In The News

Caretakers cope with cancers of their own
Breast cancer can strike even those who make their careers treating it.

By BLYTHE BERNHARD
September 18, 2005
The Orange County Register

"I didn’t care about me. I didn’t care about my breasts. I just wanted to be around for my child." - Dr. Lisa Curcio

Michael Kitada, The Orange County Register
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Dr. Lisa Curcio didn't want her breast cancer patients to see her cry. That's why the surgeon was hesitant initially to divulge her own battle with the disease.

"I waited my whole life to set my career up and have my kids. (Cancer) happens and it deflates your plans," Curcio said. "I couldn't share that without becoming emotional."

Nobody is immune to breast cancer, including the physicians who treat it. When a doctor becomes the patient, the new perspective makes an impact in different ways. Some talk about it with their patients. Others become more empathetic. And they all recognize how terribly indiscriminate the disease can be.

While stationed in Biloxi, Mississippi as a surgeon with the Air Force, Curcio had her first mammogram at age 35. It was normal.

The next year she gave birth to a son and after six months of breastfeeding, one of her nipples started to bleed. The new mother attributed that to an eager feeder and tender nipples. When the bleeding continued after she stopped nursing out of that breast, Curcio got another mammogram.

She read the x-ray herself and immediately knew what the new dark spots meant. After her colleague performed a biopsy, Curcio walked her own tissue specimen to the lab.

Because of the extent of the cancer in her breast, Curcio needed a mastectomy. She knew it would be too emotional to undergo surgery in the same operating room where she worked, so Curcio went to San Antonio. Eight months later, she had her other breast removed as a precaution.

For a long time before having a healthy second child, Curcio was afraid to get pregnant again. She thinks her first pregnancy may have hastened the progress of the cancer because her mammogram results had changed so quickly.

Curcio, now 42, divides her life experiences into before and after cancer. Surviving cancer is something that changes you, she said.

"Every time you have a pain somewhere you wonder," she said. "You can really torture yourself by thinking about the what-ifs. Yes, it may come back, but you can't live your life in fear."

Now working in Mission Viejo, Curcio chooses carefully which patients she will tell about her cancer because she doesn't want her choices about treatment to influence their own. Just because she chose a double mastectomy doesn't mean that's right for everybody, she said. For Curcio, motherhood was the deciding factor in taking the aggressive route.

"I didn't care about me. I didn't care about my breasts. I just wanted to be around for my child," she said.

It's easier today for Curcio to talk about the experience. When she feels it's appropriate, she'll share her story with a patient who is particularly conflicted.

"The lack of control, the feeling of being betrayed by your own body, I experienced first-hand," she said.

The surgeon has never once thought about not working with breast cancer patients, she said.

"If anything it made me more passionate," Curcio said. "I'm doing what I'm supposed to be doing."
 

'IT'S MY TURN'

Like most women who develop breast cancer, Dr. Lauralyn Markle had no family history of the disease. The director of the Memorial Care Breast Center at Saddleback Memorial discovered her cancer in 2003 after a yearly mammogram. It did not come as a shock, Markle said.

"One out of seven of us is going to get it," she said. "I just thought, 'Oh great, it's my turn.' "

Getting the disease was more of a "nuisance" than a crisis for Markle. As a breast cancer expert, she knew about treatment choices and possible outcomes.

"A lot of anxiety is fear of the unknown," said Markle, 52. "I knew it was curable."

Markle usually doesn't tell patients about her breast cancer because she wants their interactions to be about the patient and not the doctor. Having breast cancer didn't change the way Markle diagnoses a patient or tells them their prognosis, she said. The only difference is now she has practical advice for what to expect after surgery.

Roxanne Wodarck, a mammogram tech assistant at Saddleback, is one of Markle's breast cancer patients who knew what her doctor had been through.

"I was extremely comforted with the fact that she was so open about her breast cancer," said Wodarck, 50. "It certainly gave me complete trust and confidence in her opinions."
 

CAUGHT OFF GUARD

Dr. Carolyn Kaelin, director of the Breast Health Center at Brigham and Women's Hospital in Boston, wrote "Living Through Breast Cancer," which combines patients' and her own experiences, recent research and advice.

Kaelin, 44, discovered her breast cancer two years ago when training for a 190-mile bike ride for cancer research. When she took off her sports bra one day after a practice ride, she noticed a slight inward pulling of the skin on her right breast.

"If my vocation was not as a breast cancer surgeon, I would not have noticed it at such an early stage," Kaelin said. "It was very, very subtle."

A mammogram she had the next day turned out normal, but an ultrasound and biopsy revealed the cancer.

"To be told that I had breast cancer very much caught me off guard," Kaelin said. "I know this isn't a rational thought, but having a vocation for over a decade where I care for women with breast cancer, I thought I should have some immunity to this particular condition."

While undergoing chemotherapy, Kaelin wrote the book at the urging of her patients. When patients ask about the metallic taste in their mouths during chemotherapy treatment, Kaelin can tell them that cinnamon gum helped her. She knows about acne flare-ups, nausea and fatigue during treatment, because she experienced it, too.

"It is helpful to hear that somebody's struggles are credible, are common," Kaelin said. "To be validated during the difficult parts of treatment can be very liberating."

Kaelin said since her diagnosis she is even more aware of the disease's uncertainty.

"Breast cancer really has no boundaries; it can affect anyone at any time," she said.

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