Recent breast cancer diagnosis? Advice from breast cancer survivors

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Now what? Once you move beyond your initial reaction to a breast cancer diagnosis, whether it is disbelief, fear, anger or uncertainty, what should you do? We asked three breast cancer survivors for words of wisdom to the recently diagnosed.

1. Bring a trusted friend or family member as an advocate to your doctor’s appointments

When faced with a cancer diagnosis the options can seem daunting and the information overwhelming. It can be invaluable to have an advocate in the room to be a second set of ears. A person who is confident enough to ask questions, able to take notes and willing to process the information afterward with you. Advocates should understand their role prior to going to your appointment so they can be prepared.

2. Write down your questions

Create a written list of specific questions prior to your appointments to discuss with your doctor. Let your doctor know that you have questions at the beginning of your appointment.

3. Beware of Dr. Google

Dr. Michelle Boyce Ley, board-certified breast oncology surgeon, medical director of TMC’s Breast Health Program and a breast cancer survivor herself said, “Don’t google outcomes. I’ve seen what’s out there and they don’t look like my own patients.” Tess X, a patient of Dr. Boyce Ley’s, said “I didn’t do much reading outside the basics because you can really get into the weeds and pseudo-science. I looked up my particular variant of BRCA2 and did some calculations on risk over 10 years and lifetime, but I have a biology background. Then I talked with Dr. Boyce Ley to discuss my risks and treatment options.”

4. Talk to your doctor about risk and benefits

“Don’t assume the risks and benefits are the same as a friend’s with the same form of cancer,” Tess X said. Two people can have the same form of cancer, but the treatment plan might be quite different dependent on stage, location and the individual’s aversion to risk.

5. Ask about all the options including if there are options in treatment that they don’t offer.

“It makes me so sad when I give a talk and someone comes up afterward and says, ‘Why didn’t they offer me that?’” said Dr. Michelle Boyce Ley, . It’s important that your physician be willing to discuss all options with you, so you can participate in shared decision-making. “You can’t make a good decision unless you have the information.”

6. Don’t be afraid to share your diagnosis with others

“I met many survivors that way,” said Vanessa Hough Buck. “They have been an encouragement to me. Find a support group of survivors.”

7. Don’t avoid being in photographs while you’re going through treatment

“Even when you don’t feel your best, be in the picture. When I look back now, those are my favorite photos,” Buck said.

8. Let people know what you need from them

“Your friends and family have good intentions but don’t always know what to do. It’s alright to ask for specific help. And it’s OK to say ‘no’ to visitors,” Buck said.

 

Are you a breast cancer survivor? What advice would you give to the recently diagnosed?

TMC for Women has a high risk breast clinic that provides education, treatment options, and coordination to best help high risk patients choose their next steps.

 

 

Hidden Scar technology allows surgeons to minimize scarring without compromising breast cancer treatment

Hidden Scar breast cancer surgery centerBreast cancer surgery can save a woman’s life. And with new advances, surgery doesn’t necessarily mean leaving scars behind that serve as a visible reminder of cancer.

Tucson Medical Center is a Hidden Scar Center, with demonstrated expertise in surgical techniques that minimize scarring while retaining effective oncologic results.

Through Hidden Scar, surgeons make incisions in a location that’s harder to see so the scar is less visible. Advanced tools and technology make it easier for surgeons to make small incisions and reduce the risk of complications, all while keeping as much healthy breast tissue as possible.

“It’s important to me to individualize the care my patients receive,” said breast surgical oncologist Michele Boyce Ley. “For many women, scars do matter.  They can impact clothing choices, self-confidence, self-esteem, intimacy, and other important factors of daily life. Through Hidden Scar techniques, women can have surgical treatment that not only offers the best clinical outcomes, but provides the best aesthetic outcome as well.”

One option to consider is whether a nipple sparing mastectomy might be appropriate. “This technology facilitates preservation of the nipple for a more natural appearance after mastectomy,” said Boyce Ley, a fellow-ship trained surgeon.

