The sole outpatient oncology department in the Adirondacks has an interesting history – and an even more interesting team.
When Adirondack Medical Center (then the General Hospital of Saranac Lake) established its oncology clinic in June 1983, a physician would fly in from Albany Medical Center once a month to work with one of the hospital’s registered nurses – Mia Ross (now a nurse practitioner) who is retired but continues to work per-diem in the clinic today.
Ross began her career at the hospital in 1969, at the age of 18, as a clerk and then as a certified nurse’s aide. She knew she wanted to become a nurse but wasn’t sure how to make that happen with two young children at home. Through a Regent’s External Degree Program and the mentorship of the hospital nurses, Ross earned her registered nursing degree in 1978 and her bachelor of nursing in 1988.
After years of working as a medical/surgical nurse, Ross transferred to the ambulatory surgery unit. During this same time, Dr. John Ruckdeschel – an oncologist at Albany Medical Center – befriended a Tri-Lakes woman who was making the three-hour trip to his hospital for breast cancer treatments. Recognizing the hardship, Dr. Ruckdeschel contacted a local doctor at the hospital in Saranac Lake who agreed to administer the woman’s treatments with his orders.
As Ross put it, “A small act of kindness would eventually have an enormous effect on the future of the hospital, our cancer patients, physicians, and nurses.”
As word got out, more patients wanted to receive their cancer care closer to home and once-a-month oncology visits were added to the ambulatory surgery unit. By default, Ross became an oncology nurse.
“People say, ‘You work in oncology … that must be so depressing,’ and I tell them ‘No, it’s the best kept secret in the hospital. You get to see the same patients all the time. You get to know them and what they need. They know us. They develop a lot of trust in us.”
With the need continuing to increase, oncologists upped their visits from monthly to bi-weekly to weekly – and then, in 1983, oncology became a department of its own. With physicians’ orders and the hospital pharmacy mixing chemotherapy treatments, Ross was able to administer treatments even when the oncologist wasn’t onsite.
“As we all became more proficient in cancer care, we grew,” she said. “Our little ‘clinic in the woods’ became well known. I was always impressed and proud whenever I went to oncology conferences and saw that we were providing the same level of care in chemo treatments as the major centers.”
In 1998, Ross earned a master’s degree as a nurse practitioner.
“In my opinion, it’s the highest quality of care a patient can have,” she said. “We have the luxury of time to spend with our patients. Since they see the same providers every visit, they develop trust and openness with us. They are treated holistically as a person, and they recognize it. Our unit believes in integrative treatment. We offer the patients music, massage, Reiki, essential oils, and fit them with wigs or a prosthesis when they need one. And most importantly, we listen very attentively. Administering chemo is a small part of caring for the patient.”
At Adirondack Medical Center, a new patient can now be evaluated, diagnosed, and start receiving treatment all in the same day, when necessary.
“When a cancer patient comments, ‘I love coming in for my treatment,’ you know it’s good,” she said.
When Ross was looking toward retirement, she sought out Sara Ames to take over as the oncology nurse practitioner.
“(Ross) was actually a nurse’s aide on the maternity floor when I was born, so we joke that she whispered in my ear when I was born, ‘You’re going to be a nurse practitioner one day,’” Ames said.
After earning her nursing degree from New York University, Ames met Ross in the early 2000s while interning in the oncology clinic at AMC. She worked as a nurse at Memorial Sloan Kettering cancer center in New York City for several years, moving home to Saranac Lake in 2005. Ames was working as a nurse in the intensive care unit at AMC when Ross asked her if she’d be interested in phasing in as the new oncology NP. That meant Ames would need to go back to school for her NP, which she did, and then began working as an oncology nurse in 2007 with Ross and Dr. David Mastrianni as her mentors. Ames also did her oncology clinical rotation with Dr. Mastrianni’s practice in Saratoga Springs.
Ames earned a master’s degree and became a nurse practitioner in 2010, allowing Ross to retire in 2015, though she continues to work per diem.
Being able to provide cancer treatment at home in the Tri-Lakes is vital to the health of the community, Ames said.
“Given how demanding cancer treatment is, to travel when you have a cancer diagnosis and are undergoing treatment would be extremely difficult,” she said. “It can be a daily or weekly commitment. Having these community cancer centers is an enormous asset to the region.”
AMC’s oncology team utilizes the larger cancer centers to help coordinate consultations, but they can carry out treatment plans close to home.
“Nobody wants a cancer diagnosis, but they’re always amazed that we even exist because they didn’t know,” she said. “The attention we are able to provide patients is pretty unique.”
Ames said the nature of cancer care requires a whole team and access to care needs to be easy. AMC’s program helps make that possible with immunotherapy, radiology, pathology, palliative care, genetic counseling, and a dedicated oncology social worker – Kristina Hybicki.
While many oncologists and nurses have helped build AMC’s oncology department into what it is today, Ames credits her mentors for its inception.
“The two of them [Ross and Dr. Mastrianni] really built the oncology program here,” Ames said.
In 2022, Dr. Mastrianni returned to AMC’s oncology department upon Dr. Eric Pillemer’s retirement. He had previously served as an oncologist here for nearly 15 years – from 1994 to 2008, while working at Albany Medical Center and in private practice in Saratoga Springs.
“One of the real challenges with a program like this is finding a generalist – and Dr. Pillemer is a generalist,” Dr. Mastrianni said. “A lot of doctors in oncology only specialize in one cancer. He was also really good at making connections with physicians who were specialists.”
“Dr. Pillemer really enhanced the quality of this program,” Ames said. “And with Dr. Mastrianni returning, I get the sense that this is a full circle effect, and he will be able to help us adapt for the future of rural cancer care. He understands rural cancer care, which is much different than being in an urban setting. The coordination of care is a huge part of what we do.”
“It’s so unbelievable that Dr. Mastrianni came back,” Ross said. “We always missed him when he left. All the doctors have been great, but he is really special. He has a way of communicating with patients, and he is very calm and gentle.”
Dr. Mastrianni credits oncology’s success to his team being so invested in their patients.
“They are what makes this program special,” he said. “They are remarkable. They are the glue.”