OUR STAFF. AN EXCEPTIONAL TEAM, HERE TO HELP

Dr Yeung

Vincent W. Yeung, M.D., serves as director of Flushing Radiation Oncology Services and brings over 30 years of experience and expertise as a board certified radiation oncologist. His experiences in clinical leadership roles have included director and attending physician of several radiation oncology facilities in the New York City area.

Alan Katz, M.D., obtained his B.A. from Yale University and M.D. from New York University. He served as Acting Chair at the Albert Einstein School of Medicine's Department of Radiation Oncology from 1991 to 1992, and as Director of Radiation Oncology at the Winthrop Hospital from 1993 to 2010. As a world-renowned expert in Cyberknife treatment, Dr. Katz has taught physicians to use the CyberKnife System in India, the U.S., Taiwan, Korea, and Thailand. He has treated over 650 prostate patients with CyberKnife and has multiple publications on his results. Click here for Dr. Katz's most recent peer review studies.

Dr. Katz recently presented his five year outcomes for Cyberknife prostate cancer treatment at ASTRO, showing excellent results for prostate cancer of all grades. Learn more about Dr. Alan Katz and his experience with Cyberknife treatment for prostate cancer.

Elisa J. Wu, M.D., is a board certified radiation oncologist specializing in the treatment of adult cancers, including breast cancer, Hodgkin’s and Non-Hodgkin’s lymphomas, and cancers of the prostate, brain, gastrointestinal tract, lung, as well as a variety of other malignancies. Her clinical expertise involves the use of sophisticated technology and advanced treatment planning to deliver precise radiation therapy, optimizing the outcome for each patient while minimizing side effects.

Dr. Wu received her medical degree from the Boston University School of Medicine. She was formerly an attending physician at Memorial Sloan-Kettering Cancer Center, a world-renowned facility where she had also completed her residency and fellowship. She is multilingual, being fluent in English, Mandarin Chinese, and Taiwanese. Dr. Wu brings state-of-the-art cancer care to patients in our community.

Isaiah Friedman, M.D., a board certified radiation oncologist, completed his undergraduate studies at Yeshiva University, graduating summa cum laude with a B.A. in philosophy. He earned his medical degree at the University of Pennsylvania School of Medicine, where he was awarded a full-tuition academic scholarship as a Gamble Scholar. Dr. Friedman completed his residency in Radiation Oncology at the Mount Sinai Medical Center in New York City, where he also served as Chief Resident.

Dr. Friedman's published research has focused on late toxicities of radiation therapy, and he has been invited to present his findings at national medical conferences. He has special expertise in intensity-modulated and image-guided radiation therapy (IMRT/IGRT), stereotactic brain and body radiation therapy (SRS and SBRT), and high dose rate (HDR) brachytherapy. He is an active member of the American Society for Radiation Oncology.

   

RADIOSURGERY SYSTEM COMPARISONS


 CyberKnifeGamma KnifeOther Linac Systems
Radiosurgery Dedicated Yes Yes No
Anatomic Area treatable with radiosurgical precision Whole body Brain/Skull base (minus extreme lateral) Varies
IMRT dosimetry Method Yes No Yes
IGRT Set-up Visualization Yes No Yes
"Conventional" Radiotherapy and/or IMRT No No Yes
Rigid Brain or Body Frame required for radiosurgical accuracy No Yes Yes
Capable of conformally and homogeneously treating a non-spherical target volume > 3.5cm Yes No Yes
Capable of fractionated radiosurgery to better preserve critical adjacent tissue Yes No Yes
Tracks patient-induced motion with radiosurgical precision (<1mm) Yes N/A Varies by method and manufacturer
IGRT Set-up Visualization Yes No Yes
Tracks spine motion with radiosurgical precision (<1mm) Yes N/A No
Tracks organ induced target volume motion with radiosurgical precision (<1mm) Yes N/A No
Tracks respiration induced organ motion with radiosurgical precision (<1.5mm) Yes N/A No

Capable of real-time submillimeter translational and rotational beam adaptation to target volume motion

 

Yes N/A No

RADIATION TREATMENT PROCESS


At FROS Radiation Oncology Cyberknife Center our focus is the patient. From the minute you make contact or visit our facility our focus is on the patient and their family.

