I have had several discussions in recent times about reconstruction after breast cancer surgery and probably one of the biggest things that I have learned is that most people did not have any discussions with their medical teams about how their cancer treatments might factor into reconstruction. I certainly understand that most surgeons and oncologists are primarily focused on removing the cancer and doing everything possible to keep it from recurring and/or spreading. However, as treatments and care evolve, the idea of limiting a patient’s focus to just the cancer itself is not necessarily in the best interest of the patient.
It has been nearly ten years since I received my second breast cancer diagnosis. At that time, my surgeon strongly advised that I have a double mastectomy with reconstruction and immediately incorporated a plastic surgeon into the conversation. While I am grateful for that course being lined out for me since it worked out so successfully, I must say that I did not have the information and options opened to me that now exist for a cancer patient. Therefore, when several patients asked me about this aspect of their treatment, I found it necessary to dig in and research what is currently available.
Most of us do not have the expertise to even know what questions to ask so my initial research centered on what my particular inquirers were asking me. Their treatment called for surgery followed by radiation. My search lead me to an inquiry piece wherein a patient was asking a plastic surgeon about radiation treatment and the type of reconstruction that she was considering. And suddenly I realized that there are options that I didn’t even know about and that any/every option has factors that need to be considered even before the initial surgery is done.
It didn’t take long to figure out that so much has changed and so many more options are part of the current landscape for a breast cancer patient now. And the more that I explored, the more that I learned that not only were there more options for the breast cancer reconstruction after surgery but there are also so many more radiation delivery systems available than I even imagined. And although I decided that some of these other issues need to be addressed in future blogs, one thing became immediately evident. Every patient must do more than just address the immediate cancer situation.
A patient needs to talk to their team members. In cases where radiation is to be administered, a patient will most likely have a primary care physician, a surgeon, an oncologist and a radiation oncologist who will be involved with their treatment. And if a patient even remotely is considering reconstruction, this is the time that the plastic surgeon should also be added to the team.
Although it may be difficult to understand why a plastic surgeon should be included, one should understand that although the medical team that is needed to treat the physical body for the cancer, there is another major factor that needs to be addressed and that is the mental impact that such surgery and treatment has on the patient. Unless a doctor has looked in the mirror at his/her body after cancer treatment, there is no way to understand the mental impact that such treatment can have on the patient. Having a body part amputated or seriously altered results in a patient not only having to deal with the physical changes but also the new appearance of their physical body and how it may affect each of them as well as any intimate partner that they currently have or may have in the future. Therefore, it is time for us to consider that in treating a cancer patient, we should consider treating the whole person and not just the physical body.