Top Doctors: Hudson Valley’s Best-Rated Doctors in 2012
Solid credentials, proven skill, and a compassionate bedside manner — these qualities are the hallmarks of a top-flight physician. Here are 145 local doctors in 38 specialties who — according to their peers — make the grade
(page 4 of 7)
Dr. Zoe A. Weinstein
“People sometimes ask how I can do this kind of work every day. They say, ‘Isn’t it depressing?’ ” But for breast cancer surgeon Dr. Zoe A. Weinstein, helping others is a key motivation. “You feel like you’re on a path toward managing the problem, striving to put new tools in your arsenal, and dealing with the disease together with your patients — as a team.”
Weinstein received her medical degree from the Albert Einstein College of Medicine and did her residency at Montefiore Medical Center, and says a real-life experience encouraged her to enter the oncology field. “When I was a young woman, a close family friend was dying of advanced breast cancer; her youngest child was only six at the time,” Weinstein recalls. “I was in my year of pathology residency and had done basic research on breast tumors. I’ve always been interested in it intellectually — that, and women’s health. I love the combination of being a surgeon and taking care of women.”
Weinstein, medical director of the Fern Feldman Anolick Center for Breast Health at Benedictine Hospital in Kingston — part of the HealthAlliance system — is enthusiastic about advances in breast cancer treatment. She notes that, as a physician, “You keep your mind open to new developments, but it’s important to also have a cautious eye and wait until the data comes out. You don’t want to find out in five years that you’ve jumped on a bandwagon for a certain treatment that’s not in a patient’s best interest.”
Among the leading-edge approaches: “We’re seeing, in breast cancer treatment, a movement away from the idea of, in many cases, immediately doing radical surgical treatment — of radical mastectomy, where the breast and underlying muscles are surgically removed, which was extremely disfiguring. Now, there’s more focus on limited breast surgery, of lumpectomy,” in which just the tumor and a relatively small amount of surrounding tissue is taken out, followed by additional treatment. This combination can render radical surgery unnecessary.
Also, Weinstein notes, “Twenty years ago, most people had all their lymph nodes removed during cancer surgery. Nowadays, in cases where patients appear to have little or no breast cancer involvement in the lymph nodes, surgeons tend to remove fewer lymph nodes than they might have in the past.” This can help reduce chances of side effects such as limited range of motion in the arm or shoulder, and lymphedema — painful arm swelling. “And if the patient goes on to have all the additional treatment they would need, like chemotherapy and radiation, they seem to do as well as patients who have all their lymph nodes removed,” Weinstein says.
New high-tech diagnostics also help doctors customize treatment plans. “There’s a test now, the Oncotype DX test, which can be done on certain breast tumors that are known as estrogen-receptor positive,” Weinstein says. “The test looks at 21 genes within a woman’s tumor sample and evaluates the patient’s risk of breast cancer recurrence if they were only to get anti-estrogen treatment such as tamoxifen. Thus, we can sometimes avoid having to give these patients chemotherapy. We’re now better able to tailor a patient’s treatment to the biological behavior of the tumor. It’s very encouraging.”
Weinstein recalls one patient with advanced cancer who underwent a double mastectomy and intensive chemotherapy. “She had a daughter in high school and a son who was 12 at the time.” Seven years later, the patient is so far doing fine, Weinstein says. “She’s been able to see her daughter go to college, and her son grow up. Those years together are crucial for the development of a family; it’s been very meaningful for me, too.”
Weinstein says the debate continues among some health professionals over how extensively to use breast cancer screening tools such as mammography. “While mammography is a great screening tool, it’s not designed to pick up everything,” she says. In cases where a woman has dense breasts, for instance, other screening techniques such as ultrasound can be an additional valuable tool.
“The leading cause of cancer-related death overall for women in the U.S. is lung cancer, but the number one cause of death for middle-aged women between 45 and 55 is breast cancer. So it’s very important to get screened,” Weinstein says.
Recent research also supports the apparent value of exercise in breast cancer prevention for many women, she says. “There’s also a relationship between postmenopausal obesity and cancer risk in general. So it’s empowering for women to know they can do something about factors such as the amount they exercise and how much they weigh, to help lower their breast cancer risk.”
Weinstein, a mom and resident of Rhinebeck, is an advocate for helping patients get all the support they need throughout their cancer journey. “When patients are finished with treatment, they should be told what to expect next,” she says. “It’s not enough to just say, as a doctor, ‘See you in six months after your next mammogram.’ ” Factors like good nutrition, exercise, and other preventative steps should be emphasized, she says. “And also, what else to expect after cancer treatment — sometimes there can be sexual dysfunction, mood swings, an altered sense of yourself.”
The American College of Surgeons has made a positive move in this direction, she says — it now mandates that all patients in its affiliated hospitals have a survivorship plan, and Benedictine Hospital is part of that post-treatment program. “Each cancer patient receives a handout that says, ‘You got this much chemotherapy, this much radiation; this plan is for you to follow’ — there’s a whole psycho-social component. I think that’s going to make a difference.”