Breast Cancer Newly Diagnosed Archives

Your diagnosis is just a starting point. Even though the path ahead may seem unclear or even insurmountable, armed with knowledge you can take control.

Let us help you become empowered to understand your diagnosis, to confidently ask questions, and to identify providers that are the best fit for you.

More resources for Breast Cancer Newly Diagnosed from Patient Empowerment Network.

Practical Questions About Breast Cancer Treatment Patients Should Ask

Practical Questions About Breast Cancer Treatment Patients Should Ask from Patient Empowerment Network on Vimeo.

Breast cancer patients and healthcare providers can be partners in care, but what’s important to discuss? Expert Dr. Demetria Smith-Graziani explains information that she presents to patients and shares common questions that patients ask.

Demetria Smith-Graziani, MD, MPH is an Assistant Professor in the Department of Hematology and Medical Oncology at Emory University School of Medicine. Learn more about Dr. Smith-Graziani.

[ACT]IVATION TIP

“…ask why a particular treatment is recommended, what the evidence is behind it, ask about the potential side effects and then ask about how the different treatment options compare if you’re given multiple options.”

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Related Resources:

Eliminating Disparities in Breast Cancer | Tips for Navigating Inequities
 
How Does Hormone Therapy Impact Breast Cancer Treatment?
 

Transcript:

Lisa Hatfield:

How do you work with your patients to make treatment decisions? With increasing treatment options, what should breast cancer patients consider when deciding on treatments?

Dr. Demetria Smith-Graziani:

So it’s important that patients are really informed about all of their options, so what I tend to do is review the details of diagnosis and staging, and then after we review that  I provide recommendations based on the national guidelines, and then I also provide recommendations for potential clinical trials that are available at our institution that may be a good fit for the patient, and then we discuss the potential risks and benefits of each option as well as how long each treatment will last and how it might affect their daily lives. 

I think that sometimes patients don’t always know what questions to ask, so I tend to suggest questions that I’ve heard in the past from other patients, and I think a lot of what patients want to know in addition to potential side effects are how long is my treatment meaning how long am I going to have to stay in the infusion center if I’m getting an IV medication? Or how many months of treatment do I need to get?

And then how much time do I need to take off of work? Am I going to be able to work while getting my treatment, so it’s those little things which aren’t so little that are important to discuss, so that the patients can get the best overall picture about how each treatment will affect them in the short and the long term, so my activation tip for patients is ask why a particular treatment is recommended, what the evidence is behind it, ask about the potential side effects and then ask about how the different treatment options compare if you’re given multiple options.


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How Is Breast Cancer Explained to Newly Diagnosed Patients?

How Is Breast Cancer Explained to Newly Diagnosed Patients? from Patient Empowerment Network on Vimeo.

What’s important for newly diagnosed breast cancer patients to know? Expert Dr. Demetria Smith-Graziani shares how she explains breast cancer to her patients and advice to patients to help ensure their optimal care.

Demetria Smith-Graziani, MD, MPH is an Assistant Professor in the Department of Hematology and Medical Oncology at Emory University School of Medicine. Learn more about Dr. Smith-Graziani.

[ACT]IVATION TIP

“…ask your doctor about what type of breast cancer you have and what cells that your breast cancer came from.”

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Related Resources:

What is High-Risk Breast Cancer?
 
An Overview of Breast Cancer Subtypes | Tips for Being Proactive
 
Noted Racial, Ethnic, and Socioeconomic Disparities In Breast Cancer Outcomes

Noted Racial, Ethnic, and Socioeconomic Disparities In Breast Cancer Outcomes


Transcript:

Lisa Hatfield:

Dr. Smith, how do you explain breast cancer to your newly diagnosed patients, knowing that they probably have heard about breast cancer or may even know somebody who has been impacted by breast cancer, this is your newly diagnosed patient, how do you explain that in detail with them?

Dr. Demetria Smith-Graziani:

So breast cancer starts when normal cells in the body or in the breast develop mutations that are changes in their DNA, and those changes caused them to grow and divide out of control. So the most common types of breast cancer come from the cells in the milk ducts, or the cells in the glands that make milk, and when the cancer starts in the cells of the milk ducts, we call it ductal cancer, when the cancer starts in the cells that make the milk, those glands, we call it lobular cancer. So my activation tip is to ask your doctor about what type of breast cancer you have and what cells that your breast cancer came from.


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What Is High-Risk Breast Cancer?



What is High-Risk Breast Cancer? from Patient Empowerment Network on Vimeo.

