In August 2020, Sarah Carlson, a filmmaker and health coach based in Kingston, found a lump she suspected was a fibrocystic mass, common in people with dense breast tissue. Because it was the beginning of the pandemic—when people were told to see a doctor only for emergencies—Carlson didn’t rush to get a mammogram because she had an appointment with her OB-GYN in December.
“Looking back, it seems stupid that I waited,” Carlson says. She noticed the lump in her breast became painful and red during her wait, and she didn’t realize, as many don’t, that she didn’t need to wait to see her OB-GYN and could have requested a mammogram through her primary care physician.
After a mammogram and ultrasound revealed that Carlson had invasive ductal carcinoma, the most common form of breast cancer that accounts for 80 percent of diagnoses, it was time to figure out her treatment plan. Carlson’s cancer was stage 2a, meaning it had invaded nearby lymph nodes, and one doctor told her she’d probably need a double mastectomy, but a second opinion said she didn’t.
Eighteen months after her diagnosis and undergoing a lumpectomy and radiation, Carlson is cancer-free. “Don’t hesitate to get a second opinion,” Carlson says. “You’re dealing with a life-threatening illness; not every doctor will have the same recommendation or even diagnosis.”
After a breast cancer diagnosis, people feel a range of emotions—and most aren’t good—but action is one of the best antidotes to despair. We have terrific medical options for breast cancer treatment in the Hudson Valley, plus non-profits providing supportive services. If you, a friend, or a loved one find yourself with a breast cancer diagnosis, here are some things to note as you navigate your care.
Lean Into Science
One of the most important things to do after a breast cancer diagnosis is to lean into science and use the diagnostic tools available. “Go for the 3-D mammogram—2-D mammograms are a waste of time and radiation,” says Hope Nemiroff, executive director and founder of Breast Cancer Options (BCO), a nonprofit that’s the largest provider of free, non-medical breast cancer services in the Hudson Valley.
Options for 3-D mammograms are abundant in the region, but Nemiroff recommends Nuvance Health, which offers 3-D mammograms without a referral (there are some requirements, such as being over 40) plus additional breast imaging services such as breast ultrasound, breast MRI, and image-guided breast biopsy. Nuvance offers imaging in Kingston, Carmel, Poughkeepsie, Rhinebeck, and Fishkill. In addition, Nuvance has New York State Cancer Service Programs at Putnam Hospital in Carmel and the Dyson Breast Center at Vassar Brothers Medical Center in Poughkeepsie.
“At Dyson, patients have mammograms and ultrasounds on one side of the center, and then, if necessary, they can go right next door to schedule with a team of doctors,” explains Amanda Miller, LMSW, a certified oncology social worker. “In addition to surgeons, Dyson has physician assistants who help with high-risk patients and a team of nurse practitioners who help with patients from treatment through remission.”
Get the Support You Need
Susan Boolbol, MD, FACS, is the system chief of breast surgical oncology and breast program at Nuvance Health. Dr. Boolbol is fellowship-trained in breast surgery, has clinical expertise in breast cancer surgical oncology, and is the president of the American Society of Breast Surgeons. Dr. Boolbol is also known for caring deeply for the whole patient and encouraging patients to vocalize their fears and emotional needs.
“Dr. Boolbol values a model that makes breast cancer as easy as possible,” Miller says, part of which includes a program of nurse navigators. Miller explains that Dyson patients meet with their doctor, who explains what type of breast cancer they have and then presents a treatment plan and the steps they can take. Sometimes, patients go straight to surgery, and sometimes medications come first. “If they need surgery, sometimes there’s clearance needed from a primary care doctor,” Miller explains, “and our nurse navigators make the connections, get clearances, schedule oncology appointments—basically everything needed from a coordination standpoint—which gives the patient one less thing to worry about.”
As a Dyson social worker, Miller meets with everyone diagnosed with breast cancer. “It allows them to create a narrative around their experience and talk to someone outside of their friends and family about what they’re going through,” Miller says. “It’s helpful for patients to have a trusted person to discuss their breast cancer with whom they don’t have to worry about burdening with the emotions of it.” Miller and other social workers can also help sort financial assistance and/or transportation because when you have breast cancer, the last thing you should be worrying about is how you’re going to pay for your care and get to appointments.
Educate yourself
The information about breast cancer can be downright overwhelming. Knowing where to begin can feel daunting, but BCO is a great place to get your bearings. Although their website hasn’t been modernized for the most user-friendly experience, there’s a wealth of information in the dropdowns, everything from their Healthy Lifestyles Calendar (you can print it or email them for a hard copy), which is as much of a resource guide as it is a calendar.
