Oct
06
No More Breast Cancer, Please
Posted by Beth Smolko, MMS, PA-CComment
 
 

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Reprinted with permission from Clinician Today 

I met her when I was in my 20s. She was in her 30s, a young mom with two small children. We were neighbors, and we shared a thin wall between our townhouses. Our families became close and I watched her children grow. My husband and I had yet to start a family, so I enjoyed the time with her and her two boys immensely.

One year, my husband and I went on a trip to London. While we were there, I discovered I was pregnant. We had struggled to conceive and I couldn’t wait to talk to my friend. When I called her, a familiar voice answered, but it wasn’t hers. It was her father; he told me my friend couldn’t come to the phone, and he had bad news.

My friend had breast cancer. She was 36 years old.

The year that followed rushed by in a blur between doctor’s appointments and treatments. I lent help whenever I could, and I spent time praying her boys wouldn’t grow up without the beautiful mother they had been given. All the while, she was strong and determined to win her battle.

I remember the day she finally heard the words “cancer-free.” She was triumphant. The years that followed were filled with cautious optimism. She became a breast cancer advocate and helped other women through the process of treatments and fears. She wasn’t just a survivor — she was indomitable.

Eighteen years have passed, and her little boys are now young men with lives of their own. A few weeks ago, her husband called and asked me if I did “home healthcare.” I jokingly told him “not usually.” He asked if I would be willing to stop by and help his wife with the five drains the surgeon had placed during her recent mastectomy.

It felt like the room was tilting. She survived this before, right? She was going to be fine, right?

She found out she was BRCA2-positive and the type of cancer she now had wasn’t like the last. She would need a full hysterectomy after she healed from the massive surgery she just experienced. Chemotherapy and XRT would not be used. Why was there nothing else?

Before I became a PA, I worked in cancer research at NIH. I know the Sisyphean task that it is. I also know there are new approaches to treating patients that we never could have dreamt up only a decade ago. Individualized treatment plans are extraordinary; they can minimize side effects and maximize the chemotherapeutic effects on specific cancer types.

Unfortunately, women continue to get breast cancer at alarming rates. In 2009, the U.S. Preventive Services Task Force (USPSTF) advised healthcare providers to stop telling our patients to do breast self-exams. Even now, in 2016, we are told our patients don’t need mammograms until they are 50, and even then, that they should have one only every two years until they are 74.

I can tell you anecdotally that a majority of my breast cancer patients found their own cancer. My friend found her own cancer twice.

We need better ways to screen women for breast cancer.

We need better treatments for women and men with breast cancer.

We need to find out what is causing so much breast cancer in our population and put an end to it.

And … I need my friend to survive.

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