CentraState - Healthy Directions

Changing Lives Globally, One Physician at a Time Cryoablation replaces surgery only and does not negate the need for radiation or chemical treatments. "What the trial is attempting to prove is that we can eliminate lumpectomies and still treat the cancer effectively," Dr. Martucci says. Dr. Tomkovich particularly finds cryoablation beneficial because "the physician can control the size of the ice ball that is formed in the procedure through the guidance of ultrasound, reducing damage to surrounding tissues." The body then reabsorbs the dead cells, eliminating any need for surgery, a procedure that removes much more breast tissue. "Despite some refinements in current breast cancer treatment, the typical protocol doesn't change whether you're 42, 62, or 82," Dr. Tomkovich says. "I think everyone should be treated as an individual, especially those with very small, nonaggressive tumors, or those patients who are a high surgical risk." Research is also raising the possibility of a resulting immunity to the particular cancer. "When the body reabsorbs the dead cancer cells in the breast, trials have shown that some patients have developed an immunity to that cancer," Dr. Tomkovich reports. As Muriel listened, the pendulum swung toward cryoablation. Muriel found the concept "neat, logical, and wonderful." After some preliminary research, Muriel called Dr. Martucci back. "What's to think about?" Muriel said. "You can cut me open or just insert a needle? I want cryoablation." A short time later, Muriel had the 30-minute procedure, met her friends for lunch, and finalized her plans to tour Israel. As part of the study, however, Muriel will meet intermittently with the trial's team of specialists in the Women's Health Center for the next five years. "We never lose track of the patient," Dr. Martucci says. "Muriel will meet with me throughout her cancer experience." Muriel is appreciative of the warmth she found at the Women's Health Center and the fact that CentraState is "at the cutting edge of research." As CentraState is one of only eight centers nationwide to offer the study and the only one in New Jersey, Muriel was convinced that she was meant to participate in the study, if only to help save younger generations of women. "By the time my granddaughters are older, there will probably be advances based on cryoablation," she says. Dr. Tomkovich is hoping the same thing. "Part of the reason I love this trial is I think it's going to expand and be applicable to even younger patients," he says. "We have developed programs here to rival any in the nation. I continue to get invited to lecture because we're doing procedures and treatments that are advanced and are going to be the future of medicine, particularly in breast cancer. Not a single patient in this trial has had a surgical procedure to remove the cancer. That is what is unique about this study. It's the first large-scale trial in the world to do this. I'm proud to say that we're doing it from our center here in the middle of Freehold." Muriel adds, "I don't know why anyone wouldn't try cryoablation. If it doesn't work, then I still have the option of surgery open to me." Her only complaint appears to be that she gained little sympathy from her friends. It all seemed too easy. She now refers to her experience as "the 47 days I had cancer." For more information about the Star & Barry Tobias Women's Health Center at CentraState, visit www.centrastate.com/ womenshealth or call 866-CENTRA7 (866-236-8727). HD When Dr. Tomkovich first visited China in 2010 as a visiting lecturer, he found that Chinese women were having mastectomies (total breast removals) whether their breast lumps were benign or cancerous. Guangzhou province physicians did this because they did not have the technology or understanding of less-invasive measures to successfully make diagnoses or excise tumors while preserving the breast, such as needle localizations, a method of locating and performing biopsies on lumps deep in the breast, or lumpectomies. So, using his extensive expertise, he taught them those procedures. In more advanced centers, Dr. Tomkovich was able to show physicians ultrasound-guided and stereotactic biopsies, tools that have advanced breast cancer detection measurably. The Chinese physicians were anxious to learn and change their thought processes, Dr. Tomkovich notes. In 2012, he invited a group of physicians from China to see CentraState's state-of-the-art technology and procedures in action so they could ultimately return to educate their fellow physicians in China. "When I returned to China in 2014, I was floored," Dr. Tomkovich reports. "A group of doctors who were doing little in 2010 had developed their own multidisciplinary breast cancer conference, all based on what I had told them they needed to do." Dr. Tomkovich was heartened by the tremendous strides that had been made. "I felt honored, lucky, and privileged to do that kind of work, where possibly millions of women were prevented from having mastectomies," he says. "I hope to return in 2018. The potential is so great." Muriel Smith with members of her CentraState breast cancer team, Dr. Kenneth Tomkovich and Dr. Mary Martucci. "We're doing procedures and treatments that are advanced and are going to be the future of medicine, particularly in breast cancer." —Kenneth Tomkovich, MD 5 www.centrastate.com Fall 2016

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