What exactly is high-risk breast cancer, and who is most at-risk for this type? Expert Dr. Demetria Smith-Graziani explains different types of high-risk breast cancer proactive questions for patients to ask their doctor for optimal care.

Demetria Smith-Graziani, MD, MPH is an Assistant Professor in the Department of Hematology and Medical Oncology at Emory University School of Medicine. Learn more about Dr. Smith-Graziani.

[ACT]IVATION TIP

“…ask, ‘What type of breast cancer do I have, what subtype of breast cancer do I have, and what stage of breast cancer do I have, and what is the risk of it coming back in the future?’”

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See More from [ACT]IVATED Breast Cancer

Related Resources:

How Is Breast Cancer Explained to Newly Diagnosed Patients?
 
What is Node-Positive and Node-Negative Breast Cancer?
 
Emerging Treatments In Breast Cancer: Are Antibody Drug Conjugates Here to Stay?
 

Transcript:

Lisa Hatfield:

Dr. Smith, what exactly is high-risk breast cancer? And what populations are most at risk for high-risk breast cancer?

Dr. Demetria Smith-Graziani:

So certain breast cancers are at a higher risk of coming back in the future after they’ve been treated,  the things that put you at a higher risk of having your breast cancer come back, is when your breast cancer is at a higher stage, meaning that it’s a larger cancer or one that has spread to the lymph nodes, under the arm or in the chest.

Also, there are certain subtypes of breast cancer that are known to be more aggressive, such as triple-negative breast cancer and HER2-positive breast cancer, and those also have a higher risk of coming back in the future, so my activation tip for patients is to ask, “What type of breast cancer do I have, what subtype of breast cancer do I have, and what stage of breast cancer do I have, and what is the risk of it coming back in the future?”


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[ACT]IVATED Breast Cancer Resource Guide en Español

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Thriving Not Just Surviving: A Breast Cancer Expert’s Perspective

Thriving Not Just Surviving: A Breast Cancer Expert’s Perspective from Patient Empowerment Network on Vimeo.

How can breast cancer patients not just survive but thrive? Expert Dr. Bhuvaneswari Ramaswamy shares actionable patient advice to strive toward optimal health while living with breast cancer.

Dr. Bhuvaneswari Ramaswamy is the Section Chief of Breast Medical Oncology and the Director of the Medical Oncology Fellowship Program in Breast Cancer at The Ohio State College of Medicine. Learn more about this expert here.

See More from Thrive Breast Cancer

Related Resources:

What Are the Treatment Options for Early Stage Breast Cancer?

How Is Metastatic Breast Cancer Treated?

Why Should Breast Cancer Patients Engage in Care Decisions?


Transcript:

Katherine:                     

We start all of our Thrive Series with the same question. In your experience, what does it mean to thrive with breast cancer?

Dr. Ramaswamy:          

That’s a great question. I think it’s an important one because we always talk about surviving breast cancer, and that’s obviously the most important thing. We all want to survive, but we all also want more than that. We don’t want to just live, we want quality of life.  

And I think one thing that to remember is as soon as the breast cancer diagnosis is done, it’s in part – it’s difficult to say that you can thrive immediately. So, your focus is on really getting through the treatments and making sure it’s all done. So, at that time, managing the toxicities and getting through the stresses of going through the treatments and surgery, radiation, et cetera takes  over everything else. But as you finish that off you, you want to focus on what are the ways you can try to get back to the life that you had prior to breast cancer.

Now it’s difficult and it’s almost impossible to forget the big C word in your life. So, that’s going to hang and that’s going to kind of make anything you look at your perspective as slightly different. I mean, every pain could be worrisome because could it be a reference? Has the cancer spread? Or every bad news about another person could you, could transport that about yourself and then kind of worry about what could happen to you.

Every visit to the doctor, and particularly your oncologist, is going to   bring back memories. So, there are certain things that you can’t take away, but time can heal those. But what we talk about thriving is that you looking at factors that is going to make you and your body healthy. That is going to be exercise, being engaged in  whether your work or your family work and being joyful and seek what brings you joy, whether it’s friends, your work or your family.

And make sure you make time for that. And also eating right and diet is an important aspect of that. Not doing inflammatory diets such as highly fatty diets or meat-containing diet, but really kind of looking at your diet and your weight and your exercise. And trying to also discuss with your team about what are the symptoms you are having and how we can support you to mitigate those   symptoms. And really having conversations and somebody you can confide with to both manage your physical aspects as well as the emotional aspects.

