October 2024 Newsletter

This month I want to focus on what we can do when confronted with the diagnosis of breast cancer for the first time. It’s often a shocking, scary and overwhelming time, leaving the patient and loved ones with a sense of impending doom.

The words, “You have cancer,” is life-changing. It brings on a storm of emotions and questions, often leaving us with a confused feeling of being on a roller-coaster.

What should we do then?

1. Breathe
Being overwhelmed is perfectly normal, and we need to give ourselves some time to process the news. It’s natural to think time is of the essence, and it is, but it doesn’t mean we have to act within seconds. In most cases, oncologists will wait several weeks before beginning treatment, usually to allow time for further testing and to get a better picture of the type of breast cancer and how advanced it is.

2. Focus on the good news
In 2013 my mom was diagnosed with breast cancer. My family and I immediately feared the worst. It’s a natural reaction as cancer can be life-threatening. But thankfully, with the advances in treatment, she managed to live eleven more years.

When faced with a breast cancer diagnosis for the first time, it’s important to take in a deep breath, and then force yourself to think both logically, and positively.

Breast cancer mortality rates have dropped to almost half since 1989, largely thanks to early detection and better assessments, and a wider, targeted, and more effective range of treatments.

Localized breast cancer, that is cancer confined to the breast, has a much better survival rate than cancer that has spread outside the breast. Even then, spread to regional lymph nodes, and even beyond, has a reasonably good prognosis.

For all these reasons, it’s important to remember, the diagnosis of cancer does not mean immediate death.

3. Gather information and write down all your questions
Once you’ve had some time to process the diagnosis, it’s time to educate yourself. This means collecting all your test results first. It’s always a good idea to request copies of all tests and results.

Talking to and reading RELIABLE sources, which include your healthcare team, cancer organizations, and reputable websites, will help broaden your view of your particular cancer and your options. Remember though, the internet can be both informative, and confusing.

Read carefully the information your doctor provided, especially what type of cancer and the stage — a number from 0-4 that describes how big the tumor is, where it is located, how far it may have spread from the breast, and the hormone receptor status and HER2 status.

And then write down a list of questions to ask your doctor. The first few appointments may be quite confusing, and writing down the questions may help ensure you don’t forget things.

4. Consider seeking a second opinion
A second opinion may confirm your diagnosis, provide new perspectives, suggest treatment options that may enhance the management of the cancer, or reassure you that your team is on the right path.

Studies have shown that getting a second opinion after a breast cancer diagnosis can be beneficial for the patient, and may actually save lives.

Learn about treatment options: Discuss the pros and cons of different treatment options, such as surgery, chemotherapy, radiation, and hormone therapy.

You may want to see an expert who specializes in your exact type of cancer. Don’t be afraid to ask your doctor for a second opinion.

5. Build your care team and discuss treatment options.
It’s recommended you choose an oncologist who practices at a cancer center that’s designated by the National Cancer Institute (NCI).

Your oncology team may include the following:

Medical Oncologist
A doctor who specializes in the field of cancer. This doctor will be the primary source guiding you throughout your care journey, from the start of diagnosis throughout your journey of cancer care. After completing cancer treatment, it is general practice to resume routine care with your primary care physician.

Surgical Oncologist
A doctor who specializes in cancer treatments involving removing tumors through a surgical approach.

Radiation Oncologist
A doctor who specializes in cancer treatment using radiation, based on the type of cancer and location of any tumors. Not every cancer patient will need radiation as part of their treatment plan.

Plastic Reconstruction Surgeon
A doctor who specializes in reconstruction of breasts with a surgical approach following cancer removal surgery or therapy.

Genetic Counselor
This is a counselor who specializes in medical genetics and evaluates risks a patient may have for a genetic link to cancer. A genetic counselor evaluation is not necessary for every patient. If you have concerns about risks or a family history of breast cancer, speak with your doctor.

Patient Navigator
A patient navigator is an individual such as a nurse, social worker, community health worker, or other healthcare professional, who can be a lifeline in helping guide patients through and around the barriers in the complex cancer care system, including the cost of treatment and other financial concerns, such as missed time from work, being uninsured, fear surrounding your diagnosis or treatment, misinformation surrounding the disease, or language barriers. As there may be potential barriers to care, such as transportation concerns, childcare, or financial stress, a patient navigator can connect you to resources and support groups that may be able to help.

Discuss treatment options with your healthcare team, including surgery, chemotherapy, radiation, and hormone therapy. Understand the benefits and risks of each.

Ask questions to ensure you understand the plan.

6. Seek support
It’s important you share the news when and with whom you feel comfortable with, and who will be most supportive.

Dealing with cancer and the possible maze of treatment options and questions is a lot, and there’s no shame in reaching out. In fact, sometimes, in our busy, nuclear lives, we forget that most people like to help.

There are also millions of breast cancer survivors in the U.S, and they can be an amazing support network.

Once you’ve notified your loved ones, it can be helpful to bring a friend or family member to your appointments. Having another person there can help with understanding what may have been discussed with the oncologist.

Online groups can be a great source of support, with others who are further along in treatment sharing their experiences and supporting you in your journey.

7. Take care of yourself

This includes:

• Maintaining an active and healthy lifestyle. Continuing some sort of exercise routine is essential for helping to deal with the stress and emotional turmoil. It also helps increase the body’s natural killer cells, boosting your immune system, and thus working together with your treatments to fight the cancer.
• A balanced and nutrient-dense diet can also help support the body during treatment and recovery. Focus on lean proteins, fruits, vegetables, whole grains and healthy fats. Avoid sugary and highly processed foods. Meeting with a nutritionist may be helpful.
• Relaxation techniques, such as meditation, yoga, or deep breathing exercises, hobbies, or spending time with loved ones is important for emotional well-being.
• Keep a treatment journal: Record your treatment schedule, side effects, your moods, experiences, and any concerns or questions you have to help you emotionally, and to stay organized and communicate effectively with your healthcare team.
• Finances: Explore financial resources or assistance programs, such as Medicaid, Medicare, or non-profit organizations, to help cover the costs of treatment.
• Be your own advocate. Educate yourself about breast cancer and its treatment options, and don't hesitate to ask questions or seek a second opinion if you're unsure about any aspect of your care.
• Think of the future. If you are of childbearing age, discuss options to preserve your fertility before starting treatment.
• Consider genetic testing both for the risk to yourself for cancer in the other breast, and other cancers such as ovarian cancer, and also for family members such as your daughters and siblings, especially if you have a family history of breast cancer.

Remember, every individual's situation is unique, so it's important to tailor these steps to your specific needs and circumstances.

Thank you for reading, and for your valuable support.