When a woman is diagnosed with breast cancer, she may ask such questions as, "How will I get through this? What should I tell my family? How should I handle this in my workplace? Where can I turn for help?" Loss of control and fear of recurrence are other common concerns.

To help patients find the answers to these questions, the Supportive Services Program at the NYU Clinical Cancer Center offers a suite of comprehensive services delivered by a team of skilled experts. "Our job is to help patients learn to live with the uncertainty, stress, and distress that can come with a cancer diagnosis and its treatment," says Mauricio Murillo, MD, Director of Supportive Services. "Supportive care is integral to the quality of life of our patients." Individual and family counseling are part of the program. Harriet Mannheim, LCSW, Manager of Supportive Services, has led the development of supportive programming and education for people living with cancer, caregivers, and survivors, which are facilitated by the multidisciplinary Supportive Services team. Ms. Sevanick developed and facilitates weekly support groups addressing the emotional impact of early-stage breast cancer and advanced breast cancer, and a monthly support group for younger women with a BRCA gene mutation.

Nurses and physicians do an initial screening to determine which patients are most in need of psychosocial support services. The program's support groups and other services are also well advertised throughout the NYU Clinical Cancer Center, and patients and family members may refer themselves.

Women with early-stage breast cancer commonly focus on adjusting to the diagnosis and learning about their treatment and how it will impact their lives. They may worry about their appearance after surgery, whether or not chemotherapy will make them lose their hair, or if breast cancer treatment may affect their sexual functioning or libido. Single women also express concerns about dating. "Those who are of child-bearing age may be particularly concerned about fertility and possible early menopause," says Ms. Sevanick.

The concerns of patients with metastatic breast cancer are somewhat different. The approach of treatment becomes how to best manage cancer as a chronic disease, rather than emphasizing cure. The good news is that women with metastatic disease have more treatment options and are living longer, which is an important change and brings new hope. The NYUCI is presenting a special full-day seminar in October devoted to the concerns of those living with metastatic breast cancer and their family and friends. (See the Events Calendar on page 11 for more information.)

It is also not uncommon for cancer patients to hear that they have to "think positive" to beat the disease. "That message upsets a lot of people," says Ms. Sevanick. "Instead, I tell them, 'You get to say when you feel good and when you don't. You're entitled to all of your feelings.'"

Along with social workers, the NYUCI's Supportive Services team also includes nutritionists and a genetic counselor. "We all step in, listen to patients' stories, and help address their needs," concludes Ms. Sevanick. "There's a team of people here who care, and we want to share that message of caring."

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