Associate Specialist Opening at the NYECC

Join Dr. Finger and his team at the New York Eye Cancer Center (NYECC)! Currently, there is an opening for a fellowship trained associate specialist to join Dr. Finger in the practice of Ocular Tumor, Orbital Disease, and Ophthalmic Radiation Therapy.

The ideal candidate should be able to treat patients with ocular tumors of the eye, lids and orbit. They must have completed at least 1-year subspecialty training in ophthalmic oncology. Candidates with additional retinal or ocular plastic surgery will be preferred. The candidate must be licensed to practice in the United States of America, American Board of Ophthalmology certified and be willing to start on or before July 1st, 2020. 

Working alongside Dr. Finger rewards one with effective mentorship and fresh perspectives on complex eye cancer cases.  The NYECC is a world-class facility for the diagnosis and treatment of eye cancer. Founded in 1995, Dr. Finger has treated many thousands of patients. Dr. Finger and his staff at NYECC work closely with patients and referring doctors to provide advanced treatment in a responsive, caring environment. 

Dr. Finger will be meeting candidates at the upcoming, 2019 American Academy of Ophthalmology Annual Meeting in San Francisco. To arrange an interview, send a cover letter, CV and two letters of recommendation to pfinger@eyecancer.com.

 

ABOUT DR. FINGER: 

Dr. Finger is certified by the American Board of Ophthalmology and is a Fellow of both the American College of Surgeons and the American Academy of Ophthalmology. He is fellowship trained in ocular tumor, orbital disease, and ophthalmic radiation therapy. He is considered a world leader and specialist in radiation treatment of the eye. 

He has researched and developed new methods of diagnosis used around the world. These include new applications of high-frequency anterior segment ultrasound (“ultrasonic biomicroscopy,” or UBM), OCT (Optical Coherence Tomography), digital imaging. He believes in small incision surgery and therefore invented the “Finger Iridectomy Technique” biopsy for iris and ciliary body tumors and FACT micro incision orbitotomy technique for orbital tumors. 

In terms of treatment, Dr. Finger is widely known to invent palladium-103 plaque radiation therapy for choroidal melanoma which has resulted in improved outcomes compared to other plaques and proton beam (See Dr. Fingers’ Results Page). He is also known for discovering anti-VEGF therapy for radiation retinopathy and radiation optic neuropathy.

At The New York Eye Cancer Center, we want patients to understand their diagnosis, alternatives of treatment and to see their current status. This is why Dr. Finger placed 4K 55″ inch HD displays in each examination room. Using photographs, OCTs, ultrasounds and angiograms, Dr. Finger and his staff can teach patients everything they need to know about their eye tumor.

Dr. Finger is looking for a motivated, compassionate and dedicated physician to join his practice. If you are striving for excellence, join us!

Practice Locations:

The New York Eye Cancer Center

115 East 61st Street – Suite 5B

New York, NY 10065

+1 212-832-8170

Teaching Locations:

 

 

Eye Cancer Cluster in Raleigh, North Carolina

A recent article was just published in an online magazine called “Southerly” about a possible correlation between cancer incidence in Huntersville, North Carolina and industrial pollution. This relationship was scrutinized upon learning that several high school kids in a school by Lake Norman were diagnosed with ocular cancer. This prompted the residents to look for a correlation, and their current findings were found to be interesting. So far, there have been 20 cases of ocular melanoma in Huntersville within a population of 56 thousand people. Usually, ocular melanoma is found in 6 per million people. 

Soon, suspicions rose that the industrial pollution below the town could be related to energy development. However, finding a definitive cause for the incidence of cancer across many younger individuals proved more than difficult. Nevertheless, initiatives to fund research started outpouring from citizens. Doctors from Columbia University started to run tests on tumors of patients while the Huntersville Mayor has asked the town for help in funding more research. This research would show whether coal ash or heavy metals could be tied to these cancer clusters.          

In fact, there are many sites around North Carolina that are Superfund sites or industrial facilities, which are required by federal and state governments to test for pollutants. However, there are currently no standards for this testing when communities around the sites begin to develop schools, commercial buildings, and eventually neighborhoods. 

