October 29, 2009
Pathologist learns meaning of ‘physician, heal thyself’
Dr. Kimberly Allison was drawn to her current position as director of the UW Medicine Breast Pathology Service because she thought it was a good way to meld her research interests within a realm that directly changes patient care. What she didn’t realize or expect, however, was a diagnosis of breast cancer two weeks after she was promoted to the job in March 2008.
She was shocked by the news, and initially figured that what she felt in her breast would turn out to be nothing. “It wasn’t a mass, but more like a shelf,” said Allison, who was breast-feeding an 8-month-old son at the time. “I hand-delivered my own specimen,” she said. “And here, the next day, my colleague had to tell me it was cancer.”
The breast pathology service examines tissue for any patient who has a breast biopsy or surgery at the Seattle Cancer Care Alliance, the Women’s Health Care Center at UW Medical Center or any other clinic within UW Medicine.
Allison, a UW faculty member since 2006, said the cancer was advanced, over seven centimeters in size and it had spread to her lymph nodes. Based on analysis in her own lab, Allison started chemotherapy the next week to try and shrink the cancer. She continued chemo for some six months and remembers the cooperation from co-workers during a difficult time.
“People were really supportive,” she said. Her boss even broached the subject of whether or not Allison wanted to continue in the service. But the pathologist said the thought of leaving never crossed her mind.
Instead, Allison drew from and continues to build on her personal experience every day on the job. Her chemotherapy was extremely successful — a complete pathologic response, she said. “That means the cancer was very sensitive to chemotherapy, and there weren’t any resistant cells.” Her lab’s initial analysis and treatment recommendation prevented the cancer from spreading and even shrunk the diseased area.
Allison, also mother to a 5-year old daughter, has been like any other patient along the way, except her knowledge made her all the more defiant and determined to beat the cancer. “I looked at my own biopsy, and talked ‘smack’ to it,” she said, with a devious smile. The physician researcher also took a picture, and burned it as an empowering experience.
Diagnosed at age 33, with no family history of breast cancer, a husband and two small children and a brand new job, Allison did what she could to cope and carry on.
Dr. Kristine Calhoun, UW assistant professor in surgery, described Allison as “remarkable.” The breast cancer surgeon works with the pathologist on the Seattle Cancer Care Alliance Tumor Board, which meets twice a week to discuss biopsy results and treatment options for patients.
“She worked throughout her chemotherapy,” said Calhoun. “She hardly took any time off and was really able to personalize it appropriately. Kim didn’t internalize anything and she also didn’t let work interfere with what was going on with her. It’s definitely allowed her to grow as a pathologist.”
Calhoun, who was Allison’s surgeon for a bilateral mastectomy in October 2008, said the pathologist has helped bring a renewed focus to the team, too. “We have a much more interactive working relationship. She’s instituted teleconferencing for the tumor board, and changed how we present some of the findings. For so early in her career, she has risen to the challenge of being in charge of the service.”
Despite all the superhuman descriptors, Allison is down-to-earth. She also now feels extremely connected with patients in a way most pathologists do not. “When it’s a young woman, I feel like I want to write in the report, ‘You’re going to be OK!’ but I know I can’t really do that,” she said.
Eventually, Allison hopes to volunteer with support groups, in part to help patients understand the pathology behind a cancer diagnosis. Allison said she would share her personal experience, too.
And it’s that experience that adds to her job title and may help her, in some ways, better explain what she does to the average person. In most breast cancer-related stories, people don’t hear about the pathologist. “Patients see the surgeon, medical oncologist, radiology oncologist, and I don’t think people really appreciate how critical your pathologist is,” said Calhoun.
“You really rely on them to tell you what’s going on. In the intensive care unit, you live and die by the great nurses. And in pathology, you live and die with pathologists. They’re never seen, they don’t get any glory, but they’re critical and we could not do our job without them.”
UW Medicine’s Breast Pathology Service provides diagnostic services to the community, promotes knowledge through clinical research and prepares tomorrow’s physicians, scientists and other health professionals. The service diagnoses diseases including cancers and conducts special studies pertaining to breast pathology.
