Week 3 - Young Hye

This week I spent most of the time in Stich Radiation Center. I shadowed Dr. Mary Hayes in radiation oncology, seeing her talking to her patients about treatment plans, running simulations to design treatment plan, follow-up visits, consultations after the end of the treatment, etc. I also shadowed radiation therapists, in treating various diseases such as breast cancer, prostate cancer, oral cavity, etc. I picked up radiotherapy vocabulary such as monitor unit, gantry, callimator, centigray (cG), fractions, etc. In simulations, the patient was placed on different molds so every time the patients get treatment they will be in an exactly same position in order to prevent radiation from targeting normal areas of the body. We also paid a visit to Mr. Cheeseborough's lab, which is an industrial R&D lab situated in Weill Cornell. They are focused on developing better radiotherapy machines, and they have been asking Dr Hayes to come and visit their lab. It was interesting to see the engineering work in medical school, although I wasn't able to follow most of their presentation. Then as we walked back to Stich, Dr Hayes told me an interesting problem which I think could be a really good engineering project; lots of breast cancer patients who underwent mastectomy and have implants, radiation therapy results in hardened implants which patients often complain of. Dr Hayes said that it would be good if a radiation-compatible tissue implant existed.

On Wednesday afternoon, I spent most of the time in cancer genetics center on 10th floor of 425 E. 61 st. I shadowed Ms. Ann Carlson, who seemed to be doing all of what Dr Pressman does, such as consulting patients, but just not a doctor. She specializes in breast cancer genetics, and she told me that BRCA1 gene mutation has a higher risk of developing breast cancer and ovarian cancer, whereas the risk is reduced in BRCA2 mutation. And for Ashkenazi Jewish descendants, the chance of carrying BRCA mutation is significantly higher, and for this particular group of people they only test three mutations because of its prevalence. Consultation went as follows; the patient comes in, draws a family tree with the consultant (doctor), discuss their likelihood of carrying BRCA mutation and passing it onto their daughters, choosing which test to go through, discussing if/how the insurance will pay for the test, the patient leaves the room and gets her blood drawn, and then the blood gets sent to a lab in Utah, which is the only place in the US that does this test.

As far as surgeries go, I saw three cases this week. One was a stereotactic radiosurgery to remove tumor in lower cerebellum, in which a headframe (called halo) was placed onto the patient's head, screws in, gets a CAT scan, the physicists do their calculations for location and dose of the radiation, and then at the end of the day the patient gets her treatment. It looked awfully painful for the patient to have the headframe screwed into her head for hours, and when the nurses took out the halo, there were holes on her forehead. The other two surgeries were more traditional ones, done in the OR, with blades and blood and whatnot. I shadowed two cases of Dr. David Kutler's, one was removing benign lipoma from the neck, and the other was removing a mass on thyroid cartilage.

As for the project, I sat with Dr Vahdat and we went through her folders of patients and online database and updated basic information of the patients such as height and weight. It's still incomplete, and I need access to Epic in order to extract patients' information. Once this is complete, then I will get to learn to pull up the slides and learn to interpret them.