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Specialty Care

Holistic Medicine - Integrative Health

Introduction

Holistic Care or Integrative Medicine combines conventional medical treatment, complementary therapies, and lifestyle changes.  It encourages a compassionate, healing relationship between patients and caregivers.  Integrative Medicine views the whole person – mind, body, and spirit.

Conventional medicine is a term that describes health care carried out by licensed medical doctors and by allied health professionals, such as physical therapists, registered nurses, and psychologists.  This type of health care is familiar to most people – it is the routine and established treatments that are carried out everyday in hospitals and clinics in the United States.  Conventional treatments may include prescription medication, x-rays, surgical procedures, physical, and occupational therapy.

Complementary therapies include yoga, massage, acupuncture, herbal therapy, dietary supplements, meditation, hypnosis, chi gung, tai chi, and reiki. Historically, complementary therapies were not part of conventional medicine; however, certain therapies are becoming more common in health care today because knowledge and research about their effectiveness continues to grow. 

Started in 2004, the Program for Integrative Medicine and Health Care Disparities at Boston Medical Center is committed to evidence-based practices. Our multidisciplinary team is composed of highly qualified:

  • Physicians
  • Massage Therapists
  • Acupuncturists
  • Class instructors

Your first appointment will be a time to meet with a provider and discuss your current health and understand any past medical issues, develop a plan with you that incorporates both integrative therapies and conventional medicine, and recommend you for a follow up appointment or refer you to integrative medicine services (massage, yoga, acupuncture, etc.) as needed.  This appointment will be 40 minutes long and will take place in the Family Medicine Clinic on the 5th floor of the Yawkey building.

At Boston Medical Center (BMC), caring for patients is a collaborative, multidisciplinary process. BMC’s Cancer Care Center organizes its services around each patient, bringing together the expertise of diverse specialists to manage care from the first consultation through treatment and follow-up visits. The Cancer Care Center is dedicated to providing treatment that is effective and innovative in curing and controlling cancer, while managing its impact on quality-of-life.

As the primary teaching affiliate of the Boston University School of Medicine, BMC combines personal, patient-focused care with the state-of-the-art-expertise and technological advances of a major teaching hospital. BMC is at the forefront of clinical practice, surgical expertise, and research in oncology.

Patients with kidney cancer, also called renal cell carcinoma (RCC), work with a urologist who takes the lead in the diagnosis, monitoring, and treatment planning of individual patients. Surgery is usually the first treatment for patients with malignant kidney tumors. 

The surgeons at BMC offer state-of-the-art surgical treatment and have extensive experience with using laparoscopic and robotic techniques to operate on kidneys. In fact, they performed some of the earliest such cases in the Boston area. When possible, the surgeons perform a partial nephrectomy, which involves removing only part of the kidney rather than a total radical nephrectomy, in which the entire kidney is removed. 

The BMC team follows the National Cancer Institute and the American Urological Association guidelines for the treatment of renal cell carcinoma. 

What is Kidney Cancer?

Kidney cancer begins in the kidneys. Each of the two kidneys are about the size of an adult fist, bean-shaped and weigh around 150 grams each. One kidney is located at each side of the backbone, just under the rib cage. They are protected from injury by a large padding of fat, the lower ribs, and several muscles.

The kidneys play a major role in maintaining general health and wellbeing. Their purpose is to continuously sort non-recyclable waste from recyclable waste in the body while also cleaning the blood. The kidneys make urine from excess fluid and unwanted chemicals or waste in the blood.

Kidney cancer is caused by the abnormal growth of cells in the kidneys. Renal cell carcinomas (RCCs) make up approximately 90% of kidney cancer cases. Other types of kidney cancers include:

  • Transitional cell carcinoma, or kidney pelvis cancer which begins in the lining of the kidney pelvis
  • Wilms tumor (nephroblastoma), the most common cancer in children 14 and under
  • Renal sarcoma, which is rare, develops in the soft tissue of the kidney

According to the American Cancer Society, kidney is the ninth most common cancer in the United States, accounting for approximately 3.7% of new cancer cases in 2016. Among men, the kidneys and renal pelvis (combined) is one of the top 10 cancer sites, and the seventh most common cancer.

