One in 8 women will have breast cancer in their lifetimes
Nurse says she got through breast cancer with "prayers and a lot of laughter"
Pathologist urges patients to continue doing the things they enjoy
When new patients worry they don’t know how they’ll get through breast cancer, Cindy Davis puts her hand on theirs and says, “I know, but I want to tell you, I truly know, because I went through this two years ago.”
“Their eyes light up and they go, ‘Whoa. Really?’” says Davis, 54. “Suddenly, I’m a human being. I’m not just the nurse.”
Having breast cancer didn’t stop Davis from continuing her work in the Department of Breast Medical Oncology at the University of Texas M.D. Anderson Cancer Center in Houston. It also didn’t stop Dr. Kimberly Allison, a pathologist at the University of Washington who diagnoses breast cancer, a condition that one in 8 women will have during their lifetimes.
These two women have continued their efforts toward optimizing the health of others while going through breast cancer therapy themselves. The disease has changed the way they view their jobs and allowed them to reach out to breast cancer patients in new ways.
“There have been times I’ve cried with the patient. You cry with them, you pray for them, you hope for them. You pray for their families. It’s a tough job, but it’s very rewarding,” Davis said.
’Why am I doing so good?’
Davis’ cancer journey began in 2000 when she was working as a case manager at a major insurance company, at age 43. Her very first mammogram caught a small stage 1 tumor. She felt upset and scared because she didn’t know much about cancer at that time, but doctors reassured her that it was treatable because they’d caught it early. She had a lumpectomy, a lymph node biopsy, radiation and medication, which appeared to eliminate the disease.
Her career took her to M.D. Anderson about 10 years ago, where she worked in various divisions before arriving at the breast center, which became her favorite place to be a nurse.
While she helped others with their cancer experiences, she believed she was free of it herself until 2009, when a pain developed in her right hip that wouldn’t go away. Her boyfriend told her to get it checked, but she thought she had just been working too hard or lifting too much. Finally she got an X-ray and, at the doctor’s unusual request, a CT scan.
On a Saturday morning, the doctor called her in. The scan had found possible metastatic breast cancer, stage 4, in her hip. Some of the cells from the original breast tumor must have migrated there in 2000, remaining dormant for years until they started eating away at the bone.
Davis knew what that most likely meant: Death in two years.
That knowledge cast a shadow when, the day after her first chemotherapy treatment, her boyfriend took her to the outdoor wine bar where they’d had their first date. He got down on one knee, opened a jewelry box to reveal a ring, and started singing the Michael Bublé song “That’s All.”
“I said, ‘No, you don’t understand what stage 4 cancer means. You don’t know what’s coming and I do. It’s more than you know.’” Davis recalls. “He just kept saying ‘I don’t care.’ I love you. I don’t have a life without you.’ “
Dennis and Cindy Davis got married while she was having chemotherapy treatments. She wore a wig for the wedding.
Davis didn’t notice her hair was falling out until the couple went on a cruise to Mexico. As she combed it, handfuls started coming out, and she began to cry. But Dennis Davis already knew, and had been cleaning it up so his wife wouldn’t see.
“That’s what makes you a woman: having breasts, hair, nails. When they take that way, you feel like an ‘it,’” she said. “Every time you look in the mirror it’s a reminder: ‘I have cancer.’”
Davis now relates all too well to patients. She urges them to treat themselves to nice wigs – insurance usually pays for one – recommending the shop where she bought her own, and the scarf shop at M.D. Anderson. Hair grows only about a half-inch a month, but some women choose to keep it short once it starts coming back in, just because it looks great, she says.
“You just got to keep your chin up and, I tell people, just try to laugh,” she said. “That’s how I have gotten through this: A lot of prayers and a lot of laughter.”
There were days during treatment that she could barely walk; other days she’d go to work and cry all the way home over her patients and herself. Her husband suggested quitting, but, beyond the money and insurance benefits, Davis wanted to take her mind off her own problems by helping others. She sensed patients’ appreciation of being able to share their experience with a nurse who was going through the same thing.
“You’re not the nurse that’s just spouting off, ‘OK this is what we do for side effects.’ You can say, ‘Well, this is what I did: When my nails started changing, I put fingernail polish on.’ I give them tips.”
Her treatment began with paclitaxel injections (Taxol) for 12 weeks, followed by a regimen of fluorouracil, doxorubicin (Adriamycin) and cyclophosphamide (Cytoxan) that ended in December 2009. Chemotherapy appointments were Fridays at 5 p.m. so she could continue working and have the weekends to recover, although she did have to miss some work days because of chemo-related illness.
