What's New

Roswell Park is First Center in New York State to Implement Monarch Bronchoscopy Platform

Minimally invasive tool uses robotic technology to enable earlier, more accurate diagnosis of lung nodules

By Annie Deck-Miller

Nathaniel Ivanick, MD, Assistant Professor of Oncology in Roswell Park’s Department of Thoracic Surgery

Lung specialists at Roswell Park Comprehensive Cancer Center now have a tool for visualizing and reaching lung nodules through a minimally invasive approach, enabling earlier diagnosis of cancer, smaller biopsies and broader treatment options for patients. The Buffalo-based cancer center has become the first facility in New York State to implement Auris Health Inc.’s Monarch™ platform for robotic navigational bronchoscopy into its interventional pulmonology program.

Robotic navigational bronchoscopy can benefit patients who have a potentially concerning lung nodule, typically detected by a CT scan. It allows physicians to safely biopsy very small, difficult-to-reach areas of the lung, enabling earlier diagnosis of suspicious lesions that were previously inaccessible without surgery.

“Peripheral nodules located in the outer section of the lungs are common — they’re found in up to a third of adults who get a chest X-ray or CT scan,” notes Sai Yendamuri, MD, FACS, Chair of Thoracic Surgery and Professor of Oncology at Roswell Park. “The vast majority of these concerning lesions — 96% — are not cancerous and don’t require treatment, but which ones? Earlier technologies did not allow us to effectively reach the lung periphery and determine the nature of the nodule as this new tool can.”

The Monarch system integrates robotics and software with bronchoscopy, allowing for real-time, continuous visualization of the bronchial tubes, or airways, through a flexible endoscope that physicians can navigate to the outer regions of the lung. Using a handheld console, physicians can access traditional endoscopic views of the lung along with computerassisted navigation based on 3-D models of the patient’s own anatomy.

There are many causes that may make lung cells appear as a mass or area of concern on traditional imaging — including not only cancer but also scar tissue, infection or inflammation, explains interventional pulmonologist Nathaniel Ivanick, MD, Assistant Professor of Oncology in Roswell Park’s Department of Thoracic Surgery.

“I have a number of tools at my disposal, and robotic navigational bronchoscopy brings all of those tools together and allows me to take information from all of those tools to choose where I’m going to take the biopsy with the greatest accuracy, the greatest safety and with real-time visualization,” he says. “By diagnosing any cancerous tumors earlier on when they are smaller, we have more treatment options to offer our patients, many of whom will be candidates for less-invasive surgeries or may even be able to avoid surgery entirely.”

Among people screened for lung cancer because they are at high risk for the disease, clinicians find lung nodules deemed to be suspicious in about 24% of cases. Of those, slightly less than 4% are found to be cancerous.

Roswell Park is able to offer this new approach to patients because of donations from individuals and organizations. A $600,000 allocation from the Roswell Park Alliance Foundation covers the cost of the new system as well as some of the associated costs of implementation. “Roswell Park is once again leading the way in an important area of care,” says Shirley Johnson, MBA, MS, RN, NEA-BC, Chief Clinical Operations Officer at the cancer center. “We are so very grateful to the many generous and passionate donors who support our mission to offer the best and most effective options for diagnosis, treatment and prevention of cancer.” “It’s amazing to see how technology has changed the way we detect lung tumors,” adds Dr. Yendamuri. “Ten or 15 years ago, it was not uncommon for patients to have large, untreatable tumors by the time they were diagnosed with lung cancer. But new treatment options and precision detection have changed the landscape entirely.”

WHAT’S NEW in Area Healthcare

NIAGARA FALLS MEMORIAL MEDICAL CENTER Dr. Ramkumar named medical director at Golisano Medical Oncology Center

Bhuvana Ramkumar, MD, has been appointed medical director of the Golisano Medical Oncology Center at Niagara Falls Memorial Medical Center, which is a member site within the Roswell Park Care Network.

A graduate of MGR Medical University in Chennai, India, Dr. Ramkumar completed an internal medicine internship at the University of Oklahoma College of Medicine and did her residency at Rochester General Hospital.

Dr. Ramkumar also completed a fellowship in hematology and oncology at SUNY Upstate Medical University in Syracuse. She is extensively trained in hematology and oncology and is boardcertified in four separate specialties: internal medicine, medical oncology, hematology and hospice/palliative care medicine. She first joined Roswell Park Comprehensive Cancer Center’s care team as a hospitalist from 2008-2011 and returned to its network of physicians in 2018 as a staff physician at Roswell Park Hematology Oncology of Niagara and Roswell Park Hematology Oncology Northtowns.

The Golisano Medical Oncology Center, which recently opened, will make expert cancer care including hematology and oncology care, consultations, chemotherapy infusion and immunotherapies readily accessible to those who live and work in Niagara County.

ROSWELL PARK CARE NETWORK Roswell Park Care Network, Oneida Health Name New Radiation Oncology Medical Director Dr. Maya Mathew will head Center in Oneida

Roswell Park Comprehensive Cancer Center and Oneida Health continue to add to the cancer expertise available through their affiliation, announcing the hire of Maya Mathew, MD, as Medical Director of the Dorothy G. Griffin Radiation Oncology Center in Oneida, part of the Roswell Park Care Network.

