Patient-centered breast cancer treatment stays on top of ever-changing field of care
SPONSORED CONTENT: By Nancy Lofholm for St. Mary’s Medical Center
Dr. Kimberly McGregor knows how a breast cancer diagnosis can send a patient into an emotional tailspin of fear and confusion. It is her job, as a woman dealing with a cancer that affects one in eight in her gender and as an oncology specialist, to lessen that turmoil by staying on top of the steady stream of new research and recommendations relating to breast cancer.
Tests, classifications of tumors, and treatment options are rapidly changing. What was touted as the best course of therapy a month ago, might no longer be at the top of the list. Treatment has become very individualized: What worked best for a friend or a relative with breast cancer might be totally different for a new patient.
Stratifying tumors and deciding on the best course of treatment is no longer focused solely on a patient’s age or the size of a tumor. Instead, the genetic makeup of a tumor is the most important factor. Patients with tumors larger than one centimeter no longer are automatically treated with chemotherapy. Some don’t need it.
The complicated considerations of breast cancer today also involve immunotherapy, genetic anomalies, enzyme activity, endocrine therapy, clinical trials, estrogen receptors, targeted therapies, stages, grades and gene expressions.
“The landscape is constantly changing. It’s always improving. Sometimes the changes happen in a matter of months. It’s hard even for primary care doctors to stay on top of it. Patients certainly can’t,” said McGregor, the newest physician practicing at St. Mary’s Cancer Center.
McGregor was recruited to join St. Mary’s when a physician who was formerly with St. Mary’s heard her speak on endocrinology at a medical conference. That physician was able to convince her she should consider moving to Grand Junction from Corvallis, Oregon. where she had been practicing. St. Mary’s had a full slate of specialists for treating breast cancer but did not have a medical oncologist overseeing the breast cancer program. McGregor could fill that slot. As a medical oncologist, McGregor works in tandem with St.
Mary’s surgeons, radiologists, and radiation oncologists to treat cancer. She is in charge of deciding on the best courses of chemotherapy, medications and targeted therapies.
McGregor’s importance in the program was recently underscored by the steady stream of knocks on her office door. Her first week on the job, physicians and nurses were wasting no time seeking her input on complicated cases. She is also able to give that input in formal meetings. She is serving as the chairwoman of a breast cancer task force at St. Mary’s. The team includes radiologists, surgeons, pathologists, radiological oncologists, counselors, social workers, mammography technicians and nurse navigators.
The team meets twice a month and reviews every breast cancer — or suspected breast cancer — case. Team members weigh in on diagnosis, tests and treatment. That means patients have the security of knowing many experts have helped to determine the most appropriate treatment. Those experts have sifted through all the pertinent details of each breast cancer so the patient can confidently make decisions about treatment.
“Patients can take comfort in knowing that so many medical professionals have weighed in,” McGregor said.
The 6-month-old task force represents part of an effort at St. Mary’s to make sure every breast cancer patient receives consistent care — not in terms of receiving the same care — but in the way each patient is treated. From the moment patients walk in the door and are assigned a nurse navigator, the process is designed to be as seamless as possible.
McGregor has been given another mission at St. Mary’s that does not involve direct patient care. But it does have an impact on that care.
St. Mary’s is completing the process to earn certification with the National Accreditation Program for Breast Centers. Accreditation by that organization means that centers have met quality performance standards of care in every aspect of breast cancer treatment — from education, support services and genetic evaluation to community outreach and research.
“They have essentially already been doing all this at St. Mary’s,” McGregor said. “But the part we are doing now is completing all the documentation and doing everything in a standardized fashion.”
When St. Mary’s completes, and is awarded, the accreditation, its cancer center will be the only program on the Western Slope to be certified. The 14 hospitals and centers currently accredited in Colorado are all on the Front Range.
Such a designation may be overlooked by a patient who has just received a diagnosis of breast cancer or is undergoing treatment. But the continuum of care behind the accreditation will be felt.
“The patient focus shouldn’t have to be on worrying about what to do next. We should be doing that for them,” said Micah Roten, RN, the clinical operations manager for the Cancer Center.
McGregor said she came to St. Mary’s with a commitment to that focus. Administering a program is an important job. Making sure every piece is in place is a priority. But her work really has one overarching mission, she said. It is what keeps her at her computer reading the latest research reports well after her working hours.
“Patient-centered care when it comes to breast cancer is becoming more and more important,” she said, “because breast cancer is becoming more and more complicated.”
PROFILE: DR. KIMBERLY MCGREGOR
Dr. Kimberly McGregor is a specialist in hematology and medical oncology. She completed medical school at the University of Arizona College of Medicine. She did her internship and residency at Santa Barbara Cottage Hospital and a fellowship at the University of Utah School of Medicine. She is certified by the American Board of Internal Medicine, by the American Board of Internal Medicine in Hematology and the American Board of Internal Medicine in Medical Oncology.