Subashini Furman educates her patients on cancer so they know what they’re fighting.
“The first thing I tell a patient — and it applies to breast cancer or any cancer — is that cancer is one of your family of cells,” she said. “I have a lot of patients that have curable cancers that can virtually kill them, but they feel well.”
The medical director of radiation oncology at Cheyenne Regional Cancer Center is a proponent of screening exams, such as mammograms, to find cancers before they cause symptoms.
“You cannot wait until you get a symptom, because cancer is part of your own family of cells, so your body doesn’t see it as a threat,” said Furman.
Early detection — when cancers are found when they are small and haven’t spread — leads to better outcomes, she said.
But education also plays a role. Furman has discovered many patients go online and self-diagnose their symptoms. The hazard there, Furman cautions, is that often patients compare symptoms in dissimilar situations.
“You have to compare apples to apples,” Furman said. “But you also have to compare the same apples. You have to compare a Golden Delicious with a Golden Delicious. If you don’t, there are huge problems. No two patients will be treated the same way.”
That misunderstanding is one of the reasons Furman prioritizes education. The other is to help alleviate fear.
“People fear the treatments more than the disease,” Furman said.
Worry about the potential side effects often keeps patients from seeking treatment. But, Furman said, those side effects do carry significance.
“We want to see some effects that show that the treatment delivered is working,” she said. “So side effects are important and necessary, because the body is responding.”
As a radiation oncologist, Furman seeks to give her patients information to combat myths. For instance, many patients believe they will lose their hair during radiation treatment.
“Radiation is a local treatment. It’s impossible for someone to lose their hair if I direct radiation at the breast,” she said, explaining that hair loss is a systemic effect from chemotherapy that transmits through the blood.
“The way we treat cancers — we have to attack cancer smart, not necessarily big,” she said. That’s why routine mammograms and annual pelvic exams are key in early detection for women.
Often, a breast cancer diagnosis or even the fear of one clouds reasoning.
“You don’t have a mastectomy because you think you’re going to cure breast cancer. Cancer wants out. So taking out the breast, you can change the biology,” Furman said.
Since cancer wants to spread, when the breasts are removed, it can reach the vital organs.
“You don’t change the biology by doing a radical surgery. The question becomes: How can you change the biology?” she said.
The answer, Furman says, is systemic treatment therapy. Any treatment that enters the bloodstream, such as a daily pill, is systemic. Maximizing systemic therapy is a common treatment with breast cancer.
According to Furman, surgery and radiation are finite, but systemic therapy isn’t.
“A cancer cell is immortal. If you want someone to be cured, you can’t get rid of 90 percent or 99 percent – you can’t leave any cancer cells behind. Curing cancer means you have sterilized 100 percent of the cancer cells through systemic therapy,” she said.
However, if a woman with breast cancer had to have radiation, she wouldn’t have to leave Wyoming to receive quality care, Furman said.
“Radiation is very precise,” she explained. “I have the technology in Cheyenne. Cancer treatments are standardized. You get the same amount of radiation as you would in Denver, Casper or Cheyenne. The radiation dose is standardized. It is illegal and unethical to take a cancer and treat it any way than the proven way. Your cure rate is identical here as it is at John Hopkins.”
“Breast cancer is highly curable – even stage four. It’s not a death sentence,”
She also noted that one important part of the process is selecting a cancer care team.
“Find someone you trust that will be a partner with you,” she said. “And understand your diagnosis, so you can make the very best decision for yourself.”