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Dr. Robert Donegan Discusses Breast Cancer on To Your Health

October 8, 2019
For women and men diagnosed with breast cancer, medical oncologists play a key role on their treatment team. Robert Donegan, MD, a medical oncologist and hematologist at the Sandra & Malcolm Berman Cancer Institute at GBMC, described it this way: “The medical oncologist is just one member of a larger team that includes the surgeon, radiation oncologist, psychologists and counsellors, geneticists, social workers, dieticians, and integrative medicine specialists. My role,” he explained, “in addition to providing treatments including chemotherapy, targeted therapy, hormonal therapy, and immunotherapy, is to be the quarterback and to coordinate each patient’s care delivered by different parts of the team as the patient moves from treatment to survivorship.”

While the BRCA1 and BRCA2 gene mutations, which increase a person’s risk of developing breast cancer, get a lot of press, Dr. Donegan explained that only 5-10% of breast cancers are caused by an inherited gene mutation. Most breast cancers don’t have an identifiable cause and the patients do not have a family history of breast cancer. Some risk factors that have been associated with an increased breast cancer risk include obesity, hormone replacement therapy, and older age. Dr. Donegan cautions against assuming that you can’t be diagnosed with breast cancer if you don’t have any of the risk factors. “Don’t think you’re safe and skip screening mammograms or breast exams because you don’t have any known risk factors,” he said. “These screening tests are the best tools we have for catching breast cancer early.”

Dr. Donegan also answered questions about what steps people can take to lower their risk of breast cancer. He recommended being physically active, eating a healthy plant-based or Mediterranean diet, and maintaining a healthy weight. For women with a family history of breast cancer or other risk factors, GBMC has a high-risk breast clinic where patients can get an assessment of their risk and a plan to manage that risk.

He also talked about the psychological impact of a breast cancer diagnosis. “People can feel not only afraid, but also isolated,” he explained. “That’s why we provide counselling for our patients and their families — so they know they are not alone in this. In addition to counsellors and support groups, we offer access to psychiatrists and an integrative medicine specialist who can help patients manage anxiety with mindfulness techniques as well manage symptoms with approaches such as acupuncture and therapeutic massage. Our overall goal is to treat the whole patient—body, mind, and spirit.”
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