CyberKnife Treatment | IGRT/IMRT Treatment | High Dose Rate Brachytherapy Treatment


CyberKnife Treatment Process

 

Consultation: Upon your first visit you will meet with our board certified radiation oncologists. You and your family will have your questions answered in a comforting and caring environment. Our CyberKnife cancer treatment team will explain to you the pros and cons of choosing CyberKnife, and they will explain what will happen during your cancer treatment.

Meet Your Medical Coordinator: After completion of the consultation every patient will have a medical coordinator assigned to them to guide them through each step of the Cyberknife process. We understand how difficult this time is for you and your family, so our trained medical coordinators will help you through the entire process. From technical questions on the Cyberknife technology to insurance authorization, our medical coordinators are here for you.

Treatment set-up: This step helps to determine your course of cancer treatment. You will be fitted for a soft, flexible mesh mask or body mold to help minimize movement during your cancer treatment. This is a painless process. Treatment of certain kinds of tumors outside of the head (Prostate, Liver, and Pancreas) may require the insertion of tiny gold markers called fiducials. These will help identify the location of cancer cells. You will then undergo imaging procedures to determine the exact location, size and shape of your tumor. The process begins with a standard high-resolution computerized tomography (CT) scan. For certain tumors, other imaging techniques, such as molecular resonance imaging (MRI), angiography or positron emission tomography (PET) may also be used. All exams will be scheduled for you through your personal medical coordinator.

Treatment planning: Your cancer treatment team inputs your tumor information into advanced CyberKnife software that calculates the number, direction and intensity of radiation beams that will be used during your cancer treatment. The CyberKnife develops a treatment plan that is specific to your unique tumor. You do not need to be present during this step. Your doctor will communicate with you about your cancer treatment plan.

Treatment delivery: Be sure to wear comfortable clothes and no jewelry the day of your appointment. Feel free to bring your own music with you to enjoy during your cancer treatment. Make sure you bring someone to drive you home, as we may give you a mild sedative to make you more comfortable. During your treatment you will lie comfortably on a treatment table, which automatically positions you. We will help position you on the table and secure your flexible mesh mask/body mold. Because the cancer treatment is painless, you will be awake throughout your entire procedure, which usually lasts anywhere from 30-90 minutes, depending on the complexity of the tumor. After your procedure, you are free to go home. Depending on the course of cancer treatment, you may have to return for more sessions. Most patients have anywhere from one to five sessions with CyberKnife.

Follow-up: After your cancer treatment, your doctor will review follow-up imaging or other tests to assess the tumor's response to the delivered radiation and measure your progress.



IGRT/IMRT Treatment Process

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Consultation: Upon your first visit you will meet with our board certified radiation oncologists. You and your family will have your questions answered in a comforting and caring environment. Our cancer treatment team will explain to you the pros and cons of choosing IMRT/IGRT, and they will explain what will happen during your cancer treatment.

Meet Your Medical Coordinator: After completion of the consultation every patient will have a medical coordinator assigned to them to guide them through each step of the IMRT/IGRT treatment process. We understand how difficult this time is for you and your family, so our trained medical coordinators will help you through the entire process. From questions on the technology to insurance authorization, our medical coordinators are here for you.

Pre-Simulation Procedures: The following steps may be performed before the CT simulation

1. Scans or blood work to see if there is any other metastasis. However it is often not necessary to order further scans.

2. For Prostate Cancer patients: Placement of gold markers to facilitate IGRT/ IMRT – by placing the “fiducial” gold-markers into the prostate using an ultrasound, this helps to locate the precise location of the organ on a daily basis.

Simulation: Prior to the radiation treatment, a Computed Tomography (CT) simulation will be performed. It is part of the “Planning Session”. All the necessary information that the radiation oncologist needs to create an individualized course of radiation is gathered. This helps the oncologists and physicists to design a customized treatment plan that matches your internal and external anatomy.

The Simulation typically lasts for 30-60 minutes. During the painless process, measurements of your body are taken and a scan of the region of treatment is taken. A body mold or mesh mask is customized to each patient before scanning begins for immobilization purposes and small ink marks may be placed on your skin to aid in daily set-up reproducibility.

After the simulation, our therapists will help you arrange your future treatment appointments, taking into consideration the timeframe that you most prefer.

