Team approach to treating breast cancer at Groote Schuur

Despite “longer than desired” waiting lists for surgery, Groote Schuur’€™s Breast Clinic is able to offer hundreds of woman treatment for breast cancer.

The patients have access to multi-disciplinary treatment that includes specialists such as radiologists, oncologists, surgeons and a social workers.

“We see about six new breast cancer patients every week, but we see hundreds of women who report with lumps that are not malignant,” said Dr Elizabeth Murray, radiation oncologist at the Breast Clinic.

She said the number of black patients had increased significantly while the number of white patients had dropped. “This is a case of white patients opting for private health facilities rather than the prevalence decreasing,” she said.

Murray is quick to point out that women had fairly easy access to the clinic. “The waiting list to see a surgeon is not that long, you could get an appointment fairly quickly (within a week), but you do have to sometimes wait for about three hours before a doctor sees you,” she says.

Murray admitted that women had to wait a long time if they need access to surgery (This was mainly due to a cuts in theatre time) or radiotherapy. This was mainly due to a cut in theatre time.

“We are concerned about the waiting lists,” she said.

Murray said they were extremely grateful to have a social worker that worked closely with the breast clinic, a luxury many other clinics didn’€™t have.

The social worker counsels the patients individually and if necessary the whole family.

In early cancer it is often a good option to remove only the lump and use radiotherapy so the rest of the breast is conserved, according to Murray.

In suitable patients this is just as safe as having a mastectomy.

However, some women do prefer to have the breast removed completely.

An important member of the multi-disciplinary team is the plastic surgeon who is responsible for breast reconstruction.

“Most women who opt for breast reconstruction are not doing it because of its perceived role in their sexuality, but because it’€™s more convenient and comfortable than a prothesis.”

Murray said most of their patients were presenting late. “In some women we are able to catch it early, but they refuse treatment and we have to let them go only to have them returning when it’€™s too late and the cancer incurable,” said Murray.

She said many of these women opted to go to sangomas. “They are more comfortable with this treatment. Also, we can’€™t offer them much in the way of childcare facilities while they’€™re being treated, which is an important issue.”

Murray said the concept of a Breast Cancer Month was very necessary in raising awareness.

“But we need something ongoing. The average woman in Khayelitsha doesn’€™t know enough about breast cancer, we need to rectify that.”

Murray advised women to trust their own instincts. “If you discover a lump and you’€™re not comfortable with the doctor’€™s diagnosis that it is not cancer, keep going. There is no harm in getting more than one opinion and in the end it’€™s how soon we discover the cancer that determines the outcome.”

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