Rethink Real Talk: Ask An Oncologist Part 2

September 29, 2021

A year after launching the Rethink Real Talks series, we caught up again with our first expert, Dr. Christine Brezden-Masley, Medical Oncologist and the Director of the Marvelle Koffler Breast Centre at Mount Sinai Hospital in Toronto, Canada. 

A year into the pandemic, she joined the Rethink community to share how it has affected patients and her practice, and to answer your questions.  And she shared a lot!

Here are the top takeaways from Dr. Brezden-Masley. To catch the full conversation, visit our YouTube page here.

On COVID-19

Vaccination: Oncologists want people who have been diagnosed with cancer to get vaccinated and protected as soon as possible. If you have completed treatment, you can get vaccinated when your time comes. This includes if you’re taking anti-estrogen therapy.

If you are in active treatment, including people living with MBC, speak to your oncologist about when you should get the vaccine.  Depending on your specific situation, you may need to schedule it between treatments.

And remember, even once you are vaccinated, keep up your diligence by wearing a mask, social distancing and hand washing until there is broad community vaccination.

Immunosuppression: When it comes to how long someone is immunosuppressed after treatment, everybody is different, and everybody varies. However, usually, a month or two after treatment neutrophils have rebounded. And generally, younger patients tend to rebound a lot better than older patients.

Highest Risk Patients: We know that lung cancer patients have been at the highest risk of being hospitalized, intubated and dying of Covid-19. So, when we apply that to breast cancer patients with lung metastasies, we worry the most about them because their lungs may already be compromised. Bottom line, we want to ensure these people are immunized through vaccination as soon as possible.

On Early Menopause

When someone has hormone receptor-positive breast cancer, as an oncologist we want your ovaries to be shut down because the ovaries are the powerhouse of estrogen production and the tumour was driven by estrogen. And we know from data that when pre-menopausal women become post-menopausal women with treatment (sometimes with chemotherapy), they tend to have better outcomes.

However, that also means the symptoms of menopause – hot flashes, not being able to sleep, trouble concentrating and sore joints. What I can tell you is there are usually ways we can help manage these symptoms, so tell us. And we will work with gynecologists, rheumatologists and others to help you manage these symptoms of menopause and symptoms of treatment.

On Treatment Breaks

If you feel like you need a treatment break, talk to your oncologist, because we probably can help you. A break can give your body and mind a chance to recover and rejuvenate, and that can be magic. Depending on the treatment, the cancer may grow a little bit during the treatment break if you have advanced (metastatic) cancer. But when you start treatment again, most people have fewer side effects and tolerate their treatment better. 

Naturopathic Treatment & Cancer

First and foremost, please tell your oncologist, pharmacist, and the rest of your health team about any naturopathic treatments you are taking or considering. We want to work together with the naturopath to make sure what you’re taking works with your cancer treatment, are not causing harm, and will help reach your treatment goals.

The long and the short of it is that many common naturopathic treatments can cause immunosuppression or strain the liver or kidneys and increase toxicity. This includes high-dose vitamin C, mistletoe injections, mushroom injections or extracts, turmeric and St. John’s wort. And when I’m treating someone for cancer, I want their liver to be as healthy as possible and their immune system at its peak. When it’s not, we need to reduce the treatment dose because the body in short cannot handle it. 

Naturopaths have a role to play in overall health, but my recommendation is to look into these medications and supplements and sometimes safest is to start once you’ve finished your cancer treatment.

* Note: This is not a replacement for medical advice or regular check-ins with your healthcare team. Also, the views and opinions expressed by our experts do not necessarily reflect the position of Rethink Breast Cancer. 

Looking for more COVID-19-related breast cancer resources? Click here. 

Christine Brezden-Masley, MD PhD FRCPC is a practicing Medical Oncologist and the Director of the Marvelle Koffler Breast Centre at Mount Sinai Hospital as well as the Medical Director of Cancer Program for Sinai Health System in Toronto, Canada. She obtained her PhD in Medical Biophysics at the Princess Margaret Hospital in Toronto and her Medical Degree from the University of Toronto. She is currently an Associate Professor at the University of Toronto and senior scientist for the same Clinical Research Group at the Lunefeld-Tanenbaum Research Institute for Sinai Health System in Toronto, Canada. She is also on the Rethink Breast Cancer Board of Directors and on the Rethink Scientific Medical Advisory Committee.