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By Heather Lofy
Choosing W Teams Who you select to help you navigate your breast cancer treatment can make all the difference.
hen Wendy Lybarger, 58, was diagnosed with breast cancer during the summer of 2018 after a routine mammogram, the Dayton resident met with an oncology team in her area to discuss her diagnosis and treatment options. “We quickly got to the ‘This is sounding pretty severe and urgent and scary’ phase,” explains Lybarger. “This was worth a second opinion. I really had not had much interaction with or had learned much about breast cancer before that.” Having previously spent time living in Central Ohio, she was familiar with the Ohio State University Comprehensive Cancer Center – James Cancer Hospital & Solove Research Institute. Lybarger decided to call the James, thus beginning her journey of creating her care team and planning her treatment.
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“Each step of the way, there were multiple levels of interaction and care,” Lybarger says. “I had a lot of questions. I was cautious about what internet research I did. I was trying to learn myself, so that I could understand and ask relevant questions. It was great to have that level of support.” For patients like Lybarger, a breast cancer diagnosis is full of uncertainty—and that’s why assembling and working with a care team that can help you take control of your care is imperative. So where should you begin? Many oncology groups in Columbus take a comprehensive approach. “Breast cancer is a good model for the comprehensive care that cancer patients require,” says Dr. William Farrar, CEO of the James and director of its Stefanie Spielman Comprehensive Breast Center. “It‘s important for patients to realize that, as it is becoming more and more complicated to put together a treatment plan, you need to have doctors that are treating one or possibly two cancers, because the information, clinical trials and research makes treatment changes more frequent. It‘s important to seek out someone who really specializes in breast cancer care.” A breast cancer patient often will work with several different types of oncologists: a medical oncologist, who helps plan overall
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treatment; a surgical oncologist, who can remove cancerous tumors; and sometimes a radiation oncologist, who specializes in radiation therapy. “If I see a patient today in surgical oncology, we have an algorithm,” says Farrar. “They may see three or sometimes four doctors in different specialties to answer all of their questions and help them make a decision. I may see a patient today with early stage breast cancer, then they may talk to a radiation oncologist and plastic surgeon, and then at the end of the day, I’ll see them back in my office to discuss everything they learned and come to some decision on how they would like to be treated. Some people like to think for a few days, and then they can come back to make a decision.” But the James isn’t the only cancer care center in town. The Zangmeister Cancer Center, located near John Glenn Columbus International Airport, offers both cancer and hematology services. It also aims to provide all the key players a patient needs. “We have an interdisciplinary team working to take care of cancer patients,” says Christine Pfaff, associate practice director at the center. “Our goal is to have all the services a patient needs under one roof.” Along with 12 medical oncologists on staff, the Zangmeister Cancer Center con-
nects its patients with other potential key members of a care team. “We have nurse practitioners who run an acute care clinic,” says Pfaff. “If a patient calls in after they had chemo three days ago and they aren‘t feeling right, we can get them in the same day. Those nurse practitioners are great. They take care of all the immediate needs of the patient, instead of [having the patient go] to an emergency room.” Similarly, Lybarger relied heavily on the physician assistants who were accessible during her treatments at the James. “As I dealt with both medical and radiation oncology, there was this physician assistant level of care,” she says. “In particular with medical oncology, that person was my lifeline as I was moving into this. There were still questions about the diagnosis. They were always accessible to me. I could call in and ask a question, and she [the physician assistant] would get back to me. I knew by the end of the day I would get a call back. That was an extremely important area of care in those early stages.” A pathologist also may be involved, says Farrar, and although they are not present at the Stefanie Spielman Comprehensive Breast Center, the team will bring in their knowledge when needed. “If someone has a biopsy at an outside institution, it’s important to review the slides
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There is no routine breast cancer. Breast cancer is never logical or straightforward or routine. That’s why fighting breast cancer with routine treatment just isn’t enough. At The James, you get the expertise of a multidisciplinary team that specializes not just in cancer but breast cancer. They apply their collective thinking toward discovering the most effective therapies, and delivering them at exactly the right time, for you — which means you can count on comprehensive breast cancer care that’s far beyond routine. To learn more, visit cancer.osu.edu/breast.