Nonetheless, it is clear that this town must discover answers to this heartbreaking incidence among high school children.

AJCC Celebrates 60th Anniversary

This year, 2019, is the 60th anniversary of the founding of the American Joint Committee on Cancer, the AJCC. This committee was founded in 1959 by leaders of the American College of Surgeons in order to support patients by creating a staging system for cancer. The founders had the foresight as well as the influence to develop a cancer classification system based on the tumor, nodal status, and metastatic findings (TNM). What is interesting is that these features were first used by a French surgeon in the 1940s to classify breast cancer! They later became the standard international language for the staging system locked in place today by the AJCC for the needs of US physicians and hospitals. 

As the decades went by, the AJCC collaborated with the Union for International Cancer Control (UICC) to create a standardized cancer language for the world. Through the hard work of numerous physicians dedicated to improving cancer mortality, a worldwide TNM system was achieved in 1987. Since 1997, AJCC has published periodic improvements to the TNM system. 

In 2005, our very own Dr. Finger was selected to join the American Joint Committee on Cancer: Section on Ophthalmic Oncology! Then, 4 years later he was elected Chair, for Ophthalmic Oncology. Dr. Finger has participated in the AJCC for over 14 years. His work with the AJCC includes developing the AJCC Ophthalmic Oncology Task Force of over 50 eye cancer specialists from 13 countries on 6 continents. Dr. Finger put together specialty committees to develop a useful classifications to standardize how doctors describe their patients tumors and patterns of metastatic disease. For example, in 2014 the American Brachytherapy Society’s Ophthalmic Oncology Task Force adopted the AJCC staging rules for intraocular melanoma! 

Dr. Fingers’ hard work and dedication is further epitomized by his creation of The Eye Cancer Foundation, a community that aims to provide support to patients with ocular cancers, promote the education of the diagnosis and treatment of eye cancers, and train eye cancer specialists around the world. Numerous physicians from underserved and unserved countries have been trained under the sponsorship of the ECF and gone on to use their newfound knowledge to benefit patients in their home countries. 

The ECF will never stop saving lives and saving sight.

Click here to make a donation to the foundation and save the life of a child suffering from retinoblastoma!

Annual Ophthalmic Oncology Lectureship

At the 41st Annual Tulane Eye Alumni Day at the Renaissance New Orleans Pere Marquette Hotel, Dr. Finger lectured about how and why his important innovations came to life. In the lecture, he discusses his early work on plaque microwave hyperthermia and TRT for intraocular tumors, pd-103 plaque radiation therapy, the slotted plaque, the amniotic membrane buffer technique, epicorneal plaques, and anti-VEGF therapy for radiation maculopathy.

As Dr. Finger presented these innovations in chronological order, thanking his mentors along the way, he provides data to support the success of these creations. As an ophthalmic oncologist and specialist in ophthalmic radiation therapy, Dr. Finger’s inventions have not only paved way for safer radiation therapy practice and reduced vision loss in patients suffering from eye cancer, but also significantly increased patient comfort.

Select Innovations Discussed:

  • Pd-103 Plaque Radiation Therapy:
      • Ophthalmic plaque radiation therapy is used as treatment for choroidal melanoma. The first plaques incorporated radioactive material Cobalt-60 and later Ruthenium-106 and Iodine-125. However, palladium-103 became available for the first time treatment of intraocular tumors.
      • Pd-103 had more advantages than Iodine-125. For example, while in both cases the eye tumor is destroyed, palladium-103 radiation is absorbed faster than iodine-125. This difference relatively spares and thus preserves critical normal intraocular tissues used for seeing and preserving the treated eye.
  • Amniotic Membrane Buffer Technique:
      • By placing an amniotic membrane on top of the cornea and below the gold plaque during treatment of iris melanoma, Dr. Finger was typically able to reduce patient pain from 9/10 to 2/10. In addition, the cornea had less surgical irritation. All this was done for patient care while effectively curing the cancer.
  • Slotted Radiation Plaques: Peripapillary. Juxtapapillary, Circumpapillary melanomas:
    • Only Fingers’ Slotted Plaques will allow melanomas near, touching, or covering the optic nerve to be completely irradiated. The slotted plaque was created to overcomes orbital optic nerve obstruction which prevents round and notched plaques from encircling these melanomas. That is why, Dr. Finger created a slot in the plaque big enough to accommodate the optic nerve sheath (typically 6mm wide). Sliding the plaque posterior to the optic nerve obstruction normalizes plaque position to completely surround the tumor.
  • Anti-VEGF suppresses radiation vasculopathy(retinopathy and optic neuropathy):
    • Originally described by Dr. Finger. Intraocular anti-VEGF injections have allowed patients to retain their vision after radiation treatment causes retinal and optic nerve side effects. In a study done by Dr. Finger, it was found that, after a decade, 80% of patients treated with anti-VEGF therapy were within 2 lines of pre-irradiation visual acuity.

