By Donna Valentine, PA-C
I have never had breast cancer, although it’s played a role in my daily life for over two decades. And I wouldn’t have it any other way.
My career path as a Physician Assistant (PA) was introduced to me in the spring of 1999, when I was fortunate enough to do a clinical rotation in breast surgery at MD Anderson Cancer Center in Houston.
I knew the moment I stepped into the operating room with one of the premier breast surgeons in the country that I had found my passion in taking care of breast cancer patients. I liked assisting in surgery, but I loved helping breast cancer patients navigate their journey through an overwhelming and scary time. I’m an intuitive listener and have a fairly calm demeanor, and I knew I could make a difference in assisting their overall physical and emotional healing. I returned to school in California and declared my goal of specializing as a PA in breast cancer! My classmates and professors insisted I would never find a job in that field because it was too subspecialized.
How wrong they were. After graduation, I spent five solid years working with a dynamic forward-thinking team of breast surgeons, assisting in surgery and patient after-care, educating patients on their diagnosis and options. In this, we saved hundreds of lives and affected thousands of others through their loved ones, because a person never goes through this alone. Cancer is a crab, reaching out in all directions of a person’s life, touching everyone who is close.
Toward the end of my tenure in surgery (I had decided to change my focus to Medical Oncology), I received a call from my older sister Diane. She had been having some breast changes and the radiologists wanted to do a biopsy. “They think it’s cancer,” she said. And unfortunately, it was. My role as a PA for my patients would now include the role of caregiver for my sister with that one phone call.
I’m not a believer in coincidence, but it wasn’t always that way. So I didn’t think twice when during my rotation at MD Anderson I came across Susan G. Komen founder Nancy Brinker’s book The Race Is Run One Step at a Time. It’s about the legacy she built to honor her sister Suzy, who passed away from breast cancer. The story resonated with me, and at the time I wasn’t sure why, but it was one of the reasons I became so interested in working with breast cancer patients. I would find out later that the story about her experience with her sister would be similar to Diane’s and mine. Not a coincidence.
While Diane was going through the surgical portion of her treatment, I was still working in surgery. When she started her chemotherapy, I had already begun working with an oncologist. In retrospect, her treatment matched my career transition in a way that seemed “planned.” I would travel to northern California to go to appointments with her and help navigate her treatment and aftercare with her doctors.
Walking the tightrope between taking care of my patients and being there for my sister took its toll on me — primarily because before starting chemotherapy, Diane’s body scans had shown the cancer had metastasized to her bones. Stage 4 breast cancer. In 2004, the prognosis for this was not good. Giving her hope every day came with a heavy burden of knowing what the ultimate outcome would be. My heart was breaking, but I wasn’t going to show it. Couldn’t show it. I needed her and my family to be strong.
There were good times and bad times through her treatment, and then there were really, really bad times. And like Nancy Brinker’s sister Suzy, Diane passed after a three-year battle with breast cancer. Every day I was there for her, and I held her hand as she left this world. I saw and felt her fight. I still feel my own fight after 17 years, and I miss her every day.
I consider myself a co-survivor because I discovered a strength in this fight and as difficult as it was, scars and all, I would repeat it again and again to help my big sister during the toughest and scariest part of her life.
Donna (left) and her sister Diane (right).
After Diane died, I did a lot of soul searching. But unlike Nancy Brinker, I did not start a global movement to end breast cancer. What I did do was continue taking care of breast cancer one person at a time. For another seven years I continued to work in medical oncology. Because of my journey with my sister through her breast cancer fight, I am a much more empathetic and compassionate clinician from a place of knowing. I engage with my patients and their families better. I am equipped to say the “right” things — which I’m embarrassed to say I didn’t always do prior to Diane’s diagnosis.
There are times when a patient begins to cry in my exam room. Something I did or said allowed them to let their fear and anxiety out. It’s then I know I’m doing something right. They feel safe. Safe enough to let their feelings out — sometimes for the first time. And that release is so important to the healing process. The beginning really.
I continued to work in medical oncology for a few years until I received an opportunity to be involved in another part of the breast cancer experience — survivorship. For six years I specialized in caring for cancer survivors from a primary care aspect. I managed my patients’ overall health; their high blood pressure, diabetes, elevated cholesterol, low thyroid, depression, anxiety, etc. All the while, I was taking into consideration their previous cancer, their specific treatments and all that entailed for them as a survivor physically and emotionally.
It was during this time that I became very interested in ways of helping the emotional anxiety that cancer survivors experience. I feel it’s the most debilitating thing about having cancer that never goes away completely. I was so tired of writing prescriptions for anti-anxiety and anti-depression medications. I hated that my patients were living on these pills and needing more and more to get relief.
I started exploring more complimentary ways of dealing with the emotional component of cancer, and what at the time I considered a type of PTSD (since then, there have been articles written about just that). I spoke to my patients about the benefits of therapy, meditation, mindfulness and gratitude work and movement therapies like Tai Chi and yoga. I also learned and shared more about nutrition, functional genetics that put some people more at risk for anxiety, and the importance of sleep on our overall emotional and physical health. Some of my patients embraced these things, and some did not. Getting people (cancer survivors or not) to take care of themselves is a difficult task in our society. There are a lot of things that get in the way — such as time, money, energy, all of which can be hard to come by these days.
Diane (left) and Donna (right).
People often ask if I chose to work with breast cancer due to my sister’s diagnosis. My response is: before my sister even had breast cancer I was guided in that direction. And I believe it was because my sister and my family would need me there at that brief moment in time. No coincidence there. The remainder of my work has been for others. And if I can be honest, for me. Because I am rewarded every day by helping my patients and their loved ones move through breast cancer.
I am now back to my roots working as a surgical PA — so I’ve made a full clinical circle of a breast cancer patient’s experience. Treatments have vastly changed and improved over the last two decades. More people are surviving this dreaded disease, and I look forward to someone putting me out of business by finding a cure. But until then, I will be a dedicated caregiver of cancer survivors, hand-holder and hugger during good times and grief, educator, and advocate of all things that can be done to live a happier, healthier, and better life than ever before breast cancer.
Diane.
Be Well & Happy.
Donna Valentine
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