Because every cancer is different, it’s important to discuss options with your physician and surgeon, based on the size and location of the tumor.

“Sometimes, we need a creative solution; I take a lot of pride in finding the solution that best matches the needs of each patient,” said Boyce Ley.

 

Technology puts Tucson Medical Center at the center of complex cancer care

image3Cancer is often anything but a textbook disease.

Thoughtful deliberations go into each case: Is surgery an option? Should radiation and/or chemotherapy be considered? If so, in which order and for what duration?

When a case isn’t straightforward, it helps to bring a multidisciplinary team of experts together to review images and discuss the best treatment options.

And thanks to technology, physicians practicing here at Tucson Medical Center are now a part of the discussion with Mayo Clinic physicians through eTumor Boards via something akin to a WebEx on steroids.

Tucson Medical Center’s position as a member of the Mayo Clinic Care Network provides physicians with the ability to consult with Mayo Clinic specialists, as well as participate in multidisciplinary discussions regarding complex cancer cases.

And now, working with experts across the country, physicians have a dedicated room where they can share slides on an 80-inch screen with enough detail and definition to determine the best approach for each unique patient – all while having face-to-face conversations on a another screen.

The space, which accommodates 15 participants, also features high-definition screens at each individual station that allow the user to toggle back and forth between a speaker and the slides.

Scott Marshall, a manager of information services at TMC, thanked Mayo Clinic for its work with TMC on the eight month project. “Building a room like this is extremely intricate. We must have robust audio and video capabilities, while ensuring the information is encrypted and secure. The Mayo technicians were instrumental in guiding us through this project as we worked together to provide a mechanism for stronger collaboration that will improve outcomes for patients.”

Stephanie Boreale, the senior director of ambulatory services at TMC, said the facility supports best practices, since tumor boards are associated with improved clinical outcomes and patient satisfaction. “The ability to conduct video conferencing will facilitate the engagement of providers in discussions of cases, improving coordination and strengthening patient care.”

Breast cancer – what men need to know

shutterstock_325524227October is awesome! The baseball and football seasons are both thumpin’. The NFL just got into gear, and MLB is ramping up for the World Series. We’re talking Heath Miller, Deangelo Williams, Matt Kemp, Drew Brees, Richard Sherman, Anthony Rizzo and more! OK, where’s the remote and the chips?!

October is also awesome because it is Breast Health Awareness Month, and the athletes mentioned above are all taking part in supporting it. Guys, this should remind us all that men have a part in supporting breast health awareness.

“Hold up! I don’t have to worry about breast cancer; I’m a dude.” If that is your attitude, then you are wrong in two ways.

One: Men can get breast cancer. More than 2500 men are diagnosed with breast cancer every year. Two:  Breast cancer doesn’t affect just one person, it affects everyone around her. Whether it’s your mom, sister, friend, cousin, wife or daughter, their health and wellbeing are a part of your life. How serious could this be? Breast cancer is the most common cancer among women and a leading cause of cancer-related deaths in women.

“Got it; I’ll get out my pink t-shirt and pull on a pink bracelet. Done.” That’s great bro, but we can take the support up a notch.

No need to research for weeks or try to mansplain every detail. Knowing the basics and being able to thoughtfully answer some questions will help support her in making decisions about her own health. And it shows we care – because we do.

Here are a few things guys should know about breast cancer:

  • Early detection can save lives. Getting a regular mammogram is the best way to detect cancer early. At what age, and how often should a woman get a mammogram? Every woman is unique and should assess her risk and discuss preventative measures with her doctor.
  • Mammogram: OK, everybody has probably heard this term, but what it is exactly? It is an x-ray of the breast. There have been a lot of advancements in mammography. Digital and 3D mammography create clearer images for better detection. Just so ya’ know fellas, the breast has to be compressed and it isn’t fun.
  • Symptoms: Breast cancer has many symptoms other than a lump. Itching, redness, swelling, dimpling, clear or bloody discharge can all be symptoms of breast cancer. If a woman is experiencing these symptoms, she should consult her doctor.
  • There is more than one type. There are many forms of breast cancer, and there are varied treatments depending on the type of cancer and the age of the patient.
  • There is hope: There has been a dramatic increase in breast cancer survivability rates in the past 40 years. New tests, targeted drugs and early detection are making a difference. While one in eight women will be diagnosed with breast cancer, the five-year breast cancer survival rate is 90 percent, up from 75 percent in 1975.