“Best” Ophthalmologists in New York

Dr. Paul Finger of the New York Eye Cancer Center is consistently rated among the best doctors in the greater New York City region.

As of 2023, Dr. Finger has appeared on the Castle Connolly list of “Top Doctors” in the New York area for the 16th time since 2005. Castle Connolly Medical Ltd., a New York City research and information company, creates this list yearly by using an online database of more than 53,000 Castle Connolly Top Doctors® across the US. Of these 53,000 doctors, 7,400 are located in the New York area.  You can view Dr. Finger’s profile page on the Castle Connolly website here.

New York Magazine annually publishes their own list of “Best Doctors,” and as of 2023 our very own Dr. Paul Finger has consistently made their list over the past 18 years.  Castle Connolly gives New York Magazine a shortened version of this list, which it then uses to create its list of Best Doctors in New York. In spite of this select group limited to 1,390 doctors, Dr. Finger has maintained on the noble list as one of the best ophthalmologists for eight years running (as of 2023) Read more on the New York Magazine website about how they select doctors for the list.

Regarding the decision method, Castle Connolly interestingly conducts a peer-review survey. The firm believes that physicians and medical professionals are in the best position to pass judgement onto other physicians. These participating physicians are asked to nominate doctors who they believe are the “best” in their specialties, taking into consideration not only professional excellence and reputation, but also personal patient interaction. They choose the best well-rounded doctors who transcend required knowledge of their practice and instill trust in and show empathy to their patients. Doctors are not permitted to nominate themselves and all nominations are confidential. These licensed doctors vote online (castleconnolly.com/nominations) for the doctors they find to be exceedingly exceptional.

Other prestigious recognition includes his selection for America’s Most Honored Professionals 2019 – Top 1%, America’s Top Doctors for Cancer 2019, and New York Metro Area’s Top Doctors 2019. These same awards are given every year and Dr. Finger has repeatedly been given the “Best Doctor” award for each. This consistency points to the dedication and ambition that Dr. Finger possesses, driven daily by his desire to help – to cure sight and to save lives.

A more than well-deserved title for our exceedingly outstanding physician!

 

Surgical Ophthalmic Oncology: A Collaborative Open Access Surgical Textbook

In 2014, the First Eye Cancer Working Day was hosted by The Curie Institute in Paris, France. There, we decided to develop a Collaborative Open Access Surgical Textbook (COAST) aimed at offering guidance and international outreach for ophthalmologists in countries without eye cancer specialists.

The resultant 5-year effort was spearheaded by Drs. Sonal Chaugule, Santosh Honavar and Paul T Finger. Supported by The Eye Cancer Foundation (http://eyecancercure.com) and published by Springer Nature; The Surgical Ophthalmic Oncology: A Collaborative Open Access Reference, should be described as an easy-to-use, open-access surgical textbook supported by surgical videos. It provides surgical guidance to all the general ophthalmologists currently treating eye cancer patients in unserved and underserved countries. Surgical Ophthalmic Oncology

In addition, this textbook can be used for surgeons, fellows, and trainees around the world who deal with these diseases in their patients. For these physicians in these areas who lack the advanced technology and instrumentation to diagnose and cure diseases, this comprehensive textbook meticulously covers various surgical techniques and provides videos needed to manage different eye cancers.

