Cancer Center at Hahnemann University Hospital 
 
 
 
 

                   

To schedule an appointment with a Hahnemann Cancer Center cancer specialist call 1-866-884-4HUH (4484).

Hahnemann University Hospital, in affiliation with Drexel University College of Medicine,  provides the region expertise in diagnosing, staging and treating cancer using advanced technology.

Our cancer team includes experts in:

Medical Oncology
Surgical Oncology

Radiation Oncology

Community Outreach and Education:

Hahnemann is one of the first hospitals in the Philadelphia region to serve as an off-site location for The Wellness Community of Philadelphia.  The Wellness Community offers professional programs to people with cancer and their families designed to enhance their health by providing emotional support, education and hope. Wellness Community programs including support groups, stress management workshops and cancer education are offered on the Hahnemann campus weekly.

Learn more about Hahnemann’s programs for:
Brain and spine cancer
Breast cancer
Colorectal and other gastrointestinal cancers
Endocrine cancer
Gynecologic cancers (cervical, uterine, ovarian, endometrial, vulvular)
Hematologic cancers (leukemia, lymphoma, myeloma
Liver, pancreas and other hepatobiliary cancers
Lung cancer
Prostate cancer

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Hahnemann’s Cancer Programs by Modality

Medical Oncology

Specialists in hematology/oncology provide evaluation, diagnosis and treatment for a variety of neoplastic diseases including leukemia, lymphoma and myeloma as well as for solid tumors.

Hahnemann performed one of the region's first Bone Marrow Transplant in 1976 and the program continues to employ this treatment modality for many hematologic diseases.  Types of bone marrow transplants performed include allogeneic (sibling), autologous (same), peripheral blood stem cell and unrelated donor transplants.  A mini-transplant program with abbreviated conditioning regimens for older patients with hematologic malignancies is offered.

The bone marrow transplant team includes attending physicians, oncology fellows, medical residents, nursing, pharmacists, transplant coordinators and other support caregivers.

The program is part of the National Marrow Donor Program, as both a transplant and a harvesting procurement site.  Through this program, marrow transplants are possible from volunteer unrelated donors for patients.

 

Surgical Oncology

Surgical oncologists work closely with other members of the cancer team at Hahnemann and focus primarily on these types of cancer:

  • Breast cancer
  • Endocrine tumors
  • Thyroid and parathyroid tumors
  • Gastrointestinal tumors (such as stomach, pancreas, liver, small and large bowel, soft tissue or sarcomas of the abdomen and GI tract)

Our surgical oncology program offers some of the latest surgical techniques with a focus on minimally invasive approaches.   These leading edge techniques include:

Radiofrequency ablation (RFA) for liver tumors, which uses alternating current radiofrequency to heat and destroy liver tumors;

Anal/sphincter preserving surgery for rectal cancer that allow our surgeons to preserve the anus and sphincter muscle and avoid a permanent colostomy bag;

Sentinel lymph node mapping therapy used in conjunction with breast conservation surgery as a minimally invasive approach;

Mammosite catheter insertion for breast cancers; and

Videoscopic (laparoscopic) surgery, including minimally invasive staging, diagnosis and treatment. Colectomy for colon cancer is routinely performed.

 

Radiation Oncology

Hahnemann’s Department of Radiation Oncology works in close collaboration with other members of the cancer team to offer a high level of expertise in the management of both benign (non-cancerous) and malignant (cancerous) lesions with radiation treatment.  A comprehensive range of radiation therapy modalities is offered, including:

Stereotactic Radiosurgery is a way of treating brain tumors with precise delivery of a single high dose of radiation in a one-day session. Treatment involves the use of focused radiation beams delivered to a specific area of the brain.  Through the use of three-dimensional computer-aided planning, the treatment may minimize the amount of radiation to healthy brain tissue.

Intensity Modulated Radiation Therapy (IMRT) is an advanced form of radiation therapy.  IMRT allows delivery of a higher, more precise dose of radiation to the tumor and spares surrounding tissues from damage. IMRT differs from standard radiation therapy in that IMRT uses computer-generated images to plan and deliver tightly focused radiation beams to cancerous tumors.  It not only shapes the radiation beam to the exact size of the tumor, it delivers substantially more cancer-killing energy to tumors.  It targets areas where there are more cancer cells and can reduce damage to normal tissues.  Image acquisition software links diagnostic images to the treatment planning process.  Technology called multileaf collimators shape the radiation beam to the tumor.

3-Dimensional Treatment Planning is a technique that preserves areas surrounding the cancerous tumor.

