Are patients comfortable speaking about their personal problems with their physicians?
A lot of patients are ashamed to bring up their sexual lives. When they’re with a physician, they’ll talk about cancer recurrence and cancer survival. For me, it’s only when I leave and my nurse practitioner comes in that they are able to open up and discuss the problems they are facing sexually. Physicians must assure patients it’s OK to speak with them about these problems and even consider bringing up the topic themselves.
Why do physicians need to be aware of problems patients face in their personal lives?
As a surgeon, I may not have the solutions they need, but I still have to be aware that my patient is not just a person with breast cancer. She is a woman. I may not be able to address her specific problems myself, but I have a colleague next to me who may be able to help.
Treating a patient with cancer is just like a symphony. The maestro cannot conduct the symphony without other players. Cancer needs to be treated in a multidisciplinary fashion.
How is the field evolving?
Things are definitely evolving, particularly as we find out it’s not just BRCA1
, there are all these other actionable genes. We started with 2 genes, now there are 5 genes that are actionable that do lead to prophylactic mastectomies and oophorectomies.
As things are evolving, I think educating yourself and staying on top of things are very important. Before, we probably changed our pattern of practice every 10 years. Now, we probably change our practice every 6 months to every year. That’s how rapidly things are evolving in our area.
Why is survivorship so important to address at a meeting such as ASCO?
Survivorship is coming to the surface. Before, it was an afterthought. We congratulated ourselves after getting rid of the cancer in our patient, particularly in breast cancer, because it has a high survival rate. Now we’re really starting to focus on what happens next. Getting rid of cancer is part A, but part B is just as important. It’s becoming an increasingly relevant topic. We’re highlighting the importance of not just curing but taking care of a whole patient and her whole life, not just the episode where the cancer began and ended.