So, you’ve been diagnosed with breast cancer. Of course, you’re shaken and you want to know more about what happens next and how you’ll fight back. But because this is all so new to you, how do you know what to even ask your doctor?
Start here with these six questions that every woman newly diagnosed with breast cancer should ask their oncologist, according to David A. Riseberg, MD, chief of medical oncology and hematology at Mercy Medical Center in Baltimore:
1. What is my stage, and what does that mean?
Breast cancer stages are used to determine the extent of your cancer, or how much it has grown and spread.
“The stage of your cancer is associated with how advanced the disease is, and that can be correlated with prognosis, risk of recurrence, and risk of death,” Riseberg says.
Knowing more about the chance that the cancer will come back and how much benefit you’re likely to get from each treatment can be helpful in deciding on a plan with your care team.
2. What do I need to know about hormones and HER2 receptors?
“The receptors are important, both in assisting with discussions about prognosis and in providing insight into how aggressive the cancer is, as well as specific treatment options. Some women are hormone receptor-positive, and some women are HER2 receptor-positive,” Riseberg says.
Breast cancer cells are hormone receptor-positive when they have estrogen receptors and/or progesterone receptors. If your cancer is hormone receptor-positive, you may benefit from anti-hormone therapy drugs that lower the hormones that are fueling the cancer’s growth.
Breast cancer cells are HER2-positive if they have higher than normal levels of a protein called HER2. If your cancer is HER2-positive, it is more likely to grow and spread. On the flip side, HER2-positive cancers respond well to targeted cancer drugs.
3. What are my surgical options?
You may be a candidate to have just a portion of your breast removed, which is a lumpectomy, or a mastectomy, which is where the entire breast is removed.
“In instances of mastectomy, there are a number of different reconstructive plastic surgery options, which could involve either placement of an implant or moving some of their own tissue to make a new breast,” Riseberg says.
Surgery can remove an entire tumor in your breast, and is often done in stages I, II, and III, along with other treatments. If cancer has spread beyond the breast tissue and lymph nodes, surgery likely won’t cure your breast cancer, but it may still be helpful in slowing down your cancer’s spread and relieving its symptoms.
4. Would a genomic test be helpful in deciding about the need for chemotherapy?
There are several breast cancer gene expression tests — such as Oncotype DX, MammaPrint, and Prosigna — which can be used to learn more about your cancer and customize your treatment. Which test is used depends on your type and stage of cancer.
In each of these tests, patterns of your genes are analyzed, and the results can help predict if your cancer is likely to come back. This helps you and your care team determine whether chemotherapy after surgery is a good idea. If your results indicate that you are low-risk, chemotherapy may not be helpful.
“For the tests, a biopsy is taken and sent to a lab that can run the specific tests based upon the gene expression,” Riseberg says.
5. Are there any clinical trials available for me?
Clinical trials study people and treatment effects, and it’s where newer and better treatments are found every day.
“Check to see if there’s a research study at your institution that might offer a treatment with the potential to be more beneficial than standard of care. This also allows a woman to participate in the continued march toward improvement in outcomes, which we can’t achieve without participation in clinical trials,” Riseberg says.
To find current breast cancer trials, you can also visit the National Cancer Institute.
6. What can I do beyond the recommended treatment to help myself?
Riseberg recommends these lifestyle changes:
- Eat a healthy diet with lots of vegetables and not much fat
- Limit your alcohol intake
- Get plenty of exercise
- Maintain a healthy weight
- Quit smoking
In addition, integrated care options help balance your physical, mental, and emotional needs. They may help lessen your cancer symptoms and treatment side effects, making each day a little brighter.
Some options include:
- Chiropractic care
- Guided imagery
- Medical marijuana
- Music therapy
- Progressive muscle relaxation
- Support groups
Learning more can help you overcome some of the worry and fear that come with a cancer diagnosis. Your medical team will support you and help you understand your prognosis and possible treatment options. Asking questions and talking openly with your doctor is a key first step on your road back to health.