And really kind of thriving and becoming   an advocate for yourself as well as for others who have breast cancer is what I would say is truly thriving with breast – with the diagnosis of breast cancer.

What Are the Types of Breast Cancer?

What Are the Types of Breast Cancer? from Patient Empowerment Network on Vimeo.

Breast cancer expert Dr. Bhuvaneswari Ramaswamy shares an overview of breast cancer types and explains the standard biomarker testing that occurs following a diagnosis.

Dr. Bhuvaneswari Ramaswamy is the Section Chief of Breast Medical Oncology and the Director of the Medical Oncology Fellowship Program in Breast Cancer at The Ohio State College of Medicine. Learn more about this expert here.

See More from Thrive Breast Cancer

Related Resources:

Thriving With Breast Cancer Tools for Navigating Care and Treatment

What Role Do Breast Cancer Patients Play in Care and Treatment Decisions?

Why Should Breast Cancer Patients Feel Empowered to Speak Up About Their Care?


Transcript:

Katherine:

Let’s start with an essential piece that helps people thrive, understanding their breast cancer. First, what are the types of breast cancer?

Dr. Ramaswamy:          

Yeah, and I think that’s extremely critical.   Empowering you, the patient, with the knowledge of the type of breast cancers and what’s the   outcomes and why they’re getting some treatments,  and what to look for is probably one of the most important things to do. And part of it lies primarily with the providers to ensure that education   empowerment. But part of it also lies on the part of the patient to make sure they ask the right questions and learn about their breast cancer.

So, the type of breast cancers you have that are hormone receptor -sensitive breast cancer, that means your tumor would be positive for estrogen and or progesterone receptors. And it depends on estrogen and or progesterone for its growth and well-being. And then there is a HER2-positive breast cancer, which means the HER2 protein is high in your tumors and that drives the cancer cells.

And so, it’s important to understand that subtype and why we have certain treatments to improve the outcomes. And then the last one is when all those three are not there, ER, PR, and HER2. So, hence the word triple-negative breast cancers. These are the large subtypes of breast cancers that are based on these biomarkers, which are proteins that drive the growth of breast, the cancer cells. There is of course different types of breast cancer based on histology that is invasive ductal cancer, that’s very most common. The less, slightly less common is the  invasive lobular cancer, about 10 to 15 percent.

But then there are also very less than 3 percent called   metaplastic breast cancers and other types of  breast   cancers that could also be histological different subtypes.

And it’s important for you to know what type of subtype of histological or how does it look under the microscope is important for you to know as well. So, these I would say are the most important understanding of our breast cancer subtypes, at least  this much to definitely educate the patient and patient having the understanding of their cancer.

Katherine:                     

What biomarker testing is standard following a breast cancer diagnosis?

Dr. Ramaswamy:          

So, the three biomarkers that we definitely test for at this point are the estrogen receptor for strong receptors and the HER2. And, of course, there’s also  the grade that your pathologist would grade your tumor. And grade is different from stage. And that is looking at how quickly your cells are growing. And these are the basic understanding that you should have about your cancer at this point.

How Is Breast Cancer Staged?

How Is Breast Cancer Staged? from Patient Empowerment Network on Vimeo.

What do breast cancer patients need to know about staging? Expert Dr. Bhuvaneswari Ramaswamy explains clinical staging and discusses common breast cancer genetic mutations.

Dr. Bhuvaneswari Ramaswamy is the Section Chief of Breast Medical Oncology and the Director of the Medical Oncology Fellowship Program in Breast Cancer at The Ohio State College of Medicine. Learn more about this expert here.

See More from Thrive Breast Cancer

Related Resources:

Thriving With Breast Cancer Tools for Navigating Care and Treatment

What Role Do Breast Cancer Patients Play in Care and Treatment Decisions?

Why Should Breast Cancer Patients Feel Empowered to Speak Up About Their Care?


Transcript:

Katherine:

Dr. Ramasamy, how is breast cancer staged?

Dr. Ramaswamy:          

The breast cancer is usually staged by using couple of things. One is clinical staging. So, when you come in with the initial you feel a lump and you get a mammogram. So, we will stage you by   understanding the size of your tumor in your breast as well as whether we are able to palpate your lymph nodes. Second, we, you know, the imaging. What we feel as a size is usually a little bit   overestimated when we look at the mammograms or  the MRIs that you have. And then we’ll see whether in the – in those imagings whether your lymph nodes are looking abnormal. So, we use these initially to do clinical staging. But then when we go to surgery, that’s when we do the correct   pathological staging because now, we know exactly your tumor size. Then they do what’s called a sentinel lymph node biopsy.