that were obtained,” Farrar says. “We do that on all our breast cancer patients to make sure the diagnosis is correct. That’s key to our multidisciplinary approach.” A breast cancer patient also might rely on the help and expertise of a social worker. Pfaff explains social workers are not always common in the outpatient setting, but they can help navigate any psychosocial issues. “If a woman is losing her hair, a social worker can help her get a wig,” Pfaff says. “They can help get transportation. There’s lots of counseling in the office. If a patient has children, what can we do to help with that?” Columbus Oncology and Hematology Associates, another Central Ohio cancer clinic, has a relationship with OhioHealth to connect its patients to even more resources. “Some patients who undergo surgery will do reconstruction,” says Dr. Nse Ntukidem of Columbus Oncology and Hematology Associates. “At the time of surgery, our oncologists can refer patients to those surgeons.” Ntukidem shares that his group typically has a patient talk to a dietitian through OhioHealth as well. OhioHealth has a wellness program in which patients have structured physical activity in a group class.
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They are exposed to nutritional information and other resources. Breast cancer patients also may elect to try complementary care. Ntukidem says that acupuncture or massage therapy can help with the stressful process, as can talking to a therapist or counselor. There’s an additional member of your care team you might heavily rely on who does not have a medical degree: a financial counselor. “The financial impact [of breast cancer] is a huge deal,” Pfaff says. “A financial counselor meets with patients to talk about insurance coverage and what to do if you can’t afford your medicine, among other things. The question is always, ‘How am I going to pay for this?’ The counselors can help navigate that for the patient.” Pfaff recommends that if a patient chooses a center without a financial counselor, they should ask if there is a foundation or other resources available to help financially. The Zangmeister Cancer Center works with a Mount Carmel foundation called Haven of Hope, which promotes financial, emotional, physical and spiritual support for patients. From a patient perspective, Lybarger wants other breast cancer patients to know that as they are assembling their care team, the patients can be their own best advocates. “It‘s OK to ask questions,” Lybarger says. “I’m sure I asked questions two, three, 10 times. Sometimes I forgot I asked that question, and other times it was because I didn‘t understand. Be that advocate for yourself, and have that person for you who can come and be your other set of ears. My anxiety was reduced the more I knew.” Organization also was imperative for Lybarger, especially since she was commuting from Dayton for her treatments. “I got a folder and I had a bag that that folder went in, along with anything related to my appointments and test results,” she says. “My bills went in there. Everything went in that, so I knew where everything was and I could grab it and take it with me and update it with the next set of information that came in. That’s my way of control over what felt like a very out-of-control situation.” And when in doubt, a second opinion can help a patient feel more comfortable. “If patients are empowered, they should ask [for a second opinion],” says Pfaff. “If there is ever a point where a patient feels they are not sure, they should ask for a second opinion.”
Sonia Abuzakhm, M.D.,
Scott Blair, M.D.,
Jarred Burkart, M.D. , Shabana Dewani, M.D.,Christopher George, M.D., Andrew Grainger, M.D., Joseph Hofmeister, M.D., Elizabeth Kander, M.D.,
Peter Kourlas, M.D., Kavya Krishna, M.D., Erin Macrae, M.D.,
Nse Ntukidem, M.D.,
Emily Saul, D.O.,
Thomas Sweeney, M.D., Jennifer Seiler, CNP, Lauren Sockrider, CNP
LEADERS in Cancer Care
Columbus Oncology and
Hematology Associates 810 Jasonway Ave., Columbus, Ohio 43214
For general cancer information please call OhioHealth’s Cancer Call (614) 566-4321
coainc.net
Tel: (614) 442-3130
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