Mammosite is a promising new treatment option for patients with early-stage breast cancer.  Delivered in five days as opposed to whole-breast radiation therapy, which may take six weeks, this partial breast irradiation delivers radiation directly to the breast cancer site, sparing health breast tissue. This therapy is generally recommended for patients aged 45 years and older.

High-dose rate brachytherapy uses computer technology to aid in the placement doses of radiation within the tumor through a temporary tube or implant device, allowing radiation to be delivered directly to the tumor site.  The see automatically retreats through the tube or implant device back into the machine.

Other modalities include standard external beam radiation and total body irradiation.

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Hahnemann’s Cancer Programs by Site

Brain and spine cancers

Professionals at the Brain and Spinal Tumor program at Hahnemann treat primary brain tumors – tumors that have arisen from brain tissue itself – as well as metastatic disease and complications from medical or radiation cancer treatment that affects the brain.

The multidisciplinary team includes:
- neuro-oncology
- radiation oncology
- medical oncology
- neurosurgery
- neurology
- pathology
- imaging
- nursing
- social work
- patient care coordinator

The patient care coordinator follows the patient through the treatment process and serves as the liaison between the clinical team, the patient, family, and caregivers.  Other services such as nutrition advice, neuropsychology, physical/occupational and speech therapy services are available.

Technology and treatment advances may help many brain tumor patients live longer, often with improved quality of life.  The program is designed to facilitate coordination of services and promote continuity of care.

Screening and diagnostic services include:
- risk factor analysis
- neurophysiological examination
- CT, PET, MRI and SPECT studies
- Computerized EEG analysis
- Stereotactic biopsies
- Neuropathology

Treatment options for brain and spinal cancers include surgery, radiation therapy, and chemotherapy.

Surgery

Image-Guided Stereotactic Surgery is a new technology which utilizes navigation software to aid the neurosurgeon in guiding the instruments to the precise location of the tumor. It allows surgeons to plan operations in advance, and provides orientation and guidance during the surgical procedure.
Neuroendoscopy procedures are performed by working through a small opening in the skull using a small telescope and high-resolution video camera to see into the skull, brain, and spine. Advantages of this minimally invasive procedure include a small incision site, an enhanced ability to perform microsurgical procedures, and potentially less trauma to healthy tissue.

Radiation Therapy

MRI/CT Image Fusion utilizes software to align MRI and CT scans and superimpose the images to plan radiation treatment.
Brachytherapy involves implanting catheters to deliver precise doses of radiation within the tumor. The catheters and seeds are removed when the therapy is complete.
Stereotactic Radiation Therapy is a way of treating brain tumors with precise delivery of a single high dose of radiation in a one-day session. Treatment involves the use of focused radiation beams delivered to a specific area of the brain.  Through the use of three-dimensional computer-aided planning, the treatment can minimize the amount of radiation to healthy brain tissue.

Chemotherapy

In recent years, researchers have refined and expanded the use of chemotherapy for use after surgery and radiotherapy for the treatment of brain tumors.

Among the drugs most commonly used in the treatment of central nervous system tumors are the nitrosoureas, fat-soluble agents such as carmustine, and lomustine (CCNU). Newer agents now available, such as temozolomide, may be easier to take and have fewer side effects.

Investigational Approaches

Investigational therapies are sometimes offered to eligible patients through clinical trials.  The program participates in national cooperative group chemotherapy studies and ongoing basic research into newer and better methods to treat brain and spinal tumors.
Immunotherapy.

Hahnemann is evaluating monoclonal antibodies designed to elicit an immune response to brain cancers.

Breast cancer

Breast cancer patients can benefit from Hahnemann’s multidisciplinary approach, which includes specialists from surgery, radiation and medical oncology, diagnostic radiology, pathology, psychology, and social services. Services provided include breast cancer screening, risk factor counseling, diagnostic testing, a wide range of treatment options, access to clinical trials, breast reconstruction, and psychological support following treatment.

Surgery

For women with early stage breast cancer, breast conservation surgery, or surgery to remove the cancer and a small amount of tissue surrounding the cancer without removing the remainder of the breast, is offered.  This procedure is also known as a lumpectomy.  Breast reconstruction (surgery to rebuild a breast's shape) is often an option after mastectomy. Reconstruction may be done at the same time as the mastectomy or several months or even years later.  Reconstruction may be performed using breast implants or reconstruction with tissue flaps where a flap of skin, muscle, and fat can be moved from another part of the body to the chest area where it is formed to create a breast shape.