We don’t need to take all the lymph nodes to stage your nodal status anymore. We just use this   methodology in the surgery, in this – during surgery  to just pick out those nodes that is draining your tumor back. And whether they’re positive or not. In general, as long as you don’t have a very locally advanced cancer, we don’t need to do staging scans to stage you for breast cancer. But in case you are unlucky enough to have cancer spread in those, and we do scans and you have cancer either in your bone or liver or lung, then that is a higher staging, and that’s what’s called the stage IV cancer.

Considerations That Help Guide Breast Cancer Treatment Decisions

Considerations That Help Guide Breast Cancer Treatment Decisions from Patient Empowerment Network on Vimeo.

What are key factors that help guide breast cancer treatment decisions? Expert Dr. Bhuvaneswari Ramaswamy explains what is considered and explains the significance of each factor.

Dr. Bhuvaneswari Ramaswamy is the Section Chief of Breast Medical Oncology and the Director of the Medical Oncology Fellowship Program in Breast Cancer at The Ohio State College of Medicine. Learn more about this expert here.

See More from Thrive Breast Cancer

Related Resources:

What Role Do Breast Cancer Patients Play in Care and Treatment Decisions?

Thriving With Breast Cancer Tools for Navigating Care and Treatment

Why Should Breast Cancer Patients Feel Empowered to Speak Up About Their Care?


Transcript:

Katherine:

Another key component of thriving is finding  a treatment that is right for your disease. What are the considerations that guide a treatment decision?

Dr. Waks:

Yeah, great question. So, what we just talked about,  the two things that are very important for us to make a decision, and that’s where we have come far in the last 20, 25 years, is because we are not just taking the staging.

That is anatomical staging, meaning what’s the size of your tumor and the lymph node involvement. We use those. That is important for us because that obviously changes the risk. The higher the stage, the higher risk of   recurrence. The higher the risk, we have to do more treatment to get a benefit, right? So, that’s one side. But what we have come to understand is biomarkers  are very important. That is biology of your tumor.

So, the grade, how quickly it’s proliferating although it’s not a biomarker, but it tells us a lot. And then the three important biomarkers we talked about ER, PR, and HER2. Those all are important for us to make a decision. In addition to that, we do something called a genomic testing called Oncotype  DX assay. There is also another test called   MammaPrint. These are genomic testing.

That is, we look at some of the genes that are up or downregulated in your tumor to decide whether you  are going to benefit for something called   chemotherapy or maybe just targeted therapies enough. So, these are some of the factors that we use to make a decision.

Now, do we use age and your performance status? Meaning how well you are? Do you have   comorbidities? Do you have bad diabetes? Do you have heart disease? Yes, they all go into that whole treatment decision, but the primary is made out of biomarkers and genomic testing and anatomic, and the rest are additional factors that go into our decision-making.

Katherine:

Yeah. What about metastatic disease? Are the considerations different when it comes to treatment?

Dr. Ramaswamy:

It is a little bit different because the first thing that we have to understand is when we are seeing them in stage I, stage II, stage III, which is stage IV is metastatic, stage II – we – our goal is a curator. We are trying to really throw the kitchen sink, although that’s really not what we do. We are trying to still be  tailored therapy, but we are trying to do everything we can to prevent a recurrence.

But now when you have a stage IV disease that is the cancer has   spread, that is the horses have left the  barn in the breast and has gone and settled in distant  organs and gone, our goal is to try to contain the disease. So, prevent further progression, prolong the  life and survival, and also improve quality of life. So, there are those consideration.

The biomarkers still go into consideration. We ensure we biopsy the metastatic site and look for those biomarkers. We do the genomic testing, gene sequencing of this. That will also help with our decision-making. We, of course, look for clinical trials because new novel therapies are always more important, but these are the other factors. And, of course, performance status that is how well you are,  how well your organs are functioning, and what’s your age, and how that affects your morbidity. All of those are also important.

What Questions Should Breast Cancer Patients Ask About Their Treatment Options?

What Questions Should Breast Cancer Patients Ask About Their Treatment
Options?
from Patient Empowerment Network on Vimeo.

What do breast cancer patients need to know about treatment options? Expert Dr. Bhuvaneswari Ramaswamy shares key questions that patients should ask their team about potential treatment approaches.

