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Doctors Get Cancer, Too

When I found myself on the other side of the consultation table.

Nagashree Seetharamu, MD | Photo credit: The Well

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Nagashree Seetharamu, MD, is a medical oncologist specializing in cancers of the head and neck and thoracic malignancies. She serves as the institutional principal investigator on many clinical trials at Northwell Heath and associate program director for the hematology/oncology fellowship program at Donald and Barbara Zucker School of Medicine at Hofstra/Northwell.

It was two years ago. Our children were 3 and 8. Winter break was coming and our family was looking forward to a Caribbean vacation for some much needed sunshine and family time. A lot of exciting things were happening in my life and I had just started a new job as a medical oncologist at Northwell Health. Amid the vacation planning, I had an appointment with my primary care physician who had been urging me for months to get a mammogram. I had been putting off the test and the ever-changing guidelines made for an easy excuse. I finally got around to scheduling it, and it happened to be two days before our trip.

I have no family history of breast cancer. I had been doing breast self-exams for years. I assumed the results were going to be normal. Anything to the contrary was not on my radar. So when the radiologist walked in and said she thought she saw something in there, I could not have been more shocked.

My mind went racing. My life was packed with activities. I had patients to see, research projects to work on, grant applications to apply for, school functions to attend, and suitcases to pack. What was happening? My smooth-sailing boat was entering a turbulent zone.

The following day was a whirlwind of additional diagnostic tests and biopsies. And then before I knew it, I found myself on a plane to Barbados. Much to the consternation of my radiologist, I insisted she call me with the results as soon as they were available. But I already knew. I had seen the films.

Three days into our vacation, I got the call that would shake me to my core. I had cancer. I thought I knew how it would feel. I thought I would be prepared. I thought I knew what feelings would emerge. I work with cancer patients every day. But I was unprepared for the flood of uncertainty that would follow.

Only in my early 40s, thoughts of “I’m too young for this,” and “How am I going to get through this?” filled my head. I began anticipating the coming weeks and months. I started thinking about the next steps, which felt particularly daunting because I knew so much already—I have seen the worst of the worst. What I knew was haunting me and I couldn’t sleep.

“I thought I knew how it would feel...I work with cancer patients every day. But I was unprepared for the flood of uncertainty that would follow.”

The doctor in me began to think about what could go wrong. But the patient in me was able to find some optimism. Maybe it wouldn’t be so bad.

When we returned home, I walked a tightrope—I immersed myself in work because I found that when I did that, I was able to forget about myself. My work kept me grounded. I was the doctor and I was well informed. But when I was home, it was a different story. I was the patient and I didn’t know what to do with that. I went through moments where I would just cry. Just like many women in this situation, I went online to research my condition, even though I was quite knowledgeable about the disease and its treatment. I checked for any recent updates reported in medical literature and read all the blogs. It seemed like I had dual personalities—one was confident and the other vulnerable.

The one thing I knew for sure I had going for me was that I was already in the right place to be treated. My colleagues, with whom I had consulted for patients, suddenly became my treatment team and I left myself in their very capable hands. I made it through a lumpectomy with relative ease. I was relieved to find out that I had early stage breast cancer and was looking forward to finishing up radiation and starting hormonal treatment. However, molecular tests of the tumor revealed that I had intermediate risk for disease recurrence, and this meant that there were two possible directions in which I could have gone. I found myself having internal debates about which path to choose. Ultimately, the patient in me won and I did everything that my team recommended—including chemotherapy.

It was interesting—as a doctor, I was confident and “take charge.” But as a patient, I wanted to be cared for and told what to do. I wanted someone with the right experience to guide me. Surrendering to the experts turned out to be the right decision. As the weeks and months unfolded, I saw how perfectly orchestrated everything was. And I felt comfort not just for myself but for the countless patients I had been treating all these years who were terrified and vulnerable and brave enough to leave their lives in our hands. So, I decided to proceed with chemotherapy as recommended by my oncologist. I had treated several patients with the same chemotherapy drugs and I thought I knew how I would tolerate them.

However, what ensued was not something I had ever expected. For the first time, I realized how much I love my hair. In the past, when patients told me of their fears about losing their hair, my head and heart would silently respond with “It’s just hair. It’ll grow back.” I never understood the profound impact one’s hair could have until I faced the prospect of losing my own. And lose it I did. That physical change was harder on me than I was expecting. I think because now people would look at me and think, “That’s a sick person.”

I bought a few wigs to wear. My son was particularly impacted by this physical change. He wrote some essays in school regarding this and tried to minimize his feelings, and mine, with humor. He would wear my wigs and masquerade around the house with them. To this day, he still talks about them as he processes our cancer experience. And it was “our” experience. Because this disease affected everyone, no matter how hard I tried to prevent exactly that. Side effects such as mild constipation which I never thought could interfere with life made my life miserable. The cramps and aches that I had after each treatment felt unbearable at times.

I’m on Tamoxifen now and I have been experiencing some of the weirdest side effects from it. I’ve realized that I now have a new normal and I am still adjusting to it. Every time there is a scan ordered or there’s a concern, every time I feel an ache somewhere in my body, I wonder if my cancer is back. But I’m trying not to let it make me nuts. I’m treading carefully and trying to find balance. I fully trust my team of doctors and rest my mind by knowing that they would always look out for my best interest.

“I never understood the profound impact one’s hair could have until I faced the prospect of losing my own.”

The lessons I learned from my cancer journey have been invaluable, as it gave me quite a different perspective on things that I didn’t really place a lot of importance on before. I don’t know if I ever knew what the experience would be like before I actually experienced it for myself. It’s a very unique education that I got. And I’m a better doctor and better person for it.

My most heartfelt thanks to Dr. Lora Weiselberg (medical oncology), Dr. Lucille Lee (radiation oncology), Dr. Dominic Filardi, (surgery) and so many others who formed my star-studded cancer care team.

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Published July 10th, 2018

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