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Breast cancer treatment decisions geared to case

Staff writer

Breast cancer patients who must travel out of the county for treatment are likely to find oncologists who believe getting to know patients is an important part of effective care.

Radiation oncologist Claudia Perez-Tamayo, who sees patients in Newton as well as Salina’s Central Care Cancer Center, said the first thing she does is help the patient be calm.

“When they first come in, we spend about an hour with them talking to them,” Perez-Tamayo said. “It’s what’s in that black box that’s scary.”

Medical oncologist Bassam Mattar, a physician with Cancer Center of Kansas, sees many patients at Newton Medical Center.

Mattar also focuses on relieving his patients’ anxiety during their first visits.

“They come very anxious, very worried, with a frightening new diagnosis of cancer,” Mattar said. “My first thing is to let them know their kids and husband are not going to lose them.”

Mattar said he reminds his patients of why they are there — to get better.

Part of a patient-focused approach is deciding what path to take in the treatment.

“We’re trying to be more focused on your risk, and the risk dictates the type of treatment you’re going to have,” Perez-Tamayo said.

Factors that oncologists consider include genetics, whether the mass is invading nearby tissue, how rapidly the mass is growing, menopausal status, and lifestyle or environmental risks. Even stress is a factor oncologists take into account.

“If you are ill or stressed, your body is fighting many battles at the same time,” Perez-Tamayo said. “It’s not at all a situation that can be decided by talking to one doctor. Usually you have several different doctors.”

Which treatment is given first, radiation, chemotherapy, or surgery, depends on the specific patient, Perez-Tamayo said.

Making decisions about which treatments to use, and what order to use them, is complicated and depends on the individual patient, Mattar said.

If the tumor is very small, then surgery might come first and be followed by other treatments.

If the tumor is very large, chemotherapy is likely to be the first weapon used, he said.

“It depends on how the disease is, you may bring a bigger or smaller weapon against it,” Mattar said.

“When the cancer is very small and ‘friendly,’ it may just require a little bit of treatment and not much,” Perez-Tamayo said.

However, after cancer is successfully treated, that might not be the end.

“I would say at least a quarter of the patients that I treat have a recurrence of cancer,” Perez-Tamayo said.

“If you look around you, one out of 8 will have cancer,” Mattar said. “It doesn’t mean you will die from it.”

Both physicians encourage vigilance and getting regular mammograms. They also say a newly-noticed lump should be checked.

“If you see a lump, don’t ignore it and think it will go away,” Mattar said. “Immediately if you find a lump, go see a doctor. The sooner you find it, the better your chance of beating it. The smaller the cancer, the smaller the enemy, and the easier it is to fight.”

Fast breast cancer facts

According to the American Cancer Society, a painless, hard mass with irregular edges is more likely to be cancer, but breast cancers can be painful and soft or rounded.

Some women, because of their family history, a genetic tendency, or certain other factors, should be screened with MRIs along with mammograms. The number of women who fall into this category is very small. Talk with a health care provider about your risk for breast cancer and the best screening plan for you.

According to the National Cancer Institute, a woman’s chance of developing breast cancer at some point in her lifetime is 1 in 8.

Statistics by decade of life paint a different picture, showing that risk increases with age. Risks of breast cancer by age are:

  • Age 30, 1 in 227
  • Age 40, 1 in 68
  • Age 50, 1 in 42
  • Age 60, 1 in 28
  • Age 70, 1 in 26

These probabilities are averages for the whole population. An individual woman’s breast cancer risk may be higher or lower depending on a number of known factors and on factors that are not yet fully understood.

Last modified Oct. 19, 2017

 

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