Dr. Bhuvaneswari Ramaswamy is the Section Chief of Breast Medical Oncology and the Director of the Medical Oncology Fellowship Program in Breast Cancer at The Ohio State College of Medicine. Learn more about this expert here.

See More from Thrive Breast Cancer

Related Resources:

Why Should Breast Cancer Patients Engage in Care Decisions?

How Is Metastatic Breast Cancer Treated?

What Are the Treatment Options for Early Stage Breast Cancer?


Transcript:

Katherine:

What questions should patients ask about their treatment options?

Dr. Waks:

I think the most important thing is to understand what you have first. So, kind of the doctor will talk to you about what type, histological type of breast cancer you have. They’ll also talk to you about what  biomarkers you have. And they will also talk to you  about the treatment options, which could be   chemotherapy versus target therapies, and what are the outcomes from those using clinical trials. So, I think the questions that you have to ask them is that,  what do you feel like you would is right for your body, right? That’s important. That what you have some of the preconceived notions that we all carry. That bias and preconceived notions is just a normal natural way of learning. And so ask about those fears, ask about those hopes that you have. And if your hope is, “Hey, can I do as well without chemotherapy?” Ask that question. So, and it’s important to understand the side effects and the outcomes of each therapy.

It may also be important for you if you do – you really don’t want to have treatments to understand if   you don’t get treatment, what are your outcome changes? So, those are, I think, the important thing. And then what that does mean to you? What do you want out of your life? Longevity, quality of life? How long will your quality of life be affected? And how does that impact your understanding of what you want out of your life? I think those are important for you to ask and make sure you have a friend or a relative with you so that not everything is going to go in at the first or the second visit, so you have someone else who’s taking notes.

Recent Advances in Treating Breast Cancer

Recent Advances in Treating Breast Cancer from Patient Empowerment Network on Vimeo.

What are the latest breast cancer treatment and research advances? Expert Dr. Bhuvaneswari Ramaswamy shares treatment updates for specific breast cancer types and discusses testing for circulating tumor DNA.

Dr. Bhuvaneswari Ramaswamy is the Section Chief of Breast Medical Oncology and the Director of the Medical Oncology Fellowship Program in Breast Cancer at The Ohio State College of Medicine. Learn more about this expert here.

See More from Thrive Breast Cancer

Related Resources:

Thriving With Breast Cancer Tools for Navigating Care and Treatment

Why Should Breast Cancer Patients Feel Empowered to Speak Up About Their Care?

What Role Do Breast Cancer Patients Play in Care and Treatment Decisions?


Transcript:

Katherine:

Are there emerging therapies that are showing promise?

Dr. Ramaswamy:  

Oh, my God. There’s just tremendous emerging therapies that are showing extraordinary progress. And I talk about this to my patients all the time. I mean, I tell them like two years ago say in a patient with – patient with metastatic disease, I’ll say, last year this drug wasn’t approved.

This drug is now approved for you to be given, and it shows extraordinary effect. So, every year we have new drugs getting approved, and we are also trying to get it used to be a little bit of a richness on the HER2-positive disease. And now we are seeing definitely a lot of richness on hormone receptor-positive disease. And I think we’re starting to see some new particular immunotherapy and other targeted therapies showing some response in triple-negative breast cancer.

Now, I know that’s a place that we still need to see more newer therapies, but overall, in the stage IV setting, we have really many options to keep them in good quality of life and longer. But people will ask, “Really, why do I even need to get to stage IV?” Really look at me and improve the curative setting. And that again, we are able to pick the higher risk patients, what me – what it means to have higher risk disease, how do we target them, newer drugs to target them. So, I think in so many ways we are doing better. And we are also getting to a place can we detect higher-risk patients, not just  by their initial diagnosis and response, but follow them sequentially by circulating tumor cells?

And we are getting to that place where we can actually do circulating tumor DNA, so just isolate the DNA, and we know what will belong to the tumor. And then circulating tumor cells seemingly even after your curative therapy. And so that is something that’s getting approved. And so we are not only seeing treatment, but we are also trying to see better detection of that reference. So, I think we are in so many ways, improving. And I am – I’ve been in this for 20 years, some of the things that thought was a dream is coming true. So, truly just keep living well and keep thriving. There are options.

Katherine:                     

Yeah. That’s, it’s positive.

Dr. Ramaswamy:          

Yes.

Breast Cancer Treatment Side Effects | What Are They and How Are They Managed?

Breast Cancer Treatment Side Effects | What Are They and How Are They
Managed?
from Patient Empowerment Network on Vimeo.

