Geneva oncologist shares what it's like to treat breast cancer patients

GENEVA – Dr. Perry Menini knows a lot of what he says in his initial contact with patients likely won't be heard.

Although they might not show it on the outside, the oncologist said, people who learn they have cancer often go into panic mode and don’t really hear the rest of what he has to tell them.

So, Menini – who treats breast cancer patients at the Cadence Cancer Center on the Delnor Hospital campus – has learned he will have to repeat himself later.

That initial conversation is the beginning of a relationship that generally includes about six months of active treatment and – hopefully – a cancer-free outcome. While Menini sees about 15 new breast cancer patients each month, he said most survive the disease.

Breast cancer, he stressed, is not a death sentence.

October is Breast Cancer Awareness Month. According to the American Cancer Society, breast cancer death rates had slowly increased for many years – about 0.4 percent a year from 1975 to 1990.

Because of improvements in treatment and early detection, death rates have decreased by 34 percent from 1990 to 2010, the society reported.

Last year, nearly 40,000 women and 410 men were expected to die from breast cancer, according to the organization. Conversely, the society reported, more than 2.9 million U.S. women with a history of breast cancer – including those still undergoing treatment – were alive Jan. 1, 2012.

Telling someone they have breast cancer is difficult, Menini said, noting many unfortunately see their diagnosis as a negative end. He said he presents a “cup is half full” perspective.

He compared it to the role of a football coach. A coach doesn’t do any good by telling his team members that their opponent is really good and that they probably don’t have a shot at winning, he said. Rather, he said, the coach has to get the team ready to go out and fight the fight.

He said he tells his patients this: “In the end, I want this to be a bad memory.”

He frequently sees his patients during their treatment and works to manage their side effects, he said. He said each meeting is an opportunity for him to infuse positive information.

A positive attitude can affect a patient’s ability to tolerate treatment, which may include chemotherapy and radiation therapy, Menini said.

The course of treatment can depend on their age, as pre- and post-menopausal women require different strategies, he said.

His patients range in age from the early 30s to 95, he said, noting he is seeing more and more patients in their 40s. There is no specific reason for that, he said, but the younger a patient is, the more aggressive the cancer usually is.

Those whose genes predispose them for developing breast cancer can be faced with the decision to have a bilateral mastectomy – a "bold move" that has become more acceptable since actress Angelina Jolie had the preventative surgery, Menini said.

Genetic testing is recommended at age 20 for those who have a first-degree relative – mother, father, sister – with breast cancer, he said. Otherwise, he said, yearly mammograms are recommended at age 40.

Relief and disbelief are common reactions among patients when Menini tells them they are cancer-free, he said.

“It’s emotional,” he said. “It’s tearful.”

Patients and their families often will send Menini letters or cards thanking him for what he did for them, even if the patient didn’t survive, he said. Grandchildren, for example, have thanked him for giving them more Christmases with their grandparent.

“I don’t know if any medical specialty builds bonds like oncology does,” Menini said.

Visit www.cancer.org for information about breast cancer.