Wednesday, January 27, 2010

Breast Cancer Doctors Embrace Multidisciplinary Approach

Recent technological advances in medicine mean that electronic medical records, X-rays and prescription information are all available instantly for seamless communication.

But the doctors who work with breast cancer patients at the Cancer Center at Lake Manassas have taken information sharing a step further. Oncologists, radiologists and surgeons gather in the same room once a month to discuss treatments for their mutual breast cancer patients.

Technology is invaluable, but this is a thoroughly human approach. Doctors confer with doctors – face to face -- about the physical and emotional needs of their patients.

The group of a dozen or so physicians – including medical director of the Cancer Center, radiation oncologist Sanjeev Aggarwal, M.D. -- has been gathering for about a year, sharing new techniques and comparing notes on their patients’ surgical, chemotherapy and radiation treatments.

Opening the group’s January meeting, breast surgeon John Williams, M.D., described a new approach he had used during a recent surgery. Using a marker on poster board, he drew a picture of the surgery that used elements of breast reduction surgery to remove a cancer and, at the same time, leave the breasts looking intact and of equal size.

“Breast cancer is very complex,” said Dr. Williams. “Particularly when I use a new technique, I need to know how my surgery is going to affect a patient’s radiation or chemotherapy treatment. That’s why we make this effort to talk to one another. The more reconstruction you do at the time of the initial surgery, the more difficult it can make radiation treatments. I took some special steps in this surgery to make Dr. Aggarwal’s job easier.”

Dr Aggarwal said, “These meetings are very important for us, especially when we alter the treatment slightly from what we’ve done before.”

Breast surgeon Cynthia Dougherty, M.D., said, “Our jobs are very specialized, and don’t overlap very much. But many of our patients see at least three different specialists throughout the course of their treatment. It’s important that we communicate.”

Throughout the discussions during the January multidisciplinary meeting, the physicians introduced new research and talked about the latest studies. But time after time, they returned to each patient and her specific situation. General surgeon Joe Brown, M.D. explained, “Every patient is different. Treatment depends on how big the tumor is, where the tumor is, and how the patient is feeling about surgery. A 70-year-old woman may want to have mastectomies of both breasts to have a better chance of eradicating the cancer. A younger woman may want to approach the same situation with a breast preserving surgery.”

Dr. Dougherty agreed, “I don’t make treatment decisions for my patients. I give them all the information. It is up to them. A lot of women ask me, ‘What would you do?’ I’ll tell them, but the decision is theirs.”

“It’s helpful for us to know how patients feel before we see them. In addition to these meetings, we all communicate all the time by phone about specific patients.”

Jey Maran, M.D. medical oncologist, said, “The medical data on breast cancer is very clear, the treatments very established, so we don’t usually disagree on treatment, but we are learning from each other to be comprehensive, and to consider each case from all perspectives.”

Fauquier Health Participating Physicians

Sanjeev Aggarwal, M.D.
Radiation Oncologist
Cancer Center at Lake Manassas, 703-753-4045

David Allison, M.D.
Plastic Surgery
David Allison, M.D., P.C, 703-754-8228

Joseph Brown, M.D.
General Surgeon
Northern Virginia Surgical Specialists, 540-347-2805

Cynthia Dougherty, M.D.
Breast Surgeon
Northern Virginia Surgical Specialists, 540-347-2805

Lynn Samuel, M.D.
Fauquier Health, 540-316-5604

Benjamin Wampler, M.D.
General Surgeon
Northern Virginia Surgical Specialists, 540-347-2805

John Williams, M.D.
Breast Surgeon
Northern Virginia Surgical Specialists, 540-347-2805

Cancer Center at Lake Manassas
Location: 7901 Lake Manassas Drive, Gainesville
Phone: 703-753-4045
The Cancer Center at Lake Manassas is a partnership between Fauquier Health and Prince William Hospital.


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