Causes of Kidney Cancers

There are several risk factors of kidney cancer, including gender, age, race, and lifestyle choices. Men are nearly twice as likely to develop RCC as women. Kidney cancer is typically found in people age 50-75, with the average age of diagnosis being 64. The risk of developing the disease is slightly higher for African Americans and American Indians/Alaska Natives than for Caucasians.

Other risk factors include:

  • Smoking
  • Obesity
  • Exposure to certain substances in the workplace
  • High blood pressure
  • Certain genetic and hereditary conditions (such as von Hippel-Lindau disease, hereditary papillary renal cell carcinoma, and others)
  • Family history of the disease
  • Advanced kidney disease

Symptoms of Kidney Cancer

Early kidney cancers do not usually cause any signs or symptoms, but larger ones may. Some possible signs and symptoms of kidney cancer include:

  • Stomach pain
  • Lower back pain on one side
  • Blood in the urine
  • Loss of appetite

These symptoms, however, can be caused by other benign diseases.

Diagnosis

Because kidney cancer is usually asymptomatic, the tumor is usually found when a patient undergoes a medical test for another reason.  Still, a doctor may order the following tests to confirm the diagnosis.

Computed Tomography (CT) Scan

CT scans use x-ray equipment and computer processing to produce 2-dimensional images of the body. The patient lies on a table and passes through a machine that looks like a large, squared-off donut. Doctors order CT scans when they want to see a two-dimensional image of the body to look for tumors and examine lymph nodes and bone abnormalities. If contrast dye is used to improve the computer image, the patient may need to avoid eating or drinking for 4 to 6 hours before the test. Patients should tell their provider before the test if they have any allergies or kidney problems.

MRI Scan

An MRI is a non-invasive diagnostic imaging that doesn't use ionizing radiation. It is painless and a harmless way of looking inside the body without using X-rays. Instead it uses a large magnet and computer to scan the body. This provides the doctor with information not available from other scans.

Staging

Staging is the process of determining how extensive the cancer is. It is an important part of diagnosis because the stage determines the most appropriate course of treatment options. The stages of kidney cancer range from Stage I (the least severe stage) to Stage IV. When patients are confirmed to have kidney cancer, the doctor will discuss the staging.

Stage I The tumor is 7 cm or smaller and is only located in the kidney. It has not spread to the lymph nodes or distant organs.

Stage II The tumor is larger than 7 cm and is only located in the kidney. It has not spread to the lymph nodes or distant organs.

Stage III Either of these conditions:

  • A tumor of any size is located only in the kidney. It has spread to the regional lymph nodes but not to other parts of the body.
  • The tumor has grown into major veins or perinephric tissue and may or may not have spread to regional lymph nodes. It has not spread to other parts of the body.

Stage IV Either of these conditions:

  • The tumor has spread to areas beyond Gerota's fascia—the layer of connective tissue compressing the kidneys and the adrenal glands—and extends into the adrenal gland—small glands located on top of each kidney that produce hormones—on the same side of the body as the tumor, possibly to lymph nodes, but not to other parts of the body.
  • The tumor has spread to any other organ, such as the lungs, bones, or the brain.

Treatment

When a person is diagnosed with kidney cancers, a team of doctors will meet and determine the right treatment plan for that patient.  Typically, the plan includes some combination of the following:

  • Active surveillance
  • Minimally invasive or open surgery
  • Ablative therapies (Radiofrequency ablation, cryotherapy, and other energy based treatments)
  • Immunotherapy
  • Chemotherapy
  • Radiation therapy

Treatments in Terms of Stage:

Stage IA: Usually requires surgery with a partial nephrectomy (generally through robotic or laparoscopic partial nephrectomy) being performed.  Active surveillance with serial imaging is performed in select patients, and radiofrequency ablation is performed for nonsurgical candidates who require treatment.

Stage IB: Partial or radical nephrectomy is generally performed, but whenever possible partial is performed.   

Stage II: Most patients undergo radical nephrectomy, though in select patients partial nephrectomy is performed. 

Stage III: Radical nephrectomy is performed.  In certain patients with renal cell carcinoma with blood clots in the vena cava—a large vein carrying deoxygenated blood into the heart—removal of the tumor and thrombus are performed.

