Cooling Caps Help Reduce Hair Loss from Chemotherapy Treatments

By Dr. Nevin Wadehra, hematologist/oncologist with Wellstar and Northwest Georgia Oncology Centers

The world of breast cancer can be confusing, especially because of all the abbreviations and acronyms. Knowing these terms can help us better understand breast cancer.

What does BRCA or HER2 mean when it comes to breast cancer?

To doctors, they’re important pieces of information that can guide their treatment strategies. To patients, they can mean the difference between one treatment plan and another—or even between risk and prevention.

Understanding BRCA

The Definition: BRCA is short for “Breast Cancer Gene.” It includes two separate genes: BRCA1 and BRCA2. These genes have been found to impact a person’s chance of developing certain cancers.

The Explanation: In the past few decades, breast cancer research has advanced from general diagnosis to highly personalized treatment. For example, BRCA1 and BRCA2 are associated with increased risk for several cancers including breast and ovarian cancer in women and prostate cancer in men. This is traditionally referred to as hereditary breast and ovarian cancer (HBOC) syndrome. However, there are other increased risks with BRCA, including prostate and pancreatic cancer.

Patients without cancer but who have a family history of these cancers should discuss BRCA testing with their physician and consider evaluation by a genetic counselor. For patients with cancer who are known to have the BRCA gene, this could affect their treatment choices with more targeted therapy.

Understanding HER2

The Definition: HER2 stands for Human Epidermal Growth Factor Receptor 2. It is a protein found on the surface of breast cancer cells and plays a role in how the cells grow and divide.

The Explanation: Approximately 20% of female patients with breast cancer have tumors with high levels of HER2. Because HER2 is involved in the growth of cancer cells, this type of breast cancer can be aggressive. It's important that anyone diagnosed with breast cancer has their tumor tested for the presence of HER2.

In the past, HER2-positive tumors were associated with an increased risk of both recurrence and death from breast cancer. However, with the use of chemotherapy and targeted treatment against HER2, the prognosis of HER2-positive breast cancer has improved substantially.

Treatment options may include surgery, HER2-directed therapy with chemotherapy, endocrine therapy and radiation therapy. The best combination of treatments and the order in which to receive them can vary depending on the situation. Most patients with HER2-positive breast cancer will receive one or more chemotherapy drugs plus trastuzumab, a HER2 antibody. Many studies have shown that these treatments dramatically improve survival for patients with HER2-positive breast cancer. Trastuzumab and chemotherapy are even recommended for patients with very small, HER2-positive breast cancers. Tumors as small as 0.5 centimeters often warrant such treatment.

Decisions must be individualized based on your unique risk. Talk to your doctor about whether you are a candidate for trastuzumab, especially if you have a small HER2-positive tumor.

How do you determine what treatment is best?

There are many options for the treatment of breast cancer, and deciding which is best can be confusing. Expert guidelines help clarify what treatments are most appropriate for large groups of patients.

However, individual factors—including your personal values and preferences, as well as your cancer stage and characteristics—are also important to consider. Talk to your care team about your treatment options and what is best suited to your individual needs.

Learn more about breast cancer care at wellstar.org/breastcancer.

If you had to guess which cancer took the most lives in America, what would your guess be?

“Lung cancer is the No. 1 cancer killer in the U.S. for both women and men since 1986,” said Dr. Daniel Miller. Dr. Miller is the chief of thoracic surgery and the director of the Wellstar Georgia Cancer Center lung cancer screening program.

About 80% of lung cancer cases are associated with cigarette smoking, including secondhand smoke. Unfortunately, when symptoms begin showing, the cancer has already spread, making treatment very time-sensitive. When a patient is diagnosed, their care team typically includes not just one, but four doctors: a thoracic surgeon, an interventional pulmonologist, a medical oncologist and a radiation oncologist. There are many benefits to having a large care team, but a huge drawback can be the wait time between appointments with each doctor.

“When you have cancer, you want to be seen now and be treated now,” Dr. Miller said.

The speed of treatment time for patients is what inspired the creation of the Thoracic-Oncology NOW (New Oncology Workgroup) Clinic at Wellstar Georgia Cancer Center. The multidisciplinary clinic is staffed by specialized physicians in the treatment of thoracic malignancies. 

The clinic treats not just lung cancer, but also esophageal cancer, metastatic disease to the lungs and malignant pleural effusions.

“You’re cutting back on treatment time, waiting time, travel time and, more importantly, you have a group of doctors, rather than a doctor, who are talking about your care,” said Hematologist and Oncologist Dr. Girinda Raval.

The clinic operates on Wednesdays and acts as a one-stop shop for patients, saving their time and the time of their loved ones who join them for treatments. Patients also have access to Wellstar Georgia Cancer Center’s registered dietitians and social workers, along with a scheduler, financial personnel and medical assistants, creating one large care team ready to help them on their treatment journey.

“There is a degree of reassurance for the patient that there is a team who are all engrossed in caring for that patient,” Dr. Raval said.

To learn more about the Thoracic-Oncology NOW Clinic or make an appointment, call (706) 721-6744 for more information.

Kathy DeJoseph delights in making and giving away thousands of soft and cheerful hats to Wellstar cancer patients through a nonprofit she founded called Happy Caps. It’s all in the name of bringing a little light and comfort to people during a hard time.

Where did the idea come from? It started with Kathy’s own lung cancer diagnosis.

A commitment to yearly lung cancer screening

A cancer survivor for more than a decade, Kathy said regular lung cancer screenings were the key to her survival. With a long history of smoking and growing up around relatives who smoked, she decided to join an early detection lung cancer study at Wellstar.

Even though she felt fine and had no symptoms, committing to the study meant having an annual low-dose CT scan every year. After several years of clean scans with no signs of lung cancer, Kathy told a nurse that she was going to quit. But the nurse persuaded her to come in for another screening.

“Thank goodness she did,” Kathy said. “I was diagnosed the very next day.”

Quick and efficient treatment at the STAT Clinic

Being a part of the study and getting screened early allowed Kathy to move immediately to Wellstar Lung Cancer STAT Clinic at Wellstar Kennestone Regional Medical Center.

STAT stands for Specialty Teams and Treatment, highlighting the collaboration of multiple cancer experts. Together, they come to a consensus on a treatment plan and meet with the patient on the same day. This puts the patients at the center of their care plan, allowing them and their families to get immediate answers to questions, make decisions and start treatment faster.

“The biggest benefit for me with the way the STAT Clinic works is that I didn’t have to worry about whether the doctors had actually talked to each other,” Kathy said. “They’d come in one after another and tell me what they thought from their expertise.”

Immediate communication and mutual agreement among medical experts mean treatment plans are established and started faster, which is proven to improve long-term survival. On average, it takes 60 to 90 days from the time of diagnosis to treatment in the U.S. With the STAT Clinic at Wellstar, patients go from diagnosis to treatment in 14 to 20 days.

Kathy’s treatment started quickly—she had a lung biopsy the day after her STAT Clinic appointment and started chemotherapy a week later.

“I wasn’t as terrified for as long as most people are because I had answers within a short period of time,” Kathy remembered.

She had surgery once she completed chemotherapy. Throughout the process, she had the support of an entire cancer team, including a medical oncologist, a lung cancer surgeon, a pulmonologist and a nurse navigator.