Christina Metcalf, M.D.: Empowering Women to Take Control of Their Health

By Kim lucey Millen  /  Photography by STAN GODLEWSKI

As a mom of four plus a new puppy, Christina Metcalf, M.D., division director of breast surgery at Saint Francis Hospital, knows very well the energy many women put into keeping a household running in order. Unfortunately, as a doctor, she’s also seen many cases of women putting their own health on the backburner while they work so hard to take care of everyone else. “Women’s health is important, and often overlooked,” says Dr. Metcalf. “We work every day to empower women to know their personal risks, so they can be proactive and take control of their health. In particular, breast cancer is very treatable if caught early. It’s been a very rewarding part of my career to help women through that journey to remission and recovery.”

Finding her Way to Trinity Health Of New England

Dr. Metcalf is from the East Coast, growing up in New Jersey, with schooling and training around the area. She completed her general surgery residency in Philadelphia, and surgical oncology fellowships at the NIH/National Cancer Institute Surgical Branch and Virginia Commonwealth University. Her first job brought her up to Connecticut to work at UConn Health for 12 years. Last year, she had the opportunity to make the switch over to Saint Francis to help lead the Karl J. Krapek, Sr. Comprehensive Women’s Health Center; she says she’s found it to be a great fit.

“The program at Saint Francis has such a great reputation. I jumped at the chance to come lead the program and help expand it even further,” states Dr. Metcalf. “Having the opportunity to work more closely with the community, particularly with patients in need, has been very fulfilling for me professionally. And, personally, Connecticut is just a beautiful state, and a great place to raise my two daughters and two stepdaughters. I love that you can find anything you want to do here or nearby in New England.”

Prevention

Dr. Metcalf says great strides have been made in detecting breast cancer, particularly in the genetic testing for assessing risk. “It used to be that we could only test for a couple of genes, but now we’ve identified at least 40 that might relate to breast cancer risk,” says Dr. Metcalf. “At the same time, insurance coverage has also expanded for those tests in the past 10 years. In many cases, out-of-pocket costs used to total more than $3,000, and now they’re closer to $250.”

But she says genetics only play a small role in assessing risk, as many breast cancers are not related to a gene. In some cases, personal history that can’t be changed plays a factor: when the patient got their first period, had their first child, whether or not they breastfed, and whether their breast tissue is dense. Other factors are things that patients can take charge of, such as being active, exercising regularly to get your heart rate up at least three times a week for 30 minutes or more, maintaining a normal weight (particularly after menopause), not smoking, and limiting alcohol. Dr. Metcalf says that for many people, the cancer outlook comes down to a combination of all of these factors.

Screening and Treatment, All in One Place

The patient comes first at the Comprehensive Women’s Health Center in Hartford. Breast imaging is located right across the hall from Dr. Metcalf. If any abnormalities are detected in patient screenings, doctors can coordinate closely with radiology to get them in quickly. Patients also get same-day mammogram results.

“Sometimes the waiting can be worse than the test itself,” says Dr. Metcalf. “Patients leave here with results in hand, cutting the stress out of that part of the process.”

Genetic counselors are available for testing and risk assessment. A high-risk program with a medical oncologist is available for additional risk assessment and access to risk reducing medications. And gynecologic oncologists work in the center as well, making it possible to treat the whole woman in one location. Of course, that blends well with Trinity Health Of New England’s core value of treating the whole patient: body, mind and spirit. “It really is amazing,” says Dr. Metcalf. “I think this center is a testament to the fact that we are focused on women’s health here, and we’re doing our best to make it as seamless of a process as possible.”

Fighting Breast Cancer

Doctors say one in eight women in the U.S. is expected to develop breast cancer over her lifetime. Researchers are constantly learning more about the best ways to treat breast cancer once it’s found. “We’ve learned more about certain sub-types and what these cancers respond to best,” says Dr. Metcalf. “Immunotherapy in addition to chemotherapy can be very effective for some types of cancer.”

She says the center has access to clinical trials to help enroll patients and explore that process further. If surgery is the best option, Dr. Metcalf says lots of ground has been covered there as well. Earlier this year Saint Francis unveiled its adoption of Elucent’s EnVisio® surgical navigation system and SmartClip® Technology. “This one is a game-changer,” says Dr. Metcalf. She explains that the new technology is a huge improvement for surgeons removing cancerous tumors during lumpectomies. A doctor implants a wireless SmartClip Soft Tissue marker before surgery, allowing them to pinpoint and mark the location of cancerous tissue that needs to be removed, without disrupting healthy tissue. “It’s much more accurate for the doctor, and much more comfortable for the patient,” says Dr. Metcalf. “Technology like this is a win-win for everyone involved.”

Ensuring Equitable Care

Dr. Metcalf believes one of the greatest barriers to women finding the right care is understanding what they need to do. Guidelines around mammograms have been changing, and people don’t always understand their personal risk factors, family history and what markers are significant for breast health. Also, many times women in underserved populations have trouble just getting childcare and transportation to make it to an appointment. Dr. Metcalf says she’s proud to work at a place that offers resources to help with those factors, to ensure no woman misses out on taking control of her health. In addition, Saint Francis hosts annual “Pink Link” events every October, which provide free mammograms to underinsured and uninsured members of the community. The program, which launched in 2012, has provided more than 400 free mammograms for local women in the last five years.

Looking to the Future

With such great strides already made in breast cancer research, Dr. Metcalf says the future is bright for treatment. “My hope is that I’ll be out of business one day,” she says. “The ideal goal is a world without breast cancer. We just never know what research is going to be the magic ticket to figure it out.”

Those big improvements made in blood tests for different markers may end up being the key. She believes that someday doctors will be able to know through a blood test which patients will get cancer and prevent it from happening through medications and treatments before the cancer shows up. “I wouldn’t mind retiring someday, and never having to treat another patient with breast cancer,” Dr. Metcalf reflects, not afraid to dream.

For more information about the Comprehensive Women’s Health Center at Saint Francis, including how to schedule an appointment, visit TrinityHealthOfNE.org/CWHC.

Kimberly Lucey Millen is a freelance journalist with more than two decades of experience in both print and broadcast media. She lives in New England with her husband and son, exploring all that each of the four seasons has to offer.

Stan Godlewski is an editorial, corporate and healthcare photographer based in Connecticut and working primarily between Boston and New York City.