Treatment Planning: The next step is the most important. Once we have your anatomy (images from the CT simulation) on the computer, data will then be reviewed by the Radiation Oncologist with the aid of our New York State Licensed PhD Physicists. Using sophisticated software, the shape and angles of the radiation beams are optimized. In the next few days after your CT simulation, a dosimetric Intensity Modulated Radiation Therapy (IMRT) or Image-Guided Radiation Therapy (IGRT) plan will be created based on a precise radiation treatment model which makes sure most of the radiation goes to those areas that need to receive treatment.

Every plan that is done at FROS is reviewed by at least two of our PhD Physicists, Radiation Oncologist and licensed Radiation Therapist to assure the Quality of the treatment plan. A QA test is done for each plan that assures the amount of dose is being given to the correct area.

Treatment Verification: After radiation oncologist and physics team created a perfect modeled treatment plan for you, the oncologist will meet with you again. He will specify the number of treatments, risks and side effects and what daily activity patient should continue or avoid during this period. Your consent/agreement with the radiation oncologist is needed to start the treatment. After you sign the consent, our medical coordinator will escort you to a therapist team and your first treatment will begin.

Our Licensed Radiation Therapists will verify the area we are treating by taking orthogonal images to assure the area we are treating is accurate. Our Radiation Oncologists will verify these images are correct before treatment begins.

Daily Treatments: The radiation oncology department works from Monday to Friday. The entire IMRT / IGRT treatment lasts from 10 to 15 minutes depending on the treatment plan complexity. Please arrive 10-15 minutes earlier for the treatment. The therapist will escort you into the treatment room and will make sure you are exactly in the same position as you were in the CT simulation by setting up the Immobilization devices and using the marks on your skin.

The therapist will monitor the treatment outside the room. Treatment will be stopped immediately if any emergency happens. During the treatment Cutting edge radiation technologies are utilized for further precision. As in the IGRT treatment, On-Board Imaging, Cone-Beam CT will help to find the exact and precise location of the targeted region. You won’t feel any pain or discomfort when the treatment is on.

On-Treatment Visits: On your first day and even first few weeks of treatment, you are likely to be without any side effects. If any side effects occur and raise your concern, you may contact your radiation oncologist immediately through the medical coordinator assigned to your case. You will see the radiation oncologist and nurse for weekly status checks. If medication is necessary for any possible side effects, our radiation oncologist will prescribe it or modify your treatment process. Also during the course of treatment, the therapist team will report your current treatment status to the radiation oncologist for the treatment plan adjusting.

Regular Follow-Ups: Once radiation therapy is completed, our office staff will make you the follow-up appointments with the radiation oncologist. Typically, you will be seen back in our offices one month following completion of treatment, then in 3months, 6months and 1 year. During these follow-up visits, assessment of your response to treatment and disease status is reviewed. In addition, if any tests were performed from another facility it will be requested upon follow up to be reviewed by the radiation oncologist. Within this period, please feel free to contact the medical coordinator and physicians about any request or questions concerning to your health.



High Dose Rate Brachytherapy Treatment Process

 

Consultation: Upon your first visit you will meet with our board certified radiation oncologists. You and your family will have your questions answered in a comforting and caring environment. Our cancer treatment team will explain to you the pros and cons of choosing High Dose Rate Brachytherapy, and they will explain what will happen during your cancer treatment.

Meet Your Medical Coordinator: After completion of the consultation every patient will have a medical coordinator assigned to them to guide them through each step of the High Dose Rate Brachythrapy process. We understand how difficult this time is for you and your family, so our trained medical coordinators will help you through the entire process. From technical questions on the technology to insurance authorization, our medical coordinators are here for you.

Treatment Day

Step 1: Implant placement
FROS Radiation Oncology physicians decide which type of implant the patient requires, based on location, tumor extent and other factors. The three types are:

1. Intracavitary Implant: an applicator is inserted into a body cavity to reach the tumor. Intracavitary implants are performed on an out-patient basis. Local anesthesia and/or conscious sedation are all that is required.
2. Intraluminal Implant: the catheters are inserted into a "tube" structure such as the bronchus, esophagus, or bile duct. These are treated the same as intracavitary implants on an outpatient basis.
3. Accuboost Breast Treatment

Step 2: Simulation
After the implant has been placed, a CT is taken by the radiation therapists to determine the exact location of the implant in the body and the relationship to adjacent organs. The therapists' expertises in taking these images assure that the implant and nearby organs are visualized clearly. The physician reviews these films and makes final adjustments to the implant if necessary.

