Breast Cancer Articles

Turning Tragedy to Triumph

By Basia Christ
Today's Woman of South Orange County
 

A few facts about cancer
Cancer can begin almost anywhere in your body. It comprises a group of more than 100 diseases characterized by uncontrolled, abnormal growth of cells. These cells form a lump or mass called a tumor, named for the type of cell where the cancer started. For example, carcinomas begin in the skin or tissue that covers internal organs and glands. Sarcomas begin in connective tissue, such as muscle, fat, cartilage or bone.

Some cancers, however, such as blood cancers, don’t form tumors. Tumors can be benign (non-cancerous) or malignant (cancerous). Benign tumors may grow, but they don’t spread to other body parts. They usually aren’t life threatening, unlike malignant tumors that grow and invade other tissues.

Sometimes cancer spreads to the lymph nodes, tiny, bean-shaped structures that filter the flow of lymph, the clear fluid that is an important part of the body's immune system. Lymph nodes are clusters in the neck, groin area and under the arms. Malignant tumor cells may break away and travel throughout the body, continuing to grow. This process is metastasis. Metastatic cancer is named for where it began. For example, if breast cancer spreads to the lungs, it is called metastatic breast cancer, not lung cancer.

If you’re diagnosed with cancer, the doctor who diagnosed it usually refers you to an oncologist. You, your family, the cancer specialist, and his or her staff will work closely throughout your treatment to provide the best care possible.

The role of the oncologist
Once a cancer diagnosis is made, an oncologist is responsible for the patient care from the moment of diagnosis throughout the course of the disease. The oncologist's role is to explain the diagnosis and meaning of the disease stage to the patient; discuss treatment options; recommend the best course; deliver optimal care; and improve quality of life both through curative therapy and palliative care with pain and symptom management.

We’re fortunate to have the only female surgical oncologist in Orange County right in our own backyard. Dr. Lisa Curcio was born in Pennsylvania where she received her undergraduate degree. She attended George Washington University, Washington, D.C. where she also completed her six-year residency in general surgery.

In 1997, she completed a three-year Fellowship in Oncology at the City of Hope, Duarte, and married her husband, Frank Mancera. After receiving her degrees, she took on active duty fulfilling her Air Force Health Profession commitment in Biloxi at Keesler AFB.

She promised Frank they would move back to Southern California, which they did in 2001. She has two children, son Niko, 6, and daughter, Mia, 3. Dr. Curcio first joined Mission Hospital as a general surgeon with a group of surgeons. She worked at the Trauma Center, but her true passion has always been surgical oncology and the care of breast cancer patients. In 2005 she decided to go out on her own and specialize. Because she’s the only female oncology surgeon locally, she had already developed a large following which was the basis for her practice.

Seventy to eighty percent of her patients are female with breast cancer. She specialized in the least common type of oncologist, Surgical Oncology, because her Fellowship was focused on surgery. The other types are Medical Oncology, which treats cancer patients with medicine and chemotherapy, and Radiation Oncology which treats it with radiation.

Dr. Curcio designed her offices with earth tones and warm colors - not the stark white of most medical facilities.  The effect is both soothing and elegant.

When and why did Dr. Curcio decide on this career path? “My grandfather died of pancreatic cancer when I was in the fifth grade. I was very close to him. Because of this, I wanted to be in the medical field and help others.”

She considered nursing and did a lot of volunteer work. But her heart led her to working with patients with cancer. Surgical oncologists treat cancer with biopsy, staging, and surgical resection of tumors. “It's a very rewarding specialty because women get immediate results and a reassurance that the cancerous tumor has been removed."

If you’re diagnosed with cancer, several oncologists will be a part of your medical team. Dr. Curcio encourages patients to take an active role in determining which treatment provides the best solution for them. Every case is different, and she suggests considering the following when choosing your oncologist:

1. Discuss your choice with family and friends. Ask for referrals.

2. Speak with other patients who are being treated by the doctor.

3. Review the doctor's credentials.

   1. Has he or she received advanced training?

   2. Is the doctor board certified in Oncology or fellowship trained?

   3. Although surgery does not offer board certification in surgical oncology, there are fellowships for additional training
       

4. How many years has the doctor been in practice?

5. How many patients with your type of cancer does the doctor see annually?

6. Does the doctor have access to research therapies and clinical trials?

7. Is the office staff supportive?

   1. Does the doctor use registered nurses (RNs) or physician extenders (Physician
      assistants or Nurse practitioners) in the office?

