The Breast Cancer Dream Team

Throughout our lives, there are many challenges that we're forced to face alone. It's part of the struggle of growing up, maturing, and finding our own way in the world. But when it comes to matters of medical care, facing an uncertain future can be an overwhelming and emotional experience that few of us would want to tackle on our own. That's why when Mary Jane Combs was facing one of the biggest challenges of her life, she turned to the expert team at The Christ Hospital Health Network for her care.

When Mary Jane first discovered a lump in her breast while on vacation with her husband in March 2015, she was at a point in her life where she was thriving. She had built a successful career as a scientist for Proctor & Gamble and she was in the best shape of her life as an active endurance athlete. She kept up with all of her doctor's appointments and physicals. In fact, just three months prior to finding the lump, Mary Jane had received a clear mammogram and a clean bill of health.

As aggressively successful as Mary Jane's life was, her breast cancer was equally aggressive against her. Just two days after returning home from vacation, Mary Jane saw her doctor, who referred her to The Christ Hospital Comprehensive Breast Center, where a biopsy confirmed that the lump was cancer. Mary Jane was diagnosed with triple negative breast cancer, a particularly aggressive form that can proliferate rapidly, on April 1, 2015.

From the very beginning of her experience—and before Mary Jane even knew it herself—her health and wellness was the focus of a team of doctors, nurses and support staff at The Christ Hospital Health Network, which boasts some of the highest volumes of breast cancer treatment and care in the state with equally as impressive outcomes. The process of exceptional service begins from the moment an individual turns to The Christ Hospital Health Network for any portion of their care, beginning with doctors like Dr. Raymond Rost, a diagnostic radiologist who specializes in breast imaging and is the Medical Director over The Christ Hospital Comprehensive Breast Centers in Mt. Auburn and Montgomery.

"As radiologists, we often act as gatekeepers," Dr. Rost said. "We will review the patient's mammograms, ultrasounds, breast MRI's, recommend biopsies, evaluate biopsy results and then, based on the results, get the patient on the right track for treatment."

The Christ Hospital Comprehensive Breast Centers specialize in screening and diagnostic breast imaging services, and they typically serve as step one in a patient's journey. For some, the journey begins and ends here, as their biopsy results are normal and they can return to life as they knew it. For others, like Mary Jane, it is the beginning of a long and challenging road of treatment, care and, with hope, recovery. But, no matter how long their individual journey is, breast cancer patients at The Christ Hospital Comprehensive Breast Centers have the immediate, personal support of people like Vicki Estridge, a nurse of 42 years who has spent most of her career in cancer care, and now works directly with breast cancer patients as a breast health patient navigator.

On paper, the role of a patient navigator is to help patients coordinate their care. From scheduling appointments with the appropriate doctors to following up with results, Vicki ensures that patients are staying on track and on time with their treatment plan. In reality, the role is much more profound and impactful. Vicki provides emotional, spiritual, medical and practical support for patient and their loved ones that is often desperately lacking from typical breast cancer care. The Christ Hospital Health Network ensures that all individuals affected by breast cancer, including Mary Jane, are put in contact immediately with a patient navigator like Vicki to see them through the challenges that lie ahead.

"It was like an angel had come into my life at a very confusing time to help me through this process," Mary Jane said. "Before my first appointment, she came into the waiting room and introduced herself. She told me she was here as a resource and would be with me throughout the whole experience, regardless of what part of treatment I was in."

Anyone who has gone through the experience of receiving a medical diagnosis can attest to the fact that the experience is emotional, often confusing and nearly always overwhelming. At The Christ Hospital Health Network, the doctors always consider the patient perspective and recognize that having an individual like Vicki is critical to the patient's experience.

"I support patients and loved ones through the journey, which starts with the diagnosis and then moves through appointments with specialists," Vicki said. "But the support is more about checking in with the patient and their loved ones to ask how they are doing, how they are feeling and making sure they understand their options along the way."

