Florida Weekly Employees | September 29, 2021
Technology and treatment can help save more lives
October brought healthy hope for fighting against the second leading cause of female death.
Breast Cancer Awareness Month, a national annual event
The Breast Cancer Foundation has raised public awareness of the diseases that one in eight women will face. Although this statistic sounds scary, advancements in technology and treatment have brought better results for those diagnosed than ever before.
"I think this is the trend of the future," said Dr. Maria Castilla, a general surgeon at Fawcett Memorial Hospital in Port Charlotte.
Robotic surgery optimizes procedures for cardiothoracic, colorectal, gynecology and other cases involving small incisions. It provides better control and flexibility. The subject is currently investigating and researching nipple-preserving mastectomy, and preliminary results indicate that it may be a promising new technique.
"I'm very excited about this," Dr. Castilla said. "If I can do anything on the robot, I will. With the robot, the technology is much more advanced. It has better visualization than any laparoscopic camera on the market."
The mammogram area at the Naples Breast Center provides a sanctuary-like atmosphere in an environment dedicated to breast imaging. Courtesy photo
In nipple-preserving mastectomy, all breast tissue will be removed, and the skin of the nipple and areola will be preserved. If after investigation and research, robotics becomes an acceptable solution, then this technology will take at least five years.
"We are trying to find a way to apply robotics to everything," said Dr. Castilla.
Genetic testing is another area that is gaining attention in the cure race. More than 20 genes — and increasing ones — are linked to an increased risk of breast cancer.
"Patients have very good feedback on genetic testing," said Dr. Castilla. "A lot of my young patients want to complete it. They want to know why I got breast cancer at such a young age."
"It will affect surgery, drugs, and how we monitor patients in the future," said Dr. Janine Harewood, a medical oncologist at the Lee Health Regional Cancer Center in Fort Myers, of genetic testing.
One of Dr. Harewood's patients underwent genetic testing after the diagnosis and learned that she had Li-Fraumeni syndrome, a rare disease that made her susceptible to breast cancer and other cancers. The conclusion is that the patient should not receive any type of radiation. So she had a double mastectomy instead of a lumpectomy.
"If we didn't know that she had this syndrome, we would cause her harm," Dr. Harwood said. "The number of genetic tests we have performed to find these mutations has increased, and we are doing it at the time of diagnosis. This is one of the biggest changes."
The study of discovering cancer through simple blood tests is a hot topic in academia and science.
"This is still very early research, but found blood tests for circulating tumor cells-this is what they hoped," Dr. Harwood said. "The idea is that if you can detect these cells before imaging, you can make a diagnosis."
"In terms of targeted new therapies, we have indeed made medical advancements," said Dr. Talya Schwarzberg, a medical oncologist at the Palm Beach Gardens campus of the Tampa General Hospital Cancer Center in South Florida, speaking of drug development for HER2 patients -Positive breast cancer.
HER2-positive breast cancer is related to human epidermal growth factor receptor 2, a protein that promotes the growth of malignant cells. Dr. Schwarzberg described the protein as "driving breast cancer" and the new prescription as "an excellent brake with the accelerator pedal off".
"It's not like chemotherapy, all fast-growing things will be killed," she said, noting that there is no hair loss, no nausea and less fatigue. "This is a well-explored and very successful path."
A new treatment for triple-negative breast cancer-PARP inhibitors-is also a medical advancement. Triple-negative breast cancer is still the most difficult to treat because it lacks hormone receptors-estrogen and progesterone-and the HER2 protein, and does not respond to treatments directed at these targets. Until a few years ago, chemotherapy has been the mainstay of treatment.
"This has significantly improved the cure rate of serious cancers in history," said Dr. Kelly Foster, a medical oncologist who worked with Dr. Schwarzberg.
PARP or poly ADP ribose polymerase is an enzyme that helps repair damaged cells. PARP inhibitors prevent enzymes from repairing cancer cells, and then the cells die.
"Until a few years ago, triple-negative breast cancer was an area where our prognosis was very poor," said Dr. Foster. "We are now seeing which drugs have been approved by the FDA, which is a very meaningful improvement in this area."
The US Food and Drug Administration approved an immunotherapy drug in July that targets the patient's immune system, triggering it to recognize and attack cancer cells as bad cells.
"It really only improved the overall results to some extent," Dr. Foster said. "There is so much progress in the world. Yes, having to go through this is a bad thing, but it can be cured."
Part of the process includes having someone in your corner-a navigator who can guide the patient through the entire process from diagnosis to treatment to cure.
"Although the Breast Health Center uses the latest equipment and treatment options to fight cancer, we believe that the key to providing superior results and superior patient experience is caring, compassionate and professional breast health navigation," Sean McConnell Er said, Director of Marketing and Communications for the NCH Healthcare System in Naples.
The Breast Health Center of the NCH Healthcare System has established the position of Breast Health Navigator to guide women through the many knowledge they need to learn and the decisions they must make in order to develop a treatment plan that best suits their lifestyle. The rapid dissemination of the diagnosis and the ensuing information may overwhelm the patient at the beginning of the journey. The Breast Health Navigator is the "first choice" for services and is a registered nurse who can provide emotional support. The most important duty of a breast health navigator is to ensure that the patient knows exactly what will happen during testing and treatment.
When handled separately, appointments, procedures, and schedules can be confusing. The Breast Health Navigator coordinates appointments, schedules procedures, and establishes a timetable so that everyone can participate in the process. The Breast Health Navigator also arranged referrals to community resources, financial assistance, and support groups.
"Our breast health navigator is a consistent contact," said Mr. McConnell. “She can help them solve these problems by listening to women’s voices, talking to them, and getting them in touch with people who know how to help.”
After all, early detection is crucial.
"Unfortunately, due to the COVID-19 pandemic, breast cancer has not stopped, so screening is not affordable," said Dr. Krystal Smith, founder of the Naples Breast Center.
Earlier this year, the doors of the 6,000-square-foot imaging office were opened to patients seeking a safer place for annual screening.
Although early detection of cancer is the key, many women skipped mammograms in 2020, and due to the Delta variant of the virus, more women are considering skipping mammograms this year. At the Naples Breast Center, patients can expect a sanitized, socially distanced, shelter-like environment, where the only customers are those seeking breast imaging.
"We are not like a huge outpatient center," Dr. Smith said. "It's just a very loving, kind, and warm environment."
Other services include ultrasound and biopsy.
"We are very, very hands-on," Dr. Smith said. "We take care of everything, from A to Z."
This brings her back to a key point:
"Mammography is the only test that can reduce breast cancer deaths," Dr. Smith said. γ
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