Medical Oncology at UNC Rockingham Health Care includes medical diagnosis and treatment services such as cancer diagnosis and staging, chemotherapy, blood product replacement, hydration therapy, apheresis, pain management, anti-emetic therapy and use of biological response modifiers.
Radiation Oncology is a subspecialty which uses radiation to shrink or eliminate malignant tumors.
Miraluma – High Tech Breast Diagnosis
Sometimes mammograms are difficult for the physician to interpret because of specific characteristics of breast tissue. Some breast tissue is dense, making it harder for radiologists to interpret a mammogram. Breast surgery may leave scars that look similar to cancerous lesions on a mammogram or radiation therapy can thicken or change breast tissue, making mammograms more difficult to interpret. Although noncancerous themselves, calcium deposits may appear in normal breast tissue, but also may be associated with cancer. It is sometimes difficult for the radiologist to tell the difference between cancerous and benign patterns of calcifications.
Breast implants can physically mask the presence of a cancer and can reduce the ability of a mammogram to detect it. Because of these characteristics, the primary physician may need to take a further step to make a determination about a breast lesion. To assist the physician, UNC Rockingham Health Care has installed a nuclear medicine test called MIRALUMA Imaging. These tests use radiation, but the exposure is very low, leaving the woman’s body in a matter of hours.
MIRALUMA Imaging is not an uncomfortable or painful procedure. It requires no compression of the breast the way a mammogram does. A small amount of radioactive material is injected into the bloodstream and travels through the body. When it reaches the breast tissue it usually concentrates in cancerous cells if those cells are present. It then emits invisible GAMMA rays and a GAMMA camera is used to examine breast tissue where MIRALUMA concentrates.
By interpreting images taken by the camera, doctors have more information to help evaluate breast tissue abnormalities in women, regardless of the breast density. This is especially advantageous because it may resolve uncertainty for the woman and her doctor in helping to decide what to do next.
Diagnostic Imaging Department
The Diagnostic Imaging Department of UNC Rockingham Health Care is actively involved with the hospital Quality Improvement Program assuring that all procedures meet appropriate quality standards.
Diagnostic Imaging is represented at the hospital’s regularly scheduled Tumor Board monthly meeting. The radiologists regularly attend local and national professional meetings and in turn share knowledge with the medical and radiological staff. The radiological medical staff consists of three full-time board certified radiologists with about 28 support personnel and technologists.
The Department is fully equipped and cooperates completely with the hospital’s cancer program. A wide range of modalities is present for routine diagnostic imaging and for special procedures used in cancer patients.
The following equipment and procedures are available at UNC Rockingham Health Care:
Conventional x-ray equipment combined with fluoroscopy is used with studies on the entire body or portions of the body, including spine, skull, chest, and extremities. Standard barium and iodine contrast studies are utilized daily.Special procedures are done including arteriography, venography, myelography, arthrography and others. Angioplasty of peripheral vessels and dialysis shunts are available.
Interventional procedures that are performed include guided needle biopsies, drainage of cysts and abscesses, and nephrostomy drainage.
A full range of CT scanning is available and the department does these studies on a daily and emergency basis.
CT is used for studies involving the head, chest, abdomen and pelvis for determination of metastatic disease. The CT guided needle aspiration or biopsies contribute to the diagnosis of cancerous cells of a suspected mass or lesion. CT planning scan images are provided for radiation therapy purposes by scanning the outlines and affected area. Our new spiral CT Scanner decreases scan time and increases the quality of the images.
Magnetic Resonance Imaging
MRI (Magnetic Resonance Imaging) is available using a 1.0 Tesla Mobile Unit. MRI is an excellent technology used today in helping to detect and define metastatic disease within various parts of the body with much emphasis placed on the brain for various tumors, stroke, and degenerative diseases. It is also used to image the spine and spinal cord for bone disease, disc abnormalities, and to evaluate for metastatic disease or tumors.
Nuclear Medicine is a diagnostic tool that uses radioactive materials to study specific organs in the body. UNC Rockingham Health Care is equipped with a Sopha SPECT (Single Photon Emission Computerized Tomography) gamma camera which enhances the quality of diagnostic services available. Many routine diagnostic studies, including studies of the liver, thyroid, and gastrointestinal system, are performed in Nuclear Medicine. These studies help to diagnose disease and enhance the quality of patient care at our hospital.
Myocardial perfusion studies are performed routinely with approximately 25-30 studies being performed monthly. These studies are useful in diagnosis of early stages of heart disease and evaluation of patients with known disease.
Bone scans are very important in diagnosis and treatment of bone lesions (primary or metastatic) in certain types of cancer. The Nuclear Medicine Department also performs therapeutic iodine treatment for hyperthyroidism and Graves’ Disease. Strontium 89 is a relatively new drug used to relieve pain caused by metastatic bone disease. The drug is injected into a vein and is taken up in the bone.
UNC Rockingham Health Care has been performing mammographies since modern mammographic techniques were introduced to the medical world. Conventional low-dose screen film mammography combined with special capabilities such as magnification, coning and needle localization, is currently being used. The mammography program emphasizes both low cost and low radiation exposure with breast ultrasound and needle biopsy localization procedures available. In 1998, 5,489 mammographic procedures were performed at UNC Rockingham Health Care. Our program is certified by the American College of Radiology and the Federal Drug Administration.
The Occupational Health Services Department can be contacted for on-site mobile mammography for industries.
Bone densitometry is the tool for diagnosing and managing low bone density (0steoporosis). It can also measure common fracture sites, detect clinical changes, and monitor therapeutic responses. The test is fast, painless, and patients can be scanned fully clothed. The radiation dose to the patient is extremely low. The Lunar DPX unit was installed in 1998 and it has been a valuable diagnostic tool for both patients and physicians.
Endoscopy is the examination of the esophagus, stomach, small intestine, or colon with a flexible tuve attached to a powerful light source. There were 1464 endoscopic examinations completed within the department during the last fiscal year.
The Ultrasound Department offers a variety of examinations including obstetrical, gynecological, abdominal, thyroid, breast, and testicular exams. The well-equipped department consists of two machines, Acuson and ATL. Both have the capability of color Doppler analysis.
The diagnostic tools used in the laboratory help to identify, analyze, and evaluate cancer cases. The phlebotomy team maintains a close relationship with the oncology patients. Each patient has special needs and concerns and the phlebotomy team meets these challenges with skillful blood draws each day.
The hematology department focuses on specimen integrity and accuracy. Quality assurance programs ensure that the results given to the oncologist are accurate and precise. The automated Coulter instrument uses electrical impedance and flow cell techniques to count and identify thousands of red and white blood cells in a matter of minutes. The technologist scans smears for abnormal cells in blood and body fluids, then notifies the pathologist or oncologist of any unusual findings. The chemistry department tests for cancer antigens, offering screening tests such as the prostatic specific antigen (PSA), and breast cancer antigen (Ca 27- 29). In addition to complex testing, the department offers basic work-ups needed for routine chemistries.
The blood bank department provides component therapy needed by oncology patients. These components include red cells, platelets, and fresh frozen plasma. physician, and the American Red Cross to assure these products are provided and maintained for safe use.
A full-time pathologists working with two technologists prepare, process, and diagnose tissue specimens received from patients. Using the hospital’s advanced new histology facilities, he is able to provide a wide variety of pathology services, ranging from intraoperative frozen section diagnosis, to fine needle aspiration biopsy, to special tissue stains. Immunohistochemistry techniques are ordered as needed, and are interpreted on-site. The pathology department at UNC Rockingham Health Care thus provides the diagnostic services crucial for the proper treatment of cancer.