An emotional journey: Breast surgeon follows her patients through cancer treatment
ZANESVILLE - Dr. Shannon Hanley's job is year-round.
"Cancer is a 365 day a year disease," she said.
She does, however, often see a spike in patients at the end of October and the beginning of November, as Breast Cancer Awareness Month reminds women to get screened for breast cancer. Those with abnormal results then visit Hanley.
"A lot of people don't know that I'm here, and what we have to offer," she said.
Hanley, a breast surgeon with Genesis HealthCare System, sees between 25 and 30 patients every day, treating everything from benign breast disease and pain, in both women and men, to severe category five breast cancer patients. She see patients from six counties - Muskingum, Coshocton, Perry, Morgan, Guernsey and Noble.
Hanley trained as a general surgeon, completing an extra year fellowship in Akron focusing specifically on breast health.
"As a general surgeon, you don't generally develop long-term relationships with your patients. You take out their gall bladder or their appendix, you check up with them later, and then they go about their way," she said. "I like the long-term relationships with my patients."
When a woman steps inside Hanley's office, that begins a relationship between the two that lasts for at least five years, if not longer.
"After five years, I say 'You know, you can go back to a normal screening with your family doctor,'" she said. "Some will go 'Ok, see you,' but others would rather stay here. Some have an entity of anxiety after five years, and some just go about their day like they don't have a care in the world."
The journey of a woman diagnosed with breast cancer, through surgery and recovery, is an emotional one, Hanley said.
"When the patients first come in, of course they're terrified," she said.
But after the initial visit, each women has her own way of dealing with the diagnosis and the process of recovery.
"Some women respond, of course, with sadness and fear. Some are angry," she said. "And some women are very calm and take it day-by-day."
When she first meets with a patient, Hanley said she is upfront with giving all the information to the patient, and letting them make their own decision on how to proceed.
Some women often walk in and immediately want a mastectomy.
"They say they don't care what they look like, and I tell them to take a deep breath and just take a few days to think about it, because they may feel like that now because they're very upset and they're fearful that they were just diagnosed with breast cancer," she said. "But five years down the road, I want them to look in the mirror and feel good about what they see as well."
The best course of action varies for each person and each diagnosis, and a mastectomy is not always the right choice, Hanley said.
"With breast cancer, a lot of women will say 'I want the surgery that's going to make me live the longest,'" she said. "What a lot of women don't know is that undergoing a lumpectomy, taking out the tumor and getting radiation after, has the same survival rate as a mastectomy. Meaning the ability that they're going to be able to live into their 90s is the same."
And a mastectomy of one breast does not necessarily mean the other one has to go, since the chance of the cancer coming back in the other breast is quite low, she said.
Hanley performs between five and 10 surgeries a week, and is able to perform many operations with tiny incisions and minimal cosmetic damage. And in the rare case where a woman needs, or chooses, a mastectomy, the hospital is able to do immediate reconstruction. Previously, women would have to travel to Columbus for a second procedure.
"Whenever I look at a woman who's undergone a mastectomy and they wake up and there's something there, it does something for their psyche, rather than going home flat and having to do the reconstruction at a later date," she said.
Breast cancer continues to be one of the most common cancer, with one in 12 women diagnosed with the disease. Roughly 10 to 15 percent is genetic, while the majority is due to spontaneous mutation.
But with advances in technology, it has become easier to catch the disease early. In the last year, Genesis introduced breast tomosynthesis, effectively a three-dimensional mammogram, that makes it easier to detect masses.
"Especially in younger women, they may have dense breast tissue, meaning it almost shows up white on a mammogram. Well, the things to worry about also show up white, so it's kind of like looking for a snowball in a snow storm," she said.
A technician can manipulate the scan in slices to see if something is in fact a concerning mass. The technology also helps reduce false positives, which can decrease patient anxiety, Hanley said.
Catching breast cancer earlier often means a smaller surgery, as well as reduces the chance of the cancer moving to other parts of the body, including lungs, liver and brain.
At the same time, while technology can help catch breast cancer more easily, it still falls on the woman to schedule an exam yearly.
"Breast cancers are very different," Hanley said. "Some are pretty boring, very slow growing. Some mammograms can look perfect last year and look nasty the year after."
Women in Zanesville and the surrounding areas are not culturally more or less susceptible to breast cancer than anyone anywhere else in the country or world, Hanley said. She has, however, seen a delay in some women coming in for screening because of financial concerns.
"I never, ever want them to feel that way, because we can always find a way to get everything covered," she said.
When it is all said and done, after surgery and possible chemotherapy, there is a feeling of release.
"Typically we wait for a while after chemotherapy before removing the port," she said, referring to a catheter, usually in the chest, used to inject the chemotherapy drugs into the bloodstream. "Whenever we take their port out, most women breathe a sigh of relief. 'Whoo, I'm done.'"