Expertise, Personalized Care, and Comprehensive Support Close to Home

This article was published in our Cancer Program 2014 Annual Report.

Brenda CaswellWhen someone is given a cancer diagnosis, their world is turned upside down. Suddenly there is a lot of information to absorb, many tests to take, and hard decisions that have to be made quickly—all when people are feeling most vulnerable.

Travelling to receive treatment and follow-up cancer care can be expensive, exhausting, and complicated to organize. At Gifford patients with cancer have treatment options that can relieve these stresses.

Most cancers—especially breast, colon, prostate, and bladder cancers—can be treated here in our community hospital with caregivers that patients know and trust, close to the family and friends who will support them during treatment.

“Our goal is to make sure people know that they can receive the same quality of care offered at larger hospitals close to home, with a support network they know,” said Rebecca O’Berry, vice-president of Surgery and Operations at Gifford. “Battling a cancer diagnosis is hard enough—I’m thankful that we can provide quality cancer care locally and decrease our patient’s travel time during treatment.”

First accredited by the American College of Surgeons Commission on Cancer in 1965 (we received our most recent 3-year accreditation in December of 2014), our cancer program has been delivering quality cancer care to our community for nearly fifty years. Our oncology services include cancer care from an experienced oncologist, hospital specialists and surgeons, and specially certified oncology nurses; lab and diagnostic services; advanced diagnostic services, including stereotactic breast imaging; outpatient chemotherapy; preventive cancer screenings; and a strong palliative care program. Our multidisciplinary approach to each patient’s care includes identifying social service needs as well as appropriate medical expertise.

Experience, expertise, and compassionate care close to home

“With cancer, making the right diagnosis and getting the right treatment is key,” says Dr. Richard Graham, a Gifford urologist who treats prostate, bladder, and renal cancers. “Experience with specific cancers is also important. We have the expertise and technology to diagnose a lot of rare cancers, but we are small enough to see patients as individuals: You are not a number here.”

Graham notes that he saw an increase in patients whose small cancers were treated with cryosurgery and laparoscopic surgery in 2014.

Personalized support for the cancer care each patient chooses

When a patient chooses cancer treatment that is not offered here, our providers make referrals and collaborate with outside oncologists so things go smoothly. Patients have the option to receive post-operative care and chemo treatments close to home.

Brenda Caswell, a Randolph mother of five, regularly comes to Gifford for medical care and annual mammogram screenings. She missed three years of annual visits because of her pregnancy and the birth of her youngest child, and when she resumed her check-in’s her provider insisted that she get a mammogram.

“My provider didn’t let me out of the office without scheduling a mammogram,” Caswell says. “She knew me, knew that my mom had had breast cancer, and knew that regular screening was especially important for me.”

A small tumor was detected, and after a biopsy and two consultations with Dr. Ciccarelli, she decided to have mastectomy and reconstructive breast surgery through a program offered at a larger hospital. Dr. Ciccarelli’s team made referrals and helped her arrange treatment. When her cancer was found to be more invasive than originally thought, she had to plan for chemotherapy after surgery. Then, when post-operative complications required a week of inpatient care right before the holidays, she knew she wanted to be close to home and with her family.

“I was able to be at Gifford, just down the street from my home,” Caswell said. “The doctors were wonderful—they collaborated with the oncologists who were treating me, sharing blood counts and test results. It was a very smooth process.”

Click here to read our full Cancer Program 2014 Annual Report.

Gifford Cancer Program Overview

Gifford's cancer program

This article was published in our Cancer Program 2014 Annual Report.

Gifford cancer committeeEstablished in 1959, Gifford’s Cancer Program is accredited by the American College of Surgeons Commission on Cancer.

A dedicated cancer committee meets regularly to provide leadership for the program, including setting program goals and objectives, driving quality improvements and best outcomes for patients, and coordinating Gifford’s multidisciplinary approach to cancer treatment.

Operating out of our relaxing Ambulatory Care Unit, Gifford’s Oncology Department includes:

  • Cancer care from an experienced oncologist
  • Specially certified oncology nurses
  • Planning options for cancer treatment following a diagnosis
  • Outpatient chemotherapy
  • Treatments for some hematology conditions

The medical center is home to advanced diagnostic technology, including stereotactic breast biopsies; a breast care coordinator providing education and outreach; a patient care navigator; many surgical offerings; data management and quality oversight; and cancer prevention programs, including a “Prevention into Practice” model that works with patients and their health care providers to bring screenings to the forefront.

Click here to read our full Cancer Program 2014 Annual Report.

BRCA Test Can Help Determine Risk for Breast, Ovarian Cancer

By Dr. Ellamarie Russo-DeMara, Gynecologist

Angelina Jolie’s courageous decision to undergo a double mastectomy to reduce her risk of developing hereditary breast cancer has brought to light an important test done regularly, and promoted, at Gifford.

The reason behind Jolie’s decision was a positive BRCA test. BRCA is a test for hereditary breast and ovarian cancers. It is as pain-free as a test gets; all you have to do is spit in a test tube.

In more scientific terms, the test is of your saliva or, buccal DNA, and is done right in the doctor’s office to check for an inherited mutation or alteration in the BRCA 1 or BRCA 2 gene.

While hereditary breast and ovarian cancer account for only 5 percent of these cancers, knowing your BRCA status can help you and your family make informed decisions and choices.

A woman with BRCA 1 or 2 mutations has a markedly elevated risk of developing breast and ovarian cancer, including:

  • Up to a 50 percent risk of developing breast cancer by age 50 (compared to 2 percent in the general population)
  • Up to an 87 percent risk of developing breast cancer by age 70 (compared to 8 percent in the general population)
  • Up to a 64 percent risk of developing a second breast cancer
  • Up to a 44 percent chance of developing ovarian cancer by age 70 (compared to less than 1 percent in the general population)

Knowing whether you have this mutation will enable you to have increased surveillance and/or treatment, which can potentially save your life and help your family members make informed decisions. Management strategies may include earlier breast cancer screening with mammography or MRI, risk reducing surgery such as ovary removal after childbearing is completed, and chemoprevention, such as tamoxifen or birth control pills.

Red flags for hereditary breast and ovarian cancers, include:

  • Breast cancer before age 50
  • Ovarian cancer at any age
  • Male breast cancer at any age
  • Ashkenazi Jewish heritage
  • Relatives of a BRCA carrier

If you or a loved one falls into one of these categories, contact your primary care or gynecologist’s office to inquire about testing.

Dr. Ellamarie Russo-DeMara is a gynecologist at Gifford’s Bethel Health Center and Twin River Health Center in White River Junction. She provides BRCA advice and testing. She is also a breast cancer survivor.

Free women’s health talk addresses menopause, genetic testing for breast and ovarian cancers

Ellamarie Russo-DeMara

Dr. Ellamarie Russo-DeMara

RANDOLPH – Gynecologist and certified menopause practitioner Dr. Ellamarie Russo-DeMara is leading a free women’s health talk on April 10 from 6-7 p.m. in the Porter Community Room at the Montshire Museum of Science in Norwich.

Dr. Russo-DeMara, who provides women’s health care in White River Junction at the Twin River Health Center and at the Bethel Health Center, will address menopause, genetic testing for hereditary breast and ovarian cancers and more.

The talk is free. Participants, however, are encouraged to register by calling the Twin River Health Center at 296-7370 by April 3.

The Twin River and Bethel health centers are part of Gifford Medical Center in Randolph. Dr. Russo-DeMara has been providing women’s care for more than two decades. Learn more online at