What should breast cancer patients know about treatment side effects? Expert Dr. Bhuvaneswari Ramaswamy shares common treatment side effects and explains her perspective on how to manage specific side effects for improved quality of life.

Dr. Bhuvaneswari Ramaswamy is the Section Chief of Breast Medical Oncology and the Director of the Medical Oncology Fellowship Program in Breast Cancer at The Ohio State College of Medicine. Learn more about this expert here.

See More from Thrive Breast Cancer

Related Resources:

What Are the Treatment Options for Early Stage Breast Cancer?

How Is Metastatic Breast Cancer Treated?

Why Should Breast Cancer Patients Engage in Care Decisions?


Transcript:

Katherine:

Dr. Ramaswamy, along with treatment can also come side effects. What are some common side effects of breast cancer treatment?

Dr. Ramaswamy:          

Yeah, great question. Again, an important question for you all to consider. So, let’s divide our treatment  to targeted therapy and chemotherapy. The targeted therapy could be the estrogen receptors and then the  HER2 because the HER2, again, remember that biomarker. And then the chemotherapy that any patient with breast cancer could get, including, of course, the triple-negative. And then we’ll touch base  a little bit later on with the immunotherapy. So, when we look at the targeted therapy with estrogen receptor, anti-estrogen receptors, of course, it’s like putting you into menopause again. It’s like so you could have hot flashes, you could have some emotional liability and you could have vaginal dryness and sexual libido could be lower.

And also you could have joint aches and pains and your bone density could go down and cause osteopenia and osteoporosis and fractures. So, those  are some of the – and we can address all of those that we’ll come to later. With the HER2-targeted therapies, one of the main things will be the heart. These can affect the heart because there are some receptors that are present there that these HER2 therapies can affect the myocardial function. So, they don’t cause increase in heart attacks, but just the pumping action of your heart could go down. We keep checking your heart function to help with that. And then with the chemotherapies, other than your blood counts going down, these are acute events. Those blood counts could go down, which could put you at higher risk for infections. Again, some of the heart chemotherapies can affect the heart. So, we’ll keep an eye on that.

And, of course, fatigue that comes with all of these treatments that can happen. But some of those chronic things that can happen is also neuropathy. So, tingling, numbness in your hands and feet, even sometimes pain in your hands and feet. And then this can stay on for a little bit longer and can cause some trouble buttoning your shirt or playing the piano or putting your earrings. So, it can affect your  daily quality of life and cause pain. The other important thing, which we do have now an option is  also hair loss. I know that is something hard for age.  It’s so hard for women to lose hair and the consequence of being identified differently and not having that – when you look at the mirror, it’s a constant reminder.

So, we do have something called a scalp cooling that you could take an option and discuss with your doctors whether that how helpful that’ll be for your  type of chemotherapy and whether you could use it and you can – but 60 percent of the time not lose all your hair and need a wig. So, that is something that you can address. So, broadly, these are the issues that can happen. Again, this is very broad. Depending on your treatment, you still need to talk to your doctors.

Katherine:

How can some of these side effects be managed?

Dr. Ramaswamy:      

So, the key thing is to be first thing that I want to advise all our patients is that be vocal about your side effects. Okay? Sometimes we all think, okay, they did tell me I’m supposed to have all the side effects. I just need to keep quiet about it. That’s not what is important. And I think I did miss mentioning the GI tract changes like nausea, vomiting, or diarrhea. Again you think, oh, this is our part of all chemotherapy, I just need to keep quiet. No, that’s not the case because we actually give you anti-nausea medications before the   chemotherapy. So, if it’s not effective, you need to have to tell your doctors, “Okay, this time I had a couple of sensations of nausea, but no vomiting.”

Or “No, I was vomiting a lot.” Whatever it is. Even if you had just nausea, it’s important to tell your doctors. If it’s diarrhea, you need to tell them. We do give you some medications, but if it’s not working, you need to tell them. And again, we always underplay the issues with sexual side effects because you don’t want to talk about that. I mean, it’s not important. No, it is important.

It’s important for your intimacy, it’s important for your life, and it’s important for you to speak because there are supportive care therapies that we can provide. Neuropathy, again, I think your doctors will always ask you, but being vocal about it, being honest about it, and talking about it is important. So, again, fatigue.

They are going talk to you about exercise, because exercise does overcome that fatigue. But if you’re not able to do it again, it’s honest to say, “No, but I didn’t do what you said last time.” So don’t feel bad about it. And there could be other ways we can improve your fatigue too. So, again, sharing those side effects is important and we can. We can address all of these side effects. Now, I’m not saying the minute we address these side effects it’s all going to go away completely, but they can get better. And it’s important for you to talk about it and  get those supportive care measures.

