For Sharyn N. Lewin, MD, FACS, and Phyllis A. Tarallo, DNP, DCC, the practice of gynecologic oncology and surgery within the context of women’s health has been elevated from a profession to something akin to a calling.
Dr. Lewin, a board-certified gynecologic oncologist and Medical Director of the Gynecologic Oncology Division of Holy Name Medical Center’s Regional Cancer Center, and Tarallo, a nurse practitioner, are highly trained and experienced specialists who care for patients with gynecologic cancers and complex benign gynecologic conditions. Dr. Lewin’s practice will focus on all gynecologic cancers, including uterine, ovarian, cervical, vulvar and vaginal. The doctors also treat patients who have abnormal Pap smears, irregular bleeding and a variety of other conditions. Women at high risk for ovarian and breast cancer constitute a significant portion of the practice.
But it is their philosophy of whole-patient care that sets them apart from many oncology providers.
Sharyn N. Lewin, MD, FACS, Medical Director of the Gynecologic Oncology Division of Holy Name Medical Center’s Regional Cancer Center, and Phyllis A. Tarallo, DNP, DCC, review a patient’s test results.
“Our practice takes a comprehensive, multidisciplinary team approach to the screening, treatment and overall improvement in quality of care for women with gynecologic cancers and those at high risk,” Dr. Lewin says. “Caring for the whole patient means affording access to clinical trials, in addition to conventional chemotherapy and complex surgical procedures, all delivered with personalized attention to individual needs. It’s offering the services of a social work professional, a registered oncology dietitian, and complementary therapies such as acupuncture, massage therapy and guided imagery.”
Maintaining continuity of care while being present for their patients is an essential part of their treatment approach.
“We value personal relationships with our patients,” Dr. Lewin explains. “We stay with them throughout the disease process, guiding them through surgery, radiation and chemotherapy to survivorship. We also provide genetic testing, make sure screenings are up-to-date and engage ancillary providers, such as nutritionists, when necessary. We embrace a warm, hands-on philosophy of care.”
On the Leading Edge
A nationally recognized educator on hereditary breast and ovarian cancer syndrome, Dr. Lewin looks forward to raising awareness about how family history affects women’s health. Many women are at risk for gynecologic cancer, she says, and “we intend to reach out extensively, educating both men and women about genetic predisposition.” The team also plans to incorporate community education about how nutrition, weight management and lifestyle choices can minimize cancer risk.
An important aspect of outreach is letting patients know about the tools available. An expert in minimally invasive and robotic surgery, Dr. Lewin uses these techniques whenever possible.
“The da Vinci robotic surgical system is a wonderful tool for women with uterine or early cervical cancer,” says Dr. Lewin. “It is also used for benign conditions, such as fibroid removal and hysterectomy. We can perform these complex surgeries through a small incision, resulting in a shorter recovery time and faster return to work and family. Patients experience less pain and blood loss, too. Often, we can perform single-site surgery through an incision in the belly button, with cosmetically appealing results.”
Dr. Lewin also performs complex surgeries for ovarian cancer, including radical pelvic resections and upper abdominal surgery.
Dr. Lewin’s practice offers important oncologic treatments, some of which are not widely available, including intraperitoneal chemotherapy, a procedure in which chemotherapy is administered directly into a patient’s abdomen. Applicable to women with ovarian cancer, this treatment pairs abdominal administration of medications, such as cisplatin and paclitaxel, with standard intravenous chemotherapy. The most recent randomized trial supported by the Gynecologic Oncology Group found combined intraperitoneal and intravenous chemotherapy results in increased overall survival.
“The longer survival is probably related to pharmacokinetics, or the distribution of chemotherapy through the abdomen,” Dr. Lewin says. “We have seen excellent benefits, but not everyone has access to this treatment. It’s important to extend this therapy to appropriate patients who have had ovarian cancer surgery, so we will offer it here at Holy Name.”
Dr. Lewin is also exploring heated intraperitoneal chemotherapy, a treatment in which ovarian cancer patients are given a hot chemotherapy “bath” of the abdominal cavity immediately after surgery, before the incision is closed.
