, Port Arthur, Texas


October 15, 2013

Breast cancer treatment more personal than in the past

PORT ARTHUR — Had Denise Hatchel been diagnosed with breast cancer two decades ago, she would have had two options — to treat, or not to treat.

“If you say, ‘I have breast cancer — do I need hormone therapy? Do I need radiation? Do I need surgery? — the answer to every one of those questions is, 'It depends,'” said Dr. Ernest Hymel, an oncologist at the Medical Center of Southeast Texas who is currently treating Hatchel.  “Whereas 20 years ago, the patients didn't have a lot of say because there were fewer options. The choice was maybe, ‘Get treated or not.’”

When Hatchel was diagnosed with Stage 1 breast cancer in April after discovering a lump in her breast, not receiving treatment was out of the question. However, after a discussion with her doctor, Hatchel opted not to have a mastectomy — the surgical removal of one or both breasts.

“That doesn’t really mean anything,” Hatchel said. “You take it off, it can still come back somewhere else.”

Hatchel had her first radiation treatment on July 23. Recent technological strides made the radiation bearable, she said. For six weeks, she drove to the Medical Center of Southeast Texas to receive radiation at 8 a.m. every weekday, before driving to her job in human resources (HR) at Mobil Oil Credit Union in Beaumont.

“Years and years ago, it would just burn you so bad,” said Hatchel, who was in the process of moving to her current home in Nederland from Port Arthur when she was diagnosed. “Now they’ve got all this specialized equipment. It blistered my skin like a sunburn, but it really wasn’t that bad.”

Like Hatchel, Susan Weatherford — who was diagnosed in January 2010 and declared cancer free six months later — also opted out of the mastectomy. Both women underwent radiation treatment and received a lumpectomy — a surgical procedure designed to remove the malignant lump from the breast.

“Mine was small when they found it,” said Weatherford, also of Nederland. “They thought this would be the best course for me.”

That’s where the similarities end between the two women’s treatments. An examination of eight of Hatchel’s lymph nodes deemed removal unnecessary. Weatherford, on the other hand, had several removed — and just two decades ago, she would have been missing all of her lymph nodes. Until a procedure called the sentinel lymph node biopsy became available in the ‘90s, the only option was a complete axillary dissection — the removal of all lymph nodes, which contributed to a condition called lymphedema, or swelling of the arm.

“That allows us to take a far fewer number of lymph nodes so that you have less side effects from the surgery down the line,” Hymel said. “It almost completely eliminates lymphedema.”

After 33 radiation treatments, all that remained for Weatherford was to take a daily dose of Tamoxifen, an estrogen blocker often called the 5-year-pill, for the next five years. On Sept. 16, Hatchel began the first round of chemotherapy, a process she will repeat every three weeks until she has completed four to six rounds.

“Whether or not you need chemotherapy varies quite a bit,” Hymel said. “There are maybe 10 factors that we have to consider before we can make a specific recommendation.”

During the past 20 years, Hymel said, breast cancer treatment has become more about the tailoring of breast cancer treatment to the individual patient. Gone are the days of the doctor acting as the sole decision maker. Hymel said he acts as more of an advisor for his patients.

“A lot of times my conversations are, 'OK, here are the pros and cons of those particular approaches — which one would you like to do?’” Hymel said. “It’s a partnership.”

Another recurring theme of breast cancer treatment, Hymel said, is, “Can we do less safely without compromising the ability to cure?”

“Treatment is tailored in a way to minimize the side effects and hopefully even minimize treatment,” Hymel said. “There's a great advance in technology that lets us give less treatment because we find out the patients are not going to benefit from it.”

One constant Hymel has encountered throughout his 12 years in oncology is that early detection is the key to high cure rates. Without early detection, he said, these options wouldn’t exist — something that both Hatchel and Weatherford second. Weatherford’s cancer was detected during a yearly mammogram.

“It was a very early stage,” she said. “That’s why they’re thinking I won’t have any more problems.”

Even in the throes of side effects from the chemotherapy that include bone pain, low-grade fever and loss of energy, Hatchel has never once regretted her decision to undergo treatment.

