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A Full Circle Approach to Cancer Care

At Circle Health, our focus on cancer extends well beyond the diverse array of vital diagnosis and treatment options offered by our expert providers and facilities. With a strong focus on preventing cancer through community education and helping reduce risk factors for cancer and other chronic illnesses, Circle Health physicians, providers and member organizations — Lowell General Hospital, Circle Home (formerly Visiting Nurse Association of Greater Lowell), and Lowell Community Health Center — offer a comprehensive and collaborative approach to cancer care for thousands of residents throughout the Merrimack Valley. From the latest diagnostic testing and treatment options and patient and family-centered support, to home and hospice care and support groups, Circle Health offers a full circle of services and programs that help us deliver on our promise of Complete connected care to our community.

Lowell Community Health Center Targets Prevention and Education

In addition to the medical services it provides, Lowell Community Health Center serves as a resource for information on a broad variety of health topics, including disease prevention and wellness. The Health Center, whose mission is to reach the most diverse and under-served members of our community, focuses on education and preventive care so people understand cancer risk factors, symptoms and how and when to seek care. In addition, the Health Center offers a call center that serves as a direct line for women’s health services, and workshops are offered in homes and community settings in languages such as Spanish and Portuguese.

“Our goal is to educate patients on the importance of breast self-exams, regular mammography and skin screenings, as well as addressing the cross-cultural or language barriers,” says Melanie Priestly, Director of Family Planning at Lowell Community Health Center. “If one of our patients has an abnormal pap smear, or finds something unusual, we help her navigate the next course of action and if needed coordinate care through the cancer specialists at Lowell General Hospital’s Cancer Center.”

Imaging Technology is Key in the Fight Against Breast Cancer

Proper diagnosis and effective treatment of a breast abnormality often begins with accurate imaging. Lowell General Hospital offers the latest in screening and diagnostic technology for all types of cancer. Accredited by the American College of Radiology as a Breast Imaging Center of Excellence, the hospital’s consistent quality performance for mammography, breast ultrasound, and stereotactic breast biopsy represents the highest level of image quality and patient safety.

From fully digital mammography suites featuring 3D mammography (Tomosynthesis), breast ultrasound and stereotactic biopsy, breast MRI, and genetic testing for breast cancer, patients benefit from the latest technology and confidence that each mode of detection — mammography, ultrasound and biopsy — meets the standards of excellence set forth nationwide.*

Additionally, the hospital offers on-site certified Breast Health Navigators — specialized nurses who assist women in facilitating timely tests and treatment as needed for breast care as well as providing emotional support and educational resources.

World Class Treatment at the Cancer Center at Lowell General Hospital

When faced with a cancer diagnosis, members of our community receive care that not only offers the greatest hope for a cure, but is compassionate and addresses his or her needs as a person. Cancer treatment requires the expertise of many specialists from different departments and disciplines. A partnership with the Massachusetts General Hospital Cancer Center allows Lowell General to bring world class treatment to area residents with the comfort and convenience of staying close to home and family. Lowell General offers a multidisciplinary approach where a team of care specialists review the diagnosis and collaborate to develop a comprehensive treatment plan. With affiliations for clinical research trials, multidisciplinary conferences and access to some of the world’s best cancer specialists, patients receive integrated care to help fight the disease and maintain their quality of life.

New Advances in Image-Guided, Targeted Cancer Therapies

Doctors treat most cancers with surgery, chemotherapy, radiation therapy, or some combination of these treatments, depending on the type and stage of a patient’s cancer. Specialty-trained physicians, called interventional radiologists, are uniquely skilled in using imaging to deliver targeted treatments to cancer patients.

Traditionally, the role of interventional radiologists was to aid in cancer diagnosis by performing image-guided biopsies, and to place chest ports allowing for safe and reliable access directly into the vein for medication administration. Now, with the aid of imaging such as X-rays, computed tomography (CT) scans and ultrasound (US), the interventional  radiologists at Lowell General Hospital have an evolving role in cancer treatment.

“Working closely with the medical and surgical oncologists, we have brought new image-guided, targeted treatment options to Lowell General,” says Dr. Gregg Franco, who specializes in interventional oncology. “Two of these procedures that have been very beneficial for patients are transarterial chemoembolization for the treatment of Hepatocellular Carcinoma (HCC), the most common type of liver cancer, and microwave ablation for the treatment of solid tumors involving the kidney, liver, lung and bone.”