Stage IV, or for recurrence: Patients are treated with immunotherapy and/or chemotherapy, or a combination of surgery and immunotherapy)

It can be difficult for individuals to tell if they are suffering from allergies or have a more serious condition like chronic sinusitis.  At Boston Medical Center, the physicians who care for these conditions work with each patient individually to come up with a diagnosis and a treatment plan. 

Chronic Sinusitis

Chronic rhinosinusitis, or sinusitis, is a common medical condition affecting about 10-15% of people. Symptoms of sinusitis include:

  • headaches
  • facial pain
  • dental pain
  • bad smell in the nose
  • nasal blockage and or nasal drainage
  • fatigue
  • reduced sense of smell

Diagnosing Chronic Sinusitis

To determine if a patient has chronic sinusitis, the doctor will conduct a physical exam and ask about symptoms.  An X-Ray or CT scans will also be done to look inside the sinuses. In addition, the doctor might look inside the patient’s nose with a small camera for signs of disease that can’t be seen from the outside.

Treating of Chronic Sinusitis

Treatment of sinusitis often requires multiple different medications. Depending on what the doctor finds, this may include nasal sprays, antibiotics, steroids, or salt water rinses. Sometimes, severe cases may benefit from surgery to open their sinuses and allow them to drain properly.

Allergic Rhinitis (also known as Hay Fever or Allergies)

Similarly to chronic sinusitis, allergic rhinitis is a common medical condition. It affects about 30% people. Symptoms include:

  • sneezing
  • rashes
  • puffy eyes
  • watery eyes
  • nasal blockage
  • nasal drainage
  • throat clearing
  • voice and swallowing difficulty
  • fatigue
  • decreased sense of smell

Diagnosing Allergic Rhinitis

Allergic rhinitis is diagnosed by a combination of symptoms and examination findings. The doctor may also wish to perform allergy testing with a scratch test or blood draw. 

Treating Allergic Rhinitis

Treatment of allergy is done on a patient to patient basis. This may involve nasal sprays, and allergy medications, methods for avoiding exposure, and allergy shots or allergy drops. Allergy shots and drops involves giving patients small amounts of what they are allergic to and building it up over time until they no longer have symptoms from exposure. 

Locations

BMC Rhinology Clinic
Moakley Building
830 Harrison Avenue, Suite 1400
Boston, MA 02118
617.638.8124

Charles River Medical Practice
930 Commonwealth Avenue 
Boston, MA 02215
617.414.6800

Sickle cell disease (SCD) is a chronic, genetic blood disorder which causes painful attacks (sickle cell crises) that can be difficult for patients to manage. Patients with SCD over their lifetime can have problems which affect practically every part of the body.  SCD changes normal, round red blood cells into ones shaped like crescent or half-moons. Normally, healthy red blood cells carry oxygen through the body. However, people with SCD do not have enough normal cells to carry the right amount of oxygen. This causes the sickled cells to get stuck and block blood vessels, which stops the oxygen from getting through the body and causes a lot of pain. When there is a blockage, the hands, feet, abdomen, back, or chest are affected.

Along with pain, symptoms of SCD can include fatigue, shortness of breath, rapid heart rate, paleness or jaundice, swelling of the hands or feet, and an increased rate of infections. Sometimes, SCD can lead to damage of many organs throughout the body, delayed growth, vision problems, and strokes. 

Diagnosis of Sickle Cell Disease 

Sickle cell disease can be diagnosed by a blood test. Every state requires that all babies, before they leave the hospital, are tested for SCD as part of their newborn screening. 

Treatment of Sickle Cell Disease 

Treatment of young patients usually includes antibiotics from 2 months to 5 years of age to help prevent infections. Children and adults should be seen regularly in the outpatient clinic to assess for symptoms, screen for complications of the disease and promote general health and well-being.  We recommend appropriate immunizations across the lifespan. Many patients living with SCD experience pain on a daily basis and using the right combination of therapies can help to treat this.  Developing a pain management plan with a physician or pain management specialist is encouraged at the center. 

Center of Excellence in Sickle Cell Disease

BMC’s Center of Excellence in Sickle Cell Disease is the largest center of its kind in New England, serving more than 450 patients annually, from newborns to adults. The center’s multidisciplinary team is committed to providing patients across their lifespan with highly personalized care to manage their symptoms associated with the disease so they can live as normal a life as possible.

