Encouraging patients with breast cancer: ‘Don’t steal hope’

As a doctor treating patients with breast cancer, Karisa Beebe has had many conversations where she has had to deliver life-changing news.

Beebe, a surgical oncologist with Penn State Health, has told patients that they have been diagnosed with breast cancer, and in some cases, she has had to tell patients they have an advanced stage of the disease.

But even as she has to give patients the reality of their condition, Beebe says she wants to ensure that patients understand they can get through it. She tells Chief Healthcare Executive® that she doesn’t ever want a patient to feel that the situation is hopeless.

“You review everybody's cases, you look at all of their images, you look at their pathology, you look at their receptors, and then you go into the conversation. And you don't steal hope from anyone,” Beebe says.

“You tell them the facts the way they are,” she explains. “You give them the statistics as you know them. But you have to realize not everybody follows the statistics. I could give you the most amazing statistics ever, but if you're that one in 1,000 … it doesn't matter what the statistics are. But the truth of the matter is, most of the time when we catch a breast cancer, we're catching it early, and patients have really, really good outcomes because of that.”

Across all cancers, more patients are surviving and living for many years after a diagnosis. Cancer mortality rates have dropped 34% between 1991 to 2022, according to research from the American Cancer Society.

Fewer women are dying due to breast cancer, although declines in mortality have slowed from 2% annually in the 2000s to 1% annually since 2010, according to the American Cancer Society.

Physicians and researchers note encouraging progress in treatment of breast cancer.

Alpa Patel, senior vice president of population science for the American Cancer Society, points out that there is much more knowledge about risk factors, including genetics. But there is also more knowledge about factors that can be reduced, such as smoking, alcohol use, and maintaining a healthy weight.

Patients are now getting screened at earlier ages. Starting at the age of 40, women should begin regular screenings for breast cancer, according to guidelines from the U.S. Preventive Services Task Force.

Researchers have seen an uptick in breast cancer cases among women under the age of 50. But doctors are detecting cancers at earlier stages.

“We have improved the technology around early detection,” Patel says. “The quality of mammograms is so much better today than it was in the 1980s.”

Patel also hails significant advances in chemotherapy and radiation, along with targeted therapies and immunotherapies.

“We can characterize the genetics of each person's tumor to understand at the genetic and molecular level what therapies are likely to work best for you, and so we can be more precise in our recommendations of the type of treatment you should get,” Patel says.

“We have more treatments, but we also know how to match, because of our better understanding of the biology of the cancer, we can match you to the treatment that gives you the best chances of survival,” she adds.

Beebe marvels at advances in treatments for patients with breast cancer in recent years.

“Even women who have been diagnosed with very aggressive diseases, women who have been diagnosed with metastatic diseases … they're having wonderful outcomes,” Beebe says. “So you can't steal hope from people, because we have made so many advances over the last 10 years, and I feel like we're just going to keep on doing better and better and better for our patients.”

Read more: Breast cancer and Black women: Gaps in care and research