What Should I Do If Im Simply Having Trouble Coming To Grips With My Diagnosis
If youre struggling to cope with a cancer diagnosis, youre not alone. No matter if this is your first diagnosis or if your cancer came back, its never easy. You may not know where to turn or who to ask for support.
Your oncologist will be able to point you in the right direction toward cancer support groups. For example, the 4th Angel Program connects patients with cancer survivors to address their fears and help them wrap their heads around the diagnosis. Patients often appreciate talking with people who have been through it before and it gets people through their fear of whats coming.
Should I Get A Second Opinion
A second opinion may confirm your original diagnosis and treatment plan, provide more details about the type and stage of your breast cancer, raise additional treatment options not considered, or lead to a recommendation for a different course of action. A second opinion may also help you feel more confident in your treatment decisions and help you find a doctor you feel comfortable with.
What Should I Bring With Me
In order to make it a thorough consultation, the oncologist youre meeting with should have all your reports and other requested materials. This includes copies of scans, x-rays, MRIs, CTs, or other imaging tests that were done, and pathology slides if a biopsy was performed.
In addition, we always ask that you bring in any medications you take, including over-the-counter pain relievers, vitamins, herbs, and supplements. Rather than just making a list, we ask that you bring in the actual medicines so we can note the dosages. Before recommending a treatment, doctors have to know what youre taking in order to make sure there are no potential interactions. People may forget things like calcium and vitamin D, but those can interfere with some treatments.
We encourage you to take notes during your appointment. If you can, bring someone with you a family member or a friend to be another set of ears in the room. In addition to providing emotional support, they can help you remember what the doctor says, take notes for you, and remind you of key questions that you dont want to forget to ask.
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How Quickly Do I Need To Make A Decision About Breast Cancer Treatment
Treatment for breast cancer generally should start soon after diagnosis, but in most cases, it wont hurt to wait a few weeks to begin treatment. Even more important than beginning treatment immediately is to understand and evaluate all your treatment options with your care team and loved ones, and then decide whats best for you.
Talking To Your Doctor Or Nurse
To get the most out of your visit you might consider:
- requesting a longer appointment if you have a number of issues to discuss
- preparing your questions beforehand
- taking a friend or relative for support, or writing down answers to your questions if possible
- asking your doctor to explain again, if you don’t understand the answers
- asking your doctor to give you a written summary of your treatment plan
- asking for an interpreter if you have difficulty communicating in English
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What Are The Potential Side Effects Of This Treatment
Many people who undergo radiation therapy for breast cancer have some breast pain and skin irritation. The affected skin may eventually become red and swollen like a sunburn. These conditions typically begin within a few weeks of starting treatment and go away on their own within six months after treatment ends. For some patients, these symptoms may not occur until several months or years after treatment. Other common side effects include fatigue, especially in the later weeks of treatment and for some time afterward, and firmness or shrinkage of the breast. Women who have had radiation therapy to the lymph nodes in the underarm area may develop lymphedema, a condition in which fluid collects in the arm, causing it to swell.
Questions About Your Diagnosis
If youve been diagnosed with breast cancer, you may want to learn everything you can about your cancer, or you may want information a bit at a time.
Dont be afraid to ask questions of your specialist, breast care nurse or anyone else in your treatment team.
It may take a while for them to gather all the details of your diagnosis while different tests and investigations are carried out.
You may get bits of information as you go along and sometimes this information can change.
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If I Am Advised To Have A Mastectomy What Are The Risks And Benefits Of Immediate Breast Reconstruction
If a mastectomy is necessary, immediate reconstruction offers a great psychological benefit to most women. However, as is often the case in medicine, there are trade-off risks that must be considered. If the reconstruction is done during the same surgery as the mastectomy , the final results of the pathology tests on the removed tumor and tissue is not yet known and will not be known for at least a day or two.
There are sometimes findings on the final pathology report that make chest wall radiation advisable in order to reduce the risk of local recurrence. If a prosthesis for the breast has been implanted, the radiation treatment will still work, but the radiation may significantly compromise the cosmetic appearance of the prosthesis. There may also be healing problems that delay chemotherapy, potentially increasing the risk of breast cancer recurrence. These and other factors should be discussed and carefully considered before committing to immediate breast reconstruction.
Is A Clinical Trial Right For Me
There is a lot of misinformation about clinical trials. Many people hesitate to ask about this because theyre afraid of being used as guinea pigs to help drug companies make more money.
In reality, patients who participate in clinical trials generally do better than those who do not, says Dr. Kamath. Theyre getting tomorrows breakthrough therapy today.
