When diagnosed with breast cancer, the new patient begins a journey. To help them along the way are several key players who at one point or another will be a focal point of treatment.

Their life-saving knowledge, training and expertise will help the patient and their loved ones.

Those who will help are the surgeon and then the oncology team.

Nicole Reyes, C.O. is a doctor of osteopathic medicine specializing in breast surgical oncology at the Joanie Abdu Comprehensive Breast Care Center, located adjacent to St. Elizabeth Youngstown Hospital.

She began at the center in August after completing a one-year fellowship at the Akron branch of the Cleveland Clinic in breast surgical oncology. Prior to that she completed a five-year residency in general surgery in Dayton. She graduated from medical school at the Lake Erie College of Osteopathic Medicine.

What was it that drew her into this specialty?

“The patients made me go into breast cancer oncology,” she said. “I did a general surgery residency; however, this is one of the few specialties that offers a lifelong relationship with your patients.”

Reyes meets her patients following their biopsy when the diagnosis of breast cancer has been made. The patients are referred to her by their OB-GYN or personal care provider.

At the first appointment, Reyes explains what her patient’s treatment will look like and introduces them to the multi-disciplinary team that will work with them.

Treatment depends on a shared decision-making process of the team, and Reyes informs them of their options.

That’s all just one aspect of the journey.

Christine Smoot is the Joanie Abdu regional oncology nurse manager. She has a master’s degree in science of nursing and supervises the oncology teams, which include oncology nurses, medical assistants, secretaries, nurse navigators and dieticians.

“The nurse navigator is one of the first nurses to see the patient after a diagnosis. The nurse will then follow the patient through the entire process and help if the patient is having any difficulty,” Smoot said.

The oncology infusion nurse will educate the patient on the specific drug they will be getting and administer all pre-meds, chemotherapy hydration, blood transfusions, perform scans and whatever else is ordered by the oncology doctor.

Patients don’t always have to undergo the rigorous regime of radiation and chemotherapy.

“Sometimes we can’t determine if a patient needs radiation or chemotherapy right away until surgery is performed to remove the cancer,” Reyes said. “The decision is complex because everybody’s tumor is different, and the final decision is made by medical oncology.”

Part of her role with the patient’s health journey is walking them through the entire process, discussing what to expect with a lumpectomy and radiation, and a partial or full mastectomy.

“I tell them what’s involved, the

risks and the benefits, so they can make an informed decision about their treatment,” Reyes said.

With the diagnosis of a mastectomy, women have the option of meeting with a plastic surgeon to pursue reconstruction surgery.

“The first question patients ask her during their first appointment is ‘Am I going to be OK?’, ‘Am I going to make it?'” Reyes said. “While every patient is different, I reassure them that breast cancer mortality has decreased by over 40% within the last two decades due to the advancement in treatment.”

She added that if breast cancer is caught early, it’s something that’s “completely treatable.”

The interdisciplinary team plays a significant role in patient care.

“Our nurses really need to have a love for oncology to do this job,” Smoot said. “Our patients are very special. Those in this field know this work is different, and this makes them want to work harder. These patients are fighting for their lives. Staff must be caring and dedicated to excellent patient care.”