The Region’s #1 Cancer Center Arrives in Chester County

 Penn Medicine is bringing the expertise of one of the nation’s leading cancer centers to Chester County. The new Abramson Cancer Center at Penn Medicine Valley Forge features two floors and 18 exam rooms, designed to offer patients the best experience possible. Penn’s Abramson Cancer Center at Valley Forge offers patients:

World-class cancer experts right in your community

• Chemotherapy and innovative medical oncology treatments in a newly designed infusion suite 
• State-of-the-art radiation therapy and laboratory service
• Access to the latest clinical trials and research, as well as cutting edge treatments like proton therapy — the most advanced and precise form of radiation therapy in the world.

800.789.PENN(7366)  |  PennMedicine.org/Abramson

Penn Ob/Gyn Associates

Meeting the needs of women through every stage of life

For women, finding an obstetric and gynecologic practice that can meet their needs from adolescence throughout menopause and beyond can be challenging. That’s because with every year, a woman’s reproductive needs change. And with every change—be it a pregnancy, a difficult health diagnosis or menopause—her physical and emotional needs change as well.

Fortunately, at PennOb/Gyn Associates, there are physicians and specialists available to meet the needs of every woman throughout every stage of her life. 

“As a group, we can offer a wide range of services for women from adolescent reproductive health care to managing diabetes in pregnancy to robotic surgery for gynecologic problems,” says Rochelle Lindenbaum, MD, assistant professor of clinical obstetrics and gynecology and physician at Penn
Ob/Gyn Associates.

As part of Penn Medicine, physicians and clinicians in the group have access to resources only available in an academic environment.

“We work side by side with multiple subspecialties including maternal fetal medicine specialists who offer high-risk maternity care, infertility experts, nationally recognized cancer care specialists and cardiologists who specialize in cardiac disease in women,” says Abike James, MD, assistant professor of clinical obstetrics and gynecology at Penn. “We also have access to clinical trials only available at Penn Medicine.”

Birth and Beyond

Obstetricians at Penn Ob/Gyn Associates delivered more than 1100 babies last year, 

but Dr. Lindenbaum says women should make it a habit to see their ob/gyn every year 

— not just while pregnant.

“Many women only visit their ob/gyn practice for their health care needs rather than seeing a general practitioner,” says Dr. Lindenbaum. “That’s why it’s important to choose a practice that has the knowledge base for overall health, as well as access to specialty resources should the need ever arise.”

Dr. Lindenbaum says it’s important for women to get back to basics when it comes to health care. An annual visit with a gynecologist should include recommended screenings, health education, an exam and consultation about pre-conception counseling, menopause or any other health concern that needs attention.

Same-day Appointments

Penn Ob/Gyn Associates also offers same-day appointments for women with emergent concerns.

“Women who believe they have an urgent health concern may call us for a

 same-day appointment,” says Dr. James. “We can triage patients over the phone, 

and then schedule an in-office appointment if it is appropriate.”

“While we are a large practice, we still provide individualized care,” says Dr. James. 

“We know our patients well, and are committed to meeting their reproductive health care needs.”

Penn Ob/Gyn Associates introduces the Medical Acupuncture Program

Iliana Robinson, MD

Penn Ob/Gyn is happy to introduce the Medical Acupuncture Program led by Iliana Robinson, MD, an obstetrician/gynecologist at Penn who also practices medical acupuncture.

“Acupuncture can be used as a complement to traditional medical treatment, enabling a patient to use less or no pain medication or hormone replacement therapies, and avoid harmful side effects.  As a physician, I can view the entire framework of a patient’s medical condition, and prescribe the most beneficial mix of conventional treatment and acupuncture,” says  Dr. Robinson. Many physician acupuncturists come from the field of pain management or orthopaedic medicine, so Dr. Robinson is one of a few gynecologists who specialize in the use of acupuncture for women’s health issues.

Acupuncture is used to treat a variety of women’s health conditions and is frequently
used to lessen pain in patients with chronic pelvic pain, post-surgical pain, neuromuscular
pain, or migraine headaches.   Acupuncture can be used to reduce symptoms of premenstrual
syndrome and menopause, including hormonal imbalance, mood swings, insomnia,
and hot flashes.Patients experiencing reproductive or infertility issues may benefit
from acupuncture. It is also used to treat emotional issues like anxiety and depression and may be used to prevent or lessen allergies and enhance immunity when used as a preventive measure.

“As a physician, I can view the entire framework of a patient’s medical condition,
and prescribe the most beneficial mix of conventional treatment and acupuncture.”

New options for joint replacement

It’s a fact that men and women experience different physical changes and develop unique
health issues as they age. Osteoarthritis is one condition that affects women more than men
and leads women to seek joint replacement surgery. Penn Orthopaedics offers joint replacement
services for those suffering from advanced joint disease and tailors treatment options to meet
a woman’s specific needs, so they can live life to the fullest — pain-free.

