October 10, 2012
When Karen Vaniver found out she had breast cancer, she felt the color drain from her face and her body go numb, but she wasn’t surprised. She lost her grandmother to breast cancer and her mother and sister were breast cancer survivors, so she understood how devastating the disease could be.
What made Karen’s situation unique? She was a cosmetic and reconstructive surgeon who had performed breast reconstruction surgery for numerous cancer patients. This meant Dr. Vaniver already knew the difficult road to wellness she would need to navigate. Not only did Dr. Vaniver become a breast cancer survivor, her situation impacted her career by inspiring her to dedicate a large portion of her medical practice to working with breast cancer patients.
Dr. Vaniver was not alone in her breast cancer diagnosis. According to the American Cancer Society, there have been an estimated 289,870 new cases of breast cancer diagnosed among U.S. women in 2012 and the National Cancer Institute estimates that 1 out of 8 U.S. women are at risk of developing breast cancer in their lifetime. “Because there was already so much breast cancer in my family, I always secretly suspected I would eventually have to deal with it, but I never knew when it would happen. When I heard the diagnosis, all I could think of was, ‘Really? Right now, when I’m so busy with my career and my life?’ The diagnosis couldn’t have come at a worse time,” recalled Dr. Vaniver.
While Dr. Vaniver had worked with many breast cancer patients in her breast reconstruction work, she didn’t realize just how hard it was going to be as a patient. In support of October being Breast Cancer Awareness month, read this emotionally inspiring interview with Karen Vaniver, MD to find out how having cancer made her a better doctor, why she believes cancer can be used as a stimulus for positive life growth, and her advice for women diagnosed with breast cancer.
Q&A with Karen B. Vaniver, MD, FACS
Q: You previously worked with breast cancer patients in your breast reconstruction work, so you were already familiar with how difficult the treatment process could be when you were diagnosed. How did being a patient help make you a better doctor?
Dr. Vaniver: The first thing I realized was how important it is to be heard. As physicians, we can get more caught up in treating the disease than the patient. I learned it’s really imperative to take the patient’s values into account when leading her through the decision making process. The second thing I realized was how much information a person is dealt. It can be overwhelming and anxiety producing. I think it’s really important for the treating physicians to work as a team, with the patient’s needs in the center, and to be able to flex between specialties so patients receive a fairly cohesive message, even when there are multiple options.
Q: I understand you author a blog, “Cancer Made Me Nice”. Love that title! What’s your take on how cancer made you a nicer person?
Dr. Vaniver: When I was diagnosed with cancer, it was six weeks after my move to Washington State and my world was completely upended. I had recently joined a fitness Boot Camp with a group of women in Enumclaw, Washington and these women took over my life, shuttling me to doctor appointments, chemotherapy, and the emergency room. They even unpacked my house and my garage while I had every complication known to man during my cancer treatment.
Whenever I look back on that period, I know in my heart that those women’s hands were the hands that held me. I started my “Cancer Made Me Nice” blog because I needed to express my shock and fear. While the blog started out as a way to communicate about my illness to friends and family, it soon became a vehicle for me to reach out to others with the lessons I learned. Surgeons are often bred to be intolerant perfectionists, married to our egos, and respecting only our own decisions. Yet sometimes, a patient’s greatest growth is in the dying process. Cancer made me a nicer (and better) person because it taught me about the power of compassion and the courage that lies within vulnerability. My “Cancer Made Me Nice” blog honors the humanity that is so important in all of us.
Q: Tell me about the support group you founded, “Girltalk”, which I understand uses breast cancer as a stimulus for positive life growth.
Dr. Vaniver: Breast cancer is like a stop sign that hits you in the head. You fall down, you get up, you rub your head and say, “Ouch! Where was I going? Oh, do I want to go there? Maybe I want to go somewhere else?” Recognizing this as an opportunity, I started Girltalk along with six of my first patients in Seattle. Our mission was to use breast cancer as a stimulus for positive life growth. I believe that the transition from sickness to wellness is a journey, much like the Hero’s Journey in mythology, which includes a “call”, a refusal, an intervention, a sacrifice, a journey, a change, and a return. It seems that the women I treat each have their own Hero’s Journey and diagnosis is the “call.” This is so much bigger than the disease.
