Team approach to breast cancer care is key to successful outcomes
By Trevor Bayliss, MD
If you’re among the one in every eight American women who develop invasive breast cancer over your lifetime, the evidence shows your prospects for full recovery are vastly improved when your diagnosis, treatment and other services are provided in a tightly integrated, synchronized program of care.
In the older, traditional pattern of medicine in the 20th century, various specialists tended to work in silos, focusing on their specific areas, but not fully cross-communicating to deliver the optimum level of care. Today, the most effective cancer programs are those in which close-knit, interdisciplinary teams of experts, coordinated by oncology nurse navigators who personally guide each patient through the entire process, work in unison toward successful outcomes.
Cancer centers ideally consolidate all or most of their services at a one-stop location, so patients can consult with their oncologists and undergo treatments in same-day visits. The best cancer programs also convene weekly “tumor board” meetings where specialists in oncology, pathology, radiology, chemotherapy and surgery discuss each case and jointly decide the right course of treatment for each patient.
Nowhere is that team approach more important than in the care of breast cancer, the most common cancer in women worldwide, affecting more than 1.6 million annually, projected to increase to 2.2 million by 2025. For men, the lifetime risk is about 1 in 833.
Comprehensive breast cancer care requires a constant focus not only on the medical aspects of treatment, but on the psychological impact of a diagnosis. Even when patients medically recover from a bout with breast cancer, they often experience depression, anxiety and fear not unlike what they felt when they first were first diagnosed, with the lead question being, “Will my cancer come back?”
Sensitivity to the unique medical and emotional needs of a breast cancer patient is central to the team method of care. Here’s a look at how that approach should play out every step of the way:
Navigation: From pre-diagnosis through all phases of the cancer experience, oncology nurse navigators provide individualized guidance to patients and families, coordinating with specialists to ensure timely access to all aspects of care.
Diagnosis: The news of a breast cancer diagnosis understandably triggers fear and anxiety, which is why your medical oncologist should work quickly with radiologists, pathologist and others to develop a clear plan of action.
Treatment: Whatever course of treatment or combination is recommended, less is always better when possible.
Surgery: The goal should always be to make it as least invasive and extensive as possible. Preserving healthy breast tissue is a priority.
Radiation Therapy: The focus should be using the latest technology to target delivery to only the tissues that need it, sparing healthy tissues and minimizing side effects.
Chemotherapy: The goal should be to use the most effective, cancer-targeted drugs while minimizing side effects.
Rehabilitation: This includes physical and occupational therapy, one-on-one sessions with a social worker and other body-and-mind methods to restore health and resilience.
Integrative Therapies: During treatment, recovery and beyond, exercise programs and therapies like yoga, mindfulness meditation, acupuncture, Reiki, healing imagery, and art and music therapy are highly effective in relieving stress and symptoms.
Palliative Care: This specialty also focuses on relieving pain, symptoms and stress. The goal is to improve quality of life and is appropriate at any stage, in tandem with curative treatments.
Survivorship: This is about living with, through, and beyond cancer. Cancer survivorship begins at diagnosis and includes people who are cancer-free and those who continue to have treatment long term to either reduce risk of recurrence or manage chronic conditions.
Through constant interaction with their patients and each other, today’s oncology teams are achieving better and better outcomes in the fight against breast cancer.
Trevor Bayliss, MD, a hematologist-oncologist, is interim director of the BMC Cancer Center in Pittsfield.