Dec 9, 2012|
The Roswell team talks about the dental services available.
The Roswell team discusses women in research; mentoring the next generation.
A Roswell physician discusses Melanoma and Immunotherapies.
March is colorectal cancer awareness month. The Roswell team discusses screening options.
The Roswell Park Team and a family member discuss "The Healing Touch" Pilot Program
Automatically Generated Transcript (may not be 100% accurate)
-- This is Roswell. Rookie by Roswell Park Cancer Institute. Your team opinion or your total options. Your host him -- -- welcome back to Roswell -- -- comprehensive look at all aspects of cancer care treatment diagnosis and research. From a comprehensive source of Roswell. -- cancer institute in Buffalo, New York. That's where we are right now I'm Tim Wenger and today we're talking about something we have not before in dental services here at Roswell park. Might surprise you it didn't meet and really is something pretty interest thing and is you'll find out pretty important. To what goes on here at Roswell park. Welcome to the studios today doctor Rachel recede don't she's a dentist here at Roswell park. I guess you don't thank you for being here. Thank you for having us appreciate and I can't wait to hear your here aspects of what goes on here Russell park. With regard to dentistry doctor -- -- here as well another dentist here. At the Roswell park dental care center tank were happy to be here yeah thanks for being here. I you know when I first saw you know the -- cross my computer screen. It was eye opening you know dentistry. In it with regard to cancer care in in in treatment. Doctor is you know let's start with you I mean where does it come into play. Yeah a lot of people don't even know that we're here because a lot of times only referred -- department when their doctors will send them all where. So our department is comprised of the about 50% of our -- our head and neck cancer patients -- patients and -- cancer of the oral cavity. Or of the neck or the tirade at that are going to be undergoing either surgical reception or combination of chemotherapy and radiation therapy. And then the other half of our department. Is just general cancer patients that are gonna that I having dental problems. Similar at a dental applications. Of the general public but because of their chemotherapy treatments -- because of their compromised health they're going to be seen in our department. In a little bit more of a controlled setting. Doctor corporal from both of you will get into the details of what you know specialized care you you folks provided in this department but. You get the response or do you get the reaction that that I'm having with you today where. In order tennis doing here it is if Russell park is that something common trio. Yes I'm in the buffalo community. People are surprised to hear that we do have awful. Running dental clinic in the hospital but within the institute itself for pretty well known we have referrals from many of the services. So that's kind of why we're here today to get the word now and -- but the community know what we're all about. Well obviously it's real important and there there are aspects of cancer treatment. That did affect someone's dental health and and vice Versa where there that you know dental care can affect their their treatment of cancer. If you could for me you know the purity mentioned head and neck cancers are are prone to you know. A large proportion of of the folks you see that why is it that dentistry is needed in a place like Roswell park. Wolf her head and neck cancer patients -- we screen all the patients -- when their first diagnosed. So we'll take X rays on them or take a look we'll make sure there's no teeth that are infected or need to be extracted before they start therapy. On and then also coordinate with the surgeons on the they need to have any any work done -- orally. In conjunction with the surgery or in preparation. For radiation therapy. So when patients undergo head and neck radiation therapy. 5% and higher risk for infection. After. After radiation if they need to have teeth extracted or any dental surgery so we -- do a lot of the care and -- on the front end. To avoid potential problems in the future. You know doctor or maybe you can address this I mean why wouldn't someone's dental health or their dental. You know either do what what perspective there at the time of diagnosis and treatment. -- be important to me why isn't why does it affect. Someone's care. -- the mouth is a huge source of infection. And a lot of these cancer patients are seeing treatments chemotherapy and radiation detectors you don't mention. That can seriously compromised immune system there body's ability to fight infection. So smiled on section for a healthy patient and Indymedia OK and be able to fight it off for the patients whose. Onions has done is so compromised. It can greatly affect -- it can be a systemic problem. Hands on compromise -- treatment so it's really important to get those patients in and screen them before they see these treatments. So we can be sure to rule out any sources of infection that could compromise their course of treatment. You know we -- You know most of us you know go to see a -- once twice a year -- you know we go through our annual cleaning and you know we have a feeling here there and I'm hopefully that's