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Lois Greene
Program Dir., NJCEED for Cathedral Regional Cancer Ctr.
at St. Michael's Medical Ctr.
The goal of the NJCEED (New Jersey Cancer Education and
Early Detection) program is to increase awareness and encourage
individuals to use screening services. Studies indicate
that participation in annual mammography screening and treatment
of the disease at its earliest stages offers the best opportunity
for decreasing mortality and improving survival. Lois states
that educational outreach is the most powerful tool in fighting
breast cancer. She advises that outreach workers from St.
Michael's go out into the community (churches, schools,
laundromats, etc.) and speak to low income racially diverse
women about breast health. She advises that the hardest
challenge is combating misinformation in the community.
"If you get cancer you're going to die" is a common
misconception, as is the belief that early detection doesn't
matter because "I don't have insurance to pay for it
so why bother… " Those in the field are working
towards changing that mentality and promoting pro-active
health behaviors.
Lois notes that there are a host of issues related to why
some minority populations do not seek treatment. An example
is an undocumented alien who is afraid to seek medical care
because she fears being sent back to her country of origin.
Lois advises that personal advocacy includes knowing one's
treatment options, keeping a journal with you in which you
list medications, side effects, questions, etc. Advocacy
and family/friend support are intertwined. Bringing a friend
with you when you go for any treatment or visits to help
you ask questions is important for two reasons. The first
is that you suffer a "60% memory loss when naked",
and the second is that a friend provides emotional support
which is another key element in attaining successful outcomes.
(Lois also serves as the director of the "In the Pink"
program, funded by The Susan G. Komen Breast Cancer Foundation, at St. Michael's
that provides breast cancer education and diagnostic screening
procedures for the uninsured and underserved women in the
community.)
Richard Michaelson, M.D.
Medical Oncologist, St. Barnabas Medical Center
Dr. Michelson believes personal advocacy begins with learning
how to navigate the health care system. He states that a
woman who has been diagnosed with breast cancer should talk
with her primary care physician or gynecologist to obtain
referrals to a physician specializing in treating cancer.
This discussion should include the referred physicians'
styles of practice and reputation. In addition, Rick recommends
that patients talk to advocacy groups like The Susan G. Komen Breast Cancer Foundation
to obtain a list of physicians. Additionally, questions
that the patient should ask as she determines her choice
of physician include what type of board certification the
doctor has obtained, and asking the physician to describe
his or her relationship with their medical oncologist. Inquiring
if the physician participates in clinical trials is a good
way to determine that he/she is familiar with the latest
research. Rick also states that women should watch the way
the physician treats other members of his/her staff, as
this is a good indicator of his/her communication style.
Rick advises that there are two schools of thought concerning
obtaining second and third opinions. He advises that a woman
should seek another opinion if her case is unusual or if
it offers her greater piece of mind. He states that breast
cancer is not a disease that changes on a daily basis, so
an individual has some time to obtain a second opinion if
she wants to, although, except in unusual cases, it is not
mandatory. Rick can speak to diagnostic and treatment options
including mastectomies, lumpectomies, chemotherapy, and
new trends in radiation therapy (mammo-site).
Barbara Waters
Education Coordinator, The Susan G. Komen Breast Cancer
Foundation North Jersey Affiliate
Barbara's primary focus is on self-education. She knows
a great deal about breast cancer resources and advises how
best to access information on the Internet. Information
is empowering. Knowing your treatment options, consulting
additional specialists for their opinions, and engaging
the doctor and team in a dialogue about your specific plan,
is crucial in maintaining some control in a process that
can be overwhelming. Barbara chairs education and outreach
for the Affiliate and co-chairs advocacy. She states that
"Everything begins with education" (self, one-on-one,
all socioeconomic, educational, organizational levels in
the community).
She maintains that her focus is "the Foundation and
its breast health/breast cancer mission in the community,
its message of early detection; its dedication to women,
particularly underserved women; and its role as teacher,
facilitator, force and resource in the community."
Wendy Van Besien
Breast Cancer Survivor
In November 2000, Wendy performed a breast self-exam and
discovered a small lump. A married mother of two girls,
Wendy went to her ob/gyn who advised that the lump was "nothing
to worry about." Wendy didn't agree and went for another
opinion. Five weeks later, following a biopsy, she was told
that she had malignant cancer. Upon leaving the hospital
both Wendy and her husband Steve began "working the
phones." They reached out to their vast network of
friends and began gathering information on physicians and
resources, such as books and Internet sites.
The day after receiving the news, Wendy's father and her
husband went to the drug store in her hometown of Scotch
Plains and picked up a notebook and Dr. Susan Love's book
on breast cancer. From the start, Wendy says that she knew
she had to be her own advocate. "I was either going
to have to fight this at the top of my game or it would
consume me." She interviewed numerous physicians, always
arriving with her notebook filled with questions regarding
their qualifications, preferred methods of treatment, etc.
and made her decision based on their responses. Rick Michaelson
is Wendy's Medical Oncologist. She advises that she went
with notebook in hand to Rick's office to discuss medication
options (AC versus CMF) and what the side effects were of
both. Wendy notes that it isn't the cancer that makes you
feel sick - it’s the treatment.
Wendy spoke with her then eight and five-year-old daughters
about her cancer. She wanted the kids to hear it from her,
rather than from one of her friends or supportive neighbors.
In addition, Wendy called her daughter's friends and advised
them she had breast cancer and that her daughters knew she
had it too. She did this because she didn't want it to be
a secret and she also wanted to let the other mothers know
why their child might be talking about cancer. In addition,
Wendy met with the girls' teachers and the principal at
their school. She wanted everyone to be informed and to
help her kids to try and maintain a "normal" lifestyle.
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