Physician uses breast cancer diagnosis to improve practice

Abigail Fletcher, M.D. has been practicing primary care since 1998. As the director of the Family Medicine Residency Program at MemorialCare Long Beach Medical Center, Dr. Fletcher trains the newest group of young physicians while caring for the full scope of patients from newborns to older adults.

Knowing the importance of preventative health screenings, Dr. Fletcher scheduled her annual mammogram at the MemorialCare Breast Center at Long Beach Medical Center in November 2018. As a young, healthy woman, Dr. Fletcher wasn’t expecting anything out of the ordinary, but something appeared on her results. By January, she was diagnosed with stage 1 breast cancer.

“I had no symptoms,” says Dr. Fletcher. “I’ve always encouraged my patients to stay on top of their mammograms, so I have done the same. I never felt a lump before my test, so I’m glad I kept my appointment and they caught the cancer early.”

After she was diagnosed, Dr. Fletcher chose to work with the comprehensive care team at the MemorialCare Breast Center, including Jessica Rayhanabad, M.D., medical director, breast surgery, and Maria Dungo, M.D., breast oncologist. Her next step included a bilateral mastectomy, which involved the surgical removal of both breasts, with Dr. Rayhanabad.

“Drs. Rayhanabad and Dungo are so passionate about helping their patients,” says Dr. Fletcher. “They work by your side to develop the appropriate treatment plan to care for your unique breast cancer.”

Once her surgery was complete, Dr. Fletcher underwent four rounds of chemotherapy at the Ambulatory Infusion Center at the MemorialCare Todd Cancer Institute at Long Beach Medical Center, which included an infusion every three weeks. During her chemotherapy, Dr. Fletcher continued to work.

While hair loss is a common side effect of chemotherapy, Dr. Fletcher chose to use the DigniCap Scalp Cooling System to minimize hair loss. The DigniCap Scalp Cooling System circulates a temperature-regulated coolant through channels within a cooling cap. The reduced temperature results in a decreased blood flow to scalp area so that less chemotherapy reaches the hair cells.

“The cooling cap allowed me to keep my hair, which in turn allowed me to control who I told about my diagnosis,” says Dr. Fletcher. “Also, my kids are young, and I continued to work during my treatment. Since my appearance never changed, it gave us all a sense of ‘normalcy’ and my kids weren’t scared of my diagnosis. It also made me feel better because I didn’t look like I was ill.”

Dr. Fletcher completed her treatment in May 2019, and her experience with cancer has impacted the way she treats her patients.

“I definitely understand what it feels like to receive bad news which now helps me better communicate that news to my patients. I also have now experienced being in the hospital as a patient rather than a physician which helps me to understand what my own hospitalized patients are experiencing”.

In addition to her work as a primary care physician, Dr. Fletcher recently was named the medical director of The Center Long Beach. She is coordinating a clinic license with The Center to ideally provide primary care for the LGBTQ community.

While a breast cancer diagnosis is always overwhelming, Dr. Fletcher has chosen to not let it change who she is.

“I didn’t want to be a patient who let my breast cancer diagnosis define me. It isn’t who I am. I am still a doctor, and a mom, and I’m just tackling breast cancer at the same time. Hopefully I can help my patients who also are tackling cancer or other chronic illnesses share a similar mindset”.

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