After a breast cancer diagnosis, the deluge of medical information, doctors' appointments and treatment options can be overwhelming for patients to manage, let alone process.
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A smartphone app for Michigan Medicine patients could help calm the confusion — and even provide a bit of comfort.
Known as Breast Cancer Ally, the iPhone app was developed in 2016.
It is the first such product developed by Michael S. Sabel, M.D., chief of the division of surgical oncology at Michigan Medicine. The health care system recently introduced a similar app for melanoma patients.
Both efforts are intended to provide organizational tools and action-oriented advice intuitive to each patient's case.
With Breast Cancer Ally, information can be tailored based on the location and grade of a user's tumor and the type of treatment she is receiving.
"This is two-way communication during a complex journey," says Sabel. "It asks the patient about what stage they're at, and then we can target that education."
That's important for breast cancer patients, a group Sabel says tends to be highly informed about all elements of their care. But the sources they consult may not be accurate or reputable. Some women also may struggle to balance logistics or reach a clinician after hours.
Sabel, who was involved with creating and implementing Breast Cancer Ally, doesn't see the app as a substitute for face-to-face interaction. Instead, it's meant to represent "a little person you could send home with your patient" in between visits, he says.
Other hospitals could potentially use the software, Sabel adds.
He spoke more about the technology and how it can benefit both patients and their doctors:
5 benefits of the Breast Cancer Ally app
It's unique to each user: The app is tailored to focus only on the specifics and timing of a patient's care plan. That approach, Sabel says, is a change from past practice, when doctors gave out a booklet explaining all types and treatments of breast cancer. Here, a patient whose surgery doesn't require drains wouldn't have to read — or worry — about them. Says Sabel: "You are not exposed to information that would be irrelevant or possibly confusing."
It keeps details in order: To make things easier, the app curates key milestones. It lists what a patient needs to bring on her first visit. With guidance from a trained clinician, patients enter details about future visits. The app, in turn, offers directions and contact information. Based on input, pre- and postoperative information (and notifications) will follow. The app also updates a woman's medical history for easy sharing with a primary care physician.
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It prompts action (and accountability): Beyond keeping appointments outside the home, cancer patients in recovery must manage self-care tasks. Which is why app users are given gentle reminders to follow through. A patient who had breast surgery under the arm, for example, would receive text messages — with links to illustrations — to conduct daily postoperative exercises. Users indicate completion via the app; doctors can check for compliance.
It tracks patient concerns: Periodically, the app asks patients to record their symptoms by asking for levels of fatigue, depression and other factors. That often varies from what a woman might tell her doctor during an in-person visit, Sabel says: "Many patients will report to the app they have symptoms, but when they see the doctor the patient will say everything's great." Clinicians can review the findings, allowing them to address any unspoken concerns.
It's a complement to human contact: Because some patients travel long distances, the app can help address certain issues remotely: A "toxicity tracker" allows users to input frequency and severity of nausea during chemotherapy. The app then can supply coping tips or advise them to call their clinician. The latter method isn't any less crucial, Sabel notes: "Patients said to us, 'Sometimes when I call, it's not because I have a question. I need human connection.'"