Sentinel Node Biopsy

Breast cancer staging and treatment planning is determined in part on whether breast cancer cells have spread to the lymph nodes.  Using sentinel lymph node biopsy, a surgeon injects a blue dye, a radioactive substance (tracer), or both into the area around the tumor. The dye or tracer follows the path that tumor cells would most likely take from the tumor area to the lymph nodes. The surgeon then removes just the one lymph node (or sometimes a few) that first takes up the dye or tracer. This lymph node, the one that cancer cells are most likely to travel to, is called the "sentinel" node. Nodes near the sentinel node may also be removed. If a pathologist finds cancer cells in these lymph nodes, then a surgeon usually does a standard lymph node removal to check for additional areas of cancer. But if no cancer cells are found in the sentinel node, no more nodes are removed. Sentinel node biopsies, because fewer nodes are typically removed, may involve fewer side effects such as numbness, sensitivity, and swelling in the area where the lymph nodes were removed.

Drug therapy including chemotherapy and hormone therapy.  Many breast tumors have receptors for estrogen and progesterone, which stimulate them to grow.  Breast cancer patients whose tumors are estrogen sensitive are likely to be offered hormone therapy. Hormone therapies are designed to prevent estrogen and progesterone from stimulating growth of the breast cancer.

Radiation therapy

In addition to the standard external beam modality, Mammosite is a promising new treatment option for patients with early-stage breast cancer.  Delivered in five days as opposed to whole-breast radiation therapy, which may take six weeks, this partial breast irradiation delivers radiation directly to the breast cancer site, sparing health breast tissue. This therapy is generally recommended for patients aged 45 years and older.

Investigational Approaches

Investigational modalities are sometimes offered to eligible patients through clinical trials.  Some new approaches being employed at Hahnemann include ductal lavage, a technique where a catheter is inserted to irrigate breast cells to determine if the cells are capable of becoming cancerous, and Trans-scans, where electricity is used to determine if breast cancer exists.

 

Colorectal and other gastrointestinal cancers

Hahnemann’s focus is the prevention and early detection of cancers, including colon, esophageal, rectal and liver cancers.  Many digestive tract cancers are preventable by detecting and treating disorders that are precursors to it including colon polyps, colitis, chronic hepatitis, Barrett’s esophagitis and hemochromatosis.  Patients with these diseases, or at risk for them may benefit from our program of education, screening, diagnosis and access to new, innovative therapies.
 
Our experienced specialists join forces to offer comprehensive preventive care and treatment for digestive health problems.  Many are involved in specialized clinical research.

Our abdominal oncology surgeons are fellowship-trained from the nation’s leading institutions and bring knowledge of advanced science and technology to our hospital.  Our use of endoscopic ultrasound identifies tumors of the pancreas and stomach wall, and stages tumors of the esophagus, stomach and rectum.

Minimally invasive approaches allow laparoscopic evaluation with ultrasound for the most complex cases, and allow our physicians to help their patients choose the best treatment alternatives. 

Our surgeons are experienced in the most complex major resections for cancer using the new technologies such as radio-frequency ablation and trans-catheter embolization.

Specialized team for Inflammatory Bowel Disease (IBD):

Patients with serious, often debilitating conditions like Crohn’s disease and ulcerative colitis have access to an internationally recognized team of physicians and other healthcare professionals for the prevention, diagnosis, and management of these diseases.

In addition to gastroenterologists and colorectal surgeons who provide ongoing medical and surgical care, support teams include: dietary personnel to assist patients with their special nutritional needs, social service professionals, stomal therapy, psychiatry, and consultations with other appropriate subspecialty physicians.

Our surgeons provide an expertise for patients with complicated IBD problems, including minimally invasive laparoscopic surgery for Crohn’s disease and ulcerative colitis.

Through the endowed Drexel University College of Medicine’s Kranser Center for Inflammatory Bowel Disease, exciting new therapies are in clinical trials.

New approaches to colorectal surgery

Many colorectal cancer patients are now eligible to have laparoscopic surgery, which involves removing the tumor through a far smaller incision. With this new technique, patients experience less post-operative pain, have shorter hospital stays and recover more quickly. Patients undergoing this procedure usually stay in the hospital for just two nights. 

Another exciting surgical innovation is same-day surgery for some early stage rectal cancer patients where a transanal excision is performed, instead of an incision on the outside of the body.

Renowned for the treatment of Gastroesophageal Reflux Disease (GERD)

Individuals suffering from gastroesophageal reflux disease (GERD), disorders caused by the reflux of gastric contents into the esophagus and upper airway, may benefit from our multidisciplinary approach.

One important area of expertise is Barrett’s esophagitis, a disease which develops from gastroesophageal reflux and can lead to adenocarcinoma of the esophagus, a serious form of cancer. The good news is that the majority of these cancers are preventable through the use of appropriate surveillance techniques.

