Whole-Patient Care: Breast Cancer
SLUCare breast surgeon Dr. Theresa Schwartz and breast radiologist Dr. Christina Doherty collaborate for better patient care
The path from breast cancer diagnosis to cure can seem like a daunting journey, often fraught with high emotions and stress. Many questions and concerns arise along the way, but modern medicine equips providers to calm any fears with highly specialized and compassionate care from start to finish, SLUCare doctors say.
Before medical professionals began to fully understand whole-person care, their focus was simply on treating the cancer, says SLUCare breast surgeon Dr. Theresa Schwartz, who sees patients at SSM Health Saint Louis University Hospital. “But today, we realize the importance of addressing the patient’s emotional and psychological needs as well as her physical ones,” she notes.
Schwartz says one of SLUCare’s best support resources for breast cancer patients is its nurse navigator, Jill Behymer. “She works with each patient who comes in with an abnormal mammogram or exam, and helps her understand every step of the treatment and recovery process,” Schwartz explains. “By the time I see the patient, she already knows Jill well and views her as a go-to resource for questions and concerns. Jill coordinates patients’ care, gets them in for additional tests if needed, and serves as a point person they can reach anytime. If she doesn’t have the answer they need, she knows who does.”
Behymer also works closely with patients after surgery and treatment, making sure they understand their individually tailored ‘survivorship plans,’ including follow-up visits, medication, diet, exercise and other recommendations. Throughout the treatment process, she connects them with physicians and other care providers to make sure all needs are addressed quickly.
Patients can receive care at Saint Louis University Cancer Center at SSM Health Saint Louis University Hospital.
When the patient has a team of doctors and nurses she can trust, it’s much easier for her to open up and admit that she’s having pain, is not handling things very well emotionally or doesn’t know how to talk with her kids about it. Then we can get her the help she needs.”Dr. Theresa Schwartz, SLUCare breast surgeon
Schwartz says each patient’s survivorship plan is portable and gives a comprehensive record of all medications, tests, treatments and surgeries. “If the patient moves, she can take it with her so future care providers will know her history,” she notes. SLUCare’s confidential online patient portal also keeps track of each person’s entire record, and it can be used to contact doctors, ask questions, schedule appointments and view explanations of test results, says SLUCare medical oncologist Dr. Mary Klix, who sees patients at the Des Peres Hospital campus.
“When the patient requests an office visit during treatment, we always try to make sure she can get in to see us quickly,” Klix says. “We tailor her care to whatever she needs. For example, one patient had trouble drinking liquids and was more comfortable coming in each week for IV fluids. If a patient is having nausea during chemotherapy, experiencing pain or having trouble sleeping, we stay in tune to her unique situation.”
Klix says SLUCare’s entire care team works together to ensure the best possible outcome for each patient, including the surgeon, medical oncologist, radiation oncologist, mammographer, radiologist, nurses and therapists. They can use highly advanced tests like MammaPrint and Oncotype to identify genetic breast cancer risk and rule out treatment the patient doesn’t need, Klix says.
Schwartz says patients also have access to ‘prehabilitation’ services that improve the body’s ability to heal after breast cancer. “When the patient is scheduled for surgery and there’s a chance of her physical function being affected, I send her for physical therapy before the operation,” Schwartz says. “It allows her greater control throughout the healing process because it increases physical strength and gives her an idea of what therapy will be like after the procedure.” Patients also learn how to do helpful exercises at home. Cancer treatment can be daunting because so many complex decisions are being made regarding medication, treatment and surgery, Schwartz says. So taking an active role in her own care can be empowering to a patient, and that confidence can help with mood, outlook and physical healing. “Prehabilitation puts the ball back in the patient’s court and helps her return to good overall health,” she notes.
Advising patients about lifelong nutritional and exercise habits is another way SLUCare practitioners help breast cancer patients stay strong. “Exercise is beneficial, but you don’t have to train for a marathon,” Schwartz notes. “Thirty minutes of walking each day is helpful, and it’s something nearly everyone can do. There’s also good evidence that weightlifting and strength training can improve muscle and bone health. Working with a trainer can help increase the patient’s mobility.”
Depending on the type of treatment or surgery a patient has had, working with physical therapists also can be helpful. They can help her regain strength and normal movement. “For example, if the patient has had her axillary (underarm) lymph nodes removed, a therapist can work with her to increase range of motion in the shoulder and improve the pliability of the skin and muscles,” Schwartz says.
Klix adds, “Recent studies suggest that cancer patients who stay physically active tend to heal better, live longer and have a higher quality of life. If needed, we also can work with the wellness community to help women find support groups and other resources. The idea is to keep the patient as healthy as she can be. The emotional and physical support we provide happens at every step.”
SLUCare Physician Group provides comprehensive and compassionate care for breast cancer patients. For more information, call 314-977-4440 or visit slucare.edu/breast-surgery.