Key points from today’s guests:
Claudia Ricks Hubbard, breast cancer survivor
- Claudia, a former hospital chaplain, had two cancer diagnoses, the second was a side effect from the radiation treatment from her first bout with cancer in 2014.
- For her second diagnosis, she noticed she started to have discoloration on her breast. She saw a lymphedema specialist and the specialist took her from the exam room right over to meet Dr. Larson and her team and had a punch biopsy within an hour.
- Claudia had the mastectomy with the new diagnosis. There were two follow up surgeries after the mastectomy, seeking clean margins.
- She had to undergo three radiation treatments per day, so the hospital set aside a treatment room for Claudia with her name on it. A nurse arranged for a recliner so she could have a place to relax in between the treatments.
- Claudia said it is really easy to get focused only on the disease and on the treatment and to lose sight of the person who is behind all of that and no matter how intense the diagnosis and therapy are, that’s only a small part of who someone is.
Dr. Kelsey Larson, breast surgical oncologist, The University of Kansas Cancer Center
- Breast conservation allows women to have a much smaller surgery, a much faster recovery and to keep their breast which is both cosmetically favorable for most patients. They don't have the same sorts of issues that they have after mastectomy.
- Angiosarcoma is a is a bit of a challenge, especially from the surgeon’s standpoint, because they can't see where the cancer cells start and where they end. Cancer spreads out and it infiltrates throughout the tissue. You may see an area of discoloration, but often the area the actual cancer cells are beyond what the eye can see.
- When the pathology gets back at a microscopic level, there could be cancer cells that are infiltrating much farther than what the surgeon can be seen.
- Claudia’s example really highlights the need for the whole team. All of our breast cancer patients have really good survivorship care -- not just your treatment team, but then once you're done with your treatment, making sure you're doing your follow ups and providing support.
- You need the surgical oncologist do their work with a cancer radiation and cancer treatment. But you also had plastic surgeons, you had pain management physicians, you have wound care physicians -- all sorts of people that needed to come around and provide you that support.
- The whole support system within the whole Health System is needed and necessary to provide great care.
- Claudia’s positive attitude and wonderful spirit played a major part in carrying her through her treatment journey.
Dr. Shane Stecklein, radiation oncologist, The University of Kansas Cancer Center
- We have known for a very long time that radiation-associated angiosarcoma is a rare but serious potential side effect from radiation for breast cancer.
- The best data we have is from a study that was done in the Netherlands, and they looked at almost 300,000 women who'd received or not received radiation and they were able to very clearly show that the risk of that is about one in 1000, nearly eight years after treatment. So that means we have to follow 1000 patients who have given radiation for eight years to find one case of angiosarcoma.
- Claudia had a very unique clinical circumstance and the challenge in her case is that her chest wall had already been irradiated about five years before and we still had sizeable deposits of cancer that we had to treat.
- Claudia needed to have a pretty high dose to eradicate every last cell that's there. Instead, we opted to perform radiation treatment multiple times a day called hyper fractionation. Claudia’s radiation was divided into many small doses three times a day rather than giving bigger doses once a day.
- The primary benefit of that is it can reduce late side effects.
- I wanted to avoid as much as possible radiating tissue that had previously been irradiated. Claudia's angiosarcoma and her primary breast cancer were both on the left side of her body and we know that patients who have left sided breast cancer, we need to be really thoughtful about avoiding radiation dose to the heart to avoid long term cardiovascular side effects.
- Claudia dealt with this entire thing with such grace and humility. She went through hell and back and at this point she's far enough out, so we are very, very optimistic that this thing is gone forever and never coming back.
Dr. Dana Hawkinson, medical director, infection prevention and control, The University of Kansas Health System
- The Health System has 17 patients with active COVID infections this week, up slightly from last week.
- A meta-analysis published in a medical journal looked at 24 different studies from December 2019 to June 2023.
- It found that there was about a 32 percent vaccine efficacy against a long COVID for those people that had received two doses of vaccine.
- For those up to date on vaccinations, meaning they’ve received at least three doses, there was about a 70 percent reduction in the risk of getting long COVID.
Tuesday, Oct. 31 at 8 a.m. CT is the next Morning Medical Update. Accepting your new body while fighting breast cancer or after surviving it can be a battle in itself. Our patients share the emotional journey and how the care teams here have guided them.
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