Swedish News Blog

Bilateral Mastectomies: a patient’s personal decision

Claire L. Buchanan, MD, FACS

Claire L. Buchanan, MD, FACS
Breast Cancer Surgeon

Last week the Seattle Times reported that women diagnosed with early stage breast cancer in one breast are choosing to have bilateral mastectomies to reduce their chances of getting cancer again, but recent research shows that that there is no survival benefit, even in younger women. Researchers at Stanford and the Cancer Prevention Institute of California evaluated the outcomes of over 190,000 women from the California Cancer registry who were diagnosed with breast cancer in one breast between 1998 and 2011. The rate of bilateral mastectomies rose from 2% to 12.3% over the study period, yet there was no survival benefit to bilateral mastectomies versus lumpectomy and radiation.

To those of us who work in the field, this data comes as no surprise; the trend of bilateral mastectomies is a known phenomenon. More than 10 years ago, I remember the chatter among surgeons at national meetings asking if others noticed that more and more, younger women were coming in asking for bilateral mastectomies. Back in 2007, Dr. Todd Tuttle authored a study in the Journal of Clinical Oncology that found that the rate of contralateral prophylactic mastectomy was on the rise, from just under 2% in 1998 to 5% in 2003. This week’s study only validates that this upward trend shows no sign of leveling off.

Why do patients choose bilateral mastectomies?

Many women ....

PALB2 Gene Mutation & Breast Cancer: What it Means For You

Robert Resta

Robert Resta
Genetic Counselor

PALB2 is a gene that was first linked to hereditary breast cancer risk back in 2007. Today’s Seattle Times reports on a recent study about PALB2 that was just published in the New England Journal of Medicine. The study, the largest to date, detailed the breast cancer risks faced by  women – and to a lesser extent, men – who carry a mutation in their PALB2 gene. The breast cancer risks were several times greater than the ~12% risk faced by all women, and varied with the woman’s age and family history. Currently, there is no consistent evidence to suggest  that men or women who carry a single PALB2 gene mutation are at greater risks of developing ovarian or other cancers.
 
PALB2 genetic testing can provide very important information that can help women and their families better understand and reduce their risks of developing breast cancer. However, even among women with a very strong personal or family history of breast cancer, very few will test positive. Studies suggest that only about 1-3% of high risk women  will carry a PALB2 mutation. In my personal experience, I have tested about 300 high risk women for PALB2 mutations, and ...

Summer 2014 Cancer Community Walks & Runs

Brian Aylward, BS, CHES

Brian Aylward, BS, CHES
Health Navigator

Each year, the Swedish Cancer Institute (SCI) partners with local and national organizations in an effort to help spread awareness of cancer, associated treatments, and resources available in our communities.
 
Summer 2014 is no different. We’ve signed on to take part in more events than ever before—and we want you to join us! As an active patient, survivor, family member, friend or advocate, your voice and participation matter.
 
American Cancer Society Relay for Life
These overnight community fundraising walks help raise money to fund cancer research, education, and support services like Hope Lodge®, Road to Recovery®, Look Good, Feel Better®, and Reach to Recovery®, all American Cancer Society-run programs. The Swedish Cancer Institute patients gain access to these programs throughout the Swedish network. There are several Relay for Life events going on in the Puget Sound. The Swedish Cancer Institute is taking part in:

Talking to kids about cancer

Tricia Matteson, MSW, LSWAIC

Tricia Matteson, MSW, LSWAIC
Oncology Social Worker

What do I tell my kids?” 

This is often the first question I’m asked by a parent with a new cancer diagnosis.  One of the most important things for parents to remember is that they know their children better than anyone else and they love them more than anyone…they can trust themselves to do this well.
 
Beyond that general reassurance, however, there are some practical tips for talking with children about a cancer diagnosis. 
 
Prepare for the conversation 
 
Think about your goals for the conversation.  What does your child need to know?  How you can help your child understand what’s going on?  How do you want your child to feel after the talk?  Who should tell your child you have cancer and can the person talking to your child stay relatively calm?
 
When and where should I have this conversation?  You don’t have to wait until you have all the answers.  Be prepared to ...