Dr. Mathew comes to Central New York after serving as a radiation oncologist at Memorial Hospital in Gulfport, Mississippi. She will lead a team that includes a Roswell Park medical dosimetrist and medical physicists, along with highly trained and compassionate radiation therapy and nursing personnel, developing evidence-based and peer-reviewed treatment plans that follow the same quality standards patients can expect from the National Cancer Institute-designated comprehensive cancer center in Buffalo.

Dr. Mathew earned her medical degree from Kerala University in Kerala, India and completed a radiation oncology residency at Loyola University Medical Center in Chicago.

“We look to Dr. Mathew to further the Roswell Park and Oneida Health mission of quality radiation treatment for patients who come to the Central New York center,” said Michael Kuettel, MD, PhD, Chair of the Department of Radiation Medicine at Roswell Park. “She and her staff, who are trained on Roswell Park standards, translates to exceptional care and improved quality of life.”

TRINITY MEDICAL WNY Trinity Medical WNY Welcomes Nawfal AlKhafaji, MD to its Williamsville Office

“Dr. Al” received Bachelor of Medicine and Bachelor of Surgery degrees from the University Of Baghdad Col-

lege Of Medicine. He completed Internal Medicine residency at Chicago Medical School and then a fellowship in Cardiovascular Disease at Creighton University School of Medicine. Currently he is a member of the American College of Cardiology, American Society of Echocardiography, and American Society of Nuclear Cardiology.

ST. JAMES HOSPITAL St. James Hospital is pleased to welcome UR Medicine pain management specialist, Gabriel Yacob, MD

Dr. Yacob offers non-invasive and invasive treatments of neck and back pain, headaches and facial pain, cancerrelated pain, complex regional pain syndromes, nerve injuries and neuropathy, pain of the joints, chest and abdomen, sports injuries, neuralgia and shingles pain, and related neuromedicine conditions. “We are delighted to bring Dr. Yacob to our affiliates in the Southern Tier,” said Webster Pilcher, MD, chair of URMC neurosurgery. “He will offer in-person and telemedicine appointments and do procedures at St. James Hospital, Noyes Health and Jones Memorial Hospital, expanding access to local pain management services in that region.”

Board-certified by the American Board of Anesthesiology as well as in the subspecialty of pain management, Yacob received both his Medical Doctorate and Masters in clinical

pathology from Cairo (Egypt) University School of Medicine. He completed a Residency in clinical pathology at Kasr-El Aini School of Medicine/Cairo University Hospitals; one in internal medicine at New York Methodist Hospital and Sloan Kettering Center Center/Weill Cornell Medical College (New York); and one in anesthesiology at Brookdale University and Staten Island University Hospitals (New York). Yacob did his Fellowship in pain management at University of Pittsburgh Medical Center.

URMC URMC Neurosurgery Welcomes Tyler M.

Schmidt, DO

Dr. Schmidt DO is a faculty member in the Department of Neurosurgery and Surgical Director of the new Metastatic Brain and Spinal Tumor Program within the Wilmot Cancer Institute. His clinical interests are in neurosurgical oncology, focusing on brain tumor surgery, spinal tumor surgery, brain and spinal metastasis surgery, and complex spinal reconstruction. During treatment of these disorders, he utilizes minimally invasive techniques, stereotactic neuro-navigation, brain mapping, and tumor fluorescence guided resection.

Dr. Schmidt also provides care for spinal disorders and general neurosurgical diseases of the brain and spine utilizing minimally invasive techniques. He has a special interest in the delivery of value-based care in the surgical and nonsurgical management of back pain/ spinal disorders.

Dr. Schmidt completed his neurological surgery residency at University of Rochester Medical Center and in-folded fellowship training in neurosurgical oncology at Geisinger Medical Center. He remains active in the national neurosurgical organizations.

CATHOLIC HEALTH No Appointment Necessary: Catholic Health Expands CH Care OnDemand 24/7 Telehealth Program Throughout WNY

Catholic Health is now offering CH Care OnDemand, giving Western New Yorkers 24/7 access to a medical provider, within minutes, for nonemergent conditions –all from a phone, computer or tablet.

Catholic Health has partnered with Teladoc®, a national leader in telehealth services, to become the first health system in Western New York to offer around-the-clock virtual medical visits with no appointment necessary. CH Care OnDemand offers a private and secure way for people to connect with a doctor, physician assistant, or nurse practitioner, via a video chat or phone call. The service is staffed by local providers from Catholic Health, Catholic Medical Partners, and WNY Immediate Care, as well as Teladoc’s nationwide provider network. “As we keep innovating to meet the community’s needs, telehealth will be a key component in delivering high quality care – meeting patients where, when and how they want to receive care,” said Mark A. Sullivan, President & CEO of Catholic Health. “Now, when people have a health concern, they have another option for quick, easy and safe access to virtual healthcare, even in the middle of the night. We live in an ‘on demand’ world, and, as its name implies, CH Care OnDemand offers high quality healthcare anytime, anywhere.”