Our December Hear My Voice blogger is Kelly Shanahan, MD, who writes about her shift from being a healthcare provider to being the person receiving health care for bone metastasis.
I used to think the hardest thing I’d ever done was survive medical school and a 4-year ob-gyn residency at Temple University Hospital when the program was in chaos and we were short five (out of 20) residents. Then I was diagnosed with stage IIB breast cancer in 2008. Then the hardest thing I’d ever done was telling my not quite nine-year-old daughter I had cancer. “Mommy, are you going to die?” was her first question and my answer was “Yes, I’m going to die someday, and so is the cat and so is the dog, but I’m NOT going to die from breast cancer – I’m going to kick cancer’s ass!” Following treatment, I thought, in my arrogant doctor mode, that I was done. I beat the disease, I was a survivor! HA!
While walking upstairs one day in July 2013, I sneezed and immediately developed searing back pain. I ignored the pain, and when it didn’t improve, sought help from a massage therapist and my chiropractor. It didn’t get better and I figured I must have herniated a disc. I’d get an MRI eventually, and maybe one of those inversion tables would fix it. I was a busy gynecologist and I didn’t have time for any herniated disc or chronic back pain.
In a supreme twist of irony, I began subleasing my office to an oncologist one day a week. While dropping off supplies on the day he was there, he noticed me limping. “What’s wrong”, he asked. ”Oh, I think I herniated a disc”, I answered. He looked at me, and said, “You’ve had breast cancer. You need an MRI and a PET scan.” Yeah, yeah, I thought, I’ll get around to it when I have time.
I finally scheduled the MRI and PET for November 14, 2013. Not done with irony, this is my birthday. I figured after the PET scan, I’d go home and go out for a nice dinner with my husband and our daughter, 2 weeks shy of her own 15th birthday.
I had turned my phone off for the tests. First was the MRI, then the PET. Being a doctor who sends lots of patients to the imaging facility where I had the tests done, I knew I could review the results with the radiologist, confirm the herniated disc I just knew I had, stop at Costco on the way home and buy an inversion table and I’d be good as new in no time. HA again. When I went to my car after the PET, there was a message from the oncologist I sublease my office to; I had listed him as my doctor. “Kelly, call me, here’s my cell number” was the message. In that instant I knew I had metastatic disease. I went back into the imaging facility and went to see how bad it was: it was in every bone in my body. Glancing at my scans, my skeleton looked like Swiss cheese.
Two hours later I was in the oncologist’s main office, with my husband, who immediately drove down from our home in Lake Tahoe. Dr. Jorge Perez walked into the room, sat down and looked me straight in the eyes. His first words were “I know you know the statistics. You are not a statistic. We can fight this.” He talked about treatment options, letting me know that most oncologists would recommend an aromatase inhibitor, as my initial diagnosis was ER/PR-positive and HER2-negative, with the goal of slowing progression. Or, we could do aggressive IV chemo, with the hope of getting me into a stage of no evidence of disease, or “NED”. Dr. Perez said, “together we can fight this, and I am confident we can allow you to live with this cancer for many years.”
One of the metastases was within a hair’s breadth of eroding through my femur, so I called an orthopedic surgeon colleague. He was able to look at the images and scheduled me for surgery to place a titanium rod in my femur the following week. I called the general surgeon and arranged for him to place a port. I was in doctor mode, taking charge and getting things done.
Two days later I did two more of hardest things I’d ever done: telling my 87-year-old mother (who had already lost one child to a genetic disease when he was 3) and my daughter that my cancer was back, that it had spread to my bones and that it was incurable. My daughter told me she already knew, and had known since I’d come home on my birthday. You can’t keep anything from kids: they are perceptive and wise beyond their years.
Six days after my diagnosis of metastatic breast cancer, I had the femoral rodding and port placement. Ten days after that I started chemo. At present, I am able to work a few hours a day a couple of days a week, between chemo and acupuncture and yoga and being the passenger while my daughter with her learner’s permit drives to school and back, just enjoying every moment of life.
Being a doctor means I know more right off the bat than the average patient, a double-edged sword. One the one hand, it’s easy for me to understand all the jargon, and the stats, and the studies. On the other hand, I know the stats, and the side effects, and the complications.
But, being a doctor also means everyone else expects me to be strong every minute of every day. They expect me to beat the odds, because, heck, I’m the doctor. But I am a human, I have insecurities and fears, just like you. My training as a doctor may make me better at hiding my fears, but they are there. And those nasty cancer cells lurking in my body could care less that I’m a board certified ob-gyn with years of training and experience; they just want to divide and spread.
I used to think that being a doctor was who I was. It was integral to my sense of self and self worth. Now, I can no longer do surgery, and I likely never will return to the OR, and that’s ok. My cancer is not who I am either. I am a wife, a mother, a daughter, a doctor, a friend, an advocate, a woman LIVING with metastatic breast cancer.
Dr. Kelly Shanahan is a board certified gynecologist practicing in South Lake Tahoe, CA. She is also a wife, a daughter (of a mom who is dealing with breast cancer for the 3rd time), a mom of a 16 year old daughter, an advocate for breast cancer research and prevention, a writer and a woman living life to the fullest with metastatic breast cancer.
Want to read more Hear My Voice blog posts? Visit lbbc.org/hearmyvoice to read more posts from people living with metastatic breast cancer.