When Professor Bogda Koczwara started working in oncology 25 years ago, her breast cancer patients were told different messages about their general health than they hear today.
“My patients would be told by the surgeons to‘ just take it easy’ and then they could spend six months sitting on the couch,” says Professor Koczwara.
Whereas, nowadays, she says “the message that patients are getting is ‘you should be active’, ‘you should be exercising’, ‘you should maintain a healthy weight’, ‘you should eat a healthy diet’.
This focus on a breast cancer patient’s overall health has many interconnecting benefits, such as reducing cancer recurrence along with other conditions and diseases.
Multidisciplinary care is a must, and Professor Koczwara believes it’s important for this double message to get across to breast cancer patients and healthcare providers.
“That’s kind of the core business of my research– trying to see the patient, not just from a perspective of one condition they might have, but also seeing them as a whole, and trying to manage their entire health needs,” she says.
With a particular clinical and research interest in the care of cancer survivors, Professor Koczwara is improving the management of coexisting conditions that breast cancer survivors experience.
Join Breast Cancer Trials tomorrow (Wednesday 7 August), from 5-6:30pm (AEST), for a free online Q&A, where leading researchers and women with a history of breast cancer will discuss the link between breast cancer and heart health. The session will be moderated by author and journalist Annabel Crabb. To register click here.
Breast cancer and pre-existing conditions
Professor Koczwara says that research has shown breast cancer patients don’t necessarily start off with “a clean slate” once they’re diagnosed. Often, patients are already dealing with pre-existing conditions such as cardiovascular disease.
“Those conditions often get worse during cancer treatment,” she says, noting that, “also, cancer treatment itself often leads to a degree of neglect of other health problems because the patient is so focused on management of the cancer.”
For patients with pre-existing health conditions, maintaining a focus on overall health is especially important.
“I’ve had patients in the past who would come in and say, ‘Now that I’m having cancer treatment, I’m not going to see my doctor about my diabetes or my high blood pressure because I’m just busy with cancer’,” Professor Koczwara says.
And yet, strategies shown to improve outcomes for cancer have also been shown as beneficial for managing pre-existing conditions. These strategies include weight reduction, exercise and healthy eating.
“We can effectively do two for the price of one,” says Professor Koczwara, adding that this means we can improve both conditions through the same intervention.
Pre-existing cardiac disease is one of the most important risk factors to take note of, she says, as research shows women diagnosed with breast cancer have a higher risk of developing cardiovascular complications, such as heart failure, heart attacks and hypertension.
“I would see patients who have high blood pressure, high cholesterol, obesity, etc,” she says, noting that “these are risk factors for the heart– so high blood pressure and high cholesterol would be problems that really need to be managed”.
Obesity is also a risk factor for cardiovascular disease, as is smoking and inactivity.
“It is those patients who have poorly controlled blood pressure or who are inactive or who smoke, that are more likely to develop heart conditions,” says Professor Koczwara. “So, if we could manage those risk factors early, then potentially we could prevent heart disease after cancer.”
Why breast cancer patients should seek a multidisciplinary care team
As part of Professor Koczwara’s routine conversations with patients, she makes sure to check that they are able to work with their GP, who she says “plays an incredibly important role”.
“Certainly, patients who have established a relationship with the GP should maintain that relationship, and the GP should be given all the information they require so they can actually provide appropriate advice to patients,” she says about the multidisciplinary care approach needed during cancer treatment.
“I also want to emphasise that there are some patients who have complex needs, and those patients might benefit from a visit with a specialist,” says Professor Koczwara, adding that there are growing numbers of experts, such as cardiologists, who could best manage heart conditions.
“Good care of a person with cancer is not just about giving them a cancer drug. It is more about looking at them as a whole person, with multiple needs, and that requires a multidisciplinary team– not just an oncologist, but a GP, potentially a specialist, potentially an exercise physiologist, etc.,” she says.
“There’s much more to keeping people well in the long run than just shrinking the tumour.”
Tomorrow, Professor Bogda Koczwara will be joining Breast Cancer Trials’ free Q&A webinar, alongside other leading researchers and women with a history of breast cancer, to discuss the link between breast cancer and heart health.
The session will be moderated by author and journalist Annabel Crabb. To register for tomorrow’s event (Wednesday 7 August, from 5-6:30 pm AEST) click here.