostate Cancer: Novel Approaches

A part from skin cancer, prostate cancer affects more men than any other form of cancer, says Dr. Lawrence D. Koutcher, regional director of Clinical Operations for Radiation Oncology at NewYork-Presbyterian Hudson Valley Hospital in Cortlandt Manor and NewYork-Presbyterian Westchester (formerly Lawrence Hospital) in Bronxville. Fortunately, the disease is especially treatable when caught early, thanks to new technologies, such as prostate-specific membrane antigen (PSMA) positron emission tomography (PET) imaging.

Approved by the FDA in December 2020 and used with prostate cancer patients at NY-P Westchester since early 2022, PSMA PET imaging is better at locating cancer than standard imaging techniques, such as CT and bone scans, according to Koutcher.

Dr. Lawrence D. Koutcher
Dr. Lawrence D. Koutcher. Courtesy of Thompson & Bender.

“Take the scenario of someone who had surgery but whose PSA [the blood test that measures the amount of prostate-specific antigen in blood that may signify cancer] is rising, thereby indicating recurrent disease,” says Koutcher. “In the past, with conventional imaging such as CT and bone scans, we’d almost never be able to find the location of the cancer recurrence. We’d just know that the cancer is there because of the rising PSA — we could not locate it. We would use a CT scan and a bone scan, but that almost never showed where it was unless the PSA was very high. We don’t want to wait till the PSA is high because that lowers the probability of successful treatment. Before the PSMA PET, we often radiate the prostate bed in the hope that the cancer cells were located there.”

Dr. Koutcher says the PSMA PET scan is so sensitive, it can locate cancer cells even in patients with very low PSA values. Being able to see those cells “can change our management and treatment strategy, including whether we use hormonal therapy or radiation therapy,” which is of course, a win for patients.

Enhancing Cancer Care in the Hudson Valley

It’s been just over three years since Dr. Ahmad Raza became director of the Cheryl R. Lindenbaum Comprehensive Cancer Center at New York-Presbyterian Hudson Valley Hospital. Not only has the doctor seen the Cancer Center through the worst parts of the pandemic; he also worked toward the goals he’d set for himself when joining the institution. Among these is building Hudson Valley’s research and clinical collaborations with the Herbert Irving Comprehensive Cancer Center at New York-Presbyterian/Columbia University Irving Medical Center. Herbert Irving is one of just four National Cancer Institute-designated comprehensive cancer centers in the state.

Dr. Ahmad Raza
Dr. Ahmad Raza. Courtesy of Thompson & Bender.

Hope for Metastatic Breast Cancer Patients

The news that the FDA had approved T-DXd — the first targeted therapy for patients with HER2-low breast cancer that has metastasized but cannot be surgically removed — was cause for celebration when it was announced in August. Approval was based on the results of a clinical trial led by Memorial Sloan Kettering Cancer Center medical oncologist Dr. Shanu Modi. Treatment with T-DXd is now available for patients who qualify at MSK Westchester.

Cancer care in Westchester
Dr. Shanu Modi. Courtesy of Memorial Sloan Kettering Cancer Center.

“During the study, we compared T-DXd to standard chemotherapy drugs that are not particularly effective for advanced HER2-low breast cancer,” says Modi. “T-DXd doubled the time cancers can remain under control. The drug prolongs survival about one-third longer than standard therapy.”

Modi hopes T-DXd will have an even greater impact in the future, when it can be used to treat early-stage HER2-low breast cancer patients.

“We’re in the beginnings of a very exciting new frontier with these drugs,” says Modi. “This trial was about breast cancer … but you can apply this strategy to many different kinds of cancer scenarios and tumor types. I think these results are the beginning of what could be a real revolution for cancer patients.”

Support Services and Resources for Your Cancer Journey

These county nonprofits are helping patients to live their best lives during treatment.

Cancer Support Team

Founded in 1978, the Cancer Support Team, or CST (cancersupportteam.org), is the only Westchester-based home-care program that provides all services free of charge regardless of patients’ insurance coverage. Additionally, says Executive Director Tania Weiss, the organization is one of just a few in the county that offers financial and transportation services.

Tania Weiss. By Toshi Tasaki

“Our RNs live and breathe oncology. They walk you through your cancer journey.”
—Tania Weiss Executive Director, Cancer Support Team

“When people hear ‘cancer,’ that’s all they hear,” says Weiss, who adds that patients may not be able to process important information about support services during a brief medical consultation. Nurses, social workers, and caseworkers with CST understand how overwhelming a cancer diagnosis can be and have the experience, compassion, and patience to provide individualized attention to patients whose needs go way beyond medical care.

“We go to their homes and educate them; we get them answers to their questions; we provide financial assistance; go with them to appointments; and provide rides for them. Our RNs live and breathe oncology. They walk you through your cancer journey.”

During the last fiscal year, the organization completed 830 rides to chemotherapy or radiation appointments and distributed more than $60,000 in financial assistance grants.

CST is especially focused on assisting underserved members of the community, says Weiss. She is excited about a new partnership between CST and White Plains Hospital Center for Cancer Care that makes it possible for a CST oncology nurse to work on-site at the Center 20 hours a week.

“[CST and White Plains Hospital] are both dedicated to reducing the healthcare disparities in this county,” says Weiss.

Gilda’s Club, Westchester

It’s been more than 20 years since Gilda’s Club (gildasclubwestchester.org), a nonprofit organization that offers free social and emotional support to anyone impacted by cancer, opened in White Plains.

Named for Saturday Night Live star Gilda Radner, Gilda’s Club’s free membership includes support groups, individual counseling, educational workshops, healthy-lifestyle classes, social activities, and community resources and referrals. The club serves adults, children, and teens with cancer, as well as their families and friends.

“When someone … comes to us, they are often experiencing a lot of uncertainty,” says Gilda’s Club program director Sarah Sedo. “They may be feeling overwhelmed and like they just need a community of others who can support them, listen, and validate their feelings. There are so many complicated emotions that come with a cancer diagnosis or a loss to cancer.”

During the pandemic, when many people couldn’t attend Gilda’s Club in person, the organization began offering virtual programs, an option Sedo says the Club will continue to offer even after the pandemic is no longer a major consideration.

When it comes to accessing support through Gilda’s Club, “making that first phone call can be the hardest part,” says Sedo. “Not everyone wants to be in a support group or talk to other people or ask for help. But once you make that first phone call and talk to somebody who understands the cancer journey, it becomes much easier to get connected. We like to say that community is stronger than cancer.”

Cancer Resource Center of the Hudson Valley

The navigation service Cancer Resource Center (hudsonvalleycancer.org) helps patients and their families with “all the challenges and tribulations that come along with cancer,” says founder and cancer survivor Casey MacDonald of Montgomery. “We help patients decide what physicians to use, how to get a second opinion, where to find childcare, financial questions, and transportation needs, because cancer affects every aspect of our lives.”

Patients can call the center and speak with a navigator, or they can use the Center’s new online navigation system (set to have launched by press time) to access the information they need.

“We are the only cancer resource in the entire Hudson Valley that helps patients regardless of location, diagnosis, or income level. The Center also offers presentations for employers who want to educate their employees about supporting colleagues with cancer. “We’re small but mighty,” says MacDonald.

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