The SCD team includes physicians and a nurse practitioner from pediatric and adult hematology, adult and pediatric primary care, and other specialties as well as nurses, social workers, case management and a patient navigator to help guide patients through their care. The program focuses on providing consistent care between the Emergency Department, inpatient services, and outpatient clinics.  The program utilizes the pediatric STAR unit and the Infusion Center in the adult Hematology/Oncology clinic for outpatient transfusions and pain management. 

Features of the Center

Locations and Hours

BMC Adult SCD Clinic
Moakley Building
830 Harrison Avenue, Suite 3200
Boston, MA 02120
617.414.6428

Monday to Friday: 8:00a.m. to 4:00p.m.

BMC Pediatric SCD Clinic
Yawkey Center 
Pediatric Specialty Clinics, 5th floor 
850 Harrison Avenue
Boston, MA 02118
617.414.4841
To reach the Pediatric Hematologist on call, phone 617.414.5000 and page #5731. 

Monday to Friday: 8:00a.m. to 4:00p.m.

The Ryan Center for Sports Medicine at Boston University offers a range of comprehensive sports medicine services at one convenient location. The multi-disciplinary team of family medicine physicians trained in sports medicine and orthopedic surgeons, along with rehabilitation staff provide patients with advanced diagnostics and treatment for sports injuries. The scope of services include doctor’s appointments, physical therapy, nutrition, athletic training, and a concussion program.

The doctors at the Ryan Center guide patients through the diagnosis and treatment process of their medical issues – acute, chronic musculoskeletal (MSK) issues and medical issues related to sports participation. The Center offers on-site x-rays and ultrasound to help diagnosis a patient’s condition. Once diagnosed, physicians can design a treatment plan that is patient-specific in order to obtain the best results possible.

The Ryan Center is a unique facility in Boston offering a range of services at one location. Learn more about the Ryan Center for Sports Medicine.

The Department of Obstetrics and Gynecology at Boston Medical Center  is a leader in women’s health. Caretakers contribute to the long-term health and well-being of the women served by consistently providing the highest quality medical care to each and every patient.

BMC’s extraordinary range of support services are available including a full-time medical interpreter staff that provides more than 30 languages on site, 24/7.
 

Alzheimer's disease care at Boston Medical Center is under the auspices of the Boston University Alzheimer's Disease Center established in 1996. We are one of two Alzheimer’s Disease Centers in Massachusetts and one of 31 Centers nationwide, funded by the National Institute on Aging.

We provide a range of clinical services for patients and families affected by Alzheimer's disease and related memory and neurobehavioral problems. Our expert multidisciplinary team of clinicians includes experienced professionals in the fields of neurology, neuropsychology and nursing. We provide care in both outpatient and inpatient settings located throughout eastern Massachusetts.

Researchers at our Center are working to translate research advances into improved diagnosis and care for Alzheimer's disease patients while, at the same time, focusing on the program’s long-term goal—finding a way to cure and possibly prevent Alzheimer's disease.

We invite you to visit the official website for the Alzheimer's Disease Center, hosted by Boston University, for additional information.

We are located in Boston Medical Center's beautiful Shapiro Center in Boston’s historic South End.

We are continually working to improve diagnosis and care for Alzheimer's disease patients as well as finding a cure.

Appointments

Call: 617.638.8456
Fax: 617.638.8465

Boston Medical Center
Department of Neurology

Shapiro Center
7th Floor, Suite 7B
725 Albany Street
Boston, MA 02118

Satellite Office
Boston University Neurology Associates
1221 Main Street
South Weymouth, MA 02190

Call: 617.638.9944
Fax: 781.337.2891

Alzheimer's Disease Clinical & Research Program
72 East Concord Street, B-7800
Boston, MA 02118

Call: 617.638.7100

The Autism Program at BMC is a multi-disciplinary, comprehensive and culturally competent program that is uniquely equipped to meet the complex needs of patients and families.  

Our team of Resource Specialists and Family Navigators offers specialized outreach, training, and advocacy services, forms effective partnerships with schools, collaborates with local organizations, and draws upon a deep knowledge base of social service agencies to facilitate linkages to critical resources.

