Sarah Henretta/Dr. Cristofanilli - Week 6

This week started off with my research progress presentation in the Cristofanilli Lab meeting. During this presentation I summarized everything I had done thus far and led an open conversation about where and how my work could be applied in the future. We discussed the possibility of continuing this project as a collaboration when I return to Ithaca which I am excited about. 

Since the program is nearing the final weeks, I tried to spend as much time in the clinic as possible. I was back to my regular schedule with Dr. Cristofanilli and spent two full days seeing patients with him. We had a few unique patients this week and I appreciated the conversations I had with Dr. Cristofanilli regarding which type of treatment would be best for the patients. Specifically, I saw one patient who had a glycogen storage disease in addition to breast cancer. While I am unfamiliar with glycogen storage diseases, it was intriguing to consider how to balance the patient’s cancer treatment to manage healthy levels of glucose in the patient. Additionally, I saw another patient who had been dealing with breast cancer for over a decade. They had a particularly tricky tumor because it kept mutating and shifting its presentation. This meant that many different therapies, or lines of treatment, were used to continue effectively treating the tumor. Recently, the patient’s tumor had progressed again, and the medical team was struggling to come up with another treatment option. It was interesting to see how the doctors considered the patients past treatments, current pathology, and tumor mutations to identify the best course of treatment. 

On Wednesday I also attended tumor board, where many of the medical oncologists, surgical oncologists, and radiation oncologists met to discuss their most complex cases. This meeting was one of the highlights of my week because I enjoyed listening to the clinicians present the patient, consider all the facts, and discuss what course they would follow and why. During this meeting, the clinicians were constantly mentioning and discussing current and past clinical trials, emphasizing the importance of staying up to date on literature.

In addition to my usual clinic days with Dr. Cristofanilli, I also worked with Dr. Ng, a radiation oncologist. It was interesting to see the difference between a radiation oncologist and a medical oncologist. While working with Dr. Ng, I was to see the preparation sequence before a radiation treatment which involves the simulation appointment, the doctor contouring the images, and the physicists designing the perfect combination of radiation beams. I was even able to observe a patient receiving an adaptive radiation technique which uses an MRI linear accelerator to image the patient in real time and allows their doctor to re-contour the image and adapt the protocol before each treatment. This new technology is especially useful for radiation in the abdomen, where the organs are likely to move and change size in-between treatments. 


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