it but we've certainly had you know more serious things. What what do you find her what what are you most actively involved and what type of dentistry. Do you. You know practice here for the most part. -- get most of our patients and a referral basis like we sent from the outside psychologist at the surgeon so they come to us initially for a screening where. Where we do like -- once over there and then from there we do all aspects of dentistry -- in our department. So if they need extra actions done it any feelings gun if they need root canals or ultimately -- they need. Partial dentures or -- is we do that all right our department. -- Now you're QQ both in in your you're uniforms today and Max palatial and sale next solo facial -- -- facial okay do you explain that to me what is what does that mean. -- -- facial prosthetics is. Specialty of dentistry and we're really lucky that in our center we have two of these specialists and -- fees shall cost of scientists. -- -- Any specialized. In making prosthetics for patients whose had a -- anatomy has been altered in some way. Whether it be from. Cancer treatments like surgery year recovery section in the oral cavity where to their had a knack. Or even from Tom -- the facts so they specialize in making -- extra patients who've had their anatomy changed. In some way. At what point of the process immediately you know we talk a lot in this studio in here arousal part about. This whole. You know multi disciplinary approach to cancer care and are so many different aspects of it here Roswell in your part of it. -- at what point in someone's care plan. Do you folks get involved in years in your department. On the -- depends on what type of cancer diagnosis they have. We do see -- -- a lot of the head and neck cancer patients with and we also see patients from all different disciplines in the department. Whether it's pre screening for her chemotherapy. Or for IV this fascinates. Or we do see a lot of the floor patience when their in the hospital. If they have any down problems or sometimes just for like a routine screening to real irony in action the doctor quirks that. I'm so it all depends but patients are also -- -- -- just -- department and come. Come as a patient Roswell and they're seeing him at Roswell for other for other reasons. -- -- -- is this you know on a daily basis are you seeing patients for your work consulting cases. You know from from afar how does how does it work as far as your interaction with in individual case -- passionate. Most of our day is spent treating patients. The institute. We also do a lot of consultations. Referred from other clinics prior to they get prior to them getting on their treatment. We also respond to family counselor counsel patients -- are staying at the hospital on the flowers and may have. Don't emergencies -- -- so we're kind of taking care of the -- institute in terms of any -- issues. But most of our day is spent and in the clinic seeing patients treating. Mentioned you know dental emergencies what would one be what would give me an example of what that might be her a lot of our patients on the floor thirstein you know very staunch human therapies and they have side effects in the mouth. Kind of like we touched a kind disorders. Or if they do have a talent factions so that kind of thing like this at a talent faction. In an -- immune compromised patient and is a serious thing we can have a lot of -- pain swelling that type things so we we can respond to anything. Any changes in our candy -- -- impatient worse you know. Just firmly on the from a -- for uniform from the average person out there listening right now is not dealing. Hopefully with -- with cancer center Blake Russell park and it's going to see their Dennis. I know there's an example for oral cancer. That the -- due to provide. You know what do. Tell me about that I mean it's always something that's somewhat surprising I think when we you know -- are you going to get your teeth cleaned and they're doing some sort of cancer screening. Yet there threat to our school all. End in residency training. Dentists often learn about a thorough had a neck examine it really is important that. That your average your general dentist will provide it for you so it's just. A local -- Intra oral tissues and a -- exam to see -- lymph -- neck and -- -- C or any eight facial asymmetry. That may indicate. You know early stage oral cancer. So a lot of the patients if they do have some sign of this -- that referred our department for imaging studies or for biopsy is. -- can prescreen them for for early diagnosis. That is the reason for the question is to his -- you know so often I think is that in today's society we think of dental. Health sometimes is cosmetic you know and it's not it's really important it's important to. Our own you know personal health higher hygiene and in the as you mentioned you know it can get more serious. Definitely there's a lot of there's a lot of common infections in the mouth that can really affect your whole life systemically -- be carried our diseases or. You know SST that are just quiet. I'm an average patient. But then once they're diagnosed with the in immune compromising cancer can really flare up and really 'cause bigger problems that's why I would like to see the patients when they first get diagnosed. Both of you mentioned head and neck cancers