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Tuesday, August 30, 2011 - Breast Cancer: Taking Control, Moving On



Upbeat and determined breast cancer patient Margaret Gonzalez-Cino finished her chemo and radiation a week before dancing at her son’s wedding.
The excitement of a family wedding! The youngest of Margaret Gonzalez-Cino’s three sons was getting married in June and her other two sons were flying in from California to Mamaroneck with their families.

Forget cleaning the house. Forget about food for all the guests coming in for the weekend. The most important thing on Gonzalez-Cino’s mind was looking good for her family. She was still a cancer patient, having completed surgery, chemotherapy and the final radiation treatment just seven days before the rehearsal dinner. Her sons and husband Ron, her “greatest supporter,” all thought she looked terrific. They loved the wig. “It was an adorable little pixie – the kind of hair I always wanted to have,” said Gonzalez-Cino, a lover of life and full of positive energy and determination.

Gonzalez-Cino is among the one in eight women who will develop invasive breast cancer at some point in her life, according to American Cancer Society statistics.

For those already juggling family, career and hobbies, breast cancer is a huge interrupter. It changes their routine and often their outlook, making them realize good health can’t be taken for granted and forcing them to face the fact of mortality. Thankfully, most women with breast cancer survive. The reasons? Early detection and modern medicine.

Mammograms: “the mainstay”
Dickerman Hollister, MD, a medical oncologist at Greenwich Hospital, says mammography remains the mainstay of early detection. Additionally, breast ultrasound is being used for women with denser breasts. And for women with specific high-risk factors, breast MRI can supplement both mammograms and ultrasounds.

Getting mammograms on a regular basis is probably the single most important thing women can do to protect themselves against breast cancer.  Gonzalez-Cino was always diligent about her exams because her mother had breast cancer. “My mom was diagnosed when she was in her 30s. She passed away from cancer when she was in her late 40s,” she related.

Gonzalez-Cino, now in her 60s, knows that having a parent or sibling who has had breast cancer increases personal risk. She herself has had it twice. The first time was 11 years ago. It required a lumpectomy (removal of a small portion of the breast to eliminate all cancer cells) and radiation treatments.

Her second bout occurred last fall, and the timing couldn’t have been worse. She had retired from her job as a paralegal in September. Her cancer was diagnosed in October, and her surgery was scheduled for November – all in the middle of making plans for the wedding.

There were two lumps, and not in the breast that had cancer before, so this was not considered a recurrence. It was just bad luck. More bad luck – it had spread to her lymph nodes. So, in addition to a lumpectomy and radiation, she also needed chemotherapy, powerful medication that travels throughout the body to kill cancer cells that may be trying to colonize elsewhere.

Advances in chemotherapy
“The word ‘chemo’ scared me more than the word ‘cancer,’ “ she said. “I already tackled breast cancer once, but I had heard horror stories about the side effects of chemotherapy.”

“There have been major changes in the use of chemotherapy for breast cancer in the last ten years,” said Dr. Hollister, who treated Gonzalez-Cino both times. “We use more effective chemotherapy for shorter periods of time. These new regimens have definitely improved cure rates for women at high risk of recurrence or relapse.”

A further benefit is that chemotherapy side effects are much more manageable now, with less nausea, fatigue, and risk of infection. “Hair loss remains the most troublesome side effect for most women, but the rest of the side effects resolve within a couple of months of treatment,” said Dr. Hollister. “And the hair always grows back, thicker than ever.”

Patients are “more than a medical chart”
“Our advantage is that we’re big enough to have superbly trained physicians and a hospital with the most advanced technology – yet we’re small enough to keep it personal,” he explained.

“Medicine today has become so specialized that it’s not uncommon to have different doctors for different body parts. At Greenwich Hospital, if a doctor or a radiologist sees something unusual, they’ll talk to me about it. There’s real congeniality among the medical staff. We’re specialists in communicating, and that creates better care for the patient. Here, patients are more than a medical chart.”

Preventive care, advanced treatment, clinical trials
Medical technology is combined with emotional and nutritional support at Greenwich Hospital’s Breast Center, which is designed to provide a soothing environment for patients and their families. From preventive care to advanced treatment, the Breast Center offers a full range of services at its location across from the hospital at 77 Lafayette Place. Surgical services take place at the hospital.

Patients are welcome to engage in one-on-one pre-mastectomy or pre-lumpectomy consultations with a nurse navigator to help them understand the procedures and expectations.

In addition, clinical trials are offered throughout the year. One new trial is evaluating a possible connection between vitamin D supplementation and breast cancer prevention. Another explores the use of a diabetes medication to see if changes to the body’s metabolism can affect cancer recurrence. “We’re not looking just at new treatments for breast cancer; we’re looking for ways to prevent it,” explained Dr. Hollister.

Healing the mind, body and spirit
From diagnosis through treatment, dealing with breast cancer is stressful, not only because of the procedures involved, but also because of the unknown. Medical experts agree that this is an important time to focus on the healing of mind and spirit, as well as the body. 

Among the resources Greenwich Hospital offers cancer patients is Prepare for Surgery, Heal Faster,  a workshop that helps women learn to work through fears and visualize healing. Acupuncture helps with pain management and nausea. Healing Touch, an energy-based therapy, is offered at both the hospital and the Bendheim Cancer Center.

Look Good…Feel Better is a national program held at the hospital that teaches female cancer patients about the therapeutic value of looking their best. “I never wore eyeliner, but when you don’t have hair, it’s a whole different story,” said Gonzalez-Cino. “You learn how to put the focus on your eyes, how to cover those dark circles, and how to style your wig.”

“Women are like tea bags. You never know how strong you are until you end up in hot water.”
“I’m very thankful I’m okay and could dance at my son’s wedding knowing that no one would be feeling sad for me,” reflected the happy mother of the groom. “The wedding was a beautiful, joyous occasion, filled with lots of love.”

Once again, Gonzalez-Cino is over the hump, but she’s not 100 percent out of the woods yet. Every three weeks for the next year she will receive an injection of Herceptin, one of the new antibody drugs that boosts the effects of her previous chemo treatments. Dr. Hollister explains that this is recommended for Gonzalez-Cino, but not necessarily for every woman. When it comes to cancer treatment, one size does not fit all.

One trait does seem to have a universal impact, though, Dr. Hollister points out. Patients who are optimistic and engaged in life seem to do better, and they certainly have a better quality of life. “We want our patients to be as active as possible and to try to limit the effects of this diagnosis and treatment on their daily activities. The goal of treatment is not to have good check-ups. It’s to do the things you want to do; to have a great life.”

Does being happy give you better chemistry? Or does better chemistry make you happy? Nobody knows. Either way, Margaret Gonzalez-Cino decided that her cancer story was going to have a happy ending.

Get Your Mammogram!
Currently, about 2.5 million American women have survived breast cancer and are now considered cancer-free. Early detection through a mammogram is vital. Don't put it off!

Free mammograms for uninsured or underinsured women are available at Greenwich Hospital's Breast Center.

Call 203-863-3031 to find out if you are eligible.

October Breast Cancer Awareness Month Events
In recognition of this special month, please join us for many upcoming events.
See our Calendar and search "breast cancer."