DEAR DOCTOR K:
I was just diagnosed with breast cancer. I’ve found an oncologist, and she’s great. Now what can I do?
I’m glad you’ve found a great doctor. The choice of treatments depends both on the details of your cancer and your own values. For example, how important is it to preserve your breast if the doctor says removal of the whole breast has a slightly better prognosis than just removing the cancer from the breast? So I hope your doctor will take the time to get to know you and your priorities. You should feel comfortable asking your doctor questions and making decisions with her.
There is no “one size fits all” treatment for breast cancer. The treatments you should consider depend on details such as the size of your cancer, whether it has spread outside your breast, whether you have close relatives with breast cancer, and other factors. Your doctor will consider these details and your values in recommending your treatment options.
Today there are many diagnostic tests and treatments available to women with breast cancer that were not even in the planning phases when I went to medical school. Many of these advances have come from basic medical research. For example, the breast cancer treatment Herceptin came from a discovery in the 1980s of a gene that turned cells cancerous.
Your oncologist, or cancer doctor, will be one member of a team of health professionals that will manage your care. Regarding breast cancer, oncologists generally fall into three categories: (1) surgical oncologists, (2) medical oncologists and (3) radiation oncologists. Depending on your treatment, you may work with one, two or all three types. (The medical oncologist, who recommends chemotherapy, hormonal therapy and other treatments, is often the de facto leader of the team.)
Other health care professionals may participate in your care. For example, mental health services are often provided by oncology social workers or psychologists. Acupuncturists and massage therapists may offer complementary therapies. Consultations with dietitians may be helpful. And so on.
If this seems overwhelming, ask if your hospital has a “navigator” who can help you to quickly and carefully steer through the vast array of services provided by your institution.
Once you’ve assembled your medical team, you can help yourself by doing the following:
- Reach out to friends for emotional support, not medical advice.
- Reach out to doctors for medical advice, not emotional support.
- Keep a written log of every phone call and appointment.
- Gather your medical information, including laboratory, imaging and biopsy reports.
- Avoid drinking alcohol as much as possible.
- Sleep as well as you can. If you can’t sleep, talk to your doctor about this.
There is a lot of good advice on successfully navigating through a breast cancer diagnosis and treatment. You may want to read “Chicken Soup for the Soul: Hope & Healing for Your Breast Cancer Journey” by Harvard Medical School’s Dr. Julie Silver. The book contains stories from many breast cancer patients about their diagnosis and treatment, as well as medical advice. Dr. Silver is the perfect person to weave it all together, as she is a rehabilitation expert who is herself a breast cancer survivor.