She also received the intravenous zoledronic acid (Zometa) to strengthen her bones monthly and the anti-hormone drug anastrozole (Arimidex). There were also six weeks of radiation to her right iliac bone, which she’d have early in the morning before work.
She continues to take Arimidex and receives an injection of a bone-strengthener called denosumab every other month, in addition to having regular scans and lab tests.
These days Davis’ scans suggest that she has, once again, beaten cancer. She’s thrilled, but can’t help but feel a sense of survivor’s guilt at the hospital.
“When I see my patients and one of them is doing poorly, I think, ‘Why am I doing so good and they’re not?” she said. “But I’ll take it, whatever the reason is. I am thankful for every day.”
The sunny side of chemotherapy
It was one of the bigger cancers that Dr. Kimberly Allison had seen as a pathologist. And it was in her own breast.
Allison’s 7-month-old son was still breastfeeding when she noticed the upper part of one breast seemed slightly firmer than the other, and it wasn’t going away. Her husband persuaded her to get it checked, even though she wasn’t worried. She was only 33, and had just taken over as director of breast cancer pathology at her hospital.
“My poor colleagues had to come in and tell me the news,” she said. “I felt like Alice in Wonderland. It was bizarre, not something you ever expect to happen to you, certainly not when you specialize in diagnosing something.”
The large mass turned out to be stage 3 cancer, and it had taken up so much of her breast that merely removing the lump was not an option. She’d need six months of chemotherapy to shrink it before surgery.
Allison chose to have a bilateral mastectomy – complete removal of both breasts, so she wouldn’t have to worry about screening the unaffected breast so often in the future. The surgery took away all residual cancer, but she still needed to have radiation.
“My director asked me after I was diagnosed: ‘So do you still want to specialize in breast cancer?’” she remembers. “‘We can talk about moving you to a different field if this is going to be too hard. Do you want to do prostate instead?’”
But Allison refused to leave her work.
“I wanted to keep doing the research I was doing. I felt even more obligated to continue in breast because I knew what it was like now to go through treatment and through the whole experience from the patient side,” she said.
Unlike Davis, Allison has good memories of losing her hair. In college, Allison’s husband had been a member of the University of Washington’s rowing team, which has a ceremony for freshmen to shave their heads. The coach was a family friend, so Allison got to lose her hair in the captain’s chair.
“It was this initiation instead of crying over the sink,” she said.
Cancer treatment had its low points, but it wasn’t as horrific as Allison thought it would be.
Chemotherapy seemed scariest during the first visit. Over six months she was given doxorubicin (Adriamycin), nicknamed “the red devil” because of its nasty side effects and its fruit-punch color, as well as cyclophosphamide (Cytoxan) and later paclitaxel (Taxol), three drugs that Davis also received. Allison found the nurses and support staff made her feel comfortable, and she received other drugs to manage side effects.
“I tried to think of it as my spa treatment,” she said of chemotherapy. And treatments became opportunities to spend quality time with her husband, who had been previously busy with a restaurant he’d opened just before her diagnosis.
Radiation involved a robotic arm shooting a laser beam into her, but each session was fast. It did give her skin problems, but “you heal and move on,” she says. She also took trastuzumab (Herceptin) for a year.
“You can still, even while getting treatment, go on a hike. Go on vacation. Do the things you enjoy. You don’t really have to stop living,” she said.
While Allison feared leaving her children behind if she succumbed to cancer, her daughter Maddy, who is now 8, enjoyed having her parents and grandparents around more at that time. Maddy even thought her mother’s baldness was cool. “She’ll notice one of those little pink ribbons and she’ll be like, ‘Mom, chemotherapy!’ like it was a good time,” Allison says.
Allison’s initial diagnosis was in March 2008, and she’s cancer-free. The experience has made her crave patient contact, since her primary interactions as a pathologist are with physicians. She wrote a recently published memoir, “Red Sunshine,” as a way to reach out to patients, and meets breast cancer survivors regularly while giving book talks. “Red sunshine” is what she renamed the “red devil” drug, reflecting her determination to view the situation in a positive light.
Today, she teaches her residents to get results out that are accurate and fast, since Allison remembers the anxiety of waiting for the report that informed her of the cancer growing in her body.
“I know what they’ve been through now, and I want to tell them when I’m writing up my report giving them the diagnosis I know is going to totally change their lives,” she said. “I wish I could be there.”