A breast cancer diagnosis can unsettle most people. Still, timely action and direct communication with an oncologist and proactive cancer care team working together with the patient make a considerable difference in the experience. Chicago native and Saint Alphonsus oncologist Dr. Bobby Chawla now calls the Treasure Valley home. He wants people to know that a breast cancer diagnosis does not mean a death sentence with the current treatments and screening access.
When he celebrated his fifth anniversary in practice at Saint Alphonsus, he noted that a cancer diagnosis could quickly put life into perspective. However, he emphasized that each person’s cancer and course of their treatment experience in the healing process will vary.
Compared to what was available 10 or 20 years ago, “a lot of cancers, including breast cancer, have evolved because of the treatment options we have available now,” Chawla said. “Then, there were limited options like chemotherapy. In some of my patients’ cases, their cancer has different targets and markers. Before, we threw the kitchen sink at cancer, but now, we’ve learned that every cancer is different.”
The improvement of treatments and latest research and push for early screenings mean that cancer, when diagnosed, is a treatable disease. “The introduction of immunotherapy has dramatically changed oncology from a 6% survival rate with breast cancer to a six-year survival. Per a recent study, the American Cancer Society reports that the number of women who died from breast cancer dropped about 40% in the past 25 years. These advancements change cancer treatment to become more managed like other chronic diseases like hypertension or diabetes. Even if you have 10 different people with breast cancer, I’d have 10 different treatments for them. We’re curing more people than we’ve done in the past and treating people longer.”
The great news is tempered with a caveat, as Dr. Chawla hoped to see more medical students elect to become oncologists. The pandemic has also made the doctor shortage an issue. Saint Alphonsus Cancer Institute in the Treasury Valley offers Telehealth consulting for the surrounding area to extend access to doctors.
“My team is amazing,” he said, “but there’s a huge shortage of medical oncologists in the country — a 40% shortage. I’ve had patients move to Sun Valley and realize there’s no cancer care, which is more of a challenge in rural areas. All the physicians here have worked through Telehealth, especially since the beginning of the pandemic. I do at least two to three televisits a day for patients who can’t travel or come from La Grande or McCall. And we try to do those things the best we can, but resources are becoming more limited. One thing the pandemic caused is that we’ve had many doctors and nurses retire from burnout. So at Saint Alphonsus, we’re working creatively on how to provide those resources to limited areas.”
Prevention and screening are without a doubt the most critical aspect of all, according to Dr. Chawla. He said, “The goal of cancer screening is to detect cancer early enough so that we can cure you. Saint Alphonsus has worked to create a strong screening program for breast cancer, cervical cancer, and lung cancer. We also have a strong program for colon cancer. No one wants to go through chemotherapy. If they get their screening done on time and by age 40, we can detect these cancers early and improve their survival. We can treat them with minimal surgery, a minimal treatment they may need, and maybe a pill to take for five years instead of aggressive chemo. So I think screening is very critical.”
Many people have misconceptions about what to expect when faced with a lumpectomy, chemotherapy, radiation, and a mastectomy — and just how hard the process would be. One patient of Dr. Chawla, Ginger Loucks, is a success story that is an example of the power of having not only the right team of medical professionals advocating and working on your treatment but a strong support network, according to Dr. Chawla. “I think family and friends provided a huge support structure for patients with chronic disease. It’s critical because you can get sick at home and need that additional support and help, and that is why we try to keep everything as local as possible. Right now, Saint Alphonsus can offer anything that any major cancer center in the country can offer; we have multiple tumor boards, tumor panels, incredible nurse navigators … so patients have access to resources that any other major institution would offer. We’re able to provide that cancer care locally and at a very high level.”
Loucks was delivered the news over the phone from her primary care physician, who connected her immediately to Dr. Chawla. She said: “My primary care physician, Dr. Samantha Portenier, shared the news with me, and she said we could meet and go over different doctors. I grew up around her and trusted her opinion. She connected me to Dr. Chawla, telling me he was going to be one of the best doctors you could consult with to go over the diagnosis.”
Meeting Ginger and seeing the unusual web-like large mass cancer she was facing, Dr. Chawla got to the point with Loucks and they decided on a bilateral mastectomy and reconstruction, with chemo and radiation therapy. This mother of four had a great support system and, notably, a mother who was with her almost every step of the way.
“Her case was challenging for many reasons,” said Dr. Chawla, “but she had an excellent support structure, with her mother by her side the entire time. Her mother was a tough lady, too. She would ask all the right questions. But my approach to medicine is always to be honest and upfront with every patient, whether it’s good or bad news. I’m always about telling people what the plan is and the truth, and the overall outcome. People have to plan for their lives. I want to treat any patient as if I got diagnosed with cancer and know if that journey will be difficult. Ginger opted for breast reconstruction surgery and a bilateral [mastectomy], and that was her choice. She was young and did not want to deal with cancer ever again. And those surgeries are a long journey and tough to go through. Also, with her family’s history, counselors were involved, and they discussed the risk factors, and that helped to make her decision.”
Today, Ginger Loucks is one of Dr. Chawla’s success stories, grateful to the team of nurses, techs, radiologists, geneticists, surgeons, and counselors who got her back on her feet.
On Oct. 5, Ginger brought her Cowgirls Catering food truck to Saint Alphonsus in Nampa to serve up American specialties to the Saint Alphonsus cancer care team, thanking them for what they did for her.
“I want to give back to the Saint Alphonsus Cancer Institute,” she said. “All of the team there were so amazing. Can you imagine taking care of really sick people day in and day out? It has to be tiring, and I wanted to show my appreciation.”
And her thoughts on the entire experience and of her oncologist, Dr. Chawla? “You learn a lot when you have cancer. Mostly to not let any day go by without making a difference. I believe you have to experience it to understand that you really cannot take life for granted in any form. And, I think if you don’t know Dr. Chawla, you’re missing out.”