Our physicians also offer patients the most advanced monitoring system for evaluating GERD. The catheter-free Bravo pH Monitoring System is a new alternative to traditional pH monitoring, one that is more comfortable and convenient for patients, while providing a more accurate pH recording for physicians.

We offer a continuum of medical and surgical treatment for reflux disease, including identifying those who may be at risk.  The latest diagnostic and therapeutic endoscopic expertise is available. A strong emphasis is placed on the importance of diet. And the highest level of surgical talent and experience is available for those patients who may need surgery.

Endocrine cancer

Hahnemann’s specialists, including surgeons, medical oncologists, radiation therapists, nuclear medicine specialists and endocrinologists, provide treatment and diagnosis of various endocrinologic malignancies including thyroid tumors, adrenal, and gonadal tumors, neuroendocrine tumors including carcinoid and islet cell tumors, and patients with multiple endocrine neoplasia syndromes.

Treatment modalities include surgery, radioisotope therapy, cryosurgery, radiation therapy, chemotherapy and investigational therapy.

Gynecologic cancers

The Center for Gynecologic Oncology at Hahnemann offers, in an academic environment, a comprehensive consultation, diagnosis and treatment service for pre-malignant and malignant disease of the female reproductive system.

This multi-specialty program includes subspecialty expertise in even the most complicated surgical procedures, chemotherapy, radiation therapy, pathology, cytopathology, diagnostic radiology and genetic counseling.  It also offers the support of expert ancillary services such as anesthesiology, intensive care medicine, infections, coagulation disorders, pulmonary medicine, pain management, enterostomal therapy, and social services, among others.  This approach allows for the comprehensive evaluation and treatment of gynecologic malignancy.

Hahnemann’s physicians’ philosophy of cancer management emphasizes conservatism and quality of life in the pursuit of the highest cure rates.  They value working with community physicians and place a high priority of maintaining communication with the patient’s primary care physician.

 

Scott D. Richard, M.D. is the clinical service chief of Gynecologic Oncology at Hahnemann University Hospital.

Dr. Richard specializes in the medical and surgical management of cancers of the female reproductive system, including ovary, uterine, cervical, and vulva. He is a highly-skilled minimally invasive surgeon and has performed more than 350 robotic surgeries. His research interests include the development of novel treatment approaches for gynecologic cancers.

To schedule an appointment with Dr. Scott Richard, please call 215-762-2640

Surgical procedures offered by the Center for Gynecologic Oncology at Hahnemann:

Laparoscopic (minimally invasive) Surgery: Use of the laparoscope for diagnosis, staging and treatment of gynecological cancers when feasible.  This technology shortens the patient’s hospital stay and allows for faster recovery.

Surgical Staging for Endometrial, Cervical and Ovarian Cancer:  Hysterectomy, ovariectomy and removal of the lymph node tissue in the pelvic and para-aortic regions for endometrial and ovarian cancer, pre-radiation for retroperitoneal aortic and pelvic node removal for staging and debulking in cervical cancer.

Radical Hysterectomy:  Abdominal hysterectomy combines the removal of the tissues surrounding the cervix along with the uterus.  This surgery is used to treat selected cases of cervical and uterine cancer.  The radicalness is adjusted to the extent of the cancer being treated; e.g. a Class II radical hysterectomy is often more appropriate therapy than the traditional Class II (Meigs’) procedure.

Advanced Ovarian Cancer Tumor Reductive Surgery:  Removal of the uterus, cervix, fallopian tubes and ovaries are standard procedures.  In addition, tumor-reductive surgery to optimize chemotherapy may necessitate removal of the peritoneum, omentum, bowel segments, and retroperitoneal nodal disease.  The use of the stapling techniques for low-rectal anastomosis typically avoids the need for colostomy.  Neoadjuvant chemotherapy, the CUSA and the  Argon beam coagulator are adjuvants to surgery for patients with advanced ovarian carcinoma.

Second-look Surgery:  The examination of the abdomen and the pelvis, with multiple biopsies and removal of aortic and pelvic lymph nodes.  Second-look surgery is typically performed for ovarian cancer at the end of chemotherapy, to assess the status of the cancer and the response to treatment.  This information is used to determine whether to stop, continue or change therapy.  The procedure can be done laparoscopically or by laparotomy.

Vulvar Cancer Surgery:  Removal of the vulvar skin and tissues surrounding and deep to the cancer.  The emphasis is on conservation, such as partial vulvectomy rather than total vulvectomy.  The removal of more than half the vulva is seldom necessary and conservative surgery usually spares the clitoris.  The regional (inguinal) lymph node dissection, when necessary, can often be limited to one side.  Even this can sometimes be avoided by use of lymphatic mapping (lymphocintigraphy). For more advanced cancers, chemoradiation is employed to reduce the extent of the surgical resection.