How Are Common Breast Cancer Concerns Addressed?

How Are Common Breast Cancer Concerns Addressed? from Patient Empowerment Network on Vimeo.

How can common breast cancer concerns be addressed? Expert Dr. Bhuvaneswari Ramaswamy explains issues that can arise during a patient’s breast cancer journey and discusses how they can be managed.

Dr. Bhuvaneswari Ramaswamy is the Section Chief of Breast Medical Oncology and the Director of the Medical Oncology Fellowship Program in Breast Cancer at The Ohio State College of Medicine. Learn more about this expert here.

See More from Thrive Breast Cancer

Related Resources:

Thriving With Breast Cancer Tools for Navigating Care and Treatment

Why Should Breast Cancer Patients Feel Empowered to Speak Up About Their Care?

What Role Do Breast Cancer Patients Play in Care and Treatment Decisions?


Transcript:

Katherine:

When discussing cancer treatments with a patient, they have worries, obviously. What are some common concerns that patients typically have, and how do you counsel them?

Dr. Ramaswamy:          

I think the most common concern that they have is that their whole life has changed now. And that they’re going – this cancer is going to come back and when it comes back, they’re going to die. So, I mean, the death and the fear of recurrence is probably the most common concern. And I think the second common concern is the treatment-related toxicities that we talked about a little bit, particularly the hair loss or other things that’s going to change their lives forever after that. So, I think what is important to discuss to me, the most important thing to discuss is to clearly state to the patient there’s chances of cure. Meaning to say, your probability of being cured of this cancer, if you do this, this, and this is this high.

But there is, of course, a chance of 10 percent, 15 percent, 20 percent, 25 percent depending on the subtype of cancer they have  and the staging and their age and all of that, of this coming back. If you, even if you do the treatments, but if you don’t do the treatments, the chances of coming back is this much higher, okay?

So, I think it’s important for them to know it is still very difficult because it doesn’t really reflect what is going to happen to them. It reflects what’s going to happen to 100 people with similar cancer. So, again, that is important to explain, but what you can explain to them is if you pull out 100 out of the 100 pellets in a box if you pull out 90 pellets, they’re all going to be cured. There’s only going to be 10 pellets   that could have a recurrence. So, some ways to make them understand statistics. Not everybody comes with a good understanding of all of this. So, I think that’s important. And I think that also it’s important to talk about the treatments and how it effects – and how long it can affect them.

That they can get back and the goal of every provider is to really, the way I explain to them, you’re going to take a diversion in your life, but my goal is the diversion meets the main traffic at some point. That is the goal. And then you just go on smooth sailing. Of course, nobody knows the future, anything could happen, but we are here. And I think  the other thing that’s important, yes, we could have metastatic disease, but you are not going to, I mean,  I’m not saying nobody would, but most people with metastatic breast cancer live for several years.

And there are several treatments and new treatments  coming like I said, every year. So, having that positive approach, even if it comes back is so important for them. So, I think those are the ways; educating, answering their question, providing emotional support, and if they need counseling, addressing that. I think those are very important.

Why Breast Cancer Patients Should Share Emotional Concerns With Their Team

Why Breast Cancer Patients Should Share Emotional Concerns With Their Team from Patient Empowerment Network on Vimeo.

What is it important for breast cancer patients to share their emotional concerns? Expert Dr. Bhuvaneswari Ramaswamy reviews common emotional issues that can arise for patients, discusses why it’s important to voice concerns, and shares support options.

Dr. Bhuvaneswari Ramaswamy is the Section Chief of Breast Medical Oncology and the Director of the Medical Oncology Fellowship Program in Breast Cancer at The Ohio State College of Medicine. Learn more about this expert here.

See More from Thrive Breast Cancer

Related Resources:

Thriving With Breast Cancer Tools for Navigating Care and Treatment

Why Should Breast Cancer Patients Feel Empowered to Speak Up About Their Care?

What Role Do Breast Cancer Patients Play in Care and Treatment Decisions?


Transcript:

Katherine:

Yeah, thank you for that. It’s really helpful. And it actually leads us into the next topic. Coping with emotions that come along with a breast cancer diagnosis such as anxiety and depression can be challenging. Why is it important to share emotional concerns with your healthcare team?