and I think it's kind of a broad. B category -- we can envision what had neck cancers. Might entail that if you can get specific with me. Both if you run and what what cancer is for the most part present conditions that. The dental. Department here Russell would involve. -- the head and neck cancer currently is comprised you know tongue cancer or -- you -- cancer in changeable cancer. -- or there's also could be cancers of the nasal -- explore the sinuses. It's it's anything really from the nose down to. The voice box or down to the larynx is considered head and neck cancer. -- do you find that the that the treatment you provide is reactive to. The cancer treatment or is it something that's involved with the actual care plan mean. Is what you do. A result of treatment or is that a result of that disease it's being dealt with -- -- that's. Probably a a bit about that yet available via. And you know what are you know some of the specific. You know items that you know procedures that you -- up on a daily basis -- performing. How we do all aspects of dentistry. For our. We do treat a lot of the side effects of treatment that the patients have and let me touch a little bit about radiation and head and neck cancer that your. A lot of and that patience we'll have to undergo radiation therapy. I'm either as a final home and that being there diagnosis and treatment or after they have a surgical reception so we'll go. -- there -- colleges in after the surge and and then Melissa and what. In what form that they need radiation therapy. I'm an radiation therapy really has a lot oral side effects that they really need to. Be -- very closely. My dentist. So some of the side effects will be easier Estonia which means dry mouth. So the patient gets radiated. In their head and neck region and it really affects the saliva glands. So the saliva production is decreased. So well they will form form -- is a lot faster. And they really have to keep up with their hygiene. More so than the average individual. And also they have any potential infections -- to take care of these a lot quicker and really stand -- things. Because if they have to have done extra actions and to beat the dentist has to be very careful. On to avoid any affection of infection -- in radiated. You are listening to -- listen really uninteresting conversation about something that we not discussed here before and that's dental services. Here at Roswell Park Cancer Institute that is doctor Rachel -- don't. She's a dentist here at the Roswell dental care center along with doctor -- court. In the same department. Doctor -- if you the results of this tree and I mean. I chemotherapy radiation I mean we were attacking the body and in in trying to. You know kill off those cancerous cells what is the result. From a dental health perspective and we talked against you know specificity about had a neck cancers but just radiation in general. Chemotherapy in general does it affect dental health. Certainly. -- chemotherapy. Many human therapies you know they target rapidly turning over cells cancers house. In an -- oral cavity use that tissue is comprised of the same -- itself very rapidly turning over cells so we see patients. -- -- -- -- -- -- -- -- Which is. In the simplest terms like sores in the patient's mouth sores and ulcers that they get as a side effects from chemotherapy and it's very very common. On many can be very just comforting for the patient and can lead to infection as -- also that's. I mean thing that we see from chemotherapy. And then radiation and in general with a side effects that we see are from had a -- radiation specifically other parts of the body you know there isn't much side effect and in the mouth. But had a -- radiation and doctors -- spoke about just have so many side effects of the oral cavity. Same thing you can have from -- I Tesoro lots of generalized soreness. That we need to treat dry mouth as she touched. A pine and radiation specifically. Really affects them the micro vessels and our jobs which are the really small blood vessels. England. The side effect of that is compromised healing in the dies in the future so those that are the means and -- that we see you radiation chemotherapy. You're seeing patients both of you you know on a daily basis are you getting that that that surprise factor that I am kind of green and you know to the studio today that. You know really and senior tennis. You know that that this is part of what happens with cancer care. A lot of real it's my knees and then a lot of the patients are really surprised that there surgeon -- colleges want them to go to the day and test. At Roswell but then once you explain it to them we're really here to help you and we're here to -- Look for any problems any infections and can ask for seeing in the future and make sure you're healthy that you can make it through your treatment as successfully as possible. We want to really you know seal on the front and either do it necessary treatment and then we also put a lot of our patients -- fly -- ride. Toothpaste we put them on really strict -- -- -- -- every couple months. And -- to make sure that things that are you know staying staying healthy like healthy treatments and -- usually really. Appreciate. You know the services that we provide. I'm guessing that that I can probably answer part of this question myself and ask you both of you