Early detection key to staying healthy, says oncologist

Dr Janice Walshe is the consultant medical oncologist who treated Liz Yeates during her illness (see story on opposite page). Although more than 2,800 new breast cancer diagnoses are made every year in Ireland, there is great hope, particularly when treatment is started early, she says.

“There are many new developments in the treatment of breast cancer. First, we recognise that not all breast cancers are the same and some require less treatment than others.

“While we still rely on important factors such as tumour size and grade, and assess the involvement of the lymph glands under the arm to guide our treatments, we now have gene expression tests that help us differentiate between women who will benefit from chemotherapy and those who will not and who can therefore be spared the toxicity of treatment.

“For women who do need chemotherapy, we have better understanding of what treatment regimens to use. We have also made progress in drugs that can ameliorate side effects related to these standard care chemotherapy drugs but, excitingly, we are making progress in the area of targeted or biological agents.”

The oncologist, who works out of both St Vincent’s and Tallaght hospitals, says her job is to ensure her patients get the best possible level of care.

“As an oncologist, I am usually the third doctor who someone like Liz will meet,” she says. “By the time she sees me, she will have digested the enormity of the abnormal mammogram and a recall for biopsy; she may even have had her surgery.

“However, patients probably dread meeting the oncologist the most, as there is a fear of the unknown. Will I need chemotherapy? Will I lose my hair? Will I be the same?

“From my point of view, I focus on the path forward. Most women feel better once they have a plan. I focus on the excellent survival rates we have achieved incrementally over the past couple of decades.

“Every patient case is discussed many times in a multidisciplinary meeting involving the pathologists, radiologists, breast surgeons, medical oncologists, radiation oncologists, plastic surgeons, specialist breast-care nurses and oncology liaison nurses. Following the discussion of each patient, there is a consensus regarding the best path forward.”

Walshe says breast cancer awareness month is vital as early detection is crucial in the fight against cancer.

“We need to continue to make women and men aware that there are measures we can introduce that reduce our risk of getting cancer,” she says.

“These include keeping as active as we can, reducing our body weight to healthy limits, keeping our alcohol level low and maintaining a diet that is high in fruit and vegetables and low in red meat.

“Awareness campaigns encourage us to check our breasts monthly.

“If you are still menstruating, we recommend that you examine your breast six days after the menstrual period when your breasts are less swollen and painful.

“And if you find something, do not panic; bring it to the attention of your GP and they will advise you how to take it from there. If you have developed breast cancer, early detection continues to be the most important factor in staying well.”