Transarterial chemoembolization is a procedure performed by Dr. Franco where medicine coated on microscopic beads is delivered directly to the cancer cells through a catheter. This procedure delivers a very high concentration of chemotherapy medicine and blocks the tumor’s blood supply as well.

“Historically, patients with HCC have limited options, and a typical survival rate of less than 12 months. With these new tumor-fighting advancements, the results can significantly extend one’s life,” says Dr. Franco.

Microwave ablation offers a minimally invasive, localized treatment that kills the target tissue with heat while sparing the healthy tissue. The procedure works by placing a needle through the skin into the tumor under CT scan guidance and heating the tumor to a lethal temperature. This elevated temperature effectively “cooks” the tumor without the need for more invasive surgical removal of tissue. Patients experience little pain and are typically out of the hospital in less than a day.

“The treatment of cancer patients is an evolving field and therapies will increasingly become less invasive, more targeted and have a continued emphasis on a multidisciplinary approach to care,” adds Dr. Franco.

New Techniques in Radiation Therapy Help in the Treatment of Breast Cancer

New techniques are constantly being researched that help reduce the risk of damage to other organs for those patients undergoing radiation therapy. For example, patients who are being treated for left-sided breast cancer are now taught a new Breath-hold Technique that minimizes the heart’s exposure to radiation. When the patient takes a deep breath and holds it during radiation treatment, the lungs expand, moving the chest wall and breast tissue away from the heart.

Called Deep Inspiration Breath Hold (DIBH), the technique has been shown to reduce the radiation dose to the heart by as much as 50 percent, without compromising the dose to the breast or chest wall.

“This is important because studies suggest a link between the cardiac dose during left-breast radiation and heart problems — including heart attacks — later in life,” explains Matthew Katz, MD, Medical Director of Radiation Oncology at Lowell General Hospital.

As part of planning the treatment, each patient is first scanned breathing normally, then again holding her breath to determine how effectively it expands the lungs and creates space between the heart and the chest wall and breast tissue. “Then we can individualize treatment for each patient,” says Dr. Katz.

Lowell General’s Radiation Oncology Department treated its first patient with left-sided breast cancer using the deep inspiration breath-hold technique in February 2014.

“This patient sought us out specifically because this approach to treatment was available here,” Dr. Katz notes. “Until recently, the breath-hold technique was used more at academic medical centers, but we want to ensure our patients have the best possible treatment options, close to home.”

Supporting People with Chronic and Terminal Illness

Care for patients with cancer follows them home, especially when it becomes difficult for them to leave their houses or apartments. Circle Home continues the care by delivering a full range of home health, palliative care, and hospice services.

“Most patients with cancer want to continue living safely and comfortably in their own homes, among what is most familiar and loved,” says Cynthia Roche, Circle Home’s Director of Home Care and Hospice Services.

Circle Home clinicians include nationally-certified specialists in wound care, intravenous therapy, palliative and hospice services. They work to coordinate treatment with the patient’s physician and other providers. Rehabilitation therapists, medical social workers, and home health aides are also ready to bring their knowledge and skills to patients at home.

Roche notes that Circle Home works closely with Lowell General Hospital’s Cancer Center. “We’re in frequent communication with the physicians and nurses there,” she says. “Everyone, including the patient and family, is ‘on the same page’ regarding the details of care and treatment. We all work together to make life better for each patient, every day. We celebrate every success and every ‘good day.’”

Circle Home’s Palliative care program offers specialized care, focused on providing relief from symptoms, pain, and the stress of serious illness. “Patients who are receiving chemotherapy or other treatments often benefit from palliative care,” said Barbara Perry, Manager of Circle Home’s Palliative Care and Hospice Program.

When treatments designed to cure are no longer effective or wanted, hospice services are appropriate. Circle Home’s hospice team works to ensure comfort, dignity, and a focus on the patient’s most important goals. The team includes Medical Director Helena A. Thornley, MD, a board certified Hospice and Palliative Care physician, nurses, social workers, spiritual and bereavement counselors, aides and volunteers.

Noting that a patient’s illness affects everyone in the family, Perry says that the hospice team supports family caregivers with information and coaching. She said that “Helping a loved one complete his or her journey is a very meaningful experience that often brings families a continuing sense of peace.”

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Circle Health is a progressive collaboration of physicians, hospitals, other health providers and organizations with a shared vision for empowering people and communities to be healthier.

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