and that is. Is is your area more proactive or is it more reactive do you know upfront which patients who are going to need to see. Well -- did or is it more of a let's see how they you know how they're dental health so to speak reacts to whatever treatment is they might go through. Where we're trying to make it more pro active I mean where we really do a good job within the institute. Of being well known with services that have the side effects effect or a candy that's why. We were very closely with the bone marrow transplant department because those patients have a lot of side effects. Post transplant and throughout their transplant if they have dental problems. On similar with the leukemia and lymphoma department. And also you know breast cancer patients any patients that have metastatic disease and the phone. We screen a lot of those patients before they -- on certain types of chemotherapy is just because those therapies have a fact. And the job. If left untreated it. So we have good. Niche within the hospital of you know those oncologists really referring to us before to be proactive about avoiding avoiding. Disastrous applications sometimes. There's probably two categories that you deal with that you mentioned had a -- you know between the -- and the voice I think -- -- you be presented -- and there are some direct. You know you know correlated of effects that that cancer treatment would have you know. Your your mouth your dentistry. With with treatment. In in that regard. Beyond that in just general cancer treatment. What what can a patient expect. This fire is. You know reaction as far as their dental health is concerned if you just if you're going through chemotherapy or radiation for cancer -- related to that area of the body. Well we always recommend. In any cancer patients no matter what -- it is that they're being seen by dentists regularly and just people in general twice a year in getting that had a -- exams. You're taking care of any -- issues such -- because you never know when your health is gonna turn for the worse and just really great tend to be on top of it it's an important part of our bodies. And it really can affect our overall health systemically so we just really recommends. Twice a year. Recall screenings and exams by dentists. I'm really important. Complications you know what comes up in in your world junior department what what are the the potential complications. From a dentistry aspect that can come up with with cancer care. I'm a lot of times we have to work with the patients and ecologists. And -- tying their care. Depending on what cycle of their chemotherapy either asked. Because when patients are undergoing chemotherapy. Sometimes they're blood work we'll trapped and their platelets and white blood cells will draft to a level that's unsafe to do dental treatment. So a lot of times will coordinate care with their intelligence to actually do the -- treatment. At the best -- month. I'm in -- cycle. So one of the applications could be you know. -- excessive bleeding after an extraction and Omar and necessity for additional antibiotics. Occasionally occasionally have to be admitted after they have dental treatment but that's very rare because we really do a good job of -- timing things with psychologist. You know in a lot of what happens here is before treatment a lot of you know diagnosis and pre treatment a lot of happens obviously during the clinical treatment of someone's cancer. And then there's that post time where we're someone's being followed up on. Are you involved in all three aspects of or you and definitely more involved in one -- one the other adultery. -- we likely talked about we'd like to be proactive but we also see your patience you know well after their treatment because. The effects of radiation chemotherapy or long lasting. So we'd like to see your patients routinely or if they do have a private -- on the community we just recommend that they follow up. With Stan. I'm a regular basis. And then. After after their treatment when there diseases are stable parent or just under surveillance we just do routine care routine chemistry on these patients. Com just follow them closely. And again we've mentioned the you know had a neck cancers but you know there's that that dentistry aspect of cancer care and and the effects of it can can be from. All aspects of it do you see. Does every one. And dump it at some point being examined or you know considered for examination by the dental department or is now. Every time he'd be most most oncologists will ask there. Patients if there followed closely by a dentist and then their welcome to come our department today if they need to be. Some different forms of chemotherapy. Like. Like I need this fascinates you really. Colleges are requesting. On the specific examination an opt in by our department. A similar also the -- -- transplant department they request other patients to come our department for an examination before they start treatment. So certain factors certain departments will request the patients to come her. Our department for examination. And then some -- -- facing an -- and dentist that that's good enough but -- everyone's welcome to come and department whether it's four -- examination and or. We -- awful service panel. I -- that does them cleaning this he satire when it. First diagnosed and also -- -- in remission