Closings and delays

Medical panel in Forsyth Co. offers advice on surviving breast cancer

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Eighteenth-month-old Sara Mishra (center) smiles as she sits with her mother Dr. Dory Brown, a radiation oncologist at Wake Forest Baptist Health, on a medical panel during the 13th annual Pink Ribbon Talks Breast Cancer Survivor Conference at the Village Inn & Conference Center on Saturday, Oct. 4, 2014 in Clemmons. (Melissa Melvin-Rodriguez/Special to the Journal)

CLEMMONS, N.C. — Every year, organizers of the annual Pink Ribbon Talks hope their event becomes smaller – a sign that fewer local women are dealing with breast cancer or adjusting to their post-surgery life, according to the Winston-Salem Journal.

But until the day comes that research eradicates the disease, Cancer Services says it will continue to bring together survivors and medical personnel to share stories of encouragement, compassion and hope.

“Every person here has an important story to tell, and you need to tell it and shout it from the rooftops,” Patty Zekan, an oncologist with Novant Health Inc., told about 150 breast cancer survivors at the 13th annual event at the Village Inn & Conference Center.

The event featured medical updates on treatment advances – pre, during and post surgery procedures. Each of the five panelists spoke of significant research updates in the past two years.

A separate panel discussion focused on helping survivors better deal with what is known as “chemo brain,” when chemotherapy treatments have a dulling effect on cognitive recognition. According to several medical studies, nearly half of patients taking cancer drugs experience a decrease in mental sharpness that can last from a few days to several years.

Cancer Services also arranged a panel of survivors to share their stories, as well as a fashion show and boutique.

Dr. Julie Lawrence, an oncologist with Wake Forest Baptist Medical Center, said one notable research advancement actually has a back-to-the-future aspect.

Tamoxifen has been a preferred drug for treating early- and late-stage breast cancer for more than 40 years. It blocks the ability of cancer cells to use estrogen, the U.S. National Cancer Institute says.

However, concerns about side effects have led to it being used for no more than five years for most patients.

In May, the American Society of Clinical Oncology issued new guidelines that said tamoxifen can be provided for up to 10 years for women treated for hormone receptor-positive breast cancers between stage I and stage III.

“There appears to be indications that there is a better survival rate for women who have taken tamoxifen for 10 years over those who have taken it for just five years,” Lawrence said. She said the drug can play a role in decreasing the odds of cancer recurring in the affected breast or developing in the other breast.

Kate Hughes, a genetic counselor at Forsyth Medical Center, acknowledged her specialty can make some people uneasy, such as those who don’t want to know their risk level for breast cancer based on heredity.

“If we can identify a cancer risk in one member of a family, we can also identify who else in a family may be at risk,” Hughes said. “We can advocate for breast screening and breast MRIs at younger ages for those at higher risk.”

Hughes said recent research has shown the importance of tracing the cancer history from the father’s side of the family. “It can be just as important from a paternal grandmother or an aunt,” she said.

Another update affects women who have had radiation treatment for their left breast, said Dr. Dory Brown, a radiation oncologist at Wake Forest Baptist.

“They may be more susceptible to heart damage from the burn of radiation,” Brown said. “Some women with breast cancer may die eventually from a cardiovascular complication.

“That’s one reason why we recommend patients who receive radiation treatment to go to their follow-up sessions or join a cancer survivor clinic.”

Dr. Helena Summers, a radiologist with Forsyth, said both hospitals are offering three-dimensional mammograms, which provide a more enhanced view for those with denser breasts.

“Instead of looking at a deck of cards, we can look at each card with the 3D technology,” Summers said. “We can see upwards of 200 mammogram images instead of just four.

“It is more effective in detection and more effective in eliminating false positives.”

Summers said what is known as “fast MRI” technology is on its way. By narrowing down the breast exam “to the essential parts,” Summers said a breast MRI can take five to seven minutes rather than 20-30 minutes, “lowering the cost of the MRI and making it less claustrophobic.”

Dr. Lisa David, a plastic surgeon at Wake Forest Baptist, said some women may be eligible for breast reconstruction sooner after surgery than they were five years ago.

David said the recommendation has been “survive” the breast cancer for five to 10 years before considering reconstruction.

“Now, we believe it is possible to proceed sooner based on the individual’s recovery and the condition of their skin flaps,” David said.