5 things to know about cancer screenings

Michael Milder, MD

Michael Milder, MD
Oncologist, Swedish/Ballard

Cancer causes 580,000 deaths a year in the United States. One in eight women will develop breast cancer and one in six men will be diagnosed with prostate cancer during their lifetimes. However, many deaths can be prevented when cancer is detected at an early stage. Cancer screening and risk assessment tests are the tools we use to find cancers early.
 
How do we find early cancers?

Some cancer screenings can be done yourself at home at essentially no cost or risk. This includes regular self-examination of the breasts, testicles and skin. Home fecal occult blood testing can also be done to screen for colorectal cancer. Additional information on cancer screening and self-examinations can be found on websites such as www.cancer.org or www.webmd.com.

 
Other screening requires medical interventions. There is good evidence that well-targeted screening saves lives. However, screening tests such as mammography, colonoscopy and prostate-specific antigen (PSA) are  ...

Resources and social support for dealing with cancer

Brian Aylward, BS, CHES

Brian Aylward, BS, CHES
Health Navigator

Here at the Swedish Cancer Institute (SCI), we understand that individuals cope in their own unique ways, and that receiving personalized education and support is important in the healing process. For this reason, the SCI is devoted to providing complementary supportive services for newly diagnosed patients, those undergoing treatment, and those who have completed treatment, as well as their caregivers.

The SCI offers programs that promote education, hope, and healing. Many of these programs are offered free of charge, while others are offered on a sliding scale. These integrated care programs include:

  • American Cancer Society Patient Navigation: The American Cancer Society Patient Navigator helps patients find resources related to financial assistance, transportation, access to wigs and prosthetics, and much more.
  • Art Therapy: Art therapy is a confidential, supportive, and individualized experience for examining health issues through visual and verbal self-exploration.
  • Cancer Rehabilitation: Cancer rehabilitation integrates medical management of cancer treatment-related side effects with a variety of exercise therapies.
  • Health Education: The Swedish Cancer Education Centers offer complementary educational materials, innovative learning opportunities, and patient education classes.
  • Genetic Counseling and Testing: Genetic testing is available for individuals to determine their risk for developing certain cancers.
  • Massage Therapy: Massage therapy may help with cancer-related pain, fatigue and nausea.
  • Naturopathic Medicine: Combining modern science with natural remedies, naturopathic doctors are available for consultation and treat¬ment through coordination with the patient’s oncologist.
  • Nutrition Care Services: Nutritionists are available to help patients and caregivers make healthy dietary choices during cancer treatment.
  • Psychiatry: Psychiatrists help patients and caregivers maintain the emotional and mental well-being needed to cope with stresses of cancer.
  • Oncology Social Work: Licensed oncology social workers provide patients and caregivers ongoing counseling and assistance.
  • Support Groups: Support groups for patients and caregivers are offered weekly, creating an environment for people to share their feelings with others going through similar experiences. 

Patients often hear that it’s important to find a strong support system during and after treatment; this may include a partner, sibling, parent, child or close friend. These are ...

Cancer control and survivorship

Dan Labriola, ND

I recently attended the Southwest Oncology Group (SWOG) meeting, a consortium of research institutions doing clinical trials on cancer. The conference highlighted how new research will remarkably affect cancer survivorship, quality of life (QOL), integrative care and our ability to predict and provide needed services more accurately and with greater cost effectiveness for cancer survivors. The tools for implementing cancer control are evolving quickly.

Here are some highlights from the meeting:

  • Biomarkers, which are any human characteristics that are measurable including everything from gene expression (or over-expression) to pain surveys, can potentially predict long term survival as well as the specific services that will most benefit patients.
  • Symptoms that are increasingly predictable by biomarker assays include fatigue, insomnia, pain, anorexia, nausea, depression and others. This means that we will soon be able to better predict the patients who will be affected by these problems and deliver interventions much earlier and more effectively.
  • Patient satisfaction is frequently not related to treatment outcome. Factors such as QOL and survivorship are important.
  • Lung cancer patients suffer inordinately high, long-term QOL deficits. Many of these respond well to interventions but interventions are frequently not provided to patients with lung cancer.
  • Symptom clusters ...
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