   2. Who will give treatments?
       

8. Is the doctor available on weekends and holidays if you need to call?

9. What is the doctor’s philosophy? (“I’m telling you what to do because I’m the doctor!” or “You will be part of the team to decide what treatment is best for you.”)

10. Does the doctor work with other professionals like social workers, nutritionists, pharmacists and counselors should you need them?

11. Can your blood work be done in the office or will you have to go somewhere else?

12. Does the doctor accept your insurance?

13. Are treatments given in the office or will you have to go to a different location?

Because breast cancer is on the rise, in younger women, too, Dr. Curcio recommends mammograms for anyone over 40. Mammograms should be done yearly. For younger women with a history of breast cancer in their family, consider your first mammogram in your 30s or at least 10 years before the youngest person in your family was diagnosed. There has even been reported breast cancer in women in their late teens so it’s imperative for women to learn how to do self-examination (she doesn’t recommend mammograms for this age group).

Because cancer doesn’t hurt, it can go undetected. Any lump should be examined immediately. Although Dr. Curcio says cancer usually takes months to spread, there are always exceptions. For example, in post-menopausal women, cancer spreads very slowly, but in younger women, cancer can move more quickly.

In the past five years, new technology makes diagnoses earlier. Most treatments do involve some surgery, but even with surgery, cancer can come back. For a tiny tumor, the chance of it returning can be as low as 5-10%; but for a 2-3” tumor, the percentage can jump to 40-50%.

Breast cancer survivor

Having worn a scarf herself during her own cancer treatment. Dr. Curcio is apt at teaching women how to utilize one.

Dr. Curcio is herself a breast cancer survivor. “Six years ago I was nursing my nine-month-old son, and noticed some bleeding. I did a self examination and did not feel a mass. But because of my training and education, I immediately knew these symptoms may represent breast cancer. I felt healthy, but that’s one of the real ironies of breast cancer, you can feel and look well, but still get cancer.”

During the next few weeks, Dr. Curcio had a series of diagnostic tests. Her mammogram was speckled with calcifications that were not there 18 months previously. The tests confirmed her concerns: the tumor was malignant. She had breast cancer. Although her family has a history of other cancers, she never imagined she would would be affected by breast cancer.

As an surgical oncologist, she knew her options. She conferred with her team of specialists, spoke with family members, friends and, of course, her husband. Because of the extensive nature of the calcifications she knew breast conservation was not an option. She proceeded with total mastectomy and later decided to proceed with a prophylactic mastectomy on the contralateral side. Her cancer was noninvasive which carries an excellent prognosis, but her greater concern was going through this experience again and perhaps not being so fortunate with such an early stage of diagnosis.

“My son was just a baby and I was thoroughly enjoying my role as a mother. I wanted to make sure I was around to watch him grow up,” she confides. “Although it was difficult, I made the choice that was right for me. I’ve never regretted my decision, but the choice was still difficult.”

Today, Dr. Curcio understands what her patients are experiencing because, “I’ve been through it. Cancer has touched my family and I know the full range of emotions it can bring, along with the various stages one goes through,” she admits. “When you’re diagnosed with cancer, you’re vulnerable. I educate and empower my patients. At first they feel like they won’t have the strength to get through this because treatment can challenge physical and emotional limits. Yet every time they find the courage and we make sure they never go through it alone.”

Being diagnosed with cancer is frightening. The important thing to remember is treatment is available, usually with a variety of options. Finding the right team of doctors is critical in supporting you through this challenging time. For further information on this topic, please go to www.mybreastcarespecialist.com.

To speak with Dr. Lisa Curcio or her staff, please call 949.770.0797. Advanced Breast Care Specialists offers risk assessment and evaluation as well as diagnosis and treatment. The office is located at 25892 Pala, Suite 140, Mission Viejo. 

Visit"Advanced Breast Care Specialists of Orange County"  in Mission Viejo, California.