The Interlude of Cancer

Breast cancer is unexpected.

Breast cancer is life-changing.

You cannot prepare yourself for what a cancer diagnosis will feel like and what cancer treatment will be like. You may have stood by the side of a family member or a friend as they navigated their own breast cancer journey. You may have participated in fundraising efforts and walked in a sea of women awash with pink to support breast cancer awareness and research efforts. You may have felt the mild tinge of nervousness as you waited for the results of your annual screening mammogram. Despite all this, that phone call with the news that “you have breast cancer” will stop you in your tracks and even bring you to your knees.

I am a breast medical oncologist and when I graduated from my hematology/oncology fellowship at New York University School of Medicine and started my first job as an attending physician, I focused on the clinical aspects of breast cancer. When I met a woman for the first time with a new cancer diagnosis, I had a well-rehearsed speech full of statistics, treatment plans, lists of drugs, and side effects. I wanted to make sure that I was giving all the information that someone needed to make their treatment choices. I didn’t want to leave anything out. Over time, I realized that while I was providing evidence-based recommendations for medical care filled with the most up-to-date research and latest clinical trial results, I still didn’t completely understand what it was like to have breast cancer.

I distinctly remember an interaction I had with a young patient several years ago. She was in my office before her next cycle of chemotherapy, which was scheduled for later that morning. I asked her how the prior cycle had gone.

“How was this last cycle of chemotherapy?” I asked my patient in the exam room. She was there for a routine follow-up visit before her next cycle of chemotherapy, which was scheduled for later that morning. She sat on the examining table, wearing a wig that was irritating her newly bald head, and a paper-thin gown that didn’t cover much.

“It went okay. I had some nausea and constipation but I am managing.”

“How has your mood been these past few weeks?”

“It’s fine. I’m doing okay.”

At this, I tried to probe more and asked, “How are your children coping with everything?”

Her eyes welled up with tears. I waited patiently, silently giving her the space and permission to open up more. A few minutes later, she shared that she was in too much pain and discomfort to take her four-year-old son to the playground and that her eight-year-old daughter was struggling with her mom being bald. She told me about the increased stress that chemotherapy was placing on her husband and their financial situation at home.

In that moment, all I wanted and all she needed was for me to sit and hold her hand and just listen to her story. In that moment, every cliché cancer quote about her strength and bravery was wrong. There was nothing I could say. I could not make it better. I could only listen.

However, that wasn’t possible. I didn’t have the time. There were other side effects to address, other patients to see, labs and scans to review, appointments to schedule, notes to write…and the list goes on. But I was unsettled. I wasn’t truly understanding how cancer treatment really affected my patients. It was becoming clear to me that if I, as an oncologist, didn’t completely “get it”, how could others?

As such, I started asking for more personal information. I started to have conversations with my patients about their mental health, financial toxicity, parenting with cancer, and interpersonal relationships, among other things. There is so much more to a breast cancer diagnosis than management of hot flashes, early menopause, and low blood counts, and it is those other layers that distinctly shape a woman’s experience with cancer. I then knew that I wanted to speak to women experiencing breast cancer outside of the fifteen-minute office visit. I wanted to hear more. Out of this, the Interlude Podcast was born, so aptly named, as cancer creates an interlude in life. I initially wanted to create a space for women to share their experiences in an effort to provide support, encouragement, inspiration, and hope to other women also navigating through their own cancer journey. It has become so much more than that.

The conversations that I have had on the podcast have changed my perspective on cancer. They are deeply personal, vulnerable, and transparent. I have learned that the emotional repercussions of a cancer diagnosis and treatment go far beyond what I ever imagined. I have learned that patient shaming and blaming are pervasive and very often occur in the medical field through the language that we use. I have learned about the critical importance of patient advocacy and empowerment. I became a better doctor.

Now, over one hundred podcast episodes later, I truly believe the patient stories that I have had the privilege to share are the human experience of cancer. They have made me rethink my perspective and my approach as an oncologist. Simply put, they have changed me.

This article was featured at our August 2022 Perkatory. Click here to learn more about Perkatory and sign up for an upcoming Perkatory!