On average, every two minutes a woman is diagnosed with breast cancer in the United States. A diagnosis happens more than a quarter of a million times each year and the chances of a woman being diagnosed are 1 in 8. So, you’ve been diagnosed…What comes next?
First off, know you are not alone. Second, know that there are more options available than ever before. And lastly, feel confident that the medical professionals at the Northwest Indiana Breast Care Center and Oncology Institute at Methodist Hospital are knowledgeable, supportive, and will be with you every step of your journey.
Not all breast cancers are the same. There are several different types and subsets of breast cancer, all of which can be diagnosed at different stages and treated differently. At the Oncology Institute, after a woman has surgery (lumpectomy or mastectomy as appropriate) for her breast cancer, two of the main options for treatment are systemic therapy and/or radiation therapy.
According to Dr. Bharat Barai, oncologist at the Oncology Institute, based on the stage and the DNA molecular profile of the cancer, many patients need local radiation therapy and systemic therapy which includes hormone therapy, targeted therapy, antibody-drug conjugated, or cytotoxic chemotherapy.
“First of all, we aim for the treatment option that is the least toxic and most effective. The treatment chosen is based on and customized to a patient’s DNA molecular profile. This is based on factors such as family history, menstrual status, size and extent of the tumor, and more,” Dr. Barai said.
Chemotherapy works in many ways. Some drugs are designed to target tumors like a laser-guided bomb, while others provide a more blanket approach. However, all treatments are determined based on a patient’s individual health and the opinions from multiple professionals at the Oncology Institute.
Dr. Barai said that physicians recommend high-risk, genetic testing for certain patients who are young or have a strong family history of breast, ovarian, or uterine cancers. If these patients have a high probability of developing breast or ovarian cancers, they may be recommended to undergo a prophylactic mastectomy or oophorectomy as part of genetic counseling. In other words, the presence of certain genes and genetic markers can determine how aggressive a cancer should be and how it will be best treated.
In any case, radiation therapy is also often another aspect of breast cancer treatment. Dr. Ram Narayan, Radiation Oncologist at the Oncology Institute, said there are many different approaches to radiation therapy. Most commonly, radiation is used after surgical removal of breast cancer to kill any remaining cancer cells.
“If patients receive lumpectomy surgery (or partial mastectomy), we are able to follow up with radiation to the entire breast afterward. This treatment is equivalent to doing a mastectomy and has shown great cure rates,” Dr. Narayan said. “However, if the breast cancer is more advanced and lymph nodes are involved, there is a more extensive radiation treatment and technique that is applied.”
In addition, different factors such as age, tolerance, medical history, and more are weighed into the picture. Once these factors are considered, the best treatment option for the patient is chosen based on high-level evidence, research, and successful trials.
“I like to begin the treatment planning process by sitting down with patients and go through the history of breast cancer and explaining how it has evolved over the years. Then, I go through which treatment plan I think would be most beneficial as well as some alternatives and list the risks and benefits both long-term and short-term,” Dr. Narayan said. “Once we are at an understanding and decide to proceed with a specific treatment, we move forward with the treatment planning process.”
While the medical professionals at the Breast Care Center are educating patients on treatment plans focused on the scientific side of things, they always take into account the human aspect and try to alleviate some of the stress patients and their families are experiencing.
“Today, 90% of women that will be diagnosed with breast cancer will be living five years and beyond,” said Dr. Barai. “I always let my patients know this because this eases their minds a great deal in the moment.”
“I assure my patients that I’m going to give this treatment my absolute all in order to work towards curing,” Dr. Narayan said. “I work hard to keep their spirits up and keep a sense of hope instilled.”
Once the proper treatment is hand-selected for the individual patient, Sara Zilz, Oncology Nurse Navigator, also sits down to educate patients and their families on next steps and identify ways to help with the financial impact that a cancer diagnosis brings, but most importantly, Zilz is there to comfort and relieve some of the stress that comes with this difficult journey.
“When a test does come back positive and treatment is selected, a lot of people don’t know where to turn or what the next step is, but that’s what I’m there for,” Zilz said. “I’m their main point of contact during their journey. They can contact me at any time, and I try to take as much worry away from them as I can.”
In doing so, Zilz is working around the clock to ensure her patients are educated, up to date with treatment schedules, and remain level-headed and positive during their treatment time at Methodist Hospitals.
“I love being their main support person and a friend to patients; It’s a joy for me to be available for them whenever they need me. I feel this way mostly because I couldn’t imagine going through what they are by myself,” Zilz said.
During a biopsy and other stressful moments, Zilz uses a specific calming method with her patients where she encourages them to “find their calm”.
“During stressful moments or procedures, I encourage patients to find their calm. Whether they want to talk about their children, vacations, or anything else that calms them, we do it. If they want to squeeze my hand as hard as they can, I’m there. If they want to cry with me, I’ll cry with them –Whatever they need to find their ‘calm’ is what I do,” she said.
Although Zilz is passionate about all aspects of her role as an Oncology Nurse Navigator, her favorite part of her job is when a patient can come up to her and tell her they are cancer-free.
“It’s rewarding and joyous. I like to be able to comfort people and put them at ease, and when they beat it, there’s no better feeling. I’ve been at Methodist for 16 years and hearing this news never gets old,” Zilz said.
For more information, visit https://www.methodisthospitals.org/clinical_services/breast-care-center/.