In our October issue, on newsstands September 18, we sat down with Dr. Elisa Port, chief of breast surgery at N.Y.C.’s Mount Sinai Medical Center and the co-director of the Dubin Breast Center to talk about her important new book, The New Generation Breast Cancer Book: How to Navigate Your Diagnosis and Treatment Options—and Remain Optimistic—in an Age of Information Overload ($11; amazon.com). It's essential reading for breast cancer patients and close friends and family weathering the experience along with them. Below, you’ll find the complete conversation we had with the author, as well as an excerpt from the book.
What motivated you to write this book?
Good question! One could easily ask, “Why another breast cancer book?” My answer is that just writing a book wasn’t my motivation. The idea for a new and unique book about breast cancer was born out of what I was seeing in my office: so many women coming in, inundated with information (much of it the wrong information, having nothing to do with their particular case). I started to realize that over the last 10 years, women facing breast cancer were also facing a new landscape of information overload, and could probably use some guidance on how to navigate that landscape. So I really wrote the book out of my perception that a need was not being met, and perhaps I could help do that.
One of the points that you make early on in the book is that women who receive a breast cancer diagnosis should be optimistic about their prospects. Can you explain why?
The cure rate for breast cancer has never been better, approaching 90% overall. And thus for the majority of women newly diagnosed with breast cancer, there is every reason to have hope and optimism and that they will be just fine. Between 2000 and 2010, the death rate from breast cancer dropped almost 2% per year. This progress is mostly related to early detection initiatives with mammograms and other tests, and improvement in treatments that we have to offer: there are so many more options, even for the more advanced cases.
Why is finding the right team important?
One of the reasons why the cure rates for breast cancer have improved is that there are more options for treatment, both surgical and medical, than ever before. Most women with breast cancer will have many choices to make: Lumpectomy or mastectomy? Single mastectomy or double mastectomy? Saving the nipple or removing it? And that’s before a woman even starts treatment! For sure, the decision-making process can be quite complex. This can be overwhelming, but with the right guidance it shouldn’t be. And the right guidance comes from experienced doctors and health care providers who are specialized in breast cancer treatment. Also, many women with breast cancer will see multiple specialists for their care which can include a breast surgeon, a medical oncologist, a plastic surgeon, a radiation oncologist, and more. A specialized center will help guide their patients through the steps, from one doctor to the next, and help make the transitions seamless.
What is the best advice you would give to someone with a friend who gets a breast cancer diagnosis?
Just saying, “be supportive,” doesn’t seem to be enough. Support can take many forms, depending on the person and her needs. Going to doctors’ appointments if asked can be critical: a second pair of ears to hear what the doctors have to say, and to discuss options afterwards is so helpful to many women. And many women, especially those who undergo larger surgery, such as a mastectomy, may need help after surgery being driven to appointments and getting around. What’s not helpful is to second guess plans in place or to try to make medical recommendations based on your own “research” on the internet that may or may not have anything to do with the friend’s particular case.
There are so many recommendations out there about diet and exercise as a pathway to maintaining good health and remaining cancer-free. Are there prevention tips that resonate with you?
Absolutely. The two main ones are to 1. Maintain a healthy body weight: obesity definitely increases one’s risk of getting breast cancer and actually also increases the risk of recurrence (breast cancer coming back) for women who already have it. And 2. Avoid heavy alcohol intake. More than one to two drinks a day also increases the risk of breast cancer and recurrence. Drinking in moderation, four to five drinks per week is probably fine relative to breast cancer risk. Other than that, a healthy diet with lots of fruit and vegetables and whole grains, and exercise can also have contributing roles to overall well-being, both through weight control and probably independently as well. And while smoking really has very little to do with breast cancer risk, if someone smokes, many of the resulting illnesses (emphysema, heart disease, lung cancer and so many more) are significantly more life-threatening than breast cancer.
If there is one message that you want people to walk away with after reading your book, what would it be?
In breast cancer treatment, there is no one-size-fits-all. And for most women newly diagnosed with breast cancer, with the right treatment and the right team, you have every reason to be optimistic.