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One Doctor’s Approach to Cancer Prevention, Genetic Testing, and Patient Care

Oct 22, 2020

As one of only three NCI-designated Comprehensive Cancer Centers in Texas, the Baylor College of Medicine Dan L Duncan Comprehensive Cancer Center at Baylor St. Luke’s Medical Center not only embraces proven therapies — we find new ones.

Dr. Julie Nangia,Medical Director of the Breast Cancer Prevention and High Risk Clinic at Baylor College of Medicine, is one of the physicians who translates research into clinical trials that create real-world benefits for the patients we serve. Here’s how her work is going beyond traditional treatment options to create more positive outcomes for more cancer patients.

Chemo, Hair Loss, & Scalp Cooling

One of Dr. Nangia’s clinical research focuses is scalp cooling, a practice that can allow patients to keep their hair even while undergoing chemotherapy treatment for cancer. By wearing a cool cap before, during, and after chemo, the temperature of the patient’s scalp is lowered by a few degrees. This, in turn, reduces the amount of blood flow to the area, limiting the amount of chemo drugs absorbed by the hair follicles. Currently, these devices enable about 50% of patients to keep their hair.

“Hair retention can be very important for patients of all ages, particularly women,” said Dr. Nangia. “I have women in their eighties who want to keep their hair. It's part of you. You don't want to wake up and look in the mirror and look sick when you feel well, or be treated like you’re sick by the people around you. This research has played a big part in helping patients stay positive and work through treatments.”

Cancer Prevention & Genetic Testing

As part of her work at the Dan L Duncan Comprehensive Cancer Center, Dr. Nangia also works with people at a high risk of hereditary cancer. After meeting with a genetic counselor and giving a full family history, these patients will see Dr. Nangia to determine if they should undergo genetic testing, receive screening MRIs in addition to mammograms, or begin taking a drug like tamoxifen that can decrease the risk of breast cancer in high-risk women.

“If someone’s genetic testing comes back positive I’ll follow them lifelong. The most common genes associated with breast cancer are the BRCA genes and I follow more than 450 patients that have these genes.  These women have a 60-88% lifetime risk for breast cancer as well as other cancers, and some will elect for preventative prophylactic surgeries,” said Dr. Nangia.

There are many factors that go into whether or not a patient chooses to move forward with a preventive mastectomy after learning they have the BRCA gene. Cultural differences, personal preferences, and lifestyle choices all play a part. Some would rather the assurance that they would never develop breast cancer, while others would prefer to monitor regularly and catch any cancer at its earliest stage. 

“You really have to take the time to listen and get to know patients, to see where they're coming from and understand what they really want.”

If you or someone you know faces a cancer diagnosis or is at increased risk for developing cancer, reach out to our specialists today. With nationally ranked cancer care, leading research, and innovative treatment options, our team at the Dan L Duncan Comprehensive Cancer Center combines precision medicine with compassion. That’s humanity in cancer care.