LEEP Cone Biopsy:  A procedure performed under local anesthesia for diagnosis and treatment of cervical dysplasia.

Hematologic cancers (leukemia, lymphoma, myeloma)

Specialists in hematology/oncology provide evaluation, diagnosis and treatment for a variety of neoplastic diseases including leukemia, lymphoma and myeloma as well as for solid tumors.

Hahnemann performed one of the region's first Bone Marrow Transplant in 1976 and the program continues to employ this treatment modality for many hematologic diseases.  Types of bone marrow transplants performed include allogeneic (sibling), autologous (same), peripheral blood stem cell and unrelated donor transplants.  A mini-transplant program with abbreviated conditioning regiments for older patients with hematologic malignancies is offered.

The bone marrow transplant team includes attending physicians, oncology fellows, medical residents, nursing, pharmacists, transplant coordinators and other support caregivers.  The program is part of the National Marrow Donor Program, as both a transplant and a harvesting procurement site.  Through this program, marrow transplants are possible from volunteer unrelated donors for patients.

Liver, pancreas and other hepatobiliary cancers

The Liver Center team at Hahnemann includes physicians specializing in adult and pediatric liver medicine, surgery, transplant, and oncology as well as nurses, case coordinators, social services and support staff.  The team is dedicated to caring for the complex needs of patients with liver disease.

Care is provided for patients with liver diseases including liver cancer, tumors and masses; hereditary hemochromatosis, hepatitis, Wilson’s disease; non-alcoholic steatohepatitis; alpha-1-antitrypsin deficiency; Budd-Chiari syndrome; and primary scherosing cholangitis.

Surgeons at the Liver Center are experienced in advanced and complex surgeries:

Liver resection.  Surgeons are now performing a new technique prior to a liver resection to stimulate liver regeneration if the portion of the liver remaining after resection would be too small.  This technique is called pre-operative portal vein embolization.

Cryoablation involves freezing the tumor

Radiofrequency ablation involves use of radio waves to heat the tumor until it is destroyed. RF ablation is used primarily for smaller tumors.

Minimally invasive surgery
Treatment plans are developed based on whether the tumors are malignant (cancerous) or benign (non-cancerous) as well as primary versus secondary liver cancers.

Most of the time liver cancer does not start in the liver but has spread from a cancer in another site in the body such as the pancreas, colon, stomach, breast, or lung, and metastasize to the liver. These tumors are known as secondary tumors.

Pancreatic cancer ranks 4th in terms of cancer mortality.  Hahnemann’s surgical oncologists peform a variety of complex surgical procedures to treat pancreatic cancer.  Hahnemann surgeons have even performed laparoscopic pancreatic resections in some cases.

Surgical procedures include:

Whipple procedure (pancreatoduodenectomy): This is the most common procedure used to treat pancreatic cancer, including resectable cancers of the ampulla of Vater, and involves removing the wide end of the pancreas which requires removal of the duodenum, gallbladder and the end of the common bile duct. Part of your stomach may be removed as well.

Total pancreatectomy: The entire pancreas as well as the bile duct, gallbladder and spleen; part of the small intestine and stomach; and most of the lymph nodes in the area are removed.

Distal pancreatectomy: This procedure is primarily used to treat islet cell cancers and only the tail — or the tail and a small portion of the body of the pancreas — is removed. Sometimes the spleen may also be removed.
Surgical bypass: Tumors that block the bile duct, pancreatic duct or duodenum can cause pain, digestive difficulties, nausea, vomiting, jaundice and severe itching. To help ease these symptoms, an operation to reroute the flow of bile by going around (bypassing) the tumor may be performed.

Stent insertion: As an alternative to bypass, a stainless steel or plastic tube (stent) may be placed in the bile duct to keep it open.

Lung cancer

Malignancies of the lung, esophagus, trachea, chest wall, periocardium and pulmonary system are managed by Hahnemnann’s team of oncology professionals.

 

Prostate cancer

Hahnemann’s team of cancer specialists provide all forms of treatment for prostate cancer including 3-D conformal radiation therapy, intensity modulated radiation therapy (IMRT), permanent seed implantation and high dose rate (HDR) brachytherapy, surgery and medical therapies as needed.

To learn more about our Minimaly Invasive Robotic Urology Surgery, click here.

To learn about Cancer Support Services at Hahnemann University Hospital, click here. 

 
 
 
 
 

Hahnemann University Hospital | 230 N Broad St, Philadelphia, PA 19102