Don’t define a breast cancer patient only by the lump in her body

“Her family, her body, her husband, her children, her sexuality, her friends, her career – all these are different facets of a woman with breast cancer,” says Dr. Arash Rafil Tabrizi, Professor of Genetics, and Professor of Obstetrics and Gynecology at Weill Cornell Medicine-Qatar. “She shouldn’t be defined only by that lump in her breast. She needs to be treated holistically.”

Dr. Tabrizi, a French national who originally hails from Iran, says that while research and surgical techniques are gaining ground in the fight against breast cancer, the medical community often forgets that a woman is a person who has a range of needs.

“Most physicians and surgeons across the world still don’t cross over and relate to a patient beyond that lump,” he says. “When they discuss a procedure with a patient, they talk about the duration of the process, how many stitches she will have, and so on. These are technical points.

“The patient listens to the doctor, nods her head, and leaves the room - with 100 other questions racing through her mind. How is this going to affect my sexuality? Can I lift my little boy? Will my colleagues feel I can’t take the pressure at work anymore?”

The professor at Weill Cornell Medicine-Qatar (WCM-Q), a Qatar Foundation partner university, says such situations arise because most doctors prefer to keep an emotional distance from their patients. They may smile and chat with their patients, but they cannot bring themselves to get to know their personal circumstances better. He points out that this prevents a doctor from being a reassuring presence in a breast cancer patient’s journey – from her very first visit, to complete recovery or death.

“We need to be there to help breast cancer patients cope with surgery, follow-ups and the ultimate outcome,” says Dr. Tabrizi. “One of my patients told me that at the end of a treatment plan, doctors told her to go home and come back for a follow-up CT scan after three months.

“What the doctors didn’t know was that, for those three months, she was agonizing over the upcoming CT scan session and its results – without being able to talk to her doctor. Couple that with the other issues a woman may face at home, at work or in society, and you have a woman who is emotionally fragile. This affects the overall outcome.”

Over the last few years, Dr. Tabrizi has led a team of researchers in a study where 130 patients were provided with a more holistic treatment protocol for their breast reconstruction process. They were given physiotherapy, massages, cosmetic minimally-invasive breast reconstruction, and physical activities such as trekking and rock-climbing, alongside surgery, medications and radiation therapy. They were also given the option of contacting their personal physician whenever they wanted to – not just at medical appointments.

“The results in terms of both the physical and emotional recovery of the patients are highly encouraging, and will soon be published,” he explains.

“If we can demonstrate that a holistic and personalized approach combining minimally-invasive processes and increased doctor-patient rapport improves patients’ quality of life, then our next step will be to discuss this with health stakeholders in Qatar to roll out a more comprehensive treatment plan for patients across the country.”

The WCM-Q faculty member has been in Qatar for 11 years, and has seen the effects of increased awareness among the public about the disease. And he feels that, to obtain better results, all three stakeholders – medical professionals, researchers, and the patient community – need to work together.

“The medical team treating a breast cancer patient need to shed their white-coat image and get to know the woman in front of them better,” he says. “They need to give her the confidence to discuss those issues that are important to her – her sexuality, her children, her job, her fears.

“Research is an important tool, especially when it comes to fighting the disease at the genetic level. At the moment, teams across the world and at WCM-Q are trying to find ways to improve cancer chemotherapy and treatment with more targeted therapies. There is considerable interest in the area of preventive medicine with wider genetic screening or personalized breast cancer risk assessment. In the future, we can expect to see innovative therapies such as combined targeted therapies, or genetic correction in the preventive context.”

Dr. Tabrizi says that patients can also help doctors and researchers understand the need for a more comprehensive approach to treatment.

“Every woman who has breast cancer should have the confidence to tell her colleagues and family that losing a breast or her hair does not make her any less feminine,” he said.

“When a breast cancer patient stands up and says ‘I am a complex human being. I need to be treated as a whole. The cancer is only one small part of my life. I will not allow it to be made bigger than it is.’ the rest of the world will fall in line, and a more holistic approach will be possible.”