CentraState - Healthy Directions

www.centrastate.com Summer 2014 5 I n March 2013, Kausar Anver, now 52, was concerned when she noticed redness on her left breast and felt a lump. This Karachi, Pakistan, native, like many Pakistani women, was private about her discovery, only telling her sister, Nigar, whom she lives with. At Nigar's urging, Kausar decided to consult a breast specialist at her local hospital. An ultrasound at the local hospital didn't show anything and Kausar was told it was likely a bruise. She went home and tried her best to ignore the redness and lump, but six months later she noticed the redness was increasing. As the baby of the family, her older sisters, worried, urged her to go to another Karachi hospital for a second ultrasound. Because of the often antiquated technology, seeking a second opinion from a doctor at another hospital with a better reputation is commonplace. After waiting a few months, Kausar went to a breast surgeon at a well-respected hospital in Karachi, where an ultrasound and mammogram showed a lump. A biopsy revealed she had breast cancer. The breast surgeon recommended chemotherapy and a lumpectomy. For Kausar and Nigar, the decision was easy—come to the United States for treatment. "For many Pakistanis, having family in the United States who you can stay with during treatment is an advantage," Kausar explains. "Cancer treatment in the United States is considered the gold standard." Another older sister, Naheed, lives with her family in Howell, and she insisted Kausar and Nigar make the trip to New Jersey. Naheed was familiar with CentraState Medical Center and had heard good things about the cancer center. Her daughter's pediatrician, also affiliated with CentraState, told Naheed that her sister should come to CentraState, and through her own research found board-certified and fellowship-trained breast surgeon Mary Martucci, DO, FACOS, FSSO. Dr. Martucci also ordered a mammogram, ultrasound and biopsy and confirmed the diagnosis. Like the breast surgeon in Karachi, Dr. Martucci—along with the breast cancer tumor board (a multi-disciplinary group of oncologists, radiologists, pathologists, cancer registrar and nurses who review and discuss complex cases)-—also recommended an initial course of treatment including chemotherapy. As an unexpected bonus, Kausar and her sisters learned that CentraState cancer registrar, Uzma Rizwan, also a Karachi, Pakistan, native, would be helping to coordinate her care—a caring touch from someone close to home. With a smile, Kausar explains, "As soon as I entered CentraState Medical Center, I felt like a VIP. It is a big, beautiful hospital and everyone loves you and greets you with a smile." She adds, "Having Uzma available to help me better understand my treatment is reassuring and makes me feel more relaxed." This is in contrast to health care in Pakistan, where the patient is responsible for arranging tests and appointments and hospital workers are unapproachable. Nigar comments, "In Pakistan the stress of care is put on the patient, but here people share your burden." This is an important quality for anyone facing a battle with cancer. "Ideally Kausar would have begun treatment last March, when she first felt the lump in her breast; however, there is still much that can be done clinically to treat her cancer," Dr. Martucci explains. "One of the most important contributors to her treatment is the positive attitude she maintains as she is continuing through her treatment journey." Bhavesh Balar, MD, a board-certified hematologist/oncologist on staff at CentraState, is helping coordinate Kausar's care. "It is absolutely critical to have a multidisciplinary approach to treating breast cancer," Dr. Balar explains. "In this particular case, we determined that she, in fact, has a more locally advanced disease and we've also determined that she will need genetic counseling because of the type of breast cancer she has. Genetic testing may have implications for her and her relatives in terms of cancer prevention strategies." In the weeks ahead, Dr. Balar explains, "She will be receiving chemotherapy first, which will allow for better surgical results. We expect she will have a favorable outcome." For more information about CentraState's Cancer Center, call 855-411-CANCER (855-211-2262) or visit www.centrastatecancercenter.com. HD From Pakistan to Freehold: A Woman's Breast Cancer Journey The World Health Organization describes breast cancer in Pakistan as "rampant, the leading cancer killer among women." While the population of Pakistan is nearly half that of the United States, the number of women dying of breast cancer is on pace with the United States (40,000 per year). Cancer registrar Uzma Rizwan travels to her native Pakistan twice a year to train physicians and researchers on cancer data management. "One of the key messages I send to participants is to promote annual mammograms," Rizwan says. While breast cancer is not publicly spoken of in this conservative culture, Pakistani politician and breast cancer survivor Fehmida Mirza is attempting to change that by working in Parliament to advocate for women's health issues. "As soon as I entered CentraState Medical Center, I felt like a VIP. It is a big, beautiful hospital and everyone loves you and greets you with a smile." —breast cancer patient Kausar Anver Kausar is grateful to the CentraState team that has helped her through her breast cancer treatment, including breast surgeon Dr. Mary Martucci (left) and cancer registrar Uzma Rizwan (right).

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