Posted: Monday, October 5, 2020

A Team Approach to Fighting Breast Cancer

Being diagnosed with breast cancer can trigger a range of reactions and emotions, one of which is, of course, fear. At some point, that fear gives way to acceptance, often followed by the “okay, what now?” phase. The “now” part of that “what now?” phase is easy: “What can be done to help me fight this as soon as possible?” The “what” part of “what now?” can be much more complex, however, which is why it’s helpful to have a plan of attack and a team of experts alongside you helping create that plan.

“The treatment of breast cancer has become quite complex due to the availability and timing of many forms and variations of treatment,” said Blount Memorial Hospital board-certified and fellowship-trained surgical breast oncologist Dr. Randal Croshaw. “No two cases are alike, and treatment plans are individualized. That is why it is important to have a well-developed and coordinated team. The individual players that are integral to the process are a breast imaging nurse for counseling, scheduling and making sure you are ready for any needed studies; radiologists with experience and expertise in evaluating and interpreting specialized breast imaging; the breast surgeon, who usually is the first to encounter someone at the time of a breast cancer diagnosis; the nurse navigator to provide additional education and practical advice and guidance through all aspects of treatment and beyond; as well as the medical oncologist, radiation oncologist, plastic surgeon, and even the skilled fitters at the specialty bra and wig shop for those who need it or want it,” Croshaw explained. “You also have to add to that list physical therapists and certified lymphedema specialists, as well. It’s a big group of people, but you definitely should have total confidence in your entire team before you embark on a course of treatment,” he said.

In addition to his part as the breast surgeon on that team, Croshaw says he also works to ease patients’ fears. “I try to allay fear by increasing understanding,” he said. “I want to give an overview of who the other specialists involved are, what their role will be and integrate them at the appropriate time. My goal is to be available to evaluate potential problems and initiate or coordinate diagnostic studies in a succinct way; to counsel and educate so that the patient and his or her family understand what he or she is facing; and to explain the treatment options and recommend what may be best for his or her particular case,” Croshaw explained. “We discuss everything from the particular type of cancer and, based on the type and other factors, how it is treated in several different ways. We also openly discuss all options and recommend an individualized course of action that takes into account the patient’s individual needs and desires. I also try to determine if there is a hereditary component and provide genetic counseling and testing to be able to explain how the results may impact treatment recommendations, along with further screening and risk-reducing methods for patients and their close family,” he added.

And while that may sound like a lot, when you’re facing a breast cancer diagnosis, you want all those areas covered. “I see my job as helping a person to understand what we are up against, what factors are considered to guide individualized decisions, explaining the different forms of treatment, recommending a course of action, and explaining why we’re taking the path we’re taking as opposed to others available,” Croshaw said. “This way, patients can be engaged, empowered and able to take an active role in their treatment choices,” he added.


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