Recognizing the Complex Clinical and Social Needs of Advanced Breast Cancer Patients

Clinician Dr. Diana Lüftner works closely with patients to manage complex treatment decisions along with the socioeconomic challenges confronting patients

Dr. Diana Lüftner, Professor and Senior Physician at the Department of Hematology and Oncology of the Charite Medical School and Comprehensive Cancer Center in Berlin, has dedicated her twenty-year career to helping patients with cancer, particularly younger patients and women with breast cancer (BC). In 2016, she founded the German Foundation for Young Adults with Cancer to address the unique problems of patients ages 18 to 39. She talks about her priorities as a physician and the complex needs of metastatic breast cancer (MBC) patients.

In your experience, what are some of the most pressing unmet needs impacting patients with MBC?
The most important thing is to make sure the patient is getting sufficient information about her breast cancer subtype, whether it’s hormone-receptive or so-called triple negative. Very often the patient gets absolutely misleading or incorrect information online or through other media. In April there was an article in a major German news magazine saying that methadone improves outcomes for advanced BC patients—there is absolutely no scientific basis for that information, but patients are still coming in and asking about this.

What drives your work?
My goal is to prolong life with the highest quality of life. It’s complex because there are 200 different treatment regimens for MBC and every one of them has different side effects. Nausea and vomiting, for example, can be both a side effect and a symptom of disease, so it is vital to be clear about what is causing it and adjust the treatment accordingly.

What has changed as far as the clinical management for MBC patients?
More than in the past, we can really improve quality of life by focusing on the patient experience. At our center, we’ve found that it’s much more effective to involve patients in their own medicine assessment. Sometimes physicians do not pick up on problems as quickly as patients, and when co-medicines are not adjusted, it  can significantly impact quality of life.

Do you see social needs that are neglected?
Ten percent of MBC patients have an imminently life-threatening disease. Others do not, but many patients are weak, and cannot follow a normal working schedule. People often think of cancer as a disease of only older people in their 60s or 70s. But there are younger patients, there are single mothers with children. If they can’t work as before the illness, who is going to support them and their families? It’s very problematic, a psychological burden, and the reason cancer and poverty are directly correlated. Clearly more needs to be done to support this group of patients.

What inspired you to co-found the Foundation for Young Adults with Cancer?
Through my work with patients, it was clear that young adults with cancer have a very different experience than patients who are middle-aged or older. The illness comes in the middle of major life steps like higher education, career building, and starting a family. Childbearing potential is a major focus, especially for patients receiving treatment between 20 and 30 years of age. Another example is young women treated for breast cancer—they are at risk for developing osteoporosis or chronic cardiac disease, something they’ll have to manage for the rest of their lives. The foundation provides support and valuable information and help in dealing with these problems. New treatment options are important, but we also need to treat the whole patient to manage their life.