(Article repurposed with permission from The News & Sentinel)
Breast cancer can be a scary proposition for anyone, but the WVU Cancer Institute at Camden Clark is working to help patients make the best decisions about their treatment.
The institute uses a team approach in treating breast cancer patients in the Mid-Ohio Valley, utilizing technology and physicians who specialize in treating cancer, surgical oncologists, medical oncologists and radiation oncologists.
The newest data from the American Cancer Society estimates 268,000 women are diagnosed every year with breast cancer and 40,000 die each year nationwide.
”We see a new breast cancer patient in this area almost every day,” said Jo Hendershot, clinical nurse manager. ”It does not seem to be slowing down.”
Dr. Nik Shah, medical director of the WVU Cancer Institute at Camden Clark, said breast cancer awareness is important.
“Breast cancer is one of the most common causes of cancer in women,” he said. ”It is second only to skin cancer.”
Early mammography screenings help detect breast cancer early. When diagnosed early, the chances of surviving and being rid of cancer go up.
”At five years, we have more than 95 percent of patients free of cancer,” Shah said.
The American Cancer Society recommends women who are 45 to get regular mammogram checks. Women older than 40 have the choice whether to start earlier.
”If you ask me, I think they should start at age 40,” Shah said.
Women 45 to 55 are recommended to get checked once a year.
Many cancers can be free of symptoms or signs, Shah said. The earliest sign can be microcalcification, which can be used to test the earliest signs of breast cancer, Shah said.
”There are various manifestations of breast cancer,” he said. ”Many patients feel a lump (in the breast or under the arm). If a woman notices a change in shape or size of the breast or has bloody discharge from the nipple.”
Once a diagnosis is made, a team approach is made in treatment utilizing the expertise of the surgical oncologist, a medical oncologist, a radiation oncologist and a plastic surgeon to determine the best approach in treating the patient. This can include removing the cancer through a lumpectomy, removing the lump or a lymphadenectomy, the surgical removal of one or more groups of lymph nodes followed by radiation after healing from the surgery.
Some get a mastectomy, the removal of the whole breast, but other treatment options have limited patients from going that route.
The medical oncologist guides the patient through their treatment and helps them understand what is happening and guide what follow up treatment may be needed, Shah said.
Treatments have advanced over the years where doctors can test for certain things and determine if hormone therapy or chemotherapy is needed.
For those without a primary physician or those who are underinsured or not insured, patients can inquire through the Camden Clark Foundation’s Pink Mammogram Fund which provides free screening mammograms, diagnostics, genetic testing and stereotactic breast biopsies for those in need. There are no financial applications, no residency restrictions or age limits for the program.
”Every year Camden Clark performs over 15,000 mammograms,” Hendershot said. ”Nearly 200 free mammograms were done in the last year through the Pink Mammogram Fund.
”In total the Pink Mammogram Fund has provided over 25,000 procedures and covered over $25,000 dollars in mammograms, diagnostic testing and genetic testing (over the last nine years).”
Dr. Sumaira Shafi, a hematologic oncologist with the WVU Cancer Institute at Camden Clark, related the story of her aunt who recently passed away from metastatic breast cancer. Her aunt had originally been noticing a “wound” on one of her breast.
It is warm and humid in Shafi’s native Pakistan and her aunt thought it was weather related and she wasn’t taking good care of her skin. She got powders to help dry up the wound, but it didn’t help. The wound was persistent for 3-4 months.
She finally had an ultrasound and it appeared cancer was likely. Her family asked Shafi to look at the results, because they weren’t sure.
”I would say the first thing that is important is that anything that appears on the breast needs to be examined by a physician and needs to be mammogramed and go from there,” Shafi said. ”Anything that is not your normal.
”If you have a discharge from your breast, if your nipples don’t look the way they should, if one breast looks bigger than the other, if you are feeling a lump in the breast or if you are seeing an ulcer, a hole-like thing, on your breast – consult your doctor.”
Everything starts with someone’s primary physician for an initial examination. An initial mammogram would be addressed by the primary doctor. They can refer the patient on to the cancer center and a specialist for more specific tests, such as ultrasounds and biopsy tests, as well as treatment options once something is determined.
If the disease is localized or widespread it will determined if surgery is needed to remove the tumor or the entire breast or if chemo is needed to shrink any tumor before surgery is performed. After surgery, chemo may still be need to be done.
Hendershot said chemo is not always necessary.
Shafi said that is a big fear among many patients, that they will have to undergo chemo.
”They have a fear they will have to have chemo therapy and then they will try to avoid us,” she said.
Shah said he has also seen this. He said chemo still has the stigma to it after 40 years of being in his practice.
Advancements have been made in medications that help treat the side effects of chemo.
”It is the job of the oncologist to educate the patient and their family,” Shah said.
People are afraid of losing their hair and their normal looks. Shafi said she discusses it with the patients to address their concerns and answer their questions.
There are treatments that have helped with preventing hair loss. There are headscarfs and caps some patients have taken up wearing. She tries to be upfront with them in that they may lose their hair, but she says she has patients who still look beautiful without any hair. She encourages them to look at the scarves, caps and wigs that are available.
”I try to be encouraging,” Shafi said. ”For me, if someone is being encouraging to me it gives me a little courage to live life.”
Hendershot said another common fear is people will be sick on chemo.
”We hear that all the time,” she said. ”Chemo is not the same as it was 5, 10, 15, 20 years ago. We have seen so many advancements in medications we can give. ”People are no longer sick on chemo like they used to be. That is a fear will keep people from coming but that really should not be a concern anymore. We do everything we can to make sure people are not sick on treatment.”
Shafi said medications are available that help control that.
”We don’t want people to stop living when they have cancer,” Hendershot said. ”We want them to maintain as much of a normal life as they can while on treatment.”