Published by: Kim Allison on 10/24/2011 1:43:03 PM
I was made the Director of Breast Pathology at the University of Washington Medical Center 2 weeks before I received my own diagnosis of Stage 3 breast cancer. I was 33 years old and had just had my second child. While it was a terrifying experience – it also proved to be an invaluable education that has impacted the way my colleagues and I have viewed patients, the disease and its treatment.
Shortly after my colleagues gave me the bad news, I was busy looking up survival statistics for my particular cancer. It was a high-grade cancer, 8 cm large, hormone receptor negative, positive for over-expression of HER2, with a high proliferative index and at least one positive lymph node. In short, one of the more aggressive forms of the disease – “big, bad and ugly.” And the survival statistics out there for me to comb over were bad enough to make me feel like a dead woman walking.
I went home to see my young kids (4 years and 7months old) and husband and grimly envisioned their life without me. But then I went in for my first appointment with my treatment team at the University of Washington/Seattle Cancer Care Alliance (also colleagues). All the details of the treatment options they were explaining to me were important, but the one thing I most clearly remember is the hope that my breast surgeon gave me when she said that my cancer was highly likely to respond to treatment, that it was important to remember most statistics are based on older data, and that I should plan on seeing my grandkids. My grandkids? Here I was thinking that I might not even see my own children graduate preschool and she is giving me hope of seeing my grandchildren. That gift of hope and encouragement was the best thing my physician could have given me at that point in the process.
Looking back now, I can see that the period between diagnosis and meeting with my treatment team was the most anxiety filled in the whole ordeal. It is an incredibly fearful time that I think hospitals should strive to keep as short as possible by making every effort to get newly diagnosed patients in to talk to a clinician as soon as possible – even if all the final results of the innumerable tests required to make final treatment recommendations are not back yet. Meeting you is the very first part of their therapy and their first step toward getting through this difficult time. And clinicians should remember that when meeting with a newly diagnosed patient, your words of encouragement are perhaps just as important as your medical advice.
As a pathologist, I am removed from the front lines of direct patient contact. But having cancer brought new meaning to my practice by being more cognizant of giving fast and accurate results to treating clinicians. I now know firsthand what it is like to wait for pathology results and know the effects of treatments that the details in my reports will make patients candidates for. My diagnosis was also a big education for the residents-in-training I work with, who could no longer think of a patient as another number on a glass slide, but as a person whose life was about to be turned upside down by what they saw under the microscope. I think it inspired them to work harder to become better diagnosticians and made them more aware of treatment implications of their diagnoses.
My experience with cancer has also made me want to come out from behind my microscope and reconnect with patients. My memoir, Red Sunshine, is one way that I have attempted to reach out to cancer patients and their supporters in a more direct way. Sharing a personal story can be such a powerful way to give insight to another’s journey. I know I certainly benefited from talking with other survivors, and our patients will look to us for ways to find them. We should prioritize delivery of these connections as well as better ways of helping patients navigate our complex medical system, just as we prioritize delivery of our medical therapies.
Today I am 37 and cancer free (picture my fingers crossed as I type this) and I feel incredibly lucky to be planning my future. But the lessons I learned from my experience with cancer serve as a reminder that the care we deliver as physicians and health care organizations may be there very care we need ourselves. And sometimes what we need most as patients is rapid access to the system and reassurance, in addition to the delivery of the most cutting edge cancer-killing therapies.
Kim Allison, MD
Director of Breast Pathology
University of Washington Medical Center
Author of breast cancer memoir, Red Sunshine
Survivor