Clinical trials exist to test for ways to prevent, treat and diagnose cancer while also managing symptoms and possible side effects. Clinical trials are available for every stage of cancer, too. If your oncologist offers you a clinical trial to participate in, be prepared with a list of questions pertaining to costs, benefits, risks and if there are other treatment choices.
Its important to know that no patients get placebos or sugar pills alone in oncology clinical trials, says Dr. Kamath. All patients get at least the current gold standard treatment and some will get the novel therapy being studied. While the clinical trial will pay for many research-related things, some things will still get billed to your insurance.
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Should Breast Cancer Patients Have Their Lymph Nodes Removed
Lymph nodes are small glandular structures that filter tissue fluids. They filter out and ultimately try to provide an immune response to particles and proteins that appear foreign to them. There are thousands of these nodes scattered in groups throughout the body. Each cluster is more or less responsible for the drainage of a particular region of the body.
The lymph nodes under the arm are the dominant drainage recipients from the breast. When cancer cells break free from breast cancer, they may travel through the lymph tubes to the lymph nodes. There, the cancer cells may establish a secondary growth site. The presence of cancer cells in the lymph nodes proves that cancer cells have traveled away from the primary breast tumor. Therefore, the presence or absence of cancer cells in these regional nodes is an important indicator of the future risk of recurrence. This information is often important in making decisions about whether to use chemotherapy and what type of chemotherapy should be employed.
Unfortunately, removal of the lymph nodes also carries a potential risk of lymphedema, a condition that may cause the arm to swell. Lymphedema can occur early after surgery or many years later. It can be a difficult and disabling condition. Here again, there are tradeoffs in risk. When more lymph nodes are removed, more accurate information about tumor spread is obtained and the chance for tumor recurrence is less. But there is a greater incidence of lymphedema.
What Is The Tumor Grade
Particular characteristics of breast cancer cells affect how aggressive your tumor is. These include the amount of tumor cells that are reproducing, and how abnormal the tumor cells appear when examined under a microscope.
The higher the grade, the less the cancer cells resemble normal breast cells. The grade of your tumor can influence your outlook and treatment plan.
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What Is Inflammatory Breast Cancer
Considered a rare disease, inflammatory breast cancer typically forms in the soft tissues, blocking lymph vessels in the breast skin. That’s why the breast often becomes firm, tender, itchy, red and warm, from the increase in blood flow and a build-up of white blood cells. IBC differs from other forms of breast cancer, especially in symptoms, prognosis and treatment. The term inflammatory is not meant to reflect what’s happening inside the breast, only in how the breast appears. When an infection or injury causes the breasts to become inflamed, they often become tender, swollen, red and itchy, but the underlying cause is not inflammation.
Even Though My Breast Tumor Does Not Have Hormone Receptors Should I Take Tamoxifen To Reduce The Risk Of A New Tumor
Following completion of your treatment for breast cancer, whether or not tamoxifen is prescribed should at least be addressed. In many cases, the primary breast cancer for which the patient is being treated may not be hormone-receptor positive. In these cases, tamoxifen is not generally part of the treatment protocol.
However, the Breast Cancer Prevention Trial demonstrated a significant reduction in the development of new cancers in the opposite breast in patients who were treated with tamoxifen. So, the possible use and benefits of tamoxifen should not be ignored. A thoughtful evaluation of all the factors in a particular case will lead to a recommendation which balances the benefits of tamoxifen against the potential risks. Your treatment team should address this issue with you.
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What Can You Tell Me About My Tumor
In short, your doctor will be able to tell you what causes your specific type of cancer to grow, stabilize, or shrink. The majority of breast cancers are hormone-receptor positive, meaning estrogen and progesterone feed the cancer. These types of breast cancer are most often treated with a combination of antiestrogen therapy and a newer class of targeted therapies called CDK 4/6 inhibitors, which, Dr. Fasano says, have revolutionized advanced breast cancer treatments. Your tumor may be HER2-positive or triple-negative. In all cases, these distinctions help dictate your treatment: If its triple-negative and expresses the PDL1 protein, you may be a candidate for immunotherapy. If its HER2-positive, youll likely be a candidate for multiple HER2-targeted therapies.
Questions To Ask The Medical Oncologist
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Make Sure You Get The Answers To Your Questions
Healthcare professionals know its important for your wellbeing to have your questions answered.
If you dont feel you have had an answer to your question, ask again.
Sometimes its not possible to give a definite answer, but your treatment team should be able to explain why if this is the case.
If you have any questions you feel have not been answered, or would like to talk through any concerns, call our Helpline on 0808 800 6000.