After one year, we opened the group to all patients, significant others, and friends. The sessions vary from month-to-month. Sometimes all of the patients are newly diagnosed. Sometimes they’re all patients who have completed treatment. It’s often quite interesting when we have a mix of patients. The newly diagnosed see the veterans, and it gives them hope that they, too, will be okay. The veterans see the newly diagnosed, and it reminds them, “I was just there, and I am okay.” They often reach out to the new patients to support them. Sometimes we have outside speakers; sometimes we just share our stories. Always, we serve a meal, donated by a company, so that no one has to worry when or how to eat. We share laughter, tears, tissues, fans (for hot flashes), and camaraderie. Four and a half years since we started, I think the most important thing we provide is a haven. When someone walks through that door, they know this is a safe place where everyone understands what they’re going through.
Q: You’re also a vocal advocate regarding educating women on their breast cancer reconstructive surgery options at the time of their cancer diagnosis. What advice would you like to give women who have just been diagnosed with breast cancer?
Dr. Vaniver: I would like women to know that while being diagnosed with breast cancer is awful, it isn’t the end of the world. You are starting on a journey, from which I promise you will grow stronger and more centered.
Here is my advice:
- You can look for an accredited breast center in your area through the American College of Surgeons Web Site at http://napbc-breast.org/resources/find.html. At a minimum, you should meet with a breast surgeon or general surgeon who has significant experience with breast cancer treatment.
- Prior to definitive surgery, you should meet with a medical oncologist, radiation oncologist, geneticist (if you are at risk for the breast cancer gene), and reconstructive surgeon. Your physicians are most effective when they work as a team. They should be able to offer you alternative options and to answer all of your questions. If you feel uncomfortable with any of your providers, it is time to get a second opinion.
- Let the people in your life help you. Never be pushed into a quick choice. Waiting a few weeks to wrap your head around the decision making process will not change your prognosis.
- Bring a “buddy” with you to your doctor appointments.
- Meet with all of your doctors, if you can, before you make your final decision. Your physicians should be able to speak to you in plain English and answer your questions. If one session isn’t enough, go back for a second session.
- Keep a pad of paper and pen by your bed, that way, when you wake up in the middle of the night with a burning question, you can write it down before you forget.
- Be clear on your values. For example, for some women, holding on to their own breast is the most important thing. If it is appropriate medically, they may be a candidate for lumpectomy and radiation. For other women, the anxiety of recurrence and monitoring the opposite breast may be enough to put a serious dent in their quality of life. For those patients, bilateral mastectomy and reconstruction may be the appropriate choice. In reconstructive surgery, patient satisfaction is most highly linked to being actively involved in the decision-making process and the relationship they have with their plastic surgeon.
- Take time to rest. This often will include taking time off from your career, and that’s okay.
- Take time to enjoy the people in your life. If you feel like you are doing nothing, remember that doing nothing is actively healing.
Lisa’s Summary: The Consumer Research Council of America recognized Dr. Karen Vaniver as one of America’s Top Surgeons and one of America’s Top Plastic Surgeons, she is a recipient of the 2012 Seattle Metropolitan Top Doctors Award, and is a past recipient of the American Medical Association’s Hero in Medicine Award. Karen is also a breast cancer survivor who took one and a half years out of her career to overcome complications related to her disease. While breast cancer could have severely impacted her life and her career, she realized having a difficult disease could actually be a blessing in disguise if she maintained a positive attitude and looked for the good that could come out of it.
I dedicate this article to all women with breast cancer and to breast cancer survivors. I challenge every woman reading this to look at their situation (no matter what the disease) and determine how it can make them a better person. I truly believe facing a major illness should not be seen as the end of the world, but as an opportunity to experience a journey that will uncover previously unknown strengths and abilities. What will you discover on your journey?
Interesting tidbit: This year, the American Society of Plastic Surgeons (ASPS) and The Plastic Surgery Foundation (The PSF) have launched the National Breast Reconstruction Awareness (BRA) Day, to take place on October 17, 2012, which ties in with October as Breast Cancer Awareness Month. Renowned singer-songwriter, philanthropist, and breast cancer advocate, Jewel, will serve as the national spokesperson.
Photo credits: Photos courtesy of Karen B. Vaniver, MD (portrait photograph by Yuen Lui). Medical photo, Microsoft Free Clip Art.