Dr Chandler Cortina: In Oncology, We Treat the Disease and the Person

In this excerpt from our “Getting to Know…” interview with Chandler Cortina, MD, MS, FSSO, FACS, assistant professor of surgery and breast surgical oncologist at Froedtert & the Medical College of Wisconsin, he addresses the impact that prioritizing mental health care, in addition to physical well-being, can have on patients as they navigate through their cancer journey, from diagnosis to treatment to recovery and beyond.

Transcript

How does prioritizing mental health support contribute to the overall well-being and recovery of cancer survivors?

I think that mental health is really important for cancer survivors, because cancer survivors go through all this treatment and you come out on the other side, and you're alive and you're well from a medical and clinical standpoint. But the psychological and social impact that going through a diagnosis and going through treatment has on someone is different for everyone. Everyone kind of perceives these things differently. Some people will feel guilty that they “got off so easy.” Some people will kind of perseverate on the “Why me?” if we don't have a clear answer, if there's no family history, no genetic mutation, no “How did this happen?

Usually, I feel for most patients, we really don't have a clear answer of why it happened to them, and so a lot of people can be left with these kinds of questions about “Why me?” Some people have guilt about the fact that their treatment may have been easier than others, and there's always the fear about a local or distant recurrence that moves forward. And so I think it's important whenever we treat cancer patients, we not only treat the disease but treat the person and realize that we don't want people just to like, survive cancer. But after cancer, we want people to survive and thrive, still live their lives, and really embrace the time that we all have. Because all of us, at the end of the day, are living on borrowed time, per se.

I had one patient yesterday who was like, “You know, you never know whenever one of the wheels are gonna fall off,” and I was like, it's true. We're all chugging along, we're hoping that the wheels stay on as long as they can. But, you know, even after one of those, if you have a cancer diagnosis or other health care issue that [you have] to overcome, on the other side of that, sure, people can be medically well, but we want to make sure people are psychologically and socially well and are able to really live and thrive and be themselves and be as much of themselves as they can, as they were before the diagnosis. And before that, before the battle.

We're really lucky here. We have some great trained psychologists at work within our division of surgical oncology, specifically with patients who are diagnosed with cancer going through treatment and even after treatment. Because I think it really is a very unique experience that's different from a lot of other things that people deal with, from a psychological and social standpoint. And we're really lucky to have some of those people that work here with us that are really skilled at that. But I recognize not every place has those sorts of people available.

People talk about the anxiety all the time. I saw one young lady yesterday who's a great candidate for lumpectomy, and she's just so anxious about it coming back in the breast. She doesn't have a genetic mutation, so standard of care is lumpectomy and radiation for her. But I was like, “If it's really going to cause you that much stress and anxiety, it might be a reasonable idea for you to consider mastectomy with or without reconstruction if it's really going to impact you that much.” And there's been a lot of research around decision-making around breast conservation therapy, lumpectomy vs mastectomy, bilateral mastectomy for patients. But the anxiety and the worry is real for a lot of people.