Patients of BMC represent some of the neediest people in the Greater Boston Area; almost 75% receive government-subsidized insurance such as Medicaid, and a significant portion struggle to make ends meet with incomes well below the poverty level. Seventy percent of all patients are from racial and ethnic minority populations, and 30% do not speak English as a primary language.  

Our Mission

Boston Medical Center’s Autism Program assists and empowers those affected by ASD through direct patient support, provider education and community based trainings in a culturally competent manner by offering high quality and comprehensive care to all, regardless of status or ability to pay.

History

Since 2003, clinicians have provided evaluations and ongoing care for children of all ages when there is a pediatrician concern about autism spectrum disorders (ASD) and related conditions. The Autism Program team at BMC is made up of trained professionals who work alongside Developmental and Behavioral clinicians to provide both exceptional medical care without exception and develop innovative, culturally competent approaches and methodologies to best support BMC’s patient population.

The diagnosis of ASD presents a uniquely complex set of challenges for families and the clinicians responsible for their care. There is no identified single cause, no known cure, nor any one prescribed treatment that can predict optimal outcomes for all children. Families affected by ASD confront a variety of barriers to getting needed services for their children. This includes systemic barriers, such as obtaining diagnostic appointments and securing treatment in a resource-limited economy. Many families seen at BMC are low-income, immigrant families who have the additional challenge of facing cultural, linguistic, educational, or other social barriers. To address this challenge, The Autism Program assists and empowers those affected by ASDs through direct patient support, provider education and community based trainings in a culturally competent manner by offering high quality and comprehensive care to all, regardless of status or ability to pay.

Facts and Figures

The Autism Program…

  • Has supported over 6,000 family referrals since its inception in 2007
  • Conducts annual trainings, workshops, and events for over 150 parents, professionals, and community members
  • Has over 1,100 followers on Facebook, Twitter, and Pinterest with an average of 10 new parent and professional followers each week
  • Curates a robust resource library with over 300 materials translated into multiple languages 
  • Operates a highly successful culturally and linguistically diverse Parent Leadership Network (PLAN) with over 25 parent mentor matches entering its fourth year
  • Runs a unique Teen Mentoring program (TEAM), with 24 participants in its first year
  • Hosts an annual Autism Awareness Day event for families, community members, and hospital staff
  • Has fostered successful partnerships with over 25 community based agencies and programs

Contact

The Autism Program at Boston Medical Center
Department of Developmental and Behavioral Pediatrics

Phone: 617.414.3842
Email: autismprogram@bmc.org            

Mailing Address:

72 East Concord Street
Vose 412
​​​​​​​Boston, MA 02118

Children involved in contact sports like football and soccer run the risk of sustaining a concussion during play, just like those participating in everyday activities like ice skating or riding a bike. When your child suffers a head injury, Boston Medical Center’s Concussion Clinic for Children is here to help.

Time is critical following any type of head trauma. BMC's open-access Concussion Clinic for Children located in the Shapiro Center allows patients to be seen quickly by concussion specialists.

Treating patients from infancy through age 21, the program is overseen by Alcy Torres, MD, named one of Boston’s best pediatric neurologists by Boston Magazine. Dr. Torres can provide non-native English speaking families the opportunity to easily communicate with their physician in Spanish.

In addition to seeing patients at BMC, Dr. Torres also sees patients twice per month at East Boston Neighborhood Health Center, and once per month at the Ryan Center for Sports Medicine. Dr. Torres also sees patients through the Physical and Occupational Therapy department. 

The Concussion Clinic employs a series of diagnostic tests including SCAT3 and ImPACT to determine the severity of a child’s injury and best course of treatment. It is also endorsed by concussion expert, Robert Cantu, MD, who serves as the program's senior adviser.

Pediatric Concussions

Conmocion Cerebral Pediatrico

 

The Nutrition and Weight Management Program is an integral part of the Center for Endocrinology, Diabetes, Nutrition and Weight Management. The Center offers state-of-the-art diagnostic and treatment services for nutritional disorders and weight management for people age 18 and older. The Nutrition and Weight Management team includes physicians, a nurse practitioner specializing in nutrition, and clinical dieticians including bariatric diabetes educators. Every patient receives individualized attention and a nutrition and/or weight loss plan that seeks to minimize risk and maximize results.

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