University of Wisconsin Carbone Cancer Center: A Tradition of Comprehensive, Multidisciplinary Care

Laura Bruck
Published: Monday, Jun 13, 2011
University of Wisconsin Carbone Cancer Center
University of Wisconsin Carbone Cancer Center
Recognized throughout the nation as one of the leading innovators in cancer research, patient care, and community outreach, the University of Wisconsin Carbone Cancer Center (UWCCC) in Madison has its roots in the 1940 founding of the McArdle Laboratory for Cancer Research.

UWCCC is named for Paul P. Carbone, MD, who served as director of the facility (then called the UW Comprehensive Cancer Center) from 1976 until 1994. The Center is, today, Wisconsin’s only National Cancer Institutedesignated comprehensive cancer center, and operates as an integral part of the UW School of Medicine and Public Health.

Currently, more than 250 physicians and scientists work in concert to provide state-of- the art diagnosis, treatment, and aftercare for the more than 20,000 patients seen each year at the UW hospitals, clinics, and affiliate clinical facilities. The Center’s commitment to comprehensive and multidisciplinary care is perhaps best exemplified by the allinclusive range of services provided in its UW Health Breast Center, by a novel approach to treatment for pediatric neuroblastoma, and in the efforts of the Center’s gynecologic oncologists to preserve fertility after treatment for cervical and endometrial cancer.

UW Health Breast Center:

One-Stop Comprehensive Care

The UW Health Breast Center operates in collaboration with the UWCCC, bringing together clinicians from a range of specialties— including medical and surgical oncology, plastic and reconstructive surgery, radiology/imaging, and radiation oncology—all of whom work closely with UWCCC researchers. The UW Health Breast Center clinicians see nearly 600 new patients with breast cancer each year.

“From the moment they walk through the doors, our patients have access to everything they need under one roof,” said Lee Wilke, MD, a breast surgeon and the medical director of the UW Health Breast Center. “Patients get a complete plan for their care, from screening and prevention to diagnosis, treatment, and reconstruction.”

Two prime examples of this comprehensive, multidisciplinary approach to care are the Breast Center’s high-risk clinic and an innovative program that offers surgical patients a novel alternative to general anesthesia.

High-Risk Clinic

Described by Wilke as one of the flagships of the Breast Center, the 2-year-old High-Risk Breast Cancer Clinic—soon to be renamed the Prevention, Assessment, Tailored Health Screening (PATHS) Clinic—offers comprehensive services for “previvors,” specifically those at high risk for breast and/or ovarian cancer, primarily due to the BRCA1 and BRCA2 mutations. Patient services begin with tailored screening programs, which typically include twice-yearly physical exams, magnetic resonance imaging, and ovarian cancer screening. “These patients are living with a reality not experienced by most women: namely, that they will most likely contract breast or ovarian cancer over the course of their lifetime,” said Wilke. She explained that the screening program provided at the Center gives patients a good understanding of their true risk, teaches them what to look for, and enhances their sense of control. Patients who opt for a proactive approach also have access to prophylactic surgery.

Wilke noted that some women tend to be data-driven and want all the information they can get, while others do better with information that’s given gradually over time. For example, a new patient can opt to meet only with a nurse or social worker, or she can choose to meet with a surgeon to discuss prophylactic mastectomy on her first visit to the Clinic.

“We’re careful not to overwhelm our patients and, instead, give them what they need when they need it,” said Wilke.

If they desire, patients have access to nurses (all of whom are breast-certified and serve as patient educators) and nurse practitioners, social workers, genetic counselors, nutritionists, occupational therapists, and on-site medical oncologists, gynecologic oncologists, breast surgeons, reconstructive surgeons, and reproductive endocrinologists.

Paravertebral Anesthesia

Another impressive example of what can be accomplished when clinicians from multiple disciplines employ a team approach to care is a novel anesthesia protocol employing paravertebral blocks. This new approach gives UW Health Breast Center surgery patients the option of foregoing general anesthesia for all but the most major reconstruction surgeries. In addition to the obvious benefits of eliminating the need for general anesthesia, patients who undergo surgery via paravertebral block report greater satisfaction, less pain, and less use of pain medication, said Wilke.

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