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By Michael Richardson, MD

A 68-year-old woman recently came to us who beat breast cancer more than 20 years ago and hadn’t seen an oncologist since. She appeared healthy and fit but was long overdue for follow-up care – and not just a mammogram. In fact, her past radiation and tamoxifen treatment gave her a significant risk of developing cardiovascular disease and osteoporosis. And she had never been screened for mutations that increase cancer risk.

At Levine Cancer Institute’s (LCI) Survivorship Medical Clinic, we specialize in caring for patients who have put cancer in their past. A lot of these patients feel stranded after their cancer treatment ends, because they don’t know what ongoing care they need or where to get it. We’re here to help, with specialized care that starts with examining each patient’s history through a cancer care lens.

Genetic Testing = Lifesaving Prevention

Today’s genetic tests can reveal many mutations that increase patient’s risk of future problems, and we’ve found that 18 percent of our patients have mutations that weren’t previously detected.

For instance, our 68-year-old survivor’s tests uncovered a BRCA2 mutation – and enabled her and her family to take potentially lifesaving action:

  • Because BRCA2 elevates the patient’s risk of getting breast cancer again, we recommended twice-yearly screening with alternating mammograms and MRIs. This gives her doctors the best opportunity to catch new cancer early.
  • The BRCA2 finding meant this patient had such a significant risk of developing ovarian cancer – 27 percent – that she elected to have her ovaries removed.
  • BRCA2 also increases melanoma risk, so we recommended annual visits to a dermatologist and an optometrist to look for melanoma on the skin and in the retina.
  • After we advised genetic testing for the patient’s family members, her daughter discovered that she also has BRCA2. Now her doctors know to be especially vigilant.

Tailored Protocols for 17 Cancers

The patient’s original treatment included radiation on the left side of her chest. Research has shown that this opens the door to cardiovascular disease. This information is not yet reflected in the NCCN, ASCO or American Cancer Society survivorship guidelines.

That’s one reason we developed 17 unique survivorship protocols that reflect the latest science. These are tailored to specific cancers and were created in collaboration with LCI’s subspecialists.

Our breast cancer protocol, for instance, assesses each patient who has received left-sided chest radiation for cardiovascular risk and proceeds with testing for cardiovascular disease when appropriate. Complex patients can be referred to one of our cardio-oncologists, who are intimately familiar with the unique cardiac risks that go along with cancer and its treatments.

World-Class Survivorship Experts

Our care for this particular breast cancer survivor didn’t stop with cardio-oncology. We detected osteoporosis – which is linked to premenopausal tamoxifen use – and referred her for management. We also offered access to our wide array of supportive services, which range from psychotherapy to acupuncture. Now the patient is positioned to stay fit and healthy for many years to come. And she’s just one example of how our Survivorship Medical Clinic delivers world-class care to the 70 percent of cancer survivors who have significant, unaddressed health issues.

Each of our survivorship physicians has more than 30 years of clinical experience. We’re eager to help you understand survivors’ unique needs and work hand-in-hand with you to make sure they get the best possible care.

Make a Referral

For more information, or to make a referral, call 980-442-2500.

If you are a provider at Atrium Health, referrals can be made in Encompass. Department: LCI Supportive Onc; Location: 711 E. Morehead Street; Type: Provider; Provider: Michael Richardson, MD or James B. Hall, MD (GynOnc related cancers); Reason: Survivorship.

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