Dr. Ramaswamy:          

Yeah, so I think one of the things that the breast cancer patients, I mean, I would say all cancer patients, I’ll be honest, or any kind of chronic illness, fearful illness. And I think most what they – I think what hurts them most is the how isolating the journey is because despite having very close family and they might have full trust in their providers. At the end of the day, those fears, those sorrow of potential mortality and all the side effects has to be gone through them. They’ve got to go through that. And then validating their anxiety, validating their fears, validating their symptoms is so important. So, that’s why telling your patient I understand. Whatever it is, you’re going through an isolating journey, it’s hard, and I validate all your concerns that you have.

We can’t really compare apples to apples here like patient to patient because you – we all have an inherent approach to a critical problem. And this is a critical problem that comes into your life and whatever that approach is of what – how you’re going to approach this. So, there’s no right or wrong and how she copes and you cope. And sometimes family does that and sometimes your own friends do that. Like, oh, it’s okay, but see she did well and she and you know and see how she’s coping. It doesn’t help. I think so educating the family as well to say or the spouse particularly validate their concerns, give validation and acknowledge their concerns and then say something positive to help them move forward. And I think these are important. And I think what I tell my patients is that I will never know what you’re going through if you don’t share it with me.

And this would be both emotional and your physical and okay, I can pick some of it with your in a body language, but I can’t really pick the depth of the problems and we can address how to find solutions. The third point that’s important is there are solutions or this. It’s not like they’re going to get better completely, but we can help you. We can help you whether it’s emotional anxiety symptoms, we can find peer group that could help. We can find psychosocial counseling that can help. We can also help with actual treatment and medications that helps with depression and anxiety that we can manage better. And we can help you with your sleep because sleep is so important. And when you’re sleeping is when you start worrying about many things.

And the same way with all your other physical side effects, there are some things that we can do. We are never going to say, “Well, put up with this. You just have to go through this to get better.” We never say that. We will try to address it in some way. Now, I do understand the limitations of what we can do and it doesn’t always get better to everybody, but if you don’t tell us, we can’t even try.

So, it’s so important to share and sometimes sharing  all this reduces the burden on you. So, and I think that’s important as well, so.

How Can Breast Cancer Patients Benefit From Shared Decision-Making?

How Can Breast Cancer Patients Benefit From Shared Decision-Making? from Patient Empowerment Network on Vimeo.

How can shared decision-making benefit breast cancer patients? Expert Dr. Bhuvaneswari Ramaswamy defines shared decision-making and discusses how the process may benefit patients.

Dr. Bhuvaneswari Ramaswamy is the Section Chief of Breast Medical Oncology and the Director of the Medical Oncology Fellowship Program in Breast Cancer at The Ohio State College of Medicine. Learn more about this expert here.

See More from Thrive Breast Cancer

Related Resources:

Thriving With Breast Cancer Tools for Navigating Care and Treatment

Why Should Breast Cancer Patients Feel Empowered to Speak Up About Their Care?

What Role Do Breast Cancer Patients Play in Care and Treatment Decisions?


Transcript:

Katherine:

Dr. Ramaswamy, before we move on to answering questions from our breast cancer community, I’d like to touch upon the concept of shared decision-making. In your mind, what does that mean?

Dr. Ramaswamy:          

So, it is a concept that has come more lately in our lives. Even as I started, we didn’t – not that we didn’t do it, we didn’t give it a name. And I think now giving it a name always helps because we always think about it and make sure we are doing it. I think the shared decision-making is important on two levels. Sometimes we do have treatment options that are very similar as far as outcomes, so.

It is important to understand what are the goals of the patient. Is it that even if it’s a 0.5 percent increasing their cure rate, is that their goal? Or really looking at the benefits versus the risks and versus side effects and trying to reduce the side effects and quality of life. So, I think this – those kinds of things, this will never be addressed if you don’t understand our patient and give them an opportunity to speak out what they want.

So, I think in – and this happens in every aspect of their journey, right? So, it is important even if they say sometimes they’ll talk about sexual side effects and we talk about it and we offer some clinics. And they might say, you know what? At this point, I think I know you’ve shared with me certain ways. Let me try it and then I’ll tell you when. So, everything is the shared decision-making because that’s when we have the highest sense of compliance and to feel a sense of feeling that they’re  being heard, and we are in this together. And if we are not in this together, it is almost impossible to get  the best outcomes both from quality of life and also survival. So –

Katherine:

Yeah.

Dr. Ramaswamy:

 – that’s where the shared decision-making comes to. So, understanding the patient better and the patient understanding their outcomes better.