Episode 51:  Breast Cancer recurrence detection with caregiver turned oncologist Dr. Fumiko Chino

In this episode, Dr. Fumiko Chino shares her inspiring journey from art director to oncologist, driven by her experience as a caregiver. She highlights the gap between ideal and actual cancer care by discussing a breast cancer imaging study where some patients with Stage 2 and 3 disease received scans to monitor for cancer. Dr. Chino goes into why “surveillance“ scans may or may not be beneficial, and clinicians must communicate this to their patients. She then stresses the importance of personalized communication and understanding patients' unique experiences in order to build trust. Dr. Chino also touches on why prioritizing physicians' well-being to prevent burnout matters.

This episode was supported by the Patient Centered Outcomes Research Institute (PCORI) and features this study by Caprice C. Greenberg, MD, MPH.

About our guest

Fumiko Chino, MD is a cancer researcher, Assistant Attending in Radiation Oncology, and Lead of the Affordability Working Group at Memorial Sloan Kettering Cancer Center. She is also one of the Directors at the Costs of Care group, a NGO working to improve affordability in healthcare and the recipient of the inaugural 2022 ASCO Excellence in Equity Award. Her research is focused on financial toxicity, gaps in survivorship, health care disparities, and access; she has spoken across the US and internationally on equity and the costs of care.

Watch the video of our episode on YouTube

  • 14 minutes:

    “I deliver care in the United States, one of, if not the wealthiest countries, certainly a country of privilege where we have every bell and whistle, and yet not everyone can access those bells and whistles. Not everyone has the capacity for receiving the highest quality of care. And even when I am able to offer the best, every bell and whistle delivered to the person and their capacity to receive it can be quite variable, right? And again, communication is a part of it, right? But access, affordability, these are all like large barriers.You know, one of my most well-lauded studies is on parking costs, which is quite frankly like a really stupid thing to study. Like, why would parking be a barrier to anyone? It's parking. . But what's truly insulting is that people who actually can’t get the care that they really need in the facility that would probably serve them best because of a silly barrier like parking.”

  • 47 minutes:

    “I give people permission to be mad at me all the time or to be mad at their friends or family…. I know you don't want to look sick, you know, but because you look so great, people don't know, and they think that you're done with your treatment, for example, and they're like, okay, you're better now, let's get back to life, and you're still internally scarred. It's okay to just be like, “I need a minute, or I need to ramp up, or I need to have a break”. It's okay to snap at people occasionally, not all the time. You'll lose your friends, but it's okay to be a bitch. But just realize that we all have good days and bad days. So I give people permission all the time to be mad… I haven't been through cancer treatment myself, but I think just being along for the ride is bad enough.”

  • 53 minutes:

    “...I would say that there's no right answer [for a treatment plan] often. Almost always, there's not a singular right answer, right? So understanding that, I think all physicians, providers, researchers are very type A personalities. We want to get the gold star, we want to get 100%, A++. Just realizing that what is the right plan for this person is probably not the right plan for this other person, and understanding that coming to that conclusion together, trying to figure out again, sussing out, even if it's the small tailored things of like, ‘What can we do to make this easier for you?’ It's not one size fits all. It's really, or it shouldn't be, how about that?”

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