Step 3: Dosimetry
The CT images are given to our highly trained Physics team to enter into the treatment planning computer. The computer does the initial calculation but it is the Licensed Physicist who "fine tunes" or customizes the radiation doses to conform to the target volume while minimizing the doses to the nearby normal tissues. After the treatment plan has been approved by the physician, the computer transfers the treatment plan instructions to the HDR remote afterloader.

Step 4: Treatment
The patient is moved into the brachytherapy treatment room. The ends of the applicator or treatment catheters that protrude outside the body are connected to "transfer" tubes which are then connected to the afterloader. The programmed instructions tell the afterloader where to direct the source and how long the source will stay in each dwell position. The patient is alone in the treatment room while the treatment is being given, but the therapists, radiation oncologist and physicists are continually monitoring the patient through an intercom and closed circuit TV monitors. The entire treatment process takes about 30-90 minutes depending on the size and complexity of the implant and the activity of the source. When the treatment is completed, the radiation source is retracted back into the HDR afterloader. There is no radiation left behind in the patient.

Step 5: Implant Removal
After the treatment(s) have been given, the implant is removed. Intracavitary, intraluminal and Accuboost applicators are simple to remove and the patient goes home soon after removal. With interstitial implants, sutures holding the template and/or catheters in place are clipped and the implant is gently removed.

Step 6: Follow-up
After your cancer treatment, your doctor will review follow-up imaging or other tests to assess the tumor's response to the delivered radiation and measure your progress.

OUR TREATMENT TECHNOLOGIES


Cyberknife Radiosurgery

Cyberknife Treatment in 1 to 5 Days Instead of 40 Days

The CyberKnife® Robotic Radiosurgery System is a non-invasive alternative to surgery for the treatment of both cancerous and noncancerous tumors anywhere in the body, including the prostate, lung, brain, spine, liver, pancreas, and kidney. The treatment – which delivers beams of high dose radiation to tumors with sub-millimeter accuracy – offers new hope to patients worldwide. LEARN MORE >


Image-Guided Radiation Therapy (IGRT)
Tumors can move, because of breathing and other movement in the body. IGRT allows our doctors to locate and track the tumor at the time of treatment. With this technology, we can deliver precise radiation treatment to tumors that shift as a result of breathing and movement of the bladder and bowels. LEARN MORE >

Intensity Modulated Radiation Therapy (IMRT)
Intensity Modulated Radiation Therapy delivers highly precise beams of radiation directly into a cancer. This is achieved by using computer controlled small radiation shields in a linear accelerator. Dozens of uniquely shaped shields are delivered to the patient using various angles and approaches. The pinpoint accuracy of IMRT is so advanced, it can be programmed to actually wrap and angle beams around normal tissue and organs, while protecting healthy tissue as it destroys the tumor. LEARN MORE >

Accelerated Partial Breast Irradiation (APBI)
With APBI, the radiation treatment is focused specifically on the part of the breast where the tumor was removed. This allows the radiation to be contained to the tumor cavity as much as possible. Because the radiation is so targeted, it affects less of the healthy tissue and organs close to the breasts, including the lungs, heart, ribs, muscles and skin. LEARN MORE >

High-Dose Rate (HDR) Brachytherapy
The physicians at FROS have extensive training and experience in high-dose rate (HDR) brachytherapy. High dose rate (HDR) is a technically advanced form of brachytherapy. A high intensity radiation source is delivered with millimeter precision under computer guidance directly into the tumor killing it from the inside out while avoiding injury to surrounding normal healthy tissue. LEARN MORE >

Accuboost Breast Cancer Treatment
AccuBoost is the latest innovation in breast radiotherapy that achieves the goal of targeting the boost dose to the lumpectomy cavity margin – the tissue that is the most likely site of future recurrence. The AccuBoost design combines a non-invasive method of delivering a well focused beam with the power of real-time image guidance to target the radiation dose accurately and reliably to the surgical excision site (target tissue). Additionally, AccuBoost controls unintentional exposure to otherwise healthy tissue and minimizes radiation-related side effects. LEARN MORE >

At FROS Radiation Oncology Cyberknife Center, our team is committed to bringing leading-edge technology with highly compassionate care to our patients.

Please call us at 1-888-880-6646 today to find the right treatment for you.

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LOCATIONS

Flushing: 40-22 Main St, 4th Fl,
Flushing, NY 11354
Brooklyn: 1737 Bath Ave
Brooklyn, NY 11214
Manhattan: 47 Essex St.
New York, NY 10002

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