Breast Cancer Survivor
Kimberly H. Allison, MD
- Director of Breast Pathology, University of Washington Medical Center
- Diagnosed with stage III breast cancer at age 33
- Treated with surgery, chemotherapy, and radiation therapy
- Author of Red Sunshine, a memoir about her journey from diagnosis through treatment for breast cancer
Her doctor ordered a mammogram and an ultrasound, which revealed a large mass. A biopsy of the mass was taken and sent to the same lab where Kim works.
As the director of Breast Pathology at University of Washington Medical Center, Kim spends her days examining breast biopsy tissue slides under a microscope to classify them and diagnose the stage of disease as well as many other characteristics. In a typical day, she looks at four to eight biopsies a day. Usually the finding is not cancer. However, when it is cancer, she works with the oncologists so they are aware of the biology of the cancer and what treatments will be most helpful.
“It was so surreal carrying my own biopsy to the lab. I never thought I would see my own name on a sample label, but there it was: ‘Kimberly Allison, 33 y/o female.’ It was like a strange lab experiment.”
Kim gave her biopsy to a colleague and asked her to bypass the resident ‘for privacy sake.’ Since she had no family history or other reason to suspect breast cancer, Kim was confident her sample would be benign.
She received her diagnosis the next day at work. Usually radiologists or oncologists, not pathologists, deliver the news to patients. However, in Kim’s case, her colleagues delivered the news themselves.
“It was difficult for them too. They came into my office and I realized by looking at their faces the news was bad. When I asked them if it was cancer, they nodded and started to cry. At first they cried more than I did. I was just in shock. I felt like Alice in Wonderland. The world had turned on its end. Nothing made sense anymore.” As she thought about what the diagnosis meant to her and her family, the reality of her situation sank in and she too began to cry.
Kim knows the breast surgeons and oncologists at SCCA well since she presents the pathology of all the breast patients to them. She was about to get to know them on a whole different level.
She was diagnosed with stage III breast cancer at the age of 33—seven years before the age at which routine screening by mammography is generally recommended. Mammography, and sometimes ultrasound, can pick up cancers rarely felt by physical exam—the tiny, more curable cancers that she routinely diagnoses. Often by the time cancer is found on self-examination, it is large. In Kim’s case her cancer had already spread to one lymph node and was seven centimeters, much larger than the one- to two-centimeter cancers she typically sees in her laboratory. And as if that weren’t enough, her cancer turned out to be one of the most aggressive forms of breast cancer. The tumor cells lacked hormone receptors associated with more curable cancers, but over-expressed receptors for a growth factor called HER2, which, while associated with more aggressive disease, could also be directly targeted with newer biologic agents.
“There’s never a good time to have cancer,” Kim says. “But this was clearly one of the worst. I had just gotten a promotion and was working full time, my husband had recently opened a new restaurant, and I was nursing my infant son and had a 4-year-old daughter.”
She immediately began six months of chemotherapy, including three months on Adriamycin and Cytoxan, followed by three months of Taxol, which was combined with a year of Herceptin, under the direction of Georgiana K. Ellis, MD. She had a complete response to her treatment. Her main side effects were mild nausea and fatigue. And, of course, she lost all her hair. Throughout her entire treatment, Kim worked part- or full-time, with time off only to recuperate from surgery.
Once she was cancer-free she had both breasts removed and reconstructed (with Kristine E. Calhoun, MD) and underwent radiation therapy (with Janice N. Kim, MD) to further reduce the probability that cancer cells in her body might cause a recurrence in the future.
“Having a double mastectomy is a very personal decision,” she says. “For me, I didn’t want to go through increased screening for my entire life, which I hope will be long. I didn’t have a strong emotional attachment to my breasts and was very satisfied with the concept of reconstruction.”
As she was going through treatment, Kim found it really helpful to hear from other patients about their experiences and emotions.
“There are lots of guidebooks out there for women with breast cancer,” she says. “But I wanted to know what happens beyond the science, what the treatment was like emotionally and physically. It’s a really fearful time when you’re first diagnosed. The unknown probably created more fear than actually going through the process itself. Reading about and talking about the experiences of other survivors gave me strength and helped calm my fears, so at the end of my treatment I wrote Red Sunshine. I hope my story will help enlighten the journey for other patients.”
The book’s title reflects the positive attitude that helped her weather the challenging treatment, which she completed in 2009. One of the drugs often given to women with breast cancer is Adriamycin, a bright red liquid delivered intravenously. Many patients call it the “red devil” because of its terrible side effects—severe nausea, constipation, mouth sores, and serious declines in infection-fighting white blood cells. But Kim renamed the drug ‘red sunshine’ and chose to regard the therapy, “as my ally, not my enemy. I looked forward to getting it every week. Thinking of that drug as ‘red sunshine’ helped me see the positive side of a trying situation.”
She tells her story frequently to audiences that include other doctors as well as patients and caregivers. “My experience proved to be an invaluable education that has impacted the way my colleagues and I view patients, the disease, and treatment. As a pathologist, I was removed from the front lines of direct patient contact; but having cancer made me want to come out from behind my microscope and reconnect with patients. I now know firsthand what it is like to wait for pathology results. Having cancer gave me a unique perspective that has brought new meaning to my practice, making me more cognizant of giving fast and accurate results to treating clinicians.”
Advice to patients
Kim encourages patients to view keeping a diary or journal as therapeutic. Not everyone may choose to share the writing, but she believes it is a way of processing their emotions about their disease.
She also highly recommends finding support, from a network of friends and acquaintances as well as from other survivors. “There are a number of support groups. Go to your patient resource center. They’ll have a list of support groups in your area.”
A lot of help from her friends and family made it all possible. “People want to help. It makes them feel good to help you and be part of your healing team,” she says. “But you have to let them know what you need so you don’t end up with six casseroles on the same night.”
Kim put together a personal action plan that included ‘personal gurus’ who helped her through her journey. Her ‘music guru’ made her soundtracks to listen to while she was in chemotherapy sessions. Her ‘fashion guru’ was tasked with getting information on wigs, false eyelashes, and the best eyebrow pencil available. Because she wanted to stay in good physical condition, she also had a ‘fitness guru.’
Between treatments, she and her husband took their first vacation together without the children—six days in Hawaii that rejuvenated both her body and their marriage. She suggests that oncologists prescribe more vacation time as an integral part of cancer therapy.
Now, years later, Kim sees her cancer as ‘a really powerful experience’ that helped her find inner strength, taught her not to sweat the little things, reconnected her to many people she rarely saw, and prompted her to communicate more directly with patients, who in the past had been just cells on a slide.