Article originally published Fall 2020 The Monitor magazine.
Although breast cancer is very common –with one in eight women battling the disease during her lifetime* – receiving that diagnosis alters each patient’s life in a different way.
In many cases, having an established and trusting relationship with a primary care provider is an important first step toward early detection and treatment. Just as important to the healing process is having an additional team of caregivers who don’t just treat the patient, but support them from beginning to end in their cancer journey. At least that was the case for Carla Yantes, 57, a breast cancer patient whose cancer journey was characterized by her deep connection with the people who cared for her.
Carla, of Lancaster, had an unusual start to her cancer journey. While moving a heavy box, she bumped her breast and developed a bruise. When the injury didn’t heal, Carla contacted her primary care provider (PCP), Sara Busch, CNP, of Fairfield Healthcare Professionals Old Schoolhouse Family Practice. Sara was concerned that the bruise had turned into a hematoma – a pooling of blood beneath the skin – and sent Carla for an ultrasound, which confirmed her suspicion.
Several weeks later, Carla’s pain worsened despite treatment, and when Carla contacted her primary care office about her condition, Sara advised Carla to go immediately to Fairfield Medical Center’s Emergency Department. “Sara couldn’t stress it to me enough. I was so used to the pain that it was like, ‘It’ll be okay. I’ll just wait.’ She said, ‘No, Carla, now. I’m telling you, right now.’ ”
“Carla has faith in me as her provider, and in return I have faith in her as the patient to come to me with concerns,” Sara said. “Because of that trust and willingness to share, she was able to express her concerns and trust that my insistence she be seen in the ED that day was in her best interest. This connection between the patient and provider is what primary care is all about.”
Testing done at FMC’s ED revealed that Carla had an abscess, a collection of pus that had built up within the tissue of the body and could lead to serious complications. Scott Johnson, MD, of Fairfield Healthcare Professionals General Surgery River View, was called in for emergency surgery.
During a follow-up appointment the next week, Dr. Johnson gave Carla news that she was not expecting. He explained that, during the procedure, he had found and biopsied a concerning growth. The biopsy results came back positive for breast cancer.
Carla’s sister, Charlotte Linn, was with Carla during the appointment and said the news took even Dr. Johnson by surprise. “He had them check it a couple times. I think he was kind of shocked,” she said. Dr. Johnson and his staff reassured Carla that they would do everything they could to fight the cancer.
Kanwaljit Singh, MD, of Fairfield Healthcare Professionals Hematology-Oncology diagnosed Carla with Stage 3 triple-negative invasive ductal carcinoma, an aggressive form of breast cancer that can be more difficult to treat than other types. The fact that there is no known breast cancer in her family made the diagnosis even more of a surprise for Carla.
Oncology nurse navigator Shelly Romine said cases like Carla’s highlight the importance of establishing a relationship with a PCP and keeping up with annual screenings. “Primary care is important for everyone’s health. No one knows you better than your PCP,” Shelly explained. “You need to be proactive in your health – sharing concerns with your PCP and getting yearly mammograms are great ways to do that.”
Carla’s treatment began with several strong doses of chemotherapy to slow down the cancer and shrink her tumor prior to her scheduled surgery.
Her connection with Dr. Johnson helped to put Carla’s mind at ease before her procedure. “He said a prayer with all of us before Carla went into surgery, and that’s just amazing to me,” Charlotte remembered. “He gives her the biggest hug every time he sees her. That makes you want to get well – to know that there’s somebody out there who cares enough to give you that hug.”
Dr. Johnson said he strives to provide that support for patients – beyond just caring for their medical needs. “Having a personal connection means the patient has someone familiar at the beginning of this process – to help them through their cancer battle. That familiar person is someone they can trust to tell them the hard truth, stay connected with them through this process as an ally and keep in touch with them for years to come,” Dr. Johnson explained. “I hope that personal connection allows a more authentic openness that lets the patient speak from their heart and feel heard and acknowledged. Hopefully, our connection helps patients feel empowered to ask hard questions, knowing they deserve respectful, honest answers.”
Carla had a double mastectomy with lymph node removal to take out the cancer. The surgery was followed up with more chemotherapy to fight the cancerous cells in Carla’s lymph nodes that could not be removed during her surgery. Carla also completed 25 rounds of radiation to ensure that all the cancer was eliminated.
Carla says that having an established relationship with her primary care provider is what pushed her to have her injury checked out – and her providers’ compassion and persistence is what ultimately led to her cancer diagnosis. “If it wouldn’t have been for Sara initially pouring out her heart to me and making sure that I did go to the Emergency Department, and then if it wasn’t for Dr. Johnson taking that initiative to notice something out of place and checking it out, I may not even be here today.” With Carla’s cancer already having progressed to Stage 3, any further delay in her diagnosis would have made treatment even more difficult.
“Prevention of illness and disease is the role of primary care. Trusting patient-provider relationships allow for comfort when discussing small changes, concerns and routine screening guidelines,” Sara explained. “Early detection leads to early intervention with the hope of improved outcomes.”
Today, Carla is cancer-free and thankful to all of the people who contributed to her care. “I believe every one of those providers has put forth an effort to make me well and make sure that I’m here tomorrow, and the next day and the next day, to be able to tell my story again.”
To learn more, about cancer care services at Fairfield Medical Center, click here.
Early detection saves lives. Many women with breast cancer have no symptoms, which is why regular breast screening is so important. Take control of your breast health and call 740-687-6666 to schedule your breast screening today.
Primary care is truly at the heart of wellness. It is often viewed as the building block of a healthy life and focuses first and foremost on the prevention of disease. No matter your age, you should plan to see your primary care provider once a year for a routine wellness exam.
Virtual visits are available for some appointments. Ask your provider if telehealth visits may be right for you.
5115 Amanda Northern Road, Amanda
7901 Diley Road, Ste. 120, Canal Winchester
82 E. Canal St., Carroll
2405 N. Columbus St., Ste. 280, Lancaster
2405 N. Columbus St., Ste. 260, Lancaster
1955 Lancaster-Newark Road NE, Lancaster
751 State Route 664 N., Unit A, Logan
399 Lincoln Park Dr., Ste. A