The newest advances in hip replacements include the types of surfaces being used.
The ball and cup implants used to replace a hip may be ceramic-on-ceramic, metal-on-metal
or metal-on-plastic.  “Hip replacements are not one-size-fits-all,” says Craig Israelite, MD,
co-director of the knee center and orthopaedic surgeon at Penn Presbyterian Medical Center. “All
patients are evaluated to determine the best material for their lifestyle and activity level.”

“Younger people aren’t ready to slow down and they are not going to let pain dictate their
activities.” Historically, we wouldn’t even consider joint replacement for a patient under
the age of 60. But now, with new materials that are durable and longer lasting, we can help
younger patients get back to their lives.”

 Building a Better Knee

Penn orthopaedic surgeons aim to mimic the normal kinematics of the knee. A new prosthetic
replaces both of the patient’s own cruciate ligaments, which makes a significant difference
in how the knee feels. The result is a knee that feels natural to the patients and is more stable.

Patients with arthritis in the knee may be candidates for partial, or unicompartmental,
knee replacement. If an injury results in pain or arthritis on one side of the knee joint,
Penn surgeons can use a mini-incision to replace the affected part of the knee joint, with
minimal damage to the surrounding muscles and tendons. The advantage to this
procedure is patients recover much more quickly from a partial knee replacement
than a traditional knee replacement. Patients can often walk unassisted
(without a cane or crutches)  within a week after the surgery.

“At Penn, we offer advanced, individualized care and see patients with
complex and complicated  problems,” said Gwo-Chin Lee, MD, orthopaedic surgeon.

Penn Maternal Fetal Medicine Welcomes

Jamie Bastek, MD
Hospital of the University of Pennsylvania

Corrina Oxford, MD
Pennsylvania Hospital

Managing High-Risk Pregnancy in Women with Cardiac Disease

When most women think about heart disease during pregnancy, they may think about high blood pressure, or other conditions that develop during pregnancy. But for women with congenital heart disease,
(cardiac disease that is present from birth throughout their lives), pregnancy itself can present potential serious side effects and
cardiac complications.

Adult congenital heart disease (ACHD) describes a number of different problems affecting the heart. It is the most common type of birth defect, and while some problems can be
corrected, they may still require medical supervision throughout a person’s life
especially during pregnancy.

“It’s estimated there are more than one million adults with congenital heart
disease in the United States,” says Yuli Kim, director of the Philadelphia
Adult Congenital Heart  Center. “More and more children with congenital
heart disease are reaching reproductive age, and need high-risk obstetrical
care in collaboration with specialized cardiac care.”

Women with congenital heart disease are seen at the Pennsylvania Cardiology Associates or at
The Philadelphia Adult Congenital Heart Center, a joint effort between Penn Medicine and the
Children’s Hospital of Philadelphia (CHOP). Together, they serve the unique health care needs
of these patients. The center is comprised of specialists in cardiology, cardiovascular surgery,
non-invasive imaging, genetics and reproductive services that care for patients with congenital
heart disease.  The center also offers high-risk obstetrical care through Penn’s Maternal Fetal

Medicine specialists. High-Risk Care

“Pre-conception care is recommended for any woman who plans to get
pregnant,” says Sindhu Srinivas, MD, MSCE, director of obstetrical services
at the Hospital of the University of Pennsylvania. Getting to a healthy weight prior to
conception and eliminating dangerous exposures such as smoking are emphasized
to all women.  “But a woman with cardiac disease needs counseling beyond
what a woman without cardiac disease may need.”

At Penn, women with a history of congenital heart disease receive pre-conception
counseling from a multi-disciplinary team of cardiologists and maternal fetal medicine
specialists and geneticists.A maternal fetal medicine specialist is an obstetrician who
has received additional training in the evaluation and care of high-risk pregnancies.

A geneticist can help you determine if you are at an increased risk for having
a child with a congenital heart defect. The specialist may recommend a fetal
echocardiogram during pregnancy to evaluate the fetal heart. In some cases a
specific genetic test may be recommended to determine whether the mother and/or
fetus has a genetic cause of congenital heart disease.

“It’s important we work together to create a plan and make recommendations
to women with cardiac disease,” says Dr. Kim. “Together, we can talk about
possible risks, and how to manage cardiac disease during pregnancy.”

Ensuring a Healthy Pregnancy and Delivery

“In some forms of structural heart disease, there is a risk of peripartum
heart failure or other complications that may be caused due to the physiologic
changes of pregnancy,” says Robert Debbs, MD, Director of the Maternal Fetal 
Medicine Network in New Jersey.

With careful planning and prenatal care, the risks of adverse
outcomes appear to be very small. In fact, most women with a repaired congenital
heart defect can enjoy full-term deliveries and rarely need a cesarean section
due to their heart disease.