 

This text includes chapters that discuss eyelid tumors, conjunctival and corneal tumors, intraocular tumors, enucleation and exenteration, ophthalmic radiotherapy, and ocular pathology. Throughout the chapters, one will find 84 color pictures, 4 black and white illustrations, and relevant high-quality videos. For example, these videos allow the reader to review specific surgical steps in real-time, allowing the reader to benefit from the pooled knowledge of three renowned ophthalmic oncologists! These chapters also address diagnostic indications as well as pre and post operative concerns, truly serving these physicians well as they may use this valuable learning tool in providing the best, most efficient patient care that they possibly can. Lastly, this book ends with a section on ophthalmic pathology, where readers can learn the guidelines for specimen collection and transport as well as the interpretation of the pathology report.

 

A valuable and unique resource for ophthalmologists working in underserved areas to provide the best quality care for their patients who suffer from eye cancers.

Order online here!

International Multicenter Cooperative Study Supported by The Eye Cancer Foundation

 

The American Joint Committee on Cancer (AJCC) Cancer Staging Manual compiles all currently available knowledge on cancer staging at various anatomic sites. In 2016, they released the 8th edition, conjunctival melanoma staging system which features 12 new staging systems, a wide range of new staging definitions, and an emphasis on the personalized-medicine approach. This staging system is used and respected by medical, ophthalmic, and radiation oncologists because it standardizes data reporting, prognosis, and selection of the best treatment for conjunctival melanoma. Nonetheless, a collaborative multicenter international registry was organized by our very own Dr. Finger to evaluate the accuracy of such a staging system. In addition to the 19 co-authors listed, Dr. Puneet Jain led the analysis, writing and collaborative revision of this study. He completed an Eye Cancer Foundation-sponsored Fellowship. ECF fellowships are known to foster ophthalmic oncology training, curiosity, learning and ability to perform research!

This study, performs the first ever international multicenter study to evaluate the validity of the eighth edition of the American Joint Committee on Cancer (AJCC) Cancer Staging Manual in estimating mortality rates of metastasis from conjunctival melanoma. The 8th edition AJCC ophthalmic oncology staging systems were written by more than 50 eye cancer specialists from 18 countries.

In this study, co-investigators utilized internet-based data sharing, reviewing 288 conjunctival melanoma patient medical histories. This study included data from 10 ophthalmic oncology centers in 9 countries over 4 continents — 2 in the United States and 1 in Canada, Colombia, Argentina, France, Netherlands, United Kingdom, Sweden, and Jordan. Clinical (cT) and pathologic (pT) staging were performed according to the staging system for conjunctival melanoma in the 8th edition of the AJCC Cancer Staging Manual.

This study was able to find new insights by conducting an analysis of large numbers of rare tumors. The findings corroborate the validity of the 8th edition of the AJCC Cancer Staging Manual. However, it also found several independent factors that are associated with increased mortality, such as tumor thickness, tumor invasion, and ulceration. Ultimately, this study supported the continued use of conjunctival melanoma staging system as published in the 8th edition of the AJCC Cancer Staging Manual.

Eye Cancer Care in Ethiopia

The Eye Cancer Foundation’s “2020 Campaign” claims another country, Ethiopia! We supported intensive training of a local ophthalmologist on advancements in retinoblastoma research, treatment, and diagnosis. Our most recent ECF grant recipient, Dr. Abu Amare, an ophthalmologist in Ethiopia, just completed a  6-month retinoblastoma fellowship at the Rasoole-E-Akram Hospital of The Iranian University of Medical Sciences in Tehran, Iran.

Dr. Amare notes of his experience, “The fellowship program made a big difference in my skill and knowledge in diagnosing retinoblastoma…” He also is grateful for the opportunity to have been able to shadow physicians in different disciplines, such as oculoplastic surgery, learning about enucleation and evisceration — he also observed interventional neuroradiology for intra-arterial chemotherapy and surgeons performing plaque radiotherapy. Dr. Amare was able to connect with his mentors, as they were polite and courteous and took their time to truly teach  him techniques, such as RetCam photography, that he called “profound to the maximum” and with “no limitations.” Further, he was exposed to ophthalmic pathology, including tissue processing and examinations under light microscopy for a variety of eye tumors. These valuable skills for an ophthalmologist specializing in retinoblastoma are necessary for its early diagnosis and treatment.

