By: Kamy Kemp, MD

Imagine you’re 37 years old, in a great marriage and a wonderful career. Now it seems the stage is set to begin a family. This is not an unusual scenario. Many professional women choose to get established in their careers first, then have children in their late 30s and even 40s. Now, imagine that you are one of these women and your physician tells you that you have breast cancer. Not only do your plan and your life seemingly come to a halt, but you also are forced to make some hard decisions very fast.

Let’s face it, breast cancer is no longer a disease for women in their late 60s and 70s. In my practice, I am seeing large numbers of women diagnosed with breast cancer before they even begin to have children. Some of our discussions sound like, “Have you had children yet? If not we may have to schedule an emergency embryo freezing.” We freeze the embryos because chemotherapy poses a high risk of ovarian failure in younger women. This poses as a double insult to a woman who is ready to start living her life. Now, this woman has to find a surrogate mother to carry her fertilized embryos to term. At the writing of this article, my practice is steeped in television and radio interviews, and local and national conferences to mark Breast Cancer Awareness month. But after October has ended, cancer doesn’t take an 11-month cruise to the Caribbean. Breast health and cancer awareness needs to be an everyday notion.

“Getting Breast Cancer Sucks” is the quote I often use when speaking on cancer awareness. But if you are diagnosed with breast cancer, this is the best time in the history of medicine to have it. With today’s technology, you can quickly get on the right side of treatment. Women can opt for cancer treatments that fit their medical circumstances and lifestyles. We can now examine the specific cancer gene and tailor treatment based on a patient’s gene pool. We no longer have to expose a patient to excessive levels of chemotherapy to eliminate a small cancer. In the past, we’ve known at least 30 percent of women who did not need the massive doses of chemotherapy they received. For eligible candidates, there is also another form of treatment called partial breast irradiation, where a balloon catheter is inserted into a portion of the breast for a period of five to six days, instead of five to six weeks. This is a wonderful time to practice this type of medicine because we are having great outcomes. Breast cancer is not like diseases such as pancreatic cancer, where you throw everything at it and hope and pray for the best.

For prevention, I recommend that you and your family get screened for the BRCA 1 and BRCA 2 genes. This will place you more accurately in a predisposition percentile for breast or ovarian cancer. These issues don’t just affect women. By testing positive for the gene pool for BRCA 2, men are also at increased risk for prostate, pancreatic, colon and breast cancer. More and more, you hear of men being diagnosed with and dying from breast cancer due to ignorance of the risks.

Now that we have the ability to screen for the cancer gene, a patient can make a more informed decision about treatment. Does she want a bi-lateral mastectomy or does she want to treat the cancer and see what happens? A woman can now elect to take tamoxofin, the risk-reduction pill. Having so much information almost ties the patient’s hands, because if you tell someone they have a 100 percent chance of getting breast cancer, it’s a no-brainer. They know what they need to do. But if you tell that same person that they have about a 60 percent to 80 percent chance, it becomes a more difficult decision.

The next layer is preparing them for hair loss, not just on their heads, but also in their eyebrows, eye lashes, etc. In my practice, we counsel the total woman and try to address every scenario and question that could arise. As a side note, if you or someone you love is at risk for any disease, please understand that your overall health is key to the outcomes. I counsel every one of my patients about their total health, which includes how they are faring mentally, as well as other issues they might consider outside the realm of my specialty. I once had a woman and her daughter walk out of my office because I respectfully admonished the mother for smoking and how it would affect her daughter in years to come.

The case of the 37-year-old is the real-life story of a patient I am currently treating. She has a wonderful husband and a sister who has volunteered to be her surrogate mother. This story turned out to be a very happy one.

Kamy Kemp is the Medical Director of Breast Care Center of Florida in Winter Park, FL.

Visit www.floridabreastcare.com for more comprehensive information on Breast Care