Epic Care and Bay Area Breast Surgeons are pleased to announce the availability of cryoablation for the minimally invasive treatment of breast fibroadenomas.

Although a fibroadenoma is not life-threatening, treatment may be desired because this benign tumor can cause physical deformity, discomfort, or emotional distress.

Traditionally, open excisional biopsy (i.e. surgery) has been the only option. But now, a minimally invasive option is available that can be performed in the office under local anesthesia. Cryoablation for treating fibroadenomas is approved by the Food and Drug Administration (FDA). And since 2010, over 2000 fibroadenomas had been successfully and safely treated with this method.

What is cryoablation?

Cryoablation is the use of extreme cold to destroy a breast tumor without surgery. A thin metal probe is passed through the center of the tumor with the assistance of ultrasound guidance. The tip of the metal probe is cooled to extremely low temperatures (-256°F). This freezes and kills the breast tumor without harming the surrounding tissues and without any significant scarring.

(FAQ) Frequently Asked Questions

How is cryoablation procedure done in the office?

Cryoablation is a quick procedure that is done in the office, not the Operating Room. Patients are evaluated by a Breast Surgeon to confirm that they indeed have a fibroadenoma.  Evaluation consists of an examination, breast ultrasound and core needle biopsy. Once the fibroadenoma is confirmed, the cryoablation procedure is scheduled if the patient requires treatment.

Cryoablation does not require general anesthesia. After injection of a local anesthetic, ultrasound monitoring is used to help guide a 2mm metal probe into the center of the fibroadenoma. The tip of the probe is then cooled to extremely low temperatures, which turns the fibroadenoma into a small ball of ice, and kills the cells of the fibroadenoma. The procedure takes approximately 10 – 15 minutes, after which the metal probe is removed and the patient can immediately resume normal activities.

Is cryoablation uncomfortable?

Clinical studies and our own personal experience have shown that there is minimal discomfort during or after cryoablation. Most patients take only 1 or 2 acetaminophen (Tylenol) tablets after cryoablation.

What are the advantages of Cryoablation?

Cryoablation of fibroadenomas is approved by the FDA as a safe and effective alternative to surgery. There are several advantages to cryoablation over that of surgery…

Does health insurance cover cryoablation of fibroadenomas?

Many health insurance companies cover the cryoablation of fibroadenomas. We will work with your insurance company to determine coverage and approval prior to the procedure.

If you or someone you know may benefit from this treatment option please contact our Emeryville office for more information (510) 629-6682.

To learn more about Bay Area Breast Surgeons and the services they provide please visit their website at http://www.babsurgeons.com

Personalized Cancer Care

Recently, on the program 60 Minutes, a segment was hosted by Dr. Sanjay Gupta that addressed the personalization of cancer therapy. Specifically, the program suggested that cancer should not be separated by disease site (e.g. breast, prostate, lung, etc.) for treatment but instead characterized by the specific mutations that each individual cancer has. This idea, while novel, has been researched extensively by academic cancer centers and industry for decades. We are now seeing commercially available tests and drugs that specifically identify and target these mutations.

At Epic Care, our Oncologists work in collaboration with local labs to offer several personalized technologies. For example:

Breast Cancer – The Oncotype DX test can be performed in select women after breast conserving surgery to identify if they would receive high or low benefit from chemotherapy.

Lung Cancer – We can identify three  specific mutations (Alk and EGFR and ROS1) that, if detected, may allow us to utilize molecularly targeted agents which are less toxic than chemotherapy.

Melanoma – Certain patients may harbor a mutation (B-raf) which can be treated with a target specific agent.

Our expert team of physicians stays abreast of the latest innovations in cancer research by taking leadership roles in professional societies, serving as faculty at UCSF/Stanford, and regularly attending local, national & international symposiums. In addition, Epic Care works in collaboration with our local research institutions to be able to offer you a broad array of clinical trials which often allow our patients to have access to new and state-of-the-art therapy before it is available to the public at large.

For additional information, please call any one of our offices or speak to your Epic Care Oncologist.

Epic Care Announces Availability of New Therapy for Brain Cancer

Epic Care is pleased to announce the availability of Optune (Formerly NovoTTF-100A System), a ground breaking anti-cancer therapy for the treatment of recurrent glioblastoma (GBM).

Optune is a portable, non-invasive anti-mitotic system approved for use in recurrent GBM patients 22 years of age and older. It is a treatment option for patients with recurrent glioblastoma whose disease has progressed after surgery and radiation options have been exhausted and after receiving initial chemotherapy.

“Our goal at Epic Care is to treat cancer patients with the best therapies available, so we are pleased to add Optune Therapy to our options for those fighting recurrent GBM,” said Dr. Gautam Prasad. “We know how important quality of life is to patients. Optune is a device they can use in their own homes, and it’s also been found in a clinical study to have fewer side effects typically related to treatment with chemotherapy.”

Optune delivers a novel treatment called Tumor Treating Fields (TTFields), which are frequency-tuned electric fields that have been shown in studies to disrupt the growth and spread of cancer cells. TTFields spares healthy, normal non-dividing brain cells by directing treatment directly to dividing cancer cells in tumors.

Optune is designed for continuous use throughout the day by the patient. The device is recommended to be used for at least 18 hours, and can either be plugged into a wall outlet or can run on batteries for portability.

Recurrent glioblastoma is both the most common and also the most aggressive type of malignant brain tumor, affecting approximately 10,000 people in the United States each year.