“If you walk away from something that can help you, what benefit is there if it comes back?” she said. “Who wants to go through it again?”


Twitter: @ErinnPA

Text Only
  • screenshot facebook.jpg Facebook vies with Google to Apple for mobile developers

    Facebook is pushing to change a perception that it's not a tool for developers this week at the F8 developer conference in San Francisco, the company's first major event for app makers since 2011.

    April 29, 2014 1 Photo

  • treadmill-very-fast.jpg Tax deduction for a gym membership?

    April marks another tax season when millions of Americans will deduct expenses related to home ownership, children and education from their annual tax bill. These deductions exist because of their perceived value to society; they encourage behaviors that keep the wheels of the economy turning. So why shouldn't the tax code be revised to reward preventive health?

    April 16, 2014 1 Photo

  • Jamaal Charles' Football Camp

    April 15, 2014

  • Search teams will send unmanned sub to look for missing Malaysian airliner

    Teams searching for a missing Malaysian airliner are planning for the first time to send an unmanned submarine into the depths of the Indian Ocean to look for wreckage, an Australian official leading the multi-nation search said Monday.

    April 15, 2014

  • Teens trading naked selfies for mugshots

    Will teenagers ever learn? You think yours will. Maybe so. But it's likely that was also the hope of the parents of children who were so shamed by nude photos of themselves that went south - how else can they go - that they killed themselves.

    April 11, 2014

  • Boston doctors can now prescribe you a bike

    The City of Boston this week is rolling out a new program that's whimsically known as "Prescribe-a-Bike." Part medicine, part welfare, the initiative allows doctors at Boston Medical Center to write "prescriptions" for low-income patients to get yearlong memberships to Hubway, the city's bike-share system, for only $5.

    April 11, 2014

  • Screen Shot 2014-04-08 at 2.16.35 PM.png Are Americans smart to stop drinking diet sodas?

    Recent data from Beverage Digest suggest many are cutting back on diet sodas. Consumption of diet sodas fell more than that of sugary sodas in 2013. This raises two questions: Why is total consumption declining, and is drinking diet soda harmful to health?

    April 9, 2014 1 Photo

  • Screen Shot 2014-04-08 at 10.43.57 AM.png VIDEO: Amazing dance moves at NCAA title game

    Eye-catching action wasn't confined to the court at AT&T Stadium Monday night during the NCAA Championship game between UConn and Kentucky. This pair -- apparently a father and son -- delighted the crowd during a timeout with some synchronized dance moves.

    April 9, 2014 1 Photo

  • VIDEO: White House may ban selfies

    The White House wasn't too pleased after Red Sox player David Ortiz snapped a selfie with President Obama that was later used promotionally by Samsung.

    April 9, 2014

  • Investing more money in tornado research would be a disaster

    This week, the U.S. House of Representatives passed a bill that would require National Oceanic and Atmospheric Administration funding to focus on improving forecasts of "high impact weather events" like tornadoes and hurricanes "for the protection of life and property and the enhancement of the national economy."

    April 7, 2014

Raw: Massive Dust Storm Covers Phoenix 12-hour Cease-fire in Gaza Fighting Begins Raw: Bolivian Dancers Attempt to Break Record Raw: Israel, Palestine Supporters Rally in US Raw: Palestinians and Israeli Soldiers Clash Raw: Air Algerie Flight 5017 Wreckage Virginia Governor Tours Tornado Aftermath Judge Faces Heat Over Offer to Help Migrant Kids Kerry: No Deal Yet on 7-Day Gaza Truce Kangaroo Goes Missing in Oklahoma More M17 Bodies Return, Sanctions on Russia Grow Gaza Residents Mourn Dead Amid Airstrikes Raw: Deadly Tornado Hits Virginia Campground Ohio State Marching Band Chief Fired After Probe Raw: Big Rig Stuck in Illinois Swamp Cumberbatch Brings 'Penguins' to Comic-Con Raw: Air Algerie Crash Site in Mali Power to Be Restored After Wash. Wildfire Crashed Air Algerie Plane Found in Mali Israel Mulls Ceasefire Amid Gaza Offensive
Sports Tweets