October 2020 Issue
by Diane G. Bowen, MD
We have all heard of it, know others who have had it, but never really expected it would happen to you. That diagnosis is often a woman’s fear come to life. At first there may be questions like: why me? How bad? Will I survive?
Then a second wave of questions: Will I need chemo? Will I lose my hair? Will I have to lose my entire breast? What does reconstruction mean? Well, there is hope and multiple resources available to help answer these and many more questions.
Thankfully, for many in the twenty-first century, a breast cancer diagnosis is no longer a death sentence. In many cases, it can be an opportunity to be a survivor and even a thriver. New technologies allow breast cancer to be diagnosed sooner, and needle biopsy techniques allow diagnosis without a surgery. Many advances have also been made in breast reconstruction to reduce the recovery time and optimize symmetry for the long term.
A Federal law mandates insurance cover the reconstruction of the affected breast, as well as any surgery necessary to reshape the other breast to achieve symmetry. Despite this, some women choose not to have reconstruction because they have been misinformed, or are overwhelmed by the deluge of information associated with the diagnosis of breast cancer. It is essential each woman have a consultation with a qualified plastic surgeon who can offer them the range of modern reconstructive options. When you are informed, it is easier to have the peace of mind which is key for recovery and healing. Resources like www.plasticsurgery.org/reconstructive-procedures/breast-reconstruction help in explaining what is reconstructive surgery, discussing the various types and what to expect. Having knowledge helps guide you with what questions to ask and what options exist, allowing the best care choices to be made.
In the past a mastectomy was a disfiguring guillotine style surgery. Now the breast tissue can be removed leaving behind the breast skin envelope, sometimes even the nipple. This can be filled at the time of the mastectomy using a direct to implant procedure, avoiding the many stages which were standard five years ago.
Partial mastectomy, or lumpectomy, followed by radiation therapy has become a routine way to handle many breast cancers. In the past this could leave a woman with a “sunken cupcake” look, resulting in asymmetry. As innovators, plastic surgeons applied their unique skills to develop oncoplastic reconstruction. In this technique the breast is reshaped and lifted at the same time as the lumpectomy. This helps a woman’s result to be not just as good, but sometimes even better in size and shape.
Nutrition plays an important role in positive outcomes. It is important to have a nutritional screening prior to surgery, to optimize healing and recovery. In many cases women dealing with breast cancer are also nutritionally depleted with low vitamin D levels, low zinc and low B12. Diabetes and smoking will also affect healing and recovery.
Because of these findings, I find it important to look at the whole person inside and out, focusing on nutrition, hormone imbalances and stress management. Comprehensive lab testing to evaluate nutrition levels allows for medical recommendations regarding nutritional optimization, and for some there is value in IV nutrition or B12 shots. Studies showing the correlation between Vitamin D levels and the prevention of cancer reveal that Vitamin D levels over 50 play an important role in cancer prevention, not just for Breast Cancer but also for Colon, Prostate and Ovarian.1
It is also important that no matter what type of surgery you have, doing range-of-motion exercises and getting up and moving around afterward are essentials in recovery. Exercise and movement allow you to return to usual activities in a timely manner and help the body systems regulate themselves. Patients should get up and move around as soon as possible following any type of surgery; even just walking around your living room can help with blood flow. Be sure to talking with your doctor before starting any exercises so that a timeframe and program can be created to fit your specific needs. In some cases, working with a physical therapist is recommended so these trained professionals can design an exercise program tailored to meet the individual needs of the patient. A helpful resource regarding exercises after breast cancer surgery is www.cancer.org/cancer/breast-cancer/treatment/surgery-for-breast-cancer/exercises-after-breast-cancer-surgery
You win a running marathon by getting off the sofa, eating right, running regularly and preparing. Applying this marathon preparation strategy to life and the health challenges being faced, including cancer, can make the journey a little easier and a lot more hopeful.
Diane G. Bowen, MD, completed a specific fellowship in breast reconstructive surgery. As part of that training, she studied the nutritional aspects of women dealing with breast cancer. Dr. Bowen is the owner of Golden Isles Center for Plastic Surgery and Centered on Wellness – 1015 Arthur J. Moore Dr., SSI. Available now for personal or virtual appointments to achieve your optimum wellness. Call 912.638.0034. Websites: www.drdianebowen.com and www.centeredonwellness.net