Advocate for yourself or find someone who can
A life-threatening illness can be a lonely, isolating experience, and it’s sometimes challenging for family members and friends to provide the support breast cancer patients want and need. “It’s hard to remember everything, especially because your practitioners are speaking a new language, and the brain can almost blackout with all of the information,” Carlson says.
Before the pandemic, BCO had a companion/advocate program, which matched you with a breast cancer survivor who could accompany you to medical appointments to ensure you ask all the necessary questions and help be your eyes and ears during appointments. They hope to start that up again soon.
Nuvance’s nurse navigator program helps, and so does BCO’s peer-to-peer mentoring, which matches you up with a breast cancer survivor to chat with about what you’re going through.
Join a Support Group
“My breast cancer won’t be your breast cancer,” says Nemiroff, who had breast cancer in 1995 and recognizes support groups as a critical component of this journey. Both Nuvance and BCO have a variety of support groups. Most groups currently meet online, though a few meet in person. There are general and more specialized groups for young survivors, metastatic patients, and others.
Since 2012, BCO has organized a retreat at Omega Institute for women with metastatic breast cancer. Programs are specific to women with metastatic breast cancer and include writing workshops, low-impact yoga classes, and talks from health professionals. Because it’s challenging for family members to discuss their fears with breast cancer patients, the retreat also sponsors a family night with a talk about how to navigate the hard conversations. This retreat is free, thanks to underwriting from the Omega Institute, Miles of Hope Breast Cancer Foundation, United Breast Cancer Foundation, the American Endowment Fund, and others.
Get Support for Your People
While your breast cancer treatment and recovery is top of mind, you may be wondering about some basics, like how to feed your family. While meal trains are a classic option, your friends and family might be helping with things like shuttling your kids to sports or walking your dog. Sparrow’s Nest is a nonprofit in Wappingers Falls that cooks and delivers homemade meals to families facing a cancer diagnosis within 35 miles of its kitchen.
BCO also organizes Camp Lightheart, a free sleepaway camp at Omega Institute for children who have lost their mothers to breast cancer or whose mothers are survivors. The camp’s purpose is for kids to have lighthearted fun, but there are also sharing circles for kids to verbalize their fears, often for the first time.
Don’t Forget the Self-Care
Thanks to the generosity of Miles of Hope Breast Cancer Foundation, massage and acupuncture services are provided through Breast Cancer Options. Both therapies help reduce stress and anxiety while also boosting the immune system. Patients can receive one treatment per month up to five treatments with an approved practitioner.
Don’t Be Afraid to Push
“You don’t have to be a good girl,” Nemiroff says, reminding anyone in this position that it’s okay to push for additional information if you don’t understand something about your diagnosis or treatment plan. “All questions are good questions,” she says.
Carlson, who has worked with Nemiroff at BCO since February 2023, was reluctant to take Tamoxifen, a common treatment for early breast cancer. Her sister died of an allergic reaction to a drug when she was in high school, and as a result, she doesn’t take medication blindly. After her surgery and radiation, Carlson took Tamoxifen, but had side effects that outweighed the benefit of taking it, and genetic research showed it wasn’t a great fit for her.
Consider All the Options
If conventional treatments leave you feeling less than enthused, there are other options local-ish options, such as the Stram Center for Integrative Medicine in Delmar and the UltraWellness Center in Lenox, Massachusetts.
The Stram Center combines scientific medicine with complementary practices such as acupuncture, IV infusions, and hyperbaric oxygen therapy, among other therapies. In Lenox, the UltraWellness Center is run by Elizabeth W. Boham, MD, MS, RD, who has a free e-book for women with breast cancer and links to podcast interviews on the clinic’s website. “We focus on the individual woman and where she needs to focus to create balance in her body,” Dr. Boham says, “and we work to remove things that may be causing disease/imbalance in the body (such as toxins, stress, inflammation, poor diet, high blood sugar, high insulin) and replace things that may be missing (low nutrient levels, low omega-3 levels, low levels in the microbiome, adequate sleep and time for rest, etc.).”
Make Small Changes
When faced with a life-threatening illness, we can feel paralyzed and unsure of what to do first. It’s natural to feel helpless and hopeless, but one of the easiest, most accessible ways to make change is to control what we can. Making small changes such as diet and lifestyle upgrades benefits our health and peace of mind and puts us in an empowered place to face (and beat!) a breast cancer diagnosis.
Get Involved
You can sign up for the BCO newsletter to keep up-to-date on local educational programs. Nemiroff will speak about patient advocacy on Saturday, October 7, at the O+ festival in Kingston.
Contact information for some of the services mentioned in this piece:
Breast Cancer Options (845) 339-HOPE
Dyson Breast Center (845) 790-8855
Sparrow’s Nest (845) 204-9421
The Stram Center for Integrative Medicine (518) 689-2244
The UltraWellness Center (413) 637-9991
This article appears in October 2023.
