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Ellen Chuang, MD
EllenChuangMD (Physician - Oncology - Hematology/Oncology (Verified) )| Communities: Breast Cancer | Answers: 8 |
| Member Since: Jul. 2012 |
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Professional Statement
Dr. Ellen Chuang is an Associate Professor of Clinical Medicine in the Department of Medicine, Division of Hematology and Medical Oncology at New York Presbyterian-Weill Cornell Medical Center.
Dr. Chuang graduated from the Johns Hopkins University and received her medical degree from the University of Chicago. She completed a residency in Internal Medicine from the University of Iowa and a fellowship in Hematology/Oncology at Indiana University School of Medicine. She returned to the University of Chicago to pursue a research fellowship in Immunology. Dr. Chuang joined the faculty of the Weill Cornell Medical College in 1999.
Dr. Chuang specializes in the treatment of breast cancer. Her clinical practice is located at the Weill Cornell Breast Center, where she is fortunate to work with a superb team of breast surgeons, medical oncologists, radiation oncologists, radiologists, and pathologists. Dr. Chuang is an investigator on several clinical trials, and has published and lectured on her work on numerous occasions. She is a member of the the New York Metropolitan Breast Cancer Society, and the American Society of Clinical Oncology. She enjoys her role as a teacher and mentor to medical students, residents, and fellows.
Dr. Chuang graduated from the Johns Hopkins University and received her medical degree from the University of Chicago. She completed a residency in Internal Medicine from the University of Iowa and a fellowship in Hematology/Oncology at Indiana University School of Medicine. She returned to the University of Chicago to pursue a research fellowship in Immunology. Dr. Chuang joined the faculty of the Weill Cornell Medical College in 1999.
Dr. Chuang specializes in the treatment of breast cancer. Her clinical practice is located at the Weill Cornell Breast Center, where she is fortunate to work with a superb team of breast surgeons, medical oncologists, radiation oncologists, radiologists, and pathologists. Dr. Chuang is an investigator on several clinical trials, and has published and lectured on her work on numerous occasions. She is a member of the the New York Metropolitan Breast Cancer Society, and the American Society of Clinical Oncology. She enjoys her role as a teacher and mentor to medical students, residents, and fellows.
Professional Info
Credential: MD
Primary specialty: Oncology - Hematology/Oncology
Medical school: University of Chicago Pritzker School of Medicine
Residency: University of Iowa Hospitals
Internship: University of Iowa Hospitals
Fellowship: Indiana University School of Medicine, University of Chicago
Hospital affiliation: NewYork - Presbyterian / Weill Cornell
Practice address:
425 East 61st Street 8th Floor
New York, NY
10065
Practice phone number: (212) 821-0654
EllenChuangMD Activities
Breast cancer is not just one disease. Using molecular studies, breast cancer can be divided into 4 subtypes, each with a different natural history, prognosis, and treatment.
Our own research suggests that some subtypes occur more frequently in particular Asian ethnic groups. In our study, Japanese patients were more likely to have the Luminal A subtype, which often responds to hormonal therapy, whereas Filipino patients were more likely to have the Her2/neu subtype, which often requires treatment with chemotherapy and trastuzumab (Herceptin). We don’t know why these differences exist, and this is an area of research we are exploring.
Our own research suggests that some subtypes occur more frequently in particular Asian ethnic groups. In our study, Japanese patients were more likely to have the Luminal A subtype, which often responds to hormonal therapy, whereas Filipino patients were more likely to have the Her2/neu subtype, which often requires treatment with chemotherapy and trastuzumab (Herceptin). We don’t know why these differences exist, and this is an area of research we are exploring.
New answer by EllenChuangMD (Physician - Oncology - Hematology/Oncology (Verified))
1
Answer |
10 months ago
Affinitor (everolimus) is a new class of drugs that was recently approved to be used in combination with exemestane, an aromatase inhibitor. Everolimus blocks a pathway related to cancer cell growth (the PI3K pathway). Studies in the laboratory suggested that this pathway is one of the reasons why ER positive cancer cells may develop resistance to hormonal therapy. In women whose cancers had previously progressed on either letrozole or anastrazole aromatase inhibitors, adding everolimus to exemestane was shown to be more effective than exemestane alone. This is the first time that a drug has been approved that appears to “re-sensitize” cancer cells to hormonal therapy, and that is an important milestone for the treatment of hormone receptor positive breast cancer.
New answer by EllenChuangMD (Physician - Oncology - Hematology/Oncology (Verified))
1
Answer |
10 months ago
When we speak of “lines” of chemotherapy we are referring to the practice of giving sequential regimens of chemotherapy to patients with metastatic disease. The list of FDA approved drugs for breast cancer includes more than 20 drugs. There is no “typical” or “standard” first line therapy. Factors that are taken into consideration when choosing a first line treatment include whether the cancer is ER or Her2/neu positive, whether a patient is symptomatic or not, what the extent of the cancer is, and which chemotherapy drugs the patient may have been exposed to in the adjuvant setting. Quality of life issues, such as whether the treatment will cause hair loss, and how frequently the patient has to come into the doctors’ office to get an infusion are important considerations. Some common chemotherapy drugs used in the first line setting are paclitaxel, docetaxel, and capecitabine.
