A positive cancer diagnosis means working with an oncologist, but a primary care provider plays an integral role on the road to recovery
Each year in the U.S., there are about 300,000 new cases of breast cancer. About one in eight women will have breast cancer at some point in life. The good news is that the mortality rate has decreased every year since 1987 for women over 40, and decreased until 2010 for women under 40 (and has since been largely static).
As survival rates have gone up, so has the role of primary care in both prevention, treatment, and recovery. Consistent and affordable access to a primary care team can limit the prevalence of cancer and speed recovery in a working population. Here's how.
Step 1: Prevention
Of course, the best cancer diagnosis is one that's prevented or otherwise caught early. 90% of breast cancer cases are curable when detected early. Most cancers of any kind are detected in primary care settings: during a routine screening, check-up, or while discussing care with a patient.
Especially for individuals who may be unfamiliar with common breast cancer symptoms--or may feel unsure about their ability to self-check for lumps or skin changes--a primary care team can walk through preventive steps and even recommend a mammogram or genetic test based on relevant risk factors.
Everside Health Regional Medical Director Kelly DeMeyere-Coursey, MD, notes the importance of a strong patient-provider relationship when it comes to cancer awareness and prevention.
"[Primary care providers] are in the unique position of seeing a patient multiple times over the course of their life," she says. "I get to know my patients' history, whether they are at increased risk of breast cancer through lifestyle or genetics."
"The US Preventive Services Task Force acknowledges some patients may benefit from screening sooner [than the recommended age of 50]," she adds. "I can help a patient determine whether they should screen early, and if they qualify for modalities like an MRI instead of a mammogram."
This sort of personalized care is generally impossible in urgent care or minute clinic settings, where a provider often doesn't have time to ask relevant questions. And since they are unknown, patients may hesitate to ask questions or request a screening that they feel is sensitive in nature.
Dr. DeMeyere-Coursey notes the importance of having a primary care provider on your care team--before a worrying diagnosis appears. "Primary care providers are the first-stop shop for anything related to preventive health and health maintenance," she explains.
Step 2: Collaboration with specialists
When a cancer diagnosis does occur, a patient will be referred to an oncologist for treatment. However, it's often the primary care provider that takes these first steps on behalf of their patient.
"As the one who orders the mammogram," Dr. DeMeyere-Coursey explains, "I would also order a breast biopsy if indicated and be the first to receive the result."
And if a patient has a positive result, it's often easier to be told from someone a patient knows instead of a stranger. "It's an extremely difficult conversation to have," she notes. "But [PCPs] have had time to establish trusted relationships with their patients."
Providers like Dr. DeMeyere-Coursey will place referrals as needed--whether to breast surgeons, hematology/oncology experts, or genetic specialists. While she defers to their clinical expertise, she's also had experiences with patients who call her after their specialist visits to go over their notes.
"I may have a better understanding of how to communicate with my patients than an oncologist who just met them," she says. "I'm in a good place to help translate "medical-ese", so to speak."
Step 3: Post-treatment recovery
When caught early, 90% of breast cancer diagnoses are successfully treated. But even after treatment, special care is taken by a primary care provider--often alongside the patient's oncologist. This includes aspects like watching for recurrences or new cancers--a positive breast cancer diagnosis, even after being successfully treated, requires more regular screenings for a number of years before risk of cancer returns to normal.
A primary care team is also available to manage any physical or psychosocial side effect, especially feelings of anxiety or fear that are common even after a successful treatment. Patients may often feel like they are back at "square one" with their health after a long cancer treatment. This is where a care team with an established relationship can offer personalized support and care after the oncologist's job is done.
And if lifestyle factors played a role in the diagnosis, a primary care provider can partner with their patient on making healthy habit changes that reduce the chance of cancer recurring.
Access to primary care matters
Populations with limited access to primary care (either due to cost, long wait times, or geographic remoteness) are at increased risk of chronic conditions and worrying diagnoses like breast cancer. In this way, primary care providers serve as both the front line of support and the referral glue that holds a treatment plan together.
By improving access and availability to preventive care, health outcomes can be improved and conditions prevented before they require specialist intervention--resulting in happier individuals and a healthier population.