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A Team Approach Breast Cancer Interdisciplinary Pre-Treatment Planning Conference

 The Breast Cancer Interdisciplinary Planning Team, from left to right:Varun Gupta,MD, Medical Oncology; Karin Fu, MD, Radiology; Peter Schulz, MD, General Surgery; Davood Vafai, MD, Medical Oncology (standing); J. Conrad Greenwald, MD, Gynecology; Patti Richardson, MD, Pathology; and Monica Khanna, MD, Radiation Oncology.
The Breast Cancer Interdisciplinary Planning Team, from left to right:Varun Gupta,MD, Medical Oncology; Karin Fu, MD, Radiology; Peter Schulz, MD, General Surgery; Davood Vafai, MD, Medical Oncology (standing); J. Conrad Greenwald, MD, Gynecology; Patti Richardson, MD, Pathology; and Monica Khanna, MD, Radiation Oncology.
When it comes to treating breast cancer at the Eisenhower Schnitzer/Novack Breast Center, ten heads are better than one.

Such was the thinking behind the development of the Breast Cancer Interdisciplinary Pre-Treatment Planning Conference, a group of specialists that meet bimonthly to ensure that patients are receiving the very best of care here at Eisenhower Lucy Curci Cancer Center. The group, which usually consists of a lead surgeon, radiologist, pathologist, medical oncologist, radiation oncologist,reconstructive surgeon,the Certified Tumor Registrar,Cancer Center Director,Breast Center Medical Director and Breast Nurse Specialist,as well as the patient’s primary care or referring physician, not only develops treatment plans for newly diagnosed breast cancer cases, but also reviews established treatment plans to ensure that the patient is receiving the absolute optimum level of treatment and care.

[photo dir="assets/news/story/cfhlimages/200511/featurearticle.gif" align="right" caption="The Eisenhower Schnitzer/Novack Breast Center provides a cheery, positive healing environment."]

“The conferences provide a meaningful opportunity for specialists to reach unbiased consensus on the most appropriate treatment for each individual,” says Linda Beedle, Certified Tumor Registrar and Coordinator of the Cancer Center Registry at Eisenhower Lucy Curci Cancer Center, who sits on the conference. “The Interdisciplinary Pre-Treatment Conference looks at each patient diagnosed with breast cancer, and every modality is represented.”

Most cases brought before the conference are presented shortly after diagnosis.The type of treatment recommended varies and depends on a number of factors, including the size and location of the tumor, the results of lab tests performed on the cancer cells, and the stage or extent of the disease. A patient’s age, general health, and most importantly,the patient’s general feeling about a particular treatment modality, are also considered.

“When we are in the conference discussing whether or not the patient should have chemotherapy or another treatment modality, Kim Von Haden, Breast Nurse Specialist,contributes valuable information,”Beedle says. “Kim knows the patient and the circumstances, and can tell us if the patient has a concern with a particular treatment modality.”

Kim Von Haden,RN,Breast Nurse Specialist at Eisenhower Schnitzer/Novack Breast Center, is an advocate who helps the patient through the entire diagnosis,treatment and follow-up process — helping patients understand all of their treatment options and demystifying the treatment process.

“I follow the patient through their treatment and help coordinate services, helping them get questions answered, and even make doctor’s appointments on their behalf, if needed,”Von Haden reports,helping Eisenhower breast cancer patients tap into other services and resources.“I’m a ‘liaison’ of sorts, and work to bring a personal touch to the table.”

The Breast Nurse Specialist is just one part of the well-oiled machine that is the Pre-Treatment Planning Conference, helping to pro-actively determine the treatment path ideally suited to each individual case. Although it is unique in its approach to breast cancer care, the conference is not the only one of its kind at Eisenhower.A similar Pre-Treatment Planning Team also reviews lung cancer care.

“This is really where the national standard of care is going,”says Karl Schulz,MD,the Eisenhower general surgeon who was instrumental in getting the Breast Cancer Interdisciplinary Pre- Treatment Planning Conference off the ground. “In addition to the pre-treatment review of the patient, the diagnosis and the treatment options, we also provide the retrospective analysis and the follow-up of patients.And,that is probably just as important as pre-treatment.”

According to Dr.Schulz,breast cancer treatment has been moving toward a multi-modality approach over the past 10 years, and during that time, service protocols have become well established.

“Breast cancer has developed a tremendous treatment track record,” Dr. Schulz says. “The majority of cases that come through the conference fall within the proven recommended standard of care.”

The planning conference approach provides a definite benefit to all patients reviewed by the team,although the more unique and unusual cases, according to Dr.Schulz,perhaps receive the most benefit from the Breast Cancer Interdisciplinary Pre-Treatment Planning Conference — for instance,a young woman with very advanced breast cancer, or a woman with several cancers at the same time, one in either breast or one with multiple tumors.

Breast cancer treatment at Eisenhower Lucy Curci Cancer Center includes a variety of options such as further diagnostic procedures, and local or systemic treatments.Local treatments are used to remove, destroy or control the cancer cells in a specific area and may include surgery (either lumpectomy or mastectomy).Systemic treatments are used to destroy or control cancer cells all over the body and often include chemotherapy, hormone therapy or biological therapy.

“Everything is presented to the patient,”Dr.Schulz says. “We present all the advantages and disadvantages of each treatment option to the patient, so that they can make an informed decision. They always know that we’re working in their best interest.” The Cancer Leader Eisenhower Lucy Curci Cancer Center Eisenhower Lucy Curci Cancer Center has the most comprehensive cancer treatment center, offering the widest range of total cancer services for cancer patients, in the entire Riverside County area. In 2004, Eisenhower Lucy Curci Cancer Center diagnosed and/or treated approximately 20 percent of all cancer patients in Riverside County (there are a total of 13 hospitals in Riverside County). In the Coachella Valley, Eisenhower Lucy Curci Cancer Center treated 1,227 new cancer cases, compared to only 824 cases at Tenet’s Desert Regional, in 2003. The Arnold Palmer Prostate Center is the #1 provider of prostate brachytherapy in Riverside, San Bernardino, Inyo and Mono Counties. Eisenhower Medical Center is one of only a few American College of Surgeons accredited hospitals in Riverside County. Fewer than 25 percent of all hospitals in the United States attain this accreditation, and these accredited hospitals treat 80 percent of all cancer patients in the nation. The Eisenhower Lucy Curci Cancer Center is the FIRST in state-of-the-art technologies: First in the world to offer on-site (for immediate treatment) IsoStrand™ seed stranding with cesium seeds at the Arnold Palmer Prostate Center. First in the Coachella Valley to offer on-site (for immediate treatment) IsoStrand™ seed stranding for prostate brachytherapy at the Arnold Palmer Prostate Center. First in the Coachella Valley to offer MammoSite™ Radiation Therapy System for breast cancer. First in the Coachella Valley to offer Stereotactic Radiosurgery. First in the greater Inland Empire to offer the PET/CT scanner at the Eisenhower Imaging Center. Sources – American Cancer Society and National Cancer Data Base. Sources - American Cancer Society and National Cancer Data Base.

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