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NATCHEZ — Radiation oncologist Dr. Gregory Cotter, who arrived in Natchez in 2019 to work at Mary Bird Perkins Cancer Center, said much has been learned during his 44 years practicing medicine.

“There’s a lot of new medicines that are being utilized for treatment of breast cancer,” he said.

“The other thing that’s new is we’re able to offer equally effective radiation therapy treatments — in a shorter period of time in some cases.”

Surgeries for breast cancer are less radical than they were in 1980s. Studies have found that in many cases, a modified radical mastectomy and a radical mastectomy have similar survival rates as a lumpectomy followed by radiation therapy, Cotter said.

However, what hasn’t changed is that early detection is the key to better outcomes.

Modern scans are able to detect very small early tumors.

“Some cancers are so small that after biopsy there is nothing left,” Cotter said.

Cotter relates to caregivers of those who’ve had cancer on both a personal and provider level, having lost his first wife to it in 2005.

She was diagnosed with metastatic carcinoma of unknown origin. She hurt her back putting away boxes of Christmas decorations, and being a doctor Cotter ordered her an MRI. It was then that cancer polyps were discovered throughout her body.

“I’ve been doing this for a long time but having been through it with my first wife, I know what it’s like at least for family members. It’s really tough,” Cotter said.

While his late wife’s cancer was found too late, Cotter finds gratification in helping others find better outcomes, he said.

WHAT TO EXPECT

After a mammogram, if something abnormal is detected, a patient will be referred to a surgeon to perform a needle biopsy to test if the abnormality is positive for breast cancer.

If the lesion is small, under an inch and a half, a lumpectomy may be performed, Cotter said. Larger lesions may require a mastectomy or chemotherapy may be used to shrink it down and then a primary resection is performed to remove it, he said.

“Most ladies are obviously concerned and have a variety of questions. What kind of treatments do I need, what side effects am I going to have and what is it going to look like cosmetically are the common questions,” Cotter said.

What they should know is that treatments today are safe and effective and have become more standardized nationwide.

“All the side effects are manageable,” he said, adding, “The breast cancer treatment here in Natchez is very good. Good surgery, chemotherapy and radiation therapy here. There is no need to leave town unless you just want to.”

REDUCING RISK

According to the American Cancer Society, some ways to reduce the risk of breast cancer along with many other health problems are maintaining a healthy weight, being physically active and limiting alcohol intake.

Generally, annual breast cancer screenings, or mammograms begin at age 40 or earlier for those with higher risk of having breast cancer.

Those with close relatives, especially multiple close relatives, who’ve had breast cancer are more likely to carry gene changes that may cause them to develop cancer themselves, Cotter said. Genetic testing may be done to test for BRCA1 or BRCA2 gene changes which increases risk of breast cancer, ovarian cancer, pancreatic cancer and possibly some other cancers.

Most women with a family history of breast cancer do not have an inherited gene change that greatly affects their risk.

For the small fraction who have this gene mutation a prophylactic mastectomy, surgery to remove the breasts, may be an option.

Unlike with a mastectomy to remove cancer, a prophylactic mastectomy spares skin and may or may not include reconstruction with a prosthetic implant, Cotter said.

“As a general rule, talk to your physician and see what your risk is,” he said.

“Three things I would most recommend are these. First, if something abnormal is going on with your body, go see your primary care provider. Don’t ignore anything. Second would be to listen to what your doctor recommends. Not so much today but certainly in days gone by when I first started practice there were a lot of people living with their illness and they would come in with massive breast cancers and you know it had to have been there for years but they wouldn’t see a doctor. There was a lot of fear that people had and some didn’t have access to good medical care. Things are so much better today. You can’t escape what it is. Ignoring it does not make it go away.”

Cotter’s last recommendation: “Get your screenings,” including any mammograms, pap smears and colonoscopies recommended by your primary care physician.

Putting off such screenings could lead to longer treatment or worse outcomes, he said.

“Getting your screenings is important.”

For the latest on breast cancer research and treatment, or to donate to support breast cancer research, visit the American Cancer Society page by clicking here.