Breast Cancer Pathologist, Author of
Red Sunshine, Shares Her Story
at the 2012 ASCP Annual Meeting
Kimberly Allison, MD, knows both sides of the breast cancer experience: as an expert in breast cancer pathology and as a patient. Diagnosed with stage 3 breast cancer two weeks after she was promoted to be Director of Breast Pathology at the University of Washington Medical Center, Seattle, Dr. Allison wrote about her experience as a patient in her book Red Sunshine. Just 33 years old and nursing her second child in 2008, she turned a terrifying diagnosis into an inspiring memoir about her yearlong journey from diagnosis, treatments, and surgeries to survival.
At the 2012 ASCP Annual Meeting, Dr. Allison will serve as a panelist for the general session on women's health care, Advancing Patient-Centered Care for Women Across Our Globe: The Laboratory is Part of the Puzzle, to be held on Nov. 1. Below is the first story of two articles for eNews Briefs from an interview that ASCP Director of Communications Sara Patterson conducted with Dr. Allison about how her life has changed after breast cancer, why training pathology residents is so vital, and why she seeks more direct interaction with breast cancer patients.
Question: Why did you decide to serve as an expert panelist for the General Session on Women's Health Care about Advancing Patient-Centered Care for Women Across the Globe: The Laboratory is Part of the Puzzle at the ASCP 2012 Annual Meeting?
Answer: ASCP has the right idea: focusing on how important the pathologist's role is in patient care on a global scale. I am getting the message across with a personal story. It's important to send the message that pathologists are a huge part of the healthcare team. Diagnostics are crucial to ensuring patients receive the right treatments. We are entering the golden era for pathologists where the histologic, molecular, and genetic information we provide is being used in exciting new ways, and we need to educate clinicians and global health leaders about the value we provide as diagnosticians and consultants. It's also important to remember the patient side and what our impact is for them. Every time we hear a patient story, we should take our jobs more seriously. We need to remind everyone in the laboratory that we cannot put that test off until tomorrow because someone is at home crying about it.
Q: Why is important to advance patient-centered care for women globally?
A: My perception is that some women, particularly in third-world countries, are shunned after being diagnosed with cancer. We know cancer patients are valuable members of society, and they can recover from cancer. As cancer survivors, we're not lesser people because of our diagnosis and treatment. We need to educate people globally, so that cancer does not have a social stigma. When that happens, more women will be screened earlier and not diagnosed at stage 4.
Question: Why did you write the book Red Sunshine about your personal experience as a breast cancer patient?
Answer: I wanted to reach out to newly diagnosed breast cancer patients more directly and writing Red Sunshine was an effective way to do that. By sharing my personal story, I hope to help demystify what can be a very fearful experience. So the book is both personal and educational in a way. As pathologists, we so rarely interact with patients. However, now I talk to support groups and oncology groups because I can be personal and help them both understand more about the biology of breast cancer and what it is like to go through treatment. I have even had some patients want to review their biopsies with me after reading my book.
Q: How has your experience as a breast cancer patient informed how you diagnosis patients as a breast cancer pathologist?
A: I think it's really changed in several ways. I am keenly aware of treatment decisions for breast cancer patients. I have gone through almost every treatment available and know the clinical impact these can have on a patient. That knowledge makes me think very carefully about each detail of a diagnosis. Breast cancer diagnosis has become more complex; we cannot treat all breast cancers the same. Pathologists have to tell the oncologists more.
In breast cancer, it's all about the details of the patient's treatment. Is there focal angiolymphatic invasion or more extensive invasion? Does the sentinel lymph node have micrometastic or macrometastic disease? We find out more details about the biology of breast cancer by conducting ancillary tests. If the cancer is hormone receptor positive, she may benefit from hormonally targeted therapies. If a cancer patient is HER2 positive, she can receive Herceptin or other HER2 targeted biologic therapies and increase her chances of surviving a more aggressive type of breast cancer. Because these studies make a patient a candidate for specific therapies, it is critical for us to get them right. I know personally how grateful I was to be a candidate for HER2 targeted therapy given how aggressive my cancer was.
Also, I take it seriously that tests, such as fluorescence in situ hybridization (FISH), need to be performed faster, so decisions about clinical care can be made more quickly. When a patient is diagnosed with breast cancer, it's a terrifying no man's land until the patient knows her treatment plan. Without a treatment plan, the patient's fears become magnified. I work with my colleagues to make the turnaround time in the laboratory faster for the right diagnoses.
I teach the residents in the University of Washington Medical Center program about the clinical impact of diagnoses. When do they need to be wary of a certain test results? When do certain results need to be repeated? What are the red flags? When I tell them my personal story, it makes a big impact on trainees, so they think more about their role in patient care. We are training the next generation to consider themselves as diagnostic oncologists working with clinical oncologists.