What Are Hormone Receptors
Cancer cells removed during a biopsy are tested for proteins called estrogen or progesterone receptors. When estrogen or progesterone are present, they help the cancer grow more quickly. Whether your cancer cells are hormone receptor-positive or negative will help determine the best treatment for you.
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Will I Need Surgery And What Kind Should I Have
This is an important question but the answer may be less than definitive. It will vary from patient to patient and you may have more than one choice.
According to the American Cancer Society, most women with breast cancer have some type of surgery. But some breast cancers cant initially be surgically removed. In other cases, whether to operate and the type of surgery may depend on the cancers stage, the tumors size and location, the size of your breast and your personal preference.
In women whose breast cancers are operable, the choices are breast-conserving surgery or mastectomy. Mastectomy is the removal of most or all breast tissue and possibly nearby lymph nodes. Within each of those two broad categories are further options. Talk with your oncologist and breast surgeon. If you have any doubts, you may choose to seek a second opinion.
How Urgent Is It That I Make Decisions And Begin Breast Cancer Treatment
It is extremely rare that a patient must be rushed into treatment. The biology of breast tumors is established fairly early in their development, and by the time the tumors are detectable, most have been growing undetected for considerably more than a year. This means that if you take a few weeks to complete a thorough evaluation, obtain appropriate consultations, understand the situation, discuss the alternatives, and initiate a treatment plan, it is not likely to add any significant risk. This time frame, however, should allow the facts of your case to be carefully sorted out and errors to be minimized. Your treatment team should be able to help you in this process and specifically advise you on the urgency to start certain treatments.
Are there controversies in the recommended treatments among reputable experts?
Doctors may differ in their recommendations if they weigh the risks differently. There will always be uncertainties in any given case. These issues are rarely “right versus wrong.” They can be compared with decisions such as, “How do I balance my desire to have the largest and safest care with the need to have convenience and economy?” There are tradeoffs. For example, certain breast cancer treatment options may favor cosmetic appearance but slightly increase the risk of recurrence in the affected breast. If you have concerns, a second opinion by a different treatment team can often be helpful. A good treatment team will help the patient make informed decisions.
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Feel At Ease With Your Cancer
It can be overwhelming to find out you have this disease. It is not easy to feel calm and comfortable about what will happen in the next few weeks or months. However, from the first meeting, the oncologist will make sure you understand what lies ahead. This doctor will be a resource you can feel good about. Make your first appointment today and start on the road to recovery.
Request an appointment here: or call Lindenberg Cancer & Hematology Center at for an appointment in our Marlton office.
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What Treatment Options Are Typically Available
Breast cancer treatments have two main goals: to destroy as much of the cancer as possible, and to prevent tumors from returning.
Some treatments remove or destroy the disease within the breast and nearby tissues, such as lymph nodes. These treatments include:
Surgery: Surgical options include a mastectomy, which removes the whole breast, and a lumpectomy, or breast-conserving surgery that removes only the tumor and the tissues around it. Sentinel node biopsy is a surgical diagnostic technique that removes one or a few of the first draining lymph nodes to determine whether cancer cells have spread beyond the breast. Women who have surgery as part of their breast cancer treatment may choose oncoplastic and breast reconstruction surgery to rebuild the shape and look of the breast.
Radiation therapy: This conventional technique uses targeted, high-energy radioactive waves to destroy tumors.
Because these treatments often affect the lymph nodes, lymphedemais a common treatment-related side effect for breast cancer patients who receive surgery or radiation therapy. Lymphedema is the buildup of lymphatic fluid under the skin, which often leads to swelling.
The goal of other treatments is to destroy or control cancer cells all over the body. These include:
Your doctor may recommend chemotherapy, hormone therapy or targeted therapy treatment along with surgery or radiation in order to kill cancer cells that were left behind by other treatments.
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Tips For Communicating With Your Care Team
Navigating a cancer diagnosis can feel overwhelming, especially when youre inside the doctors office. There are steps you can take to prepare for each appointment. This will help you prioritize your own questions, concerns, and needs during every visit with your care team.
- Write down your questions in advance. It can be difficult to remember what questions you have when youre in the office. Writing them down and ranking your questions will help you to not miss anything and ask the most important questions first.
- Bring a friend or family member to your appointments. A trusted friend or family member can be a huge asset during your appointment. Theyre more likely to remain calm and clear-headed, so they can ask questions you forget or miss.
- Ask for clarification. If your doctor or nurse says something you dont understand, ask for clarification. Your care team is here to help you, and that begins with ensuring you understand your diagnosis, treatment, and options.
- Record your appointment. You might want to keep an audio file of your appointment on your phone or other recorder. That way, youll be able to listen back through your doctors recommendations when you have the mental capacity to better understand the conversation.