Breast
A woman's lifetime risk of breast cancer is one in nine. At Exeter Hospital, our affiliated surgeons are committed to the early diagnosis and treatment of breast cancer. Treatment strategies are individually tailored after consultation with pathologists, radiation oncologists, primary care physicians and medical oncologists at our weekly tumor conference. Exeter Hospital also offers a Multidisciplinary Breast Clinic. This clinic allows women with a breast cancer diagnosis to meet with a team of specialists in one session and receive a comprehensive treatment plan.
The Center for Cancer Care offers a multidisciplinary breast clinic for women with a breast cancer diagnosis. The goal of the program is to coordinate each patient's care by engaging in timely collaborative treatment planning, and to pay special attention to the psychosocial as well as the clinical needs of the patient.
A team of medical and radiation oncologists, surgeons, primary care physicians, radiologists, pathologists, clinical nurse specialists and social workers meet with each patient to review their case. This team then discusses the details and treatment options, and collaboratively renders an opinion for the best course of treatment.
Normally, the process of meeting individually with each medical specialist potentially takes three to four weeks to complete. Through the multidisciplinary breast clinic, the patient's customized plan of care is rendered in one afternoon, which means a reduction of inconvenience and anxiety for both the patient and her family.
For more information about the multidisciplinary breast clinic, call the Center for Cancer Care at 1-866-9-EXETER.
A team of medical and radiation oncologists, surgeons, primary care physicians, radiologists, pathologists, clinical nurse specialists and social workers meet with each patient to review their case. This team then discusses the details and treatment options, and collaboratively renders an opinion for the best course of treatment.
Normally, the process of meeting individually with each medical specialist potentially takes three to four weeks to complete. Through the multidisciplinary breast clinic, the patient's customized plan of care is rendered in one afternoon, which means a reduction of inconvenience and anxiety for both the patient and her family.
For more information about the multidisciplinary breast clinic, call the Center for Cancer Care at 1-866-9-EXETER.
Several surgical procedures are available:
Sentinel Node Dissection - Lumpectomy removes only the breast lump and surrounding tissues. This is usually done in conjuntion with radiation therapy.
Mastectomy - This procedure involves the removal of the entire breast. Depending on the type of mastectomy (simple, total, radical), lymph nodes and underlying muscle tissue may or may not be removed.
Sentinel Node Dissection - The removal of lymph nodes that drain fluid away from the breast and are the most likely candidates for harboring cancerous growths. This procedure is usually performed on women with a high risk factor for breast cancer. It leaves the breast in place, only removing as many lymph nodes as necessary to detect and remove cancer.
Reconstructive Surgery - Options range from reconstruction with breast implants to reconstruction with muscle transfers.
The U.S. Food and Drug Administration offers a 2004 Breast Implant Consumer Handbook to the public. Click here to access this resource for the latest information available on breast implants.
Additional Services offered by Exeter Hospital
Emotional well being is equally as important as the physical well being of our patients. The diagnosis of a serious illness, such as cancer, may be a time when emotional concerns may need to be addressed. In addition to counseling services, social workers are available to help patients become more familiar with community resources, answer financial and insurance related questions, and provide referrals to VNA and other home health care agencies.
For information about counseling, please call Anthony Provazza, LICSW at (603) 580-7084.
The Center for Cancer Care at Exeter Hospital provides additional services including Pet Visits, the Look Good...Feel Better program, Integrative Therapies, Reiki, Adventure Day and Spiritual Care Services.
Pet Visits: We currently have two certified pet handlers and three pet therapy dogs who visit both medical and radiation concology weekly. These visits are sure to bring smiles and help reduce stress!
Look Good…Feel Better: In collaboration with the American Cancer Society, the Center for Oncology and Hematology hosts the Look Good…Feel Better program. This non-medical program teaches women going through cancer treatment the basics of make-up application and hair techniques to help manage the appearance related side effects of cancer treatment. A free make-up kit is provided to each individual. For more information, contact the American Cancer Society or call 1-800-ACS-2345. To register for the next class, contact Amy Litterini at (603) 580-7067.
Integrative Therapies: Integrative Therapy services such as massage, acupuncture, yoga, hypnotherapy and stress management are available at Equinox Health & Healing. All patients are advised to discuss these services with their physician to determine what is right for them. For more information, please call (603) 766-8255.
Synergy Health & Fitness Center also provides massage, acupuncture and yoga classes.
