Top Doctors 2011 Profile: Angela Keleher, M.D., Breast Cancer Surgery in Poughkeepsie
Battling breast cancer with technology and tender care
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Photograph by Michael Polito
Another positive advance: Breast-cancer surgery no longer leaves women as physically disfigured as in the past, Keleher says. “In many cases we can do a lumpectomy, which leaves much of the breast intact. And if we need to do a mastectomy and remove the breast, we usually can do immediate reconstruction by a plastic surgeon — it’s done during the same surgery. We see beautiful cosmetic results.”
Keleher says the mastectomy rate has actually been going up again, after a trend for many years of performing less-invasive lumpectomies. “More women are choosing mastectomy because of the wonderful reconstruction options,” she says, adding that New York State law now requires hospitals and doctors to discuss all available options and insurance coverage for breast reconstruction before patients have a mastectomy, lymph node dissection, or lumpectomy. (A 1998 federal law already mandated that insurance companies cover reconstructive breast surgery.) As important a factor in that choice, though, is that women nowadays thoroughly research treatment options and often choose a mastectomy for the peace of mind it brings, she says.
“In my experience, what’s most challenging about this field isn’t the surgery or dealing with the disease process itself,” Keleher says. “It’s about understanding the patient. As a physician, it’s my job to tell you what the options are for cancer treatment. But it’s also my job to listen to your needs as a patient.”
She adds: “It’s not just about the cancer. It’s about the patient, her family, her relationships, her sexuality, her job, her self-image, everything. I think that’s the wave of the future in medicine: more awareness of a patient’s total needs.
“We, the surgeons, are just part of the equation. We’re often the first people to see a patient during her medical journey. I call it ground zero; we sort of take care of them from the ground up. And nowadays, more physicians understand that it’s important to help orchestrate their other care, besides just getting a patient to the medical oncologist and the radiation oncologist and the genetic counselor.”
Keleher says the total-care approach can range from exploring palliative needs — making sure the patient is comfortable and pain-free — to arranging for a family counselor, a support group, “or maybe making sure their kids get some books or brochures to read so they understand what’s going on.”
To make her hectic day a bit easier — Keleher handles administrative duties at the breast center and maintains a full clinical/surgical practice — she skips the headache of commuting. She and her husband live just a few steps away from the hospital in Poughkeepsie. During their free time, the couple enjoys exploring the region; they’ve resided in the Valley for more than three years.
“Sometimes we’ll take the train to New York City, explore a different neighborhood each time, and maybe try a new restaurant. Or we might go to Mohonk [Mountain House] for the weekend. I’ve even taken the train up to Lake Placid. The Hudson Valley is very beautiful, and our community has been very warm and embracing to us,” Keleher says.
Her medical advice to women: “Mammograms do save lives. Do breast self-exams because you know better than anyone what’s normal for your own body. And if you do find anything abnormal, don’t be afraid to have it checked out right away. I think women should be empowered about their health — it helps patients have a faster recovery, and it helps us help you in treating the disease, so you can get back to living a full life.”