To effectively treat her particular cancer, Mary Jane's treatment plan was to undergo chemotherapy first, then surgery and, finally, radiation.

"I had to put my life on hold," Mary Jane said. "I missed eight months of work. My chemotherapy was very intense over five months, and I had an adverse reaction. But my experience was incredible."

Mary Jane's positive experience is due to her team of doctors and the nursing staff that supported her along the way.

"The first doctor I saw was Dr. Sandra Miller, a surgical oncologist," Mary Jane said. "My husband and I sat down with her and she talked with us for at least an hour about my particular cancer and our course of action and our options. We were listening and trying to take notes, but Dr. Miller stopped us. She said she would take all of the notes and that she just wanted us to listen. She made us feel comfortable with what was ahead of us, and that knowledge put me much more at ease."

Dr. Miller, who has been focused primarily on breast surgery within surgical oncology for the last 13 years, understands that there is value in helping patients understand their experience as much as possible. Unlike other cancer centers, where the care team just treats the breast cancer, we try to get to know the patient on a deeper level and understand their needs by coordinating separate appointments with each specialist involved in their care.

"We recognize that trying to do everything in one day is completely overwhelming," Dr. Miller said. "We need to make sure the patient understands the process and how we are tailoring their care for their particular needs. It's a very patient-focused program."

Tailoring cancer treatments is a cornerstone of The Christ Hospital's approach to cancer care. In addition to offering two comprehensive breast centers, the health network offers leading treatment options, including surgical approaches, medical therapies, and radiation therapies that are all specifically chosen based on the patient and his or her type of cancer, medical history and genetic makeup. The Christ Hospital is also the only health network in the region to offer Edge stereotactic radiosurgery, which is high-precision radiosurgery that can easily target difficult-to-treat tumors in the body without an incision, and intraoperative radiation therapy (IORT), a way for some early stage breast cancer patients to combine their radiation treatment and surgery. Doing both at one time eliminates the need for patients to come back numerous times for radiation treatments. IORT delivers a single dose of radiation directly to where the cancer was removed while the tissue is still exposed.

"IORT is the quickest, easiest type of radiation," said Dr. Robert Summe, radiation oncologist at The Christ Hospital Physicians. "Across the board, we are able to offer our patients state-of-the-art technology, some of the best physicians in the region, and advanced treatment options. Breast cancer treatment has gotten much better over the years, and this is an exceptional center for breast cancer care."

In addition to offering patients the care they need, Mary Jane found that The Christ Hospital's doctors and support staff, including Vicki as well as the team of oncology nurses and social workers, also offered Mary Jane's husband the support he needed along the way, too. When Mary Jane was having a particularly bad reaction to a treatment, her husband called and spoke with a nurse, who laid out the best course of action to get Mary Jane stable before her condition worsened. And according to Mary Jane, that kind of ongoing support and the relationships that Mary Jane and her husband developed were critical to her ability to stick with the rigorous treatment plan.

"Even though every patient's care requires a team, each of the doctors involved develops a relationship with the patient," said Dr. Robert Cody, a medical oncologist at The Christ Hospital Physicians, who worked directly with Mary Jane on her treatment plan. "We offer multidisciplinary, personalized care. Depending on the situation, a patient with an extensive treatment develops an extensive relationship with his or her team."

Today, Mary Jane is cancer free. And although she is moving forward in her post-cancer life, her experience at The Christ Hospital left an incredible impact on her, and she continues to be involved with the hospital and its staff. To show her appreciation and gratitude for the oncology nurse team, Mary Jane hosted a fund raiser to help the nurses launch a project that recognizes and rewards people who successfully finish their chemotherapy. Now, every patient receives a special coin when they finish their treatment as a sign of their accomplishment and a symbol of their strength and fortitude in a time of struggle.

"Vicki was incredibly instrumental in helping me stick with my treatment plan," Mary Jane said. "Sometimes she would call me out of the blue, even when my treatments were over. In spite of the awfulness of the disease, my experience was the absolute best it could have been because of the people that I met along the way."