Reiki: A gentle, non-invasive hands-on technique that reduces stress and anxiety while promoting relaxation. The Reiki system works in conjunction with both conventional and complementary medicine. Contact Lori Nathan at (603) 580-7017 for more information.
Adventure Day: In collaboration with The University of New Hampshire’s Browne Center, the Cancer Wellness program provides the biannual "Adventure Day" each Spring and Fall. This outdoor experiential program involving both high and low elements was created for any adult with cancer as well as their significant support person. An adolescent program is held the same day for participant's children. For more information, contact Amy Litterini at (603) 580-7067.
Spiritual Care: Spiritual Care can be an important part of healing for some patients. At The Center for Oncology and Hematology, the nondenominational hospital chaplain is available in the clinic or by appointment to provide spiritual counseling and support. A religious affiliation is not required as spirituality is different for every individual.
Pet Visits: We currently have two certified pet handlers and three pet therapy dogs who visit both medical and radiation concology weekly. These visits are sure to bring smiles and help reduce stress!
Look Good…Feel Better: In collaboration with the American Cancer Society, the Center for Oncology and Hematology hosts the Look Good…Feel Better program. This non-medical program teaches women going through cancer treatment the basics of make-up application and hair techniques to help manage the appearance related side effects of cancer treatment. A free make-up kit is provided to each individual. For more information, contact the American Cancer Society or call 1-800-ACS-2345. To register for the next class, contact Amy Litterini at (603) 580-7067.
Integrative Therapies: Integrative Therapy services such as massage, acupuncture, yoga, hypnotherapy and stress management are available at Equinox Health & Healing. All patients are advised to discuss these services with their physician to determine what is right for them. For more information, please call (603) 766-8255.
Synergy Health & Fitness Center also provides massage, acupuncture and yoga classes.
Reiki: A gentle, non-invasive hands-on technique that reduces stress and anxiety while promoting relaxation. The Reiki system works in conjunction with both conventional and complementary medicine. Contact Lori Nathan at (603) 580-7017 for more information.
Adventure Day: In collaboration with The University of New Hampshire’s Browne Center, the Cancer Wellness program provides the biannual "Adventure Day" each Spring and Fall. This outdoor experiential program involving both high and low elements was created for any adult with cancer as well as their significant support person. An adolescent program is held the same day for participant's children. For more information, contact Amy Litterini at (603) 580-7067.
Spiritual Care: Spiritual Care can be an important part of healing for some patients. At The Center for Oncology and Hematology, the nondenominational hospital chaplain is available in the clinic or by appointment to provide spiritual counseling and support. A religious affiliation is not required as spirituality is different for every individual.
Oncology rehabilitation has different phases of treatment:
Preventative - Treatment works to prevent problems such as fatigue, weakness or swelling (lymphedema).
Restorative - Treatment works to restore skills such as daily functional activities and strength.
Supportive - Treatment works to support conditions such as swelling (lymphedema) or nerve related symptoms such as numbness or weakness.
Palliative - Treatment is intended to help manage symptoms related to disease progression.
The Center for Cancer Care has a physical therapist on staff to provide immediate and ongoing screening for rehabilitation. Those individuals who need rehabilitation can receive Physical, Occupational and/or Speech Therapy during their hospital admission, in their home or on an out-patient basis. Treatment plans are established to meet the individual goals of the patient.
Physician referrals are required for rehabilitation; most services are covered by insurance. For more information call Amy Litterini, PT, DPT, Cancer Wellness Coordinator at (603) 580-7067. If recommended, patients may also participate in the Cancer Well-fit Exercise Program at Synergy Health & Fitness Center.
Cancer Well-fit Exercise Program
Many research studies have documented the benefits of exercise in cancer care. Some of those benefits include decreased fatigue, nausea, anxiety and depression as well as improved strength, endurance and immune system function.(1) A recent study conducted by Brigham & Women's Hospital also demonstrated an improved survival benefit in breast cancer patients who were more physically active.(2)
At the Center for Cancer Care we consider exercise to be a potential part of each patient's treatment plan. Cancer Well-fit is our exercise program designed for people who are currently in or within one year of cancer treatment. These free, 10-week, twice-weekly exercise classes are held at Synergy Health & Fitness Center on the campus of Exeter Hospital. All participants are screened by a licensed prepared physical therapist prior to enrollment and individual exercise programs are prescribed to meet the needs of each participant.
If acute one-on-one therapy is required, patients are referred for oncology rehabilitation.
Medical clearance is required for participation. Classes are available in the morning and afternoon on Tuesdays and Thursdays, with new participants starting every week throughout the calendar year. Individualized classes consist of instruction in flexibility, strengthening and cardiovascular exercises with appropriate monitoring by trained exercise professionals.
