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Hoag’s New High Risk Program in Irvine Helps “Pre-vivors” Navigate Uncertainty


What would you do?

If you knew you had a genetic mutation that increased your risk of developing breast or ovarian cancer over the course of your life – a risk as high as 80 percent – what would you do with that information?

Advances in genetics can now tell a woman whether she is at increased risk of developing potentially fatal cancers. But women aren’t a collection of risk assessments and disease statistics.

We are mothers who have children to raise. Employers who have payroll to make. Cooks, drivers, dancers, spouses, daughters and friends. We have things to do. Wringing our hands about genetic mutations and elevated risk is not one of them.

That is why, with the help of donor support, Hoag launched the Breast & Ovarian Cancer Prevention Program to address the needs of “pre-vivors,” women who don’t have breast or ovarian cancer, but have an increased risk of developing the disease.

“The thing I always felt I could do better for my patients was to create a more holistic embrace,” said Heather Macdonald, M.D., breast surgical oncologist and medical director of the Breast & Ovarian Cancer Prevention Program located at Hoag Health Center Irvine. “As physicians we are focused on the science and the medical care – how often a high risk woman needs imaging, whether preventative surgery is a good option, what oncologic care they need. That is a complicated enough network to work out.”

“What physicians often don’t address are those broader needs – diet, fitness, stress reduction, mental and sexual health. Most of us don’t have the time and expertise or feel comfortable addressing these issues.”

By adding a multidisciplinary team of experts in meditation, fitness, nutrition, and sexual and mental health to the clinical team, the new program will educate and empower high risk women beginning with their first appointment.

The broader team includes gynecologic oncologist Lisa Abaid, M.D., F.A.C.O.G., F.A.C.S.; dedicated breast radiologists January Lopez, M.D., and Jennifer Overstreet, M.D.; High Risk Nurse Practitioner Karen Herold, DNP, WHCNP-BC, FNP-BC; Nurse Navigator Lisa Fassnacht, RN, CRN; Genetic Counselor Jeanne Homer, MS; Wellness Coach Anusha Wijeyakumar, MA, RYT, CPC; Certified Personal Trainer Nicole Ervin, BS, CPT; Registered Dietitian Yasi Ansari, MS, RD, CSSD; and Licensed Psychologist and AASECT-Certified Sex Therapist Stephanie Buehler, MPW, PsyD, CST.

The program will serve high risk women throughout the community, as well as their providers. There are things a woman can do to help reduce her risk; the clinic will provide the toolbox and caring support.

“Many of these women have had people in their lives whom they watched battle cancer. It’s a devastating personal experience. So to be told you have one of six genes that carry a 60 to 80 percent elevated risk is fairly daunting,” Dr. Macdonald said. “It is a real burden. However, if we know you carry the gene mutation, there are things we can do together.”

The clinic is aimed at helping women – mind, body and soul. Among the ancillary offerings, the clinic will also give women access to increased high-tech mammography, genetic counseling and consultations about preventative surgeries.

As empowering as preventative measures can be, they alone don’t detract from the looming threat of cancer. The only cure for dread is community.

“We all feel better knowing that not only is there a plan to get me through this, but there are also people to walk the road with me,” Dr. Macdonald said. “Fear is isolating. We can offer you a team and community support.”

For more information, call 888-550-4749.