The US Food and Drug Administration (FDA) approved the Optune System for use as a treatment for adult patients (22 years of age or older) with histologically-confirmed glioblastoma multiforme (GBM), following histologically – or radiologically-confirmed recurrence in the supratentorial region of the brain after receiving chemotherapy. The device is intended to be used as monotherapy, and is intended as an alternative to standard medical therapy for GBM after surgery and radiation options have been exhausted.

If you or someone you know may benefit from this new treatment option for recurrent glioblastoma, please contact our Dublin office for more information (925) 875-1677.

Patients should only use the Optune system under the supervision of a certified physician properly trained in use of the device. More information is available at www.optune.com

Holiday Beauty Extravaganza!

Date: Friday, December 12th, 2014

Time: 5:00 pm – 7:00 pm

Location: Epic Care •  6380 Clark Avenue • Dublin, CA 94568

For all of the tough times you have experienced all year – This ladies night is all about you!

Please join us & enjoy individual/group makeovers, make-up instructions, beauty bag giveaways provided by Mary Kay Cosmetics & surprises for all. Refreshments will be served.

If you are able we are also asking guests to bring a favorite holiday dessert to share!

Please RSVP by December 5th with Shanette (925) 875-1677 or Ashley (510) 830-3100


Sharing the Warmth

Epic Care is honored to be the recipient of one young girl’s goal to warm the hearts of those fighting cancer.

Mackenzie, daughter of our patient James Martin turned a school project on Lymphoma into a blanket drive. The drive collected over 50 blankets, which she donated to our Dublin Care Center. Attached to each blanket she included a handwritten tag with words of encouragement. We plan to give out the blankets to our patients who are just starting treatment.

From all of us at Epic Care we send a BIG THANK YOU to Mackenzie, for sharing the warmth with our patients. Such a beautiful and inspiring gift to give!

Epic Care Nurse Practitioners Take the Plunge for The Women’s Cancer Resource Center!

Our Nurse Practitioners, Donna Saba, Stacey Teicher, Christine Eicher-Raymond and Sierra Velasquez have joined the Women’s Cancer Resource Center’s (WCRC) 19th Annual Swim A Mile for Women with Cancer fundraising event. They have each pledged to swim a mile to help make a difference in the lives of thousands of women and their loved ones.

Since 1986, WCRC has provided programs and a network of support and essential resources for women with cancer in the Bay Area free of charge. The annual Swim A Mile is WCRC’s major fundraising event, raising nearly one-third of their annual budget.

Please join us in helping out WCRC by going to the Epic NP Nightingales team website and making a donation  http://www.wcrc.org/swim/profiles/team/id/1383

All donations are 100% tax deductible, and make a world of difference.

The 19th annual Swim A Mile for Women with Cancer will be held on October 4th and 5th, 2014 at Mills College located at 5000 MacArthur Blvd, Oakland, CA 94613. The event will be held from 9 am to 3 pm.

For more information on the Swim A Mile event, visit www.wcrc.org/swim/

For additional information on WCRC, visit www.wcrc.org

In the News – Pink Ribbon California License Plates

Back in October 2012, we helped our patient, Heather Solari tell her story of how she battled breast cancer and about her dream of spreading breast cancer awareness one pink license plate at a time.

For the past two years Heather, who is part of the Survivor Sisters, a group of breast cancer survivors has worked towards the goal of bringing pink ribbon license plates to the state of California. So it is with great pleasure to able to announce that they have reached their goal. On September 17th Governor Brown signed the AB 49 Bill, which authorizes the creation of a Pink Ribbon breast cancer awareness specialty license plate.

Now that the bill has been signed, the California Department of Health Care Services will work with the Department of Motor Vehicles to develop the pink ribbon plate.  DMV must have at least 7,500 commitments to purchase the plate. The funds generated from the sales of the pink plate will go to the Every Woman Counts (EWC) program, which provides free clinical breast exams and mammograms to California’s women in need.

For more information on the pink ribbon plate and how to purchase yours visit the California Pink Plate Campaign website, https://pinkplate.org

To learn more about the Every Woman Counts (EWC) program click on the link below: http://www.dhcs.ca.gov/services/Cancer/ewc/Pages/default.aspx

Read more about this story and the AB 49 Bill by clicking on the link below: http://eastcountytoday.net/governor-brown-signs-pink-ribbon-plate-bill/

Epic Care Welcomes New Medical Oncologist

We are pleased to announce the addition of Wilson Tong, MD to our practice.

Dr. Tong is a graduate of the University of Arizona College of Medicine. He completed his internship and residency at the Mayo Clinic in Arizona and fellowship at the University of California, Irvine.

Dr. Tong will be practicing out of our Antioch office.

Epic Care Welcomes New Medical Oncologist

We are pleased to announce the addition of Ramandeep K. Bambrah, MD to our practice.

Dr. Bambrah received her M.D. from Ross University School of Medicine. She completed her internship, residency and fellowship at The University of Florida, College of Medicine.

Dr. Bambrah will be practicing out of our Pleasant Hill office.

Epic Care Welcomes New Medical Oncologist

We are pleased to announce the addition of Michael Min Yan, MD to our practice.

Dr. Yan received his M.D. from Perking Union Medical College and Ph.D. from Case Western Reserve University for his research in molecular cancer genetics. He completed his residency at Albert Einstein University Long Island Jewish Medical Center in New York City and fellowship at the University of California, San Diego.

Dr. Yan will be practicing out of our Oakland office.