Men are becoming more knowledgeable and involved in breast cancer awareness – and that rocks! We care and we want to be supportive.

The information is out there and easy to access. So guys, let’s browse these links and get the information that will help us be supportive this month, and the whole year-round.

Additional resources:

Susan G. Komen

Susan G. Komen Arizona

National Breast Cancer Foundation, Inc.

Breastcancer.org

Breast Cancer Research Foundation

American Breast Cancer Foundation

Foundation for Women’s Cancer

American Cancer Society

Centers for Disease Control and Prevention

If you have any concerns or questions, please feel free to contact the TMC Breast Center at (520) 324-1286 or email breast.navigator@tmcaz.com.

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Medical insurance covers annual mammography screening as a preventative service, and grant funds allow TMC to offer mammograms for uninsured women age 40 and over. To make an appointment, call (520) 324-2075.

New non-invasive colon cancer screen hits the market; is it better than a colonoscopy?

colon cancer awareness true or falseA new home-based screening test for colon cancer has recently hit the scenes. Cologuard or stool DNA testing was approved by the U.S. Food and Drug Administration this past August and is covered by Medicare.

The test looks for cancer-related DNA and red blood cells in a person’s stool. On the one hand, it doesn’t require the unpleasant preparation that is needed for a colonoscopy. But on the other hand, the $600 cost, which is not yet covered by private insurers, is much greater than the $25 it costs for a more basic fecal occult blood test, also called a FIT test.

colon cancer awareness ribbom“It’s a good test. It’s better than the stool occult blood test. Cologuard detected 92 percent of colorectal cancers and 42 percent of advanced adenomas, or polyps, in the study population, while the FIT screening test detected 74 percent of cancer and 24 percent of advanced adenomas. But it’s a very new test,” said Fadi Deeb, M.D., a local gastroenterologists, who also serves as TMC’s section chief for gastroenterology, “and we don’t know how often we should do it, every two years, every three years, or every five years? Intervals have not been tested, so we just don’t know.”

Given its $600 cost, which is equal to 24 FIT tests, it would be interesting to see a study comparing one Cologuard to 20-24 consecutive FIT tests over a period of one to three years, in detecting colon cancer and advanced adenomas. Dr. Deeb said.

It is not currently recommended as a method to screen for colorectal cancer by the United States Preventive Services Task Force. The USPSTF recommends adults age 50 to 75 who are at average risk for colon cancer to be screened using fecal occult blood every year, a sigmoidoscopy every five years plus stool occult blood every three years, or colonoscopy every 10 years.

Dr. Deeb said the new test had its limitations. “You can’t use it if you have a personal history of colon polyp, colon cancer, a family history of colon cancer, ulcerative colitis, Crohn’s disease, familial adenomatous polyposis or bleeding hemorrhoids.”

Cologuard was not test directly against colonoscopy for screening. “Colonoscopy is the gold standard” and is more effective in detecting precancerous polyps, which can be removed during the same procedure. Regular screening for and removal of these polyps with a colonoscopy can reduce a person’s risk of developing colorectal cancer by up to 90 percent.

This new test has a false-positive rate of about 13 percent, meaning those people will likely need to undergo a colonoscopy to rule out cancer.

“The test is an option for certain patients who don’t like invasive procedures or for those who can afford it,” he said.


Tucson Medical Center | 5301 E. Grant Road | Tucson, Arizona 85712 | (520) 327-5461