Treatment Choices

Twenty years ago, a physical examination of the breast was considered an essential early detection tool. Educational materials on how to perform self-exams were widely distributed, and women were strongly encouraged to learn the technique and perform it monthly. Today, the role of the self-exam in early detection is less clear.

For almost a year, Daniel Szkarlat thought his intestinal pain was due to an ulcer. When the symptoms didn't go away, a colonoscopy found he had a large mass. His doctor removed the mass and 33 lymph nodes and said he wouldn't need chemotherapy or radiation treatment. Dan and his wife weren't so sure, so they got a second opinion from John Krauss, M.D., director of the Multidisciplinary Colorectal Cancer Clinic at the University of Michigan Rogel Cancer Center.

Michigan, like much of the rest of the world, is experiencing a health care crisis right now like we’ve never seen before. Here in Southeast Michigan, we are experiencing a surge in people with COVID-19. The number of people needing care will soon be greater than our current hospital capacity. This has impacted how we are treating our patients with cancer during this difficult time. This may mean changes or delays in your treatment.

Melissa Hough considers herself to be patient No. 154. That’s how unusual her condition is. In June, she was diagnosed with cystic mesothelioma. It’s a noncancerous version of the lung disease commonly linked to asbestos exposure. In Hough’s case, hundreds of cysts had developed throughout her abdomen.

Breast cancer patients face a dizzying number of choices for breast reconstruction after mastectomy. A Michigan Medicine plastic surgeon offers advice and insight. Breast reconstruction after mastectomy can have long-lasting effects on quality of life. But with multiple options available, each with its own risks and benefits, the decision process can be overwhelming.

Metastatic means the cancer has spread beyond the breast and immediate lymph nodes to other organs or tissues in the body, most often the bones, brain, lungs or liver. It’s considered stage 4 breast cancer, which means the cancer has progressed to its most advanced stage.

Cancer comes with a lot of information and a lot of emotion. That mix can make doctor visits tricky. Doctors try to be clear as they walk through recommended treatments, explaining the possible risks and side effects. But the language involved in cancer care is complicated.

Chemotherapy and radiation therapy can cause complications like sores in the mouth and changes to the teeth, salivary glands, gums and bone, which makes mouth care important before, during and after cancer treatment.

For most patients at the Rogel Cancer Center, their treatment plan was determined in part by the results on a pathology report. Pathologists are a crucial part of every patient’s health care team, but their work usually happens behind the scenes in a laboratory setting. Michigan Medicine pathologists now have a larger, state-of-the-art space to study, understand, track and decode each patient’s biopsy so a precise diagnosis can be made and treatment can begin.

No one wants to hear they have cancer. It's shocking and frightening and, for most people, can be overwhelming. Dr. Aki Morikawa, a medical oncologist in the Breast Care Clinic, offers information -- and advice -- on what you need to know as you talk to your doctor about treatment options.