Currently, Dr. Lewin is investigating the role of poly (ADP ribose) polymerase, or PARP, in tumor self-repair. A class of medications known as PARP inhibitors may enhance the effectiveness of standard therapies, especially for cancers associated with BRCA mutations. Early data suggest that patients with BRCA mutations treated with PARP inhibitors as well as chemotherapy live longer than patients undergoing standard treatment, according to Dr. Lewin.
Caring for and about Their Patients
Dr. Lewin consults with a patient.
“Our patients feel a sense of confidence and relief when they realize they’re being treated by experienced specialists who really care about them as individuals,” Tarallo says. “One of the unique aspects of our practice is the combination of leading-edge care with warm, friendly professionalism, and this is reflected in the physical environment, as well.”
The new practice is located in Holy Name Medical Center’s accredited Regional Cancer Center, just down the corridor from the surgical and infusion suites. The space has “a living-room-like environment,” according to Tarallo, and the “homey feel extends throughout the Cancer Center.” For example, a dedicated oncology nutritionist visits patients while they are receiving chemotherapy, bringing snacks she has prepared and teaching healthy recipes.
Dr. Lewin says she inherited her passion for women’s health care from her grandmother, an obstetrician/gynecologist who worked in New York, New York.
Tarallo and Dr. Lewin share a philosophy of whole-patient care, which sets them apart among oncology providers.
“My grandmother was a pioneer and a proponent of exceptional women’s health care,” she says. “I became a physician to follow in her footsteps and care for women.”
To realize her dream, Dr. Lewin attended medical school at the University of Kansas School of Medicine, followed by an internship in obstetrics and gynecology at Washington University School of Medicine and a fellowship in gynecologic oncology at Memorial Sloan Kettering Cancer Center. As an Assistant Professor of Clinical Obstetrics and Gynecology in the Division of Gynecological Oncology of the Department of Obstetrics and Gynecology at the NewYork Presbyterian/Columbia University Medical Center, she continued her research in the areas of gynecological cancer treatment and survivorship. She also started the Woman to Woman Program, an initiative that she would like to bring to Holy Name that supports women and their families during treatment and recovery from cancer. Dr. Lewin is also the founding President and Executive Director of The Lewin Fund to Fight Women’s Cancers, a foundation devoted to women’s cancer research and improving cancer patients’ quality of life.
Partners in Women’s Health
Dr. Lewin discusses treatment options with a patient and her husband.
Because they were both active in the gynecologic oncology research and practice community, Dr. Lewin and Tarallo knew each other for many years before Dr. Lewin decided to bring her comprehensive gynecologic cancer practice to Holy Name Medical Center and the Bergen County area.
With their collaboration, the two share a future goal to spearhead the development of a women’s health center, a female-focused initiative that would reach beyond gynecologic oncology to provide care and support in multiple specialties for women of all generations.
Tarallo has led a distinguished career in the field of nursing in the areas of women’s cancers. She is an expert in the surgical care and management of gynecologic oncology patients, with 30 years of experience. Most recently the director of women’s health for the Center for Liver Disease and Transplantation at Columbia University Medical Center, Tarallo says she is “excited to get back to practicing in the field I am most passionate about.”
Throughout her academic career, Tarallo was an assistant professor at the Columbia University School of Nursing, and she is published in the areas of HPV and gynecologic oncology. She has also been principal investigator and co-investigator on numerous clinical trials for gynecologic oncology.
Dr. Lewin and Tarallo stay with their patients throughout the disease process, guiding them through surgery to survivorship.
Tarallo believes that her training as a nurse practitioner has given her a helpful perspective on patient care.
“We are taught to look at the patient from a psychosocial as well as medical model,” she says. “Taking that background into our advanced studies gives us an advantage in total patient management. We’re in tune with listening to patients, spending time with them and meeting their needs.”
“We love this community,” Dr. Lewin adds. “Holy Name Medical Center is a truly compassionate and patient-centered hospital that has so much to offer, and it does that in a way that sets it apart from other hospitals in the area. Our practice is very much aligned with Holy Name’s character, and we’re so very happy to be part of the medical center family.”
For more information about Holy Name Medical Center, please visit www.holyname.org.