Stefan Balan, MD is the director of Oncology Services at Jersey City Medical Center. He is board certified in medical oncology and internal medicine. We sat down with Dr. Balan for a one-on-one discussion about his background, why he chose to practice at JCMC and what he sees for the future of oncology services at the hospital. 

Q: You have an interesting background. You did a medical fellowship in hematology and oncology at New York University, then you left the big city for Vermont and quickly found yourself in academia at an Ivy League medical school. How has your journey influenced your practice?
 
A: While I was a Fellow at NYU, we practiced at the VA Hospital in Manhattan, Bellevue and Tisch Hospital, which offers a very diverse patient population and medical systems. It helped me see many kinds of pathologies in different settings. It offered me a comprehensive exposure. That being said, it did not prepare me for a community-based type of practice. 

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My first job after the NYU Fellowship was with a VA hospital in Vermont, which is affiliated with Dartmouth, where I had my first faculty appointment. That’s where I had exposure to a community practice in a rural and academic environment. I became involved with the gastrointestinal (GI) oncology group at Dartmouth and joined the clinical cancer research committee at Dartmouth, where I was a member for seven years.

I had a privileged introduction to academia. My supervisor at that time, dean at Dartmouth Medical School, gave me the opportunity to teach his course, and introduced me around the area and he eventually made me the chief of the VA program. That was my first dabbling into management and leadership. I made all the classical mistakes a junior manager makes. The job of conductor is different than that of a lead violin.  As physicians we’re trained how to treat patients but not how to manage a service. Fortunately, later on I attended leadership training at Dartmouth and Harvard.

Q: In 2013, you moved back to New York, met your wife, and your daughter was born in April 2015. What made you decide to join the staff of JCMC in February 2020?

A: Over the years I built several hematology and oncology programs for Dartmouth, NYU, and, most recently, Mt. Sinai. The nice thing about JCMC is that the Chief Operating Officer, the Chief Medical Officer, the Chief of Medicine and I all started at the hospital around the same time. It is a very exciting time when you have fresh blood with academic backgrounds wanting to build things together. It's a unique synergy. 

Q: What is the significance of having Rutgers Cancer Institute of New Jersey partner with JCMC. (Rutgers Cancer Institute is only 1 of 52 in the nation designated as a National Cancer Institute- Comprehensive Cancer Center and the only one in New Jersey.)

A: Having the NCI designation means that you are at the forefront of cancer research, treatment and education. . It means that you have faculty appointments and you have a serious level of academia. It means that you are developing and translating scientific knowledge from promising laboratory discoveries into new treatments for cancer patients.  It means that you are teaching, and that you're the best at the subject in the particular area. For example, the medical director of our service line, Dr. Andrew Evens, is a world specialist in lymphomas.  Sometimes people travel from other countries to come to JCMC. Right now, I am treating a 34-year-old man with a rare cancer and I have direct access to the specialist in that particular niche. 

Another important factor is that being a NCI-designated Comprehensive Cancer Center means that we’re conducting original research. We’re not only applying what other people established as a standard of care, but we are creating tomorrow’s standard of care. I'm happy to say that in spite of this challenging COVID-19 environment, we started our first clinical trial at JCMC a week ago and by the end of the year, we plan to open three more. 

We offer the kind of care that should keep a patient's from crossing the river to go to Manhattan. We’re offering the kind of services that New Jersey has not had before. I'll give another example: we hired Dr. Jason Maggi, who's a surgical oncologist specializing in pancreatic cancer, biliary cancer and hepatic cancer. These are very specialized areas and the outcome of the patient can depend on if you're being operated on by a general surgeon versus a specialized surgeon like Dr. Maggi. Now, you don't have to travel outside Jersey City to get this kind of specialized care.

Q: What would be most surprising about Jersey City Medical Center if a patient had not been here in a few years? 

A: I think people would be surprised to see that you are able to get specialized care here in Hudson County that previously you were only able to receive in Manhattan. We are fully invested in teaching and in research, in bringing up the next generation of physicians and also in advancing science. 

In March, Jersey City Medical Center will open our enhanced infusion center that will offer multidisciplinary groups and specialties. Under one roof, a breast cancer patient will see the breast surgeon and the medical oncologist specialized in breast, and receive the necessary support services. 

The new site will have a multidisciplinary gastroenterology subspecialty group. We will also have a thoracic multidisciplinary group and a gynecologic oncology group. JCMC will offer the kind of specialized, comprehensive care that no one else in Jersey City offers. We're definitely providing the best that there is in in Hudson County. 

Q: How did the Cancer Program handle COVID-19?

I think the most important thing we did was to stay open. JCMC stood out in the community and we even received patients from other centers that were closing. 

Secondly, we got smart about treating COVID-19 in cancer patients. For example, we developed guidelines on how to treat COVID by specialty, by organ. For critical patients, for example, with the help of Rutgers Cancer Institute, we developed guidelines for anticoagulation for intubated, severely ill COVID-19 patients in ICU.

The guidelines are more than a hundred pages and they were singled out throughout the RWJBarnabas Health system as an example of how to develop local policies, procedures and guidelines for how to treat COVID-19 patients. 

We also were among the first to offer virtual visits. We used various platforms, whatever the patient was comfortable with. In the case of in-person visits, we checked symptoms and body temperature of each patient and socially distanced them in the waiting room. We also spaced out the appointments so patients didn’t overlap.

Q: What is the importance of the oncology nurse navigator?

A: It's not uncommon for a patient to have a primary care physician in one place, the oncologist in another, the surgeon in another and the radiation oncologist in another place. For patients to be able to keep track of the different electronic medical records to communicate, it is essential to have a nurse navigator. We have two exceptional nurse navigators: Katie Fromm and Francine Raphael, who follow the patient from point A to point Z. They make sure that the appointments are being scheduled, the patient receives information on time, and that the medical records are being emailed, faxed, scanned, etc. They are the silent heroes of our service. I worked in many health systems, some had nurse navigators, some did not but this is by far the best system I've seen.

Q: Where do you see the oncology program going in in the next five years? 

A: In March, Jersey City Medical Center will open the new infusion center and we will have the multidisciplinary groups under one roof. We'll have even more clinical trials. We will maintain a very robust teaching program. We will have a physical cancer center, which means an entire building will be dedicated to cancer care where you have medical oncology, surgical oncology, and radiation oncology. Everyone will be a subspecialist in his or her own domain. It will not even be as far as five years. It will be sooner. It's not a dream. It's a reality in the making.