New answer by EllenChuangMD (Physician - Oncology - Hematology/Oncology (Verified))
1
Answer |
10 months ago
Chemotherapy is often recommended for stage 1 cancers if the cancer is ER negative or Her2/neu positive. In the absence of adverse features such as high nuclear grade or lymphovascular invasion, cancers that are ER positive and Her2/neu negative may be treated with hormonal therapy alone, and may not need chemotherapy. The Oncotype 21 gene assay is a molecular test that is often performed for stage 1 ER positive Her2/neu negative cancers. The test has been a valuable tool to help determine whether the addition of chemotherapy to hormonal therapy would be of benefit for a particular individual.
New answer by EllenChuangMD (Physician - Oncology - Hematology/Oncology (Verified))
1
Answer |
10 months ago
The following are recommendations from the American Society for Clinical Oncology:
All patients should have a careful history and physical examination performed by a physician experienced in the surveillance of cancer patients and in breast examination. Examinations should be performed every 3 to 6 months for the first 3 years, every 6 to 12 months for years 4 and 5, and annually thereafter. For those who have undergone breast-conserving surgery, a post-treatment mammogram should be obtained 1 year after the initial mammogram and at least 6 months after completion of radiation therapy. Thereafter, unless otherwise indicated, a yearly mammographic evaluation should be performed. Patients at high risk for familial breast cancer syndromes should be referred for genetic counseling. The use of CBCs, chemistry panels, bone scans, chest radiographs, liver ultrasounds, CT scans, PET scanning, magnetic resonance imaging, or tumor markers (carcinoembryonic antigen, CA 15-3, and CA 27.29) is not recommended for routine breast cancer follow-up in an otherwise asymptomatic patient with no specific findings on clinical examination.
All patients should have a careful history and physical examination performed by a physician experienced in the surveillance of cancer patients and in breast examination. Examinations should be performed every 3 to 6 months for the first 3 years, every 6 to 12 months for years 4 and 5, and annually thereafter. For those who have undergone breast-conserving surgery, a post-treatment mammogram should be obtained 1 year after the initial mammogram and at least 6 months after completion of radiation therapy. Thereafter, unless otherwise indicated, a yearly mammographic evaluation should be performed. Patients at high risk for familial breast cancer syndromes should be referred for genetic counseling. The use of CBCs, chemistry panels, bone scans, chest radiographs, liver ultrasounds, CT scans, PET scanning, magnetic resonance imaging, or tumor markers (carcinoembryonic antigen, CA 15-3, and CA 27.29) is not recommended for routine breast cancer follow-up in an otherwise asymptomatic patient with no specific findings on clinical examination.
New answer by EllenChuangMD (Physician - Oncology - Hematology/Oncology (Verified))
2
Answers |
10 months ago
Chemotherapy starts to work as soon as it gets inside cancer cells. Chemotherapy drug levels peak in the blood soon after the infusion, are taken up by tissues and cells, and then fall to undetectable levels as the drug is metabolized and eliminated from the body. The drug will have been completely eliminated from your body by the time the next infusion is given; this insures that drug levels do not build up with each infusion, otherwise there may be too much toxicity. Because the chemotherapy is not in the blood for very long, and not all cancer cells may take up the chemotherapy or be sensitive to the chemotherapy at all times, chemotherapy has to be given for multiple cycles.
Hormonal therapies such as aromatase inhibitors and faslodex, can take a few months to build up in the body, so they can take longer to start working.
Hormonal therapies such as aromatase inhibitors and faslodex, can take a few months to build up in the body, so they can take longer to start working.
New answer by EllenChuangMD (Physician - Oncology - Hematology/Oncology (Verified))
2
Answers |
10 months ago
On the first visit the oncologist will make a recommendation for adjuvant therapy. This recommendation is based on a review of the pathology report, together with considerations such as a patient’s age and overall medical health. During the first visit the oncologist usually discusses the expected benefits of the therapy (e.g. chemotherapy, hormonal therapy), as well as the potential side effects. To prepare for the visit, a patient should be aware of past and current medical problems, and have a list of current medications. It is also good idea to write down any questions you may want to ask the oncologist.
New answer by EllenChuangMD (Physician - Oncology - Hematology/Oncology (Verified))
1
Answer |
10 months ago
A breast cancer patient may see the oncologist at any time after her diagnosis, but most commonly the meeting occurs after the patient’s surgery, when the pathology report is available. Alternatively, in cases where the surgeon thinks the patient may benefit from preoperative chemotherapy, the surgeon will refer the patient to the medical oncologist prior to the definitive surgery. Finally some patients may seek out a medical oncologist earlier in the process in order to discuss a “big picture” view of her breast cancer treatment.
New answer by EllenChuangMD (Physician - Oncology - Hematology/Oncology (Verified))
1
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10 months ago
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