Top Doctors 2010
From surgeons to psychiatrists, meet the Hudson Valley’s top 101 medical specialists — as reviewed by their peers and fellow physicians
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Lyall Gorenstein, M.D.
“It was somewhere in high school that the idea first crossed my mind to go into medicine,” recalls Dr. Lyall Gorenstein, who grew up in Toronto. He went on to graduate from the University of Toronto Medical School, where he also did his surgical residency. Gorenstein, — who specializes in thoracic surgery and operates on the organs of the thorax (chest), including the lungs, esophagus, heart, and other related areas — also did fellowships in thoracic and cardiovascular surgery in Toronto and at the MD Anderson Cancer Center in Texas.
He and his family have lived in the Hudson Valley since 1992, when he joined the Rockland Thoracic and Vascular Associates practice, based in Pomona and Goshen. Gorenstein is affiliated with Nyack Hospital and New York-Presbyterian/Columbia hospital in New York City.
“We deal with both benign and malignant diseases, including a lot of cases of lung cancer,” explains Gorenstein, who says treatment for lung cancer has improved vastly over the years. “We’re doing a lot of minimally invasive surgery now, which wasn’t the case even 10 years ago. About 70 percent of patients who undergo lung surgery now have minimally invasive procedures — which means we’re not cracking ribs, not doing big incisions, so there’s faster recovery, too.
“It’s encouraging that survival rates for lung cancer have improved dramatically compared to 20 years ago,” Gorenstein notes. “That’s most likely due to several factors, including earlier detection, better surgical therapy, and improved radiation and chemotherapy.
“Our field is constantly changing,” he adds. “Along with more minimally invasive procedures, we also use a multi-modality approach to treating lung cancer. We interact with oncologists, radiation therapists, internists, pulmonologists — we definitely stress a team approach.” He believes, too, that it’s crucial to not only treat the disease, but to address the emotional needs of each patient and his or her family.
Research breakthroughs frequently redefine medical knowledge, he says. “One interesting thing is that, in the past, a lung cancer patient’s prognosis was traditionally based on the stage of the cancer — on the tumor size or whether it had spread to nearby nodes. But now we’re learning that the tumor’s gene profile — its genetic characteristics — also impact the prognosis. That means that possibly, more important than the stage of the cancer, is its biology. We can now determine the likeliness, for example, of a patient responding well to a certain type of chemotherapy.”
New treatment drugs are consistently being developed, too, he says. “Some of the newest ones work on what’s known as the specific molecular ‘pathways’ of tumor cells. Traditional chemotherapy is like a shotgun: it kills a lot of cells. But now there are more targeted therapies that can stop proliferation of cells, but don’t have as many side effects.”
Gorenstein and his family — which includes four kids — live in Piermont; they all enjoy the great outdoors when he’s not in the office or surgical suite. “My kids grew up as avid alpine skiers, so we would spend lots of time at Whiteface Mountain or Lake Placid,” he says. The kids are also competitive swimmers, so race meets are often on the weekend agenda. And when the weather’s right, the family loves to hit the golf course, too.
A career that involves dealing with a large number of cancer cases can obviously be challenging, Gorenstein says. But it’s rewarding, especially when lives are saved. “The field is constantly evolving. And we’re definitely able to have a large impact on improving the quality of people’s lives. That’s very satisfying.”