From Turning Point 2015
by Robert Levy
Diagnosed at age 39 with stage II
breast cancer, Colleen Sullivan quickly realized that "care" is a collective noun at the
Susan F. Smith Center for Women's Cancers at Dana-Farber.
Over the course of six months last year, her care team at Dana-Farber/Brigham and Women's Cancer Center (DF/BWCC) would include not only her breast oncologist,
Harold Burstein, MD, PhD, but also a cancer surgeon, radiation oncologist, reconstructive surgeon, chemotherapy infusion nurse, a nurse practitioner, clinical assistants and facilitators, and a range
of other professionals in the foreground and background. Had she been on a clinical trial of a new treatment, her team would have also included the investigator leading the trial, as well as other team members.
"Because I was diagnosed at a young age and had certain receptors on my tumor cells, Dr. Burstein recommended that I see a genetic counselor," says Sullivan, a schoolteacher and mother of three young daughters. "I met with one at DF/BWCC, had my blood
tested, and sure enough, it tested positive for a BRCA mutation," an inherited abnormality that can dramatically increase one's risk for breast cancer. Learning that she carried the mutation, Sullivan decided to have a double mastectomy —
rather than a lumpectomy followed by radiation, as she had originally planned.
Now finished with her treatment, Sullivan remarks on the "many helping hands who guided me through this journey with cancer." She was particularly struck by the level of communication among those on her care team. "No matter which physician I saw, he
or she had already been in touch with my other doctors," she says. "It felt as if we were one unit."
Dr. Burstein describes the care team concept in terms of concentric circles. The inner ring includes those with the greatest contact with patients. Radiating outward are rings of other specialists — in everything from pathology to the pharmacy to nutritional
counseling — who play critical, supportive roles.
"Our patients are surrounded by a team of providers to care for them," Dr. Burstein says. "One thing that makes DF/BWCC a special place is that we are all here, working side-by-side, on a daily basis. Our clinics are arranged so that we constantly connect
and interact in person — experts in every medical discipline, nurses, and laboratory scientists. Our patients feel the touch of having their medical team work together because it's real."
Young and Strong Program Supports Young Women with Breast Cancer
Like Colleen Sullivan, women diagnosed with breast cancer at a young age (45 or younger) face a unique set of challenges. Many are parenting young children or thinking about becoming parents. They may also be working to advance their careers and forming
important relationships. For women at this time of life, cancer can pose a formidable physical and emotional burden.
About 11 percent of breast cancers in the United States arise in women age 45 or younger. Recognizing the distinct needs of such patients, Dana-Farber/Brigham and Women's Cancer Center founded the
Young and Strong Program for young women with breast cancer in 2005.
The first program of its kind in New England and one of the only such programs in the U.S., Young and Strong has provided care and support to thousands of patients over the past decade, helping them navigate their journey through cancer and beyond. The
program recently received a major grant to expand its services.
Ann Partridge, MD, MPH, of the Susan F. Smith Center for Women's Cancers at Dana-Farber, the program focuses on treatment as well as research. "We created the program to focus not only on the treatment
of the disease — and on research to improve that treatment – but also on providing support, education, and information for our young patients and the professionals who care for them," Dr. Partridge says.
The program's clinical services include:
Fertility and reproductive counseling : Physicians ensure that fertility
options are addressed right away, so patients will have time to consider which is best for them.
Genetic testing : Patients have the option of being tested for inherited
mutations to the genes
BRCA2 — information that can impact their treatment options.
- Psychological support: A
social worker is identified on a young woman's first visit to provide individual counseling throughout the course of treatment.
The women also have access to a telephone
support group, an online support group of young breast cancer patients, and mental health services.
Survivorship : Patients can utilize services for fertility,
sexual health, weight management and other issues once they complete treatment. These young women also have the opportunity to participate
in a variety of research projects designed to improve the care of young women with breast cancer in the future.
Turning Point 2015 Table of Contents