Weekly Cancer Well-fit Yoga classes are also now available at Synergy's Mind Body Studio. Medical clearance and screening are also required for the Cancer Well-fit Yoga classes.
For more information, contact Amy Litterini, PT, DPT, at (603) 580-7067.
The Cancer Well-fit staff is actively completing a research project looking at the benefits of exercise on strength, fatigue and quality of life. If interested in participating, those individuals starting the Cancer Well-fit program are asked for their consent to enroll in the study.
References: 1. Galvao, D., Newton, R. (2005). Review of exercise intervention studies in cancer patients. J Clin Oncol. Feb 1;23(4):899-909. 2. Holmes, M., Chen, W., Feskanich, D., Kroenke, C., Colditz, G. (2005). Physical activity and survival after breast cancer diagnosis. JAMA. May 25;293(20):2479-86.
Many research studies have documented the benefits of exercise in cancer care. Some of those benefits include decreased fatigue, nausea, anxiety and depression as well as improved strength, endurance and immune system function.(1) A recent study conducted by Brigham & Women's Hospital also demonstrated an improved survival benefit in breast cancer patients who were more physically active.(2)
At the Center for Cancer Care we consider exercise to be a potential part of each patient's treatment plan. Cancer Well-fit is our exercise program designed for people who are currently in or within one year of cancer treatment. These free, 10-week, twice-weekly exercise classes are held at Synergy Health & Fitness Center on the campus of Exeter Hospital. All participants are screened by a licensed prepared physical therapist prior to enrollment and individual exercise programs are prescribed to meet the needs of each participant.
If acute one-on-one therapy is required, patients are referred for oncology rehabilitation.
Medical clearance is required for participation. Classes are available in the morning and afternoon on Tuesdays and Thursdays, with new participants starting every week throughout the calendar year. Individualized classes consist of instruction in flexibility, strengthening and cardiovascular exercises with appropriate monitoring by trained exercise professionals.
Weekly Cancer Well-fit Yoga classes are also now available at Synergy's Mind Body Studio. Medical clearance and screening are also required for the Cancer Well-fit Yoga classes.
For more information, contact Amy Litterini, PT, DPT, at (603) 580-7067.
The Cancer Well-fit staff is actively completing a research project looking at the benefits of exercise on strength, fatigue and quality of life. If interested in participating, those individuals starting the Cancer Well-fit program are asked for their consent to enroll in the study.
References: 1. Galvao, D., Newton, R. (2005). Review of exercise intervention studies in cancer patients. J Clin Oncol. Feb 1;23(4):899-909. 2. Holmes, M., Chen, W., Feskanich, D., Kroenke, C., Colditz, G. (2005). Physical activity and survival after breast cancer diagnosis. JAMA. May 25;293(20):2479-86.
The clinical trials program at Exeter Hospital allows our patients to participate in cutting-edge research without having to travel to Boston or Dartmouth.
The Cancer Center participates in several national research groups sponsored by the National Cancer Institute. We are able to offer a variety of clinical trials. The type of clinical trial usually offered by the Cancer Center is called a Phase III trial, meaning that the new treatment has been tested in humans and that we know the new treatment provides some level of effectiveness against cancer. The new treatment is being compared to what is felt to be “standard care.”
In addition to contributing to advancements in cancer care, one of the benefits of a clinical trial is that it may allow you to receive new treatments not yet approved by the FDA, and therefore not available unless you are in a trial. The risks of participating in a trial are that we don’t know if the treatment is better or worse than standard treatment and we may not know all the potential side effects of the treatment. The decision to participate in a clinical trial is a personal one.
If you are interested in participating in a clinical trial, talk with your oncologist. He or she can let you know if there are trials available for your type of cancer either here or in a larger cancer center. Participating in a clinical trial is voluntary. You will receive all the care and treatment that we can provide in the Cancer Center regardless of whether or not you participate in a trial.
In addition to the clinical trials, we sometimes have other research projects available. For example we may have a study open that evaluates the benefits of exercise for people with cancer or a study looking at quality of life. Again, participation is always voluntary.
To see which clinical trials and studies are currently available at the Cancer Center, please see the following list. The list changes almost every month, for the most up-to-date information, please talk with your oncologist.
Roderick McKee, MD
Diane Palladino, MD
Christopher Roseberry, MD
Jay Swett, MD
Breast Reconstructive Surgery:
Kimberly Marble, MD