and welcome come department. You know I pointed out all the time but I mean this is really agenda and our community that we have Russell park. And you're part of it your part of that whole multi disciplinary approach or not that many. Of these comprehensive centers around the country there are fewer than our states and in the United States so. You know we're proud to have it in the community you really. I guess you know give you both an opportunity to expound a little bit on affecting your part of that entire. Approach and facet of our community that is not just. You know go here for this and go to this place for that and it's all here you guys at heart of a multi -- And I will -- where we're very well respected within the institute. Distant. Just from -- being here for the years that we spend and establishing ourselves with that scientologists and -- the surge ends. That you know they sent a lot of patience to us in the they realize sit down and factions could potentially nearing harmful if left untreated. In just a little bit about how you know lucky buffalo is to have this great institution and community we have so many patients that come from very far. Six hours eight hours a -- here and seen hotels for treatment. Console it's just such a great thing and we had to institute. In buffalo. It's on. Campus and you know really it's it is amazing and you know it's I can't stress enough I mean that the fact that we have a right here in our -- community is supposed to. Who did you mention driving you know 678 hours great thing about that the both of -- is that your products of our community right -- -- both yes. Came from. Not too far in the university of buffalo dental school right. School -- plan I'm actually able born and raised in question here as well. And you know to -- that when you were growing up you hear about -- -- -- -- who would have thought right now made you know you've. You know. Proven yourself to you know move right into it that the campus here from from the campus just out of your guests are very lucky I am very proud of me. I'm gonna -- community what to either of you see as far as the future of dentistry and its involvement with with cancer treatment -- For the future we really just hope to spread the word about. How a dentist plays a role in a patient's cancer treatment a lot of the pro active. Things that we talked about just educating dentists in the community how to how to treat these patients who are going over for cancer treatments. Time. And it's. Yeah freaked him Marmara patients living with cancer and living healthy with cancer. Whether it's in remission and Boris you know kept at a level where they can just be monitored. A lot of patients out there can be in you know out there. Living. Going in the general and asked. And their minutes and dentists need to be and a little bit of education about what we do in their own practice. And also for them to be comfortable in referring to us if they have a problem if they know. Something that's a normal and he won a biopsy you -- second opinion to know that we're here and that we can provide those services. We're we're very thankful that you hear -- do you do it's really important work but I have to ask you why did you choose this aspect of dentistry you could be. You know given me my toothpaste in mind yeah right hand which is really important to why did you choose this aspect of your career start with the accuracy. Am I did my training area tested now school and I wasn't expecting to stay at Roswell but I just I really did love it. Stay here part time. And I was -- -- practice for awhile and recently I just sign that full time here rest well some very proud to be here. Yes and I did my training here. As well not expecting to stay here long term and I just had such a great time during my year residency you learn something every day working here. It's just been such a great experience so I stayed on part time and I am part time in private practice so it's kind of nice that I have a little bit of both worlds and I am praying you know what I learning needs different setting to the other jobs so it's been great. So -- -- and -- your dentist in years danced at Roswell park they're probably two different reactions yes everybody says the same thing like -- Aniston and yes. Well you don't important stuff and I appreciate it and I really is an eye opening experience and I guess I should say a mouth opening -- Had to make a bad pun here -- -- -- on this radio. Thank you both both for being here for what you do and effort taken some time today appreciate it and I think and I haven't heard doctor Rachel receive -- dentist here at the Roswell dental care center along with doctor -- court. Dentists as well in the dental care center at Roswell park. In important aspect of cancer care which we've not talked. A lot about and hopefully we will again soon and if you'd like to hear anymore about this. You can do so at Roswell park dot org you can hear this show in its entirety any other Roswell new shows Roswell park dot org. All sorts of information there and you can also call toll free anytime with question at 877 ask our PCI. That is 877275. Seven. And there. Listen to Roswell this Sunday mornings at 630 young WB yeah. -- by Roswell Park Cancer Institute your team opinion for your total options on line at Roswell this god of war. Hanging. And hanging. Then.