“Because there are so many variables involved with both
a woman’s cardiac condition, pregnancy and delivery,” adds
Dr. Srinivas, “it’s important for women to get their pre-conception
and prenatal care from a multi-disciplinary team of experts experienced in
managing high-risk pregnancies and cardiac conditions.”

The Basser Research Center at Penn

Like too many women, Sandy Cohen grew up with breast cancer in her family.

Sandy Cohen and her children

 “My grandmother died of breast cancer in her thirties. Consequently, my mother was always worried she’d  develop the disease herself,” says the Lafayette Hill resident. When Sandy’s mother did
develop breast cancer at 50 and passed away four years later, Sandy became what she calls “obsessed” with breast cancer too.

She also became determined not to let fear of breast cancer rule her own life, and  the lives of her two young children and family. “I had genetic testing because I didn’t  want to imagine my children going through life without a mother,” recalls Sandy. Sandy tested positive for BRCA1, the genetic mutation that raises a woman’s risk for breast cancer  up to 80 percent and for ovarian cancer up to 45 percent. “I was shocked,” says Cohen. “I knew breast cancer affected my family, but I was still hopeful I wouldn’t have the gene mutation.”

BRCA Research at Penn

“BRCA1 and 2 plays a protective role against the development of cancer by repairing
certain types of DNA errors that may occur each time a cell makes a copy of itself,” says
Rebecca Mueller, MS, outreach genetic counselor at the Penn Basser Research Center for BRCA.
“Mutations in BRCA1 and BRCA2 increase risk for several forms of cancer - most notably breast
and ovarian cancer.”

The Basser Research Center at Penn supports research on the BRCA1 and BRCA2 genes.
The Center is named in honor of Mindy Gray’s sister, Faith Basser, who died of ovarian
cancer at age 44.

Emphasizing outreach, prevention, early detection, treatment and survivorship,
the Basser Research Center contributes to all stages of research and clinical care related
 to BRCA-related cancers.

“Our mission is to use resources to advance the research and the clinical care for BRCA1
and 2,” says Susan Domchek, MD, Director of the Basser Research Center for BRCA. “We want
to create better choices for individuals with these gene mutations and to eliminate the
development of cancer in these individuals altogether.”

Empowered Decisions

“I felt like a walking time bomb,” remembers Cohen. “Yet, knowing my own risk for cancer
 became very empowering for me. I learned about actions I could take to lower my risk.”

Sandy underwent a double mastectomy, complete removal and reconstruction of her breasts,
which lowered her risk of breast cancer by 90 percent. She also underwent an oophorectomy,
removal of her ovaries, which lowered her risk of ovarian cancer by more than 70 percent.

“My hope is that through research at the Basser Center, we can give people with BRCA mutations
options other than surgery for prevention of cancer,” says Dr. Domchek.

Options like better screening tests for ovarian cancer, and vaccines and medications to
prevent cancer can become a reality through BRCA research at the Basser Center.

Helping Others with Breast Cancer Risk

Today, Cohen helps other individuals and families with BRCA mutations find support
and learn about their own options to reduce cancer risk through the Philadelphia chapter
of FORCE, which stands for “Facing Our Risk of Cancer Empowered.”

“I feel lucky that I could make informed decisions that could lower my risk for breast
and ovarian cancer,” says Cohen. “I know that the work being done at the Penn Basser
Research Center for BRCA will make a life-changing impact on those affected by the BRCA
gene mutation for generations to come.”

Penn Medicine participates in the 2012 NOCC WALK

In September, Penn supported the Delaware Valley chapter of the National Ovarian Cancer Coalition (NOCC) at the 14th Annual Run/Walk to Break the Silence on Ovarian Cancer
in Fairmount Park.

“Ovarian cancer is the deadliest form of cancer for women,” says Christina Chu, MD, associate professor of obstetrics and gynecology and gynecologic oncologist at the Jordan Center for Gynecologic Oncology at Penn. 
“Most women have advanced disease at the time of diagnosis because ovarian cancer may have no symptoms in its early stages.”

“Research is necessary to identify new effective methods to screen, diagnose,
and treat ovarian cancer,” she says. “Education is crucial so that women are aware
of the symptoms to look out for so that they can take charge of their health and advocate
 for themselves and their loved ones. “

“We had 34 members on the team and raised  $1,450 for ovarian cancer research
and education,” says team captain Marcella Rominiecki-Santana, RN, a nurse at
the Jordan Center for Gynecologic Oncology at Penn.

Monies raised through the event go to the NOCC to support research, education
and outreach, and treatment for ovarian cancer.

And, says Rominiecki-Santana, it brings awareness to a cause so close to her heart.

“As clinicians who work with women who have ovarian cancer, we see what this
disease can do,” she says. “We care for them in a clinical sense, but also care about
them personally and want to do whatever we can to make a difference in their lives.”

“We care for them in a clinical sense, but also care about them personally
and want to do whatever we can to make a difference in their lives.”