 

With the help of the ECF, Ethiopia has gained a learned and more knowledgeable ophthalmologist who can help in preventing blindness and retinoblastoma-metastasis within the Ethiopian population. The Foundation has given Dr. Amare the tools necessary to organize the first ever eye cancer center in his home country. On his plan to share what he has learned as a fellow, Dr. Amare says that he would “start with organizing the appropriate instruments and equipment to establish a dedicated team…creation of awareness [about retinoblastoma] ranges from policy makers down to different levels, specialties, and supports.” Such comprehensive training through the fellowship program that the ECF provides will save the sight and lives of thousands of people, for generations to come.

 

We will continue to focus on unserved and underserved countries with little to no eye cancer care. The Eye Cancer Foundation will continue to help Dr. Amare organize his ambitious and driven team, and plans to prevent and cure retinoblastoma in Ethiopia.

 

For more information on The Eye Cancer Foundation and its mission, visit www.eyecancercure.com.

 

To donate and help sponsor more specialty training in unserved and underserved countries, go to www.eyecancercure.com/donate.

 

 

A “Biomarker” for Conjunctival Melanoma

The COMS Study

What causes conjunctival melanoma (CoM)? Because of its rarity, much about CoM is unknown. Current medicine has yet to truly pinpoint any underlying genetic factors affecting CoM. In fact, no molecular drivers have been clearly defined in association with metastasis, recurrence prognosis, cell type, or other characteristic factors of CoM. In response to this gap in literature, a large multi-center study was launched. Over a dozen eye cancer centers collaborated in order to determine biomarkers that may indicate risk for metastasis or tumor growth.

With access to a large sample of nearly 100 patients from eight different eye cancer centers around the world, the researchers behind this study sought to clearly define key biomarkers of CoM metastatic risk, and to correlate these biomarkers to clinical features and outcomes. This association of molecular indicator to clinical feature would ultimately help treatment providers identify patients who are at greater risk for metastasis, and help researchers identify possible molecular targets for therapy.

At the conclusion of this study, it was found that in deletion mutations in a gene region called “chr10” (normally consisting of tumor-suppressing genes) significantly correlated with metastasis, lymphatic invasion, and increasing tumor thickness.

This study was the first to characterize chromosomal copy number alterations (CNAs) in such depth and with such a large and well-defined sample. The result is a more clearly-defined biomarker as a CoM risk factor than there has been in previous literature. The next plan of action with this newfound information, however, would be to apply this and other relevant research in order to further develop more effective therapies and accurate prognosis.

 

Click here for the full-text!

 

 

Check out The Eye Cancer Foundation for more information on the latest eye cancer research, charitable accomplishments, and for more information on how to donate and support new research and education!

ECF Research wins Best of IJO Award!

In January of 2018, ECF fellow Dr. Sonal Chaugule, alongside Dr. Paul Finger and Dr. J. Park, published the study “Topical Chemotherapy for Giant Ocular Surface Squamous Neoplasia (OSSN) of the Conjunctiva and Cornea: Is Surgery Really Necessary?” in the Indian Journal of Ophthalmology (IJO). We are pleased to announce that this research has recently been chosen for the Best of IJO Awards!

A feature at the recent International Society for Ophthalmic Oncology (ISOO) 2019 meeting, the 2017 American Academy of Ophthalmology (AAO) meeting, as well as our very own blog and Visionary newsletter, the study showed the surprising efficacy of chemotherapy eye drops. They found that even large squamous cancers of the conjunctiva can be cured with chemotherapy eye drops alone (no surgery). The drops had marvelous results: no evidence of vision-limiting complications, no tumor recurrences, and no patients required additional treatment for their giant OSSN. For all patients in the study, their cancer was cured, proving to researchers that topical chemotherapy drops were not only safe, but also effective as treatment for “giant” OSSN.

Congratulations, Dr. Chaugule!

 

To read the full study, click here.

To help sponsor ECF research and charitable endeavors, click here.

Patient Stories

"Very well treated by Dr. Finger. He explained everything I needed to know about my issue with detail and attention, putting me at ease and giving me confidence to handle this problem for the rest of my life.”
– N.N.

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