Life After Breast Cancer

When one of her breast cancer patients was struck with severe depression and post-traumatic stress disorder after breezing through her treatment, Dr. Rashida Haq had a eureka moment. “I thought, wow, she had no problems during treatment, but after completing it, suddenly…” recalled Dr. Haq, a medical oncologist and assistant professor at the University of Toronto. 

It was the start of what would become an innovative model of survivor care at St. Michael’s Hospital: a web-based, multi-faceted, personalized treatment and care plan that addresses the information needs of breast cancer patients, coordinates the entire health-care team, and guides the patients through their journey. All neatly summarized in two pages. No pile of brochures that can overwhelm, rather than inform, patients.

Now she wants these survivor care plans (SCPs) to become the standard of care for all cancer patients.

And it all began with a simple act of compassionate listening. Dr. Haq and her research group talked to a number of survivors about their post-treatment needs. The conversations were illuminating. There was the anxiety of feeling “lost” in the transition: “I do have a concern about falling off the edge of a cliff, in the sense of, all of a sudden, do you just disappear? Will I have the same sense that my physical health is being monitored?” commented one patient in the pilot study. Of being overwhelmed with getting “a bag of information” that may have nothing to do with their particular case. And the desire to regain control of their lives.

She is wrapping up the research, which has been informed by continual feedback from patients. The next phase will include exercise and nutrition “prescriptions” to rebuild muscles and manage the weight gain that breast cancer patients experience. Dr. Haq is also talking with occupational health specialists about designing work re-entry programs.

Her work is integral in making the CIBC Breast Centre—unique in bringing together a multidisciplinary team to tackle screening, diagnosis and treatment—a one-stop shop for integrated cancer care and wellness.

Dr. Haq’s journey to specialize in oncology and health-care research began when she was a second-year medical resident at the University of Toronto. She was treating a leukemia patient and knew right then that she wanted to make a difference by educating patients about their cancer. “People feel that the word cancer is like a death sentence—regardless of the stage it is caught and regardless of the fact that 85 per cent of patients recover. I wanted to change that. I wanted patients to feel empowered, to feel in control,” she says. The SCPs help them do that.

Learning goes both ways.

She recalls a session with a patient who had finished treatment and was in recovery for a year. The patient was still experiencing the residual effects of chemo—the aches and pains—but despite the fact she had the strong support of her family, she felt that her life was falling apart.

“I listened to her, and I told her that one of the components of feeling peace and happiness, no matter what you are going through, is to feel gratitude. So, she started counting her gratitudes.” Then, rather than getting a referral to a psychiatrist, the patient told Dr. Haq she wanted to try out this practice for a month. She enrolled in a mindfulness clinic and is managing much better.

“Medicine is not just science,” says Dr. Haq. “My biggest belief is that there is an art of medicine. Patients need a lot of support. And I am a strong believer in the value of taking a truly holistic approach to cancer care and wellness.”

June 26 marks Cancer Wellness Awareness Day. Please share this story with your network. To help St. Michael’s Hospital take on the toughest health challenges, click here.

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