Welcome to My Personal Page
Since 1981, I had the privilege of working with a group of wonderful partners to provide care to patients with breast cancer at the Gundersen Health System in La Crosse.
During these 37 years, the treatment of breast cancer changed from the "most treatment a patient could possibly be asked to tolerate" [to try to cure the cancer] to the "least treatment necessary to achieve a good cancer outcome".
In the first year that I started to care for patients with breast cancer, the most common operation of the last two centuries--a "radical mastectomy-- was hardly ever performed again. Based on research studies, radical mastectomy was found to be no better than lesser surgery. And for a type of breast condition called "lobular carcinoma in situ", the standard of care changed from the bilateral mastectomy to observation in most patients.
In other advancements, breast conserving treatments became possible and advances in medical oncology, radiation oncology, breast imaging, plastic surgery and genetics were transformative.
The following are just some of the many examples of improvements in diagnosis and treatment since i started caring for patients:
* needle biopsy for diagnosis instead of an operation for diagnosis
* better screening mammography--many patients can now be diagnosed at earlier (more curable) stages
* genetic testing to identify patients at very high risk of future breast cancer, allowing the opportunity for interventions to lower risk and in some cases, prevent breast cancer
*less radical surgery with many options for cosmetic reconstruction
* mastectomies that preserve the nipple and areola without compromising the cancer cure rate
* identification of a subset of patients with such low risk cancers that they can undergo simple lumpectomy without radiation
* for those patients that benefit from radiation after lumpectomy surgery, shorter (more convenient) courses of radiation
* minimal lymph node surgery (sentinel node) instead of major node surgery in every patient
* Annual advancements in medical oncology "hormone", "chemotherapy" and "targeted" therapies resulting in higher cure rates and in many cases, less toxicity
* Molecular tests that can allow some patients to avoid chemotherapy who otherwise would have received it years ago
* Genetic and molecular tests that identify opportunities for new "targeted" treatments for some patients that have relapsed with cancer after already receiving standard care. Identification of these new treatment targets sometimes allows a new treatment to be offered with hope of effectiveness
No one would dare say that having a diagnosis of breast cancer or treatment is "easy" now or that all patients are cured, but comparing the last 3 decades to those before, most patients are able to achieve better cure rates while receiving less toxic treatments. Functional, cosmetic and cancer outcomes have all improved.
The advancements cited above came as a result of basic science and clinical research studies performed around the World.
The clinical and basic science research divisions at Gundersen have contributed to the advancements above in many instances by enrolling the patients that we treat locally in research studies. All these studies require funding.
Additionally, the scientific, clinical and breast cancer quality improvement research that has been led by Gundersen providers of care have been cited many times by breast centers and academic institutions elsewhere. These citations, as well as invitations to lead national and regional breast cancer improvement projects, are evidence that our local contributions to better breast cancer care have been noted and/or adopted by others.
I have donated time and funds each year to the "steppin out in the pink" campaign and I am eager to donate again this year. I thank all previous donors for their contributions. Separate from research funds, i will also donate dollars to the "soip" contributions to "Paula's Purse", named after one of our former colleagues in the Norma J Vinger Center for Breast Care. No one ever took better care of our patients than Paula. The funds in honor of her are used for the special needs of our patients in the Cancer Center such as for food, overnight accomodations, gas money, school supplies for our patient's children, and other appropriate uses.
To all, I